Editor-in-Chief, Associate Professor Yang Ningxi
For patients, cancer is not only a "physical event" that needs to bear the physical pain of the disease and treatment process, but also the patient needs to withstand multiple tests such as psychological and social adaptation. Although technology continues to develop, clinical diagnosis and treatment also pay more and more attention to the care of patients, but in the long course of illness and diagnosis and treatment process, the study of patients' experience of illness is still insufficient, because the subject experience in the patient's disease is the uncertainty (drifting) indication outside of the object observation (hard indicators, gold standards) (often called "general situation" and not taken seriously), which encompasses the pathological expression of the four dimensions of body, mind, society and spirit and its composite overlapping effect, constituting the humanistic pathological signs of the disease. This requires more attention. In the context of Western culture, Noah's Ark is a refuge in disaster, a hope in despair. Social work in the field of health is like the sail of an ark, analyzing the causes and symptomatic interventions of patients from the perspective of human pathology, and bringing love, warmth, hope, confidence and support to patients in suffering. Social workers and medical staff work together to accompany, comfort and witness the lives of patients, helping to improve the overall health level of patients and improve the quality of life. This issue provides a preliminary introduction to cancer social work, summarizes the psychosocial problems of patients and proposes countermeasures, introduces the application of group social work in cancer patients and art therapy, and discusses the direction of future cancer social work expansion.
Executive Editor of this issue
Associate Professor Yang Ningxi
Associate Professor of School of Humanities and Social Sciences, Harbin Engineering University, Master supervisor of Postgraduate Students, Master of Medical Humanities of Peking University, Doctor of Social Medicine of Wuhan University
He has long been engaged in the research of medical humanities, clinical psychological behavior and health and healthy social work
He has served as a reviewer for many SCI and SSCI magazines
He has presided over 2 provincial-level projects and published a number of papers in Chinese and English as the first or corresponding author
He has written 1 monograph and 1 textbook
He has published more than 1 million words of works in media such as Health News
Phase IV
Associate Professor Yang Ningxi recommends: "Art Therapy for Cancer Patients (Part 1)"
The author of this article is Yang Ningxi Qiao Yu zhang ze, School of Humanities and Social Sciences, Harbin Engineering University
Qiao Yu
Master's degree in Applied Psychology, School of Humanities and Social Sciences, Harbin Engineering University
Zhang Ze
The text is as follows
Overview of Art Therapy
Art therapy is the use of art to treat patients' physical and mental illnesses, help patients recover, and maintain health. Art therapy is a dynamic process that requires professional therapists to use different art forms, such as music, drama, painting, dancing and other art forms, to connect the therapists with the patients and help the patients recover. Art therapy has unique advantages, first of all, its audience is wide, not limited by the age and education of the subject, it is easier to approach the subconscious of the subject, to achieve communication with the patient in the mind, is an important auxiliary treatment means for psychological problems and mental illness.
Music, drama, painting, dancing, are common expressions of art therapy. Why can art be used as a treatment? In fact, art is only the implementation of this therapy, but the foundation of art therapy is cognitive psychology, positive psychology, psychoanalysis, and existential psychology.
The most representative of art therapy are music therapy, drama therapy, painting therapy, and dance therapy. We have also said before that the form of action of art therapy, through visual hearing, makes the patient's cognitive processing process and the perceptual experience of artistic processing combined. From a microscopic point of view, art therapy enables patients to express psychological activities in the subconscious in an artistic way, so that patients can find the value and meaning of existence and face life with a positive psychology.
The purpose of art therapy is to explore the possibilities of life growth and mental health development from a macro perspective. Through comprehensive art therapy, we can know the subjective self-world, the objective world around us, and the connection with the people and things around us, which are indispensable and interrelated. The connection between the three can make the patient's psychological growth and sublimation, and adapt to the ever-changing world. The following is a brief introduction to each art therapy.
Experience in the use of art therapy in cancer patients
Art therapy can be used in many aspects of cancer patients, such as reducing emotional distress during treatment, improving patients' cooperation in treatment, promoting children's self-esteem and personality development. Art therapy can also improve cognition and exploration ability, etc., and improve the cognitive ability of cancer patients. Cancer patients generally feel a sense of helplessness in hospitals, and art therapy is a very effective treatment for patients because it provides a way for patients to express themselves freely, and patients can use art to temporarily leave the effects of acute stress events such as malignant tumors, get pleasure in the senses of artistic creation, and reduce their anxiety and fear levels [1].
Favara et al. provides independent rooms and materials for acute leukemia patients to create art, in the whole treatment process, the experimenters found that the experimental group of children will be more active in cooperation with the treatment, especially after the bone marrow puncture, surgery before and after these traumatic treatment methods, the children will take the initiative to ask for artistic creation; while the children in the control group show a high level of resistance and anxiety to the treatment during the entire treatment period, indicating that art therapy can effectively alleviate the children's fear and anxiety about invasive operations. Unfortunately, the authors did not quantify the effectiveness of the artistic interventions, thus limiting their generalizability [2]. Madden et al. conducted a clinical randomized controlled experiment on art therapy, which intervened in art therapy for brain tumor patients in a group of age groups, and after the intervention, compared with the control group, the children in the experimental group showed lower levels of pain, nervousness, nausea, vomiting symptoms, higher joy and excitement, and also showed a higher quality of life in subsequent follow-up [3].
The core of art therapy is communication and communication, it through the form of art, so that patients are more willing, to the medical staff, art therapists, parents to convey their fears, depression and anxiety, in the treatment process, patients can also enjoy peace and pleasure, after getting peace and pleasure, patients can also be in a better state to receive the necessary treatment.
