The Story of Jane, a Breast Cancer Patient
Discuss about the Breast Cancer for Patient Centred and Holistic Care.
The current study focuses upon the aspect of breast cancer and generating sufficient awareness for controlling the rate of the disease. Working as part of a multidisciplinary team one often has to face a number of challenges or hindrances coming from wider community. A number of hindrances are faced due to the cultural paradoxes or beliefs possessed by the people, which prevent them from reaching out to the community based healthcare centres. The study details out steps which will foster more coordinated, patient centred, holistic care. Some of these are aimed at removing the myths regarding health and diseases which help in improving the community health structure.
The current study is based upon the case study of Jane who is 45 years old woman detected with early stages of breast cancer. Jane is resident of South West Sydney and smokes about 10 cigarettes a day and drinks 2-4 alcoholic drink every day since her 20s. Jane noticed a lump in her right breast very recently which got confirmed for the presence of breast cancer. Reports have suggested breast cancer to be second most dominating cause of death in women within Australia and the figures are alarming. In the year 2014, as reported 2814 females died from breast cancer (breast-cancer.canceraustralia.gov.au, 2018). The age standardised mortality rate was 10 deaths per 100,000 persons and the mortality rate was expected to increase with age in females (Collaborative Group on Hormonal Factors in Breast Cancer, 2002). The breast cancer attributed to 6.5% of all cancer deaths in 2017 (breast-cancer.canceraustralia.gov.au, 2015). In this respect, individuals affected with breast cancer had 90% survivability rates compared to their counterparts affected with other types of cancer (swslhd.health.nsw.gov.au, 2018).
Breast cancer has considerable impact upon the quality of life of individuals even after proper treatment and cure, as it affects the mental and physical health of an individual; affects their ability to perform daily activities as one gets easily fatigued; changes appetite, nausea as a side effects of treatment are also associated. The breast cancer is often associated with a fear of recurrence within the patients which makes them suffer from anxieties and depression. As mentioned by Sallis, Owen & Fisher (2015), the melancholy and low self image often affects the relationship of the survivors of the breast cancer with their family and peers.
There are a number of social and environmental factors affecting the health behaviours of a patient. These are often dictated by the kind of community one is living in and the kind of practices that they are exposed to. Additionally, the social myths present regarding disease and health also affects the quality of life and health practices adopted by an individual (Gomez et al., 2015). As reported by the cancer council of New South Wales people often suffer from a misnomer that stress and pollution are the only factors which could trigger the development of cancer within an individual. However as supported by Branley (2015), obesity and alcohol consumption often act as contributing factors in the development of cancer. In this regard, a survey was conducted by the New South Wales Cancer Council which presented an analysis, as per which majority for the people were confused regarding the exact factors which contributed towards the development of cancer. Chemicals in food, pollution and stress have been stated as causative factors by the majority and hardly a few were aware that alcohol and obesity could be contributing factors. As mentioned by Sallis, Owen & Fisher (2015), women are less considerate about their health in mid life which often makes them indulge in activities such as smoking and drinking. Drinking promotes obesity which is predominant trigger to breast and endometrial cancer (Stewart & Wild, 2017). As mentioned by Girgis et al. (2016), lack of support from community health networks and social exclusion or falling in the company of bad peers can often subject one to bad health behaviours which deteriorates the overall quality of life.
Cultural Paradoxes and Beliefs as Challenges
The South West Sydney Local Healthcare district ( SWSLHD) focuses upon providing safe, high quality and person centred care. The ones with positive screening for breast cancer are provided with fast track cancer care pathways with strong linkages and communication between private and public partitioners (swslhd.health.nsw.gov.au, 2018). The multidisciplinary teams aim to provide documented clear referral pathways in order to minimise the waiting times. Tumours stream leaders with expertise in clinical care to be appointed. As mentioned by Youlden, Cramb, Yip & Baade (2014), the tumour stream leaders helps in providing specific cancer support such breast cancer treatment, prostate cancer treatment, liver cancer treatment etc. Therefore, referring Jade to one such tumour stream leaders would have been helpful.
The goal is to provide personalised access to care coordinator who will be able to support or advocate the need of the patients. Australia has the highest number of cancer survivors in the world which shifts the aim towards the development of holistic care practices and approaches. One such initiative is the PROMPT CARE PROJECT which is a collaborative project between the SWSLHD and the ISLHD (llawarra Shoalhaven Local Health District) researchers and clinicians. It aims at building an integrated e-health platform to help cancer survivors maintain improved health and well being.
It has been seen that the distance of travel to the treatment centres and demographic profiles of the accessible regions affects the demand for cancer radiotherapy services. Though, the government aims at providing maximum health care inclusion, there are disparities with regards to equitable distribution of healthcare services are some of the hindrances offered in this regard (Gomez et al., 2015). This is because most healthcare professionals avoid travelling to suburban regions due to transport issues. Therefore, travelling from the suburban to the main city for availing basic healthcare facilities could be an issue with Jade.
Additionally, unequal absorption of ethnic community based healthcare professionals also leads to disclosure or communication gaps as the ethnic minority communities find it difficult to communicate with the healthcare professionals in languages other than vernacular. Hence, the health care services are not completely preventative in nature.
A number of recommendations could be suggested to check the health issue which are-
- Recruiting more tumour stream leaders at the rural and suburban centres though multidisciplinary team
- Providing free visits and checkups to the dwelling places of suspected patients
- Bringing the maximum number of patients under PROMT CARE PROJECT to provide them with better infrastructure
- Community based health education
Conclusion
The current study focuses upon the aspect of providing nursing cancer for breast cancer patients. In this respect, a number of hindrances are faced with equitable distribution of healthcare services such as distance and time of travel, lack of awareness within the patients regarding health and diseases. It has been seen that there are a number of myths regrading cancer within the community at large. Therefore, it was required that sufficient health education programs be provided to make the people aware of using positive health habits and approaches.
References
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Sallis, J. F., Owen, N., & Fisher, E. (2015). Ecological models of health behavior. Health behavior: Theory, research, and practice, 5, 43-64. Retrieved from: https://books.google.co.in/books?hl=en&lr=&id=0j4LCgAAQBAJ&oi=fnd&pg=PA43&dq=Sallis,+J.+F.,+Owen,+N.,+%26+Fisher,+E.+(2015).+Ecological+models+of+health+behavior.+Health+behavior:+Theory,+research,+and+practice,+5,+43-64.&ots=w20tbptvtl&sig=LfRfOBRu2-RlhIh0Ec-krYTj0qQ#v=onepage&q&f=false
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