Résumé
The incidence of cancer continues to rise, mainly due to an ageing population and lifestyle habits that are sometimes detrimental to health. Today, cancer is the second leading cause of death in the world and the leading cause in high-income countries and in some middle-income countries. In Switzerland, around 46,500 people are diagnosed with cancer every year. Thanks to medical advances and screening programmes, the five-year survival rate is now 69%. As a result, almost 450,000 people are currently living with or after cancer.
However, life after cancer is still characterised by many challenges. It is estimated that one third of survivors have specific needs during their lifetime. Although some of these needs are already well documented and addressed, others remain largely underestimated and unaddressed. This situation causes considerable suffering for those affected, impacting their social and professional lives and thus their quality of life.
The aim of this PhD project is to contribute to the IBS2 project, which aims to raise awareness of the needs of cancer survivors and to introduce a routine assessment into the care pathway in Switzerland.
This work was divided into three main phases. First, an in-depth literature review identified the various needs of cancer survivors and the related key influencing factors. The results of this analysis showed that there are many needs, particularly in relation to information about health and the care system, that are not yet adequately addressed. Secondly, data from the SCAPE 2 study with survivors in Switzerland was analysed to determine whether the needs identified in the literature were also perceived by Swiss survivors. This analysis highlighted the importance of access to clear, appropriate information and support in understanding and processing such information. The need for active participation and support in navigating the care system was also highlighted. Finally, needs assessment materials were developed in collaboration with experts in the field and the individuals concerned. This participatory approach led to the creation of two sets of questionnaires: one aimed at survivors, the other at health and social care professionals. This material makes it easier to identify the expectations of survivors and to guide professionals towards more personalised and appropriate care.
This PhD project has highlighted a variety of unmet needs of cancer survivors that are often neglected in post-treatment care. One of the ways to improve the aftercare system is to introduce a regular and systematic assessment of survivors' needs. This assessment would form the basis for the creation of a personalised survivorship care plan that provides practical support in understanding and coping with the disease.
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