Long-Term Psychosocial Problems in Cancer Patients

Yıl 2013, Cilt: 5 Sayı: 1, 109 - 126, 01.03.2013

Beyhan Bag

https://doi.org/10.5455/cap.20130508

Öz

Developments in methods of early diagnostic and treatment of cancer have increased the rate of survival. However, research also indicates that there has been an increase in the costs to health care system caused by both post-treatment of the disease itself and the possible psychosocial problems associated with the therapy. This evaluation stresses the importance of long-term post-treatment monitoring of cancer patients and emphasizes necessity of ensuring continuity of care. Sustainable long-term treatment and care procedures for the cancer survival patients have been developed in accordance with international regulations. The psycho-social services for cancer patients offered in our country are inadequate as these are at an early stage of development. However, establishment of organizations and coordination of various consultancy services for this group of patients can lead to prevention of workforce loss and other costs, as well as raise the quality of life for these patients.

Anahtar Kelimeler

Long-term survivorship, cancer, psychooncology

Uzun Dönem Kanser Hastalarında Psikososyal Sorunlar

Öz

Kanser hastalığıyla ilgi erken teşhis yöntemlerinde ve tedavideki gelişmeler, hastalıktan uzun dönemli sağkalım oranını yükseltmiştir. Araştırmalar kanser hastalarında tedavi sonrasında hastalığın kendisinden veya tedaviden kaynaklanan olası psikososyal sorunların sağlık sistemine olan maliyetinin artırdığını göstermiştir. Bu saptama aynı zamanda kanser hastalarının tedavi sonrası uzun dönemle izlenmesi, tedavi ve bakımında sürekliliğin sağlanmasının önemini vurgular. Kanser tedavisinden sonra uzun dönemli sağ kalımı olan hastaların tedavi ve bakımında devamlılığın sağlanabilmesi için uzun dönemli tedavi planın önerildiği uluslararası yönergeler geliştirilmiştir. Ülkemizde kanser hastaları için sunulan psikososyal alanda ki hizmetler yeni kurulma ve anlaşılma evresinde olduğundan oldukça yetersizdir. Yeni kurulacak sistemde, kanserin tedavisinden sonra bu hastalardaki tedavi ve bakımdaki devamlılığın sağlanarak bu özel grup için evde bakım hizmetleri ve rehabilitasyon kapsamında çeşitli danışmanlık servislerinin ve organizasyonların oluşturulması ve uygulamaya geçirilmesi bu alandaki iş gücü ve maliyet kaybının büyük bir oranda önlenmesine yol açacağı gibi bu hastalardaki yaşam kalitesini yükseltecektir.

