1
|
Ay A, Savaş EH, Sumengen AA, Koyuncu İE, Erkul M, Semerci R. A qualitative exploration of nurses' views on technology-based interventions in pediatric oncology care. J Pediatr Nurs 2024; 79:205-212. [PMID: 39293202 DOI: 10.1016/j.pedn.2024.09.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2024] [Revised: 08/29/2024] [Accepted: 09/13/2024] [Indexed: 09/20/2024]
Abstract
OBJECTIVES Recent technological advancements offer tools for pediatric oncology care, but their integration into clnical practice is still under research. This study aimed to explore pediatric oncology nurses' perspectives on integrating technology-based interventions into care. METHODS A descriptive phenomenological qualitative study was conducted with 13 pediatric oncology nurses. The focus groups were led by the research members, and each group included four to five participants. Nurses were asked to discuss their perceptions of the technology-based intervention, the type of technology used in the clinic, and the advantages and disadvantages of the technology. The focus groups were audio-recorded and professionally transcribed. The transcripts were analyzed thematically by two study team members using MAXQDA. The Consolidated Criteria for Reporting Qualitative Research were followed. RESULTS The mean age of nurses was 38.46 ± 5.23 years and 92.3 % had more than 10 years of professional experience. As a result of the focus group interviews, three main themes and seven sub-themes were identified. These main themes included: (i) Need for competence and training for technology-based interventions, (ii) Effectiveness of technology-based interventions in pediatric patient care, and (iii) Challenges in integrating technology-based interventions into care. CONCLUSION The study found that from the perspective of pediatric oncology nurses, technology-based interventions have multifaceted benefits and are effective in improving patient outcomes and care; however, nurses' limited ability to use technology-based interventions restricts them from integrating their care. IMPLICATIONS TO PRACTICE It is recommended that nurses should be trained on technology-based interventions and the safe use of these interventions.
Collapse
Affiliation(s)
- Ayşe Ay
- Başkent University, Faculty of Health Sciences, Department of Nursing, Ankara, Türkiye.
| | | | - Aylin Akça Sumengen
- The University of Alabama, Capstone College of Nursing, Tuscaloosa, AL, USA.
| | - İlçim Ercan Koyuncu
- Başkent University, Faculty of Health Sciences, Department of Nursing, Ankara, Türkiye.
| | - Münevver Erkul
- Antalya Bilim University, Faculty of Health Sciences, Department of Nursing, Antalya, Türkiye.
| | - Remziye Semerci
- Koç University, School of Nursing, Department of Pediatric Nursing, Istanbul, Türkiye.
| |
Collapse
|
2
|
Paterson C, Anderson H, Rosano M, Cowan D, Schulz D, Santoro K, Forshaw T, Hawks C, Roberts N. What are the perceived unmet needs for patient care, education, and research among genitourinary cancer nurses in Australia? A mixed method study. Asia Pac J Oncol Nurs 2024; 11:100564. [PMID: 39286402 PMCID: PMC11403422 DOI: 10.1016/j.apjon.2024.100564] [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: 05/09/2024] [Accepted: 07/22/2024] [Indexed: 09/19/2024] Open
Abstract
Objective Specialist genitourinary (GU) nurses provide care to a broad and diverse group of patients diagnosed with kidney, bladder, prostate, testicular, adrenal, and penile cancer. The purpose of this study was to identify GU cancer nurse perspectives of perceived unmet needs in service provision, specific educational and research priorities. Methods A concurrent mixed methods study design incorporated quantitative and qualitative data collection from the GU Cancer nurses workforce in Australia. Quantitative data collected using an electronic survey instrument and were analysed using descriptive statistics. Qualitative data collected through semi-structured interviews and coded for thematic analysis. Ethical approval was gained. Results Fifty responses were received from the electronic survey. 39/50 (78%) were female and 35 (70%) were metropolitan based. The highest domains of perceived unmet needs related to psychological/emotional needs - 17/23 (74%), intimacy needs - 15/23 (65%) and informational needs - 13/23 (57%). The themes from the qualitative interviews identified: (1) Patient needs - lack of tumour specific contact for cancer patients, fragmented delivery of cancer care, perception of better access to supportive care for public patients, lack of access to supportive care screening tools for needs assessment. (2) Educational needs - lack of GU specific cancer educational resources/learning opportunities and barriers to accessing educational opportunities. (3) Research priorities - impact on carers/partners, specific needs of different GU cancers, future focus on genetic testing/counselling, interventions for financial toxicity and development of models of care for geriatric GU patients. Conclusions Specialist GU cancer nurses support a broad group of patients. Given the prominence of addressing unmet cancer care needs among people with GU cancers in this study, cancer nursing as a discipline alongside the multidisciplinary team, requires innovative solutions to overcome fragmented care which is often highly complex, and develop individualised and integrated care across the cancer care continuum. We encourage clinicians, researchers, policy makers, people affected by cancer, and their care networks, to continue to drive innovation by (1) Embedding an integrated approach to cancer nursing, (2) Implementation of shared care, (3) Implementation of patient navigation, (4) Embracing emerging technologies, (5) Future focus on education, and (6) Future focus on nurse-led research.
Collapse
Affiliation(s)
- Catherine Paterson
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, Australia
- Central Adelaide Local Health Network, Adelaide, Australia
- Robert Gordon University, Aberdeen, Scotland, UK
| | - Helen Anderson
- Cancer, Blood Disorders and Respiratory Service, Gold Coast University Hospital (GCUH), Australia
| | | | | | - Diana Schulz
- Wide Bay Hospital and Health Service, Queensland, Australia
| | | | | | - Cynthia Hawks
- Fiona Stanley Hospital, Murdoch, WA, Australia
- School of Medicine University of Western Australia, Nedlands, WA, Australia
| | - Natasha Roberts
- STARS Alliance: Metro North Health and the University of Queensland, Australia
- Queensland University of Technology, Australia
- University of Queensland Centre for Clinical Research, Australia
| |
Collapse
|
3
|
Primeau C, Chau M, Turner MR, Paterson C. Patient Experiences of Patient-Clinician Communication Among Cancer Multidisciplinary Healthcare Professionals During "Breaking Bad News": A Qualitative Systematic Review. Semin Oncol Nurs 2024; 40:151680. [PMID: 38918149 DOI: 10.1016/j.soncn.2024.151680] [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: 03/06/2024] [Revised: 05/13/2024] [Accepted: 05/20/2024] [Indexed: 06/27/2024]
Abstract
PURPOSE To explore patient experiences of patient-clinician communication during the critical moments of "breaking bad news" in cancer care. METHODS A qualitative systematic review followed the Joanna Briggs Institute methodology and has been reported according to PRISMA guidelines. Databases, including APA PsycINFO, CINAHL, MEDLINE, and Scopus, were searched from the beginning of their date range coverage to April 2023. Data extraction and quality assessment were performed, and a meta-aggregation approach was used for data synthesis. RESULTS Twenty-eight studies were included and represented 976 patients. Key themes included (1) sensing something is wrong (prior to diagnosis), (2) reaction to the diagnosis, (3) information (during breaking bad news), (4) communication with health care professionals, (5) specialist versus nonspecialist centers, (6) decision-making, and (7) feeling supported. The review underscores the need for health care professionals to adeptly navigate and respond to individual patient needs during confronting and distressing times. CONCLUSIONS The complexity and individuality of patient-clinician communication suggest that further education is needed among the cancer multidisciplinary team to develop personalized, empathetic communication strategies in clinical practice, catering to diverse patient preferences. The findings call for more inclusive research across different cultures and languages, and a need to understand evolving communication needs, especially in the context of increasing digital communication modalities in health care. IMPLICATIONS FOR CANCER SURVIVORSHIP This review provides valuable new insights into developing effective communication strategies that are responsive to the diverse needs of patients undergoing cancer treatment. Its findings emphasize the importance of empathy, flexibility, and a personalized approach in delivering bad news and supporting patients throughout survivorship.
Collapse
Affiliation(s)
- Charlotte Primeau
- Warwick Manufacturing Group, University of Warwick Coventry, Coventry, UK
| | - Minh Chau
- Faculty of Health, University of Canberra, Bruce, Canberra, Australian Capital Territory, Australia; School of Dentistry and Medical Sciences, Charles Sturt University, Wagga Wagga, New South Wales, Australia
| | - Murray R Turner
- Faculty of Health, University of Canberra, Bruce, Canberra, Australian Capital Territory, Australia
| | - Catherine Paterson
- Faculty of Health, University of Canberra, Bruce, Canberra, Australian Capital Territory, Australia; Flinders University, Caring Futures Institute, Adelaide, Australia; Central Adelaide Local Health Network, Adelaide, Australia.
| |
Collapse
|
4
|
Toohey K, Paterson C, Coltman CE. Barriers and enablers to participation in physical activity among women diagnosed with ovarian cancer. J Cancer Surviv 2024; 18:1252-1263. [PMID: 37171718 PMCID: PMC10175906 DOI: 10.1007/s11764-023-01366-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Accepted: 03/16/2023] [Indexed: 05/13/2023]
Abstract
PURPOSE Ovarian cancer is the leading cause of death among gynecological cancers, with low survival rates and a high disease burden. Despite the known benefits, most women reduce their participation in physical activity following diagnosis. Little is known about ovarian cancer survivors' experiences of physical activity. The primary aim of this study was to explore the barriers and enablers to participation in physical activity among women diagnosed with ovarian cancer. METHODS A qualitative descriptive study design was conducted via semi-structured interviews with nine women diagnosed with ovarian cancer (stages I-IV; 40-77 years). The interviews took place at the participant's home via telephone or online video conferencing software Coviu©. An inductive thematic approach was used. The organization and coding of data were completed using NVivo computer software (Version 12.6.0, QSR International Pty Ltd.). Weekly discussions occurred among the research team to ensure that themes accurately represented participant views. The consolidated criteria for reporting qualitative studies (COREQ) 32-item checklist were followed. RESULTS The main barriers to physical activity participation that emerged were (i) the lack of referral to an exercise professional within the multidisciplinary cancer team, (ii) fear of injury after surgery and during treatment, and (iii) treatment-related side effects. However, many of the participants perceived benefits of physical activity related to (i) enhanced physical and psychological health, (ii) improved cancer outcomes, and (iii) social benefits as key enablers of physical activity participation. CONCLUSIONS Physical activity interventions for women with ovarian cancer should address the modifiable barriers identified in this study. A key focus should be to streamline timely referral pathways within the multidisciplinary team, including exercise professionals, dietitians, psychologists, and specialists nurses following a diagnosis of ovarian cancer. Further research and service development are needed to optimize supported self-management through (i) education about the importance of physical activity to both healthcare professionals and women alike, (ii) enhanced symptom management for women, which was identified as a barrier to participation, and (iii) the development of shared care plans and patient center goals to address any fears or concerns. IMPLICATIONS FOR CANCER SURVIVORS People diagnosed with ovarian cancer have low participation levels of physical activity. Cancer care professionals' support could increase physical activity uptake and reduce some of the burden of an ovarian cancer diagnosis.
Collapse
Affiliation(s)
- Kellie Toohey
- Faculty of Health, University of Canberra, Bruce, Australian Capital Territory, Canberra, Australia.
- Prehabilitation, Activity, Cancer, Exercise and Survivorship (PACES) Research Group, University of Canberra, Bruce, Australian Capital Territory, Canberra, Australia.
| | - Catherine Paterson
- Faculty of Health, University of Canberra, Bruce, Australian Capital Territory, Canberra, Australia
- Prehabilitation, Activity, Cancer, Exercise and Survivorship (PACES) Research Group, University of Canberra, Bruce, Australian Capital Territory, Canberra, Australia
- School of Nursing, Midwifery & Paramedic Practice, Robert Gordon University, Garthdee, Aberdeen, UK
- Canberra Health Services & ACT Health, SYNERGY Nursing & Midwifery Research Centre, Canberra Hospital, Garran, Australian Capital Territory, Canberra, Australia
| | - Celeste E Coltman
- Faculty of Health, University of Canberra, Bruce, Australian Capital Territory, Canberra, Australia
- University of Canberra Research Institute for Sport and Exercise, University of Canberra, Bruce, Australian Capital Territory, Canberra, Australia
| |
Collapse
|
5
|
Hansen M, Schiele K, Schear RM, Richardson RN, Munoz RJ, Bourne G, Eckhardt SG, Kvale E. A comparative cohort study of gastrointestinal oncology patients: Impact of a shift to telehealth on delivery of interprofessional cancer care. J Telemed Telecare 2024; 30:1116-1122. [PMID: 36071633 DOI: 10.1177/1357633x221122125] [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] [Indexed: 11/17/2022]
Abstract
Early studies of oncology visits performed via telehealth demonstrate patient and provider satisfaction; however, understanding of the impact of telehealth on clinic workflows is limited. The incorporation of telehealth visits into an interprofessional model of oncology care was evaluated to assess for changes in care delivery and patient engagement. New patients with a gastrointestinal cancer diagnosis who were actively undergoing treatment and followed for at least three months were divided into two cohorts based on telehealth utilization. Individual patient charts were reviewed by touchpoint, consisting of in-person visits, telehealth visits, phone calls, and patient portal messages. A total of 28 patient charts were analyzed, 11 pre-telehealth conventional care patients, and 17 telehealth patients. Telehealth cohort patients demonstrated an increased average number of total touchpoints when compared to the pre-telehealth cohort (p-value = 0.008) and had an increased number of patient portal and phone call touchpoints (p-value = 0.00 and 0.002). Telehealth provided more interactions between patients and providers demonstrating increased connectivity between a patient and their care team throughout their complex cancer journey. Clinic workflows may need to adjust to account for the increased demand of unscheduled patient interactions.
Collapse
Affiliation(s)
- Madison Hansen
- Dell Medical School, The University of Texas at Austin, Austin, TX, USA
| | - Kristan Schiele
- Dell Medical School, The University of Texas at Austin, Austin, TX, USA
| | - Rebekkah M Schear
- Livestrong Cancer Institutes, Dell Medical School, The University of Texas at Austin, Austin, TX, USA
| | - Robin N Richardson
- Livestrong Cancer Institutes, Dell Medical School, The University of Texas at Austin, Austin, TX, USA
| | - Rebecca J Munoz
- Robbins College of Health and Human Sciences, Baylor University, Houston, TX, USA
| | - Garrett Bourne
- Dell Medical School, The University of Texas at Austin, Austin, TX, USA
| | - S Gail Eckhardt
- Livestrong Cancer Institutes, Dell Medical School, The University of Texas at Austin, Austin, TX, USA
| | - Elizabeth Kvale
- Livestrong Cancer Institutes, Dell Medical School, The University of Texas at Austin, Austin, TX, USA
| |
Collapse
|
6
|
Petersen LS, Sorknæs AD, Nielsen HH, Nielsen C. Development of a home visit solution with a route- and appointment planning tool for patients with severe spasticity: A participatory design study. Health Informatics J 2024; 30:14604582241270795. [PMID: 39139144 DOI: 10.1177/14604582241270795] [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] [Indexed: 08/15/2024]
Abstract
Objectives: This article describes how a home visit solution was developed in a co-design process between patients in treatment for severe spasticity, their caregivers and hospital nurses. The solution was developed using a participatory design approach and was based on the identified needs of the participants. Methods: We developed a home visit solution through an iterative process and a collective 'reflection-in-action' approach with patients, caregivers and healthcare professionals. Results: The study revealed the complexities of establishing new routines around home visits. The solution included a new workflow for the nurses and a new route and appointment planning tool. Conclusion: Through a participatory design approach, the users developed a home visit solution that minimised disruption to patients' daily lives and facilitated a dialogue between the nurses and the caregivers about the treatment and the patients' spasticity, which helped to adjust the treatment in line with the patient´s needs.
