Medical and psychological aspects of organizing medical care for patients with advanced cervical cancer in the Osh region of the Kyrgyz Republic

Abstract

Relevance of the issue. Palliative care for cervical cancer, including radiotherapy and chemotherapy, plays an important role in improving the quality of life of patients with advanced cancer by controlling symptoms and relieving pain. About 60% of patients said that they would like to discuss their diagnosis and treatment experience with a medical professional. Psychological support is aimed at improving the quality of life of sufferers. The purpose of this work: to study the state of palliative care in the Osh region of the country, to reveal and how it affects the mental/psychological state of patients. Materials and methods of the study. The study group included 83 patients with malignant neoplasms of the cervix, stages III-IV, who were registered in the Osh Interregional Oncology Center during the three-year observation period. The average age of the patients was 56 years (range 28 to 88 years). Results. Special psychological tests were used for cancer patients. Only 16 (19.3%) of the women knew that cancer could be cured. Unfortunately, the remaining patients thought that cancer would not be cured or found it difficult to answer. They were not provided with psychological help. Of the 83 patients with advanced or disseminated forms of cervical cancer, subclinically observed anxiety (8-10 points) and clinically observed anxiety (11 points and above) were detected in 35 (42.3%) and 39 (46.9%) patients, respectively. On this scale, 9 (10.8%) patients were in the "norm" gradation. In a study of another scale assessing depression, subclinically observed depression (8-10 points) in cervical cancer patients was detected in 45 (54.2%) patients, and clinically observed depression - in 30 (36.1%) patients. Comparison of proportions according to the criterion of "anxiety" (norm and clinically expressed) according to the scale of anxiety and depression in the hospital showed that clinically expressed anxiety was also significantly more common than in the comparison group (p<0.001). In general, 75 (90.4%) of 83 patients with advanced stages of the tumor process had symptoms of subclinical and clinically noticeable depression. Conclusion. Chronic pain prevailed, it was recorded in 80 (96.3%) patients. After palliative therapy, the number of patients with anxiety decreased from 39 to 19, i.e. almost twice, which was statistically significant with a high probability (p = 0.0006). After psychological correction, it was detected in 30 patients instead of 18. The difference was also statistically significant (p = 0.02). Subclinical symptoms of anxiety and depression were present in 35 (42.2%) and 45 (54.2%) patients before the start of palliative therapy, respectively. After palliative treatment, these symptoms significantly decreased - anxiety was detected in 16 patients and depression in 23 patients. All this indicated an improvement in quality of life.

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