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Moser R, Mayr NA, Nano J, Behzadi ST, Kiesl S, Combs SE, Borm KJ. A survey of cancer patients' interest in undertaking exercise to promote relaxation during radiotherapy for breast cancer and metastatic cancer. Radiat Oncol 2024; 19:68. [PMID: 38822369 PMCID: PMC11143565 DOI: 10.1186/s13014-024-02459-w] [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: 08/24/2023] [Accepted: 05/21/2024] [Indexed: 06/03/2024] Open
Abstract
BACKGROUND Approximately 25-50% of patients undergoing radiotherapy (RT) experience psychological distress and anxiety, which can detrimentally affect both their quality of life and treatment outcomes. While previous research has demonstrated that relaxation exercises can enhance the tolerability of RT and alleviate associated stress and anxiety, the specific needs for such therapies in radiation oncology remain under-explored. This study aims to investigate the demand for and preferences toward relaxation exercises among radiotherapy patients, addressing a critical gap in patient-centered care. METHODS A prospective pseudonymized survey study using a one-time paper-based questionnaire was conducted from 2022 to 2023 among patients undergoing curative-intent RT for breast cancer or patients undergoing palliative RT for bone metastases. Patients were asked in a 11-item questionnaire about their anxiety, pre-existing practice of relaxation exercises/interventions, their interest in relaxation exercises, and preferences on the type and format of instruction. Data were analyzed descriptively. RESULTS 100 patients (74 female and 26 male) responded, of whom 68 received curative-intent adjuvant RT and 32 palliative RT. Median age was 62 years. 78% of patients indicated a desire to be actively involved in their radiotherapy, but only 27% had used relaxation exercises prior to RT. 44.8% of both curatively and palliatively treated patients who wanted to be actively involved in their therapy desired to learn how to best relax. 56.4% of respondents were willing to spend extra time learning offered exercises. CONCLUSION The survey indicates that patients undergoing RT, both for curative or palliative intent, desire relaxation exercises to relieve stress and anxiety from RT. It is therefore important to assess the need for relaxation interventions in individual patients and to develop suitable programs or collaborate with other healthcare professionals to meet these needs.
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Affiliation(s)
- Rebecca Moser
- Department of Radiation Oncology, TUM School of Medicine and Health, Technische Universität München (TUM), Klinikum rechts der Isar, Ismaninger Straße 22, 81675, Munich, Germany
| | - Nina A Mayr
- School of Human Medicine, Michigan State University, East Lansing, MI, USA
| | - Jana Nano
- Department of Radiation Oncology, TUM School of Medicine and Health, Technische Universität München (TUM), Klinikum rechts der Isar, Ismaninger Straße 22, 81675, Munich, Germany
| | - Sophie T Behzadi
- Department of Radiation Oncology, TUM School of Medicine and Health, Technische Universität München (TUM), Klinikum rechts der Isar, Ismaninger Straße 22, 81675, Munich, Germany
| | - Sophia Kiesl
- Department of Radiation Oncology, TUM School of Medicine and Health, Technische Universität München (TUM), Klinikum rechts der Isar, Ismaninger Straße 22, 81675, Munich, Germany
| | - Stephanie E Combs
- Department of Radiation Oncology, TUM School of Medicine and Health, Technische Universität München (TUM), Klinikum rechts der Isar, Ismaninger Straße 22, 81675, Munich, Germany
- Institute of Innovative Radiotherapy (iRT), Department of Radiation Sciences (DRS), Helmholtz Zentrum München, Ingolstädter Landstraße 1, 85764, Oberschleißheim, Germany
- German Consortium for Translational Cancer Research (dktk), Partner Site Munich, Berlin, Germany
| | - Kai J Borm
- Department of Radiation Oncology, TUM School of Medicine and Health, Technische Universität München (TUM), Klinikum rechts der Isar, Ismaninger Straße 22, 81675, Munich, Germany.
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Fakhoury KR, Hu J, Kim E, Hansen KA, Koval TR, Wolff K, Foote-Pearce MC, Karam SD, Stavas MJ. An Integrative Medicine Educational Program for Radiation Oncology Patients: Patient-Reported Outcomes. Adv Radiat Oncol 2024; 9:101350. [PMID: 38405305 PMCID: PMC10885552 DOI: 10.1016/j.adro.2023.101350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 08/07/2023] [Indexed: 02/27/2024] Open
Abstract
Purpose Complementary health approaches (CHAs) equip patients to self-manage radiation therapy (RT)-related symptoms and fulfill unmet needs, but few disclose CHA use to their radiation oncologist. An integrative medicine educational program (IMEP) was developed to assess its ability to improve patient self-efficacy for symptom management and CHA use disclosure. Methods and Materials The IMEP included 4 1-hour sessions covering topics of (1) meditation, (2) yoga, (3) massage therapy, and (4) nutrition. Individuals over age 18 years and actively receiving RT were administered presession and postsession surveys. The primary outcomes were intention to disclose CHA use and self-efficacy. Qualitative data were assessed with a thematic approach. Results Overall, 23 patients attended 1 or more sessions, yielding 43 completed surveys. Compared with 35.9% of participants who had disclosed CHA use before the session, 67.4% intended to disclose after the session. Of the 5 self-efficacy statements, there were significant improvements in "I have ownership over my health" (increase of 0.42; 95% CI, 0.07-0.77; P = .01), "I have tools to manage my disease on my own" (1.14; 95% CI, 0.42-1.87; P = .001), and "I have control over my cancer" (0.96; 95% CI, 0.39-1.53; P < .001). Barriers to involvement included transportation, timing relative to RT appointment, and poor performance status. Conclusions A radiation-specific IMEP resulted in a high rate of intention to disclose CHA use and improvements in patients' reported self-efficacy to manage radiation-related symptoms. However, substantial resources were needed to deliver the IMEP. Future work must focus on increasing accessibility through telehealth and flexible timing.