Collapse
Affiliation(s)
- Lena Skovgård Petersen
- PhD student, Department of Neurology, Odense University Hospital, Odense, Denmark
- Department of Neurobiology Research, Institute of Molecular Medicine, University of Southern Denmark, Odense, Denmark
| | - Anne Dichmann Sorknæs
- Internal Medicine and Emergency Department M/FAM, Odense University Hospital, Svendborg Hospital, Denmark
- Department Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Helle Hvilsted Nielsen
- Department of Neurology, Odense University Hospital, Odense, Denmark
- BRIDGE-Brain Research-Inter-Disciplinary Guided Excellence, Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Department of Neurobiology Research, Institute of Molecular Medicine, University of Southern Denmark, Odense, Denmark
| | - Charlotte Nielsen
- Department of Oral and Maxillofacial Surgery, Odense University Hospital, Odense, Denmark
- Research Unit of Plastic Surgery, Odense University Hospital, Odense, Denmark
- Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
| |
Collapse
|
7
|
Donmez E, Kilic B, Dulger Z, Ozdas T. Innovative Cancer Follow-Up with Telehealth: A New Method for Oncology Nurses. Semin Oncol Nurs 2024; 40:151649. [PMID: 38734572 DOI: 10.1016/j.soncn.2024.151649] [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: 02/19/2024] [Revised: 03/31/2024] [Accepted: 04/14/2024] [Indexed: 05/13/2024]
Abstract
OBJECTIVES Telenavigation (TN) is an innovative cancer follow-up method for oncology nurses. Little is known about the effectiveness of tele-navigation on cancer patients. This study investigated the opinions of healthcare providers (HCPs) and colorectal cancer patients' experience regarding patient follow-up with TN. DATA SOURCES This is a phenomenological qualitative study. Semistructured interviews were conducted with fifteen patients and eight healthcare providers. Participants were selected by purposive sampling. Data were collected from March to October 2022 and analyzed by thematic content analysis. CONCLUSION Six themes emerged that described the experiences of TN: (1) beneficial; (2) psychological state; (3) level of knowledge, (4) technology, (5) health care system, and (6) recommendations. Patients and HCPs found TN practice helpful and reassuring and they recommended expanding these practices within the health system. As a result of the research, the TN program is described as beneficial to patients and healthcare providers. IMPLICATIONS FOR NURSING PRACTICE The TN follow-up is a beneficial implication for colorectal cancer patients undergoing treatment, and it deserves to be more widely deployed. It brings reassurance regarding psychological, reliable data access, and home follow-up. Patients and HCPs reported positive views on telephone follow-up. There is a recommendation that the innovative follow-up technique should be disseminated to the healthcare system and that cancer nurses should be more familiar with this method.
Collapse
Affiliation(s)
- Elif Donmez
- Department of Oncology Nursing, Hamidiye Nursing Faculty, University of Health Sciences, Üsküdar, Istanbul, Turkiye.
| | - Bulent Kilic
- Department of Public Health, Medical Faculty, Dokuz Eylul University, Izmir, Turkiye
| | - Zeynep Dulger
- Department of Oncology Nursing, Hamidiye Nursing Faculty, University of Health Sciences, Üsküdar, Istanbul, Turkiye
| | - Turkan Ozdas
- Department of Oncology Nursing, Hamidiye Nursing Faculty, University of Health Sciences, Üsküdar, Istanbul, Turkiye
| |
Collapse
|
8
|
Sandler CX, Gildea GC, Spence RR, Jones TL, Eliadis P, Walker D, Donaghue A, Bettington C, Keller J, Pickersgill D, Shevill M, Biggs V, Morrison B, Jonker F, Foote M, Bashford J, Hayes SC. The safety, feasibility, and efficacy of an 18-week exercise intervention for adults with primary brain cancer - the BRACE study. Disabil Rehabil 2024; 46:2317-2326. [PMID: 37310040 DOI: 10.1080/09638288.2023.2221041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Accepted: 05/27/2023] [Indexed: 06/14/2023]
Abstract
PURPOSE To determine the safety, feasibility, and potential effect of an 18-week exercise intervention for adults with primary brain cancer. MATERIALS AND METHODS Eligible patients were 12-26-weeks post-radiotherapy for brain cancer. The individually-prescribed weekly exercise was ≥150-minutes of moderate-intensity exercise, including two resistance-training sessions. The intervention was deemed "safe" if exercise-related, serious adverse events (SAE) were experienced by <10% of participants, and feasible if recruitment, retention, and adherence rates were ≥75%, and ≥75% compliance rates were achieved in ≥75% of weeks. Patient-reported and objectively-measured outcomes were assessed at baseline, mid-intervention, end-intervention, and 6-month follow-up, using generalized estimating equations. RESULTS Twelve participants enrolled (51 ± 19.5 years, 5 females). There were no exercise-related SAEs. The intervention was feasible (recruitment:80%, retention:92%, adherence:83%). Participants completed a median of 172.8 (min:77.5, max:560.8) minutes of physical activity per week. 17% met the compliance outcome threshold for ≥75% of the intervention. Improvements in quality of life (mean change (95% CI): 7.9 units (1.9, 13.8)), functional well-being (4.3 units (1.4, 7.2)), depression (-2.0 units (-3.8, -0.2)), activity (112.8 min (42.1, 183.4)), fitness (56.4 meters (20.4, 92.5)), balance (4.9 s (0.9, 9.0)), and lower-body strength (15.2 kg (9.3, 21.1)) were observed end-intervention. CONCLUSION Preliminary evidence support that exercise is safe and beneficial to the quality of life and functional outcomes for people with brain cancer.Registration: ACTRN12617001577303.
Collapse
Affiliation(s)
- Carolina X Sandler
- Menzies Health Institute Queensland, Griffith University, Brisbane, Queensland, Australia
- School of Health Sciences, Western Sydney University, Sydney, New South Wales, Australia
- Kirby Institute, University of New South Wales, Sydney, New South Wales, Australia
| | - Gabrielle C Gildea
- Menzies Health Institute Queensland, Griffith University, Brisbane, Queensland, Australia
| | - Rosalind R Spence
- Menzies Health Institute Queensland, Griffith University, Brisbane, Queensland, Australia
| | - Tamara L Jones
- Menzies Health Institute Queensland, Griffith University, Brisbane, Queensland, Australia
- Melbourne School of Psychological Sciences, Faculty of Medicine, Dentistry, and Health Sciences, University of Melbourne, Melbourne, Victoria, Australia
| | - Paul Eliadis
- Icon Cancer Centre, Brisbane, Queensland, Australia
| | - David Walker
- Newro foundation, Brisbane, Queensland, Australia
| | - Amanda Donaghue
- Queensland Sports Medicine Centre, Brisbane, Queensland, Australia
| | | | - Jacqui Keller
- Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia
| | - Deb Pickersgill
- Queensland Sports Medicine Centre, Brisbane, Queensland, Australia
| | - Molly Shevill
- Queensland Sports Medicine Centre, Brisbane, Queensland, Australia
| | - Vivien Biggs
- Newro foundation, Brisbane, Queensland, Australia
| | | | - Fiona Jonker
- Icon Cancer Foundation, Brisbane, Queensland, Australia
| | | | - John Bashford
- Icon Cancer Centre, Brisbane, Queensland, Australia
- Icon Cancer Foundation, Brisbane, Queensland, Australia
| | - Sandra C Hayes
- Menzies Health Institute Queensland, Griffith University, Brisbane, Queensland, Australia
| |
Collapse
|
9
|
Albright L, Ko W, Buvanesh M, Haraldsson H, Polubriaginof F, Kuperman GJ, Levy M, Sterling MR, Dell N, Estrin D. Opportunities and Challenges for Augmented Reality in Family Caregiving: Qualitative Video Elicitation Study. JMIR Form Res 2024; 8:e56916. [PMID: 38814705 PMCID: PMC11176885 DOI: 10.2196/56916] [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: 01/31/2024] [Revised: 03/27/2024] [Accepted: 04/26/2024] [Indexed: 05/31/2024] Open
Abstract
BACKGROUND Although family caregivers play a critical role in care delivery, research has shown that they face significant physical, emotional, and informational challenges. One promising avenue to address some of caregivers' unmet needs is via the design of digital technologies that support caregivers' complex portfolio of responsibilities. Augmented reality (AR) applications, specifically, offer new affordances to aid caregivers as they perform care tasks in the home. OBJECTIVE This study explored how AR might assist family caregivers with the delivery of home-based cancer care. The specific objectives were to shed light on challenges caregivers face where AR might help, investigate opportunities for AR to support caregivers, and understand the risks of AR exacerbating caregiver burdens. METHODS We conducted a qualitative video elicitation study with clinicians and caregivers. We created 3 video elicitations that offer ways in which AR might support caregivers as they perform often high-stakes, unfamiliar, and anxiety-inducing tasks in postsurgical cancer care: wound care, drain care, and rehabilitative exercise. The elicitations show functional AR applications built using Unity Technologies software and Microsoft Hololens2. Using elicitations enabled us to avoid rediscovering known usability issues with current AR technologies, allowing us to focus on high-level, substantive feedback on potential future roles for AR in caregiving. Moreover, it enabled nonintrusive exploration of the inherently sensitive in-home cancer care context. RESULTS We recruited 22 participants for our study: 15 clinicians (eg, oncologists and nurses) and 7 family caregivers. Our findings shed light on clinicians' and caregivers' perceptions of current information and communication challenges caregivers face as they perform important physical care tasks as part of cancer treatment plans. Most significant was the need to provide better and ongoing support for execution of caregiving tasks in situ, when and where the tasks need to be performed. Such support needs to be tailored to the specific needs of the patient, to the stress-impaired capacities of the caregiver, and to the time-constrained communication availability of clinicians. We uncover opportunities for AR technologies to potentially increase caregiver confidence and reduce anxiety by supporting the capture and review of images and videos and by improving communication with clinicians. However, our findings also suggest ways in which, if not deployed carefully, AR technologies might exacerbate caregivers' already significant burdens. CONCLUSIONS These findings can inform both the design of future AR devices, software, and applications and the design of caregiver support interventions based on already available technology and processes. Our study suggests that AR technologies and the affordances they provide (eg, tailored support, enhanced monitoring and task accuracy, and improved communications) should be considered as a part of an integrated care journey involving multiple stakeholders, changing information needs, and different communication channels that blend in-person and internet-based synchronous and asynchronous care, illness, and recovery.
Collapse
Affiliation(s)
- Liam Albright
- Department of Information Science, Cornell University, New York, NY, United States
| | - Woojin Ko
- Department of Computer Science, Cornell Tech, New York, NY, United States
| | - Meyhaa Buvanesh
- Department of Information Science, Jacobs Technion-Cornell Institute, Cornell Tech, New York, NY, United States
| | | | - Fernanda Polubriaginof
- Digital Informatics and Technology Solutions (DigITS), Memorial Sloan Kettering Cancer Center, New York, NY, United States
| | - Gilad J Kuperman
- Digital Informatics and Technology Solutions (DigITS), Memorial Sloan Kettering Cancer Center, New York, NY, United States
| | - Michelle Levy
- Digital Informatics and Technology Solutions (DigITS), Memorial Sloan Kettering Cancer Center, New York, NY, United States
| | - Madeline R Sterling
- Division of General Internal Medicine, Department of Medicine, Weill Cornell Medicine, New York, NY, United States
| | - Nicola Dell
- Department of Information Science, Jacobs Technion-Cornell Institute, Cornell Tech, New York, NY, United States
| | - Deborah Estrin
- Department of Computer Science, Cornell Tech, New York, NY, United States
| |
Collapse
|
10
|
Gitonga I, Desmond D, Maguire R. Who uses connected health technologies after a cancer diagnosis? evidence from the US Health Information National Trends Survey. J Cancer Surviv 2024:10.1007/s11764-024-01615-1. [PMID: 38744797 DOI: 10.1007/s11764-024-01615-1] [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: 10/19/2023] [Accepted: 05/09/2024] [Indexed: 05/16/2024]
Abstract
PURPOSE As the number of people living with and beyond cancer increases, connected health technologies offer promise to enhance access to care and support, while reducing costs. However, uptake of connected health technologies may vary depending on sociodemographic and health-related variables. This study aimed to investigate demographic and health predictors of connected health technology use among people living with and beyond cancer. METHODS Cross-sectional data from the US Health Information National Trends Survey Version 5 Cycle 4 (H5c4) was used. Regression analysis was used to examine associations between sociodemographic factors and the use of connected health technologies. The sample was restricted to individuals who self-reported a cancer diagnosis or history of cancer. RESULTS In this cycle, 626 respondents self-reported a cancer diagnosis, with 41.1% using connected health technologies (health and wellness apps and/or wearable devices). Most were female (58.9%) and white (82.5%); 43.4% had graduated college or higher education. One third (33.6%) had a household income of $75,000 or more. Respondents who were younger, have higher education, were living as married, had higher incomes, had higher self-rated health and had higher health-related self-efficacy were significantly more likely to use connected health technologies. There were no significant associations between gender, race, stratum, time since diagnosis, history of anxiety or depression, and use of connected health technologies among people living with and beyond cancer. CONCLUSIONS Connected health technology use among people living with and beyond cancer is associated with sociodemographic factors. Future research should examine these demographic disparities as the use of connected health technologies in healthcare continues to gather momentum. IMPLICATIONS FOR CANCER SURVIVORS The study underscores a disparity in connected heath technology usage among people living with and beyond cancer. There is a pressing need for research into adoption barriers and interventions to ensure equitable digital healthcare integration among this population, especially with the heightened adoption of technology post COVID-19 pandemic.
Collapse
Affiliation(s)
- Isaiah Gitonga
- Department of Psychology, Maynooth University, Maynooth, Ireland.
