Association_Between_the_Feminine_Archety

IPOS 10th World Congress of Psycho-Oncology Abstracts ORAL PRESENTATIONS SESSION 1, Part 1: Symposium SUFFERING AND PAIN 1S-1 Suffering and Pain Manuel Gonzalez Barón, Mariant Lacasta Hospital La Paz, Madrid, Spain PURPOSE: If our priority objective is to achieve the relief of the suffering it will be necessary according with Lazarus, Folkman, Chapman, Gravin, Bayés and Labrador, to reduce or eliminate things perceived like a threat and increase the perception of the control. For this, we need to make an instrument that it allows us to identify which are the biopsychosocial symptoms that are perceiving in each moment like threatening, so we can delete or reduce them, and at the same time to evaluate and to boost the resources. METHODS: We relief and instrument that includes the following groups of variables: subjective perception of the passing time, emotions aspects, cooping strategies, adaptation perception, pain, support perceived and suffering. Afterwards we gave the questionnaire to 83 oncologic patients that have been attended at The oncologic medic service of the university Hospital "La Paz", 36 man and 47 woman with an age average of 55 years old (DT= 15). RESULTS: Persons who say they have more suffer, are the ones who have more pain (p0,05) and the patients whit less suffering and have more wellbeing are the ones who use strategies to coping with their situation (p0,05). CONCLUSION: The instrument relieved can be effective with facilitating the intervention to relief the suffering. ACKNOWLEDGEMENT OF FUNDING: None. 1S-2 The Importance of Effective Communication to Relieve Pain and Suffering in Cancer Hernan Cancio Lopez Instituto Antae, Madrid, Spain PURPOSE: Pain and suffering management in cancer are not still as controlled as much as they could be. Data show that a high number of patients (between 40% and 80%) have pain. According to Dr. Bayés model of suffering (2001) the experience of pain is produced by the existence of two factors: 1) A symptom that is perceived as a threat for the patient and 2) A feeling of lack of control, believing that he cannot do anything against it. In addition to this, new findings in Neurology shows that brain doesn’t distinguish the stimulus that causes the experience of pain, thus it has the same response when it has an emotional origin or a biological one (Panksepp, 2003). So the subjective meaning given by the patient is crucial in the experience of pain (Hayes, 2004). METHODS: Main obstacles to an effective cancer pain approach are: an incorrect evaluation (76%) and a lack of expression of pain by the patient (67%) (Ann Intern Med.,1993). These obstacles can be overcome with an effective communication among Health Care Providers, patients and families. According to the research, the keys to assess and manage pain in oncology are: 1. To assess main worries and priorities; 2. Explore specifically if they are suffering pain; 3. Recognize and validate emotions; 4. Empower the sense of control and personal resources. Strategies like relaxation, imaginary and hypnosis can change the significance of pain and reduce it effectively. RESULTS: A good communication is a useful and available strategy to effectively manage the pain in oncology. It significantly reduces pain, anxiety and depression (p005) (Lautrette, 2007 –New England) and (Muñoz, Pérula 2003, Family Practice). CONCLUSION: And adequate approach and understanding of the subjective nature of pain and suffering help to effectively manage it in oncology. More research is needed in this area of effective communication in cancer. ACKNOWLEDGEMENT OF FUNDING: None. SESSION 1, Part 2: Individual Podium Lectures 1L-1 Doctor Patient Communication in Medical Oncology: Systematic Qualitative Review Laura Alarcó Ubach1,2 1Hospital Universitaria Nuestra Señora de la Candelaria, Santa Cruz de Tenerife, Spain, 2 Asiciación Española Contra el Cáncer, Santa Cruz de Tenerife, Spain PURPOSE: To clarify and classify actual knowledge on Oncological patients information needs. To compare actual and desirable communication practice (as shown in empiric evidence). To bring to date and verify the recommendations given in different practical guidelines (Doctor patient communication in... medical Oncology) particularly regarding breaking bad news (BBN). METHODS: Searches on Medline/Pubmed database combining various terms of research. We obtained and compared, giving more importance to the first category, three categories: Studies based on randomized controlled trials, panels of experts recommendation guidelines and data-based evidence. RESULTS: We have analysed the following points: Kind of evidence in BBN studies; Need for, and efficiency of, training in communication and emotional coping; Doctor and patient perspectives; Effect of communication in clinical results; Quantity and quality of desired information; Influence of stadium, tumoral