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Josephine G Paterson

Meeting the psychological care needs of patients with cancer Middleton RJ (2014) Meeting the psychological care needs of patients with cancer. Nursing Standard. 28, 21, 39-45. Date of submission: July 26 2013; date of acceptance: September 27 2013.

Abstract This article aims to explore the psychological aspects of cancer care from the time of diagnosis to treatment cessation. It reviews some of the main psychological issues associated with cancer, such as depression, anxiety, fear of recurrence and lack of hope, as well as identifying interventions that aim to improve the mental health of patients with cancer. The article discusses the advantages of providing such support, as well as the importance of managing a patient’s expectations and hope trajectories. Finally, the limitations of providing psychological support and the implications for nursing practice are considered.

Author Richard John Middleton Nursing student, School of Nursing and Midwifery, Keele University, Stoke-on-Trent. Correspondence to: [email protected]

Keywords Anxiety, cancer, depression, distress, hope, psychological care, survivorship

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CANCER IS BOTH a dreaded and distressing disease (Rosenbaum and Rosenbaum 2005). The psychological effect of being diagnosed with cancer can be significant and, therefore, holistic care is essential to ensure that patients’ needs are met and to encourage adherence to ongoing management of their condition (Holland 2001). Current estimates suggest that two million people in the UK have a cancer diagnosis (Macmillan Cancer Support 2013a). In 2010, 325,000 people in the UK were diagnosed with cancer, which equates to one person receiving a cancer diagnosis every two minutes (Cancer Research UK 2013). If the number of people diagnosed with cancer continues to rise an estimated four million people will be living with cancer by 2030 (Macmillan Cancer Support 2013a). Although one in three people will develop some form of cancer during their lives (Cancer Research UK 2012), survival rates are improving, with more than 50% of adults surviving more than five years and 45% of adults surviving more than ten years, and around 75% of children being cured (Cancer Research UK 2013).

Psychological challenges Patients will experience various emotions and psychological challenges depending on the stage of their cancer and treatment (Boyle 2006). At the time of diagnosis, 50% of patients will demonstrate symptoms of anxiety and depression that will adversely affect their quality of life (National Institute for Health and Care Excellence (NICE) 2004). Limited budgets and financial pressures in the NHS result in inadequate staffing levels, which means less time available for nurses to undertake training to identify patients’

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Art & science psychological care psychological needs and to meet these needs (Holland et al 2010). Patients’ psychological needs are not always documented or met (Department of Health (DH) et al 2010), despite a report from NICE (2004) that recommended that these needs should be assessed at a number of stages during the cancer trajectory. It has also been reported that the psychological care of patients with cancer has not been at the forefront of nursing or medical care (Nichols 2005). Patients with cancer will experience challenges personal to them, and each stage of the cancer trajectory also has recognised challenges. Even patients whose cancer has been treated successfully may still have psychological difficulties, for example fear of recurrence. Box 1 outlines the potential difficulties experienced by patients during diagnosis, treatment and longterm survival. NICE (2004) suggested that psychological assessment and support should be provided for patients with cancer, based on a tiered four-level approach according to the individual’s level of psychological distress: Level 1 – includes all health and social care professionals, and centres on the need for emotional care and the recognition of psychological needs. Level 2 – involves health and social care professionals with additional expertise who are able to screen for psychological distress and organise psychological interventions. Level 3 – involves only trained and accredited professionals who are able to assess and diagnose psychopathology and provide specific psychological interventions.

Level 4 – includes mental health specialists who can diagnose psychopathology and who can organise specialist psychiatric and psychological interventions. This article focuses on the role of the nurse in a patient’s illness trajectory, from diagnosis to either palliative care or transfer to a survivorship programme, and outlines some of the barriers that prevent nurses from adopting a more active role in the psychological care of patients with cancer. It highlights some of the factors that can affect a patient’s experience and the psychological complications that might occur as a result of poor communication between patients and healthcare professionals.