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Affiliation(s)
- Kareem R. Fakhoury
- Department of Radiation Oncology, University of Colorado School of Medicine, Aurora, Colorado
| | - Jungxiao Hu
- Department of Biostatistics and Informatics, Colorado School of Public Health, Aurora, Colorado
| | - Ellen Kim
- Department of Radiation Oncology, Brigham and Women's Hospital/Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Kathryn A. Hansen
- Osher Center for Integrative Health, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Taylor R. Koval
- Osher Center for Integrative Health, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Kathleen Wolff
- Osher Center for Integrative Health, Vanderbilt University Medical Center, Nashville, Tennessee
| | | | - Sana Dole Karam
- Department of Radiation Oncology, University of Colorado School of Medicine, Aurora, Colorado
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Goldsworthy S, Latour JM, Palmer S, McNair H, Cramp M. Identifying core components of a radiotherapy comfort intervention package using nominal group technique. Radiography (Lond) 2023; 29:926-934. [PMID: 37499585 DOI: 10.1016/j.radi.2023.07.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 07/05/2023] [Accepted: 07/11/2023] [Indexed: 07/29/2023]
Abstract
INTRODUCTION A comfortable treatment position in radiotherapy may promote patient stability and improve outcomes such as accuracy. The aim of this study was to identify, prioritise and determine the feasibility of delivery of intervention components as part of a radiotherapy comfort intervention package. METHODS Prior research, consisting of a systematic review and qualitative interviews with patient and therapeutic radiographers, was triangulated and 15 intervention components developed. An online nominal group technique consensus meeting with 7 patients who received radiotherapy exceeding 10 min for one of three anatomical cancer sites and 3 therapeutic radiographers (TRs) participated. Four activities were undertaken: 1) discussion of comfort intervention components; 2) initial vote; 3) prioritisation of intervention components; and 4) discussion of feasibility in radiotherapy and were analysed using established quantitative and qualitative methods. RESULTS One intervention component was added from initial discussions to the 15 pre-determined components being discussed. 11 components were recommended as 'accepted' (n = 5) or 'accepted with caution' (n = 6) to proceed to development. The highest scoring intervention components were 'Compassionate & empathetic communication training for TRs' and 'Tailored information, e.g., TRs provide the required information only as part of preparation for treatment'. Anther that followed closely was 'Adjustments & supports provided for arms or legs during treatment by TRs'. Those 'accepted with caution' included 'Soft pads/mattress under the body to alleviate body discomfort managed by TRs'. Qualitative analysis highlighted concerns over the radiation environment and emphasised the importance of resources such as equipment, training, and time. CONCLUSION The recommended comfort interventions have potential to improve patient comfort during radiotherapy and should be considered to incorporate into positioning and immobilisation guidelines. However, specific intervention strategies to address these components will need to be developed and robustly evaluated. IMPLICATIONS FOR PRACTICE Comfort interventions might help patients relax and stay still during treatment, which could improve treatment accuracy and efficacy. Introducing these comfort interventions in practice have potential to lead to a more positive patient experience and improved overall quality of care during radiotherapy.
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Affiliation(s)
- S Goldsworthy
- Beacon Radiotherapy, Musgrove Park Hospital, Somerset NHS Foundation Trust, Taunton, United Kingdom; Faculty of Health and Applied Sciences, University of the West of England, Bristol, United Kingdom.
| | - J M Latour
- Faculty of Health, University of Plymouth, Plymouth, United Kingdom; School of Nursing, Midwifery and Paramedicine, Faculty of Health Sciences, Curtin University, Perth, Australia
| | - S Palmer
- School of Healthcare Sciences, Cardiff University, Cardiff, United Kingdom
| | - H McNair
- Royal Marsden NHS Foundation Trust and Institute of Cancer Research, Sutton, United Kingdom
| | - M Cramp
- Faculty of Health and Applied Sciences, University of the West of England, Bristol, United Kingdom
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Patient engagement with radiation therapists: Patient perspectives, challenges, and opportunities. A systematic review. Radiography (Lond) 2023; 29 Suppl 1:S128-S136. [PMID: 36907794 DOI: 10.1016/j.radi.2023.02.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 02/14/2023] [Accepted: 02/21/2023] [Indexed: 03/12/2023]
Abstract
INTRODUCTION Radiotherapy is a major component of cancer care and treatment is delivered almost exclusively by therapeutic radiographers/radiation therapists (RTTs). Numerous government and professional guidance publications have recommended a person-centred approach to healthcare through communication and collaboration between professionals, agencies, and users. With approximately half of patients undergoing radical radiotherapy experiencing some degree of anxiety and distress, RTTs are uniquely placed as frontline cancer professionals to engage with patients regarding their experience. This review seeks to map the available evidence of patient reported views of their experience of being treated by RTTs and any impact, this treatment had on the patient's frame of mind or perception of treatment. METHODS In line with the principles of the Preferred Reporting Items for Systematic and Meta-Analyses (PRISMA) systematic review methodology, a review of relevant literature was conducted. Electronic databases MEDLINE, PROQUEST, EMBASE and CINAHL were searched. RESULTS Nine hundred and eighty-eight articles were identified. Twelve papers were included in the final review. CONCLUSION Increased time with, and continuity of RTTs during treatment has a positive influence on patients' perspectives of RTTs. A positive patient perspective of their engagement with RTTs can be a strong predictor of overall satisfaction in radiotherapy. IMPLICATIONS FOR PRACTICE RTTs should not underestimate the impact of their supportive role in guiding patients through treatment. A standardised method for integrating patients' experience and engagement with RTTs is lacking. Further RTT led research is required in this area.
