Progress in psycho-oncology with special reference to developing countries

Influence of Spirituality and Religiosity of Cancer Patients on Their Quality of Life

Taking into account the spiritual and religious dimensions is important when it comes to taking care of patients with cancer and their quality of life. The study aimed to show the degree of dependence between the level of spirituality/religiosity of people who have just been diagnosed with cancer or have been diagnosed with cancer in the past and their quality of life. The Daily Spiritual Experience Scale (DSES), the EORTC QLQ-C30 quality of life and EORTC QLQ-FA12 fatigue-related quality of life questionnaire were used. One hundred one respondents of the Catholic faith obtained 65.22 points in DSES; 49.84 points on the QLQ-C30 functioning scale, 58.75 points on the physical scale, 60.73 points on the social scale, 50.17 points on the emotional scale, 64.69 points on the cognitive scale, 55.45 points in fulfilling one’s role and 28.38 points in financial impact. In the QLQ-FA12, respondents obtained 45.94 points on the physical scale, 47.53 points on the emotional scale and 30.69 points on the cognitive scale. In the respondents’ opinion, fatigue was the disease that reduced their quality of life the most—on average, 51.27 points. The oncological patients were characterized by a high level of spirituality/religiosity and an average level of quality of life. Spirituality/religiosity had a positive relationship with physical, emotional and social functioning. On the other hand, it was negatively associated with disease symptoms, such as pain or emotional and physical fatigue. Future research is needed in the context of the quality of life, focused on the spiritual and religious sphere of functioning of cancer patients, conducted in various cultural, ethnic and religious circles, which can serve to improve the education of nurses and develop their spiritual competences.

Competencies for Nurses Regarding Psychosocial Care of Patients With Cancer in Africa: An Imperative for Action

Psychosocial care is considered an important component of quality cancer care. Individuals treated for cancer can experience biologic or physical, emotional, spiritual, and practical consequences (eg, financial), which have an impact on their quality of living. With the establishment of cancer centers in Africa, there is growing advocacy regarding the need for psychosocial care, given the level of unmet supportive care needs and high emotional distress reported for patients. Nurses are in an ideal position to provide psychosocial care to patients with cancer and their families but must possess relevant knowledge and skills to do so. Across Africa, nurses are challenged in gaining the necessary education for psychosocial cancer care as programs vary in the amount of psychosocial content offered. This perspective article presents competencies regarding psychosocial care for nurses caring for patients with cancer in Africa. The competencies were adapted by expert consensus from existing evidenced-based competencies for oncology nurses. They are offered as a potential basis for educational program planning and curriculum development for cancer nursing in Africa. Recommendations are offered regarding use of these competencies by nursing and cancer program leaders to enhance the quality of care for African patients with cancer and their family members. The strategies emphasize building capacity of nurses to engage in effective delivery of psychosocial care for individuals with cancer and their family members.

High anxiety and depression scores and mental health service use among South Asian advanced cancer patients: A multi-country study

CONTEXT

Addressing symptoms of anxiety and depression is important in cancer palliative care. However, little information exists on the prevalence of anxiety and depression and mental health service use among advanced cancer patients in South Asia.

OBJECTIVES

To examine among South Asian advanced cancer patients, the 1) prevalence of high anxiety and depression scores, 2) factors associated with high anxiety and depression scores, and 3) mental health service use.

METHODS

This cross-sectional, multi-site study recruited patients receiving oncology care across six major public hospitals in India, Bangladesh and Sri Lanka. Participants were adults, diagnosed with stage IV metastatic solid cancer and aware they had cancer. Participants' high anxiety and depression scores (using clinically-relevant Hospital Anxiety and Depression Scale threshold of >10), sociodemographic characteristics, patient-perceived cancer stigma and mental health service use were assessed.

RESULTS

In the overall sample (N = 1140), 54% met threshold for high anxiety and/or depression scores: 32% reported high anxiety scores and 47% reported high depression scores. Symptom burden (OR's [95% CI's] = 1.09-1.13 [1.05-1.09, 1.12-1.17]) and perceived stigma (1.11-1.16 [1.06-1.11, 1.16-1.22]) were statistically significantly associated with high anxiety and depression scores. Of the patients with high anxiety and/or depression scores (n = 617), 97% had not received mental health services, and 38% of them indicated they were open to a referral.

CONCLUSION

High, clinically-relevant anxiety and depression scores are common among South Asian advanced cancer patients. Efforts should be made to alleviate psychological morbidity, including providing greater access to supportive/palliative medicine teams or mental health services.