Diagnosis When a patient is given a diagnosis of cancer, communication between the doctor and the patient becomes paramount. Communication is important to patients and their families to help them cope with the diagnosis and make informed decisions about treatment (Molleman et al 1984, Sutherland et al 1990). However, patients are often dissatisfied with the information that they receive at the time of diagnosis (Lloyd et al 1984, Ley 1988, Chaitchik et al 1992). There may be many reasons for lack of, or ineffective, communication, including healthcare staff’s poor communication skills, withholding information and patients’ inability to remember what they have been told during diagnosis (Hogbin and Fallowfield 1989). In 2007 Lesley Fallowfield, one of the pioneers of psycho-oncology, found that ‘the first

BOX 1 Difficulties experienced by patients during cancer diagnosis, treatment and long-term survival Diagnosis Confronted by:  Anger.  Anticipatory loss.  Bodily exposure.  Confusion.  Death anxiety.  Decisional conflict.  Financial and work constraints.  Relationship changes.  Remorse over disruption of family life.  Test result scrutiny.

Treatment Adapting to:  Altered new sense of self.  Emergent crises.  Imposition on family.  Ongoing interface with ambulatory practice, laboratory tests and radiology.  Out of pocket expenses.  Partial re-entry into normal life.  Physical compromise.  Threat of treatment-related sequelae.  Toxicities.  Trusting strangers.

Long-term survival Integration of:  Family worry.  Financial constraints.  Full re-entry into normal life.  Insurance discrimination.  Ongoing debilitation and long-term effects.  Permanent altered sense of self.  Recurrence anxiety.  Relationship changes.  Reminders of cancer threat.  Response to anniversaries.  Separation anxiety.

(Adapted from Boyle 2006)

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consultation was vital in determining outcomes for adjustment, anxiety and depression’ (Beishon 2006). Fallowfield and Jenkins (1999) stated that communication is a core skill for nurses and specialists working in oncology and yet few have received much formal training in this area. Many healthcare professionals find breaking bad news stressful and as a result may develop inappropriate ways of doing so and of coping with the associated emotional effects (Fallowfield and Jenkins 2004). Patients’ poor understanding of information and lack of recall can lead to dissatisfaction, anxiety, psychological distress and depression (Fallowfield and Jenkins 1999). This, in turn, can result in reduced adherence to treatment, and may ultimately affect the patient’s longterm outcomes (Stiles et al 1979, Pruyn et al 1985, Fallowfield et al 1990). Adherence to treatment regimens has a role in effective disease management, however, research has shown that in some conditions, up to 40% of patients fail to adhere to treatment because of misunderstandings, or forgetting or ignoring healthcare advice (Martin et al 2005). While 20-40% of patients with cancer experience significant levels of distress, fewer than 10% of these individuals are identified and referred to mental health services (Holland and Alici 2010). Psychological support alongside pharmacological interventions has been shown to reduce distress in these patients and improve adherence to treatment (Holland and Alici 2010). To aid communication, initial diagnosis consultations could be tape recorded (Ong et al 1995). A randomised double-blind study with 201 patients with cancer found that patient satisfaction increased, and patient recall improved both in the short and longer term with tape-recorded initial consultations that could be listened to at the patient’s convenience (Ong et al 2000). However, a study in Australia found that taping the diagnostic consultation did not influence recall (Dunn et al 1993).

Management of patient expectations After the initial diagnosis, when the patient is likely to experience many emotions, consideration should be given to managing the person’s expectations. Measuring the success of treatment only in terms of achieving a cure will lead to a sense of failure. This may have a profound effect on the goals set by the patient and the medical staff treating him or her (Crompton 2013). If a cure is not possible then what the patient and his or her family wish to achieve from

treatment needs to be established; whether that means a few extra weeks of life, quality rather than quantity of life, time to say goodbye to family or to resolve any outstanding difficulties or arguments, to live life to the full, to see children get married or graduate, or even to set short-term goals. Kathy Oliver, co-director of the International Brain Tumour Alliance, stated that when her son was diagnosed with a brain tumour at the age of 24, they viewed treatment success in terms of cure (Crompton 2013). However, as her son’s cancer progressed ‘each successive treatment carried with it a different measure of success and expectation’ (Crompton 2013). This demonstrates the importance of being realistic when managing patients’ expectations.

