1
|
Dibble KE, Deng Z, Jin M, Connor AE. Associations between race/ethnicity and SEER-CAHPS patient care experiences among female Medicare beneficiaries with breast cancer. J Geriatr Oncol 2023; 14:101633. [PMID: 37741036 PMCID: PMC10843501 DOI: 10.1016/j.jgo.2023.101633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 08/31/2023] [Accepted: 09/13/2023] [Indexed: 09/25/2023]
Abstract
INTRODUCTION We aimed to determine if racial/ethnic disparities exist in survivorship care patient experiences among older breast cancer survivors. MATERIALS AND METHODS Nineteen thousand seventeen female breast cancer survivors aged ≥65 at post-diagnosis survey contributed data via the National Cancer Institute Surveillance, Epidemiology, and End Results (SEER) and Centers for Medicare and Medicaid Services Consumer Assessment of Healthcare Providers & Systems (CAHPS) data linkage (2000-2019). Multivariable linear regression models were used to estimate adjusted beta (β) coefficients and standard error (SE) estimates for associations between race/ethnicity and survivorship care patient experiences. RESULTS Most women were non-Hispanic (NH)-White (78.1%; NH-Black [8.1%], NH-Asian [6.5%], Hispanic [6.2%]). On average, women reported 76.3 years (standard deviation [SD] = 7.14) at CAHPS survey and 6.10 years since primary diagnosis (SD = 3.51). Compared with NH-White survivors, NH-Black survivors reported lower mean scores for Getting Care Quickly (β = -5.17, SE = 0.69, p ≤0.001), Getting Needed Care (β = -1.72, SE = 0.63, p = 0.006), and Overall Care Ratings (β = -2.72, SE = 0.48, p ≤0.001), mirroring the results for NH-Asian survivors (Getting Care Quickly [β = -7.06, SE = 0.77, p ≤0.001], Getting Needed Care [β = -4.43, SE = 0.70, p ≤0.001], Physician Communication [β = -1.15, SE = 0.54, p = 0.03], Overall Care Rating [β = -2.32, SE = 0.53, p ≤0.001]). Findings among Hispanic survivors varied, where mean scores were lower for Getting Care Quickly (β = -2.83, SE = 0.79, p ≤0.001), Getting Needed Care (β = -2.43, SE = 0.70, p = 0.001), and Getting Needed Prescription Drug(s) (β = -1.47, SE = 0.64, p = 0.02), but were higher for Health Plan Rating (β = 2.66, SE = 0.55, p ≤0.001). Education, Medicare plan, and multimorbidity significantly modified various associations among NH-Black survivors, and education was a significant modifier among NH-Asian and Hispanic survivors. DISCUSSION We observed racial/ethnic disparities in the associations with survivorship care patient experience among NH-Black, Hispanic, and NH-Asian breast cancer survivors. Future research should examine the impact of education, Medicare plans, and multimorbidity on these associations.
Collapse
Affiliation(s)
- Kate E Dibble
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe Street, Baltimore, MD 21205, USA.
| | - Zhengyi Deng
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe Street, Baltimore, MD 21205, USA
| | - Mu Jin
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe Street, Baltimore, MD 21205, USA
| | - Avonne E Connor
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe Street, Baltimore, MD 21205, USA; Department of Oncology, Johns Hopkins Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD 21205, USA
| |
Collapse
|
2
|
Brett J, Henshall C, Dawson P, Collins GP, Ehlers A, Mitchell-Floyd T, Aspinall A, Gilmour-Hamilton C, Robinson K, Watson E. Examining the levels of psychological support available to patients with haematological cancer in England: a mixed methods study. BMJ Open 2023; 13:e060106. [PMID: 36806143 PMCID: PMC9943904 DOI: 10.1136/bmjopen-2021-060106] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/22/2023] Open
Abstract
OBJECTIVES The psychological impact of a haematological malignancy is well documented. However, few studies have assessed the provision of psychological support to people with these diagnoses. This study explores the extent and nature of psychological support for people diagnosed with haematological cancer to inform future service provision. DESIGN This study consisted of an online survey with healthcare professionals (phase 1) and qualitative interviews with patients (phase 2) and key health professionals (phase 3). A descriptive analysis of survey data and thematic analysis of interviews were conducted. PARTICIPANTS Two hundred health professionals practising in England completed the survey. Twenty-five interviews were conducted with people diagnosed with haematological cancer in the past 3 years, and 10 with key health professionals, including haematologists, cancer nurse specialists and psychologists were conducted. PRIMARY OUTCOME MEASURES Level of psychological assessment undertaken with people with haematological cancer, and level and nature of psychological support provided. RESULTS Less than half (47.3%) of survey respondents strongly agreed/agreed that their patients were well supported in terms of their psychological well-being and approximately half (49.4%) reported providing routine assessment of psychological needs of patients, most commonly at the time of diagnosis or relapse. Patients described their need for psychological support, their experiences of support from health professionals and their experiences of support from psychological therapy services. There was considerable variation in the support patients described receiving. Barriers to providing psychological support reported by health professionals included time, skills, resources and patient barriers. Most doctors (85%) and 40% of nurse respondents reported receiving no training for assessing and managing psychological needs. CONCLUSIONS Psychological well-being should be routinely assessed, and person-centred support should be offered regularly throughout the haematological cancer journey. Greater provision of healthcare professional training in this area and better integration of psychological support services into the patient care pathway are required.
