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Dissertation

A program for the treatment of psychosocial distress in hospital-based palliative care patients

26 July 2004

Abstract

The dissertation describes a program for clinical psychologists to address the psychosocial needs of terminally ill patients within hospital-based specialist palliative care settings, A review of the literature addressing the prevalence of depression and death distress in palliative care patients is presented, with particular focus on the limited assessment procedures and availability of interventions for the psychosocial difficulties of palliative care patients. An analysis of the need for psychologists within the palliative care system is made, including how experts in the field suggest psychologists would be best be employed and what steps have already been taken to use psychologists in a palliative care milieu. The use of psychologists as evaluators of patient competence for utilization of assisted suicide services, and the procedures for performing such evaluations, are also explored. The proposed program's objectives and design are presented. Program components include assessment procedures for psychosocial problems, including a review of potential standardized measures for this purpose, and cognitive behavioral interventions for depression and anxiety. Causative theories for psychosocial problems in palliative care patients and possible impact of interventions are discussed. The program's financial needs are addressed, Finally, a plan for evaluation of this program will be presented, using valid measures established within the psychological and medical fields.


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