Councill's team's research found that when patients show resistance and resistance to treatment, accompanying education in artistic creation will achieve better results than doctor-ordered instructions, and patients will also show less rebellious and aggressive behavior in treatment; At the same time, patients will show better cooperation after art therapy intervention at the next treatment. In the hospital, the patient has always been the focus of medical staff and family members, but in the artistic creation, the patient's work becomes the focus, and this focus shift brings the patient a relaxed and pleasant atmosphere, and in this creative environment, the patient will be willing to say more and perform more, which will improve the degree of treatment cooperation and reduce their anxiety, fear, and depression [4]. Rollins et al. research on tumor patients found that regardless of the patient's gender, cultural background and socioeconomic status, in art therapy, therapists can always find some problems that patients do not want to say in ordinary conversations (such as parents often quarrel, domestic violence, etc.), family factors have an important role in the patient's emotions, to improve the patient's treatment cooperation, sometimes the education of the family is more important than the education of children [5]. Massimo et al. found through conversations with patients that art therapy is actually a process of self-healing and self-esteem for patients, during which there will be constant psychological conflicts, and the author suggests that if a counselor can participate in the discussion and analysis in the patient's creative process, it will be of better help to the child [6]. The following are the more mainstream music therapies in specific art therapy.
musicotherapy
As one of the methods of psychotherapy, music therapy has been widely used in different fields in recent years. It involves psychology, medicine, music and other fields, using the characteristics of music that is widely loved and used by people, as a unique psychological therapy application in the psychotherapy of clinical cancer patients.
From the 17th century onwards, physicians and practitioners consciously discovered the therapeutic role of music from the perspective of physiology and psychology. Music was originally seen as a means of relaxation and stress reduction, which can give comfort to patients, freeing them from the troubles of life, the fear of things and the anxiety of facing stress. The practical application of music therapy in modern times in Western countries began in the 18th century. It is generally believed in the psychological community that the first scientist to make practical applications of music therapy was I.M. Allutshoula, who first used music on patients at the end of the 18th century to match the emotional and spiritual responses of patients, and found that listening to music had a benign effect on the treatment of mentally ill patients. Watson's behaviorist view of psychology has a basic assumption that all behaviors can be acquired through learning. Some negative reactions, such as anxiety, panic, nervousness, depression, many of which respond accordingly after being stimulated accordingly, are established through conditioned reflexes after learning. If the intervention of music therapy is included in the illustration of the conditioned reflexes of negative reactions such as anxiety, panic, nervousness, and depression, then these negative reactions may be alleviated by the intervention of music therapy during the course of action.
Music therapy is divided into two categories, active and passive, namely active music therapy and passive music therapy. Active music therapy is also called live interactive active music therapy, in which patients participate, either as the creator of music or as a performer of music, describing how music brings themselves and expressing their emotions with the help of music. If it is cheerful music, it can promote the secretion of dopamine in the body and stimulate the patient's inner happy emotions; such as the creation and performance of sad music, it can enable patients to vent their bad emotions with the help of sub-music, remove the inner "garbage", and thus promote physical and mental health. Passive music therapy is also called receptive music therapy. Playing music by others, the patient, as a listener, focuses on feeling the music, integrates himself with the music, and regulates his emotions with the help of music expression, so as to achieve the effect of promoting the healthy development of the body and mind.
As an adjunctive therapy, music therapy is increasingly applied to the surgical treatment of cancer patients to alleviate adverse reactions before and after surgery. Previously studied the effect of music therapy on patients' postoperative pain, taking 60 patients with advanced lung cancer as participants, the experimental group carried out 15 minutes of music intervention before surgery, and after the operation, the patient entered the intensive care unit, and gave patients 1 hour of music therapy intervention at 4 time points after surgery, three hours, seven hours, fifteen hours, nineteen hours, and both groups of patients received sufentanil analgesia treatment, and the results of the study showed that the effect of music therapy combined with drug analgesia treatment was much better than that of using drugs alone Music therapy not only lowers the patient's blood pressure and heart rate, reduces postoperative anxiety, but also reduces the frequency and dosage of analgesics [7].
Sabo et al. studied the effect of music therapy on the degree of anxiety caused by chemotherapy, randomized 97 cancer patients, and the experimental group adopted the treatment method of conventional treatment combined with music, and the control group was given conventional treatment, and the results found that compared with the control group, the anxiety score of the patients in the experimental group decreased (P<0.01), but the side effects of chemotherapy were not significantly improved (P>0.05) [8]. Lesiuk conducted a four-week music intervention with breast cancer patients for one hour each time, and found that music therapy improved the patient's bad mood and made it easier for patients to relax from mental exhaustion [9]. Cai Guangrong et al. randomly divided 182 patients with clinically confirmed malignancy into a 2:1 treatment group in the control group. The treatment group performs a dual operation of music therapy and conventional anti-tumor therapy. The control group received only conventional antitumor therapy. The emotional profile of both groups was measured using the HamiltonIan Depression Scale (HAMD). The results showed that the symptoms of early awakening, constitutional symptoms, difficulty falling asleep, and suspected disease were improved in the treatment group (P<0.05), and depression, difficulty falling asleep, and mental and physical anxiety were significantly improved (P<0.01) [10].
In addition, music therapy is also used in the families of cancer patients. For example, Burns et al. used music therapy for families of hospice patients to see if music therapy could affect the mental health of their families, and the results showed that patients who received music therapy were more likely to discuss their physical and mental conditions with their families and health care providers, and believed that music therapy could provide them with positive spiritual support [11]. In short, in the oncology ward, social workers can work with therapists to perform appropriate artistic treatment on patients to improve the patient's mental health level.
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To be continued
Stay tuned · Issue 5
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