FACTORS WHICH MODIFY THE PERCEPTION OF PAIN: PSYCHOLOGICAL PROBLEMS
Psychological problems are the most common factors to aggravate the perception of pain. The possible causes of psychological distress in patients with cancer are legion. They may relate to the disease, the patient, the social situation, the treatment or the treatment team itself.
Psychological distress is often described simply in terms of anxiety and depression but in practice a wide range of psychological reactions and physical symptoms may be manifest, all representing underlying psychological distress. Such reactions include anger, fear, despair, denial, guilt, grief, sadness, apathy, passivity and avoidance.
The evaluation of a patient with pain necessarily includes assessment for psychological problems and their complexity underlines the importance of a multidisciplinary team in assessment and treatment planning.
Unrecognised or untreated psychological distress will aggravate pain; its absence or successful resolution may greatly improve it.
• Failure to recognise and treat psychological distress is a common cause of unrelieved pain.
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