Psychosocial Aspects of Palliative Care

Abstract

Introduction

Cancer – perhaps it is the most frightening diagnosis one can ever get, as it seems to be equal to painful dying and inevitable death. Even today, we still feel uncomfortable and awkward talking about death and dying, one may say, that death is still a taboo, more or less all over the world, especially in Eastern Europe, where taboos altogether are strong.  The patients and family members often feel alone with their anxiety and depression, which level is evidently higher than in the general population.

Aim

The aim of the presentation is to give an outline about the psycho-social aspects, public issues  – the problems and the possible solution – of palliative care in cancer.

Method

With the summary of the researches of Hungarian Hospice Foundation (HHF) and a review of the relevant literature, the presentation covers 4 main topics.

The 1^st part of the presentation deals with the psychological symptoms of the terminally ill patients and their families, and psychotherapy and medical treatment options of these symptoms. Comprehensive research on the psychological status of Hungarian cancer patients will be discussed, which was implemented by the professionals of the HHF. Another impressive source of information is representative research led by HHF among adult Hungarians on the preferences on end of life care.

The 2^nd part deals with communicational issues in the field of end-of-life care. Because of anxiety symptoms, and through of the taboos of death and dying, many communication problems occur both in the medical communication (among medical professionals and the cancer families), and also in the communication in the families.  Not only the problems and symptoms, but also the ways of possible solutions will be discussed.

The 3^rd part will be about education, education of medical professionals, and also of the laymen. HHF has had a rich history of Eastern European educational programs in the end of life palliative care, for Hungarian and also for international participants. The courses for medical doctors are on personnel-patient relationships and communication, but we also have courses for other medical professionals, such as nurses, physiotherapist, etc., and also for others, such as for volunteers, journalists, and also for teachers The aims and content of these courses will be discussed in the 3^rd part of the presentation.

The 4^th part will be on public issues: public education and publicity campaigns. HHF has extensive experience based on intensive fieldwork on public education through different means. These means and their relative costs and benefits will be discussed in order to open up the significance of public awareness in end of life palliative care. 

Discussion and conclusions

It is crucial to recognize and treat the fears and distress caused by advanced cancer. The most common barrier to this is the taboos by which death and end-of-life care are surrounded. In order to give adequate help to patients and their family members, the most common and most frequent problems should be known, therefore educational programs for medical professionals and for the public are much needed.