Expectations of Patients with a Diagnosis of Breast Cancer When Meeting the Psycho-Oncologist: Beyond the Assistance of the Oncologist

Objective: Cancer patients consider the oncologist as their main resource insofar as the medical needs generally take precedence over psychological needs. Nevertheless, the psychological intervention is also important. The systematic consultation implemented in our hospital after a diagnosis of cancer is a manner to answer patients’ psychological needs. In a survey, we assessed the satisfaction and expectations of the patients about this consultation. Methods: One year after a diagnosis of breast cancer, 104 patients answered a retrospective questionnaire assessing: socio- demographic data, cancer medical information, systematic consultation satisfaction, patients’ expectations for a systematic intervention, and patients’ characteristics who began a psychological follow-up. Results: 72.1% of the patients were satisfied with having the opportunity to consult a psychologist during a systematic consultation after cancer diagnosis. Their expectations were to have opportunities of emotional expression, reassurance, obtaining additional medical information, talking about their fear over additional treatments, and identifying further support. 28.8% of the patients re-contacted the psychologist for further help after the systematic consultation. They were significantly younger (p < 0.001) than the others. Conclusions: Besides the importance of support by medical specialists [1], offering the opportunity to breast cancer patients to discuss inner feelings and treatment expectations during a systematic psychological consultation was useful for most of them. About one third of the patients asked for a further consultation with a psychologist after a first systematic consultation, especially younger patients. This stressed the importance of the role of psychologists for psycho-social support of the patient after cancer treatment.

Adherence to medication: A nation-wide study from the Children's Cancer Hospital, Egypt

AIM: To investigate adherence to medical regimen and predictors for non-adherence among children with cancer in Egypt. METHODS: We administered two study specific questionnaires to 304 parents of children diagnosed with cancer at the Children's Cancer Hospital in Cairo, Egypt, one before the first chemotherapy treatment and the other before the third. The questionnaires were translated to colloquial Egyptian Arabic, and due, to the high illiteracy level in Egypt an interviewer read thequestions in Arabic to each parent and registered the answers. Both questionnaires consisted of almost 90 questions each. In addition, a Case Report Form was filled in from the child's medical journal. The study period consisted of 7 mo(February until September 2008) and we had a participation rate of 97%. Descriptive statistics are presented and Fisher's exact test was used to check for possible differences between the adherent and non-adherent groups. A P-value below 0.05 was considered significant. Software used was SAS version 9.3 for Windows(SAS Institute Inc., Cary, NC, United States).RESULTS: Two hundred and eighty-one(90%) parents answered the second questionnaire, regarding their child's adherence behaviour. Approximately two thirds of the children admitted to their third chemotherapy treatment had received medical recommendations upon discharge from the first or second chemotherapy treatment(181/281, 64%). Sixty-eight percent(123/181) of the parents who were given medical recommendations reported that their child did not follow the recommendations. Two main predictors were found for non-adherence: child resistance(111/123, 90%) and inadequate information(100/123, 81%). In the adherent group, 20% of the parents(n = 12/58) reported trust in their child's doctor while 14 percent 8/58 reported trust in the other health-care professionals. Corresponding numbers for the non-adherent group are 8/123(7%) for both their child's doctor and other health-care professionals. Almost all of the parents expressed a lack of optimism towards the treatment(116/121, 96%), yet they reported an intention to continue with the treatment for two main reasons, for the sake of their child's life(70%)(P = 0.005) and worry that their child would die if they discontinued the treatment(81%)(P < 0.0001).CONCLUSION: Non-adherence to medical regimen is common among children diagnosed with cancer inEgypt, the main reasons being child resistance and inadequate information.

Applying Cognitive Behavior Therapy to Patients with Lung Cancer

Requirements for intervention measures for lung cancer have increased in number and difficulty due to the progress of patients and influence of complex groups of symptom.The cure rate for patients with lung cancer has improved with the vigorous development of new technologies in modern medicine.However,their mental health status and physical quality of life have continued to warrant scholarly attention.The field of cognitive behavior therapy(CBT)provides innovative ideas for addressing this issue.Thus,the study reviews the origin and concept of CBT,CBT technology,and effect of its application to patients with lung cancer to provide a feasible reference for intervention on physical and mental adverse symptoms in patients with lung cancer.