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ED 08 - Talking with Patients (ID 8)
- Event: WCLC 2015
- Type: Education Session
- Track: Palliative and Supportive Care
- Presentations: 1
ED08.04 - Coping Mechanisms for People with Lung Cancer and their Families (ID 1805)
14:15 - 15:45 | Author(s): N. Doyle
ln the UK, lung cancer has one of the lowest 5 year survival rates of all cancers (8.8% of men and 11.1% of women are alive 5 years after their diagnosis) whilst only 30% of people live for more than one year following their diagnosis (Macmillan, 2014). This poor outlook can have a profound impact on the quality of life of those affected by the disease (LCA, 2015). However, helping people and their families cope with the impact and consequences of the disease and its treatment can make a substantial difference to the quality of their lives. In this context coping might be regarded as a means of understanding and regulating the emotions in response to stress but it might also be viewed as solving problems and adapting lifestyles and behaviour through goal setting and seeking information and help. By adopting a structured and planned approach to care, the healthcare professional can enhance the coping capability of the person with cancer and their families and thereby directly contribute to their quality of life. This approach can be seen in the Recovery Package. Data from the London Cancer Alliance reveals that the top ten concerns for the person with lung cancer are a mix of physical and psychological issues including breathlessness, fatigue, anxiety, weight loss, sleeping, finances, walking, pain, eating and transport. People with lung cancer have the highest number of unmet needs out of all cancer patients, mainly due to higher psychological support and physical/daily living support needs (Li et al, 2006). Depression levels tend to be higher for people with lung cancer compared to cancer patients with other types of cancer (Fischer et al, 2010). Self reported sexual concerns are common in people with lung cancer and are related to shortness of breath and emotional distress (Reese et al, 2011) whilst people with lung cancer experience higher levels of pain compared with patients with other types of cancer (Fischer et al, 2010) Link et al (2005) discuss the work of Lazarus and Folkman, and their ‘Transactional model of distress and coping’ which suggests that people respond to stressful situations by a primary appraisal (where they evaluate the significance of the stressor) and a secondary appraisal (where they evaluate their ability to change the situation and manage their emotions). It is at these key junctures that effective interventions might be best employed. The Recovery Package allows the identification and selection of suitable interventions which can be tailored to meet the specific needs of people with cancer and their families. In the UK the report ‘Taking Action to Improve Outcomes (NCSI, 2013) envisaged that care should be designed with the following key aims: Providing information and support from the point of diagnosis Promoting recovery Sustaining recovery Managing the consequences of treatment Supporting people with active and advanced disease These key aims underpin The Recovery Package which is a series of key interventions which, when delivered together, can greatly improve outcomes for people living with and beyond cancer. The Recovery Package is made up of an assessment of holistic needs and the development of a care plan to address these issues; a treatment summary that explains to the General Practitioner and individual what treatment has taken place; a cancer care review by the General Practitioner within 6 months of diagnosis; attendance at a health and wellbeing educational event. The Recovery Package The success of the Recovery Package depends upon the creation of a partnership with the individual and the focus of care is on supporting self-management after a cancer diagnosis. This is underpinned by effective assessment. Holistic needs assessment acknowledges that coping strategies are mediated by social context and that the quality and quantity of the person’s support can be quite variable. The assessment works by gathering and discussing information in order to develop an understanding of what the person living with and beyond cancer knows, understands and needs. It is focused on the whole person and the entirety of his/her needs including the physical, emotional, spiritual, mental, social, and environmental needs of the individual. The process culminates when the assessment results are used to inform a care plan. Holistic assessment tools offer front-line health service staff a structured yet collaborative way to elicit people’s concerns and, with adequate training and informational resources, respond to these concerns effectively, efficiently and humanely. By integrating the assessment of very understandable emotional concerns within a holistic treatment review there is less likelihood that psychological difficulties become pathologised by professionals or seen as a source of shame for those living with and beyond cancer (Brennan et al, 2012). Lung cancer is often characterised by rapid deterioration and a complex interplay of symptoms, concerns and worries and health care professionals can play a critical role in choice of coping strategy (which can be used to help people to more actively participate in their care) (Link et al, 2005). This can be helped by a structured and planned approach to care such as The Recovery Package.
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