Abu Dhabi, UAESunday 21 July 2019

UAE cancer specialists are 'underestimating' patient mental health needs

Researchers call for better support as study finds oncologists fail to accurately assess psychological care

A medical committee will decide whether hospitals have to pay for treatment deemed unnecesary. . Getty
A medical committee will decide whether hospitals have to pay for treatment deemed unnecesary. . Getty

Cancer specialists in the UAE are significantly underestimating the amount of psychological care their patients may require, a new study has suggested.

Researchers found that while oncologists were adept at assessing physical pain needs, they often failed to correctly identify feelings of anxiety or depression.

The authors of the study suggested new technologies, such as smartphone applications, could be employed to improve contact between consultants and their patients, boosting levels of care.

They recommended an increased use of complimentary medicines – alternative treatments used alongside conventional care – which have been proved to work well elsewhere. They also called for more research into how to best support people with cancer in the Middle East region, given different attitudes to illness and cultural dynamics compared to Western societies where most studies in the area have taken place.

The study into cancer care was conducted between 2014 and 2017 and published last month in the peer-reviewed Supportive Care in Cancer Journal.

It considered questionnaire responses from nine oncologists and more than 200 outpatients from an unnamed specialist cancer centre in Abu Dhabi.

In their paper, Satish Chandrasekhar Nair, director for medical research at Tawam Hospital in Al Ain, and Waleed Hassen, a specialist in urologic oncology at Cleveland Clinic Abu Dhabi, argued that a “disconnect” between physician awareness of their patients’ psychological needs presented an “important opportunity to improve oncology care in the region”.

The other authors are Jayadevan Sreedharan, professor of epidemiology at Gulf Medical University in Ajman, Khaled Qawasmeh, a clinical research nurse at Tawam Hospital and Halah Ibrahim, of John Hopkins University in Baltimore.

Analysis of responses to the surveys showed that doctors were generally accurate in their analysis of patients' unmet needs regarding physical pain. However, there was a significant gap in their assessment of their psychological needs.

Physicians “significantly underestimated unmet psychological supportive care needs of the patients”, the researchers said.

Cancer rates are on the rise across the Middle East, with prevalence expected to double by 2030.

In the Emirates, the disease is the third leading cause of death. Poor diets and higher life expectancy rates are among the factors behind the rise.

A wide body of research, however, suggests it is not just medical treatment that can impact on a cancer patient’s chances of recovery.

Factors such as increased stress and fear - both common in cancer patients - can also have an effect on their physical health and response to treatment.

Reacting to the research, Dr Ahmed Abdelhaq, medical director at Bareen International Hospital in Abu Dhabi, said offering the right psychological support to patients was critical to their recovery process.

He warned it was not uncommon for some cancer sufferers to deliberately isolate themselves from the outside world, question their faith and even develop clinical depression, a serious medical condition in itself.

"More than 30 per cent of cancer patients, or their families in case of children, go through a very difficult time both emotionally and psychologically,” he said.

"The patient may suffer from some fear, anxiety and failure to adjust. The feeling of guilt and helplessness is also common.

"Support can help the patient to explore new interests that may make him or her feel valued and appreciated.”

“Most cancer patients do not like their family and friends to express pity and empathy,” said Dr Abdelhaq.

In more serious cases the patient, or their families, may fall into clinical depression which is very difficult to treat.

Dr Ahmed Abdelhaq,

“They want to continue to be treated as always even if that may not be possible at times.

“In more serious cases the patient, or their families, may fall into clinical depression which is very difficult to treat.”

The study's authors went on to suggest new technologies could prove effective in improving interaction with patients, allowing medics to better assess their needs.

Meanwhile, more research is necessary to out how best to offer psychological support to patients with cancer diagnosis in the region, they said. The researchers said attitudes to disease in the Middle East, and a society that sees family and community traditionally play a greater role in their care, mean accepted policies in the West may not be as successful elsewhere.

“Although smartphones and mobile applications are readily available and popular in the region, UAE physicians and health care centres have been slow to incorporate electronic services into patient care and have instead relied primarily on face to face communication,” the report said.

“The introduction of these technologies into cancer care in the UAE can offer low-cost, confidential, and patient-centred options to improve cancer patients’ access to information and support, thereby enhancing physical and psychological well-being and better meeting supportive care needs."

On cultural differences, it said: "How best to optimise the familial and community support that already exists in the Middle East to better meet the needs of cancer patients is an important area for future research.”

Updated: April 18, 2019 12:55 PM

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