Psychology and Sociology / Clinical Psychology

Tkachenko G.A.

Of N.N.Blokhin Russian Cancer Research Center RAMS, Moscow

Features of psychological care of patients with cancer of the larynx after laryngectomy

Among the malignant tumors of the head and neck has a significant share of throat cancer [1]. In the treatment of this disease in most cases, surgical procedures are performed. The incidence of tumor, unfortunately, often restricts the use of conservative surgery, so patients performed a laryngectomy (complete removal of the larynx). The consequence of this treatment are respiratory disturbance and voice-functions, which leads to isolation of human communication, and ultimately to disability [1]. Such patients need psychological help and support.

Objective of the study - to develop effective methods of psychological care of patients with laryngeal cancer after laryngectomy.

At present, the world is widely used methods of group therapy. Group's effective in improving adaptation of the patient, as they stimulate a more open expression of feelings and emotions. However, this method is not applicable to this group of patients because of a violation of voice-functions after laryngectomy.

Individual method provides better performance than the group as all the attention is directed psychologist for one person only. This helps to better understand the patient removes the psychological barriers that inevitably arise in the presence of other people.

It should be noted that for these patients is very difficult to talk about their problems, because, as mentioned above, is a speech disorder. Only by drawing the patient is able to express themselves, their feelings and their condition. The task of the psychologist - to provide the most appropriate means of self-expression patient.

The possibility of psychological help when working with cancer patients significantly increased with a combination of different therapies, however, I would like to elaborate on the art-therapeutic method. Using exclusively techniques of art therapy helps to improve overall physical and mental condition of the patients. The effectiveness of art is based on the fact that this method can optimize the emotional sphere, explore and express emotions and feelings on a symbolic level [2].

In the process of art therapy changes the relationship of man to his own traumatic experiences, feelings, and psychotherapeutic effect is achieved in the sequencing of psychosomatic processes. The objectivity of the data is confirmed by psychophysical studies [3].

Art therapy - is one of the methods of psychological work, when the possibilities of art are used to effect positive change in the intellectual, social, emotional and personal development of the individual. The method is based on the assumption that a person can reflect his inner world in a visual way that helps the patient to get rid of many of the negative processes: fear, anxiety, unpleasant experiences, even the pain. Techniques of art therapy can reduce emotional stress, irritability, increase vitality.

Of the total funds of art therapy is used by us, is more often used to work with pattern, since this kind of art is the most secure way to relieve stress [4].

Today, there are quite a few different methods and techniques of working with patterns. Our experience shows that these are very effective methods of working with a pattern, "health and disease", "mood", "tree of life".

To study the efficacy of this therapeutic modality in working with patients was conducted clinical and psychological study, which was attended by 18 patients aged 35 to 56 years who are treated at the tumor cranio-maxillo-facial RCRC RAMS for cancer of the larynx. Each patient was performed 5-6 individual lessons on art therapy 2 times a week lasting 30 to 60 minutes. Psychological testing conducted before and after the course of art therapy.

To detect disorders of emotional sphere used hospital anxiety and depression scale (HADS). Taken into account when interpreting the results of the total index for each scale, with 3 of its allocated range: 0 - 7 - "normal" (no significantly pronounced symptoms of anxiety and depression), 8 - 10 - "subclinical severe anxiety / depression"; 11 and above - "clinically severe anxiety and depression."

For a comparative analysis using the parametric Student's t-test. The text presents the arithmetic mean and the error of the mean (M ± m).

Quantitative data analysis techniques before and after art therapy showed a decrease in anxiety in the surveyed patients, respectively, with 8, 6 ± 0,5 to 7,4 ± 0,3 points. Although no significant differences were found these quantities (t-Student = 1,09, p> 0,05), while in patients after the course of therapy art there is a clear improvement of dynamics being, reduce the total voltage. Patients have become more active, which reduces the appearance of the doldrums.

Qualitative analysis test showed that depressive symptoms of varying severity at baseline was observed in the majority of patients (88.9%). Half of the patients indicated a high level of depression. After a course of art therapy significantly decreased the number of patients with high levels of depressive symptoms (16.7%) and increased the number of patients without depression (38.9%).

Our experience clearly demonstrates the effectiveness of the use of art therapy in working with patients with cancer of the larynx.

Literature

1. Balatskaya L.N., Kitsmanyuk Z.D., Chizhevskaya S.Y. Current status of rehabilitation of cancer patients with tumors of the head and neck / / Siberian Journal of Oncology, 2002. - № 1. - P.50-53.

2. Kopytin A.I. Theory and practice of art therapy. - St. Petersburg. : Peter, 2002. - 368 p.

3. Lebedeva L.D. The practice of art therapy: approaches, diagnostics, system training. - M., 2008. - 256 p .

4. Tkachenko G.A. Psychological help cancer patients with the use of art therapy. / / Bulletin of psychotherapy. - 2010. - № 33 (38). - P. 65-69.