Article révisé par les pairs
| Résumé : | The important prevalence of psychosocial problems and psychiatric disturbances that have been reported in oncology, underlines the need for a comprehensive psychosocial support of cancer patients and their families. Psychosocial interventions designed for this purpose should be divided in five categories: prevention, early detection, restoration, support and palliation. Firstly, preventive interventions are designed to avoid the development of predictable morbidity secondary to treatment and/or disease. Secondly, early detection of patients needs or problems refers to the assumption that early interventions could have therapeutic results superior to those of delayed support, both for quality of life and survival. Thirdly, restorative interventions refer to actions used when a cure is likely, the aim being the control or elimination of residual cancer disability. Fourthly, supportive rehabilitation is planned to lessen disability related to chronic disease characterized by numerous cancer illness remission, progression and active treatment. Fifthly, palliation is required when curative treatments are likely to be no more effective, and when maintaining or improving comfort becomes the main goal. Psychosocial interventions are often multidisciplinar with a variety of content. The content of psychosocial interventions range from information and education to more sophisticated support programs including directive (behavioral or cognitive) therapies, or non directive (dynamic or supportive) therapies. Social interventions include usually financial, household, equipment, and transport assistance depending on individual and family needs and resources. These interventions may be combined with the prescription of pharmacological (psychotropic, analgesic...), physical, speech or occupational therapies, especially in rehabilitation programs. Descriptive and empirical studies available today are suggesting the need for truly multidisciplinary and strongly coordinated interventions in order to be significantly effective and to benefit to cancer patients and families. It is important to recall that despite the recognition of the high prevalence of undertreated psychosocial problems and disturbances very few studies have rigorously investigated and evaluated the effectiveness of the here above interventions. These investigations and evaluations are needed to optimize the content of programs and services offered and to improve consequently quality of cancer care in a cost utility perspective. |