Collapse
Affiliation(s)
- Jo Brett
- Health and Life Sciences, Oxford Brookes University, Oxford, UK
| | - Catherine Henshall
- Health and Life Sciences, Oxford Brookes University, Oxford, UK
- Research Delivery, Oxford Health NHS Foundation Trust, Oxford, UK
| | - Paul Dawson
- Health and Life Sciences, Oxford Brookes University, Oxford, UK
| | - Graham P Collins
- Clinical Haematology, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Anke Ehlers
- Experimental Psychology, University of Oxford, Oxford, UK
| | - Tracy Mitchell-Floyd
- Clinical Haematology, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Anya Aspinall
- Clinical Haematology, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | | | - Kate Robinson
- Patient and Public Involvement, Oxford Brookes University, Oxford, UK
| | - Eila Watson
- Health and Life Sciences, Oxford Brookes University, Oxford, UK
| |
Collapse
|
3
|
Pozzar RA, Xiong N, Hong F, Wright AA, Goff BA, Underhill-Blazey ML, Tulsky JA, Hammer MJ, Berry DL. How does patient-centered communication in ovarian cancer care enhance patient well-being? A mixed methods study. Gynecol Oncol 2022; 167:261-268. [PMID: 36057465 DOI: 10.1016/j.ygyno.2022.08.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 07/15/2022] [Accepted: 08/24/2022] [Indexed: 11/27/2022]
Abstract
OBJECTIVE Greater perceived patient-centered communication (PCC) is associated with better health-related quality of life (HRQoL) in patients with ovarian cancer. Quantitative measures of PCC and HRQoL do little to explain this association. We interviewed patients with high and low ratings of PCC to understand how it is associated with HRQoL. METHODS Explanatory sequential mixed methods study. Participants were English-speaking U.S. adults with ovarian cancer. We assessed PCC with the Patient-Centered Communication - Cancer (PCC-Ca)-36 (possible score range 1-5; higher scores represent greater patient-centeredness), and purposively sampled 14 participants with total scores in the top and bottom quartiles. Participants completed individual, semi-structured interviews about their communication experiences. Guided by the National Cancer Institute Framework for PCC in Cancer Care, we analyzed interview transcripts using directed content analysis. We integrated survey and interview findings in a joint display. RESULTS Among 176 survey respondents, PCC-Ca-36 total scores ranged from 1.7 to 5.0. Participants with scores in the top quartile (4.8-5.0) perceived clinicians as proactive and attentive to psychosocial concerns. Those with scores in the bottom quartile (1.7-3.5) described not feeling known as an individual and receiving limited support for self-management. CONCLUSIONS The association between PCC and QoL may be partially explained by differences in perceived support for psychosocial concerns and self-management. PCC may facilitate receipt of proactive, personalized care.
Collapse
Affiliation(s)
- Rachel A Pozzar
- Dana-Farber Cancer Institute, Boston, MA, USA; Harvard Medical School, Boston, MA, USA.
| | - Niya Xiong
- Dana-Farber Cancer Institute, Boston, MA, USA
| | - Fangxin Hong
- Dana-Farber Cancer Institute, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
| | - Alexi A Wright
- Dana-Farber Cancer Institute, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
| | | | | | - James A Tulsky
- Dana-Farber Cancer Institute, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
| | - Marilyn J Hammer
- Dana-Farber Cancer Institute, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
| | | |
Collapse
|
4
|
Parker PD, Prabhu AV, Su LJ, Zorn KK, Greene CJ, Hadden KB, McSweeney JC. What's in Between the Lines: Assessing the Readability, Understandability, and Actionability in Breast Cancer Survivorship Print Materials. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2022; 37:1532-1539. [PMID: 33822316 PMCID: PMC8492775 DOI: 10.1007/s13187-021-02003-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/29/2021] [Indexed: 06/12/2023]
Abstract
Educational print materials for young women breast cancer survivors (YBCS) are supplemental tools used in patient teaching. However, the readability of the text coupled with how well YBCS understand or act upon the material are rarely explored. The purpose of this study was to assess the readability, understandability, and actionability of commonly distributed breast cancer survivorship print materials. We used an environmental scan approach to obtain a sample of breast cancer survivorship print materials available in outpatient oncology clinics in the central region of a largely rural Southern state. The readability analyses were completed using the Flesch-Kincaid (F-K), Fry Graph Readability Formula (Fry), and Simple Measure of Gobbledygook (SMOG). Understandability and actionability were analyzed using Patient Education Materials Assessment Tool for Printable Materials (PEMAT-P). The environmental scan resulted in a final sample of 14 materials. The mean readability of the majority of survivorship materials was "difficult," but the majority scored above the recommended 70% in both understandability and actionability. The importance of understandability and actionability may outweigh readability results in cancer education survivorship material. While reading grade level cannot be dismissed all together, we surmise that patient behavior may hinge more on other factors such as understandability and actionability. Personalized teaching accompanying print material may help YBCS comprehend key messages and promote acting upon specific tasks.
