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Moss E, Taylor A, Andreou A, Ang C, Arora R, Attygalle A, Banerjee S, Bowen R, Buckley L, Burbos N, Coleridge S, Edmondson R, El-Bahrawy M, Fotopoulou C, Frost J, Ganesan R, George A, Hanna L, Kaur B, Manchanda R, Maxwell H, Michael A, Miles T, Newton C, Nicum S, Ratnavelu N, Ryan N, Sundar S, Vroobel K, Walther A, Wong J, Morrison J. British Gynaecological Cancer Society (BGCS) ovarian, tubal and primary peritoneal cancer guidelines: Recommendations for practice update 2024. Eur J Obstet Gynecol Reprod Biol 2024; 300:69-123. [PMID: 39002401 DOI: 10.1016/j.ejogrb.2024.06.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2024] [Accepted: 06/13/2024] [Indexed: 07/15/2024]
Affiliation(s)
- Esther Moss
- College of Life Sciences, University of Leicester, University Road, Leicester, LE1 7RH, UK
| | | | - Adrian Andreou
- Royal United Hospitals Bath NHS Foundation Trust, Combe Park, Bath BA1 3NG, UK
| | - Christine Ang
- Northern Gynaecological Oncology Centre, Gateshead, UK
| | - Rupali Arora
- Department of Cellular Pathology, University College London NHS Trust, 60 Whitfield Street, London W1T 4E, UK
| | | | | | - Rebecca Bowen
- Royal United Hospitals Bath NHS Foundation Trust, Combe Park, Bath BA1 3NG, UK
| | - Lynn Buckley
- Beverley Counselling & Psychotherapy, 114 Holme Church Lane, Beverley, East Yorkshire HU17 0PY, UK
| | - Nikos Burbos
- Department of Obstetrics and Gynaecology, Norfolk and Norwich University Hospital Colney Lane, Norwich NR4 7UY, UK
| | | | - Richard Edmondson
- Saint Mary's Hospital, Manchester and University of Manchester, M13 9WL, UK
| | - Mona El-Bahrawy
- Imperial College London, Hammersmith Hospital, Du Cane Road, London W12 0HS, UK
| | | | - Jonathan Frost
- Gynaecological Oncology, Royal United Hospitals Bath NHS Foundation Trust, Combe Park, Bath, Bath BA1 3NG, UK; University of Exeter, Exeter, UK
| | - Raji Ganesan
- Department of Cellular Pathology, Birmingham Women's Hospital, Birmingham B15 2TG, UK
| | | | - Louise Hanna
- Department of Oncology, Velindre Cancer Centre, Whitchurch, Cardiff CF14 2TL, UK
| | - Baljeet Kaur
- North West London Pathology (NWLP), Imperial College Healthcare NHS Trust, Hammersmith Hospital, Du Cane Road, London W12 0HS, UK
| | - Ranjit Manchanda
- Wolfson Institute of Population Health, Cancer Research UK Barts Centre, Queen Mary University of London and Barts Health NHS Trust, UK
| | - Hillary Maxwell
- Dorset County Hospital, Williams Avenue, Dorchester, Dorset DT1 2JY, UK
| | - Agnieszka Michael
- Royal Surrey NHS Foundation Trust, Guildford GU2 7XX and University of Surrey, School of Biosciences, GU2 7WG, UK
| | - Tracey Miles
- Royal United Hospitals Bath NHS Foundation Trust, Combe Park, Bath BA1 3NG, UK
| | - Claire Newton
- Gynaecology Oncology Department, St Michael's Hospital, University Hospitals Bristol NHS Foundation Trust, Bristol BS1 3NU, UK
| | - Shibani Nicum
- Department of Oncology, University College London Cancer Institute, London, UK
| | | | - Neil Ryan
- The Centre for Reproductive Health, Institute for Regeneration and Repair (IRR), 4-5 Little France Drive, Edinburgh BioQuarter City, Edinburgh EH16 4UU, UK
| | - Sudha Sundar
- Institute of Cancer and Genomic Sciences, University of Birmingham and Pan Birmingham Gynaecological Cancer Centre, City Hospital, Birmingham B18 7QH, UK
| | - Katherine Vroobel
- Department of Cellular Pathology, Royal Marsden Foundation NHS Trust, London SW3 6JJ, UK
| | - Axel Walther
- Bristol Cancer Institute, University Hospitals Bristol and Weston NHS Foundation Trust, UK
| | - Jason Wong
- Department of Histopathology, East Suffolk and North Essex NHS Foundation Trust, Ipswich Hospital, Heath Road, Ipswich IP4 5PD, UK
| | - Jo Morrison
- University of Exeter, Exeter, UK; Department of Gynaecological Oncology, GRACE Centre, Musgrove Park Hospital, Somerset NHS Foundation Trust, Taunton TA1 5DA, UK.
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Mikhael M, Kansara B, Basta A, Hume E, Nguyen OT, Reblin M, Hong YR, Tabriz AA, Patel K, Magnuson JS, Turner K. Optimizing presurgical education for patients with head and neck cancer receiving laryngectomy and free flap surgery: A qualitative study. Head Neck 2024. [PMID: 38459809 PMCID: PMC11381573 DOI: 10.1002/hed.27729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 02/26/2024] [Accepted: 03/01/2024] [Indexed: 03/10/2024] Open
Abstract
BACKGROUND There has been limited study of oncology professionals' perspectives on optimizing delivery of presurgical education for individuals with head and neck cancer (HNC). Therefore, we assessed oncology professionals' perspectives about presurgical education for laryngectomy and free flap surgeries, which have a significant impact on patients' quality of life. METHODS Interviews were conducted with 27 oncology professionals from an NCI-designated Comprehensive Cancer Center and a community oncology setting. RESULTS Participants identified six recommendations to improve presurgical education: (1) establishing preoperative consultations with allied health professionals; (2) educating patients and providers on the concept of team-based care; (3) optimizing education through multimodal strategies; (4) connecting patients with other HNC surgical patients; (5) preparing caregivers for their role; and (6) educating patients on insurance navigation. CONCLUSIONS Study findings demonstrate gaps in the timing, content, and mode of delivery for presurgical education and suggest strategies for further evaluation in future studies.
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Affiliation(s)
- Marian Mikhael
- Morsani College of Medicine, University of South Florida, Tampa, Florida, USA
| | - Bhargav Kansara
- Morsani College of Medicine, University of South Florida, Tampa, Florida, USA
| | - Ameer Basta
- Morsani College of Medicine, University of South Florida, Tampa, Florida, USA
| | - Emma Hume
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, Florida, USA
| | - Oliver T Nguyen
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, Florida, USA
| | - Maija Reblin
- Department of Family Medicine, Larner College of Medicine, University of Vermont, Burlington, Vermont, USA
| | - Young-Rock Hong
- Department of Health Services Research, Management and Policy, University of Florida, Gainesville, Florida, USA
| | - Amir Alishahi Tabriz
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, Florida, USA
- Department of Gastrointestinal Oncology, Moffitt Cancer Center, Tampa, Florida, USA
| | - Krupal Patel
- Department of Head and Neck Oncology, Moffitt Cancer Center, Tampa, Florida, USA
| | - Jeffery Scott Magnuson
- Morsani College of Medicine, University of South Florida, Tampa, Florida, USA
- Department of Head and Neck Surgery, AdventHealth Orlando, Orlando, Florida, USA
| | - Kea Turner
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, Florida, USA
- Department of Gastrointestinal Oncology, Moffitt Cancer Center, Tampa, Florida, USA
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Hall A, Wolfenden L, Gardner C, McEvoy B, Lane C, Shelton RC, McFadyen T, Lee DC, Shoesmith A, Austin K, Nathan N. A bibliographic review of sustainability research output and investment in 10 leading public health journals across three time periods. PUBLIC HEALTH IN PRACTICE 2023; 6:100444. [PMID: 38028253 PMCID: PMC10654021 DOI: 10.1016/j.puhip.2023.100444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Revised: 10/12/2023] [Accepted: 10/20/2023] [Indexed: 12/01/2023] Open
Abstract
Objectives Long-term delivery, or sustainability, of evidence-based interventions is necessary for public health benefits to be realised. However, sustainment of effective interventions is poor. Understanding the evidence-base and identifying potential gaps is necessary to inform where future research efforts are most warranted. Study design We undertook a repeat cross-sectional bibliographic review of research published in 10 public health journals across three time periods (2010, 2015 and 2020/2021). Methods Studies were eligible if they were a data-based study or review article. Studies were assessed as to whether they focused on sustainability. The percentage of public health research studies assessing sustainability overall and by the three time periods was calculated. The association between time period and the proportion of sustainability articles was assessed using logistic regression. Descriptive statistics were used to summarise study characteristics overall and by time period. Results 10,588 data-based articles were identified, of which 1.3 % (n = 136) focused on sustainability. There was a statistically significant association between time period and the proportion of sustainability research, with a slight increase across the three time periods: 0.3 % (95 % CI: 0.1 %, 0.7 %) in 2010, 1.4 % (95 % CI: 1.0 %, 1.9 %) in 2015 and 1.6 % (95 % CI: 1.3 %, 1.9 %) in 2020/2021. Most research was descriptive/epidemiological (n = 69, 51 %), few focused on measurement (n = 2, 1.5 %) and none on cost effectiveness. Only one intervention study assessed the effect of specific sustainability strategies. Conclusions This bibliographic review highlights the need for more public health research on sustainability, particularly in the areas of measurement, sustainability interventions, and cost effectiveness.
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Affiliation(s)
- Alix Hall
- School of Medicine and Public Health, The University of Newcastle, Newcastle, NSW, Australia
- Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
| | - Luke Wolfenden
- School of Medicine and Public Health, The University of Newcastle, Newcastle, NSW, Australia
- Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
- Hunter New England Population Health, Hunter New England Local Health District, Newcastle, NSW, Australia
| | - Carly Gardner
- School of Medicine and Public Health, The University of Newcastle, Newcastle, NSW, Australia
- Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
| | - Brydie McEvoy
- School of Medicine and Public Health, The University of Newcastle, Newcastle, NSW, Australia
- Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
| | - Cassandra Lane
- School of Medicine and Public Health, The University of Newcastle, Newcastle, NSW, Australia
- Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
- Hunter New England Population Health, Hunter New England Local Health District, Newcastle, NSW, Australia
| | - Rachel C. Shelton
- Mailman School of Public Health, Department of Sociomedical Sciences, Columbia University, New York, NY, USA
| | - Tameka McFadyen
- School of Medicine and Public Health, The University of Newcastle, Newcastle, NSW, Australia
- Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
- Hunter New England Population Health, Hunter New England Local Health District, Newcastle, NSW, Australia
| | - Daniel C.W. Lee
- School of Medicine and Public Health, The University of Newcastle, Newcastle, NSW, Australia
- Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
- Hunter New England Population Health, Hunter New England Local Health District, Newcastle, NSW, Australia
| | - Adam Shoesmith
- School of Medicine and Public Health, The University of Newcastle, Newcastle, NSW, Australia
- Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
| | - Karly Austin
- School of Medicine and Public Health, The University of Newcastle, Newcastle, NSW, Australia
- Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
| | - Nicole Nathan
- School of Medicine and Public Health, The University of Newcastle, Newcastle, NSW, Australia
- Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
- Hunter New England Population Health, Hunter New England Local Health District, Newcastle, NSW, Australia
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Jain SN, Lamture Y, Krishna M. Enhanced Recovery After Surgery: Exploring the Advances and Strategies. Cureus 2023; 15:e47237. [PMID: 38022245 PMCID: PMC10654132 DOI: 10.7759/cureus.47237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 10/17/2023] [Indexed: 12/01/2023] Open
Abstract
Enhanced recovery after surgery (ERAS) has emerged as a paradigm-shifting approach in perioperative care, aimed at optimizing patient outcomes, accelerating recovery, and minimizing hospital stays. This review delves into the latest advances and strategies within the field of ERAS, encompassing a comprehensive examination of preoperative, intraoperative, and postoperative interventions. By analyzing an array of clinical studies, meta-analyses, and implementation experiences, this review highlights the multifaceted elements contributing to the success of ERAS programs. Key components such as preoperative patient education, minimally invasive surgical techniques, tailored anesthesia protocols, judicious fluid management, optimized pain control, early ambulation, and structured nutritional support are thoroughly explored. Furthermore, the review delves into the intricacies of ERAS implementation across diverse surgical specialties, emphasizing the significance of multidisciplinary collaboration, protocol customization, and sustained quality improvement initiatives. The analysis not only showcases the tangible benefits of ERAS, including reduced complication rates, shortened hospital stays, and enhanced patient satisfaction, but also underscores the challenges and barriers that medical professionals encounter during program adoption. By synthesizing the current state of ERAS research and practice, this review provides clinicians, administrators, and researchers with valuable insights into the evolving landscape of perioperative care, fostering a deeper understanding of ERAS as a holistic approach that transcends traditional surgical pathways.
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Affiliation(s)
- Shubhi N Jain
- Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Yashwant Lamture
- Surgery, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Malay Krishna
- Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
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Johnson BM, Dewitt J, Balanoff C, Kilgore L, Aripoli A, Collins M. Oncoplastic Breast Reconstruction for Large Pediatric Breast Tumors: A Case Series. Ann Plast Surg 2023; 91:36-41. [PMID: 37450859 DOI: 10.1097/sap.0000000000003576] [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: 07/18/2023]
Abstract
ABSTRACT Large breast fibroadenomas in pediatric females may cause discomfort, asymmetry, and psychological stress, and patients may elect for surgical excision. There are no criteria for reconstruction after the excision of these masses, and the research is limited in describing oncoplastic techniques in pediatric fibroadenoma excision. Nononcoplastic techniques, such as mastectomy with implant or flap reconstruction, have been used for pediatric fibroadenoma excision reconstruction. Oncoplastic techniques using Wise pattern or circumareolar incisions have shown to have efficacious outcomes. In addition, pediatric females undergoing breast surgery risk long-term complications such as continued breast asymmetry due to further breast growth, nipple and breast hypoesthesia, and future breastfeeding difficulty. This case series describes the oncoplastic techniques used for large benign mass excision and reconstruction of 3 pediatric females. A Wise pattern technique was used for all 3 patients, and 2 underwent a free-nipple graft. Oncoplastic techniques for pediatric breast mass excision provide satisfactory aesthetic outcomes with minimal surgical morbidity. Further research assessing the long-term effects of pediatric breast mass excision and reconstruction would be beneficial.
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Affiliation(s)
| | | | | | | | - Allison Aripoli
- Radiology, University of Kansas Medical Center, Kansas City, KS
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Giannopoulos E, McBain S, Giuliani M, Wang J, Zwicker V, Fox C, Papadakos J. Health Literacy and Radiation Therapy: a Current State Assessment of Patient Education Materials. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2023; 38:924-930. [PMID: 35921064 DOI: 10.1007/s13187-022-02208-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 07/24/2022] [Indexed: 06/02/2023]
Abstract
In order to mitigate low levels of health literacy among patients, there is need to evaluate patient education (PE) materials and to ensure that the information is readily accessible to patients. The quality and comprehensiveness of radiation therapy materials were evaluated at fourteen cancer centres. To assess quality, PE leaders independently conducted readability, actionability and understandability assessments of materials. To evaluate comprehensiveness, an assessment was conducted of the scope of symptoms covered in extant materials, and the modality they were produced in (e.g. pamphlet, video). A total of 555 PE materials were reviewed for comprehensiveness and modality and seventy underwent evaluation against health literacy best practice standards. Most materials (n = 64, 91%) had a reading grade level above the recommended grade 6 ([Formula: see text] = 9, range = 4-12). Under half (n = 34, 49%) scored at or above the 80% threshold for understandability ([Formula: see text] = 74%, 33-100%) and just over half (n = 36, 51%) scored at or above the 80% target for actionability ([Formula: see text] = 71%, 33-100%). Only two cancer centres (n = 2/14, 14%) had PE materials covering the breadth of symptoms related to radiation therapy and the vast majority of materials were pamphlets (89%). Findings indicate that most radiation therapy PE materials used in cancer centres do not meet health literacy best practices, and there is a disparity between cancer centres in the topics that are available to patients and family. This evaluation highlights the need to better incorporate health literacy best practices into the development of radiation therapy PE materials and strategies to improve accessibility of such health information.
