Coping / Living with a brain tumour Leicester Information Day Alex J Mitchell Leicester
Classic Medical Model: Authoritarian 1. need to know 2. dont tell / clinician in charge 3. Sick role 4. Victim / Lack of control 5. Reactive 6. Physically based
New Medical Model: Interactive 1. what would you like to know 2. Patient is at the centre 3. Rehab early 4. Promote control / autonomy 5. Proactive => prevention 6. Holistic
Issues Picked Up?
Psychooncology Nov;20(11): doi: /pon Epub 2010 Sep Cancer Patients in Florida (Jacobsen, 2010)
Johnsen Do advanced cancer patients in Denmark receive the help they need? A nationally representative survey of the need related to 12 frequent symptoms/problems Psychooncology Adv Cancer Patients in Denmark (Johnsen, 2013)
94.2% 37.4% 8 yrs N= 9282 NCS-R P Wang Harvard In cancer?=>
If mental ill health is present in cancer: 1.Lower rates of cancer screening 2.Lower rates of cancer diagnosis 3.Lower rates of cancer treatment 4.Poorer adherence with treatment 5.Higher mortality
Chris Sedman
Main Issues
Leicester N=540
N=1465
1.Worry about future 2. Fatigue / energy 3. Anxiety / depression 4. Family / relationships 5. Memory / concentration 6. Feeling helpless/alone
Distress 40% Depress 25% Anger 20% Anxiety 50% I feel low, hopeless I feel stressed I feel worriedI feel irritable why me?
Getting Help
What Help is Wanted? 19% wanted medication (eg antidepressants) 31% want self help guidelines 31% wanted group therapy 56% wanted illness information. 58% complementary therapies 62% trusted face-to-face psychological support
Help – Who From? Nurse specialists (54%) Family and friends (21%) Spiritual advisor (8%) Psychiatrist (4%).
Problems Getting Timely Help 1.Help not requested (?trust) 2.Help not available 3.Help not given 4.Wrong help given
Offers of Help (n=2557)
Top Tips for Coping Successfully 1.Ask for help when needed 2.Talk with other patients / support groups 3.What can I do not what have I lost 4.Start slow but build up 5.Use family and friends 6.Plan for the future
Alfie Bangs
Innovations….
What is Ideal Treatment? 1.Effective 2.Acceptable 3.Easily accessible 4.Proven (evidence based) 5.Value for money
Personal Stories …power of peer support