Bergerot Cristiane Decat, Dizon Don S, Ilbawi Andre M, Anderson Benjamin O
Centro de Câncer de Brasília, Instituto Unity de Ensino e Pesquisa, Brasília, Distrito Federal, Brazil.
Brown University, Lifespan Cancer Institute, Providence, Rhode Island, USA.
Psychooncology. 2023 Jan;32(1):6-9. doi: 10.1002/pon.5969. Epub 2022 Dec 5.
Psycho-oncology is a clinical specialty in which the humanistic aspects of cancer diagnoses and treatment are addressed to reduce the psychological burden for patients and their caregivers to optimize patient participation, cancer outcomes and quality-of-life, which is especially critical in cultures where cancer is perceived as invariably fatal. Psycho-oncology programs face multiple barriers in low- and middle-income countries, including limited resource allocation and lack of training, both of which have been impediments to psycho-oncology programs becoming recognized as core competencies in cancer management and part of a standard medical curriculum.
This paper discusses the role of the Global Breast Cancer Initiative (GBCI) in helping to overcome inequities in breast cancer care and improve clinical outcomes from a psycho-oncology perspective as a model for improved cancer care in limited resource settings.
GBCI applies a comprehensive framework encompassing all phases of cancer care (defined through three pillars spanning the continuum of cancer management) and includes addressing the physical, psychological, and social needs of women throughout the life-course. Efforts to promote policies that increase access to early detection and treatment programs and improve health literacy among the public are important strategies to mitigate the most common emotional and physical challenges reported by people with cancer accessing care.
Future efforts will focus on the integration of culturally appropriate guidance to promote early cancer detection and treatment completion through training programs for clinicians to establish core competencies in psycho-oncology. Emerging advocacy efforts in the oncology arena may help guide the integration of psycho-oncology services into routine care in countries where these services are not already integrated into the standard curriculum.
心理肿瘤学是一门临床专业,致力于解决癌症诊断和治疗中的人文问题,以减轻患者及其护理人员的心理负担,从而优化患者参与度、癌症治疗效果和生活质量。在那些认为癌症必然致命的文化背景下,这一点尤为关键。心理肿瘤学项目在低收入和中等收入国家面临多重障碍,包括资源分配有限和缺乏培训,这两者都阻碍了心理肿瘤学项目被认可为癌症管理的核心能力以及标准医学课程的一部分。
本文从心理肿瘤学角度探讨全球乳腺癌倡议(GBCI)在帮助克服乳腺癌护理不平等现象以及改善临床治疗效果方面所起的作用,以此作为在资源有限环境中改善癌症护理的典范。
GBCI应用了一个全面的框架,涵盖癌症护理的各个阶段(通过癌症管理连续统一体的三个支柱来定义),并包括满足女性在整个生命过程中的身体、心理和社会需求。推动制定政策以增加早期检测和治疗项目的可及性,并提高公众的健康素养,是减轻癌症患者在接受护理时所报告的最常见情感和身体挑战的重要策略。
未来的努力将集中在通过为临床医生开展培训项目,融入文化适宜的指导,以促进早期癌症检测和治疗的完成,从而确立心理肿瘤学的核心能力。肿瘤学领域新出现的宣传努力可能有助于在尚未将心理肿瘤学服务纳入标准课程的国家,指导将其整合到常规护理中。