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Affiliation(s)
- Eleni Giannopoulos
- Cancer Health Literacy Research Centre, Cancer Education Program, Princess Margaret Cancer Centre, 585 University Avenue, ELLICSR PMB B-130, Toronto, ON, M5G 2N2, Canada
| | - Sarah McBain
- Patient Education, Ontario Health (Cancer Care Ontario), Toronto, M5G 2L7, Canada
| | - Meredith Giuliani
- Cancer Health Literacy Research Centre, Cancer Education Program, Princess Margaret Cancer Centre, 585 University Avenue, ELLICSR PMB B-130, Toronto, ON, M5G 2N2, Canada
- Radiation Medicine Program, Princess Margaret Cancer Centre, Toronto, M5G 2M9, Canada
- Department of Radiation Oncology, University of Toronto, Toronto, M5T 1P5, Canada
| | - Jenney Wang
- Patient Education, Ontario Health (Cancer Care Ontario), Toronto, M5G 2L7, Canada
| | - Victoria Zwicker
- Patient Education, Ontario Health (Cancer Care Ontario), Toronto, M5G 2L7, Canada
| | - Colleen Fox
- Patient Education, Ontario Health (Cancer Care Ontario), Toronto, M5G 2L7, Canada
| | - Janet Papadakos
- Cancer Health Literacy Research Centre, Cancer Education Program, Princess Margaret Cancer Centre, 585 University Avenue, ELLICSR PMB B-130, Toronto, ON, M5G 2N2, Canada.
- Patient Education, Ontario Health (Cancer Care Ontario), Toronto, M5G 2L7, Canada.
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, M5T 3M6, Canada.
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Grocott B, Reynolds K, Logan G, Hebbard P, El-Gabalawy R. Breast cancer patient experiences of perioperative distress and anxiety: A qualitative study. Eur J Oncol Nurs 2023; 63:102299. [PMID: 36893576 DOI: 10.1016/j.ejon.2023.102299] [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: 09/27/2022] [Revised: 02/01/2023] [Accepted: 02/16/2023] [Indexed: 02/19/2023]
Abstract
PURPOSE Distress, often manifesting as anxiety, is common in breast cancer patients and becomes particularly elevated before surgery. This study investigated perspectives of those undergoing breast cancer surgery concerning what enhances and reduces distress and anxiety across the perioperative period (i.e., from diagnostic evaluation to recovery). METHODS The present study conducted qualitative semi-structured individual interviews with 15 adult breast cancer surgery patients within three months post-operation. Quantitative surveys provided background information (e.g., sociodemographics). Individual interviews were analyzed using thematic analysis. Quantitative data were analyzed descriptively. RESULTS Four main themes emerged from qualitative interviews: 1) "fighting an unknown" (sub-themes: uncertainty, health-related knowledge and experience); 2) "the cancer takes away the control" (sub-themes: "living at the whim of others", trusting care providers); 3) person at the centre of the patient (sub-themes: "managing life:" caregiving and work-related stressors, "everybody jumped in to help:" emotional and instrumental support); and 4) physical and emotional impacts of treatment (sub-themes: pain and impacted mobility, "losing a part of yourself"). Breast cancer patients' experiences of surgery-related distress and anxiety were contextualized by broader experiences of care. CONCLUSIONS Our findings illustrate the illness-specific experience of perioperative anxiety and distress in breast cancer patients and inform patient-centered care and intervention.
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Affiliation(s)
- Bronwen Grocott
- Department of Psychology, Faculty of Arts, University of Manitoba, Canada; Department of Clinical Health Psychology, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Canada
| | - Kristin Reynolds
- Department of Psychology, Faculty of Arts, University of Manitoba, Canada; Department of Psychiatry, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Canada
| | - Gabrielle Logan
- Department of Anesthesiology, Perioperative and Pain Medicine, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Canada
| | - Pamela Hebbard
- Department of Surgery, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Canada; CancerCare Manitoba, Canada
| | - Renée El-Gabalawy
- Department of Psychology, Faculty of Arts, University of Manitoba, Canada; Department of Clinical Health Psychology, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Canada; Department of Psychiatry, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Canada; Department of Anesthesiology, Perioperative and Pain Medicine, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Canada; CancerCare Manitoba, Canada.
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8
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van Kooten RT, Elske van den Akker-Marle M, Putter H, Meershoek-Klein Kranenbarg E, van de Velde CJH, Wouters MWJM, Tollenaar RAEM, Peeters KCMJ. The Impact of Postoperative Complications on Short- and Long-Term Health-Related Quality of Life After Total Mesorectal Excision for Rectal Cancer. Clin Colorectal Cancer 2022; 21:325-338. [PMID: 36210321 DOI: 10.1016/j.clcc.2022.07.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 07/19/2022] [Accepted: 07/20/2022] [Indexed: 01/26/2023]
Abstract
BACKGROUND Survival for rectal cancer patients has improved over the past decades. In parallel, long-term health-related quality of life (HRQoL) is gaining interest. This study focuses on the effect of complications following rectal cancer surgery on HRQoL and survival. METHODS The TME-trial (1996-1999) randomized patients with operable rectal cancer between surgery with preoperative short-course radiotherapy and surgery. Questionnaires including the Rotterdam Symptom Checklist were sent at 6 time points within the first 24 months and after 14 years the EORTC QLQ-C30 and EORTC QLQ-CR29 questionnaires. Differences in HRQoL and survival between patients with and without complications were analyzed. RESULTS A total of 1207 patients were included, of which 482 (39.9%) patients experienced complications, surgical complications occurred in 177 (14.6%) patients, non-surgical complications in 197 (16.3%) and 108 patients (8.9%) had a combination of both types of complications. Three months after surgery, patients with a combination of surgical- and non-surgical complications, especially patients with anastomotic leakage, had the worst HRQoL. Twelve months postoperative HRQoL returned to a similar level as before surgery, regardless of complications. In patients who survived 14 years, no significant differences in HRQoL were seen between patients with and without complications. However, patients with complications did have lower overall survival. CONCLUSION This study shows that survival and short-term HRQoL are negatively affected by complications. Twelve months after surgery HRQoL had returned to the preoperative level regardless, of complications. Also, in patients that survived 14 years, there was no effect of complications on HRQoL detected.
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Affiliation(s)
- Robert T van Kooten
- Department of Surgery, Leiden University Medical Center, Leiden, the Netherlands.
| | | | - Hein Putter
- Department of Biomedical Data Sciences, Leiden University Medical Center, Leiden, the Netherlands
| | | | - Cornelis J H van de Velde
- Department of Surgery, Leiden University Medical Center, Leiden, the Netherlands; Leiden University Medical Center, Leiden, The Netherlands
| | - Michel W J M Wouters
- Department of Biomedical Data Sciences, Leiden University Medical Center, Leiden, the Netherlands; Department of Surgery, Netherlands Cancer Institute-Antoni van Leeuwenhoek, Amsterdam, the Netherlands
| | - Rob A E M Tollenaar
- Department of Surgery, Leiden University Medical Center, Leiden, the Netherlands
| | - Koen C M J Peeters
- Department of Surgery, Leiden University Medical Center, Leiden, the Netherlands
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9
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Wolters-Zwolle M, de Jongh MM, van Elst MW, Meijer RP, Vervoort SC. Patients' experiences with an audio-visual intervention, the use of a tailored explanimation video in patients with bladder cancer. PEC INNOVATION 2022; 1:100042. [PMID: 37213743 PMCID: PMC10194105 DOI: 10.1016/j.pecinn.2022.100042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/14/2021] [Revised: 04/10/2022] [Accepted: 04/16/2022] [Indexed: 05/23/2023]
Abstract
Objective This qualitative study explored the experiences of patients with bladder cancer with a tailored 'explanimation' video (EV) as a supportive information tool used before and during treatment. Methods Using a qualitative approach, data were collected through semi-structured interviews with 12 patients with bladder cancer and thematically analysed. Results Participants advised future use of the EV, noting it is user friendly and has a fitting difficulty level and clarifying animations. However, some mentioned practical information on 'life after treatment' was lacking, and some emphasized the importance of choosing the right moment of delivery. Patients' experiences were described in four major themes: taking own responsibility, providing opportunity for postponed information supply, easing decision-making processes and gaining a sense of calm. Conclusion Findings indicate the EV supported patients with bladder cancer in the process of being informed and in decision-making. Future use of the EV in the treatment of patients with bladder cancer is recommended. Innovation The use of audiovisual information in patient education is innovative. Tailored audiovisual information in shape of the EV is a step forward in streamlining information processes, meeting individual preferences and highlighting the most important general information for patients with bladder cancer.
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Affiliation(s)
- Marjon Wolters-Zwolle
- University Medical Centre Utrecht, Clinical Health Sciences, Nursing Science, Utrecht University, Utrecht, the Netherlands
| | - Marielle M.E. de Jongh
- University Medical Centre Utrecht, Clinical Health Sciences, Nursing Science, Utrecht University, Utrecht, the Netherlands
| | - Maarten W. van Elst
- Department of Urological Oncology, Division of Imaging & Oncology, University Medical Centre Utrecht, The Netherlands
| | - Richard P. Meijer
- Department of Urological Oncology, Division of Imaging & Oncology, University Medical Centre Utrecht, The Netherlands
| | - Sigrid C.J.M. Vervoort
- Division of Imaging & Oncology, University Medical Centre Utrecht, The Netherlands
- Corresponding author.
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10
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Zucca A, Mansfield E, Sanson-Fisher R, Wyse R, Johnston SA, Fakes K, Robinson S, Smith S. Perceived Provision of Perioperative Information and Care by Patients Who Have Undergone Surgery for Colorectal Cancer: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15249. [PMID: 36429966 PMCID: PMC9690373 DOI: 10.3390/ijerph192215249] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 11/11/2022] [Accepted: 11/15/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Active patient participation in preparation and recovery from colorectal cancer surgery can be facilitated by timely information and care and may improve patient wellbeing and reduce hospitalizations; Methods: We aimed to identify gaps in perioperative information and care by asking colorectal cancer surgical patients to retrospectively report on their perceptions of care via a cross-sectional survey; Results: Overall, 179 (64% consent rate) patients completed one of two 64-item surveys exploring their views of 'optimal care' or their experiences of 'actual care'. In total, 41 (64%) aspects of care were endorsed as optimal. Of these, almost three-quarters (73%) were received by most patients (80% or more). Gaps in care were identified from discrepancies in the endorsement of optimal versus actual survey items. Of the 41 items identified as representing 'optimal care', 11 items were received by fewer than 80% of patients, including the provision of information about the impact of surgical wait-times on cancer cure (69%); pre-habilitation behaviors to improve health (75%); the type of questions to ask the health care team (74%); impact of pain medications on bowel movements (73%); how to obtain medical supplies for self-care at home (67%); dietary or exercise advice after discharge (25-31%); and emotional advice after discharge (44%). CONCLUSIONS These gaps represent patient-centered priorities and targets for supportive interventions.
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Affiliation(s)
- Alison Zucca
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Newcastle, NSW 2308, Australia
- Priority Research Centre for Health Behaviour, University of Newcastle, Newcastle, NSW 2308, Australia
| | - Elise Mansfield
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Newcastle, NSW 2308, Australia
- Priority Research Centre for Health Behaviour, University of Newcastle, Newcastle, NSW 2308, Australia
| | - Rob Sanson-Fisher
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Newcastle, NSW 2308, Australia
- Priority Research Centre for Health Behaviour, University of Newcastle, Newcastle, NSW 2308, Australia
| | - Rebecca Wyse
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Newcastle, NSW 2308, Australia
- Priority Research Centre for Health Behaviour, University of Newcastle, Newcastle, NSW 2308, Australia
| | - Sally-Anne Johnston
- Department of Colorectal Surgery, Division of Surgery, John Hunter Hospital, New Lambton Heights, NSW 2305, Australia
| | - Kristy Fakes
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Newcastle, NSW 2308, Australia
- Priority Research Centre for Health Behaviour, University of Newcastle, Newcastle, NSW 2308, Australia
| | - Sancha Robinson
- Department of Anaesthesia, John Hunter Hospital, New Lambton Heights, NSW 2305, Australia
- Department of Anaesthesia, Calvary Mater Newcastle Hospital, Newcastle, NSW 2298, Australia
| | - Stephen Smith
- Department of Colorectal Surgery, Division of Surgery, John Hunter Hospital, New Lambton Heights, NSW 2305, Australia
- Department of Surgery, Calvary Mater Newcastle Hospital, Newcastle, NSW 2298, Australia
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11
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Carrillo GM, Mesa ML, Burbano DV. Skills Required in the Care of Cancer Patients Who Undergo Surgery in the Hospital-Home Transition. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2022; 37:1364-1371. [PMID: 33506409 PMCID: PMC9550752 DOI: 10.1007/s13187-021-01964-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/18/2021] [Indexed: 05/26/2023]
Abstract
It is essential to recognize what care is required by patients undergoing surgery in the transition from hospital to home to provide guidance for plans for release and follow-up and to achieve patient adherence to these plans. The objective of this study is to describe the skills required for the care of cancer patients who undergo surgery after hospital discharge. An exploratory-type descriptive approach was adopted, including 290 cancer patients who underwent surgery at a reference center in Bogotá, Colombia. Hospital discharge was followed by 4 weeks of telephone follow-up to investigate the skills required for care on the basis of the CUIDAR tool. The participants had a mean age of 59.3 years, with the majority being female and having low levels of education. The most prevalent type of cancer found was breast cancer, followed by colon and rectal, prostate, stomach, cervical, lung, and ovarian cancer. The first follow-up identified needs for care in most of the CUIDAR dimensions, predominantly instrumentation, knowledge, and anticipation. The fourth follow-up, which found reduced needs, focused on knowledge of diet and eating, physical activity, the management of sadness and anxiety, a permanent telephone hotline, and sharing with loved ones. Cancer patients who underwent surgery require skills for at-home care that need to be addressed in hospital discharge programs and with structured telephone follow-up. Telephone follow-up interventions need to be consolidated in hospital release or hospital discharge programs that address these care needs.