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Goldsworthy S, Latour JM, Palmer S, McNair HA, Cramp M. Patient and therapeutic radiographer experiences of comfort during the radiotherapy pathway: A qualitative study. Radiography (Lond) 2023; 29 Suppl 1:S24-S31. [PMID: 36841685 DOI: 10.1016/j.radi.2023.02.011] [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: 11/24/2022] [Revised: 02/07/2023] [Accepted: 02/09/2023] [Indexed: 02/27/2023]
Abstract
INTRODUCTION There is little research regarding the experiences of patient comfort and how it is best managed in radiotherapy. The aim of this study was to explore the experiences of patient and therapeutic radiographer views of comfort during radiotherapy. METHODS This qualitative study involved semi-structured interviews, with cancer patients (n = 25) and therapeutic radiographers (n = 25), conducted between January-July 2019. Patients were recruited from one radiotherapy clinic and therapeutic radiographers were recruited from across the United Kingdom via specialist interest groups and social media. Interviews were audio-recorded and transcribed verbatim. Thematic analysis was used to analyse the data separately between both groups and shared themes were identified. RESULTS Four themes were identified of which two themes were shared among both the patients and therapeutic radiographer. Emotional Health was a shared theme highlighting experiences such as stress, vulnerability and privacy. The second shared theme, Positioning and Immobilisation Experiences, concerned how patients' experience being physically positioned and using immobilisation for accurate radiotherapy. The theme Information and Communication Experience was derived from patients highlighting concerns over sharing and provision of information and ways of communication. The last theme, Environmental Experience, emerged from the patient interviews and related to the first impressions of the radiotherapy environment such as reception or treatment rooms and how this effects the overall feelings of comfort. CONCLUSION This qualitative study has provided the shared voice of patients and therapeutic radiographers and their experiences of comfort during radiotherapy. These shared experiences emphasise the importance of considering comfort holistically and not just from a physical context. This information can be used by therapeutic radiographers to better understand their patients experiences and needs to provide better comfort during radiotherapy to improve patients' outcomes. IMPLICATIONS FOR PRACTICE The clinical implications of our study can encourage Therapeutic Radiographers to provide holistic care for their patients throughout the pathway and specifically to comfort patients while they are having treatment. In the short term this could be via simple adaptions to practice while in the long term, research is needed to develop comfort interventions for patients receiving radiotherapy.
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Affiliation(s)
- Simon Goldsworthy
- Beacon Radiotherapy, Musgrove Park Hospital, Somerset NHS Foundation Trust, Taunton, United Kingdom; Faculty of Health and Applied Sciences, University of the West of England, Bristol, United Kingdom.
| | - Jos M Latour
- Faculty of Health, University of Plymouth, Plymouth, United Kingdom; School of Nursing, Midwifery and Paramedicine, Faculty of Health Sciences, Curtin University, Perth, Australia
| | - Shea Palmer
- Centre for Care Excellence, Coventry University and University Hospitals Coventry & Warwickshire NHS Trust, Coventry, United Kingdom
| | - Helen A McNair
- Royal Marsden NHS Foundation Trust and Institute of Cancer Research, Sutton, United Kingdom
| | - Mary Cramp
- Faculty of Health and Applied Sciences, University of the West of England, Bristol, United Kingdom
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Forbes E, Clover K, Baker AL, McCarter KL, Oultram S, Kumar M, Wratten C, Tieu MT, Nixon J, Britton B. Biofeedback Enabled CALM (BeCALM)-the feasibility of biofeedback on procedural anxiety during radiation therapy: study protocol for a pilot randomised controlled trial. BMJ Open 2022; 12:e062467. [PMID: 36600369 PMCID: PMC9730381 DOI: 10.1136/bmjopen-2022-062467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
INTRODUCTION Patients undergoing treatment for cancer who require radiation therapy (RT) report anxiety specifically relating to the RT procedure. Procedural anxiety can be detrimental to treatment delivery, causing disruptions to treatment sessions, or treatment avoidance. Acute procedural anxiety is most commonly managed with anxiolytic medication. There is a need for effective, non-pharmacological interventions for patients not suitable for, or who prefer to avoid, anxiolytic medication. The primary objectives of this pilot trial are to evaluate the: (1) feasibility of conducting the Biofeedback Enabled CALM (BeCALM) intervention during RT treatment sessions; (2) acceptability of the BeCALM intervention among patients; and (3) acceptability of the BeCALM intervention among radiation therapists. The secondary objective of this pilot trial is to examine the potential effectiveness of the BeCALM intervention delivered by radiation therapists to reduce procedural anxiety during RT. METHODS AND ANALYSIS This is a pilot randomised controlled trial. A researcher will recruit adult patients with cancer (3-month recruitment period) scheduled to undergo RT and meeting eligibility criteria for procedural anxiety at the Calvary Mater Hospital, Newcastle (NSW), Australia. Participants will be randomly assigned to receive treatment as usual or the BeCALM intervention (biofeedback plus brief breathing techniques). The primary outcomes are feasibility (measured by recruitment, retention rates and percentage of treatment sessions in which the intervention was successfully delivered); radiation therapists perceived feasibility and acceptability (survey responses); and patient perceived acceptability (survey responses). Secondary outcome is potential effectiveness of the intervention (as measured by the State Trait Anxiety Inventory-State subscale; the Distress Thermometer; and an analysis of treatment duration). ETHICS AND DISSEMINATION The study protocol has received approval from Hunter New England Health Human Research Ethics Committee (2021/ETH11356). The results will be disseminated via peer-reviewed publications, as well as presentation at relevant conferences. TRIAL REGISTRATION NUMBER ACTRN12621001742864.
