PSYCHOSOCIAL SUPPORT AND NURSING CHALLENGES IN THE MANAGEMENT OF CANCER presented by Prisca Olabisi

1
PSYCHOSOCIAL SUPPORT AND NURSING CHALLENGES IN
THE MANAGEMENT OF CANCERpresented by Prisca
Olabisi Adejumo RN, PhD.bisiandbayo_at_yahoo.com
(234) 8033923260Dept. of Nursing, College of
Medicine, Univ. of Ibadan, Ibadan, Nigeriaat
theCOLLABORATIVE TRAINING PROGRAMME IN
CANCERCENTER FOR WEST AFRICAN BIOETHICS April
17-18,2007
2
Outline

• 1. Introduction
• 2. Impact of Cancer
• 3. Concept of Psychosocial Support
• 4. Challenges of Cancer to Nursing Care
• 5. Challenges of Cancer to relatives and society
• 6. The Role of Psychosocial Support
• 7. Conclusion
• 8. Opportunities for Collaborative Research

3
Introduction

• The diagnosis of cancer and the different
  phases of the disease and its treatment could
  create psychological distress for patients and
  their families.
• This creates tremendous challenge for the
  nursing care of cancer patients necessitating an
  all embracing support in the management of cancer
  patients.
• The utilization of the social network, kinship
  system and emotional support managed within
  individualized nursing care could assist
  patients coping ability thereby relieving
  nurses burden of caring for patients with cancer.

4
Nurses Unique Function

• To assist the individual, sick or well in the
  performance of those activities contributing to
  health, its recovery or peaceful death that he
  would perform unaided if he had the necessary
  strength, will, or knowledge and to do this in
  such a way as to help him gain independency as
  rapidly as possible.
• Henderson, V (1961).

5

• Fig. 1 Role of the Professional Nurse

Elements
Caregiver
Educator
Coordinator
Consultant
Interpersonal Process
Collaborator
Patients Advocate
Change agent
6
Impact of Cancer (1)

• Depression
• Body Image disturbance
• Persistent Pain
• Lower Self Esteem / Self Efficacy
• Reduced Quality of Life

7
Impact of Cancer (2)

• 6. Possibly reduced treatment compliance
• 7. Reduced Need for Achievement
• 8. Nutritional Concerns
• 9. Sexual Dysfunction
• 10. Altered Role Perception
• 11. Family Dysfunction

8
Impact of Cancer (3)

• 12. Cachexia
• 13. Possibly reduced treatment compliance
• 14. Reduced Need for Achievement
• 15. Fatigue
• 16. Hair Loss

9
Concept of Psychosocial Support (1)

• An individuals human climate plays a
  significant role in the maintenance of health and
  in responses to life stressors.
• This encourages a human experience that is
  important for sustaining a high level of
  functioning and life satisfaction.
• Social support, a function of social networks
  could mediate human behaviour.
• Social support involves interpersonal
  transactions that include affect, affirmation
  and aid.1
• 1 Kahn, R Antonucci, T., (1980) Convoys over
  the life courseAttachment, Roles and social
  support. In Baltes, P and Brim, O lifespan
  development and behaviour. 3. New York Academic
  Press

10
Concept of Psychosocial Support (1)

• Affect Expression of liking, admiration, respect
  or love.
• Affirmation Expression of agreement,
  acknowledgement of the appropriateness of some
  act or statement of another person
• Aid Includes direct aid and assistance e.g.
  money, information, time and entitlements.

11
Challenges of Cancer to Nursing Care (1)

• Paradigm shift in the management of chronic
  illnesses e.g. cooperative care
• Nurses medication errors in cancer pain
  management
• Increasing incidence of cancer in the society
• Global nursing shortage

12
Challenges of Cancer to Nursing Care (2)

• 5. Growing global emphasis on ethical
  considerations in palliative care
• 6. Update with current research and technology in
  cancer management
• 7. Improved patients level of knowledge about
  cancer
• 8. Chronic and terminal nature of cancer

13
Implication for Nursing

• Re-orientation of nursing- training, continuous
  education, and short term certification courses
  etc.
• Motivation for Increased specialization in
  Oncology nursing
• Active collaboration with other health
  professions in research and knowledge update
• Increased ethical consciousness in cancer
  management
• Increased collaboration with primary care givers

14
Conclusion (1)

• Cancer poses a serious challenge to the patient,
  nurses and primary care givers. The burden of
  cancer.
• Nurses need skills for effective communication
  with patients with cancer, families and other
  health professionals. This has been found to
  improve their wellbeing. (Fallofield and Jenkins
  1999), and by extension, the standard of cancer
  patient care.

15
Conclusion (2)

• In recent years, the prognosis for the majority
  of cancers has improved. Patients are surviving
  longer. These have shifted patient care plans
  towards earlier discharge from hospital following
  surgery and other treatments.
• Hence there has been an increased need for
  psychosocial supports for cancer patients and
  their family members by nurses involved in caring
  for patients with cancer.
• This has great challenges for nursing. The
  relevance of improved and need based training and
  development of nurses cognitive, affective and
  psychomotor domains would be significant in the
  overall improvement of the quality of life of
  cancer patients and their primary care givers.

16
Opportunities for Collaborative Research (1)

• The Psychosocial Impact of Cancer and
  Relationship of Demographic variables in
  Southwestern Nigeria.
• The Relationship Between Available Support, Unmet
  Needs and Caregivers Burden in Patients with
  Advanced Cancer in Nigeria.
• An appraisal of lay understanding of terms used
  in cancer consultations

17
Opportunities for Collaborative Research (2)

• 4. Relationship Between Patients Expectations of
  Toxicities and Post Chemotherapy Experiences
• 5. An assessment of nurses medication errors and
  remedial measures in cancer management.
• 6. Survey of Mens and Womens Perspectives on
  Sexual Problems after Cancer Treatment.
• 7. Job Stress and Job Satisfaction of Cancer Care
  Workers in University College Hospital, Ibadan,
  Nigeria.

18
Opportunities for Collaborative Research (3)

• 8. Job Stress and Job Satisfaction of Cancer Care
  Workers in University College Hospital, Ibadan,
  Nigeria.
• 9. Comparative efficacy of Communication Skill
  Training and Audio Feedback on Knowledge and
  Treatment of Cancer.
• 10. Psychosocial Predictors of Willingness to
  participate in Mammographic screening in Nigeria.
• 11. A comparative analysis of the challenges
  faced by cancer patients and healthworkers