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Affiliation(s)
- Gloria Mabel Carrillo
- Department of Nursing, Faculty of Nursing, National University of Colombia, Street 30 No, 45-01, Bogotá, Colombia.
| | | | - Daira Vanesa Burbano
- Department of Nursing, Faculty of Nursing, National University of Colombia, Bogotá, Colombia
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12
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Streith LD, Yip SJY, Brown CJ, Karimuddin AA, Raval MJ, Phang PT, Ghuman A. Effectiveness of a rectal cancer education video on patient expectations. Colorectal Dis 2022; 24:1040-1046. [PMID: 35396809 DOI: 10.1111/codi.16143] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 01/16/2022] [Accepted: 03/28/2022] [Indexed: 12/24/2022]
Abstract
AIM Discrepancy between patient expectations and outcomes can negatively affect patient satisfaction and quality of life. We aimed to assess patient expectations of bowel, urinary, and sexual function after rectal cancer treatments, and whether a preoperative education video changed expectations. METHODS A total of 45 patients were assessed between January 2018 and January 2021 in a tertiary care hospital in Vancouver, Canada. Patients included were rectal cancer patients who had neoadjuvant chemoradiation and were listed for low anterior resection but had not yet had surgery. Following surgical consultation but before surgery, a questionnaire assessing expectations of lifestyle after treatments was administered. Patients then watched an educational video and repeated the questionnaire to assess for changes in expectations. RESULTS Patient scores indicated expectation that control of bowel movements, urination, and sexual function would sometimes be problematic, but had a range from occasionally problematic to good function. Significant change after the video was seen in the expectation of needing medications for bowel control, and 44%-69% of individual patient answers changed from prevideo to post-video, depending on the question. The education video was scored as helpful or very helpful by 82% of patients. CONCLUSIONS Patients have varying expectations of problematic control of bowel, urinary, and sexual function following rectal cancer treatments. A pretreatment education video resulted in a trend toward changed expectations for functional outcomes in most patients. Further educational modalities for patients may provide more uniform expectations of function and increase patient satisfaction after rectal cancer treatments.
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Affiliation(s)
- Lucas D Streith
- Department of Surgery, University of British Columbia, Vancouver, British Columbia, Canada
| | - Silas J Y Yip
- Department of Surgery, University of British Columbia, Vancouver, British Columbia, Canada
| | - Carl J Brown
- Division of General Surgery, Department of Surgery, St. Paul's Hospital, Vancouver, British Columbia, Canada
| | - Ahmer A Karimuddin
- Division of General Surgery, Department of Surgery, St. Paul's Hospital, Vancouver, British Columbia, Canada
| | - Manoj J Raval
- Division of General Surgery, Department of Surgery, St. Paul's Hospital, Vancouver, British Columbia, Canada
| | - P Terry Phang
- Division of General Surgery, Department of Surgery, St. Paul's Hospital, Vancouver, British Columbia, Canada
| | - Amandeep Ghuman
- Division of General Surgery, Department of Surgery, St. Paul's Hospital, Vancouver, British Columbia, Canada
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13
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Kim LS, Park T, Berger ER, Golshan M, Greenup RA. Editorial Comment on: One-Year Experience of Same-Day Mastectomy and Breast Reconstruction Protocol. Ann Surg Oncol 2022; 29:5361-5363. [PMID: 35834143 PMCID: PMC9281278 DOI: 10.1245/s10434-022-12021-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Accepted: 06/02/2022] [Indexed: 11/18/2022]
Affiliation(s)
- Leah S Kim
- Department of Surgery, Yale Comprehensive Cancer Center, Yale University School of Medicine, New Haven, CT, USA
| | - Tristen Park
- Department of Surgery, Yale Comprehensive Cancer Center, Yale University School of Medicine, New Haven, CT, USA
| | - Elizabeth R Berger
- Department of Surgery, Yale Comprehensive Cancer Center, Yale University School of Medicine, New Haven, CT, USA
| | - Mehra Golshan
- Department of Surgery, Yale Comprehensive Cancer Center, Yale University School of Medicine, New Haven, CT, USA
| | - Rachel A Greenup
- Department of Surgery, Yale Comprehensive Cancer Center, Yale University School of Medicine, New Haven, CT, USA.
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14
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Zhu S, Yang C, Chen S, Kang L, Li T, Li J, Li L. Effectiveness of a perioperative support programme to reduce psychological distress for family caregivers of patients with early-stage lung cancer: study protocol for a randomised controlled trial. BMJ Open 2022; 12:e064416. [PMID: 35998958 PMCID: PMC9403120 DOI: 10.1136/bmjopen-2022-064416] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/09/2022] Open
Abstract
INTRODUCTION Family caregivers play a key role in providing ongoing long-term care and assistance to their loved ones during cancer treatment. However, family caregivers of patients with lung cancer are frequently unprepared for their roles and they may undergo psychological distress, thus reducing their own quality of life while affecting patients' health outcomes. Interventions that specifically target this population are lacking. This study aims to evaluate the effectiveness of a perioperative support programme on family caregivers of patients with early-stage lung cancer. METHODS AND ANALYSIS This study is guided by the Stress-Coping Model. Family caregivers of patients diagnosed with early-stage lung cancer and those who are scheduled for lung resection treatment will be invited to participate. Participants will be randomised to groups that either receive the perioperative support programme or usual care. The intervention consists of four face-to-face intervention sessions during the hospital stay and two weekly telephone follow-up sessions after discharge. Primary and secondary outcomes will be assessed at baseline and at 4 and 12 weeks after the intervention. Primary outcomes will include psychological distress and secondary outcomes will include caregiving burden, quality of life, coping style and social support. Generalised estimation equation model will be used to analyse the intervention effects. ETHICS AND DISSEMINATION The study was approved by the Ethics Committee of the Second Xiangya Hospital of Central South University (LYG2022003). The authors will disseminate the study's findings by publishing them in international scientific journals. TRIAL REGISTRATION NUMBER ChiCTR2200058280.
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Affiliation(s)
- Song Zhu
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital of Central South University, Changsha, China
- Department of Thoracic Surgery, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Chen Yang
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Shihao Chen
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Lu Kang
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital of Central South University, Changsha, China
- Department of Thoracic Surgery, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Tong Li
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital of Central South University, Changsha, China
- Department of Thoracic Surgery, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Jina Li
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital of Central South University, Changsha, China
- Department of Thoracic Surgery, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Lezhi Li
- Xiangya Nursing School, Central South University, Changsha, Hunan, China
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15
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Turon H, Hobden B, Fakes K, Clapham M, Proietto A, Sanson-Fisher R. Preparation for Cancer Treatment: A Cross-Sectional Study Examining Patient Self-Reported Experiences and Correlates. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10167. [PMID: 36011803 PMCID: PMC9407820 DOI: 10.3390/ijerph191610167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 08/15/2022] [Accepted: 08/16/2022] [Indexed: 06/15/2023]
Abstract
Given the significant physical and psychosocial side-effects cancer treatment has on individuals, it is important to ensure patients receive adequate preparation prior to treatment. The purpose of this study was to explore, among Australian oncology patients, (i) the self-reported treatment preparation information they received; and (ii) the patient characteristics associated with the treatment preparation information received. Patients in the early stages of cancer treatment were invited to complete a survey exploring their receipt of information about treatment preparation. Items assessed patients' self-report of whether they had received information about the treatment process. A total of 165 participants completed the survey. Patients most frequently reported receiving information about how they might feel physically (94%) and what side effects to watch for (93%). One in five patients reported not receiving information about how to cope with any stress or worry related to treatment. Females reported receiving significantly fewer items of care compared to males (p = 0.0083). This study suggests that while self-reported preparation for cancer treatment is generally high, components of preparation related to psychosocial concerns could be improved. Survey data could be used as a feedback tool for centres to monitor delivery of care.
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Affiliation(s)
- Heidi Turon
- Health Behaviour Research Collaborative, School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW 2308, Australia
- Priority Research Centre for Health Behaviour, Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW 2308, Australia
- Hunter Medical Research Institute, New Lambton, NSW 2305, Australia
| | - Breanne Hobden
- Health Behaviour Research Collaborative, School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW 2308, Australia
- Priority Research Centre for Health Behaviour, Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW 2308, Australia
- Hunter Medical Research Institute, New Lambton, NSW 2305, Australia
| | - Kristy Fakes
- Health Behaviour Research Collaborative, School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW 2308, Australia
- Priority Research Centre for Health Behaviour, Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW 2308, Australia
- Hunter Medical Research Institute, New Lambton, NSW 2305, Australia
| | - Matthew Clapham
- Clinical Research Design and Statistics, Hunter Medical Research Institute, New Lambton, NSW 2305, Australia
| | - Anthony Proietto
- Health Behaviour Research Collaborative, School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW 2308, Australia
- Priority Research Centre for Health Behaviour, Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW 2308, Australia
- Hunter Medical Research Institute, New Lambton, NSW 2305, Australia
| | - Rob Sanson-Fisher
- Health Behaviour Research Collaborative, School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW 2308, Australia
- Priority Research Centre for Health Behaviour, Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW 2308, Australia
- Hunter Medical Research Institute, New Lambton, NSW 2305, Australia
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16
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Raso KL, Suen M, Turner J, Khatri S, Lin Y, Wildbore C, Becerril-Martinez G, Le Page P, Tan SY, Egger S, Vardy J. Prehabilitation before gastrointestinal cancer surgery (Prehab-GI): Protocol for an implementation study. (Preprint). JMIR Res Protoc 2022; 12:e41101. [PMID: 36972114 PMCID: PMC10131732 DOI: 10.2196/41101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 11/03/2022] [Accepted: 11/18/2022] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Surgery remains the standard curative treatment for early-stage colorectal and upper gastrointestinal cancer. Reduced preoperative functional capacity, nutritional status, and psychological well-being are associated with poor postoperative outcomes. Prehabilitation aims to improve preoperative functional reserves through physical, nutritional, and psychological interventions. Yet, how it transitions from a trial setting to being integrated into a real-world health setting is unknown. OBJECTIVE The primary aim is to evaluate the implementation of a multimodal (supervised exercise, nutrition, and nursing support) prehabilitation program into standard care for patients with gastrointestinal cancer (colorectal and upper gastrointestinal cancer) scheduled for curative intent surgery. The secondary aim is to determine the impact of a multimodal prehabilitation program on functional capacity, nutritional and psychological status, and surgical outcomes. METHODS This is an implementation study that will investigate a multimodal prehabilitation intervention, in a nonblinded, nonrandomized, single-group, pre-post design. Patients diagnosed with colorectal and upper gastrointestinal cancer scheduled for potentially curative intent surgery at Concord Repatriation General Hospital, with ≥14 intervention days prior to surgery and are medically cleared to exercise will be eligible. The study will be evaluated using the Reach, Effectiveness, Adoption, Implementation, and Maintenance Evaluation Framework. RESULTS The protocol was approved in December 2019 by the Concord Repatriation General Hospital Human Research Ethics Committee (reference number 2019/PID13679). Recruitment commenced in January 2020. In response to the COVID-19 pandemic, recruitment was paused in March 2020 and reopened in August 2020 with remote or telehealth intervention adaptations. Recruitment ended on December 31, 2021. Over the 16-month recruitment period, a total of 77 participants were recruited. CONCLUSIONS Prehabilitation represents an opportunity to maximize functional capacity and improve surgical outcomes. The study will provide guidance and contribute to the evidence on the integration of prehabilitation into standard care using adaptive models of health care delivery including telehealth. TRIAL REGISTRATION Australian and New Zealand Clinical Trials Registry ACTR 12620000409976; https://anzctr.org.au/Trial/Registration/TrialReview.aspx?id=378974&isReview=true. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR1-10.2196/41101.
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Affiliation(s)
- Kristy-Lee Raso
- Department of Nutrition and Dietetics, Concord Repatriation General Hospital, Concord, Australia
- Sydney Medical School, University of Sydney, Sydney, Australia
| | - Michael Suen
- Sydney Medical School, University of Sydney, Sydney, Australia
- Department of Colorectal Surgery, Concord Repatriation General Hospital, Concord, Australia
| | - Jane Turner
- Concord Cancer Centre, Concord Repatriation General Hospital, Concord, Australia
| | - Sonia Khatri
- Department of Colorectal Surgery, Concord Repatriation General Hospital, Concord, Australia
- Concord Cancer Centre, Concord Repatriation General Hospital, Concord, Australia
| | - Yanlan Lin
- Department of Colorectal Surgery, Concord Repatriation General Hospital, Concord, Australia
| | - Carolyn Wildbore
- Concord Cancer Centre, Concord Repatriation General Hospital, Concord, Australia
- Department of Upper Gastrointestinal Surgery, Concord Repatriation General Hospital, Concord, Australia
| | - Guillermo Becerril-Martinez
- Sydney Medical School, University of Sydney, Sydney, Australia
- Department of Upper Gastrointestinal Surgery, Concord Repatriation General Hospital, Concord, Australia
| | - Philip Le Page
- Department of Upper Gastrointestinal Surgery, Concord Repatriation General Hospital, Concord, Australia
| | - Sim Yee Tan
- Department of Nutrition and Dietetics, Concord Repatriation General Hospital, Concord, Australia
- Sydney Medical School, University of Sydney, Sydney, Australia
- Concord Cancer Centre, Concord Repatriation General Hospital, Concord, Australia
| | - Sam Egger
- The Daffodil Centre, The University of Sydney, A Joint Venture with Cancer Council New South Wales, Sydney, Australia
| | - Janette Vardy
- Sydney Medical School, University of Sydney, Sydney, Australia
- Concord Cancer Centre, Concord Repatriation General Hospital, Concord, Australia
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17
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Schwenk W. Optimized perioperative management (fast-track, ERAS) to enhance postoperative recovery in elective colorectal surgery. GMS HYGIENE AND INFECTION CONTROL 2022; 17:Doc10. [PMID: 35909653 PMCID: PMC9284431 DOI: 10.3205/dgkh000413] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Aim This manuscript provides information on the history, principles, and clinical results of Fast-track or ERAS concepts to optimize perioperative management (OPM). Methods With the focus on elective colorectal surgery description of the OPM concept and its elements for with special attention to the prevention of infectious complications and clinical results compared to traditional care will be given using recent systematic literature reviews. Additionally, clinical results for other major abdominal procedures are given. Results An optimized perioperative management protocol for elective colorectal resections will currently consist of 25 perioperative elements. These elements include the time from before hospital admission (patient education, screening, and treatment of possible risk factors like anemia, malnutrition, cessation of nicotine or alcohol abuse, optimization of concurrent systemic disease, physical prehabilitation, carbohydrate loading, adequate bowel preparation) to the preoperative period (shortened fasting, non-sedative premedication, prophylaxis of PONV and thromboembolic complications), intraoperative measures (systemic antibiotic prophylaxis, standardized anesthesia, normothermia and normovolemia, minimally invasive surgery, avoidance of drains and tubes) as well as postoperative actions (early oral feeding, enforced mobilization, early removal of a urinary catheter, stimulation of intestinal propulsion, control of hyperglycemia). Most of these elements are based on high-level evidence and will also have effects on the incidence of postoperative infectious complications. Conclusion Optimized perioperative management should be mandatory for elective surgery today as it enhances postoperative patient recovery, reduces morbidity and infectious complications.
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Affiliation(s)
- Wolfgang Schwenk
- GOPOM GmbH, Gesellschaft für Optimiertes PeriOperatives Management, Düsseldorf, Germany
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18
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Hanalis-Miller T, Nudelman G, Ben-Eliyahu S, Jacoby R. The Effect of Pre-operative Psychological Interventions on Psychological, Physiological, and Immunological Indices in Oncology Patients: A Scoping Review. Front Psychol 2022; 13:839065. [PMID: 35572335 PMCID: PMC9094613 DOI: 10.3389/fpsyg.2022.839065] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2021] [Accepted: 02/22/2022] [Indexed: 11/19/2022] Open
Abstract
Introduction The stressful pre-operative period exerts a profound impact on psychological, physiological and immunological outcomes. Oncological surgeries, in particular, elicit significantly higher stress responses than most other surgeries. Managing these responses through psychological interventions may improve long-term outcomes. The purpose of the current research was to review studies that have explored pre-operative psychological interventions in cancer patients in order to map the types of current interventions and provide an initial assessment of whether these interventions improved psychological, physiological, and/or immunological indices as well as long-term cancer outcomes. Methods A systematic literature search for studies that included pre-operative psychological interventions in oncology patients was conducted, using the databases PubMed and Web of Science. Inclusion criteria included studies pertaining to oncological surgery in adults, study designs that included a clearly defined pre-operative psychological intervention and control group. Results We found 44 studies, each using one of the following interventions: psychoeducation, cognitive interventions, relaxation techniques, integrated approaches. All the studies reported improved immediate post-operative psychological, physiological, and/or immunological outcomes. Only a few studies addressed long-term cancer outcomes, and only one reported improved survival. Conclusions Research on pre-operative interventions with cancer patients is missing systematic methods. Studies provide varying results, which makes it difficult to compare them and reach reliable conclusions. There is considerable heterogeneity in the literature regarding the specific intervention used, the timing of intervention, the characteristics of the patients studied and the outcome measures. In order to improve research in this field, including the measurement of long-term outcomes, we suggest some steps that should be taken in further research.
