Download the changing landscape of cancer care in kenya

PSYCHOSOCIAL CLINICAL CARE IN
CANCER TREATMENT AND
SURVIVORSHIP
PHILIP ODIYO MA. PhD(Cand) UICC –
ICRETTE Fellow 2014.
The 6 feared “D’s”
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Discomfort- Physical illness.
Dependency - Loss of autonomy
Disfigurement- Physical deformities, lymphedema.
Disability- Inability to carry out tasks
Disruption- Lifestyle, Job loss.
Disengagement- Cutting of social ties due to
treatment.
• Death
(Holland et al, 2001)
Faraja survey 2015 ( HRQoL)
• Survey carried out at Faraja on HRQL at the
breast cancer support meeting.
• HRQoL is a multidimensional concept that
includes domains related to physical, mental,
emotional and social functioning
Faraja HRQoL Survey 2015
Psychological Well Being Items
90
80
70
60
50
40
Psychological Well Being Items
30
20
10
0
Initial
Diagnosis
Cancer
Time since
Treatment Treatment
Anxiety
Depression
Future
Diagnostic
Tests(fear)
Second
Cancer
Recurrence Spreading
Complexity of Cancer
“ The complexity and variability of psychosocial
issues associated with cancer has created the
demand for highly skilled practitioners who are
trained to provide multilevel assessment and
intervention throughout the illness continuum.”
Smith, Walsh-Burke and Cruzan, 1998
The CORE business of psychosocial
care
Models of care in psychosocial
oncology
• Equitable care- Right to care( IPOS 2014,
Lisbon).
• Patient centered.
• Integrated- Screening, diagnosis, treatment,
recurrent or transition to palliative care.
• Culturally appropriate
• Multidisciplinary
• Evidence based assesment and intervention.
Diagnosis of psychosocial concerns
• 50% of Psychosocial problems missed.
• Only a minority of health professionals
identify more than 60% of their patients' main
concerns [Maguire et al 1996]
What are the common psychosocial
challenges in cancer care
Diagnosis and treatment?
Common psychosocial challenges (Cont)
Post treatment and survivorship phase
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Fear of recurrence.
Adjusting back to work.
Social relationship.
Body image.
Readjusting and realignment in family
structure.
• Stigma.
Caregivers and family
• Lifestyle changes.
• Moving on after treatment( adjustment in
family subsystems.
• Financial challenges.
• Overprotectiveness.
• Establishing the new normal.
What are some of the psychosocial programs
available in your country?
Psychosocial programs available in
Kenya
• Patient support groups.
• Cancer survivor organizations.
• Hospital based programs.
Cancer resource library and information
Our core responsibility
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Healing ( dyadic) relationship.
Education(Empowerment).
Fostering realistic hope.
Individualized care ( Precision medicine)
Healing Relationship
• You are practicing medicine when you are
listening.
• The healer can reduce suffering, even if cure is
not possible.
• Be there with the patient.
Education (empowered patients)
“ The more knowledgeable the care recipients
and informal caregivers are, the more positive
health related outcomes will be for all”
How can we foster hope ?
Fostering hope is a balancing act
In conclusion
The patient is not just a group of symptoms,
damaged organs and altered emotions
The patient is a human being, at the same time
worried and hopeful, who is searching for
relief, help and trust