- Assisting Living and Learning Institute, Maynooth University, Maynooth, Ireland.
| | - Deirdre Desmond
- Department of Psychology, Maynooth University, Maynooth, Ireland
- Assisting Living and Learning Institute, Maynooth University, Maynooth, Ireland
| | - Rebecca Maguire
- Department of Psychology, Maynooth University, Maynooth, Ireland
- Assisting Living and Learning Institute, Maynooth University, Maynooth, Ireland
| |
Collapse
|
11
|
Coles CE, Earl H, Anderson BO, Barrios CH, Bienz M, Bliss JM, Cameron DA, Cardoso F, Cui W, Francis PA, Jagsi R, Knaul FM, McIntosh SA, Phillips KA, Radbruch L, Thompson MK, André F, Abraham JE, Bhattacharya IS, Franzoi MA, Drewett L, Fulton A, Kazmi F, Inbah Rajah D, Mutebi M, Ng D, Ng S, Olopade OI, Rosa WE, Rubasingham J, Spence D, Stobart H, Vargas Enciso V, Vaz-Luis I, Villarreal-Garza C. The Lancet Breast Cancer Commission. Lancet 2024; 403:1895-1950. [PMID: 38636533 DOI: 10.1016/s0140-6736(24)00747-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Revised: 12/18/2023] [Accepted: 04/09/2024] [Indexed: 04/20/2024]
Affiliation(s)
| | - Helena Earl
- Department of Oncology, University of Cambridge, Cambridge, UK
| | - Benjamin O Anderson
- Global Breast Cancer Initiative, World Health Organisation and Departments of Surgery and Global Health Medicine, University of Washington, Seattle, WA, USA
| | - Carlos H Barrios
- Oncology Research Center, Hospital São Lucas, Porto Alegre, Brazil
| | - Maya Bienz
- Mount Vernon Cancer Centre, East and North Hertfordshire NHS Trust, London, UK; Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | | | - David A Cameron
- Institute of Genetics and Cancer and Usher Institute, University of Edinburgh, Edinburgh, UK
| | - Fatima Cardoso
- Breast Unit, Champalimaud Clinical Center/Champalimaud Foundation, Lisbon, Portugal
| | - Wanda Cui
- Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia; Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, VIC, Australia
| | - Prudence A Francis
- Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia; Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, VIC, Australia
| | - Reshma Jagsi
- Emory University School of Medicine, Atlanta, GA, USA
| | - Felicia Marie Knaul
- Institute for Advanced Study of the Americas, University of Miami, Miami, FL, USA; Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL, USA; Tómatelo a Pecho, Mexico City, Mexico
| | - Stuart A McIntosh
- School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, UK
| | - Kelly-Anne Phillips
- Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia; Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, VIC, Australia
| | - Lukas Radbruch
- Department of Palliative Medicine, University Hospital Bonn, Bonn, Germany
| | | | | | - Jean E Abraham
- Department of Oncology, University of Cambridge, Cambridge, UK
| | | | | | - Lynsey Drewett
- Royal Devon University Healthcare NHS Foundation Trust, Exeter, UK
| | | | - Farasat Kazmi
- Norfolk and Norwich University Hospitals NHS Foundation Trust, Norwich, UK
| | | | | | - Dianna Ng
- Memorial Sloan Kettering Cancer Center, New York City, NY, USA
| | - Szeyi Ng
- The Institute of Cancer Research, London, UK
| | | | - William E Rosa
- Memorial Sloan Kettering Cancer Center, New York City, NY, USA
| | | | | | | | | | | | - Cynthia Villarreal-Garza
- Breast Cancer Center, Hospital Zambrano Hellion TecSalud, Tecnologico de Monterrey, Monterrey, Mexico
| |
Collapse
|
12
|
Toni E, Ayatollahi H. An insight into the use of telemedicine technology for cancer patients during the Covid-19 pandemic: a scoping review. BMC Med Inform Decis Mak 2024; 24:104. [PMID: 38641567 PMCID: PMC11027268 DOI: 10.1186/s12911-024-02507-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Accepted: 04/12/2024] [Indexed: 04/21/2024] Open
Abstract
BACKGROUND The use of telemedicine technology has significantly increased in recent years, particularly during the Covid-19 pandemic. This study aimed to investigate the use of telemedicine technology for cancer patients during the Covid-19 pandemic. METHODS This was a scoping review conducted in 2023. Various databases including PubMed, Web of Science, Scopus, Cochrane Library, Ovid, IEEE Xplore, ProQuest, Embase, and Google Scholar search engine were searched. All quantitative, qualitative, and mixed-method studies published in English between 2020 and 2022 were included. Finally, the needed data were extracted, and the results were synthesized and reported narratively. RESULTS A total of 29 articles were included in this review. The results showed that teleconsultation, televisit, and telerehabilitation were common telemedicine services, and video conferencing and telephone were common technologies used in these studies. In most cases, patients and healthcare providers preferred these services compared to the face-to-face consultations due to their convenience and advantages. Furthermore, the findings revealed that in terms of clinical outcomes, telemedicine could effectively reduce anxiety, pain, sleep disorders, and hospital admission rates. CONCLUSION The findings provided valuable insights into the various telemedicine technologies, services, users' perspectives, and clinical outcomes in cancer patients during the Covid-19 pandemic. Overall, the positive outcomes and users' satisfaction showed that the use of telemedicine technology can be expanded, particularly in cancer care. Future research needs to investigate both clinical and non-clinical effectiveness of using various telemedicine services and technologies for improving cancer care delivery, which can help to develop more successful strategies for implementing this technology.
Collapse
Affiliation(s)
- Esmaeel Toni
- Student Research Committee, Iran University of Medical Sciences, Tehran, Iran
| | - Haleh Ayatollahi
- Health Management and Economics Research Center, Health Management Research Institute, Iran University of Medical Sciences, Tehran, Iran.
| |
Collapse
|
13
|
Harvey RD, Miller TM, Hurley PA, Thota R, Black LJ, Bruinooge SS, Boehmer LM, Fleury ME, Kamboj J, Rizvi MA, Symington BE, Tap WD, Waterhouse DM, Levit LA, Merrill JK, Prindiville SA, Pollastro T, Brewer JR, Byatt LP, Hamroun L, Kim ES, Holland N, Nowakowski GS. A call to action to advance patient-focused and decentralized clinical trials. Cancer 2024; 130:1193-1203. [PMID: 38193828 DOI: 10.1002/cncr.35145] [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] [Indexed: 01/10/2024]
Abstract
This commentary is a call to action for a concerted commitment and effort to transform clinical trials and enable people with cancer to participate in clinical trials closer to home. Three key strategies are identified to address major barriers: confront challenges with the interpretation of US Food and Drug Administration Form 1572 requirements (Statement of Investigator); broaden acceptance of local laboratories and imaging centers; and invest in the creation of effective, sustainable partnerships between research centers and local providers.
Collapse
Affiliation(s)
- R Donald Harvey
- Winship Cancer Institute of Emory University, Atlanta, Georgia, USA
| | - Therica M Miller
- Icahn School of Medicine at Mount Sinai, Tisch Cancer Institute, New York, New York, USA
| | | | - Ramya Thota
- Intermountain Health, Salt Lake City, Utah, USA
| | | | | | - Leigh M Boehmer
- Association of Community Cancer Centers, Rockville, Maryland, USA
| | - Mark E Fleury
- American Cancer Society Cancer Action Network, Washington, District of Columbia, USA
| | | | | | | | - William D Tap
- Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | | | - Laura A Levit
- American Society of Clinical Oncology, Alexandria, Virginia, USA
| | | | - Sheila A Prindiville
- National Cancer Institute Coordinating Center for Clinical Trials, Bethesda, Maryland, USA
| | - Teri Pollastro
- Metastatic Breast Cancer Alliance, Mercer Island, Washington, USA
| | - Jamie R Brewer
- US Food and Drug Administration, Rockville, Maryland, USA
| | - Leslie P Byatt
- New Mexico Cancer Care Alliance, Albuquerque, New Mexico, USA
| | | | | | - Nicole Holland
- American Society of Clinical Oncology, Alexandria, Virginia, USA
| | | |
Collapse
|
14
|
Smith GVH, Myers SA, Fujita RA, Yu C, Campbell KL. Virtually Supervised Exercise Programs for People With Cancer: A Scoping Review. Cancer Nurs 2024:00002820-990000000-00236. [PMID: 38598778 DOI: 10.1097/ncc.0000000000001353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/12/2024]
Abstract
BACKGROUND Exercise has been shown to improve physical function and quality of life for individuals with cancer. However, low rates of exercise adoption and commonly reported barriers to accessing exercise programming have demonstrated a need for virtual exercise programming in lieu of traditional in-person formats. OBJECTIVE The aim of this study was to summarize the existing research on supervised exercise interventions delivered virtually for individuals living with and beyond cancer. METHODS We conducted a scoping review of randomized controlled trials, pilot studies, or feasibility studies investigating virtually supervised exercise interventions for adults either during or after treatment of cancer. The search included EMBASE, MEDLINE, CINAHL, SPORTDiscus, Cochrane Library, and conference abstracts. RESULTS Fifteen studies were included. The interventions were delivered mostly over Zoom in a group format, with various combinations of aerobic and resistance exercises. Attendance ranged from 78% to 100%, attrition ranged from 0% to 29%, and satisfaction ranged from 94% to 100%. No major adverse events were reported, and only 3 studies reported minor adverse events. Significant improvements were seen in upper and lower body strength, endurance, pain, fatigue, and emotional well-being. CONCLUSION Supervised exercise interventions delivered virtually are feasible and may improve physical function for individuals with cancer. The supervision included in these virtual programs promoted similar safety as seen with in-person programming. More randomized controlled trials with large cohorts are needed to validate these findings. IMPLICATIONS FOR PRACTICE Individuals living with and beyond cancer can be encouraged to join virtually supervised exercise programs because they are safe, well enjoyed, and may improve physical function and quality of life.
Collapse
Affiliation(s)
- Gillian V H Smith
- Author Affiliations: Department of Physical Therapy, University of British Columbia (Mss Smith, Myers, and Yu; Mr Fujita; and Dr Campbell), Vancouver, Canada; and University of São Paulo (Mr Fujita), Brazil
| | | | | | | | | |
Collapse
|
15
|
Dunston ER, Malouf A, Podlog LW, Newton M, Bai Y, Oza S, Coletta AM. Experiences participating in a telehealth exercise program among older adults with cancer: a qualitative study. J Cancer Surviv 2024:10.1007/s11764-024-01564-9. [PMID: 38492170 DOI: 10.1007/s11764-024-01564-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Accepted: 03/10/2024] [Indexed: 03/18/2024]
Abstract
PURPOSE Telehealth delivery of exercise programs has rapidly increased in recent years; yet, little is known regarding older cancer survivors' (OCS) experiences participating in telehealth exercise. The purpose of this study was to determine OCS barriers and facilitators to participation in telehealth-delivered exercise. METHODS OCS who participated in a 12-week, one-on-one telehealth exercise program were recruited to participate in one of three focus groups. Focus groups were conducted virtually using a semi-structured interview guide. Focus groups were audio recorded, transcribed verbatim, and analyzed utilizing thematic analysis with Atlas.ti. RESULTS Fourteen OCS (age range 65-79 years) participated in the focus groups, five (35.7%) of which had not completed a telehealth follow-up assessment. The most common cancer type was breast (n = 6, 42.9%), and all cancer stages were represented. Three overall themes were identified: having adequate space to exercise, meeting OCS physical and psychosocial needs, and OCS learning throughout the exercise program. Within these themes, five facilitators and two barriers were identified. Facilitators included the individualization of the exercise program, no travel, accountability, learning to exercise, and support from staff and family. The barriers identified were having limited space to exercise and a learning curve with technology. CONCLUSION OCS viewed telehealth exercise positively. Identified barriers aligned with those in younger cancer survivors (≥18 years), indicating that OCS are able to engage with telehealth exercise programs alongside their younger counterparts. IMPLICATIONS FOR CANCER SURVIVORS Telehealth exercise mitigates exercise barriers in OCS and should be used as a strategy to support exercise participation among cancer survivors, regardless of age.
Collapse
Affiliation(s)
- Emily R Dunston
- Department of Health and Kinesiology, University of Utah, Salt Lake City, UT, USA
| | - Alec Malouf
- Department of Health and Kinesiology, University of Utah, Salt Lake City, UT, USA
| | - Leslie W Podlog
- Université de Montréal, School of Kinesiology and Physical Activity Sciences, Faculty of Medicine, Montréal, Québec, Canada
- CHU Sainte-Justine Research Center, Montréal, Québec, Canada
| | - Maria Newton
- Department of Health and Kinesiology, University of Utah, Salt Lake City, UT, USA
| | - Yang Bai
- Department of Health and Kinesiology, University of Utah, Salt Lake City, UT, USA
| | - Sonal Oza
- Department of Rehabilitation Medicine, Emory University School of Medicine, Atlanta, GA, USA
| | - Adriana M Coletta
- Department of Health and Kinesiology, University of Utah, Salt Lake City, UT, USA.
- The Huntsman Cancer Institute at the University of Utah, Salt Lake City, UT, USA.
| |
Collapse
|
16
|
Gutiérrez-Puertas L, Gutiérrez-Puertas V, Ortiz-Rodríguez B, Aguilera-Manrique G, Márquez-Hernández VV. Communication and empathy of nursing students in patient care through telenursing: A comparative cross-sectional study. NURSE EDUCATION TODAY 2024; 133:106048. [PMID: 37995617 DOI: 10.1016/j.nedt.2023.106048] [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: 02/20/2023] [Revised: 11/11/2023] [Accepted: 11/14/2023] [Indexed: 11/25/2023]
Abstract
BACKGROUND Phone calls and videoconferences are the most widely used systems to interact with patients in real time. Patient care through phone calls or videoconferences is different from an in-person meeting. Interpersonal communication skills, self-confidence communication skills and empathy with the patient may be affected during phone calls or videoconferences. AIM The objective of this study was to describe the interpersonal communication skills, self-confidence communication skills and empathy of nursing students during patient care through phone calls or videoconferences. DESIGN A cross-sectional study. PARTICIPANTS A total of 170 nursing students participated from the University of Almeria. The subjects were randomly assigned to the phone call group or videoconference group. METHODS The students contacted standardised patients through phone calls or videoconferences. Questionnaires were used to assess interpersonal communication skills with patient, empathy, and self-confidence in communication skills. Data collection was carried out between March and May 2022. RESULTS No statistically significant differences were found between self-confidence in communication skills with the patient and the type of consultation, nor were statistically significant differences found between the empathy of the nursing students and the type of consultation. The students who used videoconference reported higher patient interpersonal communication skills than the students who made phone calls. Finally, the participants who made videoconferences obtained a higher score in dimension therapeutic use of self than those who made phone calls. CONCLUSIONS Nursing students have shown a high level of empathy and interpersonal communication skills with patients and a moderate level of self-confidence in communication skills, both when interacting with patients through phone calls and videoconferences. Finally, differences were found in interpersonal communication skills with patient and type of consultation. In particular, interpersonal communication skills with the patient are greater when the nursing students make a videoconference.
Collapse
Affiliation(s)
- Lorena Gutiérrez-Puertas
- Department of Nursing, Physiotherapy and Medicine, Universidad de Almeria, Spain; Research Group for Experimental and Applied Neuropsychology HUM-061, Universidad de Almeria, Spain; Research Center Health Sciences (CEINSA), Universidad de Almería, Spain.
| | - Vanesa Gutiérrez-Puertas
- Department of Nursing, Physiotherapy and Medicine, Universidad de Almeria, Spain; Department of Hematology, Hospital Universitario Torrecárdenas, Spain; Research Group for Electronic Communications And Telemedicine TIC-019, Universidad de Almeria, Spain.
| | | | - Gabriel Aguilera-Manrique
- Department of Nursing, Physiotherapy and Medicine, Universidad de Almeria, Spain; Research Center Health Sciences (CEINSA), Universidad de Almería, Spain; Research Group for Health Sciences CTS-451, Universidad de Almeria, Spain.
| | - Verónica V Márquez-Hernández
- Department of Nursing, Physiotherapy and Medicine, Universidad de Almeria, Spain; Research Center Health Sciences (CEINSA), Universidad de Almería, Spain; Research Group for Health Sciences CTS-451, Universidad de Almeria, Spain.
| |
Collapse
|
17
|
O'Connor S, Vercell A, Wong D, Yorke J, Fallatah FA, Cave L, Anny Chen LY. The application and use of artificial intelligence in cancer nursing: A systematic review. Eur J Oncol Nurs 2024; 68:102510. [PMID: 38310664 DOI: 10.1016/j.ejon.2024.102510] [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: 10/05/2023] [Revised: 01/07/2024] [Accepted: 01/10/2024] [Indexed: 02/06/2024]
Abstract
PURPOSE Artificial Intelligence is being applied in oncology to improve patient and service outcomes. Yet, there is a limited understanding of how these advanced computational techniques are employed in cancer nursing to inform clinical practice. This review aimed to identify and synthesise evidence on artificial intelligence in cancer nursing. METHODS CINAHL, MEDLINE, PsycINFO, and PubMed were searched using key terms between January 2010 and December 2022. Titles, abstracts, and then full texts were screened against eligibility criteria, resulting in twenty studies being included. Critical appraisal was undertaken, and relevant data extracted and analysed. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. RESULTS Artificial intelligence was used in numerous areas including breast, colorectal, liver, and ovarian cancer care among others. Algorithms were trained and tested on primary and secondary datasets to build predictive models of health problems related to cancer. Studies reported this led to improvements in the accuracy of predicting health outcomes or identifying variables that improved outcome prediction. While nurses led most studies, few deployed an artificial intelligence based digital tool with cancer nurses in a real-world setting as studies largely focused on developing and validating predictive models. CONCLUSION Electronic cancer nursing datasets should be established to enable artificial intelligence techniques to be tested and if effective implemented in digital prediction and other AI-based tools. Cancer nurses need more education on machine learning and natural language processing, so they can lead and contribute to artificial intelligence developments in oncology.
