Communication skills

Communication Skills in Cancer patients care
difficult emotions
disease and treatment (surgery, radiation, chemotherapy) experience
undesirable consquences
effective communication: empathic listening, open questions
blocking communication: „belittling-normalization“ „false reassurance“, „formal agreement“, „readdressing“ “multiply questions”, “chut” et.c

Non-Verbal Communication
Vocal
Bodily
Facial expression: frown lines, position of the eyebrows and eye lids, size of pupils, shape of mouth, use of nose. Facial expression display emotion and can be used as interactive signal.
Eye contact. Important for building satisfying relationship, tells how people feel about us. Avoidance can signal feeling uncomfortable and disintegrated.
Posture. Can be related to mood, demonstrate attitudes and emotions. Can also support or conflict the spoken word.
Gestures : small movements (rising a finger) to large movements (rising the clenched fist). Gestures are used as signals ? They illustrate speechand express emotions e/g increased hand movements – anxiety, minimal hand movement – depression.

DIFFICULT EMOTIONS
ANGER
Recognition
Permission
Listen the story to get as much information as possible
Focus on related stress/feelings
Appologise
Reasons
Negotiate the Solution

Professional communication and risk of born-out
Many problems are insoluble
No one can solve them
You can only try
Bad news is bad news
Serious illness causes PAIN
My job is not to make people feel good
My job is to try and make them less bad

Cancer care health professionals are not satisfied with professional communication
Poor recognition of psychological problems.
Some health professionals are reluctant to enquire because they fear that patients will reveal strong emotions such as anger or depression which health professionals are unable to handle.

DIFFICULT EMOTIONS
ANXIETY
Recognition – verbal, non-verbal
Acknowledgement –I can see you are anxious
Permission
Understanding – I want to find out what makes you anxious
Empathic acceptance
Assessment
Alteration (if appropriate) – removal of stress
cognitive challenge
boosting coping strategies
medication

THE AIMS OF THE PSYCHOLOGICAL HELP IN DIFFERENT TARGET GROOPS DURING THE COURSE OF CANCER TREATMENT
PATIENYS
• Diagnostics of the ipsychological individuality,
including mental co-morbidity;
Nozogenia prevention
Disclosure and constructive transformation of the cognitive and behavioral patterns ;
• Psychological rehabilitation
RELATIVES and OTHER MICROSOCIAL SOURCE
• Prevention of the distress disorders as the reaction to the patient/s state and prognosis;
Help in coping with responsibility in decision –making;;
Help in coping with decision -making.;
Support in loss
MEDICAL PROFESSIONALS
• Psychological adjustment of the new professionals;
•Prevention of the
burn-out,
Communication skills training.

PATHOGENETIC FACTORS
OF MENTAL DISORDERS IN CANCER PATIENTS
Somatogenic factors of cancer and it’s treatment
MENTAL INDIVIDUAL PRE-MORBIDITY
Character
Cognitive Style
Psychological defense and coping strategies’
Structure of the meanings
Psychogenic factors of disease
and treatment experience
Microsocial factors

D I S E A S E
P S Y C H O L O G I C A L C O N S E Q U E N C E S
NON-SPECIFIC SOMATIGENIC FATIGUE
NEURO-ENDOCRINE INDUCED AFFECTIVE DISORDERS
NOSOGENIAS, DISEASE AND TREATMENT EXPERIENCE
PRIMARY MENTAL DISORDERS AS THE RESULT OF SOME BRAIN TUMORS

THE MOST PROBABLE UNDESIRABLE PSYCHOLOGICAL CONSEQENCES

LEVELS OF THE PSYCHOLOGICAL HELP
PREVENTION OF THE NOSOGENIA AND OTHER DISTRESS DISORDERS
PSYCHOLOGICAL REHABILITATION, THE SUPPORT IN REVALIDISATION OF PRIORITY MEANINGS
PSYCHOTHERAPY OF THE ACTUAL AFFECTIVE AND PERSONAL DISORDERS
SUPPOUSED EFFECTS
RESOCIALIZATION , PERSONAL DEVELOPMENT , REINTEGRATION OF SELF-PERCEPTION
INCREASE IN QoL , ELABORATION EFFECTIVE COGNITIVE AND BEHAVIORAL PATTERNS
OPTIMISATION OF THE IMMUNE REACTION ,
PREVENTION POF THE CHRONIFICATION