Collapse
Affiliation(s)
- Pearman D Parker
- College of Nursing, University of Arkansas for Medical Sciences, 4301 W. Markham Street, Slot #529, Little Rock, Arkansas, 72205, USA.
| | - Arpan V Prabhu
- College of Medicine, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - L Joseph Su
- College of Public Health, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Kristin K Zorn
- College of Medicine, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Carolyn J Greene
- College of Medicine, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Kristie B Hadden
- University of Arkansas for Medical Sciences, UAMS Health, Little Rock, Arkansas, USA
| | - Jean C McSweeney
- College of Nursing, University of Arkansas for Medical Sciences, 4301 W. Markham Street, Slot #529, Little Rock, Arkansas, 72205, USA
| |
Collapse
|
5
|
Drott J, Fomichov V, Nordén M, Larsson AL, Sandström P, Björnsson B, Eldh AC. Patient preferences and experiences of participation in surgical cancer care. Worldviews Evid Based Nurs 2022; 19:405-414. [PMID: 35607906 PMCID: PMC10946456 DOI: 10.1111/wvn.12589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Revised: 02/11/2022] [Accepted: 02/26/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND Quality cancer care necessitates opportunities for patient participation, supposedly recognizing the individual's preferences and experiences for being involved in their health and healthcare issues. Previous research shows that surgical cancer patients wish to be more involved, requiring professionals to be sensitive of patients' needs. AIMS To explore preference-based patient participation in surgical cancer care. METHODS A cross-sectional study was conducted. The Patient Preferences for Patient Participation tool (4Ps) was used, which includes 12 attributes of preferences for and experiences of patient participation. Data were analyzed with descriptive and comparative statistical methods. RESULTS The results are based on a total of 101 questionnaires. Having reciprocal communication and being listened to by healthcare staff were commonly deemed crucial for patient participation. While 60% of the patients suggested that taking part in planning was crucial for their participation, they had experienced this only to some extent. Learning to manage symptoms and phrasing personal goals were items most often representing insufficient conditions for preference-based patient participation. LINKING EVIDENCE TO ACTION To support person-centered surgical care, further efforts to suffice preference-based participation are needed, including opportunities for patients to share their experiences and engage in the planning of healthcare activities.
Collapse
Affiliation(s)
- Jenny Drott
- Department of Health, Medicine and Caring SciencesLinköping UniversityLinköpingSweden
- Department of Surgery in Linköping, Department of Biomedical and Clinical SciencesLinköping UniversityLinköpingSweden
| | - Victoria Fomichov
- Unit for Public Health and Statistics, County Council of ÖstergötlandLinköping UniversityLinköpingSweden
| | - Maria Nordén
- Department of Urology in Linköping, Department of Biomedical and Clinical SciencesLinköping UniversityLinköpingSweden
| | - Anna Lindhoff Larsson
- Department of Surgery in Linköping, Department of Biomedical and Clinical SciencesLinköping UniversityLinköpingSweden
| | - Per Sandström
- Department of Surgery in Linköping, Department of Biomedical and Clinical SciencesLinköping UniversityLinköpingSweden
| | - Bergthor Björnsson
- Department of Surgery in Linköping, Department of Biomedical and Clinical SciencesLinköping UniversityLinköpingSweden
| | - Ann Catrine Eldh
- Department of Health, Medicine and Caring SciencesLinköping UniversityLinköpingSweden
- Department of Public Health and Caring SciencesUppsala UniversityUppsalaSweden
| |
Collapse
|
6
|
Communicating is analogous to caring: A systematic review and thematic synthesis of the patient-clinician communication experiences of individuals with ovarian cancer. Palliat Support Care 2022; 21:515-533. [PMID: 35582975 DOI: 10.1017/s1478951522000621] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To systematically review and synthesize the patient-clinician communication experiences of individuals with ovarian cancer. METHODS The CINAHL, Embase, MEDLINE, PsycINFO, and Web of Science databases were reviewed for articles that described (a) original qualitative or mixed methods research, (b) the experiences of individuals with ovarian cancer, and (c) findings related to patient-clinician communication. Relevant data were extracted from study results sections, then coded for descriptive and analytical themes in accordance with Thomas and Harden's approach to thematic synthesis. Data were coded by two authors and discrepancies were resolved through discussion. RESULTS Of 1,390 unique articles, 65 met criteria for inclusion. Four descriptive themes captured participants' experiences communicating with clinicians: respecting me, seeing me, supporting me, and advocating for myself. Findings were synthesized into three analytical themes: communication is analogous to caring, communication is essential to personalized care, and communication may mitigate or exacerbate the burden of illness. SIGNIFICANCE OF RESULTS Patient-clinician communication is a process by which individuals with ovarian cancer may engage in self-advocacy and appraise the extent to which they are seen, respected, and supported by clinicians. Strategies to enhance patient-clinician communication in the ovarian cancer care setting may promote patient perceptions of patient-centered care.
Collapse
|
7
|
Pozzar RA, Xiong N, Hong F, Wright AA, Goff BA, Underhill-Blazey ML, Tulsky JA, Hammer MJ, Berry DL. Perceived patient-centered communication, quality of life, and symptom burden in individuals with ovarian cancer. Gynecol Oncol 2021; 163:408-418. [PMID: 34454724 DOI: 10.1016/j.ygyno.2021.08.007] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Revised: 08/09/2021] [Accepted: 08/10/2021] [Indexed: 12/22/2022]
Abstract
OBJECTIVE To describe perceptions of patient-centered communication (PCC); assess whether physician specialty, patient characteristics, or health system characteristics are associated with PCC; and identify associations between PCC, health-related quality of life (HRQoL), and symptom burden among individuals with ovarian cancer. METHODS Cross-sectional, descriptive survey of English-speaking adults with ovarian cancer. PCC, HRQoL, and ovarian cancer symptom burden were assessed with the PCC-Ca-36, the FACT-G, and the FOSI-18, respectively. PCC-Ca-36 scores were summarized using descriptive statistics. Predictors of PCC-Ca-36, FACT-G, and FOSI-18 scores were identified using multiple linear regression. RESULTS Participants (n = 176) had a mean age of 59.4 years (SD = 12.1). The majority (65.9%) had advanced-stage disease, while 42.0% were receiving treatment. The mean PCC-Ca-36 total score was 4.09 (SD = 0.78) out of a possible 5, indicating participants often perceived that clinicians engaged in PCC. Among the PCC functions, participants reported that clinicians least often enabled patient self-management (M = 3.65, SD = 0.99), responded to emotions (M = 3.84, SD = 1.04), and managed uncertainty (M = 3.91, SD = 0.93). In multivariable analyses, neither physician specialty nor patient and health system characteristics were significantly associated with overall PCC. Greater overall PCC predicted better overall HRQoL; better social/family, emotional, and functional well-being; and lower overall and physical symptom burden (all p ≤ 0.05). CONCLUSION Greater PCC is significantly associated with better HRQoL and lower symptom burden among individuals with ovarian cancer. PRACTICE IMPLICATIONS Promotion of PCC is a promising strategy to improve patient-reported outcomes in the ovarian cancer care setting.
