Management Of Distress In Patients Research Articles

Mind-Body Approaches for Managing Distress in Cancer Care.

Symptoms of distress are common in people living with cancer. Evidence-based interventions for distress management in patients with cancer include mind-body approaches. Deep breathing, progressive muscle relaxation, and min.

Distress Management in Patients with Digestive Cancer

Distress Management in Patients with Digestive Cancer

Correlation between Negative Life Experiences and Auditory Hallucinations in Schizophrenia

IntroductionAuditory Hallucination(AH) is a core & one of the most common symptom seen in schizophrenia. A prevalence study found that 1yr prevalence of AHs is 70% among patients of schizophrenia. Most theories of AHs discuss biological & psychological factors in phenomenology of voices. There definitely is a role of biological & neuroanatomical basis for occurrence of psychotic phenomenon & AHs, however environment & sociocultural background play important role in their genesis. It has been observed that theme of AHs is usually same, repetitive & associated with past life experiences of patients. The Negative Life Experience(NLE) though not always have significant impact on patient’s psyche, may manifest sooner or later in mental illness. Although AHs may be comforting, helping to cope up with unacceptable unconscious conflict, most patients report them to be negative, distressing & affecting socio-occupational functioning, thus making it important to understand & treat them effectively. Often, AHs stays as a residual symptom with which patient has to deal throughout life. This study is an effort to bridge existing gaps for better understanding of AHs & hence, Schizophrenia. It aims to understand effect of NLE on AHs, & thereby contribute to aetiology & therapeutic services to reduce distress of patients.ObjectivesThis study aims to find presence of history of past NLE in patients with schizophrenia having AHs, find a correlation between NLE & the content of AHs & hence to establish the role of sociocultural factors in phenomenology of AH in patients with schizophrenia.MethodsA longitudinal study of 30 patients diagnosed with Schizophrenia as per DSM-5 having AHs visiting Psychiatry Department of Government Hospital was carried out over a period of 2yrs. A quantitative study to find correlation between presence of NLE & AH in patients and a qualitative study by in-depth interview of 10 patients with help of semi-structured questionnaire to understand phenomenology by procedures of interpretative phenomenological analysis was carried out.ResultsA positive statistically significant correlation between NLE & content of AH was found. Majority of patients experienced AHs based on NLE in past & heard voices related to it. Various themes such as Guilt, Fear, Inadequacy, Anger, Frustration surfaced during the qualitative study.ConclusionsThis study thus strengthens the holistic model where sociocultural factors with biological & psychological factors play a role in pathogenesis of AHs. Treatment weighing on addressing NLE & emotions attached to it may help in foreshortening recovery & deal with residual AHs. This can help in therapeutic management of distress in patients, relieve internal conflict within their psyche, where they would feel more understood and learn to live with persistent AHs.Disclosure of InterestNone Declared

Management of Distress in Patients with Cancer—Are We Doing the Right Thing?

BackgroundScreening for distress and referral for the provision of psychosocial care is currently the preferred approach to the management of distress in patients with cancer. To date, this approach has shown a limited effect on the reduction of distress. Recent commentaries have argued that the implementation of distress screening should be improved. On the other hand, the underlying assumption that a referral for psychosocial care is required for distressed patients can be questioned. This has led to the development of an alternative approach, called emotional support and case finding.PurposeIn the context of finding innovative solutions to tomorrow’s health challenges, we explore ways to optimize distress management in patients with cancer.Methods and ResultsWe discuss three different approaches: (i) optimization of screening and referral, (ii) provision of emotional support and case finding, and (iii) a hybrid approach with multiple assessments, using mobile technology.ConclusionsWe suggest continued research on the screening and referral approach, to broaden the evidence-base on improving emotional support and case finding, and to evaluate the utility of multiple assessments of distress with new interactive mobile tools. Lessons learned from these efforts can be applied to other disease areas, such as cardiovascular disease or diabetes.

Distress Management in Patients With Head and Neck Cancer Before Start of Palliative Chemotherapy: A Practical Approach.

PurposeThis study reports the incidence of distress, the factors associated with distress, and a practical strategy to resolve distress in patients with head and neck cancer who are starting palliative chemotherapy.MethodsAdult patients with head and neck cancer planned for palliative chemotherapy underwent distress screening before the start of treatment as part of this single-arm prospective study. Patients who had a distress score > 3 on the National Comprehensive Cancer Network (NCCN) distress thermometer were counseled initially by the clinician. Those who continued to have high distress after the clinician-led counseling were referred to a clinical psychologist and were started on palliative chemotherapy. After counseling, distress was measured again. The relation between baseline distress and compliance was tested using Fisher's exact test.ResultsTwo hundred patients were enrolled, and the number of patients with high distress was 89 (44.5% [95% CI, 37.8% to 51.4%]). The number of patients who had a decrease in distress after clinician-led counseling (n = 88) was 52 (59.1% [95% CI, 48.6% to 68.8%]) and after psychologist-led counseling (n = 32) was 24 (75.0% [95% CI, 57.6% to 72.2%]; P = .136). Compliance rates did not differ between the patients with or without a high level of distress at baseline (74.2% v 77.4%, P = .620).ConclusionThe incidence of baseline distress is high in patients awaiting the start of palliative chemotherapy. It can be resolved in a substantial number of patients using the strategy of clinician-led counseling, with additional referral to a clinical psychologist as required. Patients with a greater number of emotional problems usually require psychologist-led counseling.

Management of Cancer-Related Distress in Patients With a Hematologic Malignancy

Management of Cancer-Related Distress in Patients With a Hematologic Malignancy

General practice management of psychological distress in patients with sexually transmissible infection

This paper investigates general practitioners’ (GP) self-reported practices for psychologically distressed patients with sexually transmissible infections (STI). A cross-sectional postal survey was conducted among a 15% random sample of GP practising in New South Wales. The main outcome measures were self-reported strategies to deal with psychologically distressed STI patients, priority of counselling, and perceived need for training in counselling. The great majority (82%) of GP reported that they extended their consultation time to deal with psychologically distressed patients, whereas 49% reported being likely to refer distressed patients to a counsellor. Just over half (54%) considered counselling to be a high priority in STI care, whereas 49% acknowledged benefits of further training in counselling. Overseas medical graduates were more likely to refer patients in distress to counsellors compared with Australian graduates (odds ratio = 1.80, P = 0.008). Female and metropolitan GP were more likely to consider counselling a high priority in STI care (odds ratio = 1.56, P = 0.038; odds ratio = 1.62, P = 0.028, respectively). GP appreciate the need to deal with psychological distress of STI patients; however, referral to counselling services is not a widespread priority. Further research is needed to examine practitioners’ actual practice in caring for psychological distress among STI patients and barriers to referral for counselling.