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  • ISSN: 2379-0547
    Volume 2, Issue 1
    Research Article
    Ranjana Chataut, Ashok Pandey* and NSN Rao
    Abstract:
    Introduction: The major challenge observed in oncology service in Nepal is the high cost of the treatment and because of the lack of insurance, and a proper health policy, people have to bear all burden by themselves. Early diagnosis of cancer results in lower stages of the cancer, less intensive treatment and improved survival.
    Objectives: To study the distribution of cases, past and future treatment seeking behaviour of diagnosed cancer cases and to assess the economic burden of cancer of cases treated at hospitals.
    Methods: The study was conducted at Bhaktapur Cancer Hospital, Nepal. The sampling technique for the study was Systematic random sampling of our patients of inpatients available during the study period. The data was analyzed using the SPSS Version 16. The data has been analyzed using mean and percentages, and krushkall Wallis test.
    Results: 54 percent had visited only one facility and 34 percent had visited two facilities and 11 percent had visited three facilities and 1 percent had visited up to six facilities. There is no significant difference between the stages of Cancer in the cost of care on different aspects. There is no significant difference in the cost of care between the types of cancer.
    Conclusion: Treatment seeking behaviour of person and the expenditure pattern which is very costly for the people suffering from cancer in developing countries like Nepal.
    Metin Kanıtez*, Mehmet Beşiroğlu, Ferhat Telli, Faysal Dane, Fulden Yumuk and Nazım Serdar Turhal
    Abstract:
    Introduction: Guidelines provide us with supportive information about the frequency of clinic visits among cancer patients in remission. The aim of our study was to explore this parameter in our hospital.
    Materials and Methods: We recruited breast, colon, and gastric cancer patients who had been treated between January 2005 and January 2010 in our clinic. The population data were extracted in a retrospective manner and included the demographics, date of diagnosis, stages of TNM, treatment modalities, and outpatient follow-up dates. Patients with distant metastasis and who could not achieve remission after surgery, or who developed complications, were excluded from the study. We recorded the number of outpatient visits following surgery in patients in remission during a 5-year follow-up period and considered the interval afterwards in cases of relapse.
    Results: A total of 319 patients were enrolled in the study [23% were male (n=75), and 77% were female (n=244)]. Adjuvant chemotherapy appeared to be an independent factor that affected the frequency of outpatient visits (p=0.001) in the first year of follow up. Age, gender, education status, the tumor grade, type of surgery, colostomy, or port had no effect on the frequency of outpatient visits at the second year of follow up. It can be said that more of patients were compliant with the proposed visit intervals throughout the 5-year study period, excluding the first year, due to the chemotherapy regimen.
    Ina Carola Otte1,2*, Corinna Jung2 and Klaus Bally2
    Abstract:
    Background: GPs play a crucial role in the provision of basic end-of-life care. Consequently, they are the ones to share information with not only the patient, but with the patient's consent, also with his/her family caregiver (s). The intention of GPs to start conversation about end-of-life contents is in this respect essential for the quality of care perceived. For these reasons our paper focuses on GPs understanding, purposes and rationales when initiating communication with family caregivers in end-of-life situations.
    Methods: Qualitative, Swiss-wide, semi-structured, face-to-face interviews with 23 GPs. Data was analysed using content analysis.
    Results: GPs stated to communicate with family caregivers a) to prepare them for impending important decision-making processes, b) to ensure every family member receives the same pertinent information, c) to enable open communication between all parties, d) to integrate family members into the caregiver network and e) to have the opportunity to offer emotional support for relatives' specific needs.
    Conclusions: GPs were reflective and aware that patients and their caregivers have different communication needs. Their main rationales to initiate conversation with family caregivers was to ensure that their patients can rely on the support of their families during challenging decision-making processes, to facilitate mutual communication involving difficult topics between patients and their family, to strengthen relatives for their tasks as caregivers in the caregiver network, to prepare family members for their upcoming loss and to give them emotional support.
    Onur Ozturk1, Bektas Murat Yalcin2*, Mustafa Unal3, Kadir Yildirim4 and Nuraydin Ozlem5
    Abstract:
    Objective: This study investigated sexual problems which may be faced by patients of either gender after undergoing temporary or permanent colostomy and the relationship between these problems and self-esteem.
    Materials and Methods: 42 participants undergoing temporary or permanent colostomy (study group) at the Samsun Education and Research Hospital and 42 participants working as auxiliary staff in the same hospital (control group) were included in the study. All participants completed a questionnaire investigating socio-demographic characteristics and the Rosenberg Self-Esteem Scale. Female participants also completed the Female Sexual Function Index and male participants the International Index of Erectile Function by the sealed envelope method. After one week, the data obtained from the questionnaires were evaluated among the groups.
    Findings: In the study group, 17 out of 42 cases (40%) had undergone permanent colostomy and 25 temporary colostomy. Self-esteem levels in the study group were lower (1.01±1.13) than those in the control group (0.5±0.44) (p=0.021). There was a significant relationship between male patients' IIEF scores and the self-esteem scale (r= 0.123, p=0.013). Male cases (45.00±23.71 points) in the study group had lower IIEF test scores (59.0±21.31) than the control group (p=0.026). Females with colostomy had significantly lower scores than the control group in the "arousal" subgroup only (p=0.045). Males with temporary colostomy had higher IIEF and all subgroup scores than the permanent colostomy group, and females had higher scores on the arousal, satisfaction and pain subscales.
    Conclusion: Cases of permanent colostomy have more serious sexual problems than those with temporary colostomy. More detailed studies are needed concerning sexual problems faced by patients who have undergone colostomy.
    Review Article
    Ching-Luen Ng*
    Abstract: Insomnia is a common symptom of depression. In clinical practice, the relationships between insomnia and depression are actually more complex. A literature review was undertaken to find out various possible relationships between insomnia and depression. Research evidences showed that insomnia can be a symptom of depression; insomnia can also be a risk factor of depression; and insomnia can exacerbate/perpetuate depression. Moreover, residual insomnia after treatment for depression is common; and depression may not hinder insomnia outcome. Furthermore, sometimes insomnia and depression do not co-occur. There are also evidences that for patients with both insomnia and depression, insomnia therapy concomitant with depression therapy (e.g. using antidepressant for treating depression plus using cognitive behavioural therapy for treating insomnia) can result in positive treatment outcome in depression. As a result, combination treatment of insomnia and depression may be the future treatment direction for bringing greatest treatment benefits to patients suffering from both depression and insomnia.
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