|Title||Supporting the Disfigured Patient|
The long-term, often lifetime care of the patient gives the Reconstructive Scientist a unique insight into the psychological wellbeing of this diverse patient group. Clinical Scientists in HSST will support and counsel patients with congenital or acquired defects in the context of Reconstructive Science. In this module the Clinical Scientist in HSST will be able to recognise that disfigurement can have a major effect on quality of life and many patients find it difficult to talk about their disfigurement; this may be associated with fear of recurrence of cancer, grief, or problems of societal reactions to disfigurement, particularly facial disfigurement. This module will equip the Clinical Scientist in HSST with an understanding of disfigurement, the impact of an altered appearance psychologically and socially, the impact on an individual’s body image and that of their carers and family. Clinical Scientists in HSST will develop an understanding of counselling so that they can identify when to refer a patient, empathising to allow dignified patient interactions in the context of prosthetic rehabilitation and the planning and treatment of disease, trauma and congenital deformities.
Knowledge and understanding
By the end of this module the Clinical Scientist in HSST will be able to critically analyse, synthesise and critically apply their expert knowledge with respect to the practice of reconstructive science while working independently within their professional scope of practice, including:
- equality and diversity;
- psychosocial issues that may follow from trauma, disease and surgery;
- social anxiety, depression, bullying, prejudice isolation and exclusion;
- awareness of those parts of the specialty where psychosocial issues can have particular impacts for patients, e.g. burns, cleft, craniofacial, hand, head and neck reconstruction, oncoplastic breast, skin oncology, vascular anomalies;
- the stages of bereavement associated with altered body image, body image disturbance and the clinical and psychological supports that can be put in place to assist the patient to cope with that loss;
- the process by which an individual can successfully adjust to disfigurement and apply these to Reconstructive Science and explain how the MDT can assist with that process;
- theoretical frameworks and professional issues underpinning counselling, including person-centred approach and psychodynamic perspectives;
- key concepts and theories of cognitive behavioural therapy (CBT) and how the technique is used in modern-day counselling practice;
- codes of ethics in relation to ethical issues that may arise during treatment, including safeguarding and the treatment of vulnerable adult and child patients;
- boundaries of professional competence and the importance of referral pathways;
- management of patient’s fears/anxiety as these will be witnessed from pre- diagnosis, receiving bad news, treatment planning, surgery, recovery, etc.;
- theories of health-related behaviour and effects of drugs, allergies and lifestyle factors on patient health and rehabilitation;
- common psychosocial disorders associated with congenital facial deformities, e.g. abnormal psychology, body dysmorphic syndrome, anxiety, depression, psychoses;
- the value of patient groups in group support for individuals faced with facial deformity;
- quality of life outcome measurement tools.
Technical and clinical skills
By the end of this module the Clinical Scientist in HSST will be expected to respond to the needs of individual patients to support them using a range of clinical communication skills while critically reflecting on practice. Clinical Scientists in HSST will be expected to respond to difficult situations independently while recognising when to refer for further support. They will communicate effectively with patients, carers, families, relevant clinicians and other healthcare professionals and will demonstrate the ability to:
- manage patients’ fears/anxiety and be able to empathise with patients in stressful situations, e.g. pre-op;
- recognise the manifestations of anxiety/pain and the range of methods available in their management and control;
- interact on a personal and professional level with terminally ill patients, drawing on your experience, empathising and understanding the patients’ concerns using skills such as active listening;
- provide realistic information and guide patient decision making regarding choices available and timing of those treatments;
- treat the patient as a partner in the decision-making process;
- have the confidence to elicit psychological and social needs in a range of settings;
- if deemed necessary, make an appropriate referral to a clinical psychologist or other supporting member of the MDT.
Attitudes and behaviours
This module has no attitude and behaviours information.