Psychosocial Problems in Women with Gynaecological Cancer - A Cross Sectional Survey

Background Modern cancer treatments can cure or prolong patients lives. However, the associated physical and psychosocial problems can detrimentally affect patients compliance with treatment and ultimately their outcomes. When much of the attention has been focused on the physiological care of gynecological cancer survivors, the consequences of cancer and its treatments, psychosocial wellbeing and quality of life remain relatively underexplored. Therefore, nurses need to recognize the problems experienced by these patients and help resolve these problems. Objective The aim of this study was to assess and categorise the psychosocial problems as per their severity in gynaecological cancer survivors of a teritiary care hospital and determine their association with the selected variables. Methods A cross-sectional survey was conducted on a total of 80 hospitalized women with gynaecological cancers who underwent treatment in the oncology unit. The psychosocial problems perceived by women were assessed and categorized according to their severity, using a structured interview questionnaire- Psycho-Social Assessment Questionnaire (PSA). Results Mean age of women with gynaecological cancers who participated in the study was 55years with most of them in the advanced stage of cancer undergoing various treatment modalities. Majority of them (96.2 %) experienced moderate to severe psychosocial problems across various domains. Relatively higher proportion (30.07 %) of psychosocial problems was constituted by psychological issues followed by those of family and social domains while financial problems had the least contribution. Moreover moderate and severe psychosocial problems were also observed in the areas of psychological, family and social and informational domains. This study also indicated that among the top ten priority problems, four were from the psychological domain and three each from informational, and family & social domain. Fear of spread and recurrence of cancer, feelings about the changes in physical appearance, difficulty in communicating problems to family members and not informed about diagnosis and prognosis by healthcare staff are the top four psychosocial problems experienced by the participants. Age, stage of cancer, duration of cancer diagnosis, type of treatment received showed highly significant association with psychosocial problems at p less than0.05. Conclusions This study served to highlight the psychosocial problems and begs comprehensive assessment and extended psychosocial services to address the issues of gynaecological cancer survivors to meet their ongoing needs in order to improve long term psychosocial outcomes and Quality of life. Implications for Practice This study indicated that there are specific psychosocial problem areas which should be identified and assisted by effective communication and interactional nursing skills. This may provide guidance to nurses working with these women in terms of what factors to evaluate when screening patients to determine who needs psychosocial interventions at an early period. A standardized approach or tool to screen all patients attending gynaecological cancer clinic for supportive psychosocial needs could be developed. This facilitates triaging and timely referral to appropriate services.