Nair Manjusha, Parukkutty Kusumakumary, Kommadath Sheethal
Department of Pediatric Oncology, Regional Cancer Centre, Medical College Campus, Trivandrum, India.
Pediatr Hematol Oncol. 2014 Apr;31(3):212-6. doi: 10.3109/08880018.2014.880768.
Comprehensive childhood cancer treatment in the modern era means not only strenuous treatment regimens and meticulous nursing care, it also implies attention to social, psychological, and financial aspects of disease and treatment. In a developing country like ours, though it is possible to provide good medical and nursing care in government set-up, there is always shortage of workforce and financial support, leading to nonadherence to treatment regimens by patients and parents, resulting in suboptimal treatment outcomes. Overcrowding of pediatric cancer patients along with general patients for lab tests and other hospital services, poor drug compliance, treatment abandonment, and lost to follow-up, lack of funding to meet nonmedical expenses and inadequate facility for providing psychological support were some of the major reasons we could identify as lacunae in our pediatric oncology division (POD). We introduced a new social support program with the help of additional staff supported by a nongovernmental agency, and new quality improvement services were introduced. The impact was demonstrable as reduction in waiting time in the hospital, allayed anxiety of painful procedures, better drug compliance, less treatment abandonment, and improved follow-up. This can be emulated in similar other resource-limited centers.
现代社会的儿童癌症综合治疗不仅意味着采用高强度的治疗方案和精心的护理,还意味着要关注疾病和治疗在社会、心理及经济方面的问题。在我们这样一个发展中国家,尽管在政府机构中有可能提供良好的医疗和护理服务,但始终存在劳动力和资金支持短缺的问题,这导致患者及其家长不遵守治疗方案,从而使治疗效果欠佳。儿科癌症患者与普通患者一起挤在实验室进行检查以及接受其他医院服务,药物依从性差,治疗中断,失访,缺乏支付非医疗费用的资金,以及提供心理支持的设施不足,这些都是我们在儿科肿瘤科室(POD)发现的一些主要缺陷。我们在一个非政府机构提供的额外工作人员的帮助下推出了一项新的社会支持计划,并引入了新的质量改进服务。其效果显著,包括缩短了在医院的等待时间,缓解了患者对痛苦治疗过程的焦虑,提高了药物依从性,减少了治疗中断情况,并改善了随访工作。其他资源有限的中心也可以效仿这种做法。