A Psychosocial Assessment of a Breast Cancer Patient - Essay Example

?A Psychosocial Assessment of a Breast Cancer Patient The Case of Irene Introduction Every woman who has been diagnosed with breast cancer normally becomes anxious, depressed, and distraught. As stated by the Diagnostic and Statistical Manual of Mental Disorders, the serious attributes of a breast cancer diagnosis will in a number of women qualify to the conditions of posttraumatic stress disorder (PTSD) as an “exposure to an extreme traumatic stressor” (Sadler-Gerhardt et al. 2010, 265). The possibility of death, in addition to painful and inflexible treatment that weakens self-worth, and a severe level of fear and sense of vulnerability or helplessness are a good reason for psychosocial assessment (Spiegel & Classen 2000). Once diagnosed with breast cancer, a woman becomes convinced that her life will drastically change. This paper carries out a psychosocial assessment of Irene’s case, a 51-year old female who is diagnosed with breast cancer. After identifying major psychosocial issues using Spade’s framework a treatment plan is formulated and discussed. Psychosocial Vital Signs Perception: Due to her age Irene may overestimate her current illness. According to the profile, she is already experiencing some levels of anxiety due to the absence of counselling. Perhaps due to the absence of her two children, and the limited support that her husband can give her, Irene perceives her health condition as life-threatening and something extremely depressing. Personality Style: Irene shows needs for protection and support. Yet she shows a degree of determination and optimism. She assures herself every now and then that she will be okay. But then relapses to depression when she thinks of her relationship with her husband after the surgery. She afterwards becomes bitter because of the thought that her husband will be disappointed of her and see her unattractive after the surgery. Irene displays efforts to hide or repress her emotions. Support: The current support that Irene has comes from her husband, whom she lives with, her surgeon, and her breast care nurse. Later on, after the surgery, Irene will be supported by a multidisciplinary team. Other possible sources of support are her children and other close relatives. Due to the constant support from her husband, Irene’s perception of her health condition erratically shifts from lack of concern to anxiety. Coping: Irene seems to be coping with her health illness by seeking for social support and controlling her emotions. Anxiety: Irene is experiencing four major anxieties. First is the thought that her husband will be dissatisfied of her after the surgery; second is the possibility of surgical failure; third is her belief that old age brings many infirmities; and fourth is the thought that due to her age she will be experiencing other illnesses aside from breast cancer. Cultural Issues: The diagnosis evidently affects Irene’s self-worth as a woman. She obviously adheres to the assumption that women’s breasts are marks of womanliness and beauty. Hence Irene seems to be having second thoughts about seeking treatment. Lifestyle Information: She currently lives with her husband .She works as a receptionist at a plumbing supply store. She is a non-smoker and drinks two glasses of wine each week. As shown in the profile, there seems to be no indication that Irene will develop breast cancer. Major issues risked by the current health event for Mike: Irene’s diagnosis has perhaps the same psychosocial effects on her as those of Mike. Mike, early on in the diagnosis, displays signs of distress and despair. Irene’s health condition may also lead to marital problems, severe financial or resource constraints, and family maladjustments. Based on Irene’s psychosocial vital signs, three major psychological needs are identified, which are (1) support for psychological distress, (2) appropriate coping strategies, (3) and psychosocial support for Irene’s husband and entire family. The psychosocial assessment identifies anxiety and despair as the most obvious effects of the breast cancer diagnosis on Irene and her husband. These psychological problems identified may persist even after the completion of Irene’s treatment. Determinants of Irene’s psychosocial problems are old age, sense of vulnerability, overestimation of breast cancer’s health risks, loss of control, personality aspects, social support level, and coping mechanisms used. The most appropriate treatment plan for Irene’s psychological problems and coping weaknesses is that focused on positive reappraisal (helping Irene find new meaning in her new situation) and cognitive avoidance (helping Irene divert her attention from her infirmity to something constructive). Problem-focused treatment may lead to better outcomes than emotion-focused therapy (Roberts et al. 1994). Helping Irene focus on the positive side of her new situation may reduce the level of her distress. The treatment plan should regularly measure emotional or psychological progress by looking for indicators of constructive emotional expression and coping techniques. It would be more beneficial for Irene to undergo emotional expression exercises. Widespread evidence points to the beneficial effect of social support for women with breast cancer (Kayser et al. 2010). As stated by Bigatti and Wagner (2003), it has been empirically verified that social support is related to reduced anxiety levels and better psychosocial security. The third psychosocial need is related to Irene’s husband or, her entire family, in general. As primary givers of support, it is important to address the psychosocial requirements of Irene’s immediate family. Studies have shown that the negative impacts of breast cancer are not only experienced by the patient but by her entire family (Roberts et al. 1994), Partners are a major predictor of the adjustment level of breast cancer patients. Hence, according to Foxall and colleagues (1986), spousal adjustment is “one of the most important components in rehabilitation” (as cited in Bigatti & Wagner 2003, 75). The treatment plan aims to familiarize Irene’s husband and her entire family to emotional and physical support strategies. However, the therapist should first understand the impacts of Irene’s health condition on Mike in order for the treatment to produce better outcomes for Irene and her family. One aspect that may heighten Mike’s vulnerability is the existence of major stressors. He may experience distress because of the fatal nature of breast cancer, the treatments’ side effects, and the persistent psychological and physical difficulties Irene will experience related with the diagnosis. Breast cancer treatments, like chemotherapy, may induce memory and attention problems (Bigatti & Wagner 2003) for Irene. Other consequences, like numbness and immobility, may impinge on Irene’s capacity to carry out a number of essential everyday routines. In these instances, Mike may start to play the role of an informal caregiver for his wife. Therefore, the treatment plan should involve the accessibility of social support, and promotion of hopefulness as personality attributes among Irene’s family members. Northouse (1988 as cited in Bigatti & Wagner 2003) reported that greater availability of social support was linked to better psychosocial outcomes among spouses of breast cancer patients, and that this connection was greater than between demographic and medical factors and psychosocial adjustment. Hence the treatment plan includes sessions with Irene’s family to foster optimism and reduce level of anxiety and depression among them. Conclusions Assessment of available social support for women coping with breast cancer is broadly recognised as a fundamental function of psychosocial work. Understanding of the dynamics, constraints, and effects of social support for breast cancer patients results in more precise and appropriate psychosocial evaluations and, eventually, more effective treatment plans. The outcomes of this assessment show that social support is the most important component of a treatment plan for breast cancer patients. Moreover, the assessment provides modest substantiation to earlier assumptions that the personalities of women with breast cancer, instead of the condition, bring about the evident connection between adjustment to ill health and social support. References Bigatti, S. & Wagner, C. (2003) “Psychosocial Consequences of Breast Cancer for Patients and Families,” Psychology Science, 45, 75+ Kayser, K., Feldman, B., Borstelmann, N., & Daniels, A. (2010) “Effects of a Randomized Couple-Based Intervention on Quality of Life of Breast Cancer Patients and their Partners,” Social Work Research, 34(1), 20+ Roberts, C., Cox, C., Shannon, V., & Wells, N. (1994) “A Closer Look at Social Support as a Moderator of Stress in Breast Cancer,” Health and Social Work, 19(3), 157+ Sadler-Gerhardt, C., Reynolds, C., Britton, P. & Kruse, S. (2010) “Women Breast Cancer Survivors: Stories of Change and Meaning,” Journal of Mental Health Counseling, 32(3), 265+ Spiegel, D. & Classen, C. (2000) Group Therapy for Cancer Patients: A Research-Based Handbook of Psychosocial Care. New York: Basic Books. Read More