localization, socio-cultural differences, presence of other people during BBN, use of the word cancer, and providing complementary material in the patients preferences. CONCLUSION: Literature based in the patient’s perspective shows evidence that patients subscribe to many of the recommendations given in BBN guidelines produced by panels of experts. On the other hand, there is evidence that contradicts some of the recommendations in various clinical opinion guidelines. The BBN process should be adjusted to the patients’ preferences, needs, rhythm and coping style. RESEARCH IMPLICATIONS: Comparing BBN medical practice in Oncology in different western countries, we find that medical praxis shows huge variability, while patients’ preferences do not seem to differ that much between them. This shows the need to comprehend research in this field -in our cultural context- and to quantify the importance of family pressure. CLINICAL IMPLICATIONS: The basic goal of treatment in medical oncology is to increase survival without compromising quality of life. This involves the need to establish a customized, continuous and efficient communication with each of the treated patients. An excellent doctor-patient communication is peremptory for the shared decision making process. ACKNOWLEDGEMENT OF FUNDING: None. 1L-2 Coverage of Cancer Patients’ Psychosocial Needs Marta Schröder, Dèbora Koatz Federacio Catalana d'Entitats Contra el Càncer FECEC, Barcelona, Catalunya, Spain PURPOSE: The purpose of this study has been to identify and document patient psychosocial needs and to explore how well theses needs are being covered, as well to examine service providers’ perspectives on the nature of current service provision and its adequacy in meeting the psychosocial needs of patients. The questions answered by the study are the identification of psychosocial needs, prevalence, sociodemographic and clinical features related to these needs, degree of coverage, patients’ demands and the service providers’ view related to the psychosocial needs and their coverage. METHODS: We combined quantitative and qualitative methods as follows: (1) a descriptive cross-sectional survey applied to 465 adult cancer patients (aged above 18 years) in out patient clinics and oncological treatment units from 25 randomized selected hospital centres. We utilized a self-completion questionnaire. (2) short structured interviews with a purposively selected sample of health care professionals and managers (n = 50) in 25 randomized selected hospital centres, and seven no governmental organizations. RESULTS: The needs of importance to the great majority of cancer patients related to finding valued qualities in health care professionals and systems, especially confidence, respect and receptivity. All 48 needs studied presented some degree of no coverage, being the best covered needs related with respect and confidence of professionals and family support. The needs less covered were related to emotional needs. The service providers’ interviews showed two different views of psychosocial needs. The first is a multidisciplinary view and the second an interdisciplinary view. The first leaves in social and psychological professionals the responsibility towards these needs. The second one tries to share that responsibility. CONCLUSION: This study concludes that psychosocial needs not covered are precursors of emotional distress. The most important needs for patients are related with the relational attitude of health care professionals. Most of the needs are not well-covered, specially emotional and practical needs. Patients demand psychological support as well as a better organization of the health system. On the other hand, it concludes that the way health care professionals and health system interprets psychosocial needs is conclusive in the way these professionals identify and attend these needs. RESEARCH IMPLICATIONS: It is necessary to get a deeper understanding on who has which needs, to develop comparative studies about the well-being of cancer patients related to the way these needs are approached by the professional team and to document the global effects of a good coverage of these needs versus a lack of coverage. CLINICAL IMPLICATIONS: There should be more widespread appreciation of patient psychosocial needs among health care professionals in cancer services. Cancer specialists should receive more training in communication skills and emotional support. Identifying psychosocial needs should be part of routine patient assessment. Interdisciplinary work towards an integral approach of patient should be implemented in health systems. Finally, there should be a bigger effort in prevention of emotional distress by answering the psychosocial needs. ACKNOWLEDGEMENT OF FUNDING: Study of the Catalan Federation against cancer with the funding of Health Department of the Catalan Government. Continues...