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Affiliation(s)
- Erin Forbes
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, The University of Newcastle, Callaghan, New South Wales, Australia
| | - Kerrie Clover
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, The University of Newcastle, Callaghan, New South Wales, Australia
- PsychoOncology Service, Department of Consultation Liaison Psychiatry, Calvary Mater Newcastle, Waratah, New South Wales, Australia
| | - Amanda L Baker
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, The University of Newcastle, Callaghan, New South Wales, Australia
| | - Kristen Louise McCarter
- School of Psychological Sciences, College of Science, Engineering and Environment, The University of Newcastle, Callaghan, New South Wales, Australia
| | - Sharon Oultram
- Radiation Oncology Department, Calvary Mater Newcastle, Waratah, New South Wales, Australia
| | - Mahesh Kumar
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, The University of Newcastle, Callaghan, New South Wales, Australia
- Radiation Oncology Department, Calvary Mater Newcastle, Waratah, New South Wales, Australia
| | - Chris Wratten
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, The University of Newcastle, Callaghan, New South Wales, Australia
- Radiation Oncology Department, Calvary Mater Newcastle, Waratah, New South Wales, Australia
| | - Minh Thi Tieu
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, The University of Newcastle, Callaghan, New South Wales, Australia
- Radiation Oncology Department, Calvary Mater Newcastle, Waratah, New South Wales, Australia
| | - Jodie Nixon
- School of Health and Rehabilitation Sciences, The University of Queensland, Saint Lucia, Queensland, Australia
- Occupational Therapy Department, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia
| | - Ben Britton
- Mental Health Services, Hunter New England Health, New Lambton, New South Wales, Australia
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Nuño-Solínis R, Urtaran-Laresgoiti M, Lázaro E, Ponce S, Orueta JF, Errea Rodríguez M. Inequalities in Health Care Experience of Patients with Chronic Conditions: Results from a Population-Based Study. Healthcare (Basel) 2021; 9:1005. [PMID: 34442142 PMCID: PMC8394123 DOI: 10.3390/healthcare9081005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Revised: 08/02/2021] [Accepted: 08/03/2021] [Indexed: 11/17/2022] Open
Abstract
Patients' experience is an acknowledged key factor for the improvement of healthcare delivery quality. This study aims to explore the differences in healthcare experience among patients with chronic conditions according to individual sociodemographic and health-related variables. A population-based and cross-sectional study was conducted. The sample consisted of 3981 respondents of the Basque Health Survey (out of 8036 total respondents to the individual questionnaire), living in the Basque Country, aged 15 or older, self-reporting at least one chronic condition. Patient experience was assessed with the Instrument for Evaluation of the Experience of Chronic Patients questionnaire, which encompasses three major factors: interactions between patients and professionals oriented to improve outcomes (productive interactions); new ways of patient interaction with the health care system (the new relational model); and the ability of individuals to manage their care and improve their wellbeing based on professional-mediated interventions (self-management). We conducted descriptive and regression analyses. We estimated linear regression models with robust variances that allow testing for differences in experience according to sociodemographic characteristics, the number of comorbidities and the condition (for all chronic or for chronic patients' subgroups). Although no unique inequality patterns by these characteristics can be inferred, females reported worse global results than males and older age was related to poorer experience with the new relational model in health care. Individuals with lower education levels tend to report lower experiences. There is not a clear pattern observed for the type of occupation. Multimorbidity and several specific chronic conditions were associated (positive or negatively) with patients' experience. Health care experience was better in patients with greater quality of life. Understanding the relations among the patients' experience and their sociodemographic and health-related characteristics is an essential issue for health care systems to improve quality of assistance.
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Affiliation(s)
| | - Maider Urtaran-Laresgoiti
- Research Group in Social Determinants of Health and Demographic Change (OPIK), University of the Basque Country (EHU-UPV), 48940 Leioa, Spain;
| | - Esther Lázaro
- Faculty of Health Sciences, Valencian International University, 46002 Valencia, Spain;
| | - Sara Ponce
- International Research Projects Office, University of Deusto, 48007 Bilbao, Spain;
| | - Juan F. Orueta
- Primary Health Care Center of Astrabudua, OSI Uribe, Osakidetza Basque Health Service, 48950 Erandio, Spain;
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Grilo AM, Santos B, Baptista I, Monsanto F. Exploring the cancer patients' experiences during external radiotherapy: A systematic review and thematic synthesis of qualitative and quantitative evidence. Eur J Oncol Nurs 2021; 52:101965. [PMID: 34023669 DOI: 10.1016/j.ejon.2021.101965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2020] [Revised: 03/28/2021] [Accepted: 04/14/2021] [Indexed: 11/20/2022]
Abstract
PURPOSE To investigate the subjective experience of adult cancer patients undergoing external radiotherapy and provide evidence for better practices in radiotherapy services. METHODS A systematic review was performed according to the PRISMA Statement Guidelines. Qualitative and mixed studies were identified through five electronic databases (CINAHL, PsychINFO, Medline, Scopus and Web of Science), between March and April 2020, using defined criteria. Methodological quality assessment was conducted, and the data integrated into a thematic synthesis. RESULTS Of the 886 studies identified, 13 met our inclusion criteria. Patients experiences were described into four main themes: (1) Time, (2) Physical Environment, (3) Treatment Concerns and (4) Radiotherapy Team. Time refers to waiting time and treatment time; Physical Environment states temperature in the treatment room and equipment; Treatment Concerns included side effects, daily activities, positioning and immobilization and treatment preparation (e.g., bladder filling); radiotherapy team comprised patients support; response to patients needs and recognized team. The generating analytical phase of thematic analysis allowed us to recognize that the effectiveness of the radiotherapy team operates as a facilitator of the patients' experience. In contrast, time in the waiting room, the treatment preparation when is required, and the positioning and immobilization, specifically for the neck and head patients, act as barriers. CONCLUSION Four distinct themes were identified to be positively and negatively associated with patients' experience during external radiotherapy. The evidence provides valuable recommendations to improved radiotherapy services organization, as well as to the delivery of more patient-centred care adjusted to the concerns and needs of patients.
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Affiliation(s)
- Ana Monteiro Grilo
- H&TRC-Health & Technology Research Center, ESTeSL- Escola Superior de Tecnologia da Saúde, Instituto Politécnico de Lisboa, Portugal; CICPsi - Research Center for Psychological Science, Faculty of Psychology, University of Lisbon, Portugal.
| | - Bárbara Santos
- Medical Imaging and RT Degree, Escola Superior de Tecnologia da Saúde, Instituto Politécnico de Lisboa, Portugal.
| | - Inês Baptista
- Medical Imaging and RT Degree, Escola Superior de Tecnologia da Saúde, Instituto Politécnico de Lisboa, Portugal.
| | - Fátima Monsanto
- H&TRC-Health & Technology Research Center, ESTeSL- Escola Superior de Tecnologia da Saúde, Instituto Politécnico de Lisboa, Portugal.