Collapse
Affiliation(s)
- Siobhan O'Connor
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, London, United Kingdom.
| | - Amy Vercell
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, London, United Kingdom; The Christie NHS Foundation Trust, Wilmslow Rd, Manchester, M20 4BX, United Kingdom.
| | - David Wong
- Leeds Institute for Health Informatics, University of Leeds, Leeds, United Kingdom.
| | - Janelle Yorke
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, London, United Kingdom; The Christie NHS Foundation Trust, Wilmslow Rd, Manchester, M20 4BX, United Kingdom.
| | - Fatmah Abdulsamad Fallatah
- Department of Nursing Affairs, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia.
| | - Louise Cave
- NHS Transformation Directorate, NHS England, England, United Kingdom.
| | - Lu-Yen Anny Chen
- Institute of Clinical Nursing, College of Nursing, National Yang Ming Chiao Tung University, Taipei, Taiwan.
| |
Collapse
|
18
|
Walsh EA, Safren SA, Penedo FJ, Antoni MH. If we build it, will they come? A scoping review of objective engagement metrics in asynchronous psychosocial telehealth interventions for breast cancer survivors. Clin Psychol Rev 2024; 107:102374. [PMID: 38171138 DOI: 10.1016/j.cpr.2023.102374] [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: 02/14/2023] [Revised: 12/11/2023] [Accepted: 12/21/2023] [Indexed: 01/05/2024]
Abstract
Burgeoning technologies and the COVID-19 pandemic resulted in a boom of telehealth for immunocompromised patients, such as those with cancer. Telehealth modalities overcome barriers and promote accessibility to care. Currently, efficacious psychosocial interventions exist to address negative aftereffects of a cancer diagnosis and treatment. Many of these interventions often incorporate asynchronous telehealth (e.g., web-based, smartphone mobile app) features. However, asynchronous platforms are limited by suboptimal engagement. Subjective indicators of perceived engagement in the forms of acceptability, feasibility, and adherence are often captured, yet prior research has found discrepancies between perceived and actual engagement. The FITT (frequency, intensity, time/duration, type of engagement) model, originally developed for use to quantify engagement within exercise trials, provides a framework to assess objective engagement of psychosocial interventions for breast cancer. Using 14 keywords and searching six databases through 11/2023, 56 studies that used asynchronous telehealth interventions in breast cancer were identified. All FITT domains were reported at least once across studies with intensity metrics most commonly reported. Nine metrics were described across FITT domains. Human-centered design principles to guide telehealth development and privacy considerations are discussed. Findings offer suggestions for how to represent and optimize objective engagement in asynchronous telehealth cancer care.
Collapse
Affiliation(s)
- Emily A Walsh
- Department of Psychology, University of Miami, Coral Gables, FL, USA.
| | - Steven A Safren
- Department of Psychology, University of Miami, Coral Gables, FL, USA
| | - Frank J Penedo
- Department of Psychology, University of Miami, Coral Gables, FL, USA; Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL, USA
| | - Michael H Antoni
- Department of Psychology, University of Miami, Coral Gables, FL, USA; Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL, USA
| |
Collapse
|
19
|
Attieh S, Loiselle CG. Cancer Care Team Functioning during COVID-19: A Narrative Literature Review and Synthesis. Curr Oncol 2024; 31:335-349. [PMID: 38248107 PMCID: PMC10814830 DOI: 10.3390/curroncol31010022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Revised: 12/24/2023] [Accepted: 01/04/2024] [Indexed: 01/23/2024] Open
Abstract
Amid pandemics, health care teams face unprecedented challenges, requiring significant efforts to sustain optimal functioning and navigate rapid practice changes. It is therefore crucial to identify factors affecting team functioning in these contexts. The present narrative review more specifically summarizes the literature on key elements of cancer teams' functioning during COVID-19. The search strategy involved four main databases (i.e., Medline OVID, EMBASE, PsycINFO, and CINAHL), as well as Google Scholar, from January 2000 to September 2022. Twenty-three publications were found to be relevant. Each was read thoroughly, and its content summarized. Across publications, three key themes emerged: (1) swiftly adopting virtual technology for communication and interprofessional collaboration, (2) promoting team resilience, and (3) encouraging self-care and optimizing team support. Our findings underscore key team functioning elements to address in future pandemics. More research is needed to document the perspectives of broader-based team members (such as patients and lay carers) to inform more comprehensive evidence-based team functioning guidelines.
Collapse
Affiliation(s)
- Samar Attieh
- Department of Experimental Medicine, Faculty of Medicine and Health Sciences, McGill University, Montreal, QC H4A 3J1, Canada
| | - Carmen G. Loiselle
- Ingram School of Nursing, Faculty of Medicine and Health Sciences, McGill University, Montreal, QC H3A 2M7, Canada;
- Department of Oncology, Faculty of Medicine and Health Sciences, McGill University, Montreal, QC H4A 3T2, Canada
- Segal Cancer Center, CIUSSS Centre-Ouest, Montreal, QC H3T 1E2, Canada
| |
Collapse
|
20
|
Yu J, Petersen C, Reid S, Rosenbloom ST, Warner JL. Telehealth and Technology: New Directions in Cancer Care. Cancer J 2024; 30:40-45. [PMID: 38265926 DOI: 10.1097/ppo.0000000000000692] [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: 01/26/2024]
Abstract
ABSTRACT Telehealth is a broad concept that refers to any delivery of health care in real time using technologies to connect people or information that are not in the same physical location. Until fairly recently, telehealth was more aspiration than reality. This situation changed radically due in part to the COVID-19 pandemic, which led to a near-overnight inability for patients to be seen for routine management of chronic health conditions, including those with cancer. The purpose of this brief narrative review is to outline some areas where emerging and future technology may allow for innovations with specific implications for people with a current or past diagnosis of cancer, including underserved and/or historically excluded populations. Specific topics of telehealth are broadly covered in other areas of the special issue.
Collapse
Affiliation(s)
| | - Carolyn Petersen
- Department of Artificial Intelligence and Informatics, Mayo Clinic, Rochester, MN
| | - Sonya Reid
- Division of Hematology/Oncology, Department of Medicine
| | - S Trent Rosenbloom
- Department of Biomedical Informatics, Vanderbilt University, Nashville, TN
| | | |
Collapse
|
21
|
Bramble LA, Tracy B, Siverling S, Mizuta J, Juliano K, Plack M. Patient, Provider, and Organizational Considerations for Implementing Rehabilitation Telehealth. Telemed J E Health 2024; 30:173-186. [PMID: 37318832 DOI: 10.1089/tmj.2023.0133] [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] [Indexed: 06/17/2023] Open
Abstract
Introduction: While telehealth services (THS) have been around for some time, for many in the rehabilitation services, it is a new mode of service delivery. THS can be as effective as face-to-face care and are valued by patients and clinicians. However, THS present considerable challenges and may not be appropriate for everyone. Clinicians and organizations must be prepared to triage and manage patients in this environment. Aims of this study were to capture clinician perceptions of the implementation of THS in rehabilitation and use the insights gained to provide strategies for overcoming implementation challenges. Methods: An electronic survey was emailed to 234 rehabilitation clinicians in a large urban hospital. Completion was voluntary and anonymous. Qualitative analysis of the open-ended responses consisted of an iterative consensus-driven interpretivist approach. Multiple strategies were used to minimize bias and optimize trustworthiness. Results: From the 48 responses received, four themes were identified: (1) THS provide unique benefits for patients, providers, and organizations; (2) challenges arose in multiple domains (clinical, technological, environmental, and regulatory); (3) clinicians require specific personal, clinical, and technological knowledge, skills, and attributes to be effective; and (4) individual characteristics, session type, home environment, and needs must be considered in patient selection. Discussion and Conclusion: From the themes identified, a conceptual framework illustrating the keys to effective implementation of THS was developed. Recommendations addressing challenges across multiple domains (clinical, technological, environmental, and regulatory), and at all levels of care delivery (patient, provider, and organization) are provided. Insights gained from this study can be used by clinicians in advocating for and designing effective THS programs. Educators would also gain from using these recommendations to train students and clinicians to recognize and address the challenges they may encounter in providing THS in rehabilitation.
Collapse
Affiliation(s)
| | - Brad Tracy
- Evidence in Motion, Sugar Grove, Illinois, USA
| | | | - Jay Mizuta
- Hospital for Special Surgery, New York, New York, USA
| | - Karen Juliano
- Hospital for Special Surgery, New York, New York, USA
| | - Margaret Plack
- The George Washington University, Washington, District of Columbia, USA
| |
Collapse
|
22
|
Nurtsch A, Teufel M, Jahre LM, Esber A, Rausch R, Tewes M, Schöbel C, Palm S, Schuler M, Schadendorf D, Skoda EM, Bäuerle A. Drivers and barriers of patients' acceptance of video consultation in cancer care. Digit Health 2024; 10:20552076231222108. [PMID: 38188860 PMCID: PMC10768612 DOI: 10.1177/20552076231222108] [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] [Accepted: 12/06/2023] [Indexed: 01/09/2024] Open
Abstract
Background Due to digitization in the medical sector, many healthcare interactions are switched to online services. This study assessed the acceptance of video consultations (VCs) in cancer care, and determined drivers and barriers of acceptance. Methods A cross-sectional online-based survey study was conducted in Germany from February 2022 to February 2023. Recruitment took place at oncology outpatient clinics, general practitioners, oncology practices and via cancer-related social media channels. Inclusion criteria were a cancer diagnosis, cancer treatment and internet access. Sociodemographic, medical data, eHealth-related data were acquired via an online assessment. The Unified Theory of Acceptance and Use of Technology (UTAUT) model was used to determine the acceptance of VC and its predictors. Results Of N = 350 cancer patients, 56.0% (n = 196) reported high acceptance of VC, 28.0% (n = 98) stated moderate acceptance and 16.0% (n = 56) indicated low acceptance. Factors influencing acceptance were younger age (β = -.28, p < .001), female gender (β = .35, p = .005), stage of disease (β = .11, p = .032), high digital confidence (β = .14, p = .010), low internet anxiety (β = -.21, p = .001), high digital overload (β = -.12, p = .022), high eHealth literacy (β = .14, p = .028), personal trust (β = -.25, p < .001), internet use (β = .17, p = .002), and the UTAUT predictors: performance expectancy (β = .24, p < .001), effort expectancy (β = .26, p < .001), and social influence (β = .34, p < .001). Conclusions Patients' acceptance of VC in cancer care is high. Drivers and barriers to acceptance identified should be considered for personalized applications. Considering the growing demand for cancer care establishing digital healthcare solutions is justified.
Collapse
Affiliation(s)
- Angelina Nurtsch
- Clinic for Psychosomatic Medicine and Psychotherapy, LVR-University Hospital, University of Duisburg-Essen, Essen, Germany
| | - Martin Teufel
- Clinic for Psychosomatic Medicine and Psychotherapy, LVR-University Hospital, University of Duisburg-Essen, Essen, Germany
- West German Cancer Center, University Hospital Essen, Essen, Germany
- Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University of Duisburg-Essen, Essen, Germany
| | - Lisa Maria Jahre
- Clinic for Psychosomatic Medicine and Psychotherapy, LVR-University Hospital, University of Duisburg-Essen, Essen, Germany
- Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University of Duisburg-Essen, Essen, Germany
| | - André Esber
- Clinic for Psychosomatic Medicine and Psychotherapy, LVR-University Hospital, University of Duisburg-Essen, Essen, Germany
| | - Raya Rausch
- Clinic for Psychosomatic Medicine and Psychotherapy, LVR-University Hospital, University of Duisburg-Essen, Essen, Germany
- West German Cancer Center, University Hospital Essen, Essen, Germany
| | - Mitra Tewes
- West German Cancer Center, University Hospital Essen, Essen, Germany
- Department of Palliative Medicine, University Hospital Essen, University Duisburg-Essen, Essen, Germany
| | - Christoph Schöbel
- Faculty of Sleep Medicine and Telemedicine, West German Lung Center, University Medicine Essen - Ruhrlandklinik, University of Duisburg-Essen, Essen, Germany
| | - Stefan Palm
- West German Cancer Center, University Hospital Essen, Essen, Germany
| | - Martin Schuler
- West German Cancer Center, University Hospital Essen, Essen, Germany
- Department of Medical Oncology, University Hospital Essen, University Duisburg-Essen, Essen, Germany
| | - Dirk Schadendorf
- West German Cancer Center, University Hospital Essen, Essen, Germany
- Department of Dermatology, University Hospital Essen, University Duisburg-Essen, Essen, Germany
| | - Eva-Maria Skoda
- Clinic for Psychosomatic Medicine and Psychotherapy, LVR-University Hospital, University of Duisburg-Essen, Essen, Germany
- West German Cancer Center, University Hospital Essen, Essen, Germany
- Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University of Duisburg-Essen, Essen, Germany
| | - Alexander Bäuerle
- Clinic for Psychosomatic Medicine and Psychotherapy, LVR-University Hospital, University of Duisburg-Essen, Essen, Germany
- West German Cancer Center, University Hospital Essen, Essen, Germany
- Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University of Duisburg-Essen, Essen, Germany
| |
Collapse
|
23
|
Larbre V, Romain-Scelle N, Reymond P, Ladjouzi Y, Herledan C, Caffin AG, Baudouin A, Maire M, Maucort-Boulch D, Ranchon F, Rioufol C. Cancer outpatients during the COVID-19 pandemic: what Oncoral has to teach us about medical drug use and the perception of telemedicine. J Cancer Res Clin Oncol 2023; 149:13301-13310. [PMID: 37482585 DOI: 10.1007/s00432-023-04971-0] [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: 05/03/2023] [Accepted: 06/03/2023] [Indexed: 07/25/2023]
Abstract
PURPOSE The COVID-19 pandemic has disrupted healthcare access and telemedicine has been widely deployed. The aim of this study is to assess the impact of this health crisis on treatment consumption and telemedicine development in outpatients treated by oral anti-cancer agents and followed by the Oncoral hospital/community multidisciplinary program where continuity care is maintained by a pharmacist/nurse pair. METHODS A prospective monocentric study was conducted among cancer patients who received Oncoral telephone follow-up during the 1st lockdown in France using a 56-item questionnaire which covered sociodemographic data, patient medication management, and telehealth. RESULTS 178 patients received Oncoral follow-up during the 1st lockdown and 67.4% responded to the questionnaire. During lockdown, 9.2% of patients took medication or CAM for fatigue, 6.7% for mood alteration, 10.8% for sleep disorder, 11.7% for stress and anxiety, and 12.5% to get more energy. Homeopathy consumption was triggered by the pandemic. Habits about getting drugs from the pharmacy changed significantly (p < 0.001), while other treatment habits did not. 83% of patients were satisfied by the telephone follow-up established, 69% would be in favor of repeating this in case of a new epidemic wave. Those most in favor of using telemedicine seemed to be the youngest (p < 0.001), with several dependent children (p < 0.007), high school degree or higher education (p = 0.023), and in work (p < 0.001). CONCLUSION Health system reorganization enables to limit the impact of the crisis on patients' drug use in oncology care. Telemedicine is a promising public health tool.
