FIRST, I WOULD LIKE EACH OF US TO ASK OURSELVES A QUESTION: WHAT DOES PREVENTION MEAN TO ME AND WHEN WAS THE LAST TIME I WAS FOR PREVENTIVE TESTS?

PREVENTION MEANS SECONDARY PREVENTION AND SCREENING TESTS, BUT ALSO PRIMARY PREVENTION, WHICH CONSISTS OF CONSTITUTION OF CORRECT HEALTHY LIFESTYLE PATTERNS, E.G. TAKING CARE OF DIET, PHYSICAL ACTIVITY... BUT ALSO PREVENTION, WHICH CONCERNS THE PERIOD DURING THE DISEASE AND CONSISTS OF LIMITING COMPLICATIONS AND STOPING THE PROGRESS OF THE DISEASE.

WHY DO PREVENTIVE TESTS GIVE US ANXIETY?

THERE MAY BE SEVERAL REASONS. THIS IS THE FIRST OF THEM FEAR OF RESULTS, DETECTION OF WORRYING CHANGES AND DIAGNOSIS OF THE DISEASE. IT IS ACCOMPANYED WITH A LITTLE MAGICAL THINKING ON THE PRINCIPLE "IF YOU CAN'T SEE OR FEEL SOMETHING, IT DON'T EXIST" AND "IT DOESN'T APPLY TO ME." OTHER PEOPLE ARE SICK, BUT NOT ME, NOT MY FAMILY. IT'S DIFFICULT TO MOTIVATE OURSELVES TO GO FOR TESTS WHEN WE FEEL GOOD AND NO ONE IN OUR SURROUNDINGS IS SICK. MEANWHILE, REALLY LOOKING, THERE ARE NO ''OTHER PEOPLE''. ANY OF US CAN GET SICK.

SHAME BEFORE THE TEST, UNPLEASE FEELINGS AND FEAR OF ASSESSMENT

OFTEN, THE VISIT TO THE DOCTOR ITSELF IS ACCOMPANYED BY SHAME. WHEN GOING TO AN INTERNIST, FOR EXAMPLE, WE HAVE TO PARTLY UNdress, WHICH MAY BE CONNECTED WITH SHAME ABOUT VIOLATION OF OUR INTIMACY. WE OFTEN HAVE TO SHOW WHAT IS OUR COMPLEX, WHAT WE TRY TO HIDE EVERY DAY. HOWEVER, IT IS WORTH EMPHASIZING THE FACT THAT AT THIS MOMENT WE ARE IN THE ROLE OF THE PATIENT. OF COURSE WE HAVE THE RIGHT TO FEEL DISCOMFORT IN SUCH A SITUATION, BUT AT THIS MOMENT, THE MOST IMPORTANT FOR THE DOCTOR IS OUR HEALTH AND THE PROFESSIONAL SHOULD NOT JUDGE US AT THIS MOMENT. SOME OF THE PREVENTIVE TESTS ALSO INCLUDE NUDITY: BREAST ULTRASOUND, MAMMOGRAPHY, GYNECOLOGICAL ULTRASOUND, CYTOLOGY, OR PER RECTUM EXAMINATION. IT IS WORTH THINKING THAT A GIVEN EXAMINATION AND THE DISCOMFORT RELATED TO IT LASTS ONLY A FEW MINUTES AND CAN SAVE OUR ENTIRE LIFE. ALSO, WHEN THE DISEASE IS DIAGNOSED AT A LATE STAGE, A MORE ACCURATE DIAGNOSTIC PROCESS AND THE ENTIRE TREATMENT PROCESS WILL OFTEN BE COMBINED WITH MUCH MORE FREQUENT EXAMINATIONS AND LESS PLEASANT FEELINGS.