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Nardone V, Reginelli A, Vinciguerra C, Correale P, Calvanese MG, Falivene S, Sangiovanni A, Grassi R, Di Biase A, Polifrone MA, Caraglia M, Cappabianca S, Guida C. Mood Disorder in Cancer Patients Undergoing Radiotherapy During the COVID-19 Outbreak. Front Psychol 2021; 12:568839. [PMID: 33815186 PMCID: PMC8017226 DOI: 10.3389/fpsyg.2021.568839] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Accepted: 02/25/2021] [Indexed: 12/26/2022] Open
Abstract
Introduction: Novel coronavirus (COVID-19) is having a devastating psychological impact on patients, especially patients with cancer. This work aims to evaluate mood disorders of cancer patients undergoing radiation therapy during COVID-19 in comparison with cancer patients who underwent radiation therapy in 2019. Materials and Methods: We included all the patients undergoing radiation therapy at our department in two-time points (once a week for a month in May 2019) and during the COVID-19 outbreak (in April 2020). All the patients were asked to fulfill a validated questionnaire (STAI-Y1, State trait anxiety inventory scale), the Symptom Distress thermometer (SDT) (from 0 to 10 score), and the Beck Depression Inventory v.2 (BDI-2). We took into account the COVID-19 outbreak and also sex, age, week of radiation treatment, and disease. Results: We included 458 patients (220 males and 238 females), with a median age of 64 years. STAI-Y1 median score was 40 (mean 41,3, range 19-79), whereas the median score of SDT was five and BDI-2 median score was 11. STAI-Y1, SDT, and BDI-2 were significantly correlated with the COVID-19 outbreak (p < 0,001 for all the tests), sex (p: 0,016 for STAI-Y1, p < 0.001 for SDT, p:0.013 for BDI-2), week of treatment (p: 0.012 for STAI-Y1 and p: 0.031 for SDT), and disease (p:0.015 for STAI-Y1, p < 0.001 for SDT and p:0.020 for BDI-2). Conclusions: The prevalence of mood disorders in patients undergoing radiation therapy is higher than expected and even higher during the COVID-19 outbreak. These measurements could be useful as a baseline to start medical humanities programs to decrease these scores.
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Affiliation(s)
- Valerio Nardone
- Unit of Radiation Oncology, Ospedale del Mare, Naples, Italy
| | - Alfonso Reginelli
- Department of Precision Medicine, University of Campania "Luigi Vanvitelli," Naples, Italy
| | | | - Pierpaolo Correale
- Unit of Medical Oncology, Grand Metropolitan Hospital "Bianchi Melacrino Morelli," Reggio Calabria, Italy
| | | | - Sara Falivene
- Unit of Radiation Oncology, Ospedale del Mare, Naples, Italy
| | - Angelo Sangiovanni
- Department of Precision Medicine, University of Campania "Luigi Vanvitelli," Naples, Italy
| | - Roberta Grassi
- Department of Precision Medicine, University of Campania "Luigi Vanvitelli," Naples, Italy
| | - Angela Di Biase
- Unit of Radiation Oncology, Ospedale del Mare, Naples, Italy
| | - Maria Angela Polifrone
- Unit of Medical Oncology, Grand Metropolitan Hospital "Bianchi Melacrino Morelli," Reggio Calabria, Italy
| | - Michele Caraglia
- Department of Precision Medicine, University of Campania "Luigi Vanvitelli," Naples, Italy
| | - Salvatore Cappabianca
- Department of Precision Medicine, University of Campania "Luigi Vanvitelli," Naples, Italy
| | - Cesare Guida
- Unit of Radiation Oncology, Ospedale del Mare, Naples, Italy
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How do radiation therapists detect and manage patients experiencing anxiety in the radiation oncology setting? A vignette study. Support Care Cancer 2021; 29:5973-5981. [PMID: 33770258 DOI: 10.1007/s00520-021-06133-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Accepted: 03/04/2021] [Indexed: 10/21/2022]
Abstract
PURPOSE Anxiety is commonly observed in oncology patients but infrequently screened, assessed or addressed. According to psychosocial guidelines, all healthcare professionals, including radiation therapists, are responsible for the psychosocial care of patients. Radiation therapists (RTs) interact with patients daily throughout treatment; however, little research exists to evaluate RTs' ability to identify and manage patients' psychosocial needs. This study aimed to determine if RTs can detect and manage patient anxiety. METHOD A cross-sectional, mixed-methods survey containing two clinically relevant vignettes was developed. Two fictitious patients were presented to elicit responses reflective of RTs' experiences and judgements in the recognition and management of anxiety. Surveys were distributed via email in Australia, New Zealand and Canada. Ethical approval was obtained from the University of Sydney (2016/227) and informed consent was obtained from participants. RESULTS Eligible and complete surveys were received from 582 respondents (240 (41.2%) from Australia; 78 (13.4%) New Zealand; 264 (45.4%) Canada). Almost all respondents endorsed a relevant descriptor of anxiety (vignette 1, 577 (99.1%); vignette 2, 579 (99.5%)). For both vignettes, the most frequently endorsed management strategy was to acknowledge the patients' feelings and encourage them to express their concerns (vignette 1, 548 (94.2%); vignette 2, 455 (78.2%)). CONCLUSION RTs in Australia, New Zealand and Canada are able to detect anxiety and endorse a strategy to manage patients experiencing anxiety depicted in written vignettes. Exploring RTs' abilities to detect and manage patient anxiety whilst in the high-pressure clinical environment is an important next step.
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Psychometric properties of the Persian language person-centered climate questionnaire - Patient version (PCQ-P). Heliyon 2020; 6:e05154. [PMID: 33088943 PMCID: PMC7567042 DOI: 10.1016/j.heliyon.2020.e05154] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Revised: 04/15/2020] [Accepted: 09/30/2020] [Indexed: 11/24/2022] Open
Abstract
Background Person-centered care is a valuable approach to improve the quality of care of the elderly and is a starting point for maintaining the dignity of people needing care. Objectives This study aimed at translation, cultural adaptation, and validation of the Persian version of the Person-centered Climate Questionnaire–Patient questionnaire in elderly patients admitted to the Eastern Guilan hospitals from 2017-2018. Design This research was a cross-sectional study. The Persian version of Person-centered Climate Questionnaire –Patient version was completed by 200 older adults admitted to different wards of the hospitals. They were selected through convenient sampling. Data were collected in 5 hospitals affiliated to Guilan University of Medical Sciences, East of Guilan located in the north of Iran, from November 2017 to February 2018. Methods This study was carried out in two phases. In the first phase, the original questionnaire with 17 items was translated from English into Persian using Forward-Backward translation method. In the second phase, the psychometric properties of the questionnaire were evaluated using face, content, and construct validity, as well as reliability (internal consistency and stability). Data were analyzed via SPSS software v.16. Results The results of exploratory factor analysis (EFA) led to retaining 17 items with three factors of “Safety”, “Hospitality”, and “Everydayness” which explained 47.69% of the total variance. Cronbach's alpha coefficient was calculated for each factor (0.85, 0.70, and 0.64, respectively) as well as the whole instrument (0.85), to ensure internal consistency. Stability was confirmed by calculating the intra-class correlation coefficient as 0.99. Conclusions The current study found support for assessing the person-centered climate from the perspective of the elderly patients by using the Persian version of the Person-centered Climate Questionnaire–Patient that has an appropriate cultural adaptation, validity, and reliability.