Collapse
Affiliation(s)
- V Larbre
- Hospices Civils de Lyon, Groupement Hospitalier Sud, Unité de Pharmacie Clinique Oncologique, 165 Chemin du Grand Revoyet, 69495, Pierre-Bénite Cedex, France
- Université Lyon 1-EA 3738, CICLY, Lyon, France
| | - N Romain-Scelle
- Hospices Civils de Lyon, Groupement Hospitalier Sud, Service de Biostatistique-Bioinformatique, Pôle Santé Publique, Pierre-Bénite, France
- Laboratoire de Biométrie et Biologie Evolutive, Equipe Biostatistique-Santé, CNRS, UMR 5558, Villeurbanne, France
| | - P Reymond
- Hospices Civils de Lyon, Groupement Hospitalier Sud, Unité de Pharmacie Clinique Oncologique, 165 Chemin du Grand Revoyet, 69495, Pierre-Bénite Cedex, France
| | - Y Ladjouzi
- Hospices Civils de Lyon, Groupement Hospitalier Sud, Unité de Pharmacie Clinique Oncologique, 165 Chemin du Grand Revoyet, 69495, Pierre-Bénite Cedex, France
| | - C Herledan
- Hospices Civils de Lyon, Groupement Hospitalier Sud, Unité de Pharmacie Clinique Oncologique, 165 Chemin du Grand Revoyet, 69495, Pierre-Bénite Cedex, France
- Université Lyon 1-EA 3738, CICLY, Lyon, France
| | - A G Caffin
- Hospices Civils de Lyon, Groupement Hospitalier Sud, Unité de Pharmacie Clinique Oncologique, 165 Chemin du Grand Revoyet, 69495, Pierre-Bénite Cedex, France
| | - A Baudouin
- Hospices Civils de Lyon, Groupement Hospitalier Sud, Unité de Pharmacie Clinique Oncologique, 165 Chemin du Grand Revoyet, 69495, Pierre-Bénite Cedex, France
| | - M Maire
- Hospices Civils de Lyon, Groupement Hospitalier Sud, Unité de Pharmacie Clinique Oncologique, 165 Chemin du Grand Revoyet, 69495, Pierre-Bénite Cedex, France
| | - D Maucort-Boulch
- Hospices Civils de Lyon, Groupement Hospitalier Sud, Service de Biostatistique-Bioinformatique, Pôle Santé Publique, Pierre-Bénite, France
| | - F Ranchon
- Hospices Civils de Lyon, Groupement Hospitalier Sud, Unité de Pharmacie Clinique Oncologique, 165 Chemin du Grand Revoyet, 69495, Pierre-Bénite Cedex, France
- Université Lyon 1-EA 3738, CICLY, Lyon, France
| | - C Rioufol
- Hospices Civils de Lyon, Groupement Hospitalier Sud, Unité de Pharmacie Clinique Oncologique, 165 Chemin du Grand Revoyet, 69495, Pierre-Bénite Cedex, France.
- Université Lyon 1-EA 3738, CICLY, Lyon, France.
| |
Collapse
|
24
|
Burrell SA, Ross JG, Randall R, Heverly M. Pilot Testing of Evidence-Based Symptom Management Telehealth Simulation-Based Experiences in an Oncology Nursing Seminar. Nurs Educ Perspect 2023; 44:E56-E58. [PMID: 37279068 DOI: 10.1097/01.nep.0000000000001146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
ABSTRACT Telehealth simulation-based experiences (T-SBEs) offer one approach to prepare nursing students with the requisite skills to deliver oncology evidence-based symptom management (EBSM) using telecommunication technology. Fourteen baccalaureate nursing students participated in this one-group, pretest/posttest, convergent mixed-methods pilot study with questionnaire variant. Data were collected before and/or after two oncology EBSM T-SBEs using standardized participants. The T-SBEs resulted in significant increases in self-perceived competence, confidence, and self-confidence in clinical decision-making related to oncology EBSM. Qualitative themes included value, application, and preference for in-person SBEs. Future research is warranted to definitively determine the effect of oncology EBSM T-SBEs on student learning.
Collapse
Affiliation(s)
- Sherry A Burrell
- About the Authors Sherry A. Burrell, PhD, RN, CNE, is an assistant professor, M. Louise Fitzpatrick College of Nursing, Villanova University, Villanova, Pennsylvania. Jennifer Gunberg Ross, PhD, RN, CNE, is an associate professor, M. Louise Fitzpatrick College of Nursing, Villanova University. Rachel Randall, BSN, RN, is a graduate, M. Louise Fitzpatrick College of Nursing, Villanova University. MaryAnn Heverly, PhD, RN, is a retired adjunct associate professor, M. Louise Fitzpatrick College of Nursing, Villanova University. The authors are grateful to Gail E. Furman, PhD, RN, CHSE; Patricia Prieto, MBA, RN, CHSE; and Wendi Smith, MSN, RN, of M. Louise Fitzpatrick College of Nursing, Villanova University, for their assistance on this pilot project. For more information, contact Dr. Burrell at
| | | | | | | |
Collapse
|
25
|
Im EO, Chee W, Paul S, Choi MY, Kim SY, Deatrick JA, Inouye J, Ma G, Meghani S, Nguyen GT, Schapira MM, Ulrich CM, Yeo S, Bao T, Shin D, Mao JJ. A randomized controlled trial testing a virtual program for Asian American women breast cancer survivors. Nat Commun 2023; 14:6475. [PMID: 37838727 PMCID: PMC10576740 DOI: 10.1038/s41467-023-42132-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 09/25/2023] [Indexed: 10/16/2023] Open
Abstract
A culturally tailored virtual program could meet the survivorship needs of Asian American women breast cancer survivors (AABC). This study aims to determine the efficacy of a culturally tailored virtual information and coaching/support program (TICAA) in improving AABC's survivorship experience. A randomized clinical trial (NCT02803593) was conducted from January 2017 to June 2020 among 199 AABC. The intervention group utilized TICAA and the American Cancer Society [ACS] website while the control group used only ACS website for 12 weeks. The outcomes were measured using the SCNS-34SF (needs; primary), the MSAS-SF (symptoms; secondary), and the FACT-B (quality of life; secondary). The data were analyzed using an intent-to-treat approach. The intervention group showed significant reductions in their needs from the baseline (T0) to post 4 weeks (T1) and to post 12 weeks (T2). Although the changes were not statistically significant, the intervention group had decreased symptoms from T0 to T2 while the control group had an increase in their symptoms. The intervention group had a significant increase in their quality of life from T0 to T2. A culturally tailored virtual program could therefore improve quality of life in AABC patients. Trial Registration: To Enhance Breast Cancer Survivorship of Asian Americans (TICAA), NCT02803593, https://clinicaltrials.gov/ct2/show/NCT02803593?titles=TICAA&draw=2&rank=1.
Collapse
Affiliation(s)
- Eun-Ok Im
- The University of Texas at Austin, 1710 Red River St, Austin, TX, 78712, USA.
| | - Wonshik Chee
- The University of Texas at Austin, 1710 Red River St, Austin, TX, 78712, USA
| | - Sudeshna Paul
- Emory University, 1520 Clifton Road, Atlanta, GA, 30322, USA
| | - Mi-Young Choi
- Emory University, 1520 Clifton Road, Atlanta, GA, 30322, USA
- Chungbuk National University, 1 Chungdae-ro, Seowon-gu, Cheongju-si, Chungcheongbuk-do, South Korea
| | - Seo Yun Kim
- Emory University, 1520 Clifton Road, Atlanta, GA, 30322, USA
| | - Janet A Deatrick
- University of Pennsylvania, 418 Curie Blvd, Philadelphia, PA, 19104, USA
| | - Jillian Inouye
- University of Hawaii, 2528 McCarthy Mall, Webster Hall 402, Honolulu, HI, 96822, USA
| | - Grace Ma
- Temple University, 1801 N Broad St, Philadelphia, PA, 19122, USA
| | - Salimah Meghani
- University of Pennsylvania, 418 Curie Blvd, Philadelphia, PA, 19104, USA
| | - Giang T Nguyen
- Harvard University Health Services, 75 Mt. Auburn Street, Cambridge, MA, 02138, USA
| | - Marilyn M Schapira
- University of Pennsylvania, 418 Curie Blvd, Philadelphia, PA, 19104, USA
| | - Connie M Ulrich
- University of Pennsylvania, 418 Curie Blvd, Philadelphia, PA, 19104, USA
| | - SeonAe Yeo
- University of North Carolina, Carrington Hall, S Columbia St, Chapel Hill, NC, 27599, USA
| | - Ting Bao
- Memorial Sloan Kettering Cancer Center, 321 East 61st Street, Room 456, New York, NY, 10065, USA
| | - David Shin
- University of California, Los Angeles, 855 Tiverton Dr, Los Angeles, CA, 90024, USA
| | - Jun J Mao
- Memorial Sloan Kettering Cancer Center, 321 East 61st Street, Room 456, New York, NY, 10065, USA
| |
Collapse
|
26
|
Addario B, Astratinei V, Binder L, Geissler J, Horn MK, Krebs LU, Lewis B, Oliver K, Spiegel A. A New Framework for Co-Creating Telehealth for Cancer Care with the Patient Community. THE PATIENT 2023; 16:415-423. [PMID: 37493895 PMCID: PMC10409807 DOI: 10.1007/s40271-023-00642-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 07/11/2023] [Indexed: 07/27/2023]
Abstract
The increased use of telehealth in cancer care during the coronavirus disease 2019 pandemic has added to our knowledge and experience of the modality with benefits in terms of efficacy, cost, and patient and healthcare professional experience reported. However, telehealth has also been found not to be universally available to all patients with cancer, nor to be appropriate for every healthcare interaction; additionally, not all patients prefer it. Now that coronavirus disease restrictions have essentially ended and an opportunity to re-assess telehealth provision in cancer care presents, we offer a framework that aims to ensure that the needs and preferences of the patient community are included in the development of telehealth provision. Stakeholders in this process include patients, patient advocates, healthcare providers, healthcare services commissioners, managers, and policy makers. The framework outlines how patient advocates can work with other stakeholders as equal partners at all stages of telehealth service development. The patient advocate community has a unique understanding of the patient perspective as well as expertise in healthcare design and delivery. This enables advocates to contribute to shaping telehealth provision, from policy and guideline formulation to patient navigation. Appropriate resources, education and training may be needed for all stakeholders to support the development of an effective telehealth system. Together with other stakeholders, patient advocates can make an important contribution to optimizing appropriate patient-centred telehealth provision in cancer care.
Collapse
Affiliation(s)
| | | | | | | | - Marcia K. Horn
- ICAN, International Cancer Advocacy Network, Phoenix, AZ USA
| | - Linda U. Krebs
- International Society of Nurses in Cancer Care, Vancouver, BC Canada
| | | | - Kathy Oliver
- International Brain Tumour Alliance, Tadworth, Surrey UK
| | | |
Collapse
|
27
|
Kumar D, Gordon N, Zamani C, Sheehan T, Martin E, Egorova O, Payne J, Kolevska T, Neeman E, Liu R. Cancer Patients' Preferences and Perceptions of Advantages and Disadvantages of Telehealth Visits During the COVID-19 Pandemic. JCO Clin Cancer Inform 2023; 7:e2300040. [PMID: 37656925 PMCID: PMC10569768 DOI: 10.1200/cci.23.00040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 05/16/2023] [Accepted: 06/15/2023] [Indexed: 09/03/2023] Open
Abstract
PURPOSE We aimed to ascertain oncology patients' perceptions of telehealth versus in-person (IP) visits for different types of clinical encounters. METHODS We surveyed adults undergoing cancer treatment at Kaiser Permanente Northern California infusion centers between November 2021 and May 2022 using a self-administered questionnaire. Patients were asked about visit modality preferences (video, phone, and IP) for six types of clinical discussions, overall advantages and disadvantages of telehealth (video or phone) versus IP modalities, and barriers to video visit use. RESULTS The 839 patients who completed surveys in English were 63% female; median age 63 years; 64% White; and 73% college-educated (45% ≥bachelor's degree). For the first postdiagnosis discussion visit, 83% of patients preferred IP, followed by video (27%) and phone (18%). For follow-up visits, 52% of patients preferred IP, 50% video, and 37% phone. For discussions of bad news and sensitive topics, respectively, 68% and 62% preferred IP, 44% and 48% video, and 32% and 41% phone visits. Delivery of good news was acceptable through IP (49%), video (52%), or phone (49%) visits. Perceived advantages of IP visits were greater feelings of connection with their doctor (58%), confidence in physical examinations (73%), and ease in showing things (67%) and talking (51%) to the doctor. Advantages of telehealth visits included saved time (72%) and money (38%), less infection exposure (64%), less travel concerns (45%), and ability to include more people (28%). Of 24% of patients who felt video visits would be hard, 51% cited poor internet, 41% lack of an adequate device, and 28% difficulty signing on. CONCLUSION Our results support continued use and reimbursement for telehealth visits with patients with cancer for most types of clinical encounters, including clinical trials.
Collapse
Affiliation(s)
- Deepika Kumar
- Department of Hematology-Oncology, The Permanente Medical Group (TPMG), San Francisco, CA
| | - Nancy Gordon
- Division of Research, Kaiser Permanente Northern California, San Francisco, CA
| | - Constanza Zamani
- Department of Hematology-Oncology, The Permanente Medical Group (TPMG), San Francisco, CA
| | - Tammy Sheehan
- Division of Research, Kaiser Permanente Northern California, San Francisco, CA
| | | | - Olga Egorova
- Department of Hematology-Oncology, The Permanente Medical Group (TPMG), San Francisco, CA
| | - Jessica Payne
- Department of Hematology-Oncology, The Permanente Medical Group (TPMG), San Francisco, CA
| | - Tatjana Kolevska
- Department of Hematology-Oncology, The Permanente Medical Group (TPMG), San Francisco, CA
| | - Elad Neeman
- Department of Hematology-Oncology, The Permanente Medical Group (TPMG), San Francisco, CA
| | - Raymond Liu
- Department of Hematology-Oncology, The Permanente Medical Group (TPMG), San Francisco, CA
- Division of Research, Kaiser Permanente Northern California, San Francisco, CA
| |
Collapse
|
28
|
Quinn M, Wright N, Scherdt M, Barton DL, Titler M, Armin JS, Naughton MJ, Wenzel J, Percac-Lima S, Mishra P, Danner SM, Friese CR. A descriptive study of policy and system-level interventions to address cancer survivorship issues across six United States health systems. J Cancer Surviv 2023:10.1007/s11764-023-01440-y. [PMID: 37544977 DOI: 10.1007/s11764-023-01440-y] [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: 04/25/2023] [Accepted: 07/26/2023] [Indexed: 08/08/2023]
Abstract
PURPOSE To describe policy and system-level interventions with potential to improve cancer care at six sites. METHODS In 2016, six institutions received foundation support to develop unique multi-component interventions aimed at improving cancer care for underserved populations. These organizations, located across the United States, participated in a cross-site evaluation to assess the overall initiative impact and to identify potentially promising policy and system-level solutions for dissemination and broader implementation. A health system and policy tracking tool was developed to collect data from each site and included a description of their efforts, strategies employed, and changes achieved (e.g., new policies, clinical protocols). Tracking tool data were analyzed using rapid qualitative analyses and a matrix approach. Semi-structured interviews were conducted with site leaders (N = 65) and were analyzed by thematic analysis. RESULTS Sites reported 20 system and policy efforts, which resulted in improvements to electronic health records and telehealth strategies, changes to hospital/health system policies, and standardized clinical protocols/guidelines, among others. Efforts were aimed at: (1) coordinating care across multiple providers, supported by patient navigators; (2) expanding psychosocial and supportive care; (3) improving patient-provider communication; and (4) addressing barriers to accessing care. Interview analyses provided insights into successful strategies, challenges, and implications of the COVID-19 pandemic on cancer care. CONCLUSIONS AND IMPLICATIONS FOR CANCER SURVIVORS Despite advances in diagnosis and treatment, cancer care remains inequitable. System-level improvements aimed at eliminating common barriers faced by underserved populations offer opportunities to improve the delivery of equitable, effective, and efficient care.
