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MEDICAL NEWS
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| ROLE OF THE ONCOLOGY SOCIAL WORKER AND PSYCHO SOCIAL SUPPORT SERVICES TO CANCER PATIENTS & FAMILIES |
Date Posted: 20-Nov-2002 |
INFORMATION ON HOW TO DEAL WITH CANCER PATIENTS, THEIR FEARS AND THEIR FAMILIES.
Role of the Oncology Social worker and Psycho Social Support services to
Cancer patients and their Families
Linda Greeff
GVI Oncology Cape Town Director of Psycho Social Support Services
Patients to be prioritized by the Oncology Social worker
Newly diagnosed patients & families
Patients & families on treatment & stopping treatment
Patient & families with reoccurrence of Illness
Patients & Families in crisis
Ward patients & their families
Patients that are terminal
Families dealing with bereavement issues
Psycho Social Needs of Cancer Patients
(A) Personal Aspects
Dealing with the emotions associated with the diagnosis cancer
Managing the physical aspects of the disease and treatment
Patient knowledge about the physical process of illness and treatment.
Communication problems between
-patient and family
-Medical staff and patient
-Family and treatment team.
-Assisting Patients and families in finding appropriate coping strategies.
.-Maintaining a future perspective and focus on quality of life after a diagnosis with cancer.
.-Finding resources to assist in the developing of a truly holistic approach to the treatment of the cancer. Looking at Body, Mind & Spirit
(B) Common fears
Fear of the unknown.
Loss of control.
Associated fears about disability, dysfunction and dependence.
Fear of burdening the family socially, emotionally, physically and financially.
Family Aspects
Lack of information to assist patient with informed decision making
Exacerbation of marital and/ or family problems.
Uncertainty and concern about the illness and
treatment process.
Family members being “out of step” with the patient.
Exhaustion / feeling overwhelmed.
Anticipatory grief.
Learning to deal with the reality of the illness in an open way with all family members
Reactive anxiety and depression.
(D) The Social consequences
Negotiating changes in interpersonal relationships, family roles and functions.
Dealing with the issues of living in a community with cancer, with all the perceptions and stigmas attached to it.
Overcoming obstacles of financial stability, job security and insurability.
E) Navigating the Health care system
o Dealing with inadequate insurance cover and paper work.
o Finding appropriate support services including peer support.
o Addressing the inability to access comprehensive cancer
o Care, counseling services, including rehabilitation,
o Complementary therapies and spiritual care.
Psychosocial assessment of patient and family includes:
Assessing stages of human development, illness process and treatment
.Assessment of psycho-social functioning of family (strengths, coping skills, support, social, spiritual and cultural influence)
.Development of a case plan with patient and family
.Identifying patients at risk
Team discussions and planning sessions.
Tasks and Interventions at the Initiation of Treatment
Tasks
Understanding the treatment plan
Moderating the patient’s distressed mood
Reorganizing the family to incorporate the demands of treatment and offer support to the patient
Interventions
Provide information
Assessment of Needs
Supportive services
Individual Therapy
Group Therapy (I can cope/Hoping is coping)
Family therapy
Tasks and Interventions during treatment side effects
Tasks
Rebuilding self-esteem when there is loss of a body part, hair loss, weight loss and fatigue.
Coping with the ambivalence about treatment caused by disturbing side effects of treatment.
Developing ways to have some control over side effects.
Incorporating the physical demands of treatment into ongoing personal and family life.
Interventions
Individual therapy
Crisis intervention
Relaxation
Autogenic training
Hypnosis
Other complementary therapies
Solution focused therapy
Tasks and Interventions at the Termination of treatment
Tasks
Recognizing the fear of having less medical surveillance.
Recognizing the continuation of some problems that predated the diagnosis.
Adapting to remaining physical impairments and psychological stress & losses.
Changing expectations of support from family and friends.
Interventions
Individual and group counseling
Support groups
Linking with community resources
Narrative therapy
PNI techniques
Relaxation
Tasks and Interventions during Survivorship
Tasks
o Resuming normal activities and relationships with a changed body and a changed sense of lifetime.
o Coping with a sense of emptiness – “the crisis is over.”
o Coping with the fear of recurrence.
o Confronting stigma and social barriers to normalization.
Interventions
o Rehabilitative counseling
o Referral to self help groups (Reach For Recovery/PSA groups and Buddy programs - To be presented by People Living with Cancer Groups)
o Individual counseling
o Relaxation training
Tasks and Interventions during Recurrence
Tasks
o Understanding information about the new situation.
o Regaining a life focus and time perspective appropriate to the changed prognosis.
o Alleviation of guilt or self-blame.
o Decision-making about the new treatment course and resolution of practical problems related to initiation of treatment again.
Interventions
o Supportive therapy
o Crisis intervention
o PNI techniques
o Stress management
o Cognitive therapy
o Narrative therapy
o Family interventions
Tasks and Interventions during Terminal Phase
Tasks
o Maintaining a meaningful quality of life.
o Coping with a deteriorating physical condition.
o Confronting relevant existential and spiritual issues.
o Planning for surviving family members.
Interventions
o Individual and family counseling intensifies
o Link to community resources
o Anticipatory grief therapy
o Crisis therapy
o Play therapy with young children
o Narrative therapy
o Practical assistance re will ext.
Tasks and Interventions during Bereavement
Tasks
o To accept the reality of the loss.
o To experience the pain of grief.
o To adjust to an environment in which the deceased is missing.
o To withdraw emotional energy and reinvest in another relationship.
Interventions
o Bereavement counseling
o Narrative therapy
o Practical assistance
o Play therapy
o Family interventions
Benefits Psycho Social Intervention
Assists in identifying situational factors that effect the patients and families adjustment to the crisis of diagnoses with cancer.
Assist is evaluating disease related issues (pain, lack of understanding, ext) that could enhance the patients adjustment to the cancer experience
Determines the patients and Families adjustment to treatment related issues
Assists in determining exacerbating factors that might complicate the patients & families adjustments to the illness process. (Anxiety, depression. post traumatic shock issues, suicide risk factors, delirium, ext) and plan strategies that will assist cancer patients and their families in adjusting to the illness process and deal with treatment more effectively In a Oncology treatment center the Oncologist are
To always in a position to spent endless hours with
Patients and family members to ensure that they are well informed and able to make an informed choice about their treatment.
Regular feedback will ensure the best
Possible service to the patient & the family at all time from diagnosis to the terminal phases ensuring a comprehensive approach to cancer care.
The availability of these services allows for
Proper assessment of the needs of the patients and the family and will ensure greater compliance cooperation as well as less trauma while on treatment and thus better quality of life.
Enhances the quality of services rendered by the oncology Social worker
This ensures Excellence in the provision of
Comprehensive Cancer Care. |
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