diana jeleč kaker, ph.d., soc. work institute of oncology ljubljana, slovenia fifteenth easom...
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Diana Jeleč Kaker, Ph.D., Soc. WorkInstitute of Oncology Ljubljana, Slovenia
FIFTEENTH EASOM SUMMER SCHOOL 2015: Teaching Trainees in Occupational Medicine about Psychosocial Risk Factors at work,
Bled, Slovenia, 26th – 29th August 2015
PATIENT WITH BREAST CANCER – A CASE
STUDY
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DIAGNOSIS: BREAST CANCER
Brings about changes:
Patient X:
temporary permanent
metastatic breast cancer born in 1965 married two daughters employed as a cook lives in a block of flats
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THE DISEASETHE DISEASE
Influences:
•physical – own attitude towards health, appearance
•psychological distraction (anxiety, depression)
•partner relationship
Patient X:
•Suffers from feelings of inferiority and low self-image
•Depression
•Has a great support from the family (husband and two daughters)
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COPING AND ACCEPTING THE DISEASE
Methods:
• fighting
• avoiding
• stoical acceptance
• helplessness
• anxiety
Patient X
•The patient choses fighting as a way of coping with the disease
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REHABILITATION
Approach: team work
Patient Discussions and
consultation Encouraged to actively
participate in the treatment, strengthening the abilities
FamilyThe whole family is
affected.It is an important factor insupport
Society Self-help groups
Patient X
Addresses the professionals (doctor, nurse and social worker)
Offered a lot of support by the family
Refuses to participate in the self-help group
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REHABILITATIONReturning to the workingenvironment Sick leave The possibility to gradually
return to work Work at home The option of training /
professional retraining
Purpose Achieving the desired work
efficiency Return/inclusion into society
Patient X
•Loses her job
•Has difficulties in finding new employment
•Takes sick leave
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MEDICALMEDICAL DEVICESDEVICES
Medical devices: Temporary breast prosthesis
Silicone breast prosthesis
Self-adhesive breast
prosthesis
Orthopaedic bra
Wig
Elastic glove
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TEMPORARY BREAST TEMPORARY BREAST PROSTHESIS PROSTHESIS
Temporary breast prosthesis
Designed to be worn immediately after surgery, until the operative wound heals
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SILICONE BREAST PROSTHESIS SILICONE BREAST PROSTHESIS AND ORTHOPAEDIC BRA AND ORTHOPAEDIC BRA
Silicone breast prosthesis
Self-adhesive breast prosthesis
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ORTHOPAEDIC BRA FOR THE ORTHOPAEDIC BRA FOR THE BREAST PROSTHESISBREAST PROSTHESIS
• Wide and adjustable straps
• Comfortably sewn under the armpit
• The bottom border for additional support
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MEASUREMENTS TO MEASUREMENTS TO DETERMINE THE BRA SIZEDETERMINE THE BRA SIZE
• Measure the chest circumference directly under the bust. Round the measured value to the nearest multiple of number 5.
Example: measured 78 cm = bra size 80 cm. This is the bra size.
Measure distance from the middle of sternum across the healthy breast to the centre of the spine. Multiply the measured value by two to obtain the cup size.
Example: 48 cm x 2 = 96 cm. This is the cup size.
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BRA / CUP SIZEBRA / CUP SIZE
The difference between the cup circumference and the bra size determines the size of the cup:
96 cm (cup circumference) - 80 cm (bra size) = 16 cm
•Example: 80 C
Difference in cm
Cup size
8 -10 AA
10 - 12 A
12 - 15 B
15 - 18 C
18 - 20 D
20 - 23 DD
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WIG, ELASTIC COMPRESSION WIG, ELASTIC COMPRESSION GLOVE GLOVE
• Alopecia
• Lymphoedema
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PROGRESS OF DISEASE PROGRESS OF DISEASE
Social assistance services
Help at home
Institutional care
Patient X
Refused by the patient
Receives help from the family
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Thank you for your attention