BACKGROUND. 12 Publications and presentations ( )

Transcription

1 BACKGROUND The impact cancer occurrence is variable according to the sociocultural issue, specific to each context and each area. Cancer = pejora<ve connota<on. Cancer changes pa<ent s habits and view of life. 1

2 BACKGROUND To determine the psychosocial profile of Moroccan pa<ents that have developed cancers. Prospec<ve studies Na<onal ins<tute of oncology (INO) in Rabat: the biggest public oncological center in Morocco (> 5000 new cases/year) 12 Publications and presentations ( ) 2

3 MATERIALS AND METHODS

4 MATERIELS AND METHODS The ques<onary asked about many aspects Included between pa<ents Informed consent 4

5 MATERIELS AND METHODS: TOPICS The psychosocial characterisacs of Moroccan paaents with cancer Psychosocial impact of cancer on: Religious pracace Sexuality Families Young adult and adolescents Elderly people 5

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7 RESULTS pa<ents have been iden<fied:» Socio- economic» Illiteracy» Religion» Sexuality 7

8 CONTEXT

9 (2004) 64 to 87% of pa<ents had a low income or were unemployed. 85%: Household income < 1500 MAD/ month (150 $) Cost of disease was > MAD (3500 $). 9

10 SOCIO- ECONOMIC CONTEXT SOCIO- ECONOMIC (2004) CONTEXT 85%: no medical insurance to cover therapeu<c costs 75% pa<ents come from 50% live more 200 km rural away areas the hospital Extra charges: Transporta<on, Meals Hotels,. of pa<ents were helped by their families Impact: patients, care givers and therapeutic 10

11 SOCIO- ECONOMIC CONTEXT (NOW) 2009) More an< cancer centers Rate Houses of medical of live near insurance from each increased: an<cancer «AMO center» Rate of medical insurance increased: «AMO» 11

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13 ILLITERACY 38% Only 7% had a high level of educa<on 22% primary school 28% secondary school 5% koranic school 25% spoke only berber whereas arabic is the official language. 13

14 Communica<on difficul<es between care givers pa<ents. pa<ents.» Disease» Prognosis,» Treatment, and side effects Feeling of anxiety: pa<ents. - doctors and 33% patients do not know about their illness and its prognosis. Attitudes against the therapeutic project 14

15 SPIRITUALITY

16 RELIGION/SPIRITUALITY Religion: Acceptance of disease prac<sing Muslims (49%) unprac<sing Muslims (51%) Divine tes<ng Culpability feeling Stronger faith More prac<cing

17 RELIGION/SPIRITUALITY In both groups: new behaviours 68% pa<ents began to wear the Hijab (scarf) amer diagnosis of cancer 19% used popular medicine and some healing herbs in their diet recommended by the Coran. 95% religious prac<ces (extremism, in contradic<on of medical advice). 17

18 RELIGION/SPIRITUALITY Religious and spiritual beliefs: method of coping with the disease and improving quality of life. 18

19 SEXUALITY

20 SEXUALITY In Morocco, the influence of cancer on sexuality is a delicate and liole inves<gated subject the taboo of sex adds to the mys<cal fear of the disease. In the face of the financial and health problems to worry about sexuality for Moroccan pa<ents appears trivial and shameful. 20

21 SEXUALITY 21

22 SEXUALITY Among divorced pa<ents: 41% divorced amer diagnosis (women+++) 22

23 IMPACT OF CANCER ON: Elderly pa<ents Young adults and adolescents Families

24 Socio- economic and demographic charcaterisacs The image cannot be displayed. Your computer may not have enough memory to open the image, or the image may have been corrupted. Restart your computer, and then open the file again. If the red x still appears, you may have to delete the image and then insert it again. CaractérisAques Nombre de paaents (n) 150 Age moyen (ans) 73 Sexe féminin (n / %) 81 / 54 Milieu rural (n / %) 56 / 37.3 Sans couverture sociale (n / %) 131 / 87.3 Marié (n / %) 82 / 54.7 Sans profession (n / %) 74 / 49.3 Analphabète (n / %) 115 / 76.7 SituaAon financière : Indépendant financièrement 32 / 21.3 Revenu mensuel > 5000 dh 4 / 2.7 Revenu mensuel : dh 4 / 2.7 Revenu mensuel < 2000 dh 24 / 16 Sans ressources financières 118 / 78.7

25 Elderly patients Psychological impact of cancer Lower psychological impact of cancer Acceptance of disease, optimism, family s help, fear from treatment

26 Impact of cancer on young adults and adolescents 26

27 moderate depression / 15%: severe depression tobacco Young men: 11 % their toxic habits (alcohol, of cancer cannabis) 28% stopped, 5,5% started amer diagnosis Familial help: 90 % 7,5 % : were able to con<nue studying Huge psycho-social impact of cancer 27

28 Role of families financial help moral help (distress) moral help (distress)

29 CONCLUSION in a developping country Our specificity: large study which interest Moroccan Moslem paaents Illiteracy and insufficient knowledge of Arabic language cause Unemployment Low socio- economic and divorce context exacerbate the situa<on. Unemployment and divorce exacerbate the situa<on. 29

30 Conclusion disease) Lalla Salma associa<on against cancer Compensate this drama<c situa<on. 30

31 REFERENCES cas recrutés à l Ins<tut na<onal d oncologie de Rabat. H.Errihani, et al. Revue francophone de psycho oncologie Volume 4 (2) Psychooncology Jan; 17(1): experience from the Na<onal Oncology Center of Rabat.Errihani H, Mrab< H, et al..errihani H, Mrab< H, et al. Bull Cancer Apr;97(4): H.Errihani, et al. Psycho oncologie 2010; 4 (4): Boulaamane L, Essaadi I, Lalya I, M'rab< H, Errihani H. Bull Cancer Oct 1;98(9): H. Errihani, I. Elghissassi, N. Mellas, R. Belbaraka, M. Messmoudi, W. Kaikani. Sexologies (2010) 19, Sbi{ Y, Kadiri H, Essaidi I, Fadoukhair Z, Kharmoun S, Slimani K, Ismaili N, Ichou M,

32 H. Errihani, H. Errihani, H.Mrab< et al. Annals of oncology 31th ESMO October N. Ahbeddou, M. Fetohi, I. Aaribi, N. Majid, R. Jarcau, H. Errihani.1- Abstract Book of the 35th ESMO October 2010 ASCO 2010 ASCO 2010 H.Errihani, S. Lkhouyali et al. Société française de psycho- oncologie,