Anahtar Kelimeler

Uzun dönem sağkalım, kanser, psikoonkoloji

Kaynakça

• WHO Global cancer rates could increase by 50% to 15 million by 2020 http://wwwwhoint/ mediacentre/news/releases/2003/ pr27/ en/ (Access date: 2012).
• Boyle P, Levin B. World Cancer Report 2008. France, International Agency for Research on Cancer, 2008.
• T.C Sağlık Bakanlığı Tedavi Hizmetleri Genel Müdürlüğü. Türkiye Onkoloji hizmetleri Yeniden Yapilanma Programi 2010-2023. Ankara, T.C. Sağlık Bakanlığı, 20
• Jemal A, Siegel R, Ward E, Hao Y, Xu J, Murray T et al. Cancer statistics, 2008. CA Cancer J Clin 2008; 58:71-96.
• Robert Koch-Institut. Krebs in Deutschland 2007/2008, 8. Ausgabe. Berlin, Robert Koch-Institut, 2012.
• Özyurt BE. Kanser hastalarının algıladıkları sosyal destek düzeyine ilişkin betimsel bir çalışma. Kriz Dergisi 2007; 15:1-15.
• Barber FD. Social support and physical activity engagement by cancer survivors. Clin J Oncol Nurs 2012; 16:E84-98.
• Mehnert A, Volkert J, Wlodarczyk O, Andreas S. Psychische komorbidität bei menschen mit chronischen erkrankungen im höheren lebensalter unter besonderer berücksichtigung von krebserkrankungen. Bundesgesundheitsbl Gesundheitsforsch Gesundheitsschutz 2011; 54:75-82.
• Brearley SG, Stamataki Z, Addington-Hall J, Foster C, Hodges L, Jarrett N et al. The physical and practical problems experienced by cancer survivors: a rapid review and synthesis of the literature. Eur J Oncol Nurs 2011; 15:204-212.
• Bag B. Kanser hastalarında yorgunluğa bağlı psikososyal sorunlar ve çözüm önerileri. Arşiv Kaynak Tarama Dergisi 2012; 21:253-273.
• Ullrich A, Böttcher HM, Bergelt C. Geschlechtsspezifische aspekte der rückkehr zur arbeit bei patientinnen und patienten mit einer Krebserkrankung. Bundesgesundheitsbl 2012; 55:516-534.
• Spelten E, Sprangers M, Verbeek J. Factors reported to influence the return to work of cancer survivors: a literature review. Psychooncology 2002; 11:124-131.
• Mehnert A. Employment and work-related issues in cancer survivors. Crit Rev Oncol Hematol 2011; 77:109-130.
• Bradley CJ, Oberst K, Schenk M. Absenteeism from work: the experience of employed breast and prostate cancer patients in the months following diagnosis. Psychooncology 2006; 15:739-747.
• Balak F, Roelen CAM, Koopmans PC, Ten Berge EE, Groothoff JW. Return to work after early-stage breast cancer: a cohort study into the effects of treatment and cancerrelated symptoms. J Occup Rehabil 2008; 18:267-272.
• Lee MK, Lee KM, Bae J, Kim S, Kim YW, Ryu KW et al. Employment status and work-related difficulties in stomach cancer survivors compared with the general population. Br J Cancer 2008; 98:708-715.
• Ahn E, Cho J, Shin DW, Park BW, Ahn SH, Noh DY et al. Impact of breast cancer diagnosis and treatment on work-related life and factors affecting them. Breast Cancer Res Treat 2009; 116:609-616. de Boer AG, Taskila T, Ojajärvi A, van Dijk FJ, Verbeek JH. Cancer survivors and unemployment: a meta-analysis and meta-regression. JAMA 2009; 301:753-762.
• Weis J, Faller H. Psychosoziale Folgen bei langzeitüberlebenden einer Krebserkrankung. Bundesgesundheitsbl 2012; 55:501-508.
• Herschbach P, Berg P, Dankert A, Duran G, Engst-Hastreiter U, Waadt S et al. Fear of progression in chronic diseases: psychometric properties of the Fear of Progression Questionnaire. J Psychosom Res 2005; 58:505-511.
• Gümüş BA. Meme kanserinde psikososyal sorunlar ve destekleyici girisimler. Meme Sağlığı Dergisi 2006; 3:108-114.
• Curt GA, Breitbart W, Cella D, Groopman JE, Horning SJ, Itri LM et al. Impact of cancer-related fatigue on the lives of patients: new findings from the Fatigue Coalition. Oncologist 2000; 5:353-360.
• Crawford J, Gabrilove JL. Therapeutic options for anemia and fatigue. http://www.medscape.org/viewprogram/583 (Access date 11.10.2012).
• Güleç, G & Büyükkınacı A. Kanser ve psikiyatrik bozukluklar. Psikiyatride Güncel Yaklaşımlar-Current Approaches in Psychiatry 2011; 3:343-367.
• Hallaç S, Öz F. Genital kanser tanı sürecinde varoluşsal kaygı. Psikiyatride Güncel Yaklaşımlar-Current Approaches in Psychiatry 2011; 3:595-610.
• Helgeson VS, Tomich PL. Surviving cancer: a comparison of 5-year disease-free breast cancer survivors with healthy women. Psychooncology 2005; 14:307-317.
• Park CL. Making sense of the meaning literature: an integrative review of meaning making and its effects on adjustment to stressful life events. Psychol Bull 2010; 136:257-301.
• Bostancı ND, Buzlu S. Meme kanseri hastalarında maneviyatın etkileri ve manevi bakım. Maltepe Üniversitesi Hemşirelik Bilim ve Sanatı Dergisi 2010; 1:73-78.
