A psychosocial Assessment Framework for Cancer Patients and their Families

Abstract

This article describes four areas of knowledge for social work assessments that cover the ecological system of the patient and psychodynamics. In addition, it addresses the area of dis-synchrony, which causes stress for many patients. The author focuses on the area of dis-synchrony because she believes that social workers must be clear about the differences between reactions of pathological patients and strong reactions of psychologically normal patients to extraordinary circumstances. The literature on stress has begun to look at this aspect but is still open to a pathology bias. The social work profession needs to evolve new ways of thinking about normal people and their environments. The unique access that social workers have to the range of patients in a variety of settings creates the opportunity for them to make a significant contribution to the understanding of the full range of human experiences. Moreover, the sharing of knowledge between workers in mental health settings and those in medical settings is relevant not only in the provision of direct service, but also in the development of hospital policies and national policies regarding health care for individuals and their families.

Parenting Stress in Pediatric Oncology Populations

“…Additional stressors at the time of diagnosis include difficulties in processing medical information and being able to provide an age-appropriate explanation of this information to the child, managing one's own emotional reaction to the diagnosis, reorganizing family routines to accommodate the demands of treatment, and redefinition of role functions. 48,49 A study conducted by Freeman et al 50 identifying the most predominant stressors at each phase of treatment found communication of prognosis and concerns about the cause of the brain tumor to be the most prevalent stressors at the time of diagnosis.…”

Psychological Distress, Fatigue, Burden of Care, and Quality of Life in Primary Caregivers of Patients With Breast Cancer Undergoing Autologous Bone Marrow Transplantation

“…For example, the developmental stage of the family experiencing breast cancer often includes middle-aged primary caregivers who are balancing multiple responsibilities to the patient, other family members, and themselves. Christ (1983) identified predominant transition points in the cancer experience as diagnosis, treatment initiation, treatment completion, cure, treatment failure, recurrence, decision to discontinue treatment, terminal illness, and death. Although no such clear demarcations exist for related transitional emotional stages (Lewis, 1993), family members may respond to cancer with concerns that vary with the time since diagnosis, disease status, and the patient's condition (Woods, Lewis, & Ellison, 1989).…”

Cancer: a family at risk

“…According to the treatment results, we may refer to ‘orphaned families and their psychological problems’ or the ‘survivors who need to live with the ghost of cancer’ both in terms of the possible return of the disease or its genetic burden. Christ [ 2 ] identified main transition points for the patient and the family, being: diagnosis, treatment initiation, treatment completion, cure, treatment recurrence, decision to discontinue treatment, terminal illness and death. All of these may be a source of intense stress and concern and may bring about the destabilisation of family life.…”