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The effect of individualized education with support on breast cancer patients' anxiety and depression during radiation therapy: A pilot study. Eur J Oncol Nurs 2020; 48:101826. [PMID: 32949942 DOI: 10.1016/j.ejon.2020.101826] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2020] [Revised: 08/05/2020] [Accepted: 08/17/2020] [Indexed: 11/21/2022]
Abstract
PURPOSE This study was undertaken to determine the effects of individualized education with support intervention on breast cancer patients' anxiety and depression while undergoing radiation therapy (RT). Moreover, the intervention was assessed for its feasibility in the context of Pakistan. METHODS A quasi-experimental design was used to conduct this study in RT department of a public hospital in Karachi. A total of 61 breast cancer patients receiving radiation as adjuvant therapy participated in the study. The experimental group (n = 31) received individualized education with support in the form of face-to-face sessions and information booklet prior to the commencement of RT. In addition, the nurse remained available for the consultation during the RT sessions and on telephone throughout the RT period. However, the control group received only information booklet. Patients' anxiety and depression were measured in both of the groups before the commencement of RT, and at the completion of RT by using the Aga Khan University Anxiety and Depression Scale (AKUADS). RESULTS A significant reduction was found in the overall mean anxiety and depression scores of the experimental group (p = 0.000) from pre-test to post-test. The overall mean anxiety and depression scores of the control group showed no significant difference (p = 0.187). The effect size of the intervention was large (Cohen's d = 2.5). CONCLUSION The intervention was effective in reducing anxiety and depression among breast cancer patients receiving RT. Replication of the study on a larger scale in multiple settings on other cancer patients is recommended.
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Nardone V, Vinciguerra C, Correale P, Guida C, Tini P, Reginelli A, Cappabianca S. Music therapy and radiation oncology: State of art and future directions. Complement Ther Clin Pract 2020; 39:101124. [DOI: 10.1016/j.ctcp.2020.101124] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Revised: 02/11/2020] [Accepted: 02/22/2020] [Indexed: 10/24/2022]
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Olausson K, Sharp L, Fransson P, Nyholm T, Zackrisson B, Östlund U. What matters to you? - Free-text comments in a questionnaire from patients undergoing radiotherapy. Tech Innov Patient Support Radiat Oncol 2020; 13:11-16. [PMID: 32128457 PMCID: PMC7042152 DOI: 10.1016/j.tipsro.2019.11.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Revised: 10/13/2019] [Accepted: 11/22/2019] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Most cancer patients undergo external radiotherapy (RT) at some stage during their treatment trajectory and RT is often associated with unfamiliar procedures in a highly technical environment. The purpose of this study was to explore how patients experience RT and the related processes, as described in free-text comments in a large Swedish survey with questionnaires including items on psychosocial climate and treatment environment. METHODS The data consisted of free-text comments from one open-ended question: "Is there anything else you want us to know" and were analysed using qualitative content analysis. RESULTS Of 825 returned questionnaires, 261 contained free-text comments from patients (32%). The hand-written, free-text comments reflected the patients' experience of the RT process and were abstracted into the four major categories with sub-categories: experiencing the high-tech RT environment, understanding the RT procedures and side effects, dealing with daily life during RT, and the nurses' role and performance. The categories reflect the patients' experiences and emphasize how important it is to evaluate what really matters to the patients when changing procedures, practices, and how to minimize disturbances in the patients' daily lives. CONCLUSION The main conclusions from this study are that the involvement of patients in choosing daily appointment times, providing good information during the RT process to make the patients feel safe, experience and attitude of the staff and respect for the patient's autonomy are highly ranked values for patients. An implementation of person-centred care may help relieve many of these problems.
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Affiliation(s)
| | - Lena Sharp
- Karolinska Institute, Department of Learning, Informatics, Management and Ethics, Stockholm, Sweden
- Regional Cancer Centre, Stockholm-Gotland, Sweden
| | - Per Fransson
- Umeå University, Department of Nursing, Umeå, Sweden
| | - Tufve Nyholm
- Umeå University, Department of Radiation Sciences, Umeå, Sweden
| | | | - Ulrika Östlund
- Centre for Research & Development, Uppsala University/Region Gävleborg, Sweden
- Faculty of Medicine and Health, School of Health Sciences, Örebro University, Örebro, Sweden
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
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Sadek AH, Willis J. Ways to harness the built environment of ambulatory cancer facilities for comprehensive patient support: A review of the literature. Int J Nurs Stud 2019; 101:103356. [PMID: 31731247 DOI: 10.1016/j.ijnurstu.2019.05.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2018] [Revised: 03/21/2019] [Accepted: 05/05/2019] [Indexed: 10/26/2022]
Abstract
OBJECTIVE To review patient experiences of the architectural elements conducive to a supportive or healing-promoting environment in the context of ambulatory oncology care. DESIGN A comprehensive review of original peer-reviewed qualitative studies conducted to reveal the meaning and significance of patient experience in this context was undertaken. DATA SOURCES Studies were identified through electronic databases including Ovid MEDLINE, CINAHL, PubMed and Embase. No time limit was applied and language was restricted to English. REVIEW METHODS The generated records were screened at the titles and abstracts level by the first reviewer, with full text assessment conducted by both authors. Main themes were extracted in an excel file and a narrative synthesis strategy was used to systematically gather evidence and explain the findings. The guidelines of the Centre for Reviews and Dissemination have been followed in the searching and reporting of the essential matters relevant to this review. RESULTS Eleven original studies were selected; in addition to these, fourteen other studies that did not fully meet the selection criteria, however held important information relevant to the scope of the review, were considered to expand the discussion with relevant information to ambulatory cancer facilities. The findings of these studies were synthesized into five major themes: stimulating and homely environments; flexibility and environmental enrichment; social support; complementary support and engagement; and physical and sensory support. CONCLUSION The paper identified key architectural design qualities that have the potential to support treatment and empower patients, with particular reflection on patients undergoing intravenous anti-cancer treatment within ambulatory settings. It provides examples in which designing the built environment with people in mind and providing tailored solutions to meet their actual needs and preferences may help cancer patients cope with the emotional and physical challenges of the disease and its treatment and support a general experience of patient-centred care. A conceptual framework that articulates the principal constituents of a supportive environment is tentatively proposed, extending existing theoretical propositions to facilitate further investigation of this context.