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Affiliation(s)
| | - Gabriel Nudelman
- School of Behavioral Sciences, The Academic College of Tel Aviv-Yaffo, Tel Aviv-Yafo, Israel
| | - Shamgar Ben-Eliyahu
- Sagol School of Neuroscience and School of Psychological Sciences, Tel Aviv University, Tel Aviv-Yafo, Israel
| | - Rebecca Jacoby
- Stress, Hope and Cope Laboratory, School of Behavioral Sciences, The Academic College of Tel Aviv-Yaffo, Tel Aviv-Yafo, Israel
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19
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Achrekar MS. Enhanced recovery after surgery (ERAS) nursing program. Asia Pac J Oncol Nurs 2022; 9:100041. [PMID: 35620398 PMCID: PMC9126774 DOI: 10.1016/j.apjon.2022.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Accepted: 02/07/2022] [Indexed: 11/28/2022] Open
Affiliation(s)
- Meera Sharad Achrekar
- Advanced Centre for Treatment, Research and Education in Cancer, Tata Memorial Centre, Navi Mumbai, India
- Homi Bhabha National Institute, Mumbai, India
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20
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Deressa D, Gebreyohannis T, Boka A, Geneti Y. Satisfaction with preoperative education and surgical services among adults elective surgical patients at selected public hospitals in Addis Ababa, Ethiopia. SAGE Open Med 2022; 10:20503121221143219. [DOI: 10.1177/20503121221143219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Accepted: 11/17/2022] [Indexed: 12/14/2022] Open
Abstract
Objectives: The purpose of this study was to determine the level of satisfaction with preoperative education and surgical services among adult elective surgical patients at governmental hospitals in Addis Ababa, Ethiopia. Methods: Four hundred and twenty-two elective surgical patients at Addis Ababa’s governmental hospitals took part in a facility-based cross-sectional study from 8 October to 8 November 2021. Based on past experiments, an instrument for structured data collection was modified and employed. The data were cleaned and sent to Epidata version 4.2 before being exported and analysed in SPSS version 25. Descriptive statistics were used to describe the participant characteristics, and logistic regression, which also included bivariate and multivariate analysis, was used to evaluate the association between the independent and outcome variables. The level of statistical significance was indicated by a p value of 0.05. Results: 84.6% of the participants reported feeling very satisfied with their preoperative education. Preoperative education about surgery (adjusted odds ratios (AOR) = 0.005; 95% confidence interval (CI): (0.000, 0.061)), previous surgery (AOR = 2.7; 95% CI: (2.51, 6.85)), and preoperative anxiety (AOR = 0.013; 95% CI: (0.003, 0.06)) were all significantly associated. Conclusions: About 84% of survey participants reported being satisfied with preoperative education and services. Preoperative patient satisfaction was negatively predicted by preoperative anxiety, prior surgery, and preoperative information about surgery. The decrease of anxiety and enhancement of surgical patient satisfaction may be significantly impacted by proper preoperative education.
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Affiliation(s)
- Dereje Deressa
- Department of Nursing, School of Nursing and Midwifery, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Tigistu Gebreyohannis
- Department of Nursing, School of Nursing and Midwifery, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Abdisa Boka
- Department of Nursing, School of Nursing and Midwifery, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Yomilan Geneti
- Department of Nursing and Midwifery, College of Medicine and Health Sciences, Dire Dawa University, Dire Dawa, Ethiopia
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21
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Shamsunder MG, Polanco TO, McCarthy CM, Allen RJ, Matros E, Coriddi M, Mehrara BJ, Pusic A, Nelson JA. Understanding Preoperative Breast Satisfaction among Patients Undergoing Mastectomy and Immediate Reconstruction: BREAST-Q Insights. Plast Reconstr Surg 2021; 148:891e-902e. [PMID: 34847108 PMCID: PMC8638966 DOI: 10.1097/prs.0000000000008521] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND This study aims to present normative values for satisfaction with breasts among preoperative breast reconstruction patients as assessed using the BREAST-Q instrument and to delineate factors associated with preoperative breast satisfaction. METHODS A retrospective analysis of prospectively collected data was performed examining women undergoing postmastectomy breast reconstruction at a tertiary care center who preoperatively completed the BREAST-Q from 2010 to 2017. Because breast satisfaction scores were nonnormally distributed, scores were categorized into quartiles for analysis. Patient- and treatment-level variables were tested in a multivariable ordinal logistic regression model as predictors of breast satisfaction. Preoperative satisfaction was also tested for association with choice of reconstructive modality. RESULTS Among 1306 postmastectomy reconstruction patients included in the study, mean preoperative Satisfaction with Breasts score was 61.8 ± 21.5 and the median score was 58.0 (interquartile range, 48 to 70). Factors associated with significantly lower preoperative satisfaction included history of psychiatric diagnosis, preoperative radiotherapy, marital status (married), and higher body mass index. Factors associated with significantly higher scores were malignancy (localized tumor), medium bra size (B to C cup), and self-identification as black. Preoperative breast satisfaction was lower among patients who elected autologous reconstruction than among those with implant reconstruction (p < 0.001). CONCLUSIONS Preoperative breast satisfaction is influenced by multiple factors. Understanding these factors may improve preoperative counseling and expectation management for patients who undergo postmastectomy breast reconstruction. CLINICAL QUESTION/LEVEL OF EVIDENCE Risk, III.
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Affiliation(s)
- Meghana G Shamsunder
- From the Plastic and Reconstructive Surgery Service, Department of Surgery, Memorial Sloan Kettering Cancer Center; and the Division of Plastic and Reconstructive Surgery, Department of Surgery, Brigham and Women's Hospital
| | - Thais O Polanco
- From the Plastic and Reconstructive Surgery Service, Department of Surgery, Memorial Sloan Kettering Cancer Center; and the Division of Plastic and Reconstructive Surgery, Department of Surgery, Brigham and Women's Hospital
| | - Colleen M McCarthy
- From the Plastic and Reconstructive Surgery Service, Department of Surgery, Memorial Sloan Kettering Cancer Center; and the Division of Plastic and Reconstructive Surgery, Department of Surgery, Brigham and Women's Hospital
| | - Robert J Allen
- From the Plastic and Reconstructive Surgery Service, Department of Surgery, Memorial Sloan Kettering Cancer Center; and the Division of Plastic and Reconstructive Surgery, Department of Surgery, Brigham and Women's Hospital
| | - Evan Matros
- From the Plastic and Reconstructive Surgery Service, Department of Surgery, Memorial Sloan Kettering Cancer Center; and the Division of Plastic and Reconstructive Surgery, Department of Surgery, Brigham and Women's Hospital
| | - Michelle Coriddi
- From the Plastic and Reconstructive Surgery Service, Department of Surgery, Memorial Sloan Kettering Cancer Center; and the Division of Plastic and Reconstructive Surgery, Department of Surgery, Brigham and Women's Hospital
| | - Babak J Mehrara
- From the Plastic and Reconstructive Surgery Service, Department of Surgery, Memorial Sloan Kettering Cancer Center; and the Division of Plastic and Reconstructive Surgery, Department of Surgery, Brigham and Women's Hospital
| | - Andrea Pusic
- From the Plastic and Reconstructive Surgery Service, Department of Surgery, Memorial Sloan Kettering Cancer Center; and the Division of Plastic and Reconstructive Surgery, Department of Surgery, Brigham and Women's Hospital
| | - Jonas A Nelson
- From the Plastic and Reconstructive Surgery Service, Department of Surgery, Memorial Sloan Kettering Cancer Center; and the Division of Plastic and Reconstructive Surgery, Department of Surgery, Brigham and Women's Hospital
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Alpert JM, Taylor G, Hampton CN, Paige S, Markham MJ, Bylund CL. Clinicians’ perceptions of the benefits and challenges of teleoncology as experienced through the COVID-19 pandemic: A qualitative study (Preprint). JMIR Cancer 2021; 8:e34895. [PMID: 35142622 PMCID: PMC8914732 DOI: 10.2196/34895] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 01/17/2022] [Accepted: 02/03/2022] [Indexed: 01/29/2023] Open
Affiliation(s)
- Jordan M Alpert
- College of Journalism and Communications, University of Florida, Gainesville, FL, United States
| | - Greenberry Taylor
- Department of Communication, Flagler College, Saint Augustine, FL, United States
| | - Chelsea N Hampton
- College of Journalism and Communications, University of Florida, Gainesville, FL, United States
| | - Samantha Paige
- College of Journalism and Communications, University of Florida, Gainesville, FL, United States
| | - Merry Jennifer Markham
- Division of Hematology & Oncology, Department of Medicine, University of Florida, Gainesville, FL, United States
| | - Carma L Bylund
- Department of Health Outcomes & Biomedical Informatics, University of Florida, Gainesville, FL, United States
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Marchand GJ, Coriell C, Taher A, King A, Ruther S, Brazil G, Cieminski K, Calteux N, Ulibarri H, Parise J, Arroyo A, Sainz K. Systematic review of the effect of implementing enhanced recovery after surgery on selected attributes of surgical recovery in gynecology. Turk J Obstet Gynecol 2021; 18:245-257. [PMID: 34580992 PMCID: PMC8480214 DOI: 10.4274/tjod.galenos.2021.47717] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
This study aimed to systematically review the available literature on enhanced recovery after surgery (ERAS) following gynecologic procedures performed either as an open surgery or as a minimally invasive gynecological surgery (MIGS) in terms of outcomes. This review revealed the results of published literature and assessed the benefits and diverse outcomes of ERAS implementation in patients undergoing MIGS or other gynecologic surgeries. In this review, we sought to examine the efficacy of entire ERAS protocols, faithfully performed, to determine whether they were successful in improving individual attributes of surgical recovery. Electronic databases of PubMed, Cochrane, Web of Science, Scopus, MEDLINE, and ClinicalTrials.gov were systematically searched in January 2021 for relevant studies. Data were extracted from eligible studies including LOS, change in the quality-of-life and recovery over time, postoperative complications including nausea and vomiting, opioid or anesthesia use, hospital cost, patient satisfaction, postoperative pain, and readmission rate as outcomes. Many of the included studies reported a significant reduction in the LOS as well as in readmission rates, hospital cost, and occurrence of nausea and vomiting postoperatively. Moreover, a clinically significant increase was noted in patient satisfaction in studies that have used tools that measure patient satisfaction. No studies have reported a significant increase in the overall quality of recovery using appropriately validated tools. Following ERAS implementation, patients’ postoperative rehabilitation, including postoperative discomfort, readmission rates, and satisfaction, showed a clinically significant improvement.
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Affiliation(s)
- Greg J Marchand
- Marchand Institute for Minimally Invasive Surgery, Mesa, Arizona, USA
| | - Catherine Coriell
- Marchand Institute for Minimally Invasive Surgery, Mesa, Arizona, USA
| | - Ahmed Taher
- Fayoum University Faculty of Medicine, Fayoum, Egypt
| | - Alexa King
- International University of Health Sciences, Basseterre, St. Kitts
| | - Stacy Ruther
- Marchand Institute for Minimally Invasive Surgery, Mesa, Arizona, USA
| | - Giovanna Brazil
- Marchand Institute for Minimally Invasive Surgery, Mesa, Arizona, USA
| | | | - Nicolas Calteux
- Marchand Institute for Minimally Invasive Surgery, Mesa, Arizona, USA
| | - Hollie Ulibarri
- Marchand Institute for Minimally Invasive Surgery, Mesa, Arizona, USA
| | - Julia Parise
- Marchand Institute for Minimally Invasive Surgery, Mesa, Arizona, USA
| | - Amanda Arroyo
- Marchand Institute for Minimally Invasive Surgery, Mesa, Arizona, USA
| | - Katelyn Sainz
- Marchand Institute for Minimally Invasive Surgery, Mesa, Arizona, USA
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24
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Torres GCS, Fernandez DF, Ledbetter L, Relf MV. Systematic Review of Preoperative Patient Readiness. AORN J 2021; 114:47-59. [PMID: 34181266 DOI: 10.1002/aorn.13425] [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: 07/30/2020] [Revised: 10/07/2020] [Accepted: 10/26/2020] [Indexed: 11/07/2022]
Abstract
Preoperative readiness indicates the patient's capacity to process information, consider possible outcomes, and decide to undergo a surgical procedure. This systematic review examines how the term "patient readiness" is used in the literature and synthesizes how preoperative interventions address readiness. A medical librarian searched five electronic databases to identify articles published between July 1, 2008, and June 30, 2019, that address studies including adult patients scheduled for surgery who participated in programs designed to foster readiness or studies that explored surgical readiness. After extracting 28 studies, the authors assessed the articles for quality and thematically synthesized them to describe actions and indicators of patient readiness according to the Perioperative Patient Focused Model. Readiness can positively influence surgical outcomes (eg, pain, satisfaction); however, there is a paucity of high-level, quality evidence that discusses surgical readiness for perioperative care. Nurses should use the information in this review to improve patient-centered preoperative care.
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25
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Garutti I, Cabañero A, Vicente R, Sánchez D, Granell M, Fraile CA, Real Navacerrada M, Novoa N, Sanchez-Pedrosa G, Congregado M, Gómez A, Miñana E, Piñeiro P, Cruz P, de la Gala F, Quero F, Huerta LJ, Rodríguez M, Jiménez E, Puente-Maestu L, Aragon S, Osorio-Salazar E, Sitges M, Lopez Maldonado MD, Rios FT, Morales JE, Callejas R, Gonzalez-Bardancas S, Botella S, Cortés M, Yepes MJ, Iranzo R, Sayas J. Recommendations of the Society of Thoracic Surgery and the Section of Cardiothoracic and Vascular Surgery of the Spanish Society of Anesthesia, Resuscitation and Pain Therapy, for patients undergoing lung surgery included in an intensified recovery program. REVISTA ESPANOLA DE ANESTESIOLOGIA Y REANIMACION 2021; 69:S0034-9356(21)00102-X. [PMID: 34294445 DOI: 10.1016/j.redar.2021.02.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 01/28/2021] [Accepted: 02/04/2021] [Indexed: 11/24/2022]
Abstract
In recent years, multidisciplinary programs have been implemented that include different actions during the pre, intra and postoperative period, aimed at reducing perioperative stress and therefore improving the results of patients undergoing surgical interventions. Initially, these programs were developed for colorectal surgery and from there they have been extended to other surgeries. Thoracic surgery, considered highly complex, like other surgeries with a high postoperative morbidity and mortality rate, may be one of the specialties that most benefit from the implementation of these programs. This review presents the recommendations made by different specialties involved in the perioperative care of patients who require resection of a lung tumor. Meta-analyses, systematic reviews, randomized and non-randomized controlled studies, and retrospective studies conducted in patients undergoing this type of intervention have been taken into account in preparing the recommendations presented in this guide. The GRADE scale has been used to classify the recommendations, assessing on the one hand the level of evidence published on each specific aspect and, on the other hand, the strength of the recommendation with which the authors propose its application. The recommendations considered most important for this type of surgery are those that refer to pre-habilitation, minimization of surgical aggression, excellence in the management of perioperative pain and postoperative care aimed at providing rapid postoperative rehabilitation.