Collapse
Affiliation(s)
- Martha Quinn
- School of Public Health, University of Michigan, Ann Arbor, MI, 48109, USA.
| | - Nathan Wright
- School of Nursing, University of Michigan, Ann Arbor, MI, 48109, USA
| | - Marylee Scherdt
- School of Nursing, University of Michigan, Ann Arbor, MI, 48109, USA
| | - Debra L Barton
- School of Nursing, University of Michigan, Ann Arbor, MI, 48109, USA
| | - Marita Titler
- School of Nursing, University of Michigan, Ann Arbor, MI, 48109, USA
| | - Julie S Armin
- College of Medicine, The University of Arizona, Tucson, AZ, 85711, USA
| | | | - Jennifer Wenzel
- Schools of Nursing and Medicine, Johns Hopkins University, Baltimore, MD, 21205, USA
| | | | | | - Sankirtana M Danner
- Northwestern University Feinberg School of Medicine, Chicago, IL, 60611, USA
| | - Christopher R Friese
- School of Public Health, University of Michigan, Ann Arbor, MI, 48109, USA
- School of Nursing, University of Michigan, Ann Arbor, MI, 48109, USA
- Rogel Cancer Center, University of Michigan, Ann Arbor, MI, 48109, USA
| |
Collapse
|
29
|
Chen LW, Usinger DS, Katz AJ. Telehealth use and perceptions among prostate cancer survivors. Cancer Med 2023; 12:17308-17312. [PMID: 37455582 PMCID: PMC10501258 DOI: 10.1002/cam4.6328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 05/30/2023] [Accepted: 07/02/2023] [Indexed: 07/18/2023] Open
Abstract
BACKGROUND Reasons underlying disparities in telehealth use among cancer survivors are unknown. METHODS We surveyed a sociodemographically diverse population-based cohort of 487 prostate cancer survivors regarding their use and perceptions of telehealth during the COVID-19 pandemic. RESULTS Overall, only 28.5% of survivors had used telehealth at the time of survey and just 10% felt care through telehealth is comparable to that of an in-person visit. Still, over 55% felt telehealth is a good option for initial consultations or basic care and 15% felt more likely to use telehealth since the pandemic. After adjusting for other socioeconomic factors, survivors with lower education (≤high school vs. any college) had marginally lower use of telehealth (risk ratio [RR], 0.65 [95% CI, 0.42-1.01]) and lower probability of feeling more likely to use telehealth since the pandemic (RR, 0.39 [95% CI, 0.20-0.77]). CONCLUSIONS Differences in survivor perceptions of telehealth by education level highlight new insights underlying disparities in telehealth use and potential targets for interventions.
Collapse
Affiliation(s)
- Luke W. Chen
- Department of Radiation OncologyUniversity of Kansas Cancer CenterKansas CityKansasUSA
| | - Deborah S. Usinger
- Lineberger Comprehensive Cancer CenterUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
| | - Aaron J. Katz
- Department of Radiation OncologyUniversity of Kansas Cancer CenterKansas CityKansasUSA
- Department of Population HealthUniversity of Kansas Medical CenterKansas CityKansasUSA
| |
Collapse
|
30
|
Ruda-Santolaria L, Bergerot C, Hernandez J, Pena C, Montana MF, Galindo-Vazquez O, Torres-Blasco N, Castro-Figueroa E, Esenarro L, Sanchez-Ramirez JC, Estapé T, Gany F, Costas-Muniz R. Use of telehealth for psychosocial oncology: A mixed methods study about barriers to and opportunities with Latino patients from Latin America, Spain, and the United States. Psychooncology 2023; 32:1289-1297. [PMID: 37370195 PMCID: PMC11289857 DOI: 10.1002/pon.6182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Revised: 06/08/2023] [Accepted: 06/11/2023] [Indexed: 06/29/2023]
Abstract
OBJECTIVES Telehealth for mental healthcare expanded rapidly with the COVID-19 pandemic's onset; however, global access disparities emerged. Telehealth challenges and opportunities for Latino cancer patients from different geographical regions must be explored. METHODS A cross-sectional online survey (March-July 2021) of mental health providers, serving Latino cancer patients in Latin America, United States, and Spain, contained close-ended questions related to the use of telehealth during the pandemic and open-ended questions on recommending/not recommending telehealth. RESULTS In a sample of 148 providers from 21 countries, 60.5% reported that at least some of their patients had difficulties with Internet speed and connectivity and lacked knowledge about using electronic devices (43.2%) or the Internet (45.4%). Lacking privacy at home (66.0%) and childcare (26.0%) were reported patient challenges. Internet connectivity or speed were issues for providers (43.2%) themselves. Improving patient reach was a reported telehealth benefit (64.2%). Geographical access (43.2%) and physical limitations (35.8%) were considerations in offering telehealth. Considerations for not recommending telehealth were patient age (24.3%) and lacking technological knowledge (29.1%). CONCLUSIONS Telehealth for mental healthcare may improve patient access issues caused by geographical and transportation conditions and patient functionality. Findings provide insight into telehealth benefits and challenges in Latino patient populations. Future studies should examine patient access and use by region.
Collapse
Affiliation(s)
| | - Cristiane Bergerot
- Centro de Cancer de Brasilia, Instituto Unity de Ensino e Pesquisa, Brasilia, DF, Brazil
| | | | - Cristina Pena
- Ponce Research Institute, Ponce Health Sciences University, Ponce, Puerto Rico
- School of Medicine and School of Behavioral and Brain Sciences, Ponce Research Institute, Ponce Health Sciences University, Ponce, Puerto Rico
| | | | | | - Normarie Torres-Blasco
- Ponce Research Institute, Ponce Health Sciences University, Ponce, Puerto Rico
- School of Medicine and School of Behavioral and Brain Sciences, Ponce Research Institute, Ponce Health Sciences University, Ponce, Puerto Rico
| | - Eida Castro-Figueroa
- Ponce Research Institute, Ponce Health Sciences University, Ponce, Puerto Rico
- School of Medicine and School of Behavioral and Brain Sciences, Ponce Research Institute, Ponce Health Sciences University, Ponce, Puerto Rico
| | - Loida Esenarro
- Instituto Nacional de Salud, Lima, Perú
- Universidad de Lima, Lima, Perú
| | | | | | - Francesca Gany
- Department of Psychiatry & Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, New York, USA
- Department of Psychiatry, Weill Cornell Medical College, New York, New York, USA
| | - Rosario Costas-Muniz
- Department of Psychiatry & Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, New York, USA
- Department of Psychiatry, Weill Cornell Medical College, New York, New York, USA
| |
Collapse
|
31
|
Elder AJ, Alazawi H, Shafaq F, Ayyad A, Hazin R. Teleoncology: Novel Approaches for Improving Cancer Care in North America. Cureus 2023; 15:e43562. [PMID: 37719501 PMCID: PMC10502915 DOI: 10.7759/cureus.43562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/16/2023] [Indexed: 09/19/2023] Open
Abstract
Due to widespread healthcare workforce shortages, many patients living in remote and rural North America currently have reduced access to various medical specialists. These shortages, coupled with the aging North American population, highlight the need to transform contemporary healthcare delivery systems. The exchange of medical information via telecommunication technology, known as telemedicine, offers promising solutions to address the medical needs of an aging population and the increased demand for specialty medical services. This progressive movement has also improved access to quality health care by mitigating the current shortage of trained subspecialists. Minimizing the effects of these shortages is particularly urgent in the care of cancer patients, many of whom require regular follow-up and close monitoring. Cancer patients living in remote areas of North America have reduced access to specialized care and, thus, have unacceptably high mortality and morbidity rates. Teleoncology, or the use of telemedicine to provide oncology services remotely, has the ability to improve access to high-quality care and assist in alleviating the burden of some of the severe adverse events associated with cancer. In this review, the authors describe how recent advances in teleoncology can reduce healthcare disparities and improve future cancer care in North America.
Collapse
Affiliation(s)
- Adam J Elder
- Department of Medical Education, Wayne State University School of Medicine, Detroit, USA
| | - Hussein Alazawi
- Department of Medical Education, Michigan State University College of Osteopathic Medicine, East Lansing, USA
| | - Fareshta Shafaq
- Department of Medical Education, American University of the Caribbean, Cupecoy, SXM
| | - Adam Ayyad
- Department of Medical Education, Ross University School of Medicine, Bridgetown, BRB
| | - Ribhi Hazin
- Department of Internal Medicine, Wayne State University School of Medicine, Detroit, USA
| |
Collapse
|
32
|
Tsagkaris C, Trygonis N, Spyrou V, Koulouris A. Telemedicine in Care of Sarcoma Patients beyond the COVID-19 Pandemic: Challenges and Opportunities. Cancers (Basel) 2023; 15:3700. [PMID: 37509361 PMCID: PMC10378403 DOI: 10.3390/cancers15143700] [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: 06/14/2023] [Revised: 07/15/2023] [Accepted: 07/17/2023] [Indexed: 07/30/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic has created a challenging environment for sarcoma patients. Most oncology societies published guidelines or recommendations prioritizing sarcoma patients and established telehealth as an efficient method of approaching them. The aim of this review is the assessment of current evidence regarding the utilization of telemedicine in diagnosis, treatment modalities, telerehabilitation and satisfaction among sarcoma patients and healthcare providers (HP). METHODS This systematic review was carried out using the databases PubMed and Ovid MEDLINE according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). RESULTS The application of telemedicine to the management of sarcoma has yielded improved clinical and psychological outcomes. Specifically, significant progress has been demonstrated in the areas of tele-oncology and telerehabilitation during the last decade, and the COVID-19 outbreak has accelerated this transition toward them. Telehealth has been proven efficient in a wide spectrum of applications from consultations on physical therapy and psychological support to virtual care symptom management. Both HP and patients reported satisfaction with telehealth services at levels comparable to in-person visits. CONCLUSIONS Telehealth has already unveiled many opportunities in tailoring individualized care, and its role in the management of sarcoma patients has been established in the post-COVID-19 era, as well.
Collapse
Affiliation(s)
- Christos Tsagkaris
- European Student Think Tank, Public Health and Policy Working Group, 1058 DE Amsterdam, The Netherlands
| | - Nikolaos Trygonis
- Department of Orthopaedics, University Hospital of Heraklion, 70013 Heraklion, Greece
| | - Vasiliki Spyrou
- Post Covid Department, Theme Female Health, Karolinska University Hospital, 14157 Stockholm, Sweden
| | - Andreas Koulouris
- Department of Oncology-Pathology, Karolinska Institute, 17176 Stockholm, Sweden
- Thoracic Oncology Center, Theme Cancer, Karolinska University Hospital, 17177 Stockholm, Sweden
- Faculty of Medicine, University of Crete, 70013 Heraklion, Greece
| |
Collapse
|
33
|
Yap ET, Tan CL, Dumago MP, Jacomina LE, Yu KKL, Tapispisan JAR, Agas RAF, Co JL, Bacorro WR, Mejia MA, Sy Ortin TT. Teleconsultation Perceptions of Medical and Radiation Oncologists in the COVID-19 and Post-COVID-19 Era: A National Survey in the Philippines. JCO Glob Oncol 2023; 9:e2200370. [PMID: 37348036 PMCID: PMC10497274 DOI: 10.1200/go.22.00370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2022] [Revised: 04/01/2023] [Accepted: 05/09/2023] [Indexed: 06/24/2023] Open
Abstract
PURPOSE The study reports on the current perception of medical and radiation oncologists regarding teleconsultation in the Philippines. Before the COVID-19 pandemic, the adoption of telemedicine was not widespread. With movement restrictions imposed during the pandemic, physicians were compelled to use telemedicine. It is uncertain whether physicians will still adopt its use in practice in the post-COVID-19 era. This study gives insight into the possible adaptation of this mode of consultation in the future, especially in areas with limited health care resources. MATERIALS AND METHODS We conducted a national survey among medical oncologists and radiation oncologists in the Philippines. A 43-item online survey was developed, validated, and administered to the oncologists. The demographics and data from categorical questions were reported as frequencies and percentages. RESULTS A total of 142 responses were gathered from 82 medical oncologists and 60 radiation oncologists. There was agreement among participants that, during the pandemic, teleconsultation could be used for the first visit, diagnostic workup request, treatment explanation, follow-up care, and chronic disease management. There was disagreement whether cancer diagnosis disclosure and cancer prognosis revelation could be performed via teleconsultation, and there was agreement that emergency consultation and physical examination would warrant a face-to-face consultation. After the COVID-19 pandemic, 78.7% intend to continue using teleconsultation except for emergency consultations, first visits, physical examination, diagnosis disclosure, and cancer prognosis revelation. CONCLUSION Teleconsultation was perceived by oncologists as an acceptable method of providing cancer care during and after the COVID-19 pandemic. Oncologists also intend to use teleconsultation in the post-COVID-19 era in certain aspects of patient care.
Collapse
Affiliation(s)
- Eugene T. Yap
- Department of Radiation Oncology, Benavides Cancer Institute, University of Santo Tomas Hospital, Manila, Philippines
| | - Charmaine L. Tan
- Department of Medical Oncology, Benavides Cancer Institute, University of Santo Tomas Hospital, Manila, Philippines
| | - Mark P. Dumago
- Department of Radiation Oncology, Benavides Cancer Institute, University of Santo Tomas Hospital, Manila, Philippines
| | - Luisa E. Jacomina
- Department of Radiation Oncology, Benavides Cancer Institute, University of Santo Tomas Hospital, Manila, Philippines
| | - Kelvin Ken L. Yu
- Department of Radiation Oncology, Benavides Cancer Institute, University of Santo Tomas Hospital, Manila, Philippines
| | - Julie Ann R. Tapispisan
- Department of Medical Oncology, Benavides Cancer Institute, University of Santo Tomas Hospital, Manila, Philippines
| | - Ryan Anthony F. Agas
- Department of Radiation Oncology, Benavides Cancer Institute, University of Santo Tomas Hospital, Manila, Philippines
| | - Jayson L. Co
- Department of Radiation Oncology, Benavides Cancer Institute, University of Santo Tomas Hospital, Manila, Philippines
| | - Warren R. Bacorro
- Department of Radiation Oncology, Benavides Cancer Institute, University of Santo Tomas Hospital, Manila, Philippines
| | - Michael A. Mejia
- Department of Radiation Oncology, Benavides Cancer Institute, University of Santo Tomas Hospital, Manila, Philippines
| | - Teresa T. Sy Ortin
- Department of Radiation Oncology, Benavides Cancer Institute, University of Santo Tomas Hospital, Manila, Philippines
| |
Collapse
|
34
|
Yu S, Wan R, Bai L, Zhao B, Jiang Q, Jiang J, Li Y. Transformation of chronic disease management: Before and after the COVID-19 outbreak. Front Public Health 2023; 11:1074364. [PMID: 37064686 PMCID: PMC10090362 DOI: 10.3389/fpubh.2023.1074364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 03/10/2023] [Indexed: 03/31/2023] Open
Abstract
Adults with chronic diseases often experience a decline in their quality of life along with frequent exacerbations. These diseases can cause anxiety and impose a significant economic burden. Self-management is a crucial aspect of treatment outside of the hospital and can improve quality of life and reduce the financial burden resulting from unexpected hospitalizations. With the COVID-19 pandemic, telehealth has become a vital tool for both medical professionals and patients; many in-person appointments have been canceled due to the pandemic, leading to increased reliance on online resources. This article aimed to discuss various methods of chronic disease management, both traditional self-management and modern telehealth strategies, comparing before and after the COVID-19 outbreak and highlighting challenges that have emerged.