Collapse
Affiliation(s)
- Rachel A Pozzar
- Dana-Farber Cancer Institute, 450 Brookline Ave., Boston, MA 02215, United States.
| | - Niya Xiong
- Dana-Farber Cancer Institute, 450 Brookline Ave., Boston, MA 02215, United States
| | - Fangxin Hong
- Dana-Farber Cancer Institute, 450 Brookline Ave., Boston, MA 02215, United States
| | - Alexi A Wright
- Dana-Farber Cancer Institute, 450 Brookline Ave., Boston, MA 02215, United States
| | - Barbara A Goff
- University of Washington, 1959 NE Pacific St., Seattle, WA 98115, United States
| | - Meghan L Underhill-Blazey
- Dana-Farber Cancer Institute, 450 Brookline Ave., Boston, MA 02215, United States; University of Rochester, 255 Crittenden Blvd., Rochester, NY 14642, United States
| | - James A Tulsky
- Dana-Farber Cancer Institute, 450 Brookline Ave., Boston, MA 02215, United States
| | - Marilyn J Hammer
- Dana-Farber Cancer Institute, 450 Brookline Ave., Boston, MA 02215, United States
| | - Donna L Berry
- Dana-Farber Cancer Institute, 450 Brookline Ave., Boston, MA 02215, United States; University of Washington, 1959 NE Pacific St., Seattle, WA 98115, United States
| |
Collapse
|
8
|
Kopp ML, Mayberry ALM. An End-of-Life Communication Performance Rubric: Reliability Assessment. J Hosp Palliat Nurs 2021; 23:429-434. [PMID: 34050097 DOI: 10.1097/njh.0000000000000772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Nurse educators still struggle with teaching and assessing end-of-life communication skills. Many resources are available to assist in teaching end-of-life communication, but few tools exist to assess performance learning outcomes. Behavior evaluation tools must be user-friendly and provide beneficial student feedback. Quality end-of-life patient care and nursing job satisfaction depend on skillful communication. The purpose of this study was to evaluate the reliability of an end-of-life communication clinical simulation evaluation performance rubric. Moderate interrater consistency and agreement were found between 3 evaluators when assessing the same students. All simulation evaluators agreed that the performance rubric was user-friendly and provided rich feedback for students during simulation debriefing. The performance evaluation tool was moderately effective when evaluating end-of-life communication performance and appears as a worthy framework for other behavior evaluations.
Collapse
|
9
|
Vollmer Dahlke D, Yoshikawa A, McAdam M, Malatok S, Gonzales ED. Analysis of Healthcare Team Communication Needs Among Younger vs Older Breast Cancer Survivors: A Web-based Survey (Preprint). JMIR Cancer 2021; 8:e31118. [PMID: 35302499 PMCID: PMC8976259 DOI: 10.2196/31118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 09/21/2021] [Accepted: 01/18/2022] [Indexed: 11/13/2022] Open
Abstract
Background Objective Methods Results Conclusions
Collapse
Affiliation(s)
- Deborah Vollmer Dahlke
- Texas A&M Center for Population Health and Aging, Texas A&M University, Austin, TX, United States
| | - Aya Yoshikawa
- Texas Woman's University, School of Health Promotion and Kinesiology, College of Health Sciences, Denton, TX, United States
| | - Molly McAdam
- Breast Cancer Resource Center, Austin, TX, United States
| | - Sharyn Malatok
- Breast Cancer Resource Center, Austin, TX, United States
| | | |
Collapse
|
10
|
Barlow KH, van der Pols JC, Ekberg S, Johnston EA. Cancer survivors' perspectives of dietary information provision after cancer treatment: A scoping review of the Australian context. Health Promot J Austr 2021; 33:232-244. [PMID: 33890348 DOI: 10.1002/hpja.496] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Accepted: 04/16/2021] [Indexed: 01/25/2023] Open
Abstract
ISSUE ADDRESSED To support survivor-centred care in Australia, this review maps current knowledge regarding adult cancer survivors' perspectives of dietary information provision post-treatment. METHODS A scoping review of research conducted in Australia within the past decade reported using PRISMA-ScR guidelines. Seven databases were searched (01/01/2009-05/06/2020) and records were independently screened by two researchers using eligibility criteria. Papers in the peer-reviewed literature with dietary information post-treatment as a primary and secondary outcome were eligible for inclusion. Data charting included participant characteristics, study methodology and cancer survivors' reports of dietary information provision post-treatment. RESULTS Of 531 records identified, 12 met eligibility criteria. Most studies included breast (58%) and colorectal (42%) cancer survivors within 5 years post-diagnosis (84%). Three studies were conducted amongst specific ethnic groups (Indigenous Australians, Chinese-Australians, Greek-Australians). Participants in the included studies commonly reported limited or ineffective dietary information from healthcare providers post-treatment. Cancer survivors identified a need for individualised information regarding dietary strategies to manage ongoing symptoms, professional support for weight management, and practical skills for healthy eating. Amongst ethnic groups, there was a need for dietary information that considers traditional foods and cultural beliefs, and is available in their native language. Cancer survivors valued ongoing dietary follow-up and support post-treatment, and suggested a variety of face-to-face and online delivery modes. Those residing in rural and remote areas reported barriers to accessing dietary information post-treatment including time, cost, and availability of local services. CONCLUSIONS There is scope to improve dietary information provision after cancer treatment in Australia. SO WHAT?: Dietary guidance post-treatment should consider individual needs, cultural background, and opportunity for ongoing follow-up and support.
