ABSTRACT
Cancer and the various medical treatments and tests are a major physical and psychological challenge for patients, their relatives and for the medical staff as well. Adherence and compliance become critical factors during prolonged oncological therapies. The mental health of people with malignant cancer, untreated psychological symptoms can affect survival by increasing distress and suffering, weakening quality of life and reducing adherence. Furthermore, they have a particularly high comorbidity with psychiatric disorders. The aim of this study is to introduce the tools of cognitive behavioural therapy and the therapeutic indications in the context of mental disorders associated with chronic somatic illness. Our study presents the case of a 66-year-old woman with breast cancer. She was diagnosed with mild depressive episodes and hypochondriasis based on psychodiagnostic assessment. Instead of interpreting the patient's symptoms as a serious organic illness, the goal of psychotherapy is to develop new, more adaptive attitudes and more comforting perspective of the symptoms, and to reduce secondary depression. The elements of the 16-session cognitive behavioural therapy included behavioural activation, analysis of symptomatic behaviour, diary management, development of new alternatives and behavioural experiments, conceptualisation, and summarising learned techniques and future planning. Orv Hetil. 2022; 163(23): 895-901.
Subject(s)
COVID-19 , Cognitive Behavioral Therapy , Neoplasms , Aged , COVID-19/therapy , Cognitive Behavioral Therapy/methods , Female , Humans , Psychotherapy/methods , Quality of LifeABSTRACT
OBJECTIVES: The current global health crisis of the COVID-19 pandemic has drastically affected the whole population, but healthcare workers are particularly exposed to high levels of physical and mental stress. This enormous burden requires both the continuous monitoring of their health conditions and research into various protective factors. DESIGN: Cross-sectional surveys. SETTING AND PARTICIPANTS: Self-administered questionnaires were constructed assessing COVID-19-related worries of health workers in Hungary. The surveys were conducted during two consecutive waves of the COVID-19 pandemic (N-first wave=376, N-second wave=406), between 17 July 2020 and 31 December 2020. PRIMARY AND SECONDARY OUTCOME MEASURES: COVID-19-related worry, well-being and distress levels of healthcare workers. We also tested whether psychological resilience mediates the association of worry with well-being and distress. Multiple linear regression analyses were performed. RESULTS: The results indicated that healthcare workers had high levels of worry and distress in both pandemic waves. When comparing the two waves, enhanced levels of worry (Wald's χ2=4.36, p=0.04) and distress (Wald's χ2=25.18, p<0.001), as well as compromised well-being (Wald's χ2=58.64, p<0.001), were found in the second wave. However, not all types of worries worsened to the same extent across the waves drawing attention to some specific COVID-19-sensitive concerns. Finally, the protective role of psychological resilience was shown by a mediator analysis suggesting the importance of increasing resilience as a key factor in maintaining the mental health of healthcare workers in the burden of the COVID-19 pandemic. CONCLUSIONS: Our results render the need for regular psychological surveillance in healthcare workers. REGISTRATION: Hungarian Scientific and Research Ethics Committee of the Medical Research Council (IV/5079-2/2020/EKU).