Collapse
Affiliation(s)
- Steven Yu
- Department of Respiratory Medicine, National Key Clinical Specialty, Branch of National Clinical Research Center for Respiratory Disease, Xiangya Hospital, Central South University, Changsha, China
- Center of Respiratory Medicine, Xiangya Hospital, Central South University, Changsha, China
- Clinical Research Center for Respiratory Diseases in Hunan Province, Changsha, China
- Hunan Engineering Research Center for Intelligent Diagnosis and Treatment of Respiratory Disease, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Changsha, China
| | - Rongjun Wan
- Department of Respiratory Medicine, National Key Clinical Specialty, Branch of National Clinical Research Center for Respiratory Disease, Xiangya Hospital, Central South University, Changsha, China
- Center of Respiratory Medicine, Xiangya Hospital, Central South University, Changsha, China
- Clinical Research Center for Respiratory Diseases in Hunan Province, Changsha, China
- Hunan Engineering Research Center for Intelligent Diagnosis and Treatment of Respiratory Disease, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Changsha, China
| | - Lu Bai
- Department of Respiratory Medicine, National Key Clinical Specialty, Branch of National Clinical Research Center for Respiratory Disease, Xiangya Hospital, Central South University, Changsha, China
- Center of Respiratory Medicine, Xiangya Hospital, Central South University, Changsha, China
- Clinical Research Center for Respiratory Diseases in Hunan Province, Changsha, China
- Hunan Engineering Research Center for Intelligent Diagnosis and Treatment of Respiratory Disease, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Changsha, China
| | - Bingrong Zhao
- Department of Respiratory Medicine, National Key Clinical Specialty, Branch of National Clinical Research Center for Respiratory Disease, Xiangya Hospital, Central South University, Changsha, China
- Center of Respiratory Medicine, Xiangya Hospital, Central South University, Changsha, China
- Clinical Research Center for Respiratory Diseases in Hunan Province, Changsha, China
- Hunan Engineering Research Center for Intelligent Diagnosis and Treatment of Respiratory Disease, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Changsha, China
| | - Qiaoling Jiang
- Department of Respiratory Medicine, National Key Clinical Specialty, Branch of National Clinical Research Center for Respiratory Disease, Xiangya Hospital, Central South University, Changsha, China
- Center of Respiratory Medicine, Xiangya Hospital, Central South University, Changsha, China
- Clinical Research Center for Respiratory Diseases in Hunan Province, Changsha, China
- Hunan Engineering Research Center for Intelligent Diagnosis and Treatment of Respiratory Disease, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Changsha, China
| | - Juan Jiang
- Department of Respiratory Medicine, National Key Clinical Specialty, Branch of National Clinical Research Center for Respiratory Disease, Xiangya Hospital, Central South University, Changsha, China
- Center of Respiratory Medicine, Xiangya Hospital, Central South University, Changsha, China
- Clinical Research Center for Respiratory Diseases in Hunan Province, Changsha, China
- Hunan Engineering Research Center for Intelligent Diagnosis and Treatment of Respiratory Disease, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Changsha, China
- Juan Jiang,
| | - Yuanyuan Li
- Department of Respiratory Medicine, National Key Clinical Specialty, Branch of National Clinical Research Center for Respiratory Disease, Xiangya Hospital, Central South University, Changsha, China
- Center of Respiratory Medicine, Xiangya Hospital, Central South University, Changsha, China
- Clinical Research Center for Respiratory Diseases in Hunan Province, Changsha, China
- Hunan Engineering Research Center for Intelligent Diagnosis and Treatment of Respiratory Disease, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Changsha, China
- *Correspondence: Yuanyuan Li,
| |
Collapse
|
35
|
Benson AB, Boehmer L, Mi X, Kocherginsky M, Shivakumar L, Trosman JR, Weldon CB, Tina Shih YC, Hahn EA, Kircher SM. Resource and Reimbursement Barriers to Comprehensive Cancer Care Delivery: An Analysis of Association of Community Cancer Centers Survey Data. JCO Oncol Pract 2023; 19:e428-e438. [PMID: 36521094 PMCID: PMC10530592 DOI: 10.1200/op.22.00417] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 08/30/2022] [Accepted: 10/31/2022] [Indexed: 12/23/2022] Open
Abstract
PURPOSE Comprehensive cancer care (CCC) delivery is recommended in guidelines and considered essential for high-quality cancer management. Barriers, such as insufficient reimbursement, prevent consistent access to and delivery of CCC. Association of Community Cancer Centers conducted a national survey to elucidate capacity and barriers to CCC delivery to inform policy and value-based payment reform. METHODS Survey methodology included item generation with expert review, iterative piloting, and cognitive validity testing. In the final instrument, 27 supportive oncology services were assessed for availability, reasons not offered, and coverage/reimbursement. RESULTS 204 of 704 member programs completed survey questions. Despite most services being reported as offered, a minority were funded through insurance reimbursement. The services least likely to obtain reimbursement were those that address practical and family/childcare needs (0.7%), caregiver support (1.5%), advanced care directives (1.7%), spiritual services (1.8%), and navigation (2.7%). These findings did not vary by region or practice type. CONCLUSION There is a lack of sufficient reimbursement, staffing, and budget to provide CCC across the United States. Care models and reimbursement policies must include CCC services to optimize delivery of cancer care.
Collapse
Affiliation(s)
- Al Bowen Benson
- Northwestern Medicine, Chicago, IL
- Robert H. Lurie Comprehensive Cancer Center of Northwestern University, Chicago, IL
| | - Leigh Boehmer
- Association of Community Cancer Centers, Rockville, MD
| | - Xinlei Mi
- Robert H. Lurie Comprehensive Cancer Center of Northwestern University, Chicago, IL
| | - Masha Kocherginsky
- Robert H. Lurie Comprehensive Cancer Center of Northwestern University, Chicago, IL
| | | | | | | | - Ya-Chen Tina Shih
- Department of Health Services Research, University of Texas MD Anderson Cancer Center, Houston, TX
| | - Elizabeth A. Hahn
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Sheetal M. Kircher
- Northwestern Medicine, Chicago, IL
- Robert H. Lurie Comprehensive Cancer Center of Northwestern University, Chicago, IL
| |
Collapse
|
36
|
Paterson C. Leadership in Cancer Care: Introduction. Semin Oncol Nurs 2023; 39:151359. [PMID: 36411125 PMCID: PMC9673167 DOI: 10.1016/j.soncn.2022.151359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- Catherine Paterson
- Professor of Cancer Nursing, Faculty of Health, School of Nursing, Midwifery & Public Health, University of Canberra, ACT, Australia; Professor of Cancer Nursing, SYNERGY Nursing & Midwifery Research Centre, ACT Health Directorate, Canberra, ACT, Australia; Professor of Cancer Nursing, School of Nursing, Midwifery and Paramedic Practice, Robert Gordon University, Garthdee, Aberdeen, Scotland; Professor of Cancer Nursing, Prehabilitation, Activity, Cancer, Exercise and Survivorship (PACES) Research group, University of Canberra, Canberra, ACT, Australia.
| |
Collapse
|
37
|
De Ravin E, Armache M, Campbell F, Rising KL, Worster B, Handley NR, Fundakowski CE, Cognetti DM, Mady LJ. Feasibility and Cost of Telehealth Head and Neck Cancer Survivorship Care: A Systematic Review. Otolaryngol Head Neck Surg 2023; 168:1312-1323. [PMID: 36939546 DOI: 10.1002/ohn.213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 10/28/2022] [Accepted: 11/12/2022] [Indexed: 01/30/2023]
Abstract
OBJECTIVE Evaluate the feasibility and cost-effectiveness of telehealth head and neck cancer (HNC) survivorship care. DATA SOURCES Ovid MEDLINE, Embase, Scopus, CINAHL. REVIEW METHODS A systematic search for peer-reviewed feasibility studies on telehealth models for HNC survivorship care published between 2005 and 2021 was conducted using the terms "head and neck cancer" and "telehealth" and their synonyms. Inclusion criteria were studies on telehealth survivorship program interventions for HNC patients with quantitative feasibility outcome measures (eg, enrollment, retention, attrition/dropout rate, adherence/task completion rate, patient satisfaction, cost). RESULTS Thirty-eight studies out of 1557 identified met inclusion criteria and were included for analysis. Feasibility outcomes evaluated were enrollment and attrition rates, adherence/task completion rates, patient satisfaction, and user feedback surveys in different survivorship domains. Patient enrollment ranged from 20.8% to 85.7%, while attrition ranged from 7% to 47.7%. Overall, adherence was 30.2% higher in the intervention group than in the control group (46.8% vs 16.6%). Studies with cost analysis found telehealth models of care to be statistically significantly less expensive and more cost-efficient than the standard model of care, with a $642.30 saving per patient (n = 3). Telehealth models also substantially reduced work time saving per visit (on average, 7 days per visit). CONCLUSION While telehealth survivorship programs are feasible and cost-effective and are associated with improved patient outcomes, they might not be ideal for every patient. Further investigations are needed to understand the role of telehealth in survivorship care, given the variability in study design, reporting, measures, and methodological quality.
Collapse
Affiliation(s)
- Emma De Ravin
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania, Philadelphia, Pennsylvania, USA.,Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Maria Armache
- Department of Otolaryngology-Head and Neck Surgery, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Frank Campbell
- Penn Libraries, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Kristin L Rising
- Jefferson Center for Connected Care, Thomas Jefferson University, Philadelphia, Pennsylvania, USA.,Department of Emergency Medicine, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Brooke Worster
- Department of Hospice and Palliative Care, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Nathan R Handley
- Department of Medical Oncology, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Christopher E Fundakowski
- Department of Otolaryngology-Head and Neck Surgery, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - David M Cognetti
- Department of Otolaryngology-Head and Neck Surgery, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Leila J Mady
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| |
Collapse
|
38
|
Cramb SM, Whop LJ, Garvey G, Baade PD. Cancer survival differentials for Aboriginal and Torres Strait Islander peoples in Queensland: the impact of remoteness. Cancer Causes Control 2023; 34:13-22. [PMID: 36266522 PMCID: PMC9816203 DOI: 10.1007/s10552-022-01643-1] [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: 03/27/2022] [Accepted: 10/05/2022] [Indexed: 01/11/2023]
Abstract
PURPOSE In Australia, Aboriginal and Torres Strait Islander peoples (First Nations population) often have low overall cancer survival, as do all residents of geographically remote areas. This study aimed to quantify the survival disparity between First Nations and other Queenslanders for 12 common cancer types by remoteness areas. METHODS For all Queensland residents aged 20-89 years diagnosed with a primary invasive cancer during 1997-2016, we ran flexible parametric survival models incorporating age, First Nations status, sex, diagnosis time period, area-level socioeconomic status, remoteness categories and where appropriate, broad cancer type. Three survival measures were predicted: cause-specific survival, survival differences and the comparative survival ratio, each standardised to First Nations peoples' covariate distributions. RESULTS The standardised five-year cause-specific cancer survival was 60% for urban First Nations and 65% for other Queenslanders, while remote residents were 54% (First Nations) and 58% (other). The absolute survival differential between First Nations and other Queenslanders was often similar, regardless of remoteness of residence. The greatest absolute difference in five-year standardised cancer survival was for head and neck cancers, followed by cervical cancer. The five-year comparative survival ratio (First Nations: other Queenslanders) for urban cancer patients was 0.91 (95% CI 0.90-0.93), similar to outer regional, inner regional and remote areas. The greatest comparative survival differential was for oesophageal cancer. CONCLUSION First Nations' survival inequalities are largely independent of geographical remoteness. It remains a priority to determine the contribution of other potential factors such as the availability of culturally acceptable diagnostic, management and/or support services.
Collapse
Affiliation(s)
- S. M. Cramb
- Australian Centre for Health Services Innovation & Centre for Healthcare Transformation, Queensland University of Technology, Brisbane, QLD Australia ,School of Public Health and Social Work, Queensland University of Technology, Brisbane, QLD Australia ,Centre for Data Science, Queensland University of Technology, Brisbane, QLD Australia
| | - L. J. Whop
- National Centre for Epidemiology and Population Health, Australian National University, Canberra, ACT Australia
| | - G. Garvey
- School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, QLD Australia
| | - P. D. Baade
- Cancer Council Queensland, Brisbane, QLD Australia ,School of Mathematical Sciences, Queensland University of Technology, Brisbane, QLD Australia ,Menzies Institute of Health Research, Griffith University, Gold Coast, QLD Australia
| |
Collapse
|
39
|
Nelson D, Cooke S, McLeod B, Nanyonjo A, Kane R, Gussy M. A Rapid Systematic Review on the Experiences of Cancer Survivors Residing in Rural Areas during the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16863. [PMID: 36554740 PMCID: PMC9778689 DOI: 10.3390/ijerph192416863] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 12/01/2022] [Accepted: 12/13/2022] [Indexed: 06/17/2023]
Abstract
The COVID-19 pandemic has caused considerable disruption to cancer care and may have exacerbated existing challenges already faced by cancer survivors from rural areas. This has created a need for a rapid evidence synthesis to inform the development of tailored interventions that address the specific needs of rural cancer survivors who continue to be affected by the pandemic. The review was conducted following guidance from the Cochrane Rapid Review Methods Group. Database searches were performed via the EBSCOHost interface (includes MEDLINE, CINAHL, PsycINFO) on 25 May 2022 and supplemented with searches on Google Scholar. Peer-reviewed articles published after March 2020 that reported primary data on the experiences of cancer survivors residing in rural and remote settings during the pandemic were included. Findings were tabulated and written up narratively. Fourteen studies were included. The COVID-19 pandemic had a mostly detrimental impact on the experiences of rural cancer survivors. People's individual coping mechanisms were challenging for a range of reasons. Specifically, the pandemic impacted on their ability to access testing, treatment, check-ups and supportive care, their ability to maintain and access social support with close friends and family, as well as negative consequences to their finances and emotional wellbeing with some reporting feelings of psychological distress including depression and anxiety. This review provides important insight into the experiences of rural cancer survivors that may help inform tailored support in line with the needs and challenges faced because of the pandemic.
Collapse
Affiliation(s)
- David Nelson
- Lincoln International Institute for Rural Health, University of Lincoln, Brayford Pool, Lincoln LN6 7TS, UK
- Macmillan Cancer Support, London SE1 7UQ, UK
| | - Samuel Cooke
- School of Health and Social Care, College of Social Science, University of Lincoln, Brayford Pool, Lincoln LN6 7TS, UK
| | - Ben McLeod
- Lincoln Medical School, College of Science, University of Nottingham and University of Lincoln, Lincoln LN6 7TS, UK
| | - Agnes Nanyonjo
- Lincoln International Institute for Rural Health, University of Lincoln, Brayford Pool, Lincoln LN6 7TS, UK
| | - Ros Kane
- School of Health and Social Care, College of Social Science, University of Lincoln, Brayford Pool, Lincoln LN6 7TS, UK
| | - Mark Gussy
- Lincoln International Institute for Rural Health, University of Lincoln, Brayford Pool, Lincoln LN6 7TS, UK
- La Trobe Rural Health School, College of Science, Health and Engineering, La Trobe University, Bendigo, VIC 3086, Australia
| |
Collapse
|
40
|
Narvaez RA, Canaria A, Nifras SR, Listones N, Topacio R, Baua ME. The role of telehealth on quality of life of palliative care patients during the COVID-19 pandemic: an integrative review. Int J Palliat Nurs 2022; 28:583-589. [DOI: 10.12968/ijpn.2022.28.12.583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Telehealth looks to be a viable tool to meet patients’ expectations and requirements during home treatment; however, there are obstacles to overcome. Palliative care has been described as ‘high touch’ rather than ‘high tech’, which may restrict healthcare workers’ enthusiasm in integrating technological advances into the development and refinement of interventions. As a result, the goal of this integrative review was to map and evaluate existing research on the use of telemedicine and telehealth in palliative care patients during the COVID-19 outbreak. This review was guided using the PRISMA Model and CASP guidelines. A total of 17 articles on the use of telehealth in palliative care satisfied the inclusion and exclusion criteria of the review. This integrative review provided more evidence for the function and application of telehealth in palliative care. It demonstrated the resiliency of individuals in swiftly adjusting to a new system or application and the adaptability of healthcare systems and providers in establishing an alternate means of providing treatment to patients during a crisis.
