patient
A father said with very sad facial
expression :
( He talked in a very soft-sad voice, his eyes was red and wet )
“....... I feel I was being trapped... Yes
this treatment trapped me and my son.
They pushed me to agree on something
that I hated
very much. I am in a deep resentment.
They acted like salesman promoting
products to buy.
Tell me .....do they guarantee my child
recovery ????
Physically
Psychologically
Socially
Physical Effect of treatment
Pain
Nausea and vomiting
Hair loss
Mucosal ulcers
Anemia, infections and bleeding
Effects on liver, lungs, pancreas, heart,
gonads, etc…..
Pain
Unpleasant sensory and emotional
experience related to real or potential
damage of tissues ( The International
Association for the study of Pain, 1979)
Subjective and unique
Pain sources : real and unreal
Cause stress
Pain Assessment
Believe the patient’s complaint of pain
Assess the severity of the patient’s pain
Assess the psychological state of the
patient
Take detailed history of the complaint of
pain
Perform a careful physical examination
Pain Assessment ( con…..)
Order, and personally review, any
necessary diagnostic investigations
Neurological immaturity
Should be developed
caused a young child will not
really feel the pain
Psychological effects of treatment
Anxiety
Depression
Helpless
Angry
Denial
Boring
Inability to concentrate
Terrifying nightmares, insomnia
Shame
Patient’s conflict
Good patient role ?
Expected to be
• cooperative,
• dependent,
• helpful
• pleasant
• quiet
• without demanding
excessive attention
Feeling to be understood
Faster Acceptance process
Faster adjustment process
Better coping
Social effect of treatment
• Inactive in social life social isolated
• Expensive medical cost
• Other expenses
• Social labeled / stigma
• worried about financial fulfillment for the
other family member
Social Support
• Emotional
• Instrumental
• Information
• Appraisal
Social support perceived by
leukemia children and parents
( Gamayanti, 2002 )
Emotional support :
- Influenced by parents
emotions, especially mother