A Role of Clinical Psychologists in Terminal Care for Cancer Patients

Abstract

Background and purpose: Terminal stage cancer patients often demand psychological care to retain quality of her/his life. The purpose of the present study is to report palliative interventions by a clinical psychologist for a patient with terminal stage breast cancer and coexisting long-term depression. Case report: The patient was a female of 49-years-old that had a history of an operation for right breast cancer and thereafter developed brain and left femoral metastases. The patient showed symptoms of anxiety neurosis due to depression and deteriorated activities of daily living after orthopedic operation for left femoral pathologic fracture. To palliate these symptoms, a clinical psychologist, a member of palliative care team made interventions alone and with members of treatment team and/or her family. The interventions were made through interviews of 30-minutes, twice a week, a total of 30 times for 6 months. Discussion: The psychologist recognized not only patient’s anxiety for cancer progression but also negative thinking mainly due to depression in the one-to-one interviews. The recommendation of the psychologist to be positive thinking and behavior could reduce the psychological symptoms. The psychologist organized conferences of a variety of medical staff and transferred information about patient’s psychological aspects, which facilitated effective communication between the patient and medical staff. Patient’s family attended the interviews with the patient to realize psychological problem and the attendance made them possible to collaborate on the palliative care. Conclusion: A clinical psychologist intervention was effective in reducing patient’s deteriorated psychological symptoms and enhancing QOL.