LACK OF AVAILABILITY, COST OR LACK OF TESTS

THIS IS AN ASPECT THAT NEEDS TO BE MENTIONED. I KNOW STORIES OF PATIENTS WHO ASKED FOR TESTS THEY WANTED TO DO THEM PREVENTIVELY, OR EVEN FELT SYMPTOMS, BUT THEY WERE MEETED WITH A DISCLAIMING APPROACH LIKE "WHY DO YOU NEED THESE TESTS?" I DO NOT SEE ANY INDICATION TO DO THEM.'''' YOU ARE TOO YOUNG FOR IT COULD BE CANCER.'' IN SUCH SITUATIONS, IT IS WORTH ASKING YOUR DOCTOR FOR DETAILS, BUT IT'S ALSO WORTH KNOWING YOUR RIGHTS. THE FIRST CONTACT DOCTOR WILL NOT GIVE US A REFERRAL FOR AN MRI, BUT FOR MORPHOLOGY OR ABDOMEN ULTRASOUND. IF A DOCTOR REFUSES TO PERFORM BASIC TESTS, WE CAN ASK FOR THE REASON FOR THIS REFUSAL IN WRITING, AND THIS OFTEN CHANGES THE TURN OF THE CASE IN OUR FAVOR.

SOMETIMES THE WAITING TIME FOR SPECIALIZED TESTS MAY BE LONG, OR THEY ARE NOT IN THE AGE RANGE OF A GIVEN PREVENTIVE TEST FUNDED BY THE NFZ. IF WE FEEL THE NEED TO CHECK IF EVERYTHING IS OK WITH OUR HEALTH, IT IS WORTH DOING SUCH A SHORT EXERCISE AND VISUALIZING THE TEST AND ITS COST ON THE SCALE ON THE ONE HAND AND ON THE OTHER THING THAT WE CAN BUY FOR A SIMILAR AMOUNT E.G. SHOES AND THINK ABOUT THE BENEFITS OF EACH DECISION YOU MAKE. EACH OF US HAS A CHOICE AND IT IS WORTH ANSWERING OURSELVES WHETHER ANOTHER SHOES OR MY OWN LIFE AND HEALTH IS MORE IMPORTANT TO ME AT A GIVEN MOMENT?

HOWEVER, IN THE CASE OF TESTS WHICH WE ARE INVITED TO AND WE CAN USE THEM FREE OF CHARGE, THERE MAY BE THE THINKING THAT WHAT IS FREE IS LESS VALUABLE, AND IF WE RECEIVE THE INVITATION FOR CYTOLOGY OR MAMMOGRAM BY MAIL, UNfortunately we can TREAT IT AS AN INVITATION TO A TASTING OR PRESENTATION OF POTS. WE CAN LOOK FOR A SECOND DNA IN THIS, WHICH IS NOT THERE IN THIS CASE.

IT IS WORTH LOOKING TO SEE IF ANY OF THE MECHANISMS APPEAR IN US AND TRY TO BREAK THEM. MAYBE THE NEXT TIME WE GET SUCH AN INVITATION, WE WILL BE MORE GLAD TO USE IT.

WHAT MOTIVATES US TO RESEARCH AND HOW CAN WE MOTIVATE OURSELVES?

ONE OF THE MAIN REASONS THAT MOTIVATE US TO RESEARCH IS UNfortunately PHYSICAL PAIN. UNfortunately, in the case of cancerous diseases, most of them may be asymptomatic until the late stage, and pain is usually a signal of advanced growth changes. OFTEN THESE MAY BE JUST METASTASIS AND RELATED FEELINGS. CANCER DOESN'T HURT FOR A VERY LONG TIME AND IT'S IMPORTANT THAT WE LOOK RATIONALLY AT THIS ASPECT AND TEST WHEN WE DON'T FEEL ANYTHING YET. THIS WILL NOT PROTECT US FROM GETTING DISEASES, BUT IN THE CASE OF MANY DISEASES, IT CAN PROVIDE A CHANCE TO DETECT CHANGES AT A VERY EARLY STAGE AND THEREBY PROVIDE A CHANCE FOR A FULL TREATMENT.

