By Richard Mayou, Michael Sharpe, Alan Carson
This publication offers either the proof and the assistance to allow medical professionals to enhance their review and administration of the mental and behavioural elements of the commonest difficulties featuring regularly treatment. It summarises the hot learn facts and offers logic advice on how mental and psychiatric facets of sickness should be addressed in the clinical session.
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X What are your main concerns or worries at the moment? x What have you been doing to cope with these? Has this been helpful? x What effects do you feel cancer and its treatment will have on your life? x Is there anything that would help you cope with this? x Who do you feel you have helping you at the moment? x Is there anyone else outside of the family? x Have you any questions? Is there anything else you would like to know? Principles of treatment x x x x x x x x x x Sympathetic interest and concern A clearly identified principal therapist who can coordinate all care Effective symptomatic relief Elicit and understand patient’s beliefs and needs Collaborative planning of continuing care Information and advice—oral and written Involve patient in treatment decisions Involve family and friends Early recognition and treatment of psychological complications Clear arrangements to deal with urgent problems Useful sources of information x National Comprehensive Cancer Network.
Intervention, low scorers No intervention, low scorers 40 35 30 25 20 15 10 0 Baseline 4 months 3 years Assessment Effect of immediate debriefing on victims of road traffic injury. Those with high initial scores on the impact of events scale (intrusive thoughts and avoidance) had worse outcome than untreated controls at 4 months and 3 years Later consequences and care Treatment should include clear, agreed plans for mobilisation and return to optimal activity. Physiotherapists are often involved in rehabilitation and need to be aware of the psychological as well as the physical factors that are perpetuating disability.
Management The initial long interviews serve not only to derive a problem list but also to foster a positive relationship between doctor and patient. Thereafter, the doctor should arrange to see the patient at regular, though not necessarily frequent, fixed intervals. These consultations should not be contingent on the patient developing new symptoms. Consultation outside these times should be discouraged. Planned review All symptoms reported by patients during these consultations must be acknowledged as valid.