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Affiliation(s)
- I Garutti
- Servicio de Anestesia y Reanimación, Hospital General Universitario Gregorio Marañón, Madrid, España; Departamento de Farmacología y Toxicología, Facultad de Medicina, Universidad Complutense de Madrid, Madrid, España.
| | - A Cabañero
- Servicio de Cirugía Torácica, Hospital Universitario Ramón y Cajal, Madrid, España
| | - R Vicente
- Servicio de Anestesia y Reanimación, Hospital La Fe, Valencia, España
| | - D Sánchez
- Servicio de Cirugía Torácica, Hospital Clínic, Barcelona, España
| | - M Granell
- Servicio de Anestesia y Reanimación, Hospital General, Valencia, España
| | - C A Fraile
- Servicio de Cirugía Torácica, Hospital Universitari Arnau de Vilanova, Lleida, España
| | - M Real Navacerrada
- Servicio de Anestesia y Reanimación, Hospital Universitario 12 de Octubre, Madrid, España
| | - N Novoa
- Servicio de Cirugía Torácica, Complejo Asistencial Universitario de Salamanca (CAUS), Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, España
| | - G Sanchez-Pedrosa
- Servicio de Anestesia y Reanimación, Hospital General Universitario Gregorio Marañón, Madrid, España
| | - M Congregado
- Servicio de Cirugía Torácica, Hospital Virgen de la Macarena, Sevilla, España
| | - A Gómez
- Unitat de Rehabilitació Cardiorespiratòria, Hospital Universitari Vall d'Hebron, Barcelona, España
| | - E Miñana
- Servicio de Anestesia y Reanimación, Hospital de La Ribera, Alzira, Valencia, España
| | - P Piñeiro
- Servicio de Anestesia y Reanimación, Hospital General Universitario Gregorio Marañón, Madrid, España
| | - P Cruz
- Servicio de Anestesia y Reanimación, Hospital General Universitario Gregorio Marañón, Madrid, España
| | - F de la Gala
- Servicio de Anestesia y Reanimación, Hospital General Universitario Gregorio Marañón, Madrid, España
| | - F Quero
- Servicio de Cirugía Torácica, Hospital Universitario Virgen de las Nieves, Granada, España
| | - L J Huerta
- Servicio de Cirugía Torácica, Hospital General Universitario Gregorio Marañón, Madrid, España
| | - M Rodríguez
- Servicio de Cirugía Torácica, Clínica Universidad de Navarra, Madrid, España
| | - E Jiménez
- Fisioterapia Respiratoria, Hospital Universitario de A Coruña, La Coruña, España
| | - L Puente-Maestu
- Servicio de Neumología, Hospital General Universitario Gregorio Marañón, Facultad de Medicina, Universidad Complutense de Madrid, Madrid, España
| | - S Aragon
- Servicio de Anestesia, Reanimación y Tratamiento del Dolor, Hospital Clínico Universitario, Valencia, España
| | - E Osorio-Salazar
- Servicio de Anestesia y Reanimación, Hospital Universitari Arnau de Vilanova, Lleida, España
| | - M Sitges
- Bloc Quirúrgic i Esterilització, Hospital del Mar, Parc de Salut Mar, Barcelona, España
| | | | - F T Rios
- Servicio de Anestesia y Reanimación, Hospital La Fe, Valencia, España
| | - J E Morales
- Servicio de Anestesia y Reanimación, Hospital General, Valencia, España
| | - R Callejas
- Servicio de Anestesia, Reanimación y Tratamiento del Dolor, Hospital Clínico Universitario, Valencia, España
| | - S Gonzalez-Bardancas
- Servicio de Anestesia y Reanimación, Complejo Hospitalario Universitario A Coruña, La Coruña, España
| | - S Botella
- Servicio de Anestesia y Reanimación, Hospital La Fe, Valencia, España
| | - M Cortés
- Servicio de Anestesia y Reanimación, Hospital Universitario 12 de Octubre, Madrid, España
| | - M J Yepes
- Servicio de Anestesia y Reanimación, Clínica Universidad de Navarra, Navarra, Pamplona, España
| | - R Iranzo
- Servicio de Anestesia y Reanimación, Hospital Universitario Puerta de Hierro, Majadahonda, Madrid, España
| | - J Sayas
- Servicio de Neumología, Hospital General Universitario Gregorio Marañón, Facultad de Medicina, Universidad Complutense de Madrid, Madrid, España
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Multimedia in preoperative patient education for adults undergoing cancer surgery: A systematic review. Eur J Oncol Nurs 2021; 52:101981. [PMID: 34091407 DOI: 10.1016/j.ejon.2021.101981] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Revised: 05/11/2021] [Accepted: 05/17/2021] [Indexed: 01/22/2023]
Abstract
PURPOSE The purpose of this systematic review was to determine whether adequate research evidence exists to support utilizing multimedia technology in the preoperative education of adult cancer patients. METHODS A systematic search of Medline, CINAHL, Web of Science, and PsycINFO databases from 2010 through September 24, 2020, was performed. The review included quantitative studies that examined whether education delivered by multimedia impacted levels of anxiety, knowledge acquisition, satisfaction, and compliance. The research quality was evaluated using the Joanna Briggs Institute Critical Appraisal Tool specific to the study design. RESULTS The database search identified 529 scientific articles, of these nine studies met the eligibility criteria (n = 5 randomized controlled trials; n = 4 quasi-experimental studies). The education interventions included a variety of researcher-developed, multimedia modalities, consisting of video (n = 7), a computer program (n = 1), and a tablet application (n = 1). The methodological rigor varied among these studies. Multimedia patient education resulted in decreased anxiety and improved knowledge acquisition within groups; however, there was no significant difference when compared to traditional methods. Patients were also similarly satisfied and compliant with both education methods. CONCLUSIONS In all studies, the healthcare provider played a prominent role in both multimedia and traditional interventions, revealing the strong influence of the interpersonal connection in the delivery of preoperative education. Future research is needed to investigate whether more interactive technology could improve patient outcomes.
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Waterland JL, Chahal R, Ismail H, Sinton C, Riedel B, Francis JJ, Denehy L. Implementing a telehealth prehabilitation education session for patients preparing for major cancer surgery. BMC Health Serv Res 2021; 21:443. [PMID: 33971869 PMCID: PMC8108411 DOI: 10.1186/s12913-021-06437-w] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 04/15/2021] [Indexed: 12/31/2022] Open
Abstract
Background Prehabilitation services assist patients in preparing for surgery, yet access to these services are often limited by geographical factors. Enabling rural and regional patients to access specialist surgical prehabilitation support with the use of telehealth technology has the potential to overcome health inequities and improve post-operative outcomes. Aim To evaluate the current and likely future impact of a telehealth preoperative education package for patients preparing for major abdominal cancer surgery. Methods A telehealth alternative to a hospital based pre-operative education session was developed and implemented at a dedicated cancer hospital. Adult patients (≥18 years) scheduled for elective major cancer surgery were offered this telehealth alternative. Impact evaluation was conducted using the RE-AIM framework. Results To date, 35 participants have consented to participate in the study. Thirty-one participants attended the intervention; 24 (69%) residing in rural or regional areas. Twenty-four (77%) reported that if given a choice they would prefer the online session as opposed to attending the hospital in person. The majority (97%) reported they would recommend the intervention to others preparing for surgery. Session information was recalled by all 26 participants and 77% of participants reported acting on recommendations 2 weeks after the session. Lessons learnt and recommendations for providers implementing similar programs are reported. Conclusion Telehealth alternatives to hospital based pre-operative education are well received by patients preparing for major cancer surgery. We make seven recommendations to improve implementation. Further evaluation of implementation strategies alongside clinical effectiveness in future studies is essential. Trial registration ACTRN12620000096954, 04/02/2020. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-021-06437-w.
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Affiliation(s)
- Jamie L Waterland
- Department of Anaesthesia, Perioperative and Pain Medicine, Peter MacCallum Cancer Centre, Melbourne, Australia. .,Department of Physiotherapy, The University of Melbourne, Melbourne, Australia. .,Division of Allied Health, Peter MacCallum Cancer Centre, Melbourne, Australia.
| | - Rani Chahal
- Department of Anaesthesia, Perioperative and Pain Medicine, Peter MacCallum Cancer Centre, Melbourne, Australia.,Centre for Integrated Critical Care, The University of Melbourne, Melbourne, Australia
| | - Hilmy Ismail
- Department of Anaesthesia, Perioperative and Pain Medicine, Peter MacCallum Cancer Centre, Melbourne, Australia.,Centre for Integrated Critical Care, The University of Melbourne, Melbourne, Australia
| | - Catherine Sinton
- Division of Surgical Oncology, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - Bernhard Riedel
- Department of Anaesthesia, Perioperative and Pain Medicine, Peter MacCallum Cancer Centre, Melbourne, Australia.,Centre for Integrated Critical Care, The University of Melbourne, Melbourne, Australia
| | - Jill J Francis
- School of Health Sciences, The University of Melbourne, Melbourne, Australia.,Department of Health Services Research, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - Linda Denehy
- Division of Allied Health, Peter MacCallum Cancer Centre, Melbourne, Australia.,School of Health Sciences, The University of Melbourne, Melbourne, Australia
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Turon H, Hill D, Watson R, Hobden B, Millar J, Sanson-Fisher R. A patient-centred approach to determine optimal supportive care across the cancer trajectory: a cross-sectional study. Eur J Cancer Care (Engl) 2021; 30:e13455. [PMID: 33881182 DOI: 10.1111/ecc.13455] [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: 10/10/2020] [Revised: 02/04/2021] [Accepted: 04/05/2021] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Supportive care is recognised as an integral component of cancer care. To comprehensively improve supportive care and to inform policy, it is essential to examine consumer's views of health services. This study aimed to develop and test a patient-centred approach by measuring consumer perspectives on the importance of aspects of supportive care to determine what patients consider highest quality or 'optimal' care. METHODS A cross-sectional survey was conducted in oncology outpatient clinics. Eligible patients were invited to complete the optimal care survey on an iPad. The survey consisted of 69 items assessing 14 care domains across five phases of the care trajectory. RESULTS A total of 359 participants completed the survey. Items in the 'preparation for treatment' and 'follow-up and end-of-life care' phases were endorsed as very important/essential to optimal care by most participants (79-97% and 80-100%, respectively). Items in the 'preparation for first appointment' (48-84%), 'first appointment' (51-97%) and 'receiving treatment' (32-93%) phases showed greater variation in endorsement. CONCLUSION This study provides a patient-centred tool for quantifying optimal supportive care for people with cancer across the treatment trajectory. This tool could be used by healthcare providers to evaluate existing care quality, develop policies and guide clinical service improvements.
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Affiliation(s)
- Heidi Turon
- Health Behaviour Research Collaborative, School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, Australia.,Hunter Medical Research Institute, New Lambton Heights, NSW, Australia.,Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, NSW, Australia
| | - David Hill
- Health Behaviour Research Collaborative, School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, Australia.,Cancer Council Victoria, Melbourne, VIC, Australia.,School of Population & Global Health, University of Melbourne, Parkville, VIC, Australia
| | - Rochelle Watson
- Health Behaviour Research Collaborative, School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, Australia.,Hunter Medical Research Institute, New Lambton Heights, NSW, Australia.,Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, NSW, Australia
| | - Breanne Hobden
- Health Behaviour Research Collaborative, School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, Australia.,Hunter Medical Research Institute, New Lambton Heights, NSW, Australia.,Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, NSW, Australia
| | - Jeremy Millar
- Cancer Council Victoria, Melbourne, VIC, Australia.,Alfred Health Radiation Oncology Services, Melbourne, VIC, Australia.,Central Clinical School, Monash University, Melbourne, VIC, Australia
| | - Rob Sanson-Fisher
- Health Behaviour Research Collaborative, School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, Australia.,Hunter Medical Research Institute, New Lambton Heights, NSW, Australia.,Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, NSW, Australia
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Brain cancer patient and support persons' experiences of psychosocial care: a mapping of research outputs. Support Care Cancer 2021; 29:5559-5569. [PMID: 33710411 DOI: 10.1007/s00520-021-06071-6] [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: 01/10/2021] [Accepted: 02/09/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND People with brain cancer and their support persons (SPs) are critical sources of information on the components of care that contribute to psychosocial outcomes. AIMS To determine the proportion of studies that examined (1) at least one of 14 nominated components of psychosocial cancer care and (2) more than one component of care. METHODS Medline, The Cochrane Library, PsycINFO and Embase were electronically searched for publications from January 1999 to December 2019. Publications that met the inclusion criteria were coded according to the number and type of psychosocial care components assessed from 14 listed components, and whether patient and/or SPs' views about care were elicited. RESULTS Of the 113 included publications, 61 publications included patient-reported data only (54%), 27 included both patient and SP-reported data (24%) and 25 included SP-reported data only (22%). Most assessed a single component of care (77% of patient-reported and 71% of SP-reported). No publications assessed all 14 components. The "Psychosocial" component was the most frequently assessed component of care for patient-reported (n = 80/88, 91%) and SP-reported publications (n = 46/52, 88%). CONCLUSIONS Publications reporting on psychosocial care in brain cancer present a relatively narrow view of patient and support person experiences. The inclusion of both patient and support person perspectives and the assessment of multiple components of care are required in future research to optimize psychosocial outcomes in brain cancer.
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30
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Koet LL, Kraima A, Derksen I, Lamme B, Belt EJT, van Rosmalen J, Smeenk RM, van der Hoeven JAB. Effectiveness of preoperative group education for patients with colorectal cancer: managing expectations. Support Care Cancer 2021; 29:5263-5271. [PMID: 33651182 DOI: 10.1007/s00520-021-06072-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Accepted: 02/09/2021] [Indexed: 11/26/2022]
Abstract
PURPOSE To evaluate the potential beneficial effect of preoperative face-to-face group education after colonic surgery in a pre-existing ERAS pathway environment. METHODS Patients were randomized to cohorts for 3 weeks to either the standard preoperative counseling by the colorectal surgeon and the nurse practitioner (control group) or to the additional group education (intervention group). Patients scored EORTC-QLQ-info25 after the preoperative information was completed and the EORTC-QLQ-30 and EORTC-QLQ-29 prior to surgery and 1, 3, and 6 months after surgery. RESULTS A significantly better level of information was scored considering the expectations and patient involvement in the intervention group. This coincided with a significant reduction of the in-hospital stay, enhanced return to the preoperative global health status, and persistent improved body image after surgery. CONCLUSION By investing in the preoperative group education patients develop more realistic expectations resulting in a perceived improved quality of life and body image 1 month after operation coinciding with a statistically significant reduction in duration of in-hospital stay in this study.
