Supporting cancer patients in Jamaica--a needs assessment survey.

OBJECTIVE: Global cancer incidence is rising rapidly particularly in the developing world where a majority of people present with advanced disease. In the English-speaking Caribbean, there is very little published data on the needs of cancer patients, their caregivers or those of allied health professionals. The research team sought to redress this balance by undertaking a needs assessment survey in the South Eastern Health Region of Jamaica to identify unmet needs and to make recommendations for improved service delivery. METHODS: A mixed methods, cross-sectional study design was used involving formal and semi-formal interviews and focus group discussions. RESULTS: The study results indicated that there were significant barriers to accessing healthcare. These included prohibitive costs of diagnosis and treatment, a mistrust of and poor communication with doctors, compounded by people's fears, belief in folk wisdom and lack of knowledge about cancer. Recommendations offered by the study participants focussed on a community-based model of support to address the multiple needs of people facing life-limiting illness and their caregivers. Healthcare practitioners recommended the development of specific policies, targeting, in particular improved drug availability and palliative care education in order to guide development of appropriate services for the large numbers of cancer patients in need. CONCLUSION: A multiplicity of unmet needs was identified by cancer patients, their caregivers and allied health professionals. Recommendations by study participants and the authors echoed the guidelines as set out by the World Health Organization (WHO) in its 1990 Public Health Model for the integration of palliative care into existing healthcare systems.

Supporting cancer patients in Jamaica: a needs assessment survey / Apoyo a los pacientes de cáncer en Jamaica: una encuesta para la evaluación de las necesidades

OBJECTIVE: Global cancer incidence is rising rapidly, particularly in the developing world where a majority of people present with advanced disease. In the English-speaking Caribbean, there is very little published data on the needs of cancer patients, their caregivers or those of allied health professionals. The research team sought to redress this balance by undertaking a needs assessment survey in the South Eastern Health Region of Jamaica to identify unmet needs and to make recommendations for improved service delivery. METHODS: A mixed methods, cross-sectional study design was used involving formal and semi-formal interviews and focus group discussions. RESULTS: The study results indicated that there were significant barriers to accessing healthcare. These included prohibitive costs of diagnosis and treatment, a mistrust of, and poor communication with doctors, compounded by people's fears, belief in folk wisdom and lack of knowledge about cancer. Recommendations offered by the study participants focussed on a community-based model of support to address the multiple needs of people facing life-limiting illness and their caregivers. Healthcare practitioners recommended the development of specific policies, targeting, in particular, improved drug availability and palliative care education in order to guide development of appropriate services for the large numbers of cancer patients in need. CONCLUSION: A multiplicity of unmet needs was identified by cancer patients, their caregivers and allied health professionals. Recommendations by study participants and the authors echoed the guidelines as set out by the World Health Organization (WHO) in its 1990 Public Health Model for the integration of palliative care into existing healthcare systems.

OBJETIVO: La incidencia de cáncer global está aumentado rápidamente, particularmente en el mundo en vías de desarrollo, dónde un gran número de personas se presentan con la enfermedad en estado avanzado. En el Caribe angloparlante, se ha publicado muy poca información sobre las necesidades de los pacientes de cáncer, sus cuidadores o los profesionales de salud asociados. El equipo de investigación buscó restablecer el equilibrio emprendiendo un estudio de evaluación de las necesidades en la Región de Salud Suroriental de Jamaica, para identificar las necesidades no satisfechas y hacer recomendaciones encaminadas a mejorar la prestación de servicios. MÉTODOS: Se empleo un diseño de estudio transversal con métodos mixtos, contentivo de entrevistas formales y semi-formales así como discusiones de grupos focales. RESULTADOS: Los resultados del estudio indicaron que había barreras considerables para el acceso a la atención a la salud. Estas comprendían costos prohibitivos para el diagnóstico y el tratamiento, desconfianza y pobre comunicación con los doctores, agravada por los miedos de la gente, la creencia en la sabiduría popular, y la falta de conocimientos sobre el cáncer. Las recomendaciones ofrecidas por los participantes en el estudio se centran en un modelo basado en la comunidad. Este modelo permite abordar las múltiples necesidades de las personas que enfrentan enfermedades limitantes de la vida, así como las necesidades de sus cuidadores. Los practicantes de cuidados de la salud recomendaron el desarrollo de políticas específicas, encaminadas especialmente a mejorar la disponibilidad de medicamentos y educación de cuidados paliativos para guiar el desarrollo de servicios apropiados para el gran número de pacientes necesitados, enfermos de cáncer. CONCLUSIÓN: Se identificaron una multiplicidad de necesidades no satisfechas, por parte de los pacientes de cáncer, sus cuidadores y profesionales de salud asociados. Las recomendaciones hechas por los participantes en el estudio y los autores, siguieron al pie de la letra los lineamientos trazados por la Organización Mundial de la Salud (OMS) en su Modelo de Salud Pública de 1990 para la integración del cuidado paliativo en los sistemas de cuidado de salud existentes.