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Caregiving in the South Asian context is often assumed by family automatically for the person with cancer (PWC). In this paper, we applied the disclosure decision-making model (DD-MM) to understand the motives behind cancer prognosis disclosure (or not) by caregivers to the PWC. Fifty caregivers participated in semi-structured interviews; and data were analyzed using Framework Approach. For the disclosing caregivers, some of the themes that emerged were consistent with the DD-MM framework while others were not. In particular, the theme "recipient assessment" was part of the DD-MM framework, while others such as unmet communication needs, caregiver self-reflection, and family support were outside of the framework. In contrast, for the non-disclosing caregivers, the reasons for nondisclosure fit very concisely into the DD-MM framework, particularly with information assessment, recipient assessment, and (non) disclosure efficacy. This study has significant implications for development of communication skills trainings around holding family meetings in India. [ABSTRACT FROM AUTHOR]

Byline: Mahati. Chittem, Sravannthi. Maya, Shweta. Chawak Nondisclosure of a cancer diagnosis and prognosis is a common practice in many family-centric cultures wherein cancer is viewed negatively, resulting in family [...]

Byline: Sravannthi. Maya Before choosing psycho-oncology, there was a juncture in my life when I had to select my specialization for further education. It was overwhelming to choose one from [...]

Objectives: This study explored the subjective accounts of the main barriers to self-monitoring of blood-glucose (SMBG) and medication-management among Indian patients with type 2 diabetes (T2DM), their primary family-members (PFMs) and physicians. Methods: Using convenience sampling, patients with T2DM, their PFMs, and physicians, residing in a South Indian capital city, were recruited for semi-structured, audio-recorded interviews. Thematic analysis was used to analyze the data. Results: Fifty patients (female = 14; mean age = 42.5 years) and their PFMs (female = 38; mean age = 39 years), and 25 physicians (female = 4; mean age = 49.8 years) were recruited. Three superordinate themes were identified: (i) complex medication-regimen: confusion, forgetting and reduced motivation, (ii) family recommendations of alternative therapies due to the social pressures of avoiding stigma, intrusiveness and being misrepresented for injecting insulin, and (iii) an expensive illness: choosing to spend money on only medication. Discussion: Implications of the findings highlight the need to (i) train physicians in communication and empathy skills, (ii) empower patients to communicate their barriers to physicians through triadic communication models and question-prompt lists, (iii) educate communities on the benefits of insulin for managing T2DM to reduce stigma, and (iv) equip communities with information about health insurance to address the financial toll of T2DM management. [ABSTRACT FROM AUTHOR]

Background: In India, patients often arrive at tertiary care centres when they are already at an advanced stage of cancer. The objective of this study is to understand the navigational processes of oncology patients in the context of the healthcare system and their journey to a tertiary care centre for their diagnosis and treatment. Method: 600 patients receiving treatment and diagnosis for cancer participated in the study carried out in various hospitals in Hyderabad, India. A survey was conducted, wherein participants answered questions on demographics, medical details, symptom discovery, treatment experiences and their thoughts regarding the current hospital. Data was analysed using IBM Statistical Package for Social Sciences 22. Frequencies and crosstabs, as well as directional and symmetric measures to test the strength of association were computed. Results: The results of the study revealed that there exist multiple agents which played a role in the patient's journey with respect to the diagnosis of cancer, access to healthcare and their coping strategies. The geographical location of the patient (C=0.89), classification of cancer (C=0.77, =0.73), and type of cancer (C=0.72) were strongly associated with the time between diagnosis and starting treatment. The presenting complaints leading to the diagnosis of cancer were associated with the patient's response to cancer (C=1.00, =0.83). The data also indicated a strong association between gender and response to the diagnosis (C=0.986, =0.988). Conclusion: This study highlights that the cancer journey is determined by several factors such as geographical location, type of cancer, symptoms identification and gender. Future research and practice can focus on developing interventions addressing these barriers to seeking appropriate and timely care in cancer contexts. [ABSTRACT FROM AUTHOR]