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Affiliation(s)
- Lesley Larissa Koet
- Department of Surgery, Albert Schweitzer Hospital, Dordrecht, The Netherlands
| | - Annelot Kraima
- Department of Surgery, Albert Schweitzer Hospital, Dordrecht, The Netherlands
| | - Ilona Derksen
- Department of Surgery, Albert Schweitzer Hospital, Dordrecht, The Netherlands
| | - Bas Lamme
- Department of Surgery, Albert Schweitzer Hospital, Dordrecht, The Netherlands
| | | | - Joost van Rosmalen
- Department of Surgery, Albert Schweitzer Hospital, Dordrecht, The Netherlands
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Turon H, Wall L, Fakes K, Brown SD, Sanson-Fisher R. Cancer patient preferences for the provision of information regarding emotional concerns in relation to medical procedures: A discrete choice experiment. PATIENT EDUCATION AND COUNSELING 2020; 103:1439-1443. [PMID: 32098742 DOI: 10.1016/j.pec.2020.02.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Revised: 02/05/2020] [Accepted: 02/11/2020] [Indexed: 06/10/2023]
Abstract
OBJECTIVE To explore the preferences of people with cancer regarding the timing and format of information provision about emotional concerns that may occur when undergoing medical procedures. METHODS Eligible cancer survivors were mailed a survey containing discrete choice scenarios examining their timing and format preferences for information about potential emotional concerns associated with an upcoming hypothetical medical procedure. RESULTS Of 356 eligible patients, 271 (76 %) completed the survey. Both face-to-face discussion and written materials were preferred as the mode of information delivery over access to a website. In order of descending preference, participants preferred to receive the information 1 week, 3 days and the day of the procedure. There were no differences in preferences for timing or format between subgroups based on age, gender, education and cancer type. CONCLUSION This study has demonstrated that cancer patients prefer receiving information about emotional concerns that might be experienced as part of a medical procedure in either written or via face-to-face format, and one week before the procedure. PRACTICE IMPLICATIONS In order to provide patient-centred care, clinicians and the healthcare system more broadly should consider patient preferences for information delivery about upcoming medical procedures. INFORMATION: preparation for medical procedures; discrete choice; oncology; patient preference; emotional response.
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Affiliation(s)
- Heidi Turon
- Health Behaviour Research Collaborative, Priority Research Centre for Health Behaviour, School of Medicine and Public Health, University of Newcastle, Callaghan, Australia; Hunter Medical Research Institute, Newcastle, Australia.
| | - Laura Wall
- School of Psychology, University of Newcastle, Callaghan, Australia; Newcastle Business School, University of Newcastle, Newcastle, Australia.
| | - Kristy Fakes
- Health Behaviour Research Collaborative, Priority Research Centre for Health Behaviour, School of Medicine and Public Health, University of Newcastle, Callaghan, Australia; Hunter Medical Research Institute, Newcastle, Australia.
| | - Scott D Brown
- School of Psychology, University of Newcastle, Callaghan, Australia.
| | - Rob Sanson-Fisher
- Health Behaviour Research Collaborative, Priority Research Centre for Health Behaviour, School of Medicine and Public Health, University of Newcastle, Callaghan, Australia; Hunter Medical Research Institute, Newcastle, Australia.
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Torres GCS, Relf MV, Tuazon JA. The mediating role of pre‐operative patient readiness on surgical outcomes: A structural equation model analysis. J Adv Nurs 2020; 76:1371-1383. [DOI: 10.1111/jan.14339] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Revised: 01/28/2020] [Accepted: 02/19/2020] [Indexed: 12/31/2022]
Affiliation(s)
- Gian Carlo S. Torres
- College of Nursing University of the Philippines Manila Manila Philippines
- College of Nursing University of Santo Tomas Manila Philippines
| | | | - Josefina A. Tuazon
- College of Nursing University of the Philippines Manila Manila Philippines
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Dellafiore F, Pittella F, Arrigoni C, Baroni I, Conte G, Di Pasquale C, Casole L, Villa G, Caruso R. A multi‐phase study for the development of a self‐efficacy measuring scale for ostomy care nursing management. J Adv Nurs 2019; 76:409-419. [DOI: 10.1111/jan.14242] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Revised: 09/14/2019] [Accepted: 10/15/2019] [Indexed: 12/20/2022]
Affiliation(s)
- Federica Dellafiore
- Health Professions Research and Development Unit IRCCS Policlinico San Donato San Donato Milanese Italy
| | - Francesco Pittella
- Health Professions Research and Development Unit IRCCS Policlinico San Donato San Donato Milanese Italy
| | - Cristina Arrigoni
- Department of Public Health, Experimental and Forensic Medicine Section of Hygiene University of Pavia Pavia Italy
| | - Irene Baroni
- Health Professions Research and Development Unit IRCCS Policlinico San Donato San Donato Milanese Italy
| | - Gianluca Conte
- Paediatric Intensive Care Unit IRCCS Ca' Granda Ospedale Maggiore Policlinico Foundation Milan Italy
| | | | - Lorenzo Casole
- Health Professions Research and Development Unit IRCCS Policlinico San Donato San Donato Milanese Italy
| | - Giulia Villa
- Unit of Urology IRCCS San Raffaele Scientific Institute Milan Italy
| | - Rosario Caruso
- Health Professions Research and Development Unit IRCCS Policlinico San Donato San Donato Milanese Italy
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Sun V, Raz DJ, Erhunmwunsee L, Ruel N, Carranza J, Prieto R, Ferrell B, Krouse RS, McCorkle R, Kim JY. Improving family caregiver and patient outcomes in lung cancer surgery: Study protocol for a randomized trial of the multimedia self-management (MSM) intervention. Contemp Clin Trials 2019; 83:88-96. [PMID: 31279090 PMCID: PMC6661176 DOI: 10.1016/j.cct.2019.07.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Revised: 06/27/2019] [Accepted: 07/02/2019] [Indexed: 02/04/2023]
Abstract
OBJECTIVE To describe the study protocol of the Multimedia Self-Management (MSM) intervention to prepare patients and family caregivers (FCGs) for lung cancer surgery. DESIGN The study is a five-year, single site, randomized controlled trial of 160 lung cancer surgery FCG and patient dyads (320 total participants), comparing intervention and attention control arms. SETTING One National Cancer-Institute (NCI) designated comprehensive cancer center in Southern California. PARTICIPANTS Patients who are scheduled to undergo lung cancer surgery and their FCGs are enrolled as dyads only. INTERVENTION Based on the Chronic Care Self-Management Model (CCM), the intervention is a nurse-led, caregiver-based, multimedia care program for lung cancer surgery. Its primary focus is to help FCGs develop self-management skills related to their caregiving role through goal setting, proactive planning, building problem-solving skills, and accessing family support services. The intervention also supports dyads to prepare for surgery and post-operative recovery at home. It includes videos, print, web-based, and post-discharge telephone support. MAIN OUTCOME MEASURES FCG and patient psychological distress and QOL; FCG burden and preparedness for caregiving; FCG and patient healthcare resource use (in-home nursing care, urgent care/ER visits, readmissions). ANALYSIS Repeated measures ANCOVA statistical design will be used, removing variances prior to examining mean squares for the group by occasion interactions, and co-varying the baseline scores. In addition, structured equation modeling (SEM) will assess whether mediating and moderating factors are associated with outcomes. ClinicalTrials.gov Identifier: NCT03686007.
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Affiliation(s)
- Virginia Sun
- Division of Nursing Research and Education, Department of Population Sciences, United States of America.
| | - Dan J Raz
- Division of Thoracic Surgery, Department of Surgery, United States of America
| | | | - Nora Ruel
- Biostatistics and Mathematical Modeling Core City of Hope, Duarte, CA, United States of America
| | - Jacqueline Carranza
- Division of Nursing Research and Education, Department of Population Sciences, United States of America
| | - Rosemary Prieto
- Division of Nursing Research and Education, Department of Population Sciences, United States of America
| | - Betty Ferrell
- Division of Nursing Research and Education, Department of Population Sciences, United States of America
| | - Robert S Krouse
- Surgical Services, Corporal Michael J. Crescenz Veterans Affairs Medical Center, Philadelphia, PA, United States of America; Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States of America
| | - Ruth McCorkle
- School of Nursing, Yale University, New Haven, CT, United States of America
| | - Jae Y Kim
- Division of Thoracic Surgery, Department of Surgery, United States of America
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Carrillo G, Mesa M, Gómez OJ, Numpaque O, Laguna M. Educational intervention (CUIDAR) in cancer patients treated with surgery: A quasi-experimental study. PATIENT EDUCATION AND COUNSELING 2019; 102:1475-1482. [PMID: 30878163 DOI: 10.1016/j.pec.2019.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/23/2018] [Revised: 02/06/2019] [Accepted: 03/04/2019] [Indexed: 06/09/2023]
Abstract
OBJECTIVE To assess the effect of an educational intervention (CUIDAR) in cancer patients during the post-operatory, aimed to strength the competence to care patients at home in the dimensions knowledge, instrumental unicity, enjoy, anticipation and social relationships and interactions. METHODS Quantitative quasi-experimental design with control and intervention groups, 192 patients who received surgery in the Instituto Nacional de Cancerología in Bogotá, Colombia. The intervention was conducted since the admission to the sixth week after release. Measurements of the home care competence and number of readmissions were made before and after the treatment. RESULTS In the intervention group a positive and statistically significant effect was observed in six dimensions, as well as the reduction of hospital readmissions. CONCLUSION The educational intervention CUIDAR is a feasible strategy that increases the capacity to care at home and significantly reduces the readmissions to emergency services in cancer patients treated with surgery. PRACTICE IMPLICATIONS Educational intervention (CUIDAR) may be used as a tool in cancer patients treated with surgery.
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Affiliation(s)
- Gloria Carrillo
- Universidad Nacional de Colombia, Carrera 48 No. 22-80 Manzana B, Casa 44, Bogotá 111321, Colombia.
| | - Mónica Mesa
- Instituto Nacional de Cancerología, Bogotá, Colombia
| | - Olga Janeth Gómez
- Universidad Nacional de Colombia, Carrera 48 No. 22-80 Manzana B, Casa 44, Bogotá 111321, Colombia
| | | | - María Laguna
- Instituto Nacional de Cancerología, Bogotá, Colombia
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Fakes KL, Hall AE, Carey ML, Boyes AW, Symonds M, Evans TJ, Sanson-Fisher RW. Development and Validation of the MiPrep Survey: An Instrument Assessing Patients' Perceived Preparation for Medical Interventions Including Medical Imaging, Radiotherapy, and Surgery. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2019; 22:704-711. [PMID: 31198188 DOI: 10.1016/j.jval.2019.01.017] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Revised: 12/12/2018] [Accepted: 01/13/2019] [Indexed: 06/09/2023]
Abstract
BACKGROUND Adequately preparing patients for medical interventions is an important component of quality healthcare. Nevertheless, few instruments for assessing patients' preparation exist. OBJECTIVES To develop a psychometrically rigorous instrument to assess patients' perceptions of the quality of preparation. METHODS An instrument to measure patients' preparation for medical interventions (MiPrep) was developed and tested with patients undergoing medical imaging, radiotherapy, or surgery. Patients were recruited and asked to complete 2 surveys. Survey A assessed patient and intervention characteristics. Survey B (postintervention) contained MiPrep to assess validity (face, content, and construct) and reliability (internal consistency and test-retest). RESULTS A total of 869 (85%) patients consented to participate and 551 (63%) returned the postintervention survey. Face and content validity were demonstrated. Exploratory factor analysis identified 2 survey modules: receipt and adequacy of information (2 domains) and overall appraisal of patient-centered care (1 domain). Reliability was evidenced by adequate internal consistency (Cronbach α 0.81-0.89) and item-total correlations higher than 0.20. Nevertheless, individual item test-retest reliability requires further confirmation. The final instrument contained 27 items. CONCLUSIONS The MiPrep instrument has evidence of being a valid and reliable instrument of preparation for medical interventions. Healthcare providers can use the instrument as a quality assurance tool to identify areas for improvement and areas of excellence in patients' preparation. Future studies should verify these findings in other populations and examine the divergent and predictive validity of the instrument.
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Affiliation(s)
- Kristy L Fakes
- Health Behaviour Research Collaborative, Faculty of Health and Medicine, School of Medicine and Public Health, University of Newcastle, Callaghan, New South Wales, Australia; Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, New South Wales, Australia; Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia.
| | - Alix E Hall
- Health Behaviour Research Collaborative, Faculty of Health and Medicine, School of Medicine and Public Health, University of Newcastle, Callaghan, New South Wales, Australia; Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, New South Wales, Australia; Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia; Clinical Research Design, Information Technology and Statistical Support, Hunter Medical Research Institute, Newcastle, New South Wales, Australia
| | - Mariko L Carey
- Health Behaviour Research Collaborative, Faculty of Health and Medicine, School of Medicine and Public Health, University of Newcastle, Callaghan, New South Wales, Australia; Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, New South Wales, Australia; Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia
| | - Allison W Boyes
- Health Behaviour Research Collaborative, Faculty of Health and Medicine, School of Medicine and Public Health, University of Newcastle, Callaghan, New South Wales, Australia; Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, New South Wales, Australia; Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia
| | - Michael Symonds
- Hunter New England Imaging, John Hunter Hospital/Royal Newcastle Centre, New Lambton Heights, New South Wales, Australia
| | - Tiffany-Jane Evans
- Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia; Clinical Research Design, Information Technology and Statistical Support, Hunter Medical Research Institute, Newcastle, New South Wales, Australia
| | - Rob W Sanson-Fisher
- Health Behaviour Research Collaborative, Faculty of Health and Medicine, School of Medicine and Public Health, University of Newcastle, Callaghan, New South Wales, Australia; Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, New South Wales, Australia; Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia
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Nelson G, Bakkum-Gamez J, Kalogera E, Glaser G, Altman A, Meyer LA, Taylor JS, Iniesta M, Lasala J, Mena G, Scott M, Gillis C, Elias K, Wijk L, Huang J, Nygren J, Ljungqvist O, Ramirez PT, Dowdy SC. Guidelines for perioperative care in gynecologic/oncology: Enhanced Recovery After Surgery (ERAS) Society recommendations-2019 update. Int J Gynecol Cancer 2019; 29:651-668. [PMID: 30877144 DOI: 10.1136/ijgc-2019-000356] [Citation(s) in RCA: 391] [Impact Index Per Article: 78.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Accepted: 02/18/2019] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND This is the first updated Enhanced Recovery After Surgery (ERAS) Society guideline presenting a consensus for optimal perioperative care in gynecologic/oncology surgery. METHODS A database search of publications using Embase and PubMed was performed. Studies on each item within the ERAS gynecologic/oncology protocol were selected with emphasis on meta-analyses, randomized controlled trials, and large prospective cohort studies. These studies were then reviewed and graded according to the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) system. RESULTS All recommendations on ERAS protocol items are based on best available evidence. The level of evidence for each item is presented accordingly. CONCLUSIONS The updated evidence base and recommendation for items within the ERAS gynecologic/oncology perioperative care pathway are presented by the ERAS® Society in this consensus review.
