1. Professional Development in Psycho-oncology in Ireland-
the first five years ( )
S. Wright; P. Gallagher; A. Scott.
School of Nursing , Dublin City University
Project funded by the Irish Cancer Society
INTRODUCTION
In recent years in Ireland the incidence of most cancers has increased. It is projected that the risk of developing cancer will have increased by about 15% in Ireland by 2020, leading to a doubling of new cancers (NCR, 2007). Psychosocial needs and challenges experienced by people with cancer may impose a significant threat to their quality of life and well being (Brennan, 2006; Holland, 2006,2004; Temoshok, 2004; Zabora et al. 2001). Cancer is acknowledged to cause intense psychological distress. Studies show that early recognition and treatment of distress, the 6th vital sign is especially necessary and cost effective (Steggles & McKiernan, 2007; Bultz & Carlson, 2006; NCCN, 2005; Holland, 2004; Burton & Watson, 1998). In 2003 a survey of 104 Irish healthcare institutions providing cancer care showed that only 25% provided a multidisciplinary care service to their patients. Using a biopsychosocial systems approach, the newly formed Irish Psycho-Oncology Group (IPOG), supported by the Irish Cancer Society, aims to advance education, research and clinical practice in psycho-oncology (Steggles & McKiernan, 2007).
AIMS
Through the development and delivery of skills and knowledge-based multidisciplinary professional development modules in psycho-oncology,this project aims to empower personnel working in the area of oncology to address the psychosocial needs of people with cancer and their families.
METHOD
Utilising IPOS/APOS guidelines, educational/ professional development descriptors were developed for the modules:
‘A psycho-oncology programme for volunteers’ NS290 (undergraduate)
‘Working with people affected by cancer 1’ NS484 (advanced undergraduate)
‘Working with people affected by cancer 2’ NS581 (postgraduate)
‘Terminal illness and bereavement’ NS580 (postgraduate) run in partnership with the Irish Institute of Integrative Counselling and Psychotherapy at Turning Point.
Lectures are delivered by specialists, such as clinical nurse specialists, clinical psychologists, bereavement counsellors, medical social workers, medical oncologists, epidemiologists and allied healthcare professionals as well as cancer survivors working in the oncology setting. Lectures are evaluated each day with the LecTrain evaluation tool, which asks students to rate lectures with a likert scale and to rate their understanding as either low, medium or high, pre and post lectures each study day. Students are required to submit a written assignment to gain university credits.
Topics included in the modules are:
Theoretical foundation of psycho-oncology (all modules)
Communication & counselling theory & skills (all modules)
Social support and adjustment (all modules)
Impact of cancer on quality of life (all modules)
Psychosocial stages of illness (NS484)
Bereavement, grief & loss (NS484, NS580)
Distress/Pain/Symptom control & management (NS484, NS580, NS581)
Epidemiology & microbiology (NS581)
Family as a social system (NS581)
Palliative care (NS580, NS581)
METHOD Cont
Psychosocial oncology research methods (NS581)
Issues in alternative /complementary therapies (all modules)
Types of psychosocial interventions (all modules )
Organ site specialisation (NS581)
Health promotion/cancer prevention (NS581)
Psycho-oncology service development (NS581)
Examples of students’ qualitative comments are:
NS484: ‘a lot of the information I know but it was made more concise & compact, ‘user friendly’ …’
NS484 (videolink): ‘all was excellent ..thanks’
NS290: ‘overall the course was excellent’
NS581: ‘it was very interesting..very useful’
NS580: ‘excellent ...enjoyed all aspects of lectures.
DISCUSSION
Multidisciplinary professional development modules in psycho-oncology have been offered through SoN, DCU since 2005 at undergraduate and postgraduate level. There is strong interest in the modules which now need to be developed to postgraduate diploma and masters degree level. Based on successful international models and guided by renowned international experts in psycho-oncology, a North South National Psycho-oncology Centre is currently under development. In line with the Strategy for Cancer Control in Ireland (2006) and endorsed by IPOG, the mission of the Centre will be to equip postgraduate healthcare professionals with the knowledge and skills required to provide appropriate multidisciplinary psycho-oncology services in order to minimise the psychosocial impact of cancer. Following a needs assessment, it is hoped to offer a two year graduate diploma in psycho-oncology from September 2008, facilitating development and delivery of multidisciplinary services necessary for the psychological wellbeing and health outcomes of patients with cancer and their families.
References:
RESULTS
The following modules are completed:
‘A Psycho-oncology programme for volunteers’ x 3 days; 1st (29 students); 2nd (20 students); 3rd (20 students); 4th (19 students)
‘Terminal illness & bereavement x 12 days: 1st (14 students); 2nd(13 students)
‘Working with people affected by cancer 2’ x10 days: 1st (10 students); 2nd(9 students)
‘Working with people affected by cancer 1’ x 6 days: 1st (30 students); 2nd (16 students); 5th (32 students); 3rd & 4th (videolink: 31 & 25 students)
An increase in percentages, post compared to prelectures, of students’ understanding of psycho-social issues relevant to cancer care, is shown in Figures 1-8.
Content, presentation, clarity and effectiveness of lectures were also evaluated. Generally, all study days met with students’ expectations and lectures were evaluated positively.The videolink delivery of the 3rd & 4th running of module NS484 lectures, from DCU to Letterkenny General Hospital, was considered especially successful.