Psychology and the alleviation of symptoms

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HIV AND CANCER
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Psychology and the alleviation of symptoms
Psychology also has a role to play in the alleviation of symptoms of cancer, and in
promoting quality of life (see Chapter 16 for a discussion of quality of life theory and
measurement). Cartwright et al. (1973) described the experiences of cancer sufferers,
which included very distressing pain, breathing difficulties, vomiting, sleeplessness, loss
of bowel and bladder control, loss of appetite, and mental confusion. Psychosocial
interventions have therefore been used to attempt to alleviate some of the symptoms of
the cancer sufferer and to improve their quality of life.
1 Pain management. One of the main roles of psychology is in terms of pain
management, and this has taken place through a variety of different pain management techniques (see Chapter 12). For example, biofeedback and hypnosis have been
shown to decrease pain. Turk and Rennert (1981) encouraged patients with cancer to
describe and monitor their pain, encouraged them to develop coping skills, taught
them relaxation skills, encouraged them to do positive imagery and to focus on other
things. They reported that these techniques were successful in reducing the pain
experience.
2 Social support interventions. Social support interventions have also been used
through the provision of support groups, which emphasize control, meaningful
activities and aim to reduce denial and promote hope. It has been suggested that
although this intervention may not have any effect on longevity it may improve
the meaningfulness of the cancer patient’s life. In line with this, Holland and
Holahan (2003) explored the relationship between social support, coping and positive
adaptation to breast cancer in 56 women. The results showed that higher levels
of perceived social support and approach coping strategies were related to positive
adjustment.
3 Treating nausea and vomiting. Psychology has also been involved in treating the
nausea and vomiting experienced by cancer patients. Cancer patients are often offered
chemotherapy as a treatment for their cancer, which can cause anticipatory nausea,
vomiting and anxiety. Respondent conditioning and visual imagery, relaxation,
hypnosis and desensitization have been shown to decrease nausea and anxiety in
cancer patients. Redd (1982) and Burish et al. (1987) suggested that 25–33 per cent
of cancer patients show conditioned vomiting and 60 per cent show anticipatory
anxiety. It is reported that relaxation and guided imagery may decrease these
problems.
4 Body image counselling. The quality of life of cancer patients may also be improved
through altered body image counselling, particularly following the loss of a breast
and more generally in dealing with the grief at loss of various parts of the body.
5 Cognitive adaptation strategies. Research also suggests that quality of life may also
be improved using cognitive adaptation strategies. Taylor (1983) used such strategies
to improve patients’ self-worth, their ability to be close to others, and the improvement
in the meaningfulness of their lives. Such methods have been suggested to involve selftranscendence and this has again been related to improvement in well-being and
decrease in illness-related distresses.
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