Children with Cancer: The Quality of Life

By Christine Eiser | Go to book overview

3
A History of Psychosocial Care

Summary

Before 1970, survival was relatively poor, and this was reflected in the kind of psychosocial work conducted. The focus was on helping parents to cope with the child's likely death, and ensuring that the child was protected from information about the life-threatening nature of the disease.

As survival improved, especially from the 1970s through to 1990, there was increasing recognition of side effects associated with treatment. These included physical late effects, such as loss of fertility, reduced growth, and endocrine disorders, as well as more psychosocial late effects including compromised social skills and learning difficulties. Other changes during this time included greater recognition of the need to involve children in discussions about their disease, and where possible and appropriate, allowing them some say in decisions about treatment. The focus on defining the deficits or problems experienced by children with cancer and their families slowly gave way to an emphasis on coping or resilience, and attempts were made to identify coping strategies associated with more positive psychosocial outcomes.

During the 1990s, psychosocial work mushroomed, and was characterized by involvement of a greater range of professional (specialist nurses, social workers, dietitians, psychologists) and voluntary organizations. It is apparent that one of the key challenges is understanding why some patients overcome adversity, whereas others find it much harder to manage the undoubtedly adverse implications of the disease. The incidence of

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