Emotional support to cancer patients regarding psycho-oncology

Andrés Fontalba
 

In my first post, “When it’s our turn?”, I addressed the need to promote shared clinical decision in mental disorders, from now on I will focus my interest in commenting on having emotional support in the diagnosis and cancer treatment.

The clinical dialogue between the doctor and the patient on the prognosis and care of cancer in advanced stages significantly influences how it tests both the benefits and the side effects of the treatment. It also affects how the time in which his life ends and how family members adapt to the patient's illness and death. It’s very important to detect personal differences regarding the need to receive information. Aside from a small percentage of patients who prefer not to be informed, most consider all the information they receive related to their prognosis and treatment to be precious. The exchange of information occurs in a sensitive relationship between the professional and the patient, in which they have to deal with highly emotionally charged communication and in which we must guarantee the information to be fully understandable. It’s clear that the patient, with great frequency, is anxious, among many other factors, because of the doubts about his prognosis, the family burden caused by the disease or the results of the tests. And these top levels of anxiety affect both the interpersonal relationship and the processing of information and the decisions made. It’s for all these reasons that research in psycho-oncology provides us with different tools to favour both the therapeutic link and the understanding of the patient's disease, as this review collects.

There is a lot of evidence about how negative emotions influence decision making. In a study carried out on volunteers, they randomly assigned them to an intervention group, in which emotions of anger, sadness or fear were induced by viewing videos of non-health content, or a control group. Participants then read an informed consent form from a clinical trial while they tracked their visual attention. Eye movement monitoring revealed that participants who were induced by fear and anger spent more time looking at the details of the test procedure than those who read it under neutral conditions. This more detailed reading did not translate into a better general understanding; rather the understanding of the benefits of the trial was reduced. This study suggests that negative emotions may influence both the processing and the understanding of information related to the consent of the clinical trial. Behavioural studies suggest that stress and emotions exert subtle but consistent effects on cognition, both in laboratory settings and in everyday life. These experiments explain that psychological factors directly influence how patients process clinical information.

In this way, intervention on psychological factors helps to improve understanding and clinical communication processes, essential for shared clinical decision. The intervention from psycho-oncology focuses, on the one hand, on alleviating the emotional impact that a cancer diagnosis triggers and, on the other, on facilitating the patient's adaptation to the disease so they can get involved in the decisions that affect them. Ultimately, psycho-oncology tries to give emotional support to the patient and her family to improve communication, understanding of the disease and the ability to cope with it.