Добавил:
Upload Опубликованный материал нарушает ваши авторские права? Сообщите нам.
Вуз: Предмет: Файл:
Pediatric_Oncology_A_Comprehensive_Guide.pdf
Скачиваний:
23
Добавлен:
10.02.2016
Размер:
1.86 Mб
Скачать

228

A.D. Gallo and K. Westhoff

 

 

20.2.2.4 Education in Hospital

Education in hospital serves to strengthen the patient’s motivation and self-confidence, forming a bridge to normal life through creativity, games, and learning

Hospital School:

Lessons at the right age and level for children and adolescents of school age during their stay in hospital or outpatient clinic

Regular contact with class teachers and school authorities (discussion of subjects to be covered, obtaining appropriate teaching materials, reintegration, implementation of supportive measures, change of class)

Talks with patients and parents about school issues

School visits

Education through art and play:

Development of a trusting relationship through regular contacts during creation and play

Encouraging the working through of difficult hospital experiences in a play situation

Involvement of parents and siblings, and support in educational matters

Helping to create a childand adolescent-friendly atmosphere in the hospital In addition to these core professionals, pastoral care as well as art and music

therapy contributes significantly to psychosocial work. In many clinics, parents’ associations and foundations also provide supporting activities and self-help groups for affected families.

20.3The Practice of Pediatric Psycho-oncology

20.3.1 Objectives

At the center of psycho-oncological work is the promotion of individual and family resources during the crisis of disease, therapy, and – in some cases – dying, death, and mourning. The core is formed by a supportive relationship, oriented according to the physical, psychological, and social challenges and opportunities of the sick child and his or her social environment, and taking into account individual variations in coping and adapting. The objectives of psycho-oncological work include:

Creation of a trusting and meaningful dialogue

Provision of information and expert help

Promotion of adaptive and active disease management, and the mobilization of resources to prevent or reduce disease burdens

Treatment and support in crisis situations

20.3.2 Procedure

20.3.2.1 Investigative Phase

The investigation that precedes every psycho-oncological treatment serves to identify the coping and adaptation strategies that are available to the sick child and the social environment. It also provides important basic information for the family,

20 Psychology and Psychosocial Issues in Children with Cancer

229

 

 

and an initial evaluation of what they need from psycho-oncology. The objective of the investigation is not to uncover conflicts, but primarily to create the required support

The first interview – if possible with the whole family – allows the psychooncologist a preliminary insight into the way that they are handling the burden of illness and therapy, and into family relationships and coping strategies

The investigation is generally not completed after the first interview. As a result of situations that often change rapidly during the course of the therapy (e.g., clinical complications, relationship crises, relapse), the assessment must be continuously adapted and updated

Areas Investigated

Family:

Socioeconomic situation (place of residence and domestic situation, school, profession, finances, etc.)

Social network

Existing resources and problems

Orientation and cohesion

Cultural, ethical, and religious values

Intrafamilial communication

Communication with the outside, flexibility of boundaries

Mutual distribution of responsibility and expectations

Patient (and possibly siblings):

Emotional, cognitive, and physical state of development

Most significant individual coping strategies and their state of development

Handling of earlier, critical life events

Level of information and understanding

Principal fears and concerns

Feeling of self-worth, body image

Compliance (willingness to cooperate)

Relationships with parents, other adults, siblings, contemporaries, treatment team

Ability to use relationships, maintain their own psychological equilibrium

Parents (or their representatives and other significant figures):

Most important coping strategies

Handling of earlier, critical life events

Level of information and understanding

Compliance, trust in the treatment and the treatment team

Principal anxieties

Relationship between the partners (communication, emotionality, expectations)

Relationship to the sick child and their siblings

How the children are given information

Ability and willingness to express themselves and to accept support from their environment and from psycho-oncologist

In practice, the investigation phase may often be difficult to distinguish clearly from the phase of treatment and support; both merge into each other. To prevent

Соседние файлы в предмете [НЕСОРТИРОВАННОЕ]