Collapse
|
41
|
Specchia ML, Di Pilla A, Gambacorta MA, Filippella A, Beccia F, Farina S, Meldolesi E, Lanza C, Bellantone RDA, Valentini V, Tortora G. An IT Platform Supporting Rectal Cancer Tumor Board Activities: Implementation Process and Impact Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15808. [PMID: 36497903 PMCID: PMC9736877 DOI: 10.3390/ijerph192315808] [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: 10/03/2022] [Revised: 11/22/2022] [Accepted: 11/25/2022] [Indexed: 06/17/2023]
Abstract
Colorectal cancer (RC) is the third most common cancer, with an increasing incidence in recent years. Digital health solutions supporting multidisciplinary tumor boards (MTBs) could improve positive outcomes for RC patients. This paper describes the implementation process of a digital solution within the RC-MTB and its impact analysis in the context of the Fondazione Policlinico 'A. Gemelli' in Italy. Adopting a two-phase methodological approach, the first phase qualitatively describes each phase of the implementation of the IT platform, while the second phase quantitatively describes the analysis of the impact of the IT platform. Descriptive and inferential analyses were performed for all variables, with a p-value < 0.05 being considered statistically significant. The implementation of the platform allowed more healthcare professionals to attend meetings and resulted in a decrease in patients sent to the RC-MTB for re-staging and further diagnostic investigations and an increase in patients sent to the RC-MTB for treatment strategies. The results could be attributed to the facilitated access to the platform remotely for specialists, partly compensating for the restrictions imposed by the COVID-19 pandemic, as well as to the integration of the platform into the hospital's IT system. Furthermore, the early involvement of healthcare professionals in the process of customizing the platform to the specific needs of the RC-MTB may have facilitated its use and contributed to the encouraging quantitative results.
Collapse
Affiliation(s)
- Maria Lucia Specchia
- Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
- Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Andrea Di Pilla
- Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
- Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Maria Antonietta Gambacorta
- Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
- Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Alessandro Filippella
- Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Flavia Beccia
- Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Sara Farina
- Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Elisa Meldolesi
- Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
| | - Chiara Lanza
- Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
| | - Rocco Domenico Alfonso Bellantone
- Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
- Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Vincenzo Valentini
- Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
- Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Giampaolo Tortora
- Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
- Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| |
Collapse
|
42
|
Lee Y, Kim SK, Yoon H, Choi J, Go Y, Park GW. Smart glasses and telehealth services by professionals in isolated areas in Korea: Acceptability and concerns. Technol Health Care 2022; 31:855-865. [PMID: 36442222 DOI: 10.3233/thc-220242] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND: Smart glass technology offers remote interaction between health professionals for telehealth, alleviating healthcare disparities in isolated areas. OBJECTIVE: To evaluate the professionals’ perceptions of smart glass technology as a tool for telehealth and distance learning. METHOD: This mixed-method study on health professionals in 10 different island areas in Korea involved participants experiencing a smart glass-based telehealth system using the scenario of clinical consultation with remote specialists. A group pre- and post-test design was used to examine the change in attitude and perceived importance among health professionals about using smart glasses in telehealth. RESULTS: Forty-seven participants completed both pre-and post-evaluation of smart glasses. A positive, statistically significant change in participants’ perceptions of smart glasses regarding their implications for telehealth and distance learning (p< 0.05) was found. Fifty-one health workers provided feedback on smart glasses, and a majority expressed their expectations of quality care with telehealth using advanced technology. The main concerns were patients’ privacy issues and inadequate technology for seamless application. CONCLUSION: The incorporation of smart glass technology offers great potential to enrich telehealth as well as distance learning for unskilled health professionals in isolated areas. Future studies are needed to increase efforts to secure a high level of acceptance for clinical consultation with remote specialists on this newly developed device.
Collapse
Affiliation(s)
- Youngho Lee
- Department of Computer Engineering, Mokpo National University, Muan, Korea
| | - Sun Kyung Kim
- Department of Nursing, Mokpo National University, Muan, Korea
- Department of Biomedicine, Health and Life Convergence Sciences, Mokpo National University, Muan, Korea
| | - Hyoseok Yoon
- Division of Computer Engineering, Hanshin University, Osan, Korea
| | - Jongmyung Choi
- Department of Computer Engineering, Mokpo National University, Muan, Korea
| | - Younghye Go
- Biomedical and Healthcare Research Institute, Mokpo National University, Muan, Korea
| | - Gun Woo Park
- MNU Disaster-Safety R&D Center, Mokpo National University, Muan, Korea
| |
Collapse
|
43
|
Hung DY, Rundall TG, Lee J, Khandel N, Shortell SM. Managing Through a Pandemic: A Daily Management System for COVID-19 Response and Recovery. J Healthc Manag 2022; 67:446-457. [PMID: 36350582 PMCID: PMC9640242 DOI: 10.1097/jhm-d-21-00319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
GOAL This study explored the use of a Lean daily management system (DMS) for COVID-19 response and recovery in U.S. hospitals and health systems. Originally developed in manufacturing, Lean is an evidence-based approach to quality and process improvement in healthcare. Although Lean has been studied in individual hospital units and outpatient practices, it has not been examined as a whole system response to crisis events. METHODS We conducted qualitative interviews with 46 executive leaders, clinical leaders, and frontline staff in four hospitals and health systems across the United States. We developed a semistructured interview guide to understand DMS implementation in these care delivery organizations. As interviews took place 6-8 months following the onset of the pandemic, a subset of our interview questions centered on DMS use to meet the demands of COVID-19. Based on a deductive approach to qualitative analysis, we identified clusters of themes that described how DMS facilitated rapid system response to the public health emergency. PRINCIPAL FINDINGS There were many important ways in which U.S. hospitals and health systems leveraged their DMS to address COVID-19 challenges. These included the use of tiered huddles to facilitate rapid communication, the creation of standard work for redeployed staff, and structured problem-solving to prioritize new areas for improvement. We also discovered ways that the pandemic itself affected DMS implementation in all organizations. COVID-19 universally created greater DMS visibility by opening lines of communication among leadership, strengthening measurement and accountability, and empowering staff to develop solutions at the front lines. Many lessons learned using DMS for crisis management will carry forward into COVID-19 recovery efforts. Lessons include expanding telehealth, reactivating incident command systems as needed, and efficiently coordinating resources amid potential future shortages. PRACTICAL APPLICATIONS Overall, the Lean DMS functioned as a robust property that enabled quick organizational response to unpredictable events. Our findings on the use of DMS are consistent with organizational resilience that emphasizes collective sense-making and awareness of incident status, team decision-making, and frequent interaction and coordination. These features of resilience are supported by DMS practices such as tiered huddles for rapid information dissemination and alignment across organizational hierarchies. When used in conjunction with plan-do-study-act methodology, huddles provide teams with enhanced feedback that strengthens their ability to make changes as needed. Moreover, gaps between work-as-imagined (how work should be done) and work-as-done (how work is actually done) may be exacerbated in the initial chaos of emergency events but can be minimized through the development of standard work protocols. As a facilitator of resilience, the Lean DMS may be used in a variety of challenging situations to ensure high standards of care.
Collapse
Affiliation(s)
- Dorothy Y. Hung
- School of Public Health, University of California at Berkeley, Berkeley, California
| | | | - Justin Lee
- School of Public Health, University of California at Berkeley
| | - Negeen Khandel
- School of Public Health, University of California at Berkeley
| | | |
Collapse
|
44
|
The unmet supportive care needs of people affected by cancer during the COVID-19 pandemic: an integrative review. J Cancer Surviv 2022:10.1007/s11764-022-01275-z. [DOI: 10.1007/s11764-022-01275-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Accepted: 10/07/2022] [Indexed: 10/31/2022]
Abstract
Abstract
Purpose
To critically synthesise evidence regarding the supportive care needs of those living with cancer during the COVID-19 pandemic.
Methods
An integrative systematic review followed a pre-registered protocol, reported according to the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) Guidelines. We searched three databases (CINAHL, MEDLINE, and APA PsycINFO) using keywords and included all qualitative, quantitative, and mixed methods studies irrespective of research design published between December 2019 and February 2022. All articles were double screened according to a pre-determined eligibility criterion with reference lists of the final included studies checked for further studies. The review process was managed using Covidence systematic review software. Data from the studies were extracted, methodological quality appraisal conducted, and a narrative synthesis conducted.
Results
Eighteen publications were included. The findings identified that individuals affected by cancer reported a range of physical, psychological, social, and health system unmet needs during the global pandemic. Unique to the pandemic itself, there was fear of the unknown of the longer-term impact that the pandemic would have on treatment outcomes, cancer care follow-up, and clinical service delays.
Conclusion
Many individuals living with cancer experienced unmet needs and distress throughout the different waves of the COVID-19 pandemic, irrespective of cancer type, stage, and demographic factors.
Implications for Cancer Survivors
We recommend clinicians use these findings to identify the individual person-centred needs to optimise recovery as we transition to the post-pandemic cancer care.
Collapse
|
45
|
Crispo A, Rivieccio G, Cataldo L, Coluccia S, Luongo A, Coppola E, Grimaldi M, Montagnese C, Nocerino F, Celentano E, Saviano R, Bastone A, Baglio G, De Angelis C, Ciardiello F, Avallone A, Cassata A, Costanzo R, Morabito A, Maione P, Gridelli C, Cigolari S, Borrelli A, De Placido S, Schiavone F, Bianchi AAM, Pignata S, Aquino A, Bonito C, Buonerba C, Caccavallo F, Carlomagno C, Cavaliere M, Centonze S, Damiano S, De Divitiis C, De Nardo R, Del Deo Vito A, D'Errico D, Esposito G, Esposito L, Famiglietti V, Formisano L, Formisano L, Franzese E, Gaeta V, Gragnano E, Grimaldi R, Iovane G, Lauria R, Migliore G, Mirto M, Napoletano A, Napoli D, Vitale P, Pepe S, Rambaldo MP, Renato M, Rescigno M, Rossi E, Santabarbara G, Stanzione C. New approach to implement cancer patient care: The valutazione percorso rete oncologica campana (ValPeROC)‐experience from an Italian oncology network. Eur J Cancer Care (Engl) 2022; 31:e13736. [PMID: 37039607 DOI: 10.1111/ecc.13736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 09/12/2022] [Accepted: 09/27/2022] [Indexed: 11/27/2022]
Abstract
OBJECTIVE The primary goal of the Campania Oncology Network (ROC) was to reduce cancer delay and care fragmentation through the establishment of cancer-specific multidisciplinary oncologic groups (GOMs) and diagnostic and therapeutic assistance paths (PDTAs). METHODS Five cancer centres of the ROC, with their own cancer specific GOM, were selected. In our analysis, we have focused on four neoplasms: lung, colon, ovarian and prostate cancers. The median time for pre-GOM and GOM Times was calculated for each tumour site. Univariate and multivariate logistic regressions were performed to individuate risk factors for pre-GOM and GOM Time. RESULTS Significant differences were observed for prostate cancer compared to other patients either for pre-GOM or GOM Times. Significant risks were found for ovarian and prostate cancers in pre-GOM time and for prostate cancer in GOM-Time. CONCLUSIONS This experience will produce knowledge and data to guide decision-making and to manage more effectively the challenges of fighting cancer in Campania region. The Valutazione Percorso Rete Oncologica Campana (ValPeROC) study evaluates, for the first time, the ROC activity, through the analysis of key performance indices. Pre-GOM and GOM Time represent the quality of the entire regional health system and are useful to define models, which can evaluate the performance of the ROC over time.
Collapse
Affiliation(s)
- Anna Crispo
- Epidemiology and Biostatistics Unit Istituto Nazionale Tumori IRCCS 'Fondazione G. Pascale', Naples, Italy Naples Italy
| | - Giorgia Rivieccio
- Department of Managerial Studies and Quantitative Methods University of Naples Parthenope Faculty of Economics Naples Italy
| | - Luca Cataldo
- Department of Managerial Studies and Quantitative Methods University of Naples Parthenope Faculty of Economics Naples Italy
| | - Sergio Coluccia
- Epidemiology and Biostatistics Unit Istituto Nazionale Tumori IRCCS 'Fondazione G. Pascale', Naples, Italy Naples Italy
| | - Assunta Luongo
- Epidemiology and Biostatistics Unit Istituto Nazionale Tumori IRCCS 'Fondazione G. Pascale', Naples, Italy Naples Italy
| | - Elisabetta Coppola
- Department of Urology and Gynecology Istituto Nazionale Tumori IRCCS ‘Fondazione G. Pascale’ Naples Italy
| | - Maria Grimaldi
- Epidemiology and Biostatistics Unit Istituto Nazionale Tumori IRCCS 'Fondazione G. Pascale', Naples, Italy Naples Italy
| | - Concetta Montagnese
- Epidemiology and Biostatistics Unit Istituto Nazionale Tumori IRCCS 'Fondazione G. Pascale', Naples, Italy Naples Italy
| | - Flavia Nocerino
- Epidemiology and Biostatistics Unit Istituto Nazionale Tumori IRCCS 'Fondazione G. Pascale', Naples, Italy Naples Italy
| | - Egidio Celentano
- Epidemiology and Biostatistics Unit Istituto Nazionale Tumori IRCCS 'Fondazione G. Pascale', Naples, Italy Naples Italy
| | - Rocco Saviano
- National Cancer Institute IRCCS Pascale Foundation Naples Italy
| | - Anna Bastone
- Department of Managerial Studies and Quantitative Methods University of Naples Parthenope Faculty of Economics Naples Italy
| | - Giovanni Baglio
- AGENAS ‐ Italian National Agency for Regional Healthcare Services Rome Italy
| | - Carmine De Angelis
- Department of Clinical Medicine and Surgery University of Naples Federico II Naples Italy
| | - Fortunato Ciardiello
- Oncologia Medica, Dipartimento di Medicina di Precisione Università degli Studi della Campania ‘L. Vanvitelli’ Naples Italy
| | - Antonio Avallone
- Experimental Clinical Abdominal Oncology Unit Istituto Nazionale Tumori 'Fondazione G. Pascale', Naples, Italy Naples Italy
| | - Antonino Cassata
- Medical Oncology Unit Istituto Nazionale Tumori 'Fondazione G. Pascale', Naples, Italy Naples Italy
| | - Raffaele Costanzo
- Thoracic Department Istituto Nazionale Tumori 'Fondazione G. Pascale', Naples, Italy Naples Italy
| | - Alessandro Morabito
- Thoracic Department Istituto Nazionale Tumori 'Fondazione G. Pascale', Naples, Italy Naples Italy
| | - Paolo Maione
- Division of Medical Oncology S.G. Moscati Hospital Avellino Italy
| | - Cesare Gridelli
- Division of Medical Oncology S.G. Moscati Hospital Avellino Italy
| | - Silvio Cigolari
- Hospital Health Direction Azienda Ospedaliera Universitaria ‘San Giovanni di Dio e Ruggi d'Aragona’ Salerno Italy
| | - Anna Borrelli
- Hospital Health Direction Azienda Ospedaliera Universitaria ‘San Giovanni di Dio e Ruggi d'Aragona’ Salerno Italy
| | - Sabino De Placido
- Department of Clinical Medicine and Surgery University of Naples Federico II Naples Italy
| | - Francesco Schiavone
- Department of Managerial Studies and Quantitative Methods University of Naples Parthenope Faculty of Economics Naples Italy
| | - Attilio A. M. Bianchi
- Directorate‐General for Management Istituto Nazionale Tumori 'Fondazione G. Pascale', Naples, Italy Naples Italy
| | - Sandro Pignata
- Department of Urