Unit 7 Psychosocial, Emotional and Spiritual Needs of A Cancer Patient

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.

Smoking • Diet • Environmental Hazards • Traditional Practices • Infections These are all related to lifestyle and this appears to cause up to 80% of all cancers.

Screening and Early Detection • Treatment • Survivorship • 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 • Plan the date and time • Plan the discharge before the peak in admissions • Plan discharge for 7 days a week • Patients discharged based on certain criteria

Plan discharge according to their culture and their understanding • Educate patient and family • Make appointments • Tests and results • Confirm their medications • Communicate with PCP and all physicians • Plan with family • Telephone reinforcement • 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 The need to relate to an Ultimate Other. The need to be positive, to have hope and gratitude. The need to give and receive love The need to review beliefs The need to have meaning The need for religiousity 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

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

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

Unit 7 Psychosocial, Emotional and Spiritual Needs of A Cancer Patient