Collapse
Affiliation(s)
- Katherine H Barlow
- Faculty of Health, School of Exercise and Nutrition Sciences, Queensland University of Technology (QUT), Brisbane, Australia
| | - Jolieke C van der Pols
- Faculty of Health, School of Exercise and Nutrition Sciences, Queensland University of Technology (QUT), Brisbane, Australia
| | - Stuart Ekberg
- Faculty of Health, School of Psychology and Counselling, Queensland University of Technology (QUT), Brisbane, Australia
| | - Elizabeth A Johnston
- Faculty of Health, School of Exercise and Nutrition Sciences, Queensland University of Technology (QUT), Brisbane, Australia
| |
Collapse
|
11
|
Alpert JM, Markham MJ, Bjarnadottir RI, Bylund CL. Twenty-first Century Bedside Manner: Exploring Patient-Centered Communication in Secure Messaging with Cancer Patients. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2021; 36:16-24. [PMID: 31342283 DOI: 10.1007/s13187-019-01592-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Patient-centered communication (PCC) is integral to providing high-quality health care and is recommended to be incorporated during face-to-face consultations. Electronic communication, such as the use of secure messaging (SM) within patient portals, is a popular form of patient-provider communication, but preliminary studies have shown that PCC is rarely utilized by providers in SM. As a consequence, the patient-provider relationship can be negatively affected, especially for cancer patients who have greater electronic health information needs than the general population. Therefore, our objective was to determine the importance of SM to cancer patients and to identify which attributes of PCC are preferred to be incorporated into secure messages. Five focus groups were conducted, comprised of patients with a current or previous cancer diagnosis (three all-female; two all-male). Participants recalled their own experiences and reviewed simulated messages. Three main topics emerged from the thematic analysis: (1) the normalization of SM, (2) SM quality can affect perceptions of care, and (3) patients need guidance. Overall, participants valued the ability to communicate with their care team using SM and indicated that electronic communication may have the potential to have just as big of an impact on a patient's care than in-person communication.
Collapse
Affiliation(s)
- Jordan M Alpert
- Department of Advertising, University of Florida, 2093 Weimer Hall, Gainesville, FL, 32611, USA.
| | - Merry Jennifer Markham
- Department of Medicine, Division of Hematology & Oncology, University of Florida, Gainesville, FL, USA
| | | | - Carma L Bylund
- College of Journalism and Communications / College of Medicine, University of Florida, Gainesville, FL, USA
| |
Collapse
|
12
|
Johnston EA, van der Pols JC, Ekberg S. Needs, preferences, and experiences of adult cancer survivors in accessing dietary information post-treatment: A scoping review. Eur J Cancer Care (Engl) 2020; 30:e13381. [PMID: 33377564 DOI: 10.1111/ecc.13381] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Revised: 10/13/2020] [Accepted: 11/18/2020] [Indexed: 01/08/2023]
Abstract
INTRODUCTION To support provision of healthy lifestyle information tailored to patients' needs and preferences, this review maps adult cancer survivors' self-reported needs, preferences, and experiences accessing dietary information post-treatment. METHODS A scoping review of research published within the past decade conducted using PRISMA-ScR guidelines. Seven databases were searched in June 2020. RESULTS Of 15,973 articles identified, 57 met eligibility criteria. Studies most frequently included survivors of breast cancer (49%), persons aged 40+ years (95%), ≤5 years post-diagnosis (54%), and residing in North America (44%). Cancer survivors commonly identified needing information regarding healthy eating, particularly practical skills, and support in changing dietary behaviours. Preferences included specific recommendations, direct communication with healthcare professionals, and peer support from other cancer survivors. In practice, survivors frequently reported receiving generic advice from healthcare professionals, limited dietary follow-up, and lack of referral to support. Unmet needs in healthcare settings led to dietary information-seeking elsewhere; however, survivors indicated difficulty identifying credible sources. Personal beliefs and desire for involvement in care motivated dietary information-seeking post-treatment. CONCLUSION Cancer survivors' experiences accessing dietary information post-treatment do not align with needs and preferences. Less is known about survivors who are young adults, >5 years post-diagnosis, and living in rural areas.
