Assessment of Pain, Acceptance of Illness, Adjustment to Life and Strategies of Coping with the Illness in Patients with Pancreatic Cancer

Pancreatic cancer is the fourth most common cancer causing death in the world. The prognosis of patients with pancreatic cancer is relatively low, which may be reflected in the patients’ lack of acceptance of the illness and passive attitudes towards the illness. The aim of the study was to evaluate the strategy of coping with pain and its control, acceptance of the illness and adjustment to life with cancer in patients suffering from pancreatic cancer. Forty-six patients with pancreatic cancer were included in the study. They were treated as outpatients at the Center of Oncology at Maria Skłodowska-Curie’s Institute in Warsaw between 2017 and 2018. The questionnaire included four psychometric tests: BPCQ, CSQ, AIS and MiniMAC. In the BPCQ test the highest average test result was obtained by “internal factors” (M = 16.85; SD = 5.64). The most frequently chosen strategies for coping with pain are praying/hoping (M = 22.33; SD = 7.85). The average illness acceptance score was 23.13 (SD = 7.84). The most common methods of psychological adjustment to cancer for the studied group are the strategies of positive re-evaluation (M = 20.07, SD = 3.67). Patients with pancreatic cancer have a low level of acceptance of their illness.

Evaluation of Quality of life, Social Support and Coping Strategies and Illness Adjustment in patients with breast cancer: Across sectional study

Background: This study aimed to assess the quality of life (QOL), social support and coping strategies, and illness adjustment among breast cancer patients in general and on type of breast surgery.Methods: We conducted a cross-sectional study at the Ali-Ebne-Abitaleb and Khatam-Al-Anbia hospitals in Zahedan, Iran, 2020. We recruited patients with breast cancer who underwent lumpectomy(n=44), mastectomy(n=64), and not any surgery (n=15) by census method. Data collection tools were the breast cancer-specific module (QLQ-BR 23), The adjustment to illness measurement inventory for Iranian women with breast cancer (AIMI- IBC), and the multidimensional scale of perceived social support (MSPSS) questionnaires. We performed statistical analysis by ANOVA, independent sample t-test, Kruskal-Wallis, Mann-Whitney U-test, and multiple linear regression analysis to adjust for covariates.Results: We recruited a total of 120 patients with breast cancer in this survey. 53.3% of patients underwent a mastectomy, 34.2% lumpectomy, and 12.5% of patients had not been surgery. Patients in the functioning scale reported high scores for body image (mean=78.61, SD=26.69) and future perspective (mean=55.27, SD=26.71). Patients on the symptom scale had a high score upset by hair loss (mean= 49.16, SD=38.88). Generally, patients received a high social support level, especially from family members, and used a positive coping strategy to have high illness adjustment more than a negative coping strategy. Also, patients who underwent lumpectomy had a better sexual life and body image and more illness adjustment than the other two groups of patients.Conclusion: Early detection of the disease, support for patients, and educational programs to use appropriate coping strategies can improve breast cancer women's quality of life and disease adaptation.

‘I would describe myself as a deformed troll’: Using interpretative phenomenological analysis to explore body image struggles among palliative care patients

Background: Illness adjustment is a widely studied area in the palliative care context. However, research focussing on how altered body image can affect men and women in palliative care is limited and unclear. Aim: To explore the links between palliative care patients’ affected sense of self, altered body image and terminal illness adjustment. Design: Semi-structured interviews were conducted, and the Interpretative Phenomenological Analysis approach was used to analyse patients’ experiences. Setting/participants: English-speaking, adult palliative care outpatients were interviewed at a local community hospice in the United Kingdom. The mean age was 55 years (ranging from 35–65 years). Results: Analysis of accounts indicated three superordinate themes: (1) ‘Not being me’: self-discrepancy, (2) existing in the landscape of loss, (3) living and thriving in the landscape of loss. The most disturbing issues, such as appearance-focussed struggles and low body-confidence, were stemming from participants’ frustration over their lack of control and their attachment to their former self-image. Conclusions: The patients’ insights demonstrated that body image distress was prevalent among all respondents regardless of gender or diagnosis. A spiral model is described showing how discrepancy-based processing (i.e. ‘not being me’) and rigid attachment to former self can have harmful consequences on palliative patients’ abilities to cope. In order to facilitate adjustment to a self-identity crisis resulting from a terminal diagnosis, it is necessary for professionals to recognise and address body image changes among palliative care outpatients.

Investigating the psychology of assistive device use in ALS: Suggestions for improving adherence and engagement

In ALS, assistive devices—such as wheelchairs, augmentative, and alternative communication devices (AAC) and environmental controls—are often used to compensate for the functional impairments caused by the condition. These devices may help maintain meaningful functioning and help preserve quality of life. Yet adherence to and uptake of such devices is sub-optimal. Drawing on the literature from ALS and other diseases, this chapters explores the psychosocial challenges of assistive device use, and factors that might affect usage—cognitive impairment and mood, threats to identity, social context, illness adjustment/acceptance, and the desire to maintain control over one’s health care. Methods that clinicians can use to intervene to improve non-adherence are then suggested—bio-psychosocial assessment (formulation) informed by cognitive and mood screens, voice-banking for appropriate accents in AAC devices, increasing illness acceptance via counselling, or acceptance and commitment therapy, and empathetic clinician-facilitated discussions with patient-significant other dyads and families.