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Affiliation(s)
- Gregg Nelson
- Division of Gynecologic Oncology, Tom Baker Cancer Centre, Calgary, Alberta, Canada
| | - Jamie Bakkum-Gamez
- Division of Gynecologic Oncology, Mayo Clinic College of Medicine, Rochester, Minnesota, USA
| | - Eleftheria Kalogera
- Division of Gynecologic Oncology, Mayo Clinic College of Medicine, Rochester, Minnesota, USA
| | - Gretchen Glaser
- Division of Gynecologic Oncology, Mayo Clinic College of Medicine, Rochester, Minnesota, USA
| | - Alon Altman
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Larissa A Meyer
- Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Jolyn S Taylor
- Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Maria Iniesta
- Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Javier Lasala
- Department of Anesthesiology and Perioperative Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Gabriel Mena
- Department of Anesthesiology and Perioperative Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Michael Scott
- Department of Anesthesia, Virginia Commonwealth University Hospital, Richmond, Virginia, USA
| | - Chelsia Gillis
- Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
| | - Kevin Elias
- Division of Gynecologic Oncology, Brigham and Women's Hospital, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts, USA
| | - Lena Wijk
- Department of Obstetrics and Gynecology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - Jeffrey Huang
- Department of Anesthesiology, Oak Hill Hospital, Brooksville, Florida, USA
| | - Jonas Nygren
- Departments of Surgery and Clinical Sciences, Ersta Hospital and Danderyd Hospital, Karolinska Institutet, Stockholm, Sweden
| | - Olle Ljungqvist
- Department of Surgery, Faculty of Medicine and Health, School of Health and Medical Sciences, Örebro University, Örebro, Sweden
| | - Pedro T Ramirez
- Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Sean C Dowdy
- Division of Gynecologic Oncology, Mayo Clinic College of Medicine, Rochester, Minnesota, USA
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Lemos MF, Lemos‐Neto SV, Barrucand L, Verçosa N, Tibirica E. A informação no pré‐operatório reduz a ansiedade pré‐operatória em pacientes com câncer submetidos à cirurgia: utilidade do Inventário Beck de Ansiedade. Braz J Anesthesiol 2019; 69:1-6. [DOI: 10.1016/j.bjan.2018.07.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2017] [Revised: 07/10/2018] [Accepted: 07/17/2018] [Indexed: 10/27/2022] Open
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Lemos MF, Lemos-Neto SV, Barrucand L, Verçosa N, Tibirica E. Preoperative education reduces preoperative anxiety in cancer patients undergoing surgery: Usefulness of the self-reported Beck anxiety inventory. Braz J Anesthesiol 2019. [PMID: 30401475 PMCID: PMC9391836 DOI: 10.1016/j.bjane.2018.07.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background and objectives Methods Results Conclusions
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Affiliation(s)
- Marilia F Lemos
- Instituto Nacional de Câncer (Inca), Rio de Janeiro, RJ, Brasil
| | | | - Louis Barrucand
- Universidade Federal do Rio de Janeiro (UFRJ), Faculdade de Medicina, Rio de Janeiro, RJ, Brasil
| | - Nubia Verçosa
- Universidade Federal do Rio de Janeiro (UFRJ), Faculdade de Medicina, Departamento de Cirurgia, Rio de Janeiro, RJ, Brasil
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Hyde LL, J Mackenzie L, Boyes AW, Symonds M, Brown S, Sanson-Fisher R. Medical Imaging Outpatients' Experiences With Receiving Information Required for Informed Consent and Preparation: A Cross-Sectional Study. J Patient Exp 2018; 5:296-302. [PMID: 30574551 PMCID: PMC6295811 DOI: 10.1177/2374373518765794] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Medical imaging outpatients often experience inadequate information provision and report high levels of anxiety. However, no studies have assessed patients' receipt of preparatory information in this setting. OBJECTIVE To examine medical imaging outpatients' perceived receipt or non-receipt of preparatory information from health professionals and imaging department staff prior to their procedure. METHOD Computed tomography and magnetic resonance imaging outpatients at one Australian hospital self-completed a touchscreen computer survey assessing their perceived receipt of 33 guideline-recommended preparatory information items. RESULTS Of 317 eligible patients, 280 (88%) consented to participate. Eight percent (95% confidence interval: 5%-12%) of participants reported receiving all information items. The median number of information items not received was 18 (interquartile range: 8-25). Items most frequently endorsed as "not received" were: how to manage anxiety after (74%) and during the scan (69%). Items most commonly endorsed as "received" were: reason for referral (85%) and how to find the imaging department (74%). CONCLUSION Few medical imaging outpatients recalled receiving recommended preparatory information. Preparatory communication needs to be improved to better meet patient-centered service imperatives.
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Affiliation(s)
- Lisa L Hyde
- Faculty of Health and Medicine, Health Behaviour Research Collaborative, School of Medicine and Public Health, University of Newcastle, Callaghan, New South Wales, Australia
- Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, New South Wales, Australia
- Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia
| | - Lisa J Mackenzie
- Faculty of Health and Medicine, Health Behaviour Research Collaborative, School of Medicine and Public Health, University of Newcastle, Callaghan, New South Wales, Australia
- Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, New South Wales, Australia
- Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia
| | - Allison W Boyes
- Faculty of Health and Medicine, Health Behaviour Research Collaborative, School of Medicine and Public Health, University of Newcastle, Callaghan, New South Wales, Australia
- Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, New South Wales, Australia
- Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia
| | - Michael Symonds
- Hunter New England Imaging, John Hunter Hospital, New Lambton Heights, New South Wales, Australia
| | - Sandy Brown
- Hunter New England Imaging, John Hunter Hospital, New Lambton Heights, New South Wales, Australia
| | - Rob Sanson-Fisher
- Faculty of Health and Medicine, Health Behaviour Research Collaborative, School of Medicine and Public Health, University of Newcastle, Callaghan, New South Wales, Australia
- Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, New South Wales, Australia
- Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia
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Ricon I, Hanalis-Miller T, Haldar R, Jacoby R, Ben-Eliyahu S. Perioperative biobehavioral interventions to prevent cancer recurrence through combined inhibition of β-adrenergic and cyclooxygenase 2 signaling. Cancer 2018; 125:45-56. [DOI: 10.1002/cncr.31594] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Revised: 06/22/2018] [Accepted: 07/13/2018] [Indexed: 02/06/2023]
Affiliation(s)
- Itay Ricon
- Psychoneuroimmunology Laboratory, School of Psychological Sciences; Tel Aviv University; Tel Aviv Israel
| | - Tsipi Hanalis-Miller
- Psychoneuroimmunology Laboratory, School of Psychological Sciences; Tel Aviv University; Tel Aviv Israel
| | - Rita Haldar
- Psychoneuroimmunology Laboratory, School of Psychological Sciences; Tel Aviv University; Tel Aviv Israel
| | - Rebecca Jacoby
- Medical Psychology Graduate Program, School of Behavioral Sciences; Tel Aviv-Yaffo Academic College; Tel Aviv Israel
| | - Shamgar Ben-Eliyahu
- Psychoneuroimmunology Laboratory, School of Psychological Sciences; Tel Aviv University; Tel Aviv Israel
- Sagol School of Neuroscience, Tel Aviv University; Israel
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Hyde L, Mackenzie L, Boyes AW, Evans TJ, Symonds M, Sanson-Fisher R. Prevalence and correlates of patient-centred preparatory information provision to computed tomography and magnetic resonance imaging outpatients: A cross-sectional study. PATIENT EDUCATION AND COUNSELING 2018; 101:1814-1822. [PMID: 29884532 DOI: 10.1016/j.pec.2018.05.025] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/12/2017] [Revised: 05/23/2018] [Accepted: 05/30/2018] [Indexed: 06/08/2023]
Abstract
OBJECTIVE Responsiveness to information preferences is key to high-quality, patient-centred care. This study examined the top ten preparatory information items not delivered in accordance with medical imaging outpatients' preferences, and patient characteristics associated with reporting a greater number of unmet information preferences. METHODS Magnetic resonance imaging and computed tomography outpatients were recruited consecutively in one major public hospital waiting room. Participants self-administered a touchscreen computer questionnaire assessing their sociodemographic and scan characteristics, and unmet preferences for 33 guideline-endorsed preparatory information items. RESULTS Of 317 eligible patients, 280 (88%) consented to participate. Given equal rankings, the top ten unmet information preferences included 13 items which were endorsed by at least 25% of participants, and commonly related to receiving 'too little' information. One item related to the pre-scan period, seven items to the scan period and five items to the post-scan period. None of the patient characteristics examined were significantly associated with reporting a greater number of unmet information preferences. CONCLUSION There is room to improve responsiveness to medical imaging outpatients' preparatory information preferences. Improvements should be targeted at individuals, rather than groups defined by sociodemographic or scan characteristics. PRACTICE IMPLICATIONS A standardised approach to addressing individual patient's information preferences is needed.
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Affiliation(s)
- Lisa Hyde
- Health Behaviour Research Collaborative, School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, Australia; Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, Australia; Hunter Medical Research Institute, New Lambton Heights, Australia.
| | - Lisa Mackenzie
- Health Behaviour Research Collaborative, School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, Australia; Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, Australia; Hunter Medical Research Institute, New Lambton Heights, Australia
| | - Allison W Boyes
- Health Behaviour Research Collaborative, School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, Australia; Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, Australia; Hunter Medical Research Institute, New Lambton Heights, Australia
| | | | - Michael Symonds
- Hunter New England Imaging, John Hunter Hospital, New Lambton Heights, Australia
| | - Rob Sanson-Fisher
- Health Behaviour Research Collaborative, School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, Australia; Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, Australia; Hunter Medical Research Institute, New Lambton Heights, Australia
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Ibrahim M, Lau GJ, Smirnow N, Buono AT, Cooke A, Gartshore K, Loiselle CG, Johnson K. A Multidisciplinary Preoperative Teaching Session for Women Awaiting Breast Cancer Surgery: A Quality Improvement Initiative. Rehabil Process Outcome 2018. [DOI: 10.1177/1179572718790937] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Purpose: Most of the breast cancer diagnoses are recommended for breast surgery. Unfortunately, many patients report preoperative anxiety, which can affect postoperative recovery. Preoperative teaching sessions have been shown to reduce anxiety and improve recovery for the patients with breast cancer. To better support the patients at our cancer center, a multidisciplinary preoperative teaching session was developed and delivered as a quality improvement initiative. Methods: Participants scheduled for breast surgery were invited to attend a group-delivered preoperative teaching session, either for breast-conserving surgery or mastectomy. The sessions were presented by a nurse, occupational therapist, and physiotherapist. Data were collected through a researcher-developed 2-item questionnaire administered before and after sessions to compare self-reported anxiety and knowledge levels, along with qualitative feedback. Results: A total of 94 participants attended the preoperative sessions, piloted over a year. The majority were scheduled for breast-conserving surgery. Wilcoxon signed rank tests showed that after session, self-reported levels of anxiety decreased, whereas levels of knowledge increased. Most participants found the session to be very helpful and would recommend it to other patients/families awaiting surgery. Conclusions: Patients awaiting surgery for breast cancer may be better supported through a multidisciplinary group teaching session by decreasing anxiety and improving knowledge related to the procedure. Future directions could explore the effect of specific session elements on anxiety, knowledge, and postoperative complications using psychometrically sound instruments and additional time points. Implications for cancer survivors: Standardization of these preoperative teaching sessions may enhance breast cancer care, reduce postoperative complications, and improve patient recovery.
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Affiliation(s)
- Marize Ibrahim
- Rehabilitation & Exercise Oncology Program, Hope & Cope, Jewish General Hospital, Montréal, QC, Canada
- Lady Davis Institute for Medical Research, Jewish General Hospital, McGill University, Montréal, QC, Canada
- Department of Oncology, McGill University, Montréal, QC, Canada
- Breast & Bone Health Program, Hope & Cope, Jewish General Hospital, Montréal, QC, Canada
| | - Garnet J Lau
- Breast & Bone Health Program, Hope & Cope, Jewish General Hospital, Montréal, QC, Canada
| | - Nadia Smirnow
- Rehabilitation & Exercise Oncology Program, Hope & Cope, Jewish General Hospital, Montréal, QC, Canada
| | - Anna T Buono
- Segal Cancer Centre, Jewish General Hospital, Montréal, QC, Canada
| | - Andrea Cooke
- Segal Cancer Centre, Jewish General Hospital, Montréal, QC, Canada
- Ingram School of Nursing, McGill University, Montréal, QC, Canada
| | - Kimberley Gartshore
- Segal Cancer Centre, Jewish General Hospital, Montréal, QC, Canada
- Ingram School of Nursing, McGill University, Montréal, QC, Canada
| | - Carmen G Loiselle
- Department of Oncology and Ingram School of Nursing, McGill University, Montréal, QC, Canada
- Hope & Cope, Jewish General Hospital, Montréal, QC, Canada
| | - Kyla Johnson
- Occupational Therapy Department, Segal Cancer Centre, Jewish General Hospital, Montréal, QC, Canada
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Sun V, Kim JY, Raz DJ, Chang W, Erhunmwunsee L, Uranga C, Ireland AM, Reckamp K, Tiep B, Hayter J, Lew M, Ferrell B, McCorkle R. Preparing Cancer Patients and Family Caregivers for Lung Surgery: Development of a Multimedia Self-Management Intervention. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2018; 33:557-563. [PMID: 27542378 PMCID: PMC5573658 DOI: 10.1007/s13187-016-1103-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
The surgical treatment of lung malignancies often results in persistent symptoms, psychosocial distress, and decrements in quality of life (QOL) for cancer patients and their family caregivers (FCGs). The potential benefits of providing patients and FCGs with preparatory education that begins in the preoperative setting have been explored in multiple medical conditions, with positive impact observed on postoperative recovery, psychological distress, and QOL. However, few studies have explored the benefits of preparatory educational interventions to promote self-management in cancer surgery, including lung surgery. This paper describes the systematic approach used in the development of a multimedia self-management intervention to prepare cancer patients and their FCGs for lung surgery. Intervention development was informed by (1) contemporary published evidence on the impact of lung surgery on patients and FCG, (2) our previous research that explored QOL, symptoms, and caregiver burden after lung surgery, (3) the use of the chronic care self-management model (CCM) to guide intervention design, and (4) written comments and feedback from patients and FCGs that informed intervention development and refinement. Pilot-testing of the intervention is in process, and a future randomized trial will determine the efficacy of the intervention to improve patient, FCG, and system outcomes.
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Affiliation(s)
- Virginia Sun
- Division of Nursing Research and Education, Department of Population Sciences, City of Hope, 1500 East Duarte Road, Duarte, CA, 91010, USA.
| | - Jae Y Kim
- Division of Thoracic Surgery, Department of Surgery, City of Hope, Duarte, CA, USA
| | - Dan J Raz
- Division of Thoracic Surgery, Department of Surgery, City of Hope, Duarte, CA, USA
| | - Walter Chang
- Department of Anesthesiology, City of Hope, Duarte, CA, USA
| | - Loretta Erhunmwunsee
- Division of Thoracic Surgery, Department of Surgery, City of Hope, Duarte, CA, USA
| | - Carolina Uranga
- Department of Nursing, Clinical Practice and Education, City of Hope, Duarte, CA, USA
| | - Anne Marie Ireland
- Department of Nursing, Solid Tumor Malignancies Program, City of Hope, Duarte, CA, USA
| | - Karen Reckamp
- Department of Medical Oncology and Therapeutics Research, City of Hope, Duarte, CA, USA
| | - Brian Tiep
- Department of Respiratory Diseases and Pulmonary Rehabilitation, City of Hope, Duarte, CA, USA
| | | | - Michael Lew
- Department of Anesthesiology, City of Hope, Duarte, CA, USA
| | - Betty Ferrell
- Division of Nursing Research and Education, Department of Population Sciences, City of Hope, 1500 East Duarte Road, Duarte, CA, 91010, USA
| | - Ruth McCorkle
- School of Nursing, Yale University, New Haven, CT, USA
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Mata LRFPD, Bernardes MFVG, Azevedo C, Chianca TCM, Pereira MDG, Carvalho ECD. Jacobson and Truax Method: evaluation of the clinical effectiveness of a home care program after prostatectomy. Rev Lat Am Enfermagem 2018; 26:e3003. [PMID: 29791672 PMCID: PMC5969832 DOI: 10.1590/1518-8345.2249.3003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2017] [Accepted: 01/04/2018] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE to exemplify the applicability of the Jacobson and Truax Method in a nursing intervention study that analyzed the effectiveness of a home care teaching program after radical prostatectomy. METHOD this is a descriptive study concerning the applicability of the Jacobson and Truax Method in the data analysis of a clinical trial. The intervention consisted of a teaching program for hospital discharge after radical prostatectomy through oral guidance, writing, and telephonic reinforcement. Thirty-four men participated in the intervention group and 34 men participated in the control group. A reliable index of change and clinical significance was calculated for the knowledge variable in both groups. Scatterplots were presented to demonstrate the effectiveness of the method. RESULTS for 30 individuals in the intervention group, the intervention presented clinically relevant change than in knowledge. In the control group, none of the 34 individuals presented clinical significance of the results related to this variable, that is, the statistical significance identified by the inferential tests did not have clinically relevant changes in the knowledge variable. CONCLUSION the educational intervention carried out through the combination of oral, written and telephone counseling was shown to be clinically effective in improving knowledge about home care.
