Psychosocial concerns in patients with advanced cancer: an observational study at regional cancer centre, India.
BACKGROUND
The diagnosis and treatment of cancer is associated with substantial physical, psychological, and social morbidity. The objective of this study was to identify the prevalence of psychosocial concerns in the patients with advanced cancer admitted to our institute.


METHODS
A total of 100 patients admitted to the inpatient palliative care unit of our institute were enrolled in this study. A descriptive questionnaire that dealt with the patient's psychological acceptance of the disease and emotional distress that accompanies the diagnosis was prepared. Patient's social and spiritual needs were addressed, and the future concerns that the patient is preoccupied with were discussed on a one-on-one basis with the patient himself or herself.


RESULTS
It was found that a majority of patients, though aware of their diagnosis, were not aware of the disease prognosis. There was a generalized anxiety regarding the treatment of the disease and fear of suffering. Most patients preferred to keep the revelation of the diagnosis to those close to them and not reveal it publicly. Financial drain out of resources was a major concern. Future concerns about their own fitness, the settlement of their children, and the family's well-being were seen commonly in almost all the patients.


CONCLUSIONS
Attention to psychosocial and spiritual health needs of patients with cancer is an integral part of an effective palliation, though they are less commonly expressed but are strongly felt by patients with cancer. It is therefore recommended that all clinicians and health care providers should address psychosocial health needs as a part of their routine practice.
Mishra
Seema
S
Unit of Anesthesiology, Dr B.R. Ambedkar, Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India. mseema17@yahoo.co.in
Bhatnagar
Sushma
S
Philip
Freeny Ann
FA
Singhal
Vasudha
V
Singh Rana
Shiv Pratap
SP
Upadhyay
Surjya Prasad
SP
Chauhan
Govindi
G
D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001294:Attitude to Health; D003151:Community Health Centers / Q000458:organization & administration; D016638:Critical Illness / Q000523:psychology*; D003466:Cultural Characteristics; D003674:Defense Mechanisms; D018450:Disease Progression; D005260:Female; D015438:Health Behavior; D006801:Humans; D007194:India / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000523:psychology* / Q000628:therapy; D010166:Palliative Care / Q000379:methods*; D011788:Quality of Life / Q000523:psychology*; D012649:Self Concept; D012959:Socioeconomic Factors; D029181:Spirituality; D017741:Survivors / Q000523:psychology; D013727:Terminal Care / Q000379:methods