Psychological support to patient and family with confrontation with malignant disease

Maligne bolesti predstavljaju veliki javnozdravstveni problem u cijelom svijetu, a prema Svjetskoj zdravstvenoj organizaciji maligne bolesti su trenutno nakon kardiovaskularnih bolesti vodeći uzrok smrti. Dijagnostika i liječenje malignih bolesti izaziva emocionalne traume i tjelesne simptome, a rezultat su same dijagnoze koja iziskuje doživotno liječenje agresivnim medicinskim tretmanima te promjene u dosadašnjem načinu života. Maligna bolest je sama po sebi ugrožavajuća za život i izaziva veliku količinu stresa. Psihijatrijske bolesti poput depresije i anksioznosti česta su, ali često i zanemarena, komorbiditetna stanja s malignom bolešću, koja utječe na kvalitetu života, pridržavanje liječenja, preživljavanje raka i troškove liječenja. Liječenje karcinoma može biti nedovoljno prepoznatljiv, ali reverzibilan uzrok teške, a ponekad i brze pojave psihičkih smetnji. Maligna bolest u poodmakloj fazi je neizlječiva, uzrokuje nesigurnost, patnju, egzistencijalni strah, teškoće u donošenju odluka i loše tjelesno funkcioniranje. Liječi se kao kronična bolest koja zahtjeva palijativnu skrb i iznimnu podršku i sudjelovanje prijatelja i obitelji u procesu liječenja. Psihoonkološke osnove predstavljaju niz reakcija, postupaka, razmjena i susreta koje se tiču odnosa pacijenta i okoline i podnošenja vlastite bolesti. Uključuju odnos između pacijenta i obitelji kao i međusobnu komunikaciju pacijenta i medicinskog osoblja koje prati bolesnika u dijagnostičkom i terapijskom postupku. Psihološka pomoć poprima veliku važnost u onkološkom liječenju, od procesa priopćavanja dijagnoze pa sve do terminalne faze bolesti. Osposobljavanje i usmjeravanje profesionalnog osoblja, uključujući medicinske sestre, socijalne radnike, psihijatre, psihologe i svećenike osigurava pružanje usluge psihosocijalne skrbi oboljelima različitih teorijskih usmjerenja, sadržaja intervencija i dostupnih resursa. Pružanje zdravstvene skrbi medicinskih sestara u onkologiji obuhvaća sve postupke liječenja, uključujući dijagnozu, moguće recidive, razdoblje palijativne skrbi te mirne i dostojanstvene smrti u terminalnoj fazi bolesti. Prvenstveno je potrebno poznavati bolesti, manifestaciju bolesti, način obavljanja i provođenje zdravstvene njege. Veliki izazovi s kojima se medicinske sestre susreću uvelike se odnose na komunikaciju i socijalne vještine te na empatiju i empatični pristup liječenja. Oboljeli od raka sa sigurnošću spadaju u najugroženije osobe kako u tjelesnom tako i psihološkom smislu. Zato je od velike važnosti pružanje psihološke pomoći od samog početka i susreta s dijagnozom ove bolesti.Malignant diseases is a major public health problem worldwide, and according to the World Health Organization, malignant diseases are currently the leading cause of death after cardiovascular diseases. Diagnosis and treatment of malignant diseases causes emotional trauma and physical symptoms, and are the result of the diagnosis itself, which requires lifelong treatment with aggressive medical treatments and changes in the current way of life. Malignant disease is in itself life-threatening and causes a large amount of stress. Psychiatric illnesses such as depression and anxiety are common, but often overlooked complications of cancer, which affect quality of life, adherence to treatment, cancer survival and treatment costs. Cancer treatment can be an insufficiently recognizable but reversible cause of severe and sometimes rapid onset of mental illness. Advanced malignancy is incurable and causes insecurity, suffering, existential fear, difficulty making decisions and poor physical functioning. It is treated as a chronic disease requiring palliative care and exceptional support and participation of friends and family in the treatment process. Psycho-oncological foundations represent a series of reactions, procedures, exchanges and encounters concerning the relationship between the patient and the environment and the endurance of one's own illness. They include the relationship between the patient and the family as well as the mutual communication of the patient and the medical staff accompanying the patient in the diagnostic and therapeutic procedure. Psychological help is gaining great importance in oncology treatment, from the process of communicating the diagnosis all the way to the terminal phase of the disease. Training and guidance of professional staff, including nurses, social workers, psychiatrists, psychologists and priests ensures the provision of psychosocial care services to patients of various theoretical orientations, theoretical orientations and available resources. The providing of health care of nurses in oncology encompasses all treatment procedures including diagnosis, possible relapses, a period of palliative care and a peaceful and dignified death in the terminal phase of the disease. It is primarily necessary to know the disease, manifestation of the disease, the manner of performing and conducting health care. The major challenges, that nurses face, are largely related to communication and social skills, as well as empathy and an empathetic approach to treatment. Cancer sufferers are certainly among the most vulnerable people, both physically and psychologically. That is why it is very important to provide psychological help from the very beginning and the encounter with the diagnosis of this disease