Collapse
Affiliation(s)
- Elizabeth A Johnston
- School of Exercise and Nutrition Sciences, Queensland University of Technology (QUT), Kelvin Grove, QLD, Australia
| | - Jolieke C van der Pols
- School of Exercise and Nutrition Sciences, Queensland University of Technology (QUT), Kelvin Grove, QLD, Australia
| | - Stuart Ekberg
- School of Psychology and Counselling, Queensland University of Technology (QUT), Kelvin Grove, QLD, Australia
| |
Collapse
|
13
|
Tran BQ. Strategies for effective patient care: Integrating quality communication with the patient‐centered approach. SOCIAL AND PERSONALITY PSYCHOLOGY COMPASS 2020. [DOI: 10.1111/spc3.12574] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Affiliation(s)
- Brandon Q. Tran
- Department of Psychology University of California Riverside California USA
| |
Collapse
|
14
|
Fabbri M, Finney Rutten LJ, Manemann SM, Boyd C, Wolff J, Chamberlain AM, Weston SA, Yost KJ, Griffin JM, Killian JM, Roger VL. Patient-centered communication and outcomes in heart failure. AMERICAN JOURNAL OF MANAGED CARE 2020; 26:425-430. [PMID: 33094937 DOI: 10.37765/ajmc.2020.88500] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVES To measure the impact of patient-centered communication on mortality and hospitalization among patients with heart failure (HF). STUDY DESIGN This was a survey study of 6208 residents of 11 counties in southeast Minnesota with incident HF (first-ever International Classification of Diseases, Ninth Revision code 428 or International Classification of Diseases, Tenth Revision code I50) between January 1, 2013, and March 31, 2016. METHODS Perceived patient-centered communication was assessed with the health care subscale of the Chronic Illness Resources Survey and measured as a composite score on three 5-point scales. We divided our cohort into tertiles and defined them as having fair/poor (score < 12), good (score of 12 or 13), and excellent (score ≥ 14) patient-centered communication. The survey was returned by 2868 participants (response rate: 45%), and those with complete data were retained for analysis (N = 2398). Cox and Andersen-Gill models were used to determine the association of patient-centered communication with death and hospitalization, respectively. RESULTS Among 2398 participants (median age, 75 years; 54% men), 233 deaths and 1194 hospitalizations occurred after a mean (SD) follow-up of 1.3 (0.6) years. Compared with patients with fair/poor patient-centered communication, those with good (HR, 0.70; 95% CI, 0.51-0.97) and excellent (HR, 0.70; 95% CI, 0.51-0.96) patient-centered communication experienced lower risks of death after adjustment for various confounders (Ptrend = .020). Patient-centered communication was not associated with hospitalization. CONCLUSIONS Among community patients living with HF, excellent and good patient-centered communication is associated with a reduced risk of death. Patient-centered communication can be easily assessed, and consideration should be given toward implementation in clinical practice.
Collapse
Affiliation(s)
| | | | | | | | | | | | | | | | | | | | - Véronique L Roger
- Department of Health Sciences Research, Mayo Clinic, 200 First St SW, Rochester, MN 55905.
| |
Collapse
|
15
|
Street RL, Petrocelli JV, Amroze A, Bergelt C, Murphy M, Wieting JM, Mazor KM. How Communication "Failed" or "Saved the Day": Counterfactual Accounts of Medical Errors. J Patient Exp 2020; 7:1247-1254. [PMID: 33457572 PMCID: PMC7786716 DOI: 10.1177/2374373520925270] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
Communication breakdowns among clinicians, patients, and family members can lead to medical errors, yet effective communication may prevent such mistakes. This investigation examined patients' and family members' experiences where they believed communication failures contributed to medical errors or where effective communication prevented a medical error ("close calls"). The study conducted a thematic analysis of open-ended responses to an online survey of patients' and family members' past experiences with medical errors or close calls. Of the 93 respondents, 56 (60%) provided stories of medical errors, and the remaining described close calls. Two predominant themes emerged in medical error stories that were attributed to health care providers-information inadequacy (eg, delayed, inaccurate) and not listening to or being dismissive of a patient's or family member's concerns. In stories of close calls, a patient's or family member's proactive communication (eg, being assertive, persistent) most often "saved the day." The findings highlight the importance of encouraging active patient/family involvement in a patient's medical care to prevent errors and of improving systems to provide meaningful information in a timely manner.
Collapse
Affiliation(s)
- Richard L Street
- Department of Communication, Texas A&M University, College Station, TX, USA.,Department of Medicine, Baylor College of Medicine, Houston, TX, USA
| | - John V Petrocelli
- Department of Psychology, Wake Forest University, Winston-Salem, NC, USA
| | - Azraa Amroze
- Meyers Primary Care Institute, a Joint Endeavor of the University of Massachusetts Medical School, Reliant Medical Group and Fallon Health, Worcester, MA, USA
| | - Corinna Bergelt
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Margaret Murphy
- Patients for Patient Safety (PFPS), WHO Patients for Patient Safety, Ireland
| | - J Michael Wieting
- DeBusk College of Osteopathic Medicine, Lincoln Memorial University, Harrogate, TN, USA
| | - Kathleen M Mazor
- Meyers Primary Care Institute, a Joint Endeavor of the University of Massachusetts Medical School, Reliant Medical Group and Fallon Health, Worcester, MA, USA
| |
Collapse
|
16
|
The COMFORT Communication Model: A Nursing Resource to Advance Health Literacy in Organizations. J Hosp Palliat Nurs 2020; 22:229-237. [PMID: 32282558 DOI: 10.1097/njh.0000000000000647] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The COMFORT Model has recently been revised based on feedback from bedside nurses working in palliative care and oncology and includes the following components: Connect, Options, Making Meaning, Family Caregiver, Openings, Relating, and Team. Based on clinical and nonclinical research in hospital, hospice, palliative care, and interdisciplinary education settings, the authors present the updated COMFORT Model. Originally introduced in 2012 to support the work of the nurse, the model is not a linear guide, an algorithm, a protocol, or a rubric for sequential implementation by nurses, but rather a set of communication principles that are practiced concurrently and reflectively during patient/family care. In its restructuring, we focus on the role of health literacy throughout the COMFORT components in relationship to the health literacy attributes of a health care organization. A brief summary of COMFORT components is provided and includes strategies and competencies contributing to a health-literate care organization. Both health literacy and COMFORT are explored using specific communication challenges that underscore the role of the nurse in accomplishing person-centered and culturally responsive care, especially in chronic and terminal illness. The integration of the COMFORT Model into nursing education is proposed.
