Barriers to the provision of evidence-based psychosocial care in oncology.
ABSTRACT Meeting the psychological, social and physical needs of people with cancer is a challenge for individual health practitioners, health administrators and health policy makers. However, there is a considerable gap between recommended best-evidence psychosocial and supportive care and actual practice. This paper provides a discussion of the reasons for this gap using the precede-proceed model as a theoretical framework. The model is a useful way of classifying potential barriers to the application of recommended best practice into three categories: predisposing factors which influence motivation to behave in a particular way, enabling factors which facilitate the enactment of the behaviour and reinforcing factors which increase the likelihood that the behaviour will be maintained over time. Ways of addressing these barriers are proposed and discussed.
Article: Linfedema: una patología olvidada[show abstract] [hide abstract]
ABSTRACT: Una posible patología secundaria al tratamiento del cáncer de mama es el linfedema de la extremidad superior ipsilateral y afecta, aproximadamente, a una de cada cuatro mujeres mastectomizadas, causándoles deterioro funcional, malestar psicológico e interferencias en su calidad de vida. Sin embargo, un alto porcentaje de pacientes se queja de la falta de información que les hubiera ayudado a prevenir la aparición del problema. En el artículo se discuten las causas del linfedema, su incidencia, las diferentes técnicas de tratamiento, consejos preventivos y apoyo psicológico. One secondary possible pathology of breast cancer treatment is lymphedema of the ipsilateral upper extremity and it affects to one of four women, approximately, with mastectomy and may causes functional impairment, psychological distress and interference in their quality of life. However, a high percentage of patient complains about the lack of information that she had helped them to prevent the appearance of the dysfunction. In the article discusses the causes of lymphedema, incidence and the different treatment techniques, preventive advice and of psychological support.Psicooncología, 2006.
Article: Barriers and facilitating communication skills for breaking bad news: from the specialists’ practice perspective[show abstract] [hide abstract]
ABSTRACT: Introduction: Breaking bad news is one of a physician’s most difficult duties. There are several studies related to the patient’s needs, but few reflect on the doctors’ experience.Materials and method: A descriptive, cross-sectional research was carried out to study issues related to the process of delivering bad news which might act as barriers and facilitating skills from the doctor’s point of view. These issues were identified through a self-administered survey.Results: Participant doctors use different strategies to communicate bad news to their patients. Examples of these strategies are: to be familiar with the patients’ medical history, to ensure that there is enough time, to know the patient’s caregivers and/or relatives, to determine the patient’s level of knowledge about his/her condition, to use non-technical words, to give information in small pieces, to assess the patient’s understanding, to devise a joint action plan, among others.Conclusion: The communication barriers that were identified focused on the emotional issues of the communication process, particularly those related to the recognition of own emotions, and the limited training about communication strategies available to doctors. Consequently, there is a need to implement training programs that provide doctors with tools to facilitate the bad news communication process.Colombia Médica. 01/2009;