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Palliative cancer care - general issues - Management
How should I assess and manage the person's psychological needs?
- Assessment of the psychological state of the patient should be repeated at key points during the course of the illness, including:
- At the time of diagnosis.
- Around treatment episodes.
- As treatments end.
- At the time of a relapse.
- When death is approaching.
- All staff directly responsible for patient care should offer general emotional support based on skilled communication, effective provision of information, courtesy, and respect.
- People and carers found to have significant levels of psychological distress should be offered prompt referral to services able to provide specialist psychological care.
Clarification / Additional information
- The appropriate psychological intervention will depend on the person's current psychological problem and previous history, as well as the level of support available and their prognosis:
- Psychological assessments and interventions should be undertaken somewhere that is quiet, comfortable, and private.
- Staff providing psychological care should be adequately trained and supervised, and mechanisms to ensure support for staff should be available.
- Emergency psychiatric services should be available for people with severe mental health problems.
[NICE, 2004]
Basis for recommendation
- This recommendation is based on guidance from the National Institute for Health and Clinical Excellence [NICE, 2004].
- Around 50% of people with cancer experience anxiety and depression around the time of diagnosis which is significant enough to adversely affect their quality of life.
- In the year after diagnosis, 10% of people have symptoms that require specialist intervention by psychiatric or psychology services.
- Around half of people with advanced disease experience anxiety and depression.
- Professional psychological support is likely to benefit people with cancer and their carers, whatever the severity of their psychological distress.
- Psychological symptoms are often not recognized, so services may not be offered.
- Health and social care professionals often lack appropriate assessment skills and may underestimate the benefits of psychological support.
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