Ps della Salute

[tanatoss]

Buonasera a tutti/e molti di voi sanno che mi occupo di psiconcologia in qs momento lavoro in un Dipartimento di Cure Palliative all'interno di una ASL.
In qs giorni la mia responsabile mi ha fatto incontrare i primari di quattro reparti dell'ospedale afferente alla ASL che hanno richiesto la mia presenza per un certo numero differente di ore.
Si tratta del Centro Trapianti, della Rianimazione, della Neurologia e soprattutto della Ginecologia.
L'obiettivo è di inserire lo psicologo esperto in tanatologia in ogni contesto ove è o può essere presente l'evento morte.
Se è vero che mi sono già occupata di pz con SLA e dei loro familiari non mi è mai capitato di intervenire nelle situazioni di espianto e trapianto; ecco quindi il mio primo HELP a tutti voi.
Vi chiedo se siete a conoscenza di testi, siti, articoli relative al sostegno dei familiari che devono firmare il consenso e quindi staccare le macchine che tengono in vita il loro caro.
Se addirittura alcuni di voi lavorano nel settore sarebbe per me un onore poter confrontarci ed imparare qs difficile sostegno familiare.
Rispetto al reparto di Ginecologia oltre alla PPD, alla formazione e supervisione al gruppo di lavoro e agli interventi sulla fecondazione assistita mi è stato chiesto un progetto di formazione per gli operatori che si trovano ad affrontare aborti terapeutici in una gravidanza avanzata oltre naturalmente all'intervento sull'aborto spontaneo e volontario.
Anche in qs caso il punto che più mi perplime è quello relativo all'intervento sull'aborto terapeutico proprio per prevenire burnout degli operatori e migliorare la comunicazione. Vi rivolgo il secondo Help chiedendovi testi, articoli, siti ed esperienze di chi già lavora in qs contesto.
Sono certa che saprete darmi una mano
GRAZIE

[scianica]

ciao tanatos anche io mi occupo di psiconcologia, ma sappiamo benissimo che un settore tutto da sperimentare. Vorrei poterti aiutare ma sono quasi nella tua stessa situazione. Nell'ultimo periodo mi giungono richieste da parte di pazienti di costituire un gruppo di sostegno, infatti ci sto pensando. L'unica cosa che posso dirti che sta funzionando veramente è lo scrivere ( lettere a persone care, oppure fare un diario della propria vita) questo lo puoi utilizzare con pazienti e familiari. Tieniami aggiornate e spero di poterti aiutare.

[willy61]

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Psychological Assessment of Candidates for Solid Organ Transplantation. Collins, Charlotte A.; Labott, Susan M.; Professional Psychology: Research and Practice, Vol 38(2), Apr 2007. pp. 150-157. [Journal Article] Abstract: The role of psychologists, who can assist in preparing clients for transplant surgery and support them postsurgery to sustain the complex maintenance protocol, is outlined. An overview of specific procedures used in the psychological evaluation and treatment of solid organ transplant patients, a discussion of general issues involved in treating these patients, and case vignettes are provided. As transplants become more common, the need for additional psychologists as part of multidisciplinary treatment teams increases. Because many patients live great distances from the transplant center, community psychologists may be enlisted to treat organ transplant patients and to collaborate with psychologists on transplant teams. (PsycINFO Database Record (c) 2008 APA, all rights reserved)

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How does psychological processing relate to compliance behaviour after lung transplantation? A content analytical study. By: Goetzmann, L.; Moser, K. S.; Vetsch, E.; Klaghofer, R.; Naef, R.; Russi, E. W.; Buddeberg, C.; Boehler, A.. Psychology, Health & Medicine, Jan2007, Vol. 12 Issue 1, p94-106, 13p, 4 charts, 1 diagram Abstract: Non-compliance is one of the crucial problems impairing outcome after transplantation. Fourteen lung transplant recipients were interviewed about their thoughts regarding transplant-related topics. Compliance was assessed by doctors. The psychological processing was investigated by content analysis. Highly compliant patients perceived more advantages by transplantation. In contrast, low-compliant patients reported either an emotional distance to the lung or a closer relationship to the donor. Furthermore, they showed a contradictory relationship to the medical staff. There are some indications that perception of advantages by transplantation is crucial to compliance. This experience takes place in the context of a good staff – patient relationship. Emotional distance to the lung or nearness to the donor are further contributing factors of non-compliance. [ABSTRACT FROM AUTHOR] DOI: 10.1080/13548500600780465 (AN 23022151)

