Skip to main content Skip to main navigation menu Skip to site footer
Research Articles
Published: 2016-11-15

The psychological distress and psychic phenomena in cancer patients during palliative care

Bogomolets National Medical University
psychological stress psychipathological symptoms palliative cancer patient psychological help palliative medicine


Background. Cancer diagnostics on incurable stages, the transition to palliative care because of disease progression are significant psychological challenges for the patient. Psychological help for cancer patients during palliative treatment is no less important than medical therapy.

Methods. The study was conducted at the Kyiv City Clinical Cancer Center during the 2012 - 2013 years in two phases. In the first phase was provided a psychological investigation of incurable cancer patients and assessed its dynamics during palliative therapy with followed qualitative analysis of the data (n=436 patients). Second phase included determining factors of psychological maladjustment and evaluation intensity of mental distress – participated 63 palliative cancer patients. The SCL-90r used for assessment of psychic distress.

Results. The prominent psychopathological symptoms in incurable cancer patients were somatization, depression and nonspecific symptoms. Less pronounced signs of mental distress in descending order of severity were anxiety, hostility, paranoid ideation, interpersonal sensitivity, obsessive-compulsive, psychoticism and phobic anxiety. Factors of psychological distress in cancer patients during palliative care include high physical distress; the impossibility of total control on physical and psychological symptoms; chronic pain; progressive deterioration of physical well-being; need to use opioids for relief pain; need for help; existential nature of stress; individual psychological characteristics. In patients identified psychological phenomena related to the palliative phase of treatment: psychological induction "pendulum", externalizing of mental stress, decentralization.

Conclusions. Cancer patients in the palliative stage of treatment experiencing intensive psychological distress and clinically constitute a special group with specific psychological needs, which need to be considered in providing psychological care.

Full-text of the article is available for this locale: Українська.


1. Fedorenko, Z. P., Gulak, L. O., Mihaylovich, Y. J., Goroh, E. L., Ruzhov, A. Y., Sumkina, O. V., Kucenko, L. B. (2015). Bulletin of the National Cancer Registry of Ukraine №16: Cancer in Ukraine in 2013 – 2014 years [Bulletin Natsіonalnogo cancer-reєstru Ukraine №16: Rak v Ukrainі 2013 – 2014]. Kiev: National Cancer Institute. Access:
2. Diaz-Frutos, D., Baca-Garcia, E., García-Foncillas, J., López-Castroman, J., Predictors of psychological distress in advanced cancer patients under palliative treatments (2016), Eur J Cancer Care, 25(4), pp. 608 – 615. DOI:
3. Rand, K. L., Banno, D. A., Shea, A. M., Cripe L. D. (2016), Life and treatment goals of patients with advanced, incurable cancer, Support Care Cancer, 24(7), pp. 2953 – 2962. DOI:
4. Bovero, A., Leombruni, P., Miniotti, M., Rocca, G., Torta R. (2015), Spirituality, quality of life, psychological adjustment in terminal cancer patients in hospice, Eur J Cancer Care. [Epub ahead of print] DOI:
5. Haun, M. W., Sklenarova, H., Villalobos, M., Thomas, M., Brechtel, A., Löwe, B., Herzog, W., Hartmann M. (2014), Depression, anxiety and disease-related distress in couples affected by advanced lung cancer, Lung Cancer, 86(2), pp. 274 – 280. DOI:
6. Bužgová, R., Jarošová, D., Hajnová E. (2015), Assessing anxiety and depression with respect to the quality of life in cancer patients receiving palliative care, Eur J Oncol Nurs., 19(6), pp. 667 – 672. DOI:
7. Syrjala, K. L., Jensen, M. P., Mendoza, M. E., Yi, J. C., Fisher, H. M., Keefe F. J. (2014), Psychological and behavioral approaches to cancer pain management, J Clin Oncol., 1; 32(16), pp. 1703 – 1711. DOI:
8. Lee, Y. P., Wu, C. H., Chiu, T. Y., Chen, C. Y., Morita, T., Hung, S. H., Huang, S. B., Kuo, C. S., Tsai J. S. (2015), The relationship between pain management and psychospiritual distress in patients with advanced cancer following admission to a palliative care unit, BMC Palliat Care, 2(14), p.69. DOI:
9. Hui, D., Park, M., Shamieh, O., Paiva, C. E., Perez-Cruz, P. E., Muckaden, M. A., Bruera, E. (2016), Personalized symptom goals and response in patients with advanced cancer, Cancer, 1;122(11), pp. 1774 – 1781. DOI:
10. Kissane, D. W, McKenzie, M., McKenzie, D. P., Forbes, A., O'Neill, I., Bloch, S. (2003). Psychosocial morbidity associated with patterns of family functioning in palliative care: baseline data from the Family Focused Grief Therapy controlled trial. Palliative Medicine, 17 (6), pp. 527 – 537.
11. Nipp, R. D., El-Jawahri, A., Fishbein, J. N., Gallagher, E. R., Stagl, J. M., Park, E. R., Jackson, V. A., Pirl, W. F., Greer, J. A., Temel, J. S. (2016). Factors associated with depression and anxiety symptoms in family caregivers of patients with incurable cancer. Annual of Oncology, 27(8), pp. 1607 – 12. DOI:
12. Kissane, D. W., Zaider, T. I., Li, Y., Hichenberg, S., Schuler, T., Lederberg, M., Lavelle, L., Loeb, R., Del Gaudio F. (2016), Randomized Controlled Trial of Family Therapy in Advanced Cancer Continued Into Bereavement, J Clin Oncol., 1; 34 (16), pp. 1621 – 1927. DOI:

How to Cite

Mukharovska I. The psychological distress and psychic phenomena in cancer patients during palliative care. PMGP [Internet]. 2016 Nov. 15 [cited 2022 Dec. 7];1(1):e010113. Available from: