1. PSYCHOSOCIAL CLINICAL CARE IN CANCER TREATMENT AND SURVIVORSHIP
PHILIP ODIYO MA. PhD(Cand) UICC – ICRETTE Fellow 2014.

2. The 6 feared “D’s” 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)
Going back to those first moments, what reactions come to mind?
Fear of change…

3. 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

4. Faraja HRQoL Survey 2015

5. 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

6. The CORE business of psychosocial care

7. 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.

8. 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]

10. What are the common psychosocial challenges in cancer care Diagnosis and treatment?

11. Common psychosocial challenges (Cont) Post treatment and survivorship phase
Fear of recurrence.
Adjusting back to work.
Social relationship.
Body image.
Readjusting and realignment in family structure.
Stigma.

12. Caregivers and family
Lifestyle changes.
Moving on after treatment( adjustment in family subsystems.
Financial challenges.
Overprotectiveness.
Establishing the new normal.

13. What are some of the psychosocial programs available in your country?

14. Psychosocial programs available in Kenya
Patient support groups.
Cancer survivor organizations.
Hospital based programs.

16. Cancer resource library and information

17. Our core responsibility
Healing ( dyadic) relationship.
Education(Empowerment).
Fostering realistic hope.
Individualized care ( Precision medicine)

18. 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.

19. Education (empowered patients)
“ The more knowledgeable the care recipients and informal caregivers are, the more positive health related outcomes will be for all”

20. How can we foster hope ?

21. Fostering hope is a balancing act

22. 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