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Dr Naveen
Dr Naveen
Dr Naveen
Dr Naveen
Dr Naveen
Dr Naveen
Dr Naveen
Dr Naveen
Dr Naveen
Dr Naveen
Dr Naveen
Dr Naveen
Dr Naveen
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Dr Naveen

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  • 1. Effectiveness of a Hospital Based ‘Therapeutic Community’ Approach in Care for Terminally ill Cancer Patients<br />Singh Naveen Kr., Roy Debabrata, Saini,S<br />
  • 2. Background:<br />Prediction of survival in terminally ill cancer patients is an evolving area largely dependent on evidence-based medicine.<br />
  • 3. Background:<br />Principles of ‘Therapeutic community’ or ‘Fellowshipping’ are now an integral component of palliative care/ Hospice care for terminally ill patients from various afflictions.<br />
  • 4. Background:<br />Documented evidence suggests religious and spiritual forms of coping may provide uniquely meaningful way of dealing with chronic illness and may be more effective at ameliorating affective and cognitive symptoms.<br />
  • 5. Background<br />WHO defines palliative care as the ‘ active total care of patients and their families by a multiprofessional team when their disease is no longer curable and life expectancy is predicted short’.<br />It neither hastens nor postpones death. It integrates psychological and spiritual aspects of care.<br />
  • 6. Objective:<br />Specific objective: Study therapeutic effectiveness of the counseling module ‘ASHA’, <br />Sub objective: To study change in perceived notions on morbidity & QOL among terminally ill cancer patients at HIHT (CRI).<br />
  • 7. Material and Methods:<br /> A case series of all eligible study subjects who consented to participate and identified for or undergoing ‘post- surgery 18 months’ radiotherapy follow- up’ (50) were recruited for the study.<br />A well researched group dynamics module for intervention was administered on the study subjects.<br />
  • 8. Material and Methods:<br />A structured 11-question KAP evaluation instrument with open-ended answers was applied pre & post intervention to the study group.<br />Chi square test was applied on respondents pre & post intervention, (providing appropriate / desirable answer for each of the questions) to find level of significance in differences for key parameters.<br />
  • 9. Study design: <br />Prospective with a quasi-experimental component<br />Study tool:<br />A group dynamics module for intervention and a structured KAP evaluation instrument <br />
  • 10. Counseling Module: Curriculum<br />Section 1: IEC/ BCC: Clinico- pathological aspects of cancer- essentials<br />Section 2: Sensitizing on terminal illness & hospice care<br />Section 3: Concept of ‘Fellowshipping’ along with spiritual aspects as a therapeutic modality <br />Introducing principles of ’12 steps’ of living (conceptually similar to AA’s)<br />The road from ‘Denial to Acceptance’<br />The attendant negative emotions of ‘frustration’, ‘self -pity ‘, ‘anger’ & ‘abnormal behavior/ cognition’ <br />Structured living <br />Perceptions on ‘religiosity’ and ‘spirituality’ <br />Self love & selfishness <br />Salvation- perceived notions <br />Dissolution of mind and ego<br />Contentment and Bliss<br />
  • 11. Results:Association between intervention (Counseling Module) and knowledge score<br />
  • 12.
  • 13. Conclusion:<br />Chi square test on study respondents pre & post counseling for choosing appropriate options for each of the questions, showed significant differences for key parameters.<br />Evidently the counseling module( ASHA) is an effective intervention tool to bring about changes in perceived notions in morbidity and thus enhance QOL.<br />

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