Collapse
|
17
|
Arnaboldi P, Oliveri S, Vergani L, Marton G, Guiddi P, Busacchio D, Didier F, Pravettoni G. The clinical-care focused psychological interview (CLiC): a structured tool for the assessment of cancer patients' needs. Ecancermedicalscience 2020; 14:1000. [PMID: 32153655 PMCID: PMC7032941 DOI: 10.3332/ecancer.2020.1000] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Indexed: 12/12/2022] Open
Abstract
Integrating the psychosocial perspective in oncology is warranted. Here, we introduce a structured psychological intervention, the clinical-care focused psychological interview (CLiC), to address patients' needs in the relationship with health professionals, clinical pathway and decision-making process. The perceived utility and feasibility of the CLiC were evaluated in a preliminary sample of 30 patients who were candidates to undergo a radical cystectomy at the European Institute of Oncology, Milan, Italy. Patients reported a very high satisfaction with the interview, because it prepared them for their upcoming surgery by gathering more information about their clinical pathway and allowed them to discover the information they still needed. 30% stated that CLiC helped them to reorganise their thoughts and 36.7% understood the role of psychological intervention in the clinical pathway. Only 20% considered the CLiC useful in helping to build their relationship with the clinical staff. Before an invasive surgery such as radical cystectomy, patients' need for information regarding the upcoming surgery seems to prevail. Knowing the future consequences and adjusting toward the disease could be paramount for patients in facing uncertainty and they might feel that creating a relationship with physicians could be a secondary issue. However, our data show that a structured psychological intervention such as the CLiC interview can collect important information for patients and healthcare professionals to develop real patient-centred care.
Collapse
Affiliation(s)
- Paola Arnaboldi
- Psychiatry and Medical Psychology Service (SPPM), Cantonal Socio-Psychiatric Organisation (OSC), Via Tesserete 67, 6942 Savosa, Switzerland.,Ticino League against Cancer, Piazza Nosetto, 3, 6500 Bellinzona, Switzerland
| | - Serena Oliveri
- Department of Oncology and Hemato-Oncology, University of Milan, Via Festa del Perdono, 7, 20122 Milan, Italy.,Applied Research Division for Cognitive Psychological Science, European Institute of Oncology IRCCS (IEO), via Ripamonti 435, 20141 Milan, Italy
| | - Laura Vergani
- Department of Oncology and Hemato-Oncology, University of Milan, Via Festa del Perdono, 7, 20122 Milan, Italy.,Applied Research Division for Cognitive Psychological Science, European Institute of Oncology IRCCS (IEO), via Ripamonti 435, 20141 Milan, Italy
| | - Giulia Marton
- Department of Oncology and Hemato-Oncology, University of Milan, Via Festa del Perdono, 7, 20122 Milan, Italy.,Applied Research Division for Cognitive Psychological Science, European Institute of Oncology IRCCS (IEO), via Ripamonti 435, 20141 Milan, Italy
| | - Paolo Guiddi
- Applied Research Division for Cognitive Psychological Science, European Institute of Oncology IRCCS (IEO), via Ripamonti 435, 20141 Milan, Italy
| | - Derna Busacchio
- Applied Research Division for Cognitive Psychological Science, European Institute of Oncology IRCCS (IEO), via Ripamonti 435, 20141 Milan, Italy
| | - Florence Didier
- Applied Research Division for Cognitive Psychological Science, European Institute of Oncology IRCCS (IEO), via Ripamonti 435, 20141 Milan, Italy
| | - Gabriella Pravettoni
- Department of Oncology and Hemato-Oncology, University of Milan, Via Festa del Perdono, 7, 20122 Milan, Italy.,Applied Research Division for Cognitive Psychological Science, European Institute of Oncology IRCCS (IEO), via Ripamonti 435, 20141 Milan, Italy
| |
Collapse
|
18
|
Schneider BJ, Ismaila N, Aerts J, Chiles C, Daly ME, Detterbeck FC, Hearn JWD, Katz SI, Leighl NB, Levy B, Meyers B, Murgu S, Nekhlyudov L, Santos ES, Singh N, Tashbar J, Yankelevitz D, Altorki N. Lung Cancer Surveillance After Definitive Curative-Intent Therapy: ASCO Guideline. J Clin Oncol 2019; 38:753-766. [PMID: 31829901 DOI: 10.1200/jco.19.02748] [Citation(s) in RCA: 90] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE To provide evidence-based recommendations to practicing clinicians on radiographic imaging and biomarker surveillance strategies after definitive curative-intent therapy in patients with stage I-III non-small-cell lung cancer (NSCLC) and SCLC. METHODS ASCO convened an Expert Panel of medical oncology, thoracic surgery, radiation oncology, pulmonary, radiology, primary care, and advocacy experts to conduct a literature search, which included systematic reviews, meta-analyses, randomized controlled trials, and prospective and retrospective comparative observational studies published from 2000 through 2019. Outcomes of interest included survival, disease-free or recurrence-free survival, and quality of life. Expert Panel members used available evidence and informal consensus to develop evidence-based guideline recommendations. RESULTS The literature search identified 14 relevant studies to inform the evidence base for this guideline. RECOMMENDATIONS Patients should undergo surveillance imaging for recurrence every 6 months for 2 years and then annually for detection of new primary lung cancers. Chest computed tomography imaging is the optimal imaging modality for surveillance. Fluorodeoxyglucose positron emission tomography/computed tomography imaging should not be used as a surveillance tool. Surveillance imaging may not be offered to patients who are clinically unsuitable for or unwilling to accept further treatment. Age should not preclude surveillance imaging. Circulating biomarkers should not be used as a surveillance strategy for detection of recurrence. Brain magnetic resonance imaging should not be used for routine surveillance in stage I-III NSCLC but may be used every 3 months for the first year and every 6 months for the second year in patients with stage I-III small-cell lung cancer who have undergone curative-intent treatment.
