Download Unit 7: Psychosocial, Emotional and Spiritual Needs

Unit 7
Psychosocial, Emotional
and Spiritual Needs of A
Cancer Patient
Module 1:Cultural Diversity
Cancer is a family disease no matter what
your cultural background. Moreover, cultural
diversity effects pre-diagnosis, diagnosis,
treatment and survivorship.
The American Cancer Society has been
instrumental in gathering statistics regarding
cultural differences of cancer differences
African Americans:
• African Americans are more likely to develop
and die from the disease
• African Americans are more likely to be
diagnosed at a later stage than whites
• African Americans are more likely to die within
the first five years no matter what stage they
were diagnosed.
• African Americans develop colorectal cancer
17% more than Caucasians and are more
likely to die from this disease. This disease
is highly treatable with early screening.
• African American have a lower incidence of
breast cancer than whites but have a higher
death rate because of late stage diagnosis.
• Hispanics and Latinos have some of the similar
statistical variations as compared to whites.
• Hispanics have a lower incidence of cancers but often
their cancers are related to certain infections as in
uterine cervical, liver, gallbladder and stomach
cancers.
• Breast cancer is the most widespread diagnosis of
cancer for women and again usually is diagnosed at a
much later stage than in Caucasians.
• Liver Cancer is twice as likely in this population,
while colorectal cancer is the second highest
diagnosed cancer.
• 20% of all deaths for Hispanics and Latinos is
because of a cancer diagnosis.
American Indians and American Natives have
similar disparities to whites regarding cancer
statistics.
• As is true with the Latino culture, cancer is the 2nd
leading cause of death over the age of 45 among this
group
• Lung and colorectal cancers have high incidence
rates
 Breast cancer and cervical cancers are less likely to
be diagnosed in earlier stages than Caucasians.
 Colorectal cancers are diagnosed in later stages also.
Asian Americans
• Heart disease is the leading cause of death for this
group while cancer deaths are least among any other
ethnicity.
• Different country of origin relates to cancer diagnosis:
Colorectal is highest for Chinese
Filipino’s have the highest instance for
prostate cancer.
And finally Vietnamese have higher
statistics for cervical cancer.
In all of these instances we need to use a
psychosocial tool to assess the needs of the
patients and their caregivers.
Distrust of the medical community
Low perceptions of risk/poor education
Communication
Lack of access in care
Linguistic and language barriers
Embarassment about specific procedures
According to the Centers for
Disease Control, there will be a
99% increase of cancer for
minorities by the year 2050 and a
31% increase for Non-Hispanic
Whites.
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Smoking
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Diet
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Environmental Hazards
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Traditional Practices
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Infections
These are all related to lifestyle and this
appears to cause up to 80% of all cancers.
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Screening and Early Detection
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Treatment
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Survivorship
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End of Life Care
Module 2: Discharge Planning
The patient's length of stay should be
analyzed before the patient comes to the
facility (non-emergency) or at the
beginning of the admission process
(emergency).
Discharge Planning
1) Plan the date and time
2) Plan the discharge before the peak in
admissions
3) Plan discharge for 7 days a week
4) Patients discharged based on certain
criteria
Plan discharge according to their
culture and their understanding
1) Educate patient and family
2) Make appointments
3) Tests and results
4) Confirm their medications
5) Communicate with PCP and all physicians
6) Plan with family
7) Telephone reinforcement
8) Organize postcharge services
Understanding the patient and the family
will give a safe and viable discharge plan.
Often discharge planning is not conducive
to the patient and the family because of
failure to recognize the entire cultural,
psychosocial, religious and practical
concerns.
Module 3:
Spiritual Needs
Spirituality of any
patient has long been
recognized as
essential in coping
with loss, stress and
illness. Clara Barton
who began the
American Red Cross
even utilized eastern
orthodox texts.
JCAHO, The Joint Commission on
Accreditation for Health Care Organizations
and CARF, The Commission on Accreditation
Of Rehabilitation Facilities have required that
it is necessary to make arrangements for all
patients spiritual needs.
“....the human spirit is not easy to define and
therefore some insist it is indescribable.”
Moya & Brnykczyka
Seven Dimensions of Spirituality
1) The need to relate to an Ultimate Other.
2) The need to be positive, to have hope and
gratitude.
3) The need to give and receive love
4) The need to review beliefs
5) The need to have meaning
6) The need for religiousity
7) The need to prepare for death
Patient Needs Assessment Results
Regarding Spirituality
Love/belonging/ respect
To be accepted as a person
To give/receive love
To feel a sense of connection with the world
For companionship
For compassion and kindness
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For respectful care of your bodily needs
Divine To participate in religious or spiritual
services
To have someone pray with or for you
To perform religious or spiritual rituals
To read spiritual or religious material
For guidance from a higher power
Positivity/gratitude/ hope/peace
To feel hopeful
To feel a sense of peace and contentment
To keep a positive outlook
To have a quiet space to meditate or reflect
To be thankful or grateful
To experience laughter and a sense of humor
Meaning and purpose
To find meaning in suffering
To find meaning and purpose in life
To understand why you have a medical problem
Morality and ethics
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To live an ethical and moral life
Appreciation of beauty
To experience or appreciate beauty
To experience or appreciate music
To experience or appreciate nature
Resolution/death To address unmet issues before death
To address concerns about life after death
To have a deeper understanding of death and dying
To forgive yourself and others
To review your life
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