Table 3.
Health systems resource allocations: health education, psychosocial and spiritual patient-support during treatment
| Basic | Limited | Enhanced | Maximal | |
|---|---|---|---|---|
| Health Professional Educationa | Appropriate use of CPG Women’s health Psychosocial considerationc Spiritual considerationc Health literacy, cultural literacy, communication skills |
Sexual health Psychosocial impact of breast cancer / TX (individual and community) |
Psychosocial screening methods | |
| Patient and Family Educationb | TX-related toxicities and other TX side-effects Fatigue, insomnia Reproductive health / fertility and body image Psychosocial issues Spiritual issues |
Sexual health Psychosocial impact of breast cancer / TX |
||
| Psychosocial (Treatment-related) | Patient and family educationb Psychosocial considerationc Peer support by trained volunteers |
Psychosocial assessment, including depression Patient and family support groups Psychosocial support by health professionals |
Screening and referrals for depression and distress by mental health specialist Psychosocial counseling by mental health specialist Prescription drugs for depression |
Psychiatrist, psychologist, or social worker coordinated mental health care |
| Spiritual (Treatment-related) | Spiritual considerationc Spiritual support: community-based |
Note: The table stratification scheme implies incrementally increasing resource allocation at the basic, limited, and enhanced levels. Maximal-level resources should not be targeted for implementation in LMICs, even though they may be used in some higher-income settings.
Abbreviations: CPG, clinical practice guidelines; TX, treatment.
The term “health professional” is used to acknowledge the range in medical and other professionals who provide supportive care services in LMICs. When specialists are identified as a required resource, it is assumed that a specialist has a certification for their area of expertise.
Patient, family and/or partner education may be the primary intervention for some supportive care services.
“Consideration” is a term used in this table to refer to basic patient evaluation through patient-provider interactions, including dialogue, observations, and other appropriate means of evaluation.