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Shared decision making in deceased-donor transplantation. By: Ross, Lainie Friedman; Zenios, Stefanos; ThistlethwaiteJr, J. Richard. Lancet, 7/22/2006, Vol. 368 Issue 9532, p333-337, 5p; Abstract: The article discusses the ideal shared decision making procedure used to determine the viability of kidneys donated from deceased patients. Due to the increase in demand, doctors are now forced to consider using organs of poorer quality. These kidneys have a higher chance of transplantation failure and of complications. Because of these risks, shared decision making is important. The process acknowledges both the doctor's medical knowledge and the patient's preferences. It can also help hold doctors accountable to their own preferences and prejudices. A grading system that can be used by doctor and patient is essential to facilitate shared decision making. DOI: 10.1016/S0140-6736(06)69078-8 (AN 21638355)

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Parental Grief Following the Brain Death of a Child: Does Consent or Refusal to Organ Donation Affect Their Grief? By: Bellali, Thalia; Papadatou, Danai. Death Studies, Dec2006, Vol. 30 Issue 10, p883-917, 35p, 1 chart, 1 diagram Abstract: The purpose of this study was to investigate the grieving process of parents who were faced with the dilemma of donating organs and tissues of their underage brain dead child, and to explore the impact of their decision on their grief process. A grounded theory methodology was adopted and a semi-structured interview was conducted with 11 bereaved parents who consented to, and 11 parents who declined organ donation. Findings suggest that the core themes that characterize their grief and the main variables that affect their grieving process are similar for both donor and non-donor parents. Consent or refusal of organ donation per se does not seem to affect the overall grieving process. It is the meaning attributed to the act of donation that affects how parents perceive the child's death and subsequently facilitate or hinder their adjustment to loss. [ABSTRACT FROM AUTHOR] DOI: 10.1080/07481180600923257 (AN 22493956)

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Dead Enough? The Paradox of Brain Death. By: Chen, Pauline W.. Virginia Quarterly Review, Fall2005, Vol. 81 Issue 4, p130-137, 8p, 1c; Abstract: This article presents an essay on cadaveric donors. Cadaveric donors make up the majority of organ donors in the U.S. Like their counterparts in hospital morgues, they possess all the official paperwork necessary to prove their status, including the appropriate certificates and scrawled physician notes that detail the time and date of death. There is one notable difference between cadaveric donors and their mortuary peers, however, the brain-dead hardly seem dead. They are warm, with skin that seems capable of blushing. Their chests rise and fall so convincingly with each breath that the ventilator at the head of the bed seems like superfluous machinery rather than the source of the air that fills their lungs. (AN 18454848)

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Life and Death Decisions: Using School-based Health Education to Facilitate Family Discussion about Organ and Tissue Donation. By: Waldrop, Deborah P.; Tamburlin, Judith A.; Thompson, Sanna J.; Simon, Mark. Death Studies, Aug/Sep2004, Vol. 28 Issue 7, p643-657, 15p, 2 charts Abstract: Public education that encourages family discussions about organ and tissue donation can enhance understanding, facilitate a donor's wishes and increase the numbers of donations. Action research methods were used to explore the impact of a student-initiated family discussion about donation. Most discussions were positive; only 7% middle school and 4% high school participants described them as “terrible.” “Getting it started” was the most difficult. High school students felt “very” or “somewhat” prepared, whereas middle school students only felt “somewhat prepared”. Guided family discussions ensure that families have accurate information about donation and an opportunity to talk about end-of-life choices in a non-crisis situation. [ABSTRACT FROM AUTHOR] (AN 14352648)

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Death of a Child in the Emergency Department. By: Knapp, Jane; Mulligan-Smith, Deborah. Pediatrics, May2005, Vol. 115 Issue 5, p1432-1437, 6p, 2 charts Abstract: Of the estimated 40 000 American children ≤14 years old who die each year, approximately 20% die or are pronounced dead in outpatient sites, primarily the emergency department (ED). The ED is distinguishable from other sites at which children die, because the death is often sudden, unexpected, and without a previously established physician-patient care relationship. Despite these difficult circumstances and potentially limited professional experience with the death of a child, the emergency physician must be prepared to respond to the emotional, cultural, procedural, and legal issues that are an inevitable part of caring for ill and injured children who die. All of this must be accomplished while supporting a grieving family. There is also a responsibility to inform the child's pediatrician of the death, who in turn also must be prepared to counsel and support bereaved families. The American Academy of Pediatrics and American College of Emergency Physicians collaborated on the joint policy statement, "Death of a Child in the Emergency Department," agreeing on recommendations on the principles of care after the death of a child in the ED. This technical report provides the background information, consensus opinion, and evidence, where available, used to support the recommendations found in the policy statement. Important among these are the pediatrician's role as an advocate to advise in the formulation of ED policy and procedure that facilitate identification and management of medical examiners' cases, identification and reporting of child maltreatment, requests for postmortem examinations, and procurement of organ donations. [ABSTRACT FROM AUTHOR] DOI: 10.1542/peds.2005-0317 (AN 16786681)

