Stres Yönetimi
Özet
Kanser hastaları tanıdan itibaren, tedavi sırasında ve takip sürecinde farklı düzeylerde strese maruz kalmaktadır. Bu stres hastalarda fiziksel semptomlar yaratabildiği gibi emosyonel semptomlar da oluşturabilir. Uygun şekilde tedavi edilemeyen stres, hastaların tedavi ve takip başarılarını olumsuz yönde etkilemektedir. Uluslararası komiteler ve kılavuzlar, hastaların belli periyodlarda stres açısından taranmasını önermektedir. Özellikle tanı süreci, tedavi değişimleri ve son dönem hastalık gibi kırılım noktalarında stres taraması yapılması gerekmekte olup bu tarama için çeşitli ölçekler kullanılabilir. Belli bir stres seviyesine sahip hastaların gerek psikososyal gerekse farmakolojik açıdan desteklenmesi önemlidir. Stres yönetiminde multidisipliner yaklaşım önerilmektedir.
Cancer patients are exposed to varying levels of stress from the moment of diagnosis, throughout treatment, and during follow-up. This stress can manifest as both physical and emotional symptoms. If not properly managed, stress can negatively impact the success of treatment and follow-up care. International committees and guidelines recommend screening patients for stress at specific intervals. Stress screening should be performed particularly at critical points such as the diagnosis process, changes in treatment, and advanced stages of illness, and various scales can be used for this screening. It is crucial to provide psychosocial and pharmacological support to patients with elevated levels of stress. A multidisciplinary approach is recommended in stress management.
Referanslar
Miller K, Massie MJ. Depression and anxiety. Cancer J Sudbury Mass. 2006;12(5):388–97.
McFarland DC, Holland JC. The management of psychological issues in oncology. Clin Adv Hematol Oncol HO. 2016 Dec;14(12):999–1009.
Funk R, Cisneros C, Williams RC, Kendall J, Hamann HA. What happens after distress screening? Patterns of supportive care service utilization among oncology patients identified through a systematic screening protocol. Support Care Cancer Off J Multinatl Assoc Support Care Cancer. 2016 Jul;24(7):2861–8.
Mehnert A, Hartung TJ, Friedrich M, Vehling S, Brähler E, Härter M, et al. One in two cancer patients is significantly distressed: Prevalence and indicators of distress. Psychooncology. 2018 Jan;27(1):75–82.
Krebber AMH, Jansen F, Cuijpers P, Leemans CR, Verdonck-de Leeuw IM. Screening for psychological distress in follow-up care to identify head and neck cancer patients with untreated distress. Support Care Cancer Off J Multinatl Assoc Support Care Cancer. 2016 Jun;24(6):2541–8.
Gascon B, Panjwani AA, Mazzurco O, Li M. Screening for Distress and Health Outcomes in Head and Neck Cancer. Curr Oncol. 2022 May 24;29(6):3793–806.
Bober SL, Varela VS. Sexuality in adult cancer survivors: challenges and intervention. J Clin Oncol Off J Am Soc Clin Oncol. 2012 Oct 20;30(30):3712–9.
Nipp RD, El-Jawahri A, Moran SM, D’Arpino SM, Johnson PC, Lage DE, et al. The relationship between physical and psychological symptoms and health care utilization in hospitalized patients with advanced cancer. Cancer. 2017 Dec 1;123(23):4720–7.
Fallowfield L, Ratcliffe D, Jenkins V, Saul J. Psychiatric morbidity and its recognition by doctors in patients with cancer. Br J Cancer. 2001 Apr 20;84(8):1011–5.
Holland JC. American Cancer Society Award lecture. Psychological care of patients: psycho-oncology’s contribution. J Clin Oncol Off J Am Soc Clin Oncol. 2003 Dec 1;21(23 Suppl):253s–65s.
Strain JJ, Loigman M. Citation for: Quick reference for oncology clinicians: the psychiatric and psychological dimensions of cancer symptom management. Edited by Jimmie Holland, Donna Greenberg and Mary Hughes. International Psycho‐Oncology Society (IPOS) Press, Charlottesville, VA, USA. 2006. 179pp. ISBN 0‐9785319‐0‐6. USD 20.00. Wiley Online Libr [Internet]. [cited 2024 Dec 17]; Available from: https://onlinelibrary.wiley.com/action/showCitFormats?doi=10.1002%2Fpon.1143
Institute of Medicine (US) Committee on Psychosocial Services to Cancer Patients/Families in a Community Setting. Cancer Care for the Whole Patient: Meeting Psychosocial Health Needs [Internet]. Adler NE, Page AE, editors. Washington (DC): National Academies Press (US); 2008 [cited 2024 Dec 17]. (The National Academies Collection: Reports funded by National Institutes of Health). Available from: http://www.ncbi.nlm.nih.gov/books/NBK4015/
Jacobsen PB, Jim HS. Psychosocial interventions for anxiety and depression in adult cancer patients: achievements and challenges. CA Cancer J Clin. 2008;58(4):214–30.
Comission on Cancer:Standarts and Resources. American College of Surgeons; 2020.
Distress Management Guideline version 1.2025. NCCN; 2024.
Lazenby M, Ercolano E, Grant M, Holland JC, Jacobsen PB, McCorkle R. Supporting commission on cancer-mandated psychosocial distress screening with implementation strategies. J Oncol Pract. 2015 May;11(3):e413-420.
