Mosalo, Annah2021-11-232021-11-232021https://hdl.handle.net/10539/32040A thesis submitted in fulfilment of the requirements for the degree of Doctor of Philosophy (Psychiatry) to the Faculty of Health Sciences, School of Therapeutic Sciences, University of the Witwatersrand, Johannesburg, 2021Background: Cervical cancer is the fourth most common cancer among women worldwide and the most common cause of cancer related deaths. Whilst developed countries have reduced morbidity and mortality from the disease, the situation is experienced differently from the developing countries due to lack of resources including support from the health care as patients navigate the health care system. Women in Sub-Sahara are affected by this disease resulting in increased mortality. Even though South Africa has a screening policy in place, Black South African women are mostly affected, even so at the prime of their lives when they contribute to the economy of their families. Women present late when the cancer has advanced. Curative treatment for stages IIB- IVA disease includes external beam radiation and brachytherapy with or without concomitant chemotherapy. However, facilities that offer treatment for cervical cancer are limited. Women may need to be treated away from home, family and friends whom they rely on during the disease trajectory to help them adjust and cope with the illness. Women may need to be offered time off from work to afford them an opportunity to attend the treatment. It is crucial that women are supported during this period, as it has been reported that support buffers the effects of cancer and its treatment. Aim of the study: The study explored the needs of women receiving curative treatment for cervical cancer at an Academic hospital and developed a support programme based on the needs identified. The programme was evaluated at the end. METHOD An exploratory sequential mixed method approach was utilised to explore the support needs of women receiving curative treatment for cervical cancer and to develop a support programme. The study consisted of two phases. Phase 1 utilised a qualitative approach to explore the support of women receiving curative treatment for cervical cancer including radiation and developed a support programme. Phase 2 utilised a quantitative approach using pre-and post test to implement and evaluate the programme. iv RESULTS Six themes emerged which were: symptoms experienced leading to accessing the healthcare facility; information pertaining to the disease and treatment; need for counselling during the cancer trajectory; emotional support; need for instrumental support; network, peer and media support. The needs highlighted guided the development of a support programme which was implemented and evaluated on the last day with participants who attended all the sessions. The study provided evidence that the programme was effective in providing the perception of improved support based on the opinions of the participants who attended the programme. CONCLUSION Participants in the program felt empowered regarding the information about the disease and its treatment. They felt confident that they could inform others (women) about their illness without experience of shame and could encourage them to go for screening. The program provided an environment where one could talk freely about their situation without being stigmatised. Although the programme was a pilot study it provided evidence of being effective based on the participants evaluation. However, quality of life could not be evaluated as the programme was completed on the last day of the participants receiving treatment when it could have been appropriate to asses. The researcher suggest that the programme be offered according to the different phases of the cancer trajectory, as it was noted that lots of information were shared with the participants within a short time which may not have been easy to understand considering their situation. It is further suggested that the participants in such programmes be followed up over longer period to evaluate their perception of quality of life.enThesis