Psychological distress in patients with advanced cancer.

摘要

Psychological distress may be understandable in the face of the many losses and uncertainties at the end of life but it is not inevitable as not all patients are psychologically distressed. Some are passively resigned to their death, while other patients are able to confront the challenge actively and find more personal meaning in life such as increased intimacy in their relationships. This latter situation is unlikely to occur unless the suffering caused by uncontrolled pain and symptoms or by family friction and damaged personal relationships is alleviated. This article discusses the psychological distress which may be experienced by patients and the non-pharmacological interventions which may be used to manage it. Discussion about psychiatric disorder in palliative care is beyond the remit of this article and can be found elsewhere.Psychological distress may be undetected and untreated in patients with advanced cancer. There is also growing awareness of the unalleviated distress caused by non-malignant diseases such as end-stage cardiac failure and chronic obstructive pulmonary disease (COPD). Data obtained on 209 patients with COPD in the year before death found that low mood was reported in 77% but relieved in fewer than 8%.