Insights from hospital-based psycho-oncology consultations during the COVID-19 pandemic

Resumo

Introduction. The work of hospital psychologists aims to address the psychological and social needs of patients and their families through psychological assessment, follow-up, and psychotherapeutic intervention.

Goals. To characterize the main complaints presented by adult patients attending clinical psychology and psycho-oncology consultations during the COVID-19 pandemic at a hospital in northern Portugal.

Method: Data were collected during a curricular internship through clinical record review. Data source was an electronic clinical registry system used to support psychological consultations, gathering sociodemographic, physical, emotional, psychological, and social information, as well as clinical notes regarding the patient and their family.

Results: The sample included 25 patients (mean age = 51.5 years, SD = 12.8), the majority female (n = 20). Ten participants were aged between 50 and 60 years, 13 resided in the municipality of Vila Real, and 16 lived in rural areas. Regarding education, 13 patients had completed primary school, six secondary school, and six higher education. All but one lived with relatives (collateral, ascendant, or descendant). Most were married or in a de facto union (n = 18). Three cases were unrelated to oncological disease. Among oncological cases, 15 involved breast cancer, and 16 patients were undergoing active treatment. Most (n = 16) had undergone surgery within the previous 12 months. Six patients reported physical pain during consultations. The most frequent reasons for referral were anxiety, sadness, and depression, with most referrals originating from medical oncology (n = 16) and psychiatry (n = 5). Additional issues identified included personal and family crises, interpersonal conflict, and experiences of domestic or marital violence. The most frequently used interventions were psychoeducation, emotion identification, cognitive restructuring, and correction of maladaptive beliefs.

Discussion: The findings are consistent with the literature on predictors of psychological distress in oncology, including emotional suffering, previous cancer history, self-perceived diagnosis/prognosis, social support, sociodemographic characteristics, and coping strategies.

Conclusion: During the pandemic, psycho-oncology consultations were significantly influenced by pandemic-related factors. Many patients faced additional personal and family difficulties, including violence and alcoholism. Psycho-oncology provides a therapeutic context in which psychological phenomena intertwined with personal, family, and social experiences can be better understood and addressed, thereby reducing dysfunction in patients and their families across multiple domains.