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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KUNNAMPALLIL GEJO JOHN
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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