Hope Hope is an important factor for patients with cancer, whether this is in those for whom a cure is possible or those with incurable metastatic or advanced cancer. However, hope is not a constant and can alter depending on the stage of disease (Daneault et al 2010). Oliver (2010) stated that while it is important to ensure realistic expectations are set, these must be tempered with hope, as without it, there can be no success. Success here is defined as the patient reaching a particular goal, such as seeing a family member or attending a wedding. In a study involving 126 patients, 98% (n=123) wanted the doctor to treat them as individuals, and give them the opportunity to ask questions and to be realistic (Hagerty et al 2005). Among the behaviours patients rated as giving them the most hope were medical staff appearing to be fully conversant with the patient’s type of cancer, ability to provide information on the most up-to-date treatments, being confident and collaborative in their approach, and being confident that pain could be controlled. Doctors who appeared nervous about discussing the prognosis or seemed less knowledgeable were associated with providing less hope (Hagerty et al 2005). Hope focuses on that which is specific, whether that is a birth, a wedding or some other event that is considered to be a significant moment in the patient’s and family’s life. While not guaranteed, a ‘hope object’ must be possible to attain, in other words, realistic (Whitney et al 2008). As patients with cancer move from diagnosis to treatment, remission, recurrence and advanced disease, the hope trajectory will alter (Sanders et al 2012).

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Art & science psychological care Nurses should be aware of the patient’s hope trajectory and any changes that the individual may have made to this trajectory. A comprehensive psychosocial nursing assessment should be carried out to enable nurses to help patients to re-address their hope trajectory, should the original become unrealistic (Sanders et al 2012). It is important to the patient’s wellbeing that if the hope trajectory becomes unrealistic, it is replaced by one including more realistic goals. Most patients adapt quite well to change as long as the new hope object is realistic, for example managing pain or going home for a short time (Nurgat et al 2005). Realistic hope objects are those that have reasonable and achievable outcomes (Sanders et al 2012). Helping patients to set realistic goals can help them to rediscover hope (Oliver 2010).

Treatment and long-term survival Once treatment has finished, many people who have survived cancer may feel confused and unsure about how to proceed. At the same time, those providing primary care might not be aware of a cancer survivor’s unique needs (McCreery 2012). Many people struggle to return to normal life following treatment and further support is often needed to ensure that the patient’s psychological needs are met, along with dealing with financial challenges and any physical changes that may have occurred as a result of surgery or treatment (Macmillan Cancer Support 2013b). Macmillan Cancer Support (2013c) reported that 500,000 people who have or have had cancer in the UK have a disability, poor health or psychosocial problems. It is, therefore, important to help patients readjust to their new health status following cancer treatment. It is recognised that problems may persist for ten years or more following completion of treatment (Macmillan Cancer Support 2013c). Some of the difficulties that patients encounter during and after treatment are shown in Box 2. Psychological difficulties associated with cancer are not based solely on emotional responses, but can also be classified as ‘adjustment disorders’, in that they stem from the need to adjust to physical and functional disorders as well as losing confidence and concerns about the effect of cancer on family members. A link has been found between the patient’s level of distress during treatment and his or her long-term adjustment issues (Macmillan Cancer Support 2013b).

As well as psychological difficulties, patients also experience side effects of treatment, which may include fatigue, pain, bowel and bladder incontinence, sexual problems (including loss of confidence, loss of fertility, erectile dysfunction and loss of libido), osteoporosis and cardiovascular complications (DH 2007). The report Living With and Beyond Cancer: Taking Action to Improve Outcomes (DH et al 2013a) divided cancer survivorship into five domains as listed in Box 3. If these domains are realised, the patient’s physical and psychological needs will be addressed and he or she will be better cared for. This, in turn, will lead to increased survivorship, improved mental health and timely identification of health problems such as cancer recurrence (DH et al 2013a).

Constraints and limitations In times of economic hardship, when costs in the NHS are being scrutinised and availability of resources is declining, it may be difficult for healthcare professionals to address the psychological needs of patients with cancer and provide survivorship programmes – support programmes in the community to help patients re-engage and cope with the practical and psychological issues associated with cancer survival. The financial and time restrictions

BOX 2 Common difficulties encountered during and after cancer treatment  Emotional difficulty coping with changes to body image as a result of surgery, radiotherapy or chemotherapy. This may include loss of hair, loss of a breast or testicle, or even facial changes.  Difficulty in accessing information about the type of cancer and any effects experienced as a result.  Feelings of guilt as a result of becoming a burden on family and friends.  Problems associated with returning to work and loss of role.  Relationship difficulties.  Sexual problems.  Difficulties with new relationships.  Anger management.  Anxiety and adjustment problems.  Depression.  Financial difficulties through loss of income.  Fear and anxiety associated with cancer recurrence. (Fobair et al 2006, Jones and Browning 2009, Lengacher et al 2009, Macmillan Cancer Support 2013c)

