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Kliniczny przebieg choroby nowotworowej a przystosowanie psychiczne

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The clinical course of cancer and mental adjustment
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The aim of the article is to present the basic aspects of psychological functioning in the situation when an individual struggles with the diagnosis and treatment of cancer. The article discusses issues of distress experienced by cancer patients and factors predisposing to more severe distress. Moreover, the problems affecting the level of adjustment to the situation of disease and treatment are discussed and presented in three dimensions: as factors associated with the patient as an individual, with the disease itself and with the context of patient’s life. Attention is paid to anticancer treatment, which is a huge burden for patients and, in many cases, adjustment to such a burden is a considerable challenge. The awareness of the specificity of psychological reactions to individual stages of the disease is significant for people who work with such patients or relatives who accompany them through their disease. The paper provides a characteristics of a psychological reaction to the diagnosis of cancer and presents the specific character of the remission period as well as a possible recurrence. Moreover, it discusses the advanced and terminal phases of the disease. The aforementioned stages are presented based on personal relevance of a given stage to the individual patient. Furthermore, the most common emotions are described and the psychological tasks with which patients struggle in the given stages of cancer are discussed. The last part of the paper concerns patients’ need for information. The quality and level of communication of the patient with the therapeutic team considerably affects the way they cope with the disease and therapy. The paper also discusses the most commonly mentioned needs of patients and/or their families at individual stages of the disease and phases of treatment.
Celem artykułu jest przedstawienie podstawowych aspektów psychologicznego funkcjonowania w sytuacji zmagania się z rozpoznaniem i leczeniem choroby nowotworowej. Poruszono zagadnienia dystresu doświadczanego przez chorych na raka i przedstawiono czynniki predysponujące do jego większego nasilenia. Omówiono kwestie wpływające na poziom adaptacji do sytuacji choroby i leczenia, które ujęto w trzech wymiarach: czynniki związane z osobą chorego, samą chorobą nowotworową oraz kontekstem życiowym pacjenta. Poświęcono uwagę leczeniu przeciwnowotworowemu, które jest niezwykle obciążające dla chorego i w wielu przypadkach stanowi duże wyzwanie w satysfakcjonującym przystosowaniu się do niego. Niezwykle istotna dla osób pracujących z chorymi czy towarzyszących im w chorobie z pozycji bliskiego jest świadomość specyfiki psychologicznych reakcji na poszczególne etapy choroby nowotworowej. W pracy scharakteryzowano psychologiczne reakcje na diagnozę raka, omówiono specyfikę czasu remisji, a także ewentualnego nawrotu oraz przedstawiono opis fazy zaawansowanej i terminalnej. Wymienione etapy zaprezentowano poprzez osobiste znaczenie danej fazy nowotworu dla chorego, wymieniono najczęściej doświadczane emocje, a także ukazano zadania natury psychologicznej, z jakimi zmaga się pacjent w poszczególnych okresach choroby. Ostatnia część pracy dotyczy potrzeb informacyjnych pacjentów. Jakość i poziom komunikacji chorego z zespołem leczącym znacząco wpływa na radzenie sobie z chorobą i jej leczeniem. Zobrazowano najczęściej wnoszone potrzeby pacjentów i/lub ich rodzin na poszczególnych etapach rozwoju nowotworu i podejmowanego leczenia.

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