DISEASE OF OUR LOVED ONES IT CAN BE A STRONG MOTIVATION TO UNDERTAKE PREVENTIVE TESTS AND IT'S GOOD IF THIS HAPPENS. SOMETIMES, IN THE FACE OF A FAMILY MEMBER'S ILLNESS, WE REVALUE OUR LIFE AND ADD MORE VALUE TO OUR HEALTH. BUT IT DOESN'T ALWAYS LOOK THIS WAY. VERY OFTEN, RELATED PEOPLE FORGET ABOUT THEMSELVES AND THEIR HEALTH WHEN DEVOTIONING THEIR CARE TO A LOVED PERSON, AND IN THEIR CASE, IT IS PARTICULARLY IMPORTANT TO TAKE CARE OF THEIR HEALTH, BOTH PHYSICAL AND MENTAL. THESE ARE PEOPLE LIVING IN CHRONIC STRESS AND TENSION, THEREFORE EXPOSED TO LOWER IMMUNITY AND DEVELOPMENT OF VARIOUS DISEASE PROCESSES. THAT'S WHY IT IS SO IMPORTANT EMPHASIZING THE IMPORTANCE OF PREVENTION FOR SUPPORTIVE PERSONS.

OUR BELIEFS ABOUT RESEARCH

IF, AT THE THINK OF GOING FOR PREVENTIVE TESTS, WE FEEL A PINGING IN THE HEART, A TIGHTNESS IN THE STOMACH, MUSCLE TENSION, A HEADACHE, OR OTHER SOMATIC FEELINGS, IT IS WORTH LOOKING AT OUR THOUGHTS AND EMOTIONS IN THIS AREA. SOMETIMES ANXIETY CAN PARALYZE US AND KEEP US FROM GOING TO A SPECIALIST OR FOR TESTS FOR YEARS. IT IS WORTH BEING CAREFUL ABOUT YOURSELF AND YOUR FEELINGS, SOMETIMES IT IS WORTH USING THE HELP OF A PSYCHOLOGIST AND EXPLORING OUR HEALTH BELIEFS, GIVE THEM A MORE REAL MEANING.

WAYS OF COPING WITH STRESS, FEELING IN CONTROL OF YOUR HEALTH

THERE ARE MANY WAYS TO COPE WITH STRESS. IT IS WORTH MENTIONING HERE ABOUT PEOPLE WHO COPE WITH STRESS IN AN AVOIDANT WAY. THESE PEOPLE CAN AVOID TESTS FOR A VERY LONG TIME... BUT THIS METHOD OF COPING IS EFFECTIVE, LIKE MANY DEFENSE MECHANISMS, BUT USUALLY SHORT-TERM. WALE. SOON OR LATER WE HAVE TO CONFRONT WITH WHAT WE ARE RUNNING FROM... IN THIS CASE, MOST OFTEN, DISEASE. PEOPLE WHO COPE IN A TASK-BASED MANNER MAY TREAT PREVENTIVE TESTS AS ONE OF THE TASKS TO BE PERFORMED IN THEIR CALENDAR, WHICH E.G. MUST BE DONE ONCE A YEAR. WE CAN MAKE SURE TO INTRODUCE ELEMENTS OF SUCH TASKS INTO OUR LIFE.

PSYCHOLOGISTS OF COURSE HAVE VARIOUS TOOLS TO EXAMINE OUR MOTIVATIONS AND ATTITUDES IN VARIOUS CIRCUMSTANCES, INCLUDING THOSE RELATED TO HEALTH AND ITS PROMOTION. IT IS WORTH MENTIONING HERE THE CONCEPT OF LOCATION OF HEALTH CONTROL. IT IS TESTED BY A SCALE CONTAINING 18 STATEMENTS AND ALLOWS YOU TO ASSESS WHETHER A GIVEN PERSON BELIEVES THAT THEY HAVE MORE IMPACT ON THEIR HEALTH (INTERNAL LOCATION) AND LOCATE IT IN OTHERS, E.G. DOCTORS WHETHER THEY CONSIDER IT AS THE WORK OF RANDOM FACTORS.

DO PREVENTIVE EDUCATIONAL CAMPAIGNS MAKE SENSE?

THEY HAVE IT, BUT THE HOW THEY TRANSFER INFORMATION IS EXTREMELY IMPORTANT. IF WE SEE AN INFORMATION SPOTS BETWEEN ADVERTISMENTS ON TV, WE MAY PERCEIVE IT AS ONE OF THEM, OR IGNORE IT AT ALL. LET'S IMAGINE THAT OUR FAVORITE MOVIE IS PLAYING AND SUDDENLY ADVERTISMENTS APPEAR. WHAT IS OUR REACTION? EVERYONE CAN ANSWER THIS QUESTION INDIVIDUALLY, BUT USUALLY THERE IS IRRATION AND WE CHANGE THE CHANNEL. LEAFLETS CAN HAVE A SIMILAR IMPACT ON US BECAUSE THEY CAN BE ASSOCIATED WITH LEAFLETS THAT ARE GIVEN EVERY DAY ON THE STREETS AND RARELY WHEN WE FIND SOMETHING VALUABLE FOR US IN THEM.

