This vision recognizes that optimal care requires attention to multiple sources of distress that are common in illnesses such as advanced cancer. It foresees a continuum of cancer care in which palliative skills and services ease physical and emotional suffering and enhance the quality of cancer patients and families lives throughout the course of treatment.
There is no argument that palliative care should be integrated into cancer care from diagnosis to death, but significant barriers, attitudinal, behavioral, economic, educational and legal, still limit this needed care for a large proportion of people with cancer…
But, the main question is… How can state-of-the-art cancer care with its focus on survival coexist with services that assist patients adapt to an uncertain future and support patients and families in planning and preparing for death? Does really the oncologists are well trained to explain properly the REAL situation to the patients? How about the emotional intelligence? What the patients think about this?
In integrating two seemingly disparate models of care, our program will address issues such as cultural gaps, patient and professional education. Both in their successes and their struggles, these exciting experiments in care delivery provide jumping-off points for expanded efforts to bring, comprehensive attention to comfort, quality of life and family caregiver support throughout the continuum of cancer care.
Eisai Spain, in collaboration with the Foundation “ Actitud frente al cancer” leading by Dra Ana Casas, PhD and breast cancer patient, the association of breast cancer patients “ Creando lazos” clinicians, psychologists and researchers around the country, have embraced the challenge of advancing that vision.
The project described in this briefing has translated theory into reality. Their efforts go directly to the questions of whether and how information skills have to be developed by clinicians and be integrated upstream in the continuum of cancer care.
How can state-of-the-art cancer care with its focus on survival coexist with services that assist patients adapt to an uncertain future and support patients and families in planning and preparing for death?
How will palliative services that are associated with hospice care be received by patients, their families and providers?
What exactly think the patients about this?
As small-scale pilot projects striving to build new models of care by State Hospitals, because the area of influence is Andalusia (18% of Spain) the sample size will be enough to achieve statistical significance, but the programmatic results are intriguing in a hopeful way that demands broader study.
Our hypothesis “ when patients undergoing treatment also receive appropriate information and support by clinicians they experience improved quality of care and the burden on their caregivers declines”.
Clinicians participating in this project discovered that cancer treatment and emotional intelligence, communication skills do go together. They become enthusiastic supporters of this model because they´ll see it improve the quality of care for their patients, thereby enhancing their own professional satisfaction as well.
The “Working Together, Learning Together “Team (WTLT) is composed of 25 oncologists (each one represents an important Hospital in Andalusia), 4 psychologists and three breast cancer patients as advisory board.
The oncologist, president of “Actitud frente al Cancer “Foundation and also breast cancer patient, coordinated all the workshop. A psychologist (Pilar Abad) served as consultant and leader of the training program. A distinguishing characteristic of the program is the extent the knowledge to other. In fact, every clinician well trained supported their colleagues at their hospitals.
Which were our goals? What we expected to achieve?
Approach to care to minimize the effects of the oncologist’s own attitudes toward death on the therapy, the oncologist should explore and confront personal death attitudes before explain the situation to the patients.
We´re primarily concerned with the emotional conflicts and defense mechanisms of the individual. Special issues of conflict and defense arise in the dying person, and this approach addresses them in the hope of resolving the psychic crisis to the fullest extent possible. Dying is the ultimate crisis of ego development, and as such is associated with intense infra-psychic turmoil.
These solved problems will eventually result on:
- Ongoing communication among patients, families and oncologists.
- Advanced care planning and patient-centered decision making that is iterative and reflective of patients, values and preferences.
- Formal assessment and treatment of physical and psychosocial symptoms.
- Care coordination (also known as case management) to streamline access to services and monitor quality of care.
- Spiritual care.
- Anticipatory guidance in coping with illness and issues of life completion and life closure.
- Crisis prevention and early crisis management.
- Bereavement support.
- An interdisciplinary team (oncologists, psychologists, counselors and patients associations.
