Natarajan, P (2013) A Comparative Assessment of Psychiatric Morbidity, Quality of Life and Care Giver Burden in Patients with Malignancy and Patients of Post Myocardial Infarction. Masters thesis, Stanley Medical College, Chennai.
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Abstract
INTRODUCTION : Cancer is definitely a life threatening clinical entity and the Incidence of Cancer is on the rise. The world wide death toll is about 12% Of all diseases(1) and the prevalence of cancer may increase from 11.3 Million patients in 2007 to about 15.5 million by the year 2030(1). According to the International Agency for Research on Cancer of WHO, it has been estimated that the death by cancer in India in the year 2010 about 555000(10). The incidence of cancer in India,(11) lung &bronchus first common, prostate being the second, followed by breast And colorectal and other common cancers are pancreas, stomach and Cervix uteri. For centuries, it had been believed that ” cancer equals death”(Jimmie Holland) (40). Even in this modern era of treatment, people still have the Belief that, pain and death from cancer is inevitable(3). Cancer is potentially a dangerous illness, which can have a definite Disturbances in the physical as well as psychological wellbeing of the Individual with the cancer and thereby affects the emotional and financial Needs of family members and their care givers. The patients of cancer with metastasis, who were previously found to Be more fatal, they now turned out to be long time survivors with Advancement in treatment modalities. They need palliative care which May have impact on both the patients and the care giver’s physical and Psychological morbidity and increases the care giver burden. The diagnosis of malignancy itself can cause significant psychological Distress called as sixth vital sign. The commonest psychiatric morbidity Seen with cancer patients is depression and once it was considered as the Only emotional reaction of the cancer patients. The previous studies Conducted on the out patient cancer population, reported 34% to have Clinically significant level of psychological disturbances. The studies From USA also confirmed these findings(3)(4) and it is been found that in Indian settings also about 38% of cancer patients have identifiable Anxiety or depressive disorder. In most of the patients with cancer, at advanced stage of illness and Even with difficult state of health, prefer to stay at home than at the Hospital(44,45,46) and they are taken care by their family members either Spouse, daughter and son or parents and in some cases by relatives and They are called as primary care givers. Most of these patients avoid long Term hospital stay except for treatment periods and data from some Studies also confirmed these findings(47,48,49). In the early stage of illness, the diagnosis of cancer and the treatment Is having more impact on psychological morbidity, and in the advanced Stage of illness, the physical problem and imminent death are causing More distress and increasing the decline in the quality of life and burden To the care givers. Recent studies have proved, each diagnosis and modality of treatment Has varied impact on the psychological morbidity, quality of life and care Giver burden and overall outcome in the patient. The fear of incurability, pain, disfigurement, recurrence of disease and Sense of helplessness are the major sources of continuous distress in Cancer patients. A similar life threatening medical illness is myocardial infarction(MI). Many studies have enumerated the relationship between the myocardial Infarction and the psychological factors and found to have affected the Outcome as well as the quality of life of the patient. In the causation of myocardial infarction, diabetes mellitus, Hypertension, smoking, increased low density lipoprotein and type A Personality are direct risk factors. The genetic factors also play a strong Role in the causation of ischemic heart diseases. Myocardial infarction causes 11% to almost 50% of all deaths in many Developed countries and one of the important cause of death in Developing countries. In a study, about 33% of patients with myocardial infarction developed Depression and it is also found that there is increased mortality rate after Myocardial Infarction in depressed patients than in non depressed Ones(52,53) and it is been proved that lower education, poor income, Increased stress, lack of social support are all related to the decline in Outcome in these patients(54).The increased burden caused by depression And anxiety following any other co morbid medical illness also has a Negative impact in the outcome in myocardial infarction patients. It is a proven fact that, relief of psychiatric morbidity in patients with Myocardial Infarction improve daily activities, productivity and cost Effects to the health services. This has a definite impact on the long term Survival and treatment outcome and also the quality of life. It also Increases the burden of the primary care givers. Now a days, much of the burden of care is been shifted from health Care professional to the patients and their family members. So the Importance of care giving and neglect of health of the care giver are Under further research as their burden is not expressed especially in the Indian cultural background. In India, the studies focused on life threatening illnesses with Psychiatric morbidity, quality of life and care giver burden are less Compared to western world , hence this study is undertaken to assess These factors in a tertiary care hospital.
| Item Type: | Thesis (Masters) |
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| Uncontrolled Keywords: | Psychiatric Morbidity ; Quality Life ; Care Giver Burden ; Patients Malignancy ; Patients ; Post Myocardial Infarction. |
| Subjects: | MEDICAL > Psychiatry |
| Depositing User: | Subramani R |
| Date Deposited: | 19 Aug 2017 02:55 |
| Last Modified: | 19 Aug 2017 02:55 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/1933 |
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