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POST-MORTEM ORGAN DONATION AND GRIEF: A STUDY OF CONSENT, REFUSAL AND WELL-BEING IN BEREAVEMENT. By: Cleiren, Marc P. H. D.; Van Zoelen, Ada J.. Death Studies, Dec2002, Vol. 26 Issue 10, p837-849, 13p, 1 chart Abstract: Concern about the grief processes of organ donors' families are reported by medical staff as a reason not to ask for organ donation. Objectives of the current study were to examine the relation between consenting to a post-mortem organ donation procedure and subsequent process of grief in the bereaved. A cross-sectional survey was conducted in a representative time-sample of 95 bereaved who lost a first-degree family member on intensive care wards in 27 Dutch hospitals. In 36 cases an organ donation procedure took place, in 23 cases consent was refused, and in 36 cases no request for organ donation was made to the bereaved.The authors found there were no differences in levels of depression and problems with detachment from the deceased between bereaved (first-degree family members) who participated in an organ donation procedure, those who refused consent, and families who were not approached for post-mortem organ donation. No differences were found in levels of main outcome measures between three donation conditions. However, dissatisfaction with hospital care was associated with depressive and grief symptoms.The results indicate that consenting to organ donation in itself neither hinders nor furthers the grief process. [ABSTRACT FROM AUTHOR] DOI: 10.1080/07481180290106607 (AN 8615723)

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A RECONNECTION WITH LIFE: HELPING DONOR FAMILIES COPE AFTER LOSS. By: Maloney, Raelynn. Journal of Personal & Interpersonal Loss, Oct-Dec98, Vol. 3 Issue 4, p335-348, 14p; Abstract: The article presents a case study relating to organ donation. The tragic and untimely death of a family member, especially a child, elicits intense emotions and reactions. From the moment of conception, parents have images of their child and their future. The experience of missing a loved one, a major part of grief that a parent feels, is not just a longing for the physical presence of that child, it also involves the vanishing of hopes and, dreams of that child's future. Conventional grief therapy is not enough for most donor families, because their issues are not limited to grief. Donor families experience the path of a loved one's death and the joy of continued life, a paradox. Effective support must address the unique realities these families face. Organ donation does not take away the pain, but knowing that you have helped others start new lives makes it a little more bearable. In January of 1995, 15-year-old boy, Gory, was walking to his grand-parents' house after freshman basketball practice. He was crossing the street, one he had literally crossed hundreds of times before, and he was struck by a speeding motorist, resulting in a massive head injury. After an agonizing night, it became apparent that Cory's and the doctor's battle to save his young life would be lost. Then his parents decided to donate organs of Cory. Organ and tissue donation is a bittersweet miracle. The donors are heroes in the eyes of many, and they will never be forgotten. (AN 1170254)


buona vita

[tanatoss]

Per Scianica: Grazie che piacere leggerti ti avevo cercato molto tempo fa perchè avevo letto che ti occupi del mio settore.... buonissimi spunti grazie ancora


Per Willy: GRAZIEEEEEEEEEEEEE!!!!!! Non ho parole sei stato magnifico. Ora mi metto a cercare e leggere, cercare e leggere.........

Thanck

[beatricekuei]

salve a tutti!
io sono una giovane appena entrata a lavorare come psicologa e sono ancora del tutto ingenua rispetto al come muoversi e al come farsi strada nel campo della psicooncologia che è quello dove mi stò specializzando. Per questi tempi stò accettando lavori all'interno della psicologia del lavoro tanto per pagarmi la scuola di specializzazione ma vorrei entrare a lavorare negli ospedali come faccio durante i tirocini. La mia domanda quindi è questa: come fate a collaborare con le asl? lavorando come orientatrice del lavoro per universitari mi rendo conto che gran parte dei concorsi è bloccata, quindi come fate a collaborare? con delle coperative esterne? grazie a tutti

[scianica]

Ciao Beatricekuei certamente il percorso non è facile sicuramente l'attività di tirocinio e di volontariato potrà aiutarti molto a fare questa esperienza.

[dillyswim]

Scusate se mi intrometto,...la mia è una richiesta orientativa, la psiconcologia mi interessa molto come futuro ambito di impiego ma dato che mi aspettano ancora due anni di specialistica sto solo fantasticando. Era mia curiosità capire quale fosse la formazione che vi ha condotti a praticare nel settore: l'indirizzo nella specialistica, se occorre essere psicoterapeuti...ecc,?
sapete indicarmi se esistono associazioni o strutture che prevedono questo servizio a Bologna o dintorni?
....Grazie!