Zebrack B, Kayser K, Bybee D, Padgett L, Sundstrom L, Jobin C, et al. A Practice-Based Evaluation of Distress Screening Protocol Adherence and Medical Service Utilization. J Natl Compr Cancer Netw JNCCN. 2017 Jul;15(7):903–12.
van Nuenen FM, Donofrio SM, Tuinman MA, van de Wiel HBM, Hoekstra-Weebers JEHM. Effects on patient-reported outcomes of “Screening of Distress and Referral Need” implemented in Dutch oncology practice. Support Care Cancer. 2020;28(7):3391–8.
Meijer A, Roseman M, Delisle VC, Milette K, Levis B, Syamchandra A, et al. Effects of screening for psychological distress on patient outcomes in cancer: a systematic review. J Psychosom Res. 2013 Jul;75(1):1–17.
Braeken APBM, Kempen GIJM, Eekers DBP, Houben RMA, van Gils FCJM, Ambergen T, et al. Psychosocial screening effects on health-related outcomes in patients receiving radiotherapy. A cluster randomised controlled trial. Psychooncology. 2013 Dec;22(12):2736–46.
Ma X, Zhang J, Zhong W, Shu C, Wang F, Wen J, et al. The diagnostic role of a short screening tool--the distress thermometer: a meta-analysis. Support Care Cancer Off J Multinatl Assoc Support Care Cancer. 2014 Jul;22(7):1741–55.
Massie MJ. Prevalence of depression in patients with cancer. J Natl Cancer Inst Monogr. 2004;(32):57–71.
Bortolato B, Hyphantis TN, Valpione S, Perini G, Maes M, Morris G, et al. Depression in cancer: The many biobehavioral pathways driving tumor progression. Cancer Treat Rev. 2017 Jan;52:58–70.
Peviani G, Casu D, Mansi W, De Prisco M, Madeddu F, López-Castroman J, et al. Cancer diagnosis and suicide outcomes: prevalence and risk meta-analysis. Eur Psychiatry. 2022 Sep 1;65(Suppl 1):S835–6.
Roderburg C, Loosen SH, Kunstein A, Mohr R, Jördens MS, Luedde M, et al. Cancer Patients Have an Increased Incidence of Dementia: A Retrospective Cohort Study of 185,736 Outpatients in Germany. Cancers. 2021 Apr 22;13(9):2027.
Seeman MV. Preventing breast cancer in women with schizophrenia. Acta Psychiatr Scand. 2011;123(2):107–17.
Shalata W, Gothelf I, Bernstine T, Michlin R, Tourkey L, Shalata S, et al. Mental Health Challenges in Cancer Patients: A Cross-Sectional Analysis of Depression and Anxiety. Cancers. 2024 Aug 12;16(16):2827.
Wang C, Qiu X, Yang X, Mao J, Li Q. Factors Influencing Social Isolation among Cancer Patients: A Systematic Review. Healthc Basel Switz. 2024 May 17;12(10):1042.
Astrow AB, Wexler A, Texeira K, He MK, Sulmasy DP. Is failure to meet spiritual needs associated with cancer patients’ perceptions of quality of care and their satisfaction with care? J Clin Oncol Off J Am Soc Clin Oncol. 2007 Dec 20;25(36):5753–7.
Lambert SD, Girgis A, McElduff P, Turner J, Levesque JV, Kayser K, et al. A parallel-group, randomised controlled trial of a multimedia, self-directed, coping skills training intervention for patients with cancer and their partners: design and rationale. BMJ Open. 2013;3(7):e003337.
Jacobsen PB, Meade CD, Stein KD, Chirikos TN, Small BJ, Ruckdeschel JC. Efficacy and costs of two forms of stress management training for cancer patients undergoing chemotherapy. J Clin Oncol Off J Am Soc Clin Oncol. 2002 Jun 15;20(12):2851–62.
Lin C, Tian H, Chen L, Yang Q, Wu J, Ji Z, et al. The efficacy of cognitive behavioral therapy for cancer: A scientometric analysis. Front Psychiatry. 2022 Nov 7;13:1030630.
Carlson LE, Doll R, Stephen J, Faris P, Tamagawa R, Drysdale E, et al. Randomized controlled trial of Mindfulness-based cancer recovery versus supportive expressive group therapy for distressed survivors of breast cancer. J Clin Oncol Off J Am Soc Clin Oncol. 2013 Sep 1;31(25):3119–26.
Hu J, Wang X, Guo S, Chen F, Wu YY, Ji FJ, et al. Peer support interventions for breast cancer patients: a systematic review. Breast Cancer Res Treat. 2019 Apr;174(2):325–41.
Kabat-Zinn J. Mindfulness. Mindfulness. 2015 Dec 1;6(6):1481–3.
Xunlin NG, Lau Y, Klainin-Yobas P. The effectiveness of mindfulness-based interventions among cancer patients and survivors: a systematic review and meta-analysis. Support Care Cancer Off J Multinatl Assoc Support Care Cancer. 2020 Apr;28(4):1563–78.
Laoutidis ZG, Mathiak K. Antidepressants in the treatment of depression/depressive symptoms in cancer patients: a systematic review and meta-analysis. BMC Psychiatry. 2013 May 16;13:140.
Fuller JT, Hartland MC, Maloney LT, Davison K. Therapeutic effects of aerobic and resistance exercises for cancer survivors: a systematic review of meta-analyses of clinical trials. Br J Sports Med. 2018 Oct;52(20):1311.
