A psychological analysis of cancer patients and their next-of-kin

Abstract

A supportive family environment is thought to enhance the capacity of cancer patients to adapt to their illness and treatment. But families, like patients, vary in their ability to cope with the impact of a cancer diagnosis in a family member and in their ability to fulfill the patient's needs. Increased understanding of the interrelationships between the family's and patient's responses to illness is of fundamental importance to the care of the patient with cancer. A heterogeneous sample of 201 cancer patients and their relatives were studied to determine compatibility of psychological status and to isolate clinical and demographic variables associated with psychological distress. Self‐report tests of anxiety, mood disturbance, and mental health were applied. Despite large individual variation, the psychological status of patients and their matched relatives was closely correlated. The patient's treatment status affected both patients and their next‐of‐kin. Psychological well‐being worsened according to whether patients were receiving follow‐up care, active treatment, or palliative therapy. These data suggest a mutuality of psychological response between patients and their families. Supportive intervention for the patient or relative who manifests distress, therefore, should benefit both. Because patients and relatives involved with palliative treatment are most in need of psychological assistance, particular attention should be paid to this group, as is attempted in hospice care.

Psychosocial adjustment of patients and caregivers prior to allogeneic bone marrow transplantation

“…Patient scores on the PAIS-SR, a measure used to assess psychosocial adjustment to illness, were similar to those reported by cancer patients undergoing active medical treatment (ie chemotherapy); a time known to be considerably stressful. 10 Furthermore, 25% of patients had clinical levels of psychosocial maladjustment and, compared to BMT survivors, reported more problems in this area.…”

“…10 Thus, the time prior to admission into hospital for BMT appears to be an equally significant emotional experience for both patients and their caregivers. Therefore, caregivers should not be regarded solely as a patient's support system, but rather as individuals who may themselves be in need of additional family, social or other supportive services.…”

Intimacy and relationship processes in couples' psychosocial adaptation to cancer

“…2,3 However, over the last 20 years, researchers and clinicians working in oncology have recognized the importance of viewing cancer in the family context. This realization has lead to a burgeoning literature assessing and comparing patient and partner distress levels 3,[31][32][33][34][35][36][37][38][39][40][41][42] as well as sex differences in distress. [43][44][45][46][47] With a few exceptions, 32 these studies suggest that patients report higher levels of clinically relevant distress than partners 3 and that women who are patients and partners report higher levels of distress than men who are patients and partners.…”

Chronic medical conditions and mental health in older people: disability and psychosocial resources mediate specific mental health effects

“…In addition, patients with CMCs are more likely than those without CMCs to experience symptoms of depression (Berkman et al 1986 ;Palinkas et al 1990 ;Bowling & Farquhar, 1991 ;Williamson & Schulz, 1992) and anxiety (Viney & Westrbrook, 1981 ;Nickel et al 1990), and are less able to control many aspects of their lives (Pearlin & Schooler, 1978 ; 1065 Roberts et al 1994). Impaired psychological functioning has been found in chronic conditions such as lung disease (Borson et al 1986 ;Williams, 1989), rheumatoid arthritis (Anderson et al 1985 ;Newman et al 1989), cancer (Cassileth et al 1985 ;Ell et al 1989), stroke (Thompson et al 1989 ;Castillo et al 1993) and myocardial infarction (Terry, 1992). As the prevalence of many CMCs increases with age, older adults are potentially at risk for increased psychological distress (Gurland, 1983 ;Berkman et al 1986 ;Copeland et al 1987 ;Newman, 1989 ;Blazer et al 1991 ;Beekman et al 1995 a, b).…”