Abstract
Background
Cancer related distress has a major impact on quality of life. The psychosocial needs of patients post an oesophagectomy are significant and exacerbate the physical burden. The Upper GI MDT at our hospital aim to provide holistic patient centred care that equips patients mentally and physically for their treatment pathway. Formal or structured pyschoncology services are not routinely available to our patient cohort. The aim of the audit undertaken was to assess awareness of and subsequent engagement with available mental health services in patients undergoing a curative resection for oesophagogastric cancer.
Methods
Patients who underwent either a gastrectomy or oesophagectomy in the Upper GI Centre between Nov 2018 and May 2019 were included. They each received a questionnaire to complete anonymously. Responses were via prepaid post. Responses were collated and analysed.
Results
36 questionnaires sent out with 21 patients responding (Response rate 58%).
Average age:69 (age range 40-84).
18 of the 21 responses were male
Time diagnosed with cancer: 57% were between 12 to 18 months post diagnosis and 43% between 6 to 11 months.
Source of Information received: 43% reported verbal information provided and 38% reported written information was provided
Current engagement with Mental Health Services: National, Community, and Exercise programmes were used by a very small number of patients - 6 in total out of 21 respondents
Reasons for not engaging with Mental Health Services responses included ‘Not being interested or required' to ‘fearful' ‘No knowledge of service' to ‘Cant remember ' or ‘Plans to engage'
93% of respondents would recommend use of wellbeing or mental health services to someone with a diagnosis of an Upper GI Cancer
Suggestions for improvements varied from use of information packs, information on life post op and more guidance needed surrounding availability of current mental health supports
Conclusions
Psychosocial issues need to be addressed and there is a huge deficit in current service provision. Current service is not meeting service user needs and not empowering patients how best to manage mental burden and thus contribute to maximising treatment outcomes. National Cancer Strategy acknowledges lack of access for cancer patients to pyschoncology services. The Cancer Centre is awaiting appointment of a Pyschoncology Consultant and Team in the coming months. The Upper GI MDT will seek access to this service once available for their patient cohort. In interim use limited national and community resources available. Provide education to wider team members to standardise approach providing both written and verbal information on available mental health and well being services, embed mental health awareness into daily practice with encouragement for early patient intervention if cancer related distress evident. Re Audit after introduction of these measures.
PWE-222 Audit of upper GI cancer diagnosis by endoscopy: are diagnoses being missed?