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placed on hospitals, and care in the community and primary care budget limitations may mean fewer opportunities to train staff to identify distress and anxiety in patients with cancer. Nurses working in oncology, however, are well placed to address patients’ psychological needs because they spend the most time with these individuals. Time constraints and pressures already existing for healthcare staff might limit the possibility of training oncology or primary care nurses to identify and address psychological problems. Spending time with patients to redefine hope trajectories or complete a psychological nursing assessment may also be difficult for oncology nurses. However, perhaps this role could be taken on by specialist nurses such as Macmillan nurses or oncology clinical nurse specialists, who may possess some of the skills required to undertake basic psychological assessments and provide appropriate support (Macmillan Cancer Support 2011). Support groups such as Maggie’s Centres ( or Macmillan Cancer Support ( are useful resources for patients with psychological problems such as depression and anxiety. However, Macmillan Cancer Support (2013d) has warned that the increasing number of patients with cancer means that these services will be under significant pressure in the future. The implications of not providing this support could be a continuation of problems already identified such as cancer survivors encountering difficulties re-engaging with everyday life, problems coping with altered body image, feelings of guilt and dependency issues or living in fear of cancer recurrence (DH et al 2013b).

Implications for nursing practice For nurses, self-awareness is an important factor when delivering care. Priest’s (2006) study demonstrated that while nurses are aware that patients may need psychological care, they make a choice whether or not to respond to provide this care. Staff may feel that they lack confidence in, or knowledge of, this area. Therefore, greater emphasis could be placed on the provision of psychological care in nurse education. This would help to embed psychological care giving in the profession from an early stage. Peplau (1952) developed a model of interpersonal relations in nursing to help nurses develop improved relationships with patients (Box 4). It has been suggested that developing a therapeutic relationship with the patient reduces

patient anxiety and enables the development of trust (Peplau 1952). Patients may be more prepared to be open about their problems and psychological status if they trust the healthcare professionals providing their care. Nurses with appropriate training can help patients to face their feelings and discuss any

BOX 3 Five domains of cancer survivorship Domain 1 Preventing people from dying prematurely. Reducing the risk of recurrence, supporting patients with comorbidities, and early recognition of cancer recurrence. Domain 2 Enhancing quality of life for people with long-term conditions. Better management and recognition of anxiety and depression as well as physical problems, addressing psychosocial effects such as loss of confidence or relationship difficulties. Minimising problems associated with reintegration into work or education. Domain 3 Helping people to recover from episodes of ill health or injury. Ensuring access to rehabilitation, including physiotherapy, nutritional advice, speech and language therapy, and occupational health. Psychological support should support the whole person. Domain 4 Ensuring that people have a positive experience of care. Ensuring all patients receive a written assessment and care plan, are provided with information about financial help or benefits, and are given access to written and easy to understand information about side effects. Domain 5 Treating and caring for people in a safe environment and protecting them from avoidable harm. This includes documenting treatment decisions, timely access to services, and stratifying patients according to the level of support they need. (Department of Health et al 2013a)

BOX 4 Principles of Peplau’s model of interpersonal relations in nursing  The nurse and patient develop a relationship.  The relationship itself can be therapeutic; that is, the relationship is a form of treatment.  It provides the basis for nursing assessment.  It enables the patient to learn more satisfactory and productive patterns of behaviour.  It reduces anxiety. (Peplau 1952)

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Art & science psychological care psychological difficulties associated with illness and/or treatments (Priest 2012). Nurses need the necessary skills and knowledge to be more aware of the psychological problems associated with cancer and how to address them, either by helping the patient set hope trajectories or referring him or her for counselling or to survivorship programmes as appropriate. This may enable more effective patient care and more timely patient reintegration into normal life.

Conclusion There are some simple adjustments that can be made to help reduce distress and anxiety in patients diagnosed with cancer. Recording diagnosis meetings, providing information on the latest available treatments as well as specific information about the patient’s particular type of cancer, and ensuring that communication skills training is given where appropriate to the professionals involved in providing care will all improve psychological care.