• Cotton SP, Levine EG, Fitzpatrick CM, Dold KH, Targ E. Exploring the relationships among spiritual well-being, quality of life, and psychological adjustment in women with breast cancer. Psychooncology 1999; 8: 429-438.
• Culliford L. Spirituality and clinical care. BMJ 2002; 325:1434-1435.
• Hewitt M, Greenfield S, Stovall E. From Cancer Patient to Cancer Survivor: Lost in Transition. Washington DC, The National Academies Press, 2006.
• Bolin K. Health among long-term survivors of breast cancer: an analysis of 5-year survivors based on the Swedish surveys of living conditions 1979–1995 and the Swedish Cancer Registry 2000. Psychooncology 2008; 17:1-8.
• Michael YL, Berkman LF, Colditz GA, Holmes MD, Kawachi I. Social networks and health-related quality of life in breast cancer survivors: a prospective study. J Psychosom Res 2002; 52:285-293.
• Bloom JR, Peterson DM, Kang SH. Multi-dimensional quality of life among longterm (5+ years) adult cancer survivors. Psychooncology 2007; 16:691-706.
• Ganz PA, Desmond KA, Leedham B, Rowland JH, Meyerowitz BE, Belin TR. Quality of life in long-term, disease-free survivors of breast cancer: a follow-up study. J Natl Cancer Inst 2002; 94:39-49.
• Kornblith AB, Powell M, Regan MM, Bennett S, Krasner C, Moy B et al. Long-term psychosocial adjustment of older vs younger survivors of breast and endometrial cancer. Psychooncology 2007; 16:895-903.
• Ganz PA. Cognitive dysfunction following adjuvant treatment of breast cancer: a new dose-limiting toxic effect? J Natl Cancer Inst 1998; 90:182-183.
• Schwartz CE, Andresen EM, Nosek MA, Krahn GL, RRTC Expert Panel on Health Status Measurement. Response shift theory: important implications for measuring quality of life in people with disability. Arch Phys Med Rehabil 2007; 88:529-536. Oort FJ. Using structural equation modeling to detect response-shift and true change. Qual Life Res 2005; 14:587-598.
• Poppelreuter M, Weis J, Külz AK, Tucha O, Lange KW, Bartsch HH.Cognitive dysfunction and subjective complaints of cancer patients: a cross sectional study in a cancer rehabilitation center. Eur J Cancer 2004; 40:43-49.
• Hermelink K, Untch M, Lux MP, Kreienberg R, Beck T, Bauerfeind I et al. Cognitive function during neoadjuvant chemotherapy for breast cancer: results of a prospective, multicenter, longitudinal study. Cancer 2007; 109:1905-1913.
• Mehnert A, Scherwath A, Schirmer L. Kognitiver Funktionsstatus bei Patienten mit Leukämien und Lymphomerkrankungen im ersten Jahr nach allogener hämatopoetischer Stammzelltransplantation: Eine prospektive Längsschnittstudie. DRV-Schriften 2011; 93:405-406.
• Manne S, Ostroff J, Fox K, Grana G, Winkel G. Cognitive and social processes predicting partner psychological adaptation to early stage breast cancer. Br J Health Psychol 2009; 14:49-68.
• Alibhai SM, Breunis H, Timilshina N, Marzouk S, Stewart D, Tannock I et al. Impact of androgen-deprivation therapy on cognitive function in men with nonmetastatic prostate cancer. J Clin Oncol 2010; 28:5030-5037.
• Karakoç T. Kanser hastalarında yorgunluk ve hemşirelik bakımı. Fırat Saglık Hizmetleri Dergisi 2008; 3:99-117.
• Rüffer JU, Flechtner H, Tralls P, Josting A, Sieber M, Lathan B et al. Fatigue in longterm survivors of Hodgkin's lymphoma; a report from the German Hodgkin Lymphoma Study Group (GHSG). Eur J Cancer 2003; 39:2179-2186.
• Kuhnt S, Ernst J, Singer S, Rüffer JU, Kortmann RD, Stolzenburg JU et al. Fatigue in cancer survivors--prevalence and correlates. Onkologie 2009; 32:312-317.
• Arndt V, Merx H, Stegmaier C, Ziegler H, Brenner H. Persistence of restrictions in quality of life from the first to the third year after diagnosis in woman with breast cancer. J Clin Oncol 2005; 23:4945-4953.
• NCCN (National Comprehensive Cancer Network). Clinical Practice Guidelines in Oncology: Cancer Related Fatigue. Version 1.2011. USA, NCCN, 2012.
• Lam WWT, Au AHY, Wong JHF, Lehmann C, Koch U, Fielding R et al. Unmet supportive care needs: a cross-cultural comparison between Hong Kong Chinese and German Caucasian women with breast cancer. Breast Cancer Res Treat 2011; 130:531-541.
• Gage EA, Pailler M, Zevon MA,Ch'ng J, Groman A, Kelly M et al. Structuring survivorship care: discipline-specific clinician perspectives. J Cancer Surviv 2011; 5:217-225.
• Beyhan Bag, Ph. D., Psikiyatri Hemşireliği, Giessen, Almanya. Yazışma Adresi/Correspondence: Beyhan Bag, Karl-Follen Strasse 5, 35394, Giessen, Germany.
• E-mail: [e-mail] Yazarlar bu makale ile ilgili herhangi bir çıkar çatışması bildirmemişlerdir. The authors reported no conflict of interest related to this article. Çevrimiçi adresi / Available online at: www.cappsy.org/archives/vol5/no1/ Çevrimiçi yayım / Published online 11 Kasım/November 11, 2012; doi:10.5455/cap.20130508