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Affiliation(s)
| | | | - Cissa Azevedo
- Escola de Enfermagem, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
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Sposato NS, Bjerså K. Osteopathic Manipulative Treatment in Surgical Care: Short Review of Research Publications in Osteopathic Journals During the Period 1990 to 2017. J Evid Based Integr Med 2018; 23:2515690X18767671. [PMID: 29637792 PMCID: PMC5900809 DOI: 10.1177/2515690x18767671] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background. A growing trend in surgical care is the investigation and incorporation of multimodal interventions into standardized programs. Additionally, manual therapies such as osteopathic manipulative treatment (OMT) are being used with patients in surgical care. Yet the scientific dialogue and the use of OMT in surgical care are currently insubstantial. Objective. The aim of this study was to present an overview of published research articles within the subject field of OMT in surgical care. Method. Summative review of peer-reviewed research articles published in osteopathic journals during the period 1990 to 2017. In total, 10 articles were identified. Result. Previous research has been conducted within the areas of abdominal, thoracic, gynecological, and/or orthopedic surgery with measured outcomes such as pain, analgesia consumption, length of hospital stay, and range of motion. Heterogeneity was identified in usage of osteopathic techniques, treatment duration, and occurrence, as well as in the treating osteopath’s experience. Conclusion. Despite the small number of research articles within this field, both positive measured effects as well as the absence of such effects were identified. Overall, there was a heterogeneity concerning surgical contexts, diagnoses, signs and symptoms, as well as surgical phases in current interprofessional osteopathic publications. In this era of multimodal surgical care, we argue that there is an urgent need to evaluate OMT in this context of care and with a proper research approach.
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Affiliation(s)
- Niklas S Sposato
- 1 Scandinavian School of Osteopathy, Gothenburg, Sweden.,2 The Institute of Orthopaedic Medicine, Gothenburg, Sweden
| | - Kristofer Bjerså
- 3 Linköping University, Linköping, Sweden.,4 Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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Sasaki K, Tamakoshi K. Association between the perspective of adult inpatients with digestive cancer regarding the nursing service and their quality of recovery on postoperative day 3. NAGOYA JOURNAL OF MEDICAL SCIENCE 2018; 80:29-37. [PMID: 29581612 PMCID: PMC5857499 DOI: 10.18999/nagjms.80.1.29] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Although qualitative research that focuses on inpatients' experience immediately after surgery has continued to elucidate the efficacy of the nursing service for postoperative recovery, there has been little quantitative research. Our aim was to quantitatively clarify the association between inpatients' perception of the nursing service and the quality of postoperative recovery. Seventy-one digestive cancer patients who underwent surgery were recruited. Participants completed two self-administered questionnaires, including the Japanese version of the 40-item postoperative Quality of Recovery scale (QoR-40J) and the Nursing Service Quality Scale for Japan (NURSERV-J) which has 22 items and five dimensions (tangibles, reliability, responsiveness, assurance, and empathy) on postoperative day 3. There were significant positive associations between the global scores of the NURSERV-J and the QoR-40J. The global score of the QoR-40J was compared between patients who gave full marks for each dimension of the NURSERV-J (the entirely satisfied group) and those who did not (the not entirely satisfied group). The entirely satisfied groups regarding tangibles, reliability and responsiveness had a significantly higher global score for the QoR-40J than the respective not entirely satisfied groups. Adjusted for age, gender, operative procedure, and duration of surgery, the entirely satisfied groups regarding tangibles and responsiveness had a significant higher global score for the QoR-40J than the respective not entirely satisfied groups. Patients who perceived that they had received a nursing service of high quality were likely to attain a high quality of postoperative recovery. Nursing services related to tangibles, reliability, and responsiveness especially contributed to postoperative recovery.
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Affiliation(s)
- Kumiko Sasaki
- Department of Nursing, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Koji Tamakoshi
- Department of Nursing, Nagoya University Graduate School of Medicine, Nagoya, Japan
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Steel EJ, Trainer AH, Heriot AG, Lynch C, Parry S, Win AK, Keogh LA. The Experience of Extended Bowel Resection in Individuals With a High Metachronous Colorectal Cancer Risk: A Qualitative Study. Oncol Nurs Forum 2017; 43:444-52. [PMID: 27314187 DOI: 10.1188/16.onf.444-452] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
PURPOSE/OBJECTIVES To ascertain individual experiences of extended bowel resection as treatment for colorectal cancer (CRC) in those with a high metachronous CRC risk, including the self-reported adequacy of information received at different time points of treatment and recovery.
. RESEARCH APPROACH Qualitative.
. SETTING Participants were recruited through the Australasian Colorectal Cancer Family Registry and two hospitals in Melbourne, Australia.
. PARTICIPANTS 18 individuals with a high metachronous CRC risk who had an extended bowel resection from 6-12 months ago.
. METHODOLOGIC APPROACH Semistructured interviews. Data were analyzed thematically.
. FINDINGS In most cases, the treating surgeon decided on the best option regarding surgical treatment. Participants felt well informed about the surgical procedure. Information related to surgical outcomes, recovery, and lifestyle adjustment from surgery was not always adequate. Many participants described ongoing worry about developing another cancer.
. CONCLUSIONS Patients undergoing an extended resection to reduce metachronous CRC risk require detailed information delivered at more than one time point and relating to several different aspects of the surgical procedure and its outcomes.
. INTERPRETATION An increased emphasis should be given to the provision of patient information on surgical outcomes, recovery, and lifestyle adjustment. Colorectal nurses could provide support for some of the reported unmet needs.
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Faury S, Koleck M, Foucaud J, M'Bailara K, Quintard B. Patient education interventions for colorectal cancer patients with stoma: A systematic review. PATIENT EDUCATION AND COUNSELING 2017; 100:1807-1819. [PMID: 28602564 DOI: 10.1016/j.pec.2017.05.034] [Citation(s) in RCA: 55] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/21/2017] [Revised: 05/15/2017] [Accepted: 05/25/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVES To describe the various types of patient education interventions for colorectal cancer patients with stoma and to examine their effects on quality of life, psychosocial skills and self-management skills. METHODS A systematic review was performed. Six electronic databases were searched. Inclusion criteria were: studies about patient education applying quantitative methods including digestive stoma adults with colorectal cancer. The primary outcome was quality of life. Secondary outcomes were psychosocial and self-management skills. RESULTS Thirteen studies were identified and included. Five studies examined quality of life and three reported improvements. Patient education improved some psychosocial and self-management skills. Contrasting findings were reported for specific-disease quality of life, emotional distress, length of hospital stay, stoma complications and readmission rate. CONCLUSIONS Patient education has a positive impact on some psychosocial and self-management skills, indicating that this area should be developed. Contrasting findings were reported for quality of life. Methodologies are heterogeneous making it difficult to produce evidence-based guidelines. This article proposes tools to carry out further studies on this subject and to improve understanding. PRACTICE IMPLICATION Further education intervention for stoma patients with colorectal cancer should be standardized in terms of intervention, duration and outcome measures to compare intervention and determine best practice.
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Affiliation(s)
- Stéphane Faury
- Univ. Bordeaux, Inserm, Bordeaux Population Health Research Center, UMR 1219, F-33000 Bordeaux, France.
| | - Michèle Koleck
- Univ. Bordeaux, Inserm, Bordeaux Population Health Research Center, UMR 1219, F-33000 Bordeaux, France
| | - Jérôme Foucaud
- "Laboratoire Educations et Pratiques de Santé", EA 3412, Univ. Paris-13 Sorbonne, Paris Cité, 93017 Bobigny, France
| | - Katia M'Bailara
- "Laboratoire de Psychologie", EA 4139, Univ. Bordeaux, Bordeaux, F-33076, France
| | - Bruno Quintard
- Univ. Bordeaux, Inserm, Bordeaux Population Health Research Center, UMR 1219, F-33000 Bordeaux, France
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Pynnonen MA, Gillespie MB, Roman B, Rosenfeld RM, Tunkel DE, Bontempo L, Brook I, Chick DA, Colandrea M, Finestone SA, Fowler JC, Griffith CC, Henson Z, Levine C, Mehta V, Salama A, Scharpf J, Shatzkes DR, Stern WB, Youngerman JS, Corrigan MD. Clinical Practice Guideline: Evaluation of the Neck Mass in Adults. Otolaryngol Head Neck Surg 2017; 157:S1-S30. [PMID: 28891406 DOI: 10.1177/0194599817722550] [Citation(s) in RCA: 64] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Objective Neck masses are common in adults, but often the underlying etiology is not easily identifiable. While infections cause most of the neck masses in children, most persistent neck masses in adults are neoplasms. Malignant neoplasms far exceed any other etiology of adult neck mass. Importantly, an asymptomatic neck mass may be the initial or only clinically apparent manifestation of head and neck cancer, such as squamous cell carcinoma (HNSCC), lymphoma, thyroid, or salivary gland cancer. Evidence suggests that a neck mass in the adult patient should be considered malignant until proven otherwise. Timely diagnosis of a neck mass due to metastatic HNSCC is paramount because delayed diagnosis directly affects tumor stage and worsens prognosis. Unfortunately, despite substantial advances in testing modalities over the last few decades, diagnostic delays are common. Currently, there is only 1 evidence-based clinical practice guideline to assist clinicians in evaluating an adult with a neck mass. Additionally, much of the available information is fragmented, disorganized, or focused on specific etiologies. In addition, although there is literature related to the diagnostic accuracy of individual tests, there is little guidance about rational sequencing of tests in the course of clinical care. This guideline strives to bring a coherent, evidence-based, multidisciplinary perspective to the evaluation of the neck mass with the intention to facilitate prompt diagnosis and enhance patient outcomes. Purpose The primary purpose of this guideline is to promote the efficient, effective, and accurate diagnostic workup of neck masses to ensure that adults with potentially malignant disease receive prompt diagnosis and intervention to optimize outcomes. Specific goals include reducing delays in diagnosis of HNSCC; promoting appropriate testing, including imaging, pathologic evaluation, and empiric medical therapies; reducing inappropriate testing; and promoting appropriate physical examination when cancer is suspected. The target patient for this guideline is anyone ≥18 years old with a neck mass. The target clinician for this guideline is anyone who may be the first clinician whom a patient with a neck mass encounters. This includes clinicians in primary care, dentistry, and emergency medicine, as well as pathologists and radiologists who have a role in diagnosing neck masses. This guideline does not apply to children. This guideline addresses the initial broad differential diagnosis of a neck mass in an adult. However, the intention is only to assist the clinician with a basic understanding of the broad array of possible entities. The intention is not to direct management of a neck mass known to originate from thyroid, salivary gland, mandibular, or dental pathology as management recommendations for these etiologies already exist. This guideline also does not address the subsequent management of specific pathologic entities, as treatment recommendations for benign and malignant neck masses can be found elsewhere. Instead, this guideline is restricted to addressing the appropriate work-up of an adult patient with a neck mass that may be malignant in order to expedite diagnosis and referral to a head and neck cancer specialist. The Guideline Development Group sought to craft a set of actionable statements relevant to diagnostic decisions made by a clinician in the workup of an adult patient with a neck mass. Furthermore, where possible, the Guideline Development Group incorporated evidence to promote high-quality and cost-effective care. Action Statements The development group made a strong recommendation that clinicians should order a neck computed tomography (or magnetic resonance imaging) with contrast for patients with a neck mass deemed at increased risk for malignancy. The development group made the following recommendations: (1) Clinicians should identify patients with a neck mass who are at increased risk for malignancy because the patient lacks a history of infectious etiology and the mass has been present for ≥2 weeks without significant fluctuation or the mass is of uncertain duration. (2) Clinicians should identify patients with a neck mass who are at increased risk for malignancy based on ≥1 of these physical examination characteristics: fixation to adjacent tissues, firm consistency, size >1.5 cm, or ulceration of overlying skin. (3) Clinicians should conduct an initial history and physical examination for patients with a neck mass to identify those with other suspicious findings that represent an increased risk for malignancy. (4) For patients with a neck mass who are not at increased risk for malignancy, clinicians or their designees should advise patients of criteria that would trigger the need for additional evaluation. Clinicians or their designees should also document a plan for follow-up to assess resolution or final diagnosis. (5) For patients with a neck mass who are deemed at increased risk for malignancy, clinicians or their designees should explain to the patient the significance of being at increased risk and explain any recommended diagnostic tests. (6) Clinicians should perform, or refer the patient to a clinician who can perform, a targeted physical examination (including visualizing the mucosa of the larynx, base of tongue, and pharynx) for patients with a neck mass deemed at increased risk for malignancy. (7) Clinicians should perform fine-needle aspiration (FNA) instead of open biopsy, or refer the patient to someone who can perform FNA, for patients with a neck mass deemed at increased risk for malignancy when the diagnosis of the neck mass remains uncertain. (8) For patients with a neck mass deemed at increased risk for malignancy, clinicians should continue evaluation of patients with a cystic neck mass, as determined by FNA or imaging studies, until a diagnosis is obtained and should not assume that the mass is benign. (9) Clinicians should obtain additional ancillary tests based on the patient's history and physical examination when a patient with a neck mass is deemed at increased risk for malignancy who does not have a diagnosis after FNA and imaging. (10) Clinicians should recommend evaluation of the upper aerodigestive tract under anesthesia, before open biopsy, for patients with a neck mass deemed at increased risk for malignancy and without a diagnosis or primary site identified with FNA, imaging, and/or ancillary tests. The development group recommended against clinicians routinely prescribing antibiotic therapy for patients with a neck mass unless there are signs and symptoms of bacterial infection.
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Affiliation(s)
| | - M Boyd Gillespie
- 2 Universityy of Tennessee Health Science Center, Memphis, Tennessee, USA
| | - Benjamin Roman
- 3 Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Richard M Rosenfeld
- 4 SUNY Downstate Medical Center, Long Island College Hospital, New York, New York, USA
| | | | - Laura Bontempo
- 6 University of Maryland School of Medicine, Baltimore, Maryland, USA
| | | | | | - Maria Colandrea
- 8 Veterans Affairs Medical Center, Durham, North Carolina, USA.,9 Duke University School of Nursing, Durham, North Carolina, USA
| | - Sandra A Finestone
- 10 Consumers United for Evidence-Based Healthcare, Baltimore, Maryland, USA
| | | | | | - Zeb Henson
- 13 University of Mississippi Medical Center, Jackson, Mississippi, USA
| | | | - Vikas Mehta
- 15 Lousiana State University, Shreveport, Louisiana, USA
| | | | | | - Deborah R Shatzkes
- 18 Hofstra Northwell School of Medicine, Lenox Hill Hospital, New York, New York, USA
| | - Wendy B Stern
- 19 Southcoast Hospital, North Dartmouth, Massachusetts, USA
| | | | - Maureen D Corrigan
- 21 American Academy of Otolaryngology-Head and Neck Surgery Foundation, Alexandria, Virginia, USA
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