References Beishon M (2006) Lesley Fallowfield: getting the message across. Cancer World. March-April, 6-13. Boyle DA (2006) Survivorship. Clinical Journal of Oncology Nursing. 10, 3, 407-422. Cancer Research UK (2012) Lifetime Risk of Cancer. (Last accessed: January 2 2014.) Cancer Research UK (2013) Cancer Statistics: Key Facts. All Cancers Combined. (Last accessed: January 2 2014.) Chaitchik S, Kreitler S, Shaked S, Schwartz I, Rosin R (1992) Doctor-patient communication in a cancer ward. Journal of Cancer Education. 7, 1, 41-54. Crompton S (2013) What counts as a ‘successful’ outcome? Cancer World. 54, 22-27. Daneault S, Dion D, Sicotte C et al (2010) Hope and noncurative chemotherapies: which affects the other? Journal of Clinical Oncology. 28, 13, 2310-2313. Department of Health (2007) Cancer Reform Strategy. The Stationery Office, London.

Department of Health, Macmillan Cancer Support, NHS Improvement (2010) National Cancer Survivorship Initiative: Vision. 82j3wl7 (Last accessed: January 2 2014.)

Fallowfield LJ, Hall A, Maguire GP, Baum M (1990) Psychological outcomes of different treatment policies in women with early breast cancer outside a clinical trial. British Medical Journal. 301, 6752, 575-580.

Holland JC, Breitbart WS, Jacobsen PB, Lederberg MS, Loscalzo MJ, McCorkle RS (Eds) (2010) Psycho-Oncology. Second edition. Oxford University Press, New York NY.

Department of Health, Macmillan Cancer Support, NHS Improvement (2013a) Living With and Beyond Cancer: Taking Action to Improve Outcomes. The Stationery Office, London.

Fobair P, Stewart SL, Chang S, D’Onofrio C, Banks PJ, Bloom JR (2006) Body image and sexual problems in young women with breast cancer. Psycho-Oncology. 15, 7, 579-594.

Jones G, Browning M (2009) Supporting cancer patients and their carers: the contribution of art therapy and clinical psychology. International Journal of Palliative Nursing. 15, 12, 609-614.

Department of Health, Macmillan Cancer Support, NHS Improvement (2013b) Adult Survivorship Pathway: Living With and Beyond Cancer. (Last accessed: December 11 2013.)

Hagerty RG, Butow PN, Ellis PM et al (2005) Communicating with realism and hope: incurable cancer patients’ views on the disclosure of prognosis. Journal of Clinical Oncology. 23, 6, 1278-1288.

Lengacher CA, Johnson-Mallard V, Post-White J et al (2009) Randomized controlled trial of mindfulness-based stress reduction (MBSR) for survivors of breast cancer. Psycho-Oncology. 18, 12, 1261-1272.

Dunn SM, Butow PN, Tattersall MH (1993) General information tapes inhibit recall of the cancer consultation. Journal of Clinical Oncology. 11, 11, 2279-2285.

Hogbin B, Fallowfield L (1989) Getting it taped: the ‘bad news’ consultation with cancer patients. British Journal of Hospital Medicine. 41, 4, 330-333.

Fallowfield L, Jenkins V (1999) Effective communication skills are key to good cancer care. European Journal of Cancer. 35, 11, 1592-1597.

Holland JC (2001) Improving the human side of cancer care: psycho-oncology’s contribution. Cancer Journal. 7, 6, 458-471.

Fallowfield L, Jenkins V (2004) Communicating sad, bad, and difficult news in medicine. The Lancet. 363, 9405, 312-319.

Holland JC, Alici Y (2010) Management of distress in cancer patients. Journal of Supportive Oncology. 8, 1, 4-12.

Ley P (1988) Communicating with Patients: Improving Communication, Satisfaction and Compliance. Chapman and Hall, London. Lloyd GG, Parker AC, Ludlam CA, McGuire RJ (1984) Emotional impact of diagnosis and early treatment of lymphomas. Journal of Psychosomatic Research. 28, 2, 157-162. Macmillan Cancer Support (2011) Cancer Clinical Nurse Specialists:

44 january 22 :: vol 28 no 21 :: 2014 © NURSING STANDARD / RCN PUBLISHING Downloaded from by ${individualUser.displayName} on Nov 24, 2015. For personal use only. No other uses without permission. Copyright © 2015 RCNi Ltd. All rights reserved.