WHAT CAN EFFECT US POSITIVELY ARE EXAMPLES OF FAMOUS PEOPLE ENCOURAGING RESEARCH, ESPECIALLY THOSE WHO ARE ILL OR HAVE RECOVERED SICKNESS, BUT ALSO AUTHENTIC STORIES OF ORDINARY, YET EXTRAORDINARY PEOPLE WHO DESCRIBE YOUR TRUE EXPERIENCES, E.G. IN PRESS INTERVIEWS AND BOOKS. WE CAN MEET MORE AND MORE EXAMPLES OF SUCH PEOPLE WHO OPENLY SHARE THEIR STORY.

FROM A PSYCHOLOGIST'S POINT OF VIEW, IT SEEMS IMPORTANT TO TRANSFER THE PRESSURE FROM THE NEGATIVE MESSAGE, E.G. ''YOU WILL PROTECT YOURSELF FROM A DANGEROUS DISEASE, AVOID DEATH'' (BECAUSE IT ITSELF MAY CAUSE ANXIETY WHICH DOES NOT MOTIVATE US, BUT PARALYZES US) ON THE MORE POSITIVE ASPECTS OF PREVENTION AND OUR INTERNAL RESOURCES. SO THAT WE ATTRIBUTE MORE MEANING TO OUR ACTIONS AND STRENGTHEN OUR SENSE OF AUTHORITY. FOR THIS TO HAPPEN, YOU MUST FIRST CONFRONT YOUR BELIEFS.

IT HAPPENS THAT ALTHOUGH WE CONTROL OUR HEALTH REGULARLY, GO FOR TESTS, LEAD AN ACTIVE LIFESTYLE, DISEASE APPEARS. IN THIS GROUP OF PEOPLE, THERE MAY BE A FEELING OF HARM AND THE STATEMENT "I HAVE BEEN TESTED, I HAVE TRIED AND I AM SO SICK". ''I DON'T DRINK, I don't smoke and I got sick.'' AND OF COURSE A PERSON HAS THE RIGHT TO RELEASE EMOTIONS IN SUCH A SITUATION.

HOWEVER, IT IS IMPORTANT TO EMPHASIZE THIS AGAIN: EARLY PREVENTION CAN TO A LARGE EXTENT PROTECT US AGAINST CERTAIN DISEASES, ON THE PRINCIPLE OF 'PREVENTATION IS BETTER THAN CURE', TESTS CAN HELP DETECT THEM AT AN EARLY STAGE AND MORE EFFECTIVELY CLEAN, BUT THERE ARE DISEASES THAT THEY COME SUDDENLY, EVEN THOUGH WE HAVE DONE EVERYTHING WE CAN IN TERMS OF LIFESTYLE AND RESEARCH. THEY CAN TOUCH ANYONE. HOWEVER, WE CAN AVOID MANY DISEASES OR DETECT THEM VERY EASILY EARLY STAGE.

I ONCE HEARD A VERY ACCURATE STATEMENT THAT IT'S NOT ABOUT US NOT BE AFRAID, BUT TO TAKE OUR FEAR ON HAND AND GO TO EXPLORE WITH IT. IN ADDITION TO ANXIETY, IT IS SOMETIMES WORTH TAKING ANOTHER PERSON WHO WILL ACCOMPANY US OR WILL ALSO BENEFIT FROM RESEARCH. IT IS IMPORTANT THAT WE TAKE RESPONSIBILITY FOR OUR LIFE AND IF WE HAVE INFLUENCE ON SOMETHING, WE DON'T CONSCIOUSLY TAKE IT AWAY.

ILONA STANKIEWICZ, MA

PSYCHOLOGIST-PSYCHOONCOLOGIST