Communication Issues and Challenges of Information Sharing, Care Plans and Treatment Modalities for Cancer Patients and Families Accessing Hospice and Palliative Care Services in Nigeria and South Africa

Abstract

Background: The recent upsurge in the prevalence of cancer cases in Nigeria and other African countries is fast becoming a great challenge for the clinicians and urgently required holistic interventions. Most patients (60%–70%) usually present at an advanced incurable stage. Communication issues such as breaking bad news, discussions around treatment options, prognosis and advance care plans are often neglected. Cancer diagnosis is often synonymous to a death sentence and inadequate knowledge about disease trajectories and information sharing with patients and their families is often responsible for patients' frustration. A supportive palliative oncology teams play a critical role in facilitating and communicating between clinicians, patients and their families to bridge the gap and ensure effective therapeutic communication. Aim: In preparation for the forthcoming UICC African Cancer fellowship visit to the Life Abundant Palliative Care, Victoria Hospital in Wynberg, South Africa, a preliminary study will be made to identify relevant challenging issues and data among cancer patients at the Federal Medical Center Abeokuta Nigeria. Methods: A retrospective and prospective study will be performed of diagnosed cancer patients referred to the Pain and Palliative Medicine Department of the Federal Medical Centre Abeokuta, Nigeria between 2016 and 2017. Their diagnosis, treatment options, treatment compliance and defaults, offer of advance care plans, extent of interdisciplinary team and family involvement will be evaluated using the patients' case-notes. For surviving patients attending the pain and supportive palliative oncology clinic, their knowledge of the disease, treatment challenges, prognostication and family support will be identified and documented. Results: The observational gaps in the retrieved information and data about the treatment outcomes and interdisciplinary team support and challenges will form the basis or rather the prestudy platform for the planned fellowship visit on to the Life Abundant Palliative Care, Victoria Hospital in Wynberg, South Africa. The identified knowledge and skills gap would be used to design the final study in South Africa in August 2018. Conclusion: It is expected that the two studies will reflect communication issues and the approach to cancer patients' management in two different African clinical settings. The acquired lessons or experience during the second phase studies in the South Africa clinical setting would be translated to Nigeria practice and also shared at the 2018 UICC World Congress.