Giving information about the treatment process and pain relief will reduce patient anxiety and distress, as will effective symptom management. This will allow the patient to readjust to life more quickly once treatment is completed. Helping to set and adjust hope trajectories for patients with cancer is vital in promoting good mental health and should be encouraged at ward level, although this role may be carried out by specialist nurses. Given the right training and support, oncology nurses and other healthcare professionals may

An Evidence Review. oewdee5 (Last accessed: January 2 2014.) Macmillan Cancer Support (2013a) Key Statistics. (Last accessed: January 2 2014.) Macmillan Cancer Support (2013b) Living With or Beyond Cancer. (Last accessed: January 2 2014.) Macmillan Cancer Support (2013c) Throwing Light on the Consequences of Cancer and its Treatment. Macmillan Cancer Support, London. Macmillan Cancer Support (2013d) By 2020 Almost Half of Britons Will Get Cancer in Their Lifetime – But 38% Will Not Die from the Disease. (Last accessed: January 2 2014.) Martin LR, Williams SL, Haskard KB, DiMatteo MR (2005) The challenge of patient adherence. Therapeutics and Clinical Risk Management. 1, 3, 189-199. McCreery H (2012) Survivorship wellness: as survivors live longer, care focuses on long-term wellness. ONS Connect. 27, 6, 10-14.

become more involved in the psychological care of patients with cancer. Ensuring access to survivorship programmes and support groups, and giving psychological support during and after treatment will help healthcare professionals to meet the psychological needs of patients with cancer. As more people are diagnosed and living longer with cancer, the psychological aspects of care will become more important and should be an integral part of cancer care, with nurses playing a major role NS

Molleman E, Krabbendam PJ, Annyas AA, Koops HS, Sleijfer DT, Vermey A (1984) The significance of the doctor-patient relationship in coping with cancer. Social Science and Medicine. 18, 6, 475-480. National Institute for Health and Care Excellence (2004) Guidance on Cancer Services: Improving Supportive and Palliative Care for Adults with Cancer. The Manual. NICE, London. Nichols K (2005) Why is psychology failing the average patient? The Psychologist. 18, 1, 26-27. Nurgat ZA, Craig W, Campbell NC, Bissett JD, Cassidy J, Nicolson MC (2005) Patient motivations surrounding participation in phase I and phase II clinical trials of cancer chemotherapy. British Journal of Cancer. 92, 6, 1001-1005. Oliver DP (2010) Redefining hope for the terminally ill. In Fleming DA, Hagan JC (Eds) Care of the Dying Patient. University of Missouri Press, Columbia MO, 101-114. Ong LM, de Haes JC, Kruyver IP, de Reijke TM, Lammes FB (1995) Providing patients with an audio

recording of the outpatient oncological consultation: experiences of patients and physicians. Nederlands Tijdschrift voor Geneeskunde. 139, 2, 77-80. Ong LM, Visser MR, Lammes FB, van der Velden J, Kuenen BC, de Haes JC (2000) Effect of providing cancer patients with the audiotaped initial consultation on satisfaction, recall, and quality of life: a randomized, double-blind study. Journal of Clinical Oncology. 18, 16, 3052-3060. Peplau HE (1952) Interpersonal Relations in Nursing. GP Putnam and Sons, New York NY. Priest HM (2006) Helping student nurses to identify and respond to the psychological needs of physically ill patients: implications for curriculum design. Nurse Education Today. 26, 5, 423-429. Priest H (2012) An Introduction to Psychological Care in Nursing and the Health Professions. Routledge, Abingdon. Pruyn JR, Rijckman RM, van Brunschot CJ, van den Borne HW (1985) Cancer patients’ personality characteristics, physician-patient

communication and adoption of the Moerman diet. Social Science and Medicine. 20, 8, 841-847. Rosenbaum EH, Rosenbaum I (2005) Everyone’s Guide to Cancer Supportive Care: A Comprehensive Handbook for Patients and their Families. Andrew McMeel Publishing, Kansas City MO. Sanders JB, Seda JS, Kardinal CG (2012) The changing hope trajectory in patients with advanced-stage cancer: a nursing perspective. Clinical Journal of Oncology Nursing. 16, 3, 241-254. Stiles WB, Putnam SM, Wolf MH, James SA (1979) Interaction exchange structure and patient satisfaction with medical interviews. Medical Care. 17, 6, 667-681. Sutherland HJ, Lockwood GA, Till JE (1990) Are we getting informed consent from patients with cancer? Journal of the Royal Society of Medicine. 83, 7, 439-443. Whitney SN, McCullough LB, Frugé E, McGuire AL, Volk RJ (2008) Beyond breaking bad news: the roles of hope and hopefulness. Cancer. 113, 2, 442-445.

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Meeting the psychological care needs of patients with cancer.

This article aims to explore the psychological aspects of cancer care from the time of diagnosis to treatment cessation. It reviews some of the main p...
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