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Affiliation(s)
- Ahmed H Sadek
- Faculty of Architecture, Building and Planning, The University of Melbourne, Room 447, Building 133, Parkville, 3010, VIC, Australia.
| | - Julie Willis
- Faculty of Architecture, Building and Planning, The University of Melbourne, Dean's Office, Building 133, Parkville, 3010, VIC, Australia.
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Grilo AM, Gomes AI, Monsanto F, Albino D, Augusto C, Pragana C. First day of radiotherapy for women with breast cancer: predictors of anxiety. Support Care Cancer 2019; 28:1241-1248. [PMID: 31227988 DOI: 10.1007/s00520-019-04902-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2018] [Accepted: 05/31/2019] [Indexed: 10/26/2022]
Abstract
PURPOSE Radiotherapy treatment may generate anxiety, especially on the first day of treatment. This study aimed to identify potential predictors of radiotherapy-related anxiety in women with breast cancer before treatment initiation, in terms of treatment concerns and trait anxiety. METHODS This transversal study included 94 patients from one Radiation Oncology Department, who had been diagnosed with primary breast cancer and who had been prescribed external radiotherapy for the first time. Patients completed a Treatment Concerns Questionnaire and the State-Trait Anxiety Inventory (STAI) before the first treatment session. RESULTS Women identified radiation involved in the procedure and treatment efficacy as major concerns surrounding radiotherapy. No significant differences were found between patients with higher and lower state anxiety scores, or by age, level of education, cancer treatment protocol used, prior information given about treatment, or report of doubts before treatment initiation. In the final model, the combination of trait anxiety (49.1% of the total variance) with two treatment-related concerns, regarding radiation and the duration of treatment (plus 10.8% of the total variance), significantly predicted treatment-related anxiety experienced on the first day of treatment. CONCLUSION Our findings highlight the need to identify women with moderate or higher levels of trait anxiety before radiotherapy initiation and to provide them with a more approach to personalized care, adjusted to their specific concerns and susceptibility to anxious reactions. Effective education sessions involving the discussion of specific treatment concerns, and anxiety coping strategies training should be developed and applied in initial interactions with breast cancer patients.
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Affiliation(s)
- Ana M Grilo
- ESTeSL - Escola Superior de Tecnologia da Saúde, Instituto Politécnico de Lisboa, Av. D. João II, lote 4.69.01, Parque das Nações, 1990-096, Lisbon, Portugal. .,CICPSI, Faculdade de Psicologia, Universidade de Lisboa, Alameda da Universidade, 1649-013, Lisbon, Portugal.
| | - Ana I Gomes
- ESTeSL - Escola Superior de Tecnologia da Saúde, Instituto Politécnico de Lisboa, Av. D. João II, lote 4.69.01, Parque das Nações, 1990-096, Lisbon, Portugal.,CICPSI, Faculdade de Psicologia, Universidade de Lisboa, Alameda da Universidade, 1649-013, Lisbon, Portugal
| | - Fátima Monsanto
- H&TRC- Centro de Investigação em Saúde e Tecnologia, ESTeSL - Escola Superior de Tecnologia da Saúde, Instituto Politécnico de Lisboa, Av. D. João II, lote 4.69.01, Parque das Nações, 1990-096, Lisbon, Portugal
| | - Daniel Albino
- ESTeSL - Escola Superior de Tecnologia da Saúde, Instituto Politécnico de Lisboa, Av. D. João II, lote 4.69.01, Parque das Nações, 1990-096, Lisbon, Portugal
| | - Cláudio Augusto
- ESTeSL - Escola Superior de Tecnologia da Saúde, Instituto Politécnico de Lisboa, Av. D. João II, lote 4.69.01, Parque das Nações, 1990-096, Lisbon, Portugal
| | - Catarina Pragana
- Unidade de Radioterapia, Hospital CUF Descobertas, R. Mário Botas, Parque das Nações, 1998-018, Lisbon, Portugal
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Karadag E, Uğur Ö, Çetinayak O. The effect of music listening intervention applied during radiation therapy on the anxiety and comfort level in women with early-stage breast cancer: A randomized controlled trial. Eur J Integr Med 2019. [DOI: 10.1016/j.eujim.2019.02.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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Gresswell S, Renz P, Hasan S, Werts M, Fortunato M, Werts D. Determining the impact of pre-radiation treatment verification simulation/dry run by analyzing intradepartmental reported incidents and surveying staff and patients. Pract Radiat Oncol 2018; 8:468-474. [PMID: 30195926 DOI: 10.1016/j.prro.2018.05.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2018] [Revised: 04/17/2018] [Accepted: 05/16/2018] [Indexed: 01/13/2023]
Abstract
PURPOSE Error identification in radiation therapy is critical to maintain a safe and efficient therapeutic environment. A verification simulation (VS; also called a dry run for patient information) provides a dedicated time prior to treatment to duplicate steps of patient setup, imaging, and treatment process as a final quality assurance step. Through the use of surveys and analysis of reported incidents, we sought to determine the value of a VS before initiating patient treatment. METHODS AND MATERIALS In November 2014, a VS was instituted across our network of 11 radiation oncology clinics. A comparison of the incident rate reported through our departmental incident learning system (ILS) was made between a non-VS group (965 patients who were treated in the 18 months prior to instituting the VS) and a VS group (984 patients who were treated over 18 months with the VS policy in place). From August to December 2016, surveys were completed by 211 patients and 55 physicians, nurses, and therapists detailing their perspectives on the VS. RESULTS There were 28 incidents (2.9%) in the non-VS group compared with 18 incidents (1.8%) in the VS group (P = .03). In the VS group, more incidents were detected before the day of treatment (P = .03) and fewer incidents on the day of treatment (P = .02). In addition, a trend toward fewer incidents after treatment started (P = .09) was observed. Patient surveys indicated that 99.5% of patients were informed of the VS, 83% reported decreased anxiety during treatment, and 5% indicated concerns about delaying treatment. The majority of staff members (67%) were satisfied with the VS. CONCLUSIONS A VS helps identify and correct incidents before the administration of radiation therapy and reduces patient anxiety.
