How to Deal with the Past Memories of Patients in Palliative Care: A Suggested New Approach / 한국호스피스완화의료학회지

Dealing with existential concerns experienced by patients is an important part of palliative care. Interventions that use the life review method to encourage patients to reminisce about their lives can help them find new positive meanings, promote ego integrity, and reduce emotional suffering. Not everyone has positive memories when they look back on the past, however. This poses a limit on the effectiveness of the life review method for healthcare providers working in palliative care contexts. In this study, we discuss the limits of life review and suggest imagery rescripting as a new modality constituting a psychotherapeutic approach to deal with negative memories safely and effectively.

How to Deal with the Past Memories of Patients in Palliative Care: A Suggested New Approach / 한국호스피스완화의료학회지

Dealing with existential concerns experienced by patients is an important part of palliative care. Interventions that use the life review method to encourage patients to reminisce about their lives can help them find new positive meanings, promote ego integrity, and reduce emotional suffering. Not everyone has positive memories when they look back on the past, however. This poses a limit on the effectiveness of the life review method for healthcare providers working in palliative care contexts. In this study, we discuss the limits of life review and suggest imagery rescripting as a new modality constituting a psychotherapeutic approach to deal with negative memories safely and effectively.

Cancer Survivors and Returning to Work Perspectives from Occupational Health Physicians in Korea

BACKGROUND: This study was conducted from an occupational health perspective to document cancer survivors' ability to return to work, the role of clinical care, and the current status of effective return-to-work. METHODS: This cross-sectional study was conducted to evaluate the experiences and opinions of occupational health physicians (OHPs) regarding cancer survivors' return-to-work. A self-reported survey was conducted from December 30, 2015, to January 30, 2016, targeting 337 OHPs. Questions included: 1) treatment experiences of survivors in the words of OHPs, 2) current status of the assessments of fitness for work of cancer survivors, 3) experiences associated with workplace and treatment, and 4) problems of returning to work and overcoming system. RESULTS: Only 25% of the respondents said that they had experience treating cancer survivors, and the average number of patients was 12.6 per annum, which indicated that few cancer survivors were treated. Eleven cases included conducting assessment of fitness for work. There were 17 respondents who did not treat cancer survivors. Both those who had and did not have experience in treating survivors showed higher musculoskeletal system disorders (53.8 vs. 63.5) than cancer (15.5 vs. 11.2) in terms of frequency of the diseases in the assessment of fitness for work. Most respondents said that OHPs evaluate the current role appropriately and preferred OHPs in the future. They responded that OHPs found it difficult to treat cancer survivors, and it was psychologically tough to communicate with them (61.4%). Regarding the association of patient rehabilitation with workplaces, 48.9% said that workplaces provide inadequate support. CONCLUSION: As a preliminary study, we found that OHPs were found to have little experience in treating cancer survivors and undergo difficulties owing to poor collaboration with workplaces and communication with patients. This study will provide basic data for future studies to promote cancer survivors' return to workplaces.

Neurocognitive and Psychological Functioning of Children with an Intracranial Germ Cell Tumor / Journal of the Korean Cancer Association, 대한암학회지

PURPOSE: This study was conducted to investigate the neurocognitive functioning of children with intracranial germ cell tumor (IGCT) prior to receiving proton beam therapy (PBT), and to identify differential characteristics of their neurocognitive functioning depending on tumor location. As a secondary object of this study, neurocognitive functions were followed up at 1-2 years after PBT to examine early post-treatment changes. MATERIALS AND METHODS: Between 2008 and 2014, 34 childrenwith IGCT treatedwho received PBT atNational Cancer Center, Korea were enrolled in this study. Standardized neurocognitive tests of intelligence, memory, and executive functioning were performed with baseline psychological assessments using the Child Behavior Checklist (CBCL). Follow-up assessments after PBT were conducted in 20 patients (T2). The results were analyzed based on the locations of tumors, which included the suprasellar, pineal gland, basal ganglia, and bifocal regions. RESULTS: The neurocognitive function of IGCT patients was significantly lower than that of the normal population in performance intelligence quotient (p=0.041), processing speed (p=0.007), memory (p < 0.001), and executive functioning (p=0.010). Patients with basal ganglia tumors had significantly lower scores for most domains of neurocognitive functioning and higher scores for CBCL than both the normal population and patients with IGCT in other locations. There was no significant change in neurocognitive function between T1 and T2 for all types of IGCT patients in first 1-2 years after PBT. CONCLUSION: Tumor location significantly affects the neuropsychological functioning in patients with IGCT. Neuropsychological functioning should be closely monitored from the time of diagnosis in IGCT patients.

Focus Group Study on Psychosocial Distress of Cancer Patients / 성인간호학회지

PURPOSE: The purpose of the study was to describe psychosocial difficulties experienced by cancer patients. METHODS: Three focus group interviews were conducted to collect the data from 19 outpatients with cancer undergoing treatments during 2009. All interviews were audio-recorded and transcribed verbatim. The data were analyzed using constant comparative analysis of grounded theory. RESULTS: As a result of constant comparative analysis, 'psychosocial distress' was identified as a core category, and seven subcategories were identified. 'Plunged into negative emotions' and 'damaged self-identity' were identified as major categories in the individual dimension. 'Difficulty in dealing with diagnosis' and 'hasty expectations and concerns' were identified in the dimension of family. 'Inefficient communication' and 'lack of necessary information' were identified in the dimension of health care setting. 'Lonely journey into a strange territory' was identified in the dimension of society. CONCLUSION: The results of the study indicate that cancer patients experience a wide range of psychosocial problems. Thus, in assessing and relieving psychosocial distress of cancer patients, it is necessary to focus not only on the level of the individual but also on the levels of family, health care setting, and society in general is necessary.

Overview of Psychopharmacotherapy for Cancer Patients / 신경정신의학

Cancer patients experience various physical and psychological symptoms, which can be alleviated by psychotropic medications. In the process of developing the recommendations for distress management in cancer patients, the Korean psycho-oncology research group performed systematic reviews on the oncological psychopharmacotherapy literature. This study describes the general principles and some practical suggestions.

Evidence Based Pharmacotherapy for Depression in Patients with Cancer / 신경정신의학

OBJECTIVES: A significant number of cancer patients experience depressive disorders. Numerous studies have demonstrated that depression in such patients is under-diagnosed and inadequately treated, due to various factors. One of these factors is a lack of an evidence supporting the use of antidepressants in cancer patients. The aim of this systematic review was to establish the evidence for the pharmacological treatment of depression in this population. METHODS: We searched Korean domestic and international database using the keywords "cancer", "depression", and "pharmacological treatment", limiting the search to articles published between 1980 and 2008 and grading the reviewed studies' quality according to Scottish Intercollegiate Guideline Network (SIGN) methodology. RESULTS: Of 283 studies searched, 28 studies were appropriate for review. CONCLUSION: The evidence for the pharmacological treatment of depression was limited. However, based on available literature, it seems the newer antidepressants are better tolerated and can be continued safely, with satisfactory efficacy, in cancer patients. Further well-designed, long-term follow-up studies should be conducted.