Appendix B: Psychological needs
Consider a referral to a psychologist, psychiatrist, pastoral/spiritual care practitioner, social worker, specialist nurse or a relevant community-based program if the patient has these issues:
- displaying emotional cues such as tearfulness, distress that requires specialist intervention, avoidance or withdrawal
- being preoccupied with or dwelling on thoughts about cancer and death
- displaying fears about the treatment process or the changed goals of their treatment
- for patients awaiting a transplant, anxiety about transplant outcome, the shortage of organs, the uncertainty of donation and increased understanding that having a transplant may not offer a cure can lead to psychosocial problems (Schulz & Kroencke 2015)
- displaying excessive fears about cancer progression or recurrence
- worrying about loss associated with their daily function, dependence on others and loss of dignity
- becoming isolated from family and friends and withdrawing from company and activities that they previously enjoyed
- feeling hopeless and helpless about the effect that cancer is having on their life and the disruption to their life plans
- struggling to communicate with family and loved ones about the implications of their cancer diagnosis and treatment
- experiencing changes in sexual intimacy, libido and function
- struggling with the diagnosis of metastatic or advanced disease
- having difficulties quitting smoking (refer to Quitline on 13 7848) or with other drug and alcohol use
- having difficulties transitioning to palliative care.
Additional considerations that may arise for the multidisciplinary team include:
- support for the carer – encourage referrals to psychosocial support from a social worker, psychologist or general practitioner
- referral to an exercise physiologist or physiotherapist as a therapeutic approach to prevent and manage psychological health
- referral to wellness-after-cancer programs to provide support, information and offer strategies.