Collapse
Affiliation(s)
| | | | - Joachim Aerts
- Erasmus Medical Center Cancer Institute, Rotterdam, the Netherlands
| | | | - Megan E Daly
- University of California Davis Comprehensive Cancer Center, Sacramento, CA
| | | | | | - Sharyn I Katz
- University of Pennsylvania Perelman School of Medicine, Philadelphia, PA
| | - Natasha B Leighl
- Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
| | - Benjamin Levy
- Johns Hopkins Sidney Kimmel Cancer Center at Sibley Memorial Hospital, Washington, DC
| | | | | | | | | | - Navneet Singh
- Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | | | | | | |
Collapse
|
19
|
Lapedis CJ, Horowitz JK, Brown L, Tolle BE, Smith LB, Owens SR. The Patient-Pathologist Consultation Program: A Mixed-Methods Study of Interest and Motivations in Cancer Patients. Arch Pathol Lab Med 2019; 144:490-496. [DOI: 10.5858/arpa.2019-0105-oa] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Context.—
There is a wide disconnect between patients and the pathologists who make their diagnoses. Recent literature highlights successful programs in which patients meet with pathologists to review their pathology reports and see their tissue under a microscope. We do not know how many patients are interested in such a service, nor do we understand what drives interested patients to want to meet with their pathologist and what specific value it may provide.
Objective.—
To quantify patient interest in a patient-pathologist consultation program and qualitatively assess motivations for patient interest or disinterest.
Design.—
Subjects were recruited from an academic cancer center and a local community cancer support group to respond to a survey about their interest in a patient-pathologist consultation program. Both online forms and paper surveys were available. The online survey was promoted via social media.
Results.—
There was a high level of patient interest, with 75% of respondents indicating they were definitely interested in a patient-pathologist consultation program. Key themes of interest were enhanced understanding of the diagnosis and disease, an opportunity to demystify the diagnostic process, and the perception that additional knowledge would empower the patient.
Conclusions.—
In a select group of cancer patients, there is a very high level of interest in a patient-pathologist consultation program. Pathologists, clinicians, and hospital leadership should work together to pilot these programs in diverse settings. Additional quantitative work to scale interventions for the interested population and qualitative work to design effective, patient-centered consultation programs and to assess value are needed.
Collapse
Affiliation(s)
- Cathryn J. Lapedis
- From the Department of Veterans Affairs, Ann Arbor Health System, Ann Arbor, Michigan (Dr Lapedis); the Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor (Dr Lapedis and Ms Horowitz); and the Division of Quality and Health Improvement (Ms Brown, Mr Tolle, and Dr Owens) in the Department of Pathology & Clinical Labs (Drs Lapedis, Smith, and Owens, Ms Brown, and Mr T
| | - Jennifer K. Horowitz
- From the Department of Veterans Affairs, Ann Arbor Health System, Ann Arbor, Michigan (Dr Lapedis); the Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor (Dr Lapedis and Ms Horowitz); and the Division of Quality and Health Improvement (Ms Brown, Mr Tolle, and Dr Owens) in the Department of Pathology & Clinical Labs (Drs Lapedis, Smith, and Owens, Ms Brown, and Mr T
| | | | - Brian E. Tolle
- From the Department of Veterans Affairs, Ann Arbor Health System, Ann Arbor, Michigan (Dr Lapedis); the Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor (Dr Lapedis and Ms Horowitz); and the Division of Quality and Health Improvement (Ms Brown, Mr Tolle, and Dr Owens) in the Department of Pathology & Clinical Labs (Drs Lapedis, Smith, and Owens, Ms Brown, and Mr T
| | - Lauren B. Smith
- From the Department of Veterans Affairs, Ann Arbor Health System, Ann Arbor, Michigan (Dr Lapedis); the Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor (Dr Lapedis and Ms Horowitz); and the Division of Quality and Health Improvement (Ms Brown, Mr Tolle, and Dr Owens) in the Department of Pathology & Clinical Labs (Drs Lapedis, Smith, and Owens, Ms Brown, and Mr T
| | - Scott R. Owens
- From the Department of Veterans Affairs, Ann Arbor Health System, Ann Arbor, Michigan (Dr Lapedis); the Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor (Dr Lapedis and Ms Horowitz); and the Division of Quality and Health Improvement (Ms Brown, Mr Tolle, and Dr Owens) in the Department of Pathology & Clinical Labs (Drs Lapedis, Smith, and Owens, Ms Brown, and Mr T
| |
Collapse
|