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Affiliation(s)
- Steven Gresswell
- Division of Radiation Oncology, Allegheny Health Network, Pittsburgh, Pennsylvania.
| | - Paul Renz
- Division of Radiation Oncology, Allegheny Health Network, Pittsburgh, Pennsylvania
| | - Shaakir Hasan
- Division of Radiation Oncology, Allegheny Health Network, Pittsburgh, Pennsylvania
| | - Margaret Werts
- Reich College of Education, Appalachian State University, Boone, North Carolina
| | - Missy Fortunato
- Division of Radiation Oncology, Allegheny Health Network, Pittsburgh, Pennsylvania
| | - Day Werts
- Division of Radiation Oncology, Allegheny Health Network, Pittsburgh, Pennsylvania
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Rantala A, Forsberg A, Ekwall A. Person-centred climate and psychometrical exploration of person-centredness and among patients not conveyed by the Ambulance Care Service. Scand J Caring Sci 2017; 32:852-860. [PMID: 28892188 DOI: 10.1111/scs.12516] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2017] [Accepted: 08/07/2017] [Indexed: 11/27/2022]
Abstract
BACKGROUND What already is known is that as many as 50% of all Swedish Ambulance Care Service assignments are considered as non-emergency. Therefore, due to medical protocols and triage system, patients are refused conveyance to the Accident and Emergency Department by the Ambulance Care Service. AIM The aim of this study was to psychometrically explore the construct validity of a possible dimension of person-centredness, developed from a previous published qualitative study in a nonemergency ambulance care context. A second aim was to explore patients' experiences of the person-centred climate and to explore possible relationship between it and person-centredness. DESIGN/METHODS A retrospective, explorative, cross-sectional survey design with a convenience sample was employed. A total of 111 questionnaires were analysed using descriptive and comparative statistics. An explanatory factor analysis was also conducted. FINDINGS A one-factor solution for the specific items possibly constructing person-centredness was found. The responses to the Person-centred Climate Questionnaire-Patient version (PCQ-P) revealed that the climate was received as highly person-centred. Relationships were found between the specific items possibly constructing person-centredness and PCQ-P. CONCLUSION A highly valid construct of person-centredness exists within nonurgent Ambulance Care Service assignments comprising eight aspects of being taken seriously. The climate in which nonemergency ambulance care is provided has great potential to facilitate person-centredness by means of taking patients seriously. The psychosocial aspects of PCQ-P and person-centredness are somewhat related to each other.
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Affiliation(s)
- Andreas Rantala
- Department of Health Sciences, Lund University, Lund, Sweden.,Department of Pre- and Intra-Hospital Emergency Care, Helsingborg General Hospital, Helsingborg, Sweden
| | - Anna Forsberg
- Department of Health Sciences, Lund University, Lund, Sweden.,Department of Transplantation and Cardiology, Skåne University Hospital, Lund, Sweden
| | - Anna Ekwall
- Department of Health Sciences, Lund University, Lund, Sweden
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Olausson K, Holst Hansson A, Zackrisson B, Edvardsson D, Östlund U, Nyholm T. Development and psychometric testing of an instrument to measure the patient's experience of external radiotherapy: The Radiotherapy Experience Questionnaire (RTEQ). Tech Innov Patient Support Radiat Oncol 2017; 3-4:7-12. [PMID: 32095560 PMCID: PMC7033812 DOI: 10.1016/j.tipsro.2017.06.003] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2016] [Revised: 02/14/2017] [Accepted: 06/29/2017] [Indexed: 12/03/2022] Open
Abstract
A new instrument to measure the patient’s comfort and experiences during RT. The instrument gains the patients’ perspectives of the RT procedures. RTEQ has a possible application for evaluation of newly introduced techniques.
Background The patient’s perception of external radiotherapy (RT) procedures and equipment is important to evaluate as a complement to endpoints such as treatment outcome and reproducibility. There is a lack of a proper, psychometrically robust instrument to evaluate the patient’s comfort and experience of the external RT procedure. Hence, this study aimed to develop and test an instrument to measure the patient’s experience during external RT. Material and Methods A preliminary 34-item questionnaire was generated from research literature, expert consultations and patient interviews, and it was distributed to patients (n = 825) at 8 RT units in Sweden. The answers were subjected to item analysis and reduction by using exploratory factor analysis. The reliability of the final questionnaire was evaluated using Cronbach’s alpha. Mean scale scores were compared across gender, length of RT and treatment area. Results Most items were highly skewed towards positive responses. Scree plot analyses of the 34-item correlation matrix identified six underlying themes explaining 68% of the total variance. After item reduction, the 6 themes explained 73% of the variance in a 23-item questionnaire. Cronbach’s alpha was satisfactory for all themes (between 0.79 and 0.9). Significant differences between treatment areas were found for two scales: situational unease and situational repose. Conclusion The RT Experience Questionnaire is a tentatively valid and reliable instrument to measure how patients experience the external RT session process and the environment in the treatment room.
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Affiliation(s)
- Kristina Olausson
- Umeå University, Department of Radiation Sciences, Umeå, Sweden
- Corresponding author at: Department of Radiation Sciences, Umeå University Hospital, SE 901 87 Umeå, Sweden.
| | - Annette Holst Hansson
- Department of Care Sciences, Faculty of Health and Society, Malmö, Sweden
- Department of Hematology, Oncology and Radiation Physics, Skåne University Hospital, Lund, Sweden
| | | | - David Edvardsson
- La Trobe University/Austin Health Clinical School of Nursing, Melbourne, Australia
- Umeå University, Department of Nursing, Umeå, Sweden
| | - Ulrika Östlund
- Centre for Research & Development, Uppsala University/Region Gävleborg, Sweden
- Centre for Collaborative Palliative Care, Linnaeus University, Kalmar, Sweden
| | - Tufve Nyholm
- Umeå University, Department of Radiation Sciences, Umeå, Sweden
- Department of Immunology, Genetics and Pathology, Medical Radiation Science, Uppsala University, Uppsala, Sweden
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