RESUMO
Understanding the views of cancer survivors on their experience is important for informing community-based interventions. We studied, for the first time, the views of cancer survivors residing in Saint Lucia on their overall care experience. We used interview data from a cohort of adult cancer survivors from Saint Lucia between 2019 and 2020. We performed a thematic analysis to derive themes from codes. Forty-four survivors provided responses to at least one of the three questions. The majority of survivors were black, female and diagnosed with breast cancer. Survivors were interviewed on average five years after diagnosis. Four common themes emerged; "Availability of support groups", "Importance of support from family and friends", "Access to finances" and "Health education and patient navigation". Travel overseas for health services was common among survivors. Survivors expressed emotional distress during travel due to isolation from family and local providers. This is typical among island populations and is distinct from existing patient frameworks. Survivors also suggested that networking amongst providers and interventions assisted families of cancer survivors. Although tertiary care services are limited, we showed that survivors deeply value and depend on their inter-personal relationships during care. Interventions aimed at strengthening the inter-personal environment of survivors are warranted.
Assuntos
Sobreviventes de Câncer , Neoplasias , Adulto , Feminino , Recursos em Saúde , Humanos , Neoplasias/terapia , Santa Lúcia , Grupos de Autoajuda , Apoio Social , SobreviventesRESUMO
Developing robust systems for cancer care delivery is essential to reduce the high cancer mortality in small island developing states (SIDS). Indigenous data are scarce, but community-based cancer research can inform care in SIDS where formal research capacity is lacking, and we describe the experiences of cancer survivors in Saint Lucia in accessing health services. Purposive and snowball sampling was used to constitute a sample of survivors for interviews. Subjects were interviewed with a questionnaire regarding socio-demographics, clinical characteristics, health services accessed (physicians, tests, treatment), and personal appraisal of experience. We recruited 50 survivors (13 men, 37 women). Only 52% of first presentations were with general practitioners. The mean turnaround for biopsy results in Saint Lucia was three times longer than overseas (p = 0.0013). Approximately half of survivors commenced treatment more than one month following diagnosis (median of 32 days, IQR 19-86 days), and 56% of survivors traveled out-of-country for treatment. Most survivors (60%) paid for care with family/friends support, followed by savings and medical insurance (38% each). In conclusion, cancer survivors in Saint Lucia are faced with complex circumstances, including access-to-care and health consequences. This study can guide future research, and possibly guide practice improvements in the near term.
Assuntos
Sobreviventes de Câncer , Neoplasias , Atenção à Saúde , Feminino , Humanos , Ilhas , Masculino , Neoplasias/terapia , Projetos Piloto , Santa LúciaRESUMO
BACKGROUND: Few national registries exist in the Caribbean, resulting in limited cancer statistics being available for the region. Therefore, estimates are frequently based on the extrapolation of mortality data submitted to the World Health Organization. Thus, regional cancer surveillance and research need promoting, and their synergy must be strengthened. However, differences between countries outweigh similarities, hampering registration and availability of data. METHODS: The African-Caribbean Cancer Consortium (AC3) is a broad-based resource for education, training, and research on all aspects of cancer in populations of African descent. The AC3 focuses on capacity building in cancer registration in the Caribbean through special topics, training sessions, and biannual meetings. We review the results from selected AC3 workshops, including an inventory of established cancer registries in the Caribbean region, current cancer surveillance statistics, and a review of data quality. We then describe the potential for cancer research surveillance activities and the role of policymakers. RESULTS: Twelve of 30 Caribbean nations have cancer registries. Four of these nations provide high-quality incidence data, thus covering 14.4% of the population; therefore, regional estimates are challenging. Existing research and registry collaborations must pave the way and are facilitated by organizations like the AC3. CONCLUSIONS: Improved coverage for cancer registrations could help advance health policy through targeted research. Capacity building, resource optimization, collaboration, and communication between cancer surveillance and research teams are key to obtaining robust and complete data in the Caribbean.
Assuntos
Neoplasias/epidemiologia , Região do Caribe/epidemiologia , Comportamento Cooperativo , Humanos , Sistema de RegistrosRESUMO
Saint Lucia was the first country to conduct a burden of illness study in the Caribbean to determine the community prevalence and underreporting of acute gastroenteritis (AGE). A retrospective cross-sectional population survey on AGE-related illness was administered to a random sample of residents of Saint Lucia in 20 April-16 May 2008 and 6-13 December 2009 to capture the high- and low-AGE season respectively. Of the selected 1,150 individuals, 1,006 were administered the survey through face-to-face interviews (response rate 87.4%). The overall monthly prevalence of AGE was 3.9%. The yearly incidence rate was 0.52 episodes/person-year. The age-adjusted monthly prevalence was 4.6%. The highest monthly prevalence of AGE was among children aged < 5 years (7.5%) and the lowest in persons aged 45-64 years (2.6%). The average number of days an individual suffered from diarrhoea was 3.8 days [range 1-21 day(s)]. Of the reported AGE cases, only seven (18%) sought medical care; however, 83% stayed at home due to the illness [(range 1-16 day(s), mean 2.5]; and 26% required other individuals to take care of them. The estimated underreporting of syndromic AGE and laboratory-confirmed foodborne disease pathogens was 81% and 99% respectively during the study period. The economic cost for treating syndromic AGE was estimated at US$ 3,892.837 per annum. This was a pilot study on the burden of illness (BOI) in the Caribbean. The results of the study should be interpreted within the limitations and challenges of this study. Lessons learnt were used for improving the implementation procedures of other BOI studies in the Caribbean.
Assuntos
Efeitos Psicossociais da Doença , Diarreia/economia , Diarreia/epidemiologia , Gastroenteropatias/economia , Gastroenteropatias/epidemiologia , Doença Aguda , Adolescente , Adulto , Distribuição por Idade , Idoso , Causalidade , Criança , Pré-Escolar , Comorbidade , Estudos Transversais , Feminino , Doenças Transmitidas por Alimentos/economia , Doenças Transmitidas por Alimentos/epidemiologia , Humanos , Incidência , Lactente , Entrevistas como Assunto/métodos , Masculino , Pessoa de Meia-Idade , Projetos Piloto , Vigilância da População/métodos , Prevalência , Projetos de Pesquisa/estatística & dados numéricos , Estudos Retrospectivos , Santa Lúcia/epidemiologia , Índice de Gravidade de Doença , Distribuição por Sexo , Fatores de Tempo , Adulto JovemRESUMO
La anemia de células falciformes (ACF) ha sido la anemia hereditaria más común en el mundo. El presente estudio informa el análisis clínico y de laboratorio en 100 pacientes, estudiados en Camagüey y en Castries, Sta Lucía, respectivamente, los cuales fueron ingresados en el período comprendido entre el primero de enero de 1990 al 31 de diciembre de 1994, ambos inclusive. Las crisis dolorosas, fiebre y anemia fueron las causas más frecuentes de ingreso en Cuba, en Santa Lucia lo fueron las artralgias, las crisis dolorosas y fiebre. Desde el punto de vista clínico y del laboratorio, así como las complicaciones, ofrecen resultados parecidos a los encontrados en otros países del área del Caribe en donde la anemia de células falciformes tiene una alta frecuencia. La mortalidad, igualmente, ofrece resultados similares, y es una de las causas coincidentes con las reportadas en otras partes donde es común esta enfermedad. Se concluye que la anemia de células falciformes en nuestro medio, podría tener un fenotipo más benigno, resultado del ancestro Áfricano modificado por el mestizaje y los demás factores del ecosistema geográfico.
The sickle cell anemia (SCA) has been the most common hereditary anemia in the world. This study presents the clinical and laboratory analyses in 100 patients, studied in Camagüey, Cuba and in Catries, Santa Lucía, respectively, who were admitted within the period from January 1st 1990 to december 31st 1994 both included. Painfut crisis, fever and anemia were the most fraquent causes of admission in Cuba, arthralgies, painful crisis and fever in Santa Lucía. From the clinical and laboratory point of view as well as complications give results similar to that found in other countries of the Caribbean area where SCA has a high frequency. Mortality, equally, presents similar results and is one of the causes that coincides with the one reported in other parts where this discause is common. Concluding SCA in our settings, may have a more benign phenotype, result of the African ancester modified by the mixture of races and other factors of the geographical echosiptem.