Psycho Social Problems of Head & Neck Cancer Patients

7/27/2019 Psycho Social Problems of Head & Neck Cancer Patients

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Psycho Social Problems of

Head & Neck Cancer Patients

KUNNAMPALLIL GEJO JOHN

BASLP,MASLP

AUDIOLOGIST



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Prevalence

Head and neck cancer is the 10th mostcommon cancer in the world

It accounts for 4% of all malignantcancers

Concern in increasing in younger

patients and in womenThe male/female ratio is less than 2:1

This gap is closing steadily.



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COMMON FEARS

DEATH

DISSABILITYDISFIGERMENT

DEPENDENCY

DISTRUPTION OF ROUTINE

ACTIVITIES



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COMMON REACTIONS

TOCANCER

DEPRESSION

HOSTILITY

ANXIETY

GUILTCOMPLIANCE

DEPENDENCYKUNNAMPALLIL GEJO JOHN


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CANCER IMPACT

PHYSICAL SYMPTOMS

PSYCHOLOGICALSOCIAL

FINANCIAL

FAMILY

WORK



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SPECIAL SOCIAL

PROBLEMSANXIETY AND UNCERTAINITY

MISCONCEPTIONS ABOUT CANCERINCREASING COST OF TREATMENT

TRANSPORTATION

ACCOMODATIONS FOR PATIENTS ANDRELATIVES

ALLIED PROBLEMS RELATED TO

POVERTY LONG DISTANCE ETC..KUNNAMPALLIL GEJO JOHN


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MEANING OF DISEASEValue

Pain

ChallengeEnemity

Punishment

Weakness

Relief Strategy

Irreparable lossKUNNAMPALLIL GEJO JOHN


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Concerns/DemandsTreatment Issues.

Social Interaction & Support.

Changes in Life Context orPerspective.

Acceptance of the Illness.

Sexuality.

Feminine Self-Image.



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Acceptance of the illnessDifficulties during the early

diagnostic phase

The shock or trauma

How it happened too fast

why it never ends

Wondering about the future



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Making ChoicesDeciding what to do

What Doctor, SecondOpinion to trust.

Which treatment regimen

to choose.



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Uncertanity

The process of waiting &

WonderingWaiting-for test results

Worrying about Cancerrecurrence



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Treatment Issues

Difficulties in interacting with the

Health care community

Vying medical opinions

Acquiring self-care skills



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HOSPITALIZATIONBeing hospitalized far away from home.Not having friends to visit.

Having to eat cold or tasteless food.

Strangers sleep in the same room.

Having to sleep in a strange bed.

Wearing hospital dress/Unusual smells.

Having to be assisted with bed pan.

Being fed through tubes.Family members being far away.

Being in the hospital during holidays & specialholidays.



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Th h l i l


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The psychologicalimportance of voice

Voice is unique to the individualand can be central to a persons

identityThe loss of voice is more than lossof speech

Voice is an extension of thoughtand persons sense of self.



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Problems pertaining to

speech

Not being understood

Not being able to make oneself heard in

a noisy roomFeeling inhibited inexpressing,emotions such as anger,laughing, whispering , lack of volume

Embarrassment about physicalappearance



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Problems pertaining to

swallowingProblems with food intake

Impairment of taste and suckingMucous discharge

Fear of intake of liquids



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Other changes

Coughing,problems with hygiene

Blowing nose,having frequent colds

Breathlessness,less physical capacity

Fear in covering stoma

Self image



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Psychological symptoms

Anxiety,uncertainty,depression,lost of selfesteem ,suicidal thoughts ,uselessness

Shame, irritability, fear of recurrence ,senseof inferiority.

Vocabulary problems are common 20%-90%

Social withdrawal and tension in relationshipwith partner absence or infrequency of sexualintercourse 8%-33%



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Sexual ProblemsPhysical limitations - Result

from treatmentFears

Misinformation



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EMPLOYMENTLoss of job

Long leave

Absenteeism

Work problem

Conflict with supervisors/co-workers

Hostility from co-workers

Less concern about carrier goals



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FINANCIAL BURDENLoss of patients income.

Loss of family Income

Expenditure incurred --patients illness & RxExpenditure incurred --extra arrangements.

Loans taken or savings spent.

Postponement of planned activity owing tofinancial pressure.



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Fears and concerns of


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Fears and concerns of

family membersEmotional strain

Physical demands

Fear of the patient dying

Altered roles and life styles

Finances

Ways to comfort the patientPerceived in adequacies of services



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NEED FOR

REHABILITATIONLead normal life

To cope up with the illness

To sustain treatment

To adjust with family

To re-plan resources



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WHAT ISREHABILITATION ?

The process of enhancing restorations

and maintaining optimal physical and

psychological functioning.

Focuses on what a person has, instead of

what he has lost and aims at help ing a

person learn to live with what he has.



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GOALS FORREHABILITATION

Physical

PsychologicalSocial

Occupational / Vocational

Family



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Rehabilitation Starts

Diagnosis

Treatment (Multi-disciplinary)

Post-treatment and Follow-up

Terminal care



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Voice Rehabilitation



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Interventions

Education

Emotional support

Individual PsychotherapySupportive group therapy

Sharing feelings

Developing coping skillsConsidering existential issues



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FAITH

Faith in oneself

Ones doctor

Ones treatmentOnes spiritual faith



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SupportTHE MOST IMPORTANT MEDICINEIS TENDER LOVE AND CARE .

-Mother Teresa



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It is like a symphony whereeach instrument is playedharmoniously on the samescore rather than same note

Thank you



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Documents

Psycho Social Problems of Head & Neck Cancer Patients