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Table 3 Examples of strategies to address patient distress

From: A randomised trial of a psychosocial intervention for cancer patients integrated into routine care: the PROMPT study (promoting optimal outcomes in mood through tailored psychosocial therapies)

Type of Distress Specific techniques to address Distress
Practical - finances; difficulty with domestic tasks Referral to Social Work; clarification of concerns; structured problem-solving; challenging black and white thinking about the need to perform domestic tasks; re-assigning priorities.
Family - concerns about children Listening; acknowledgment of concerns; explanation about children's needs; discussion about the benefits of maintaining routine; reassuring children that they have not caused the cancer.
Emotional - anxiety about chemotherapy Explanation; identification of automatic thoughts; challenging negative cognitions; relaxation and guided imagery.
Physical - pain Referral for medical review; exploration of concerns about pain; identifying and challenging misbeliefs e.g. about becoming dependent on analgesia or that use of morphine implies inevitably poor prognosis; relaxation and guided imagery.
Spiritual - shame about dependence, low sense of worth Dignity-conserving techniques e.g. exploration of past experiences, reflection on strengths; engaging in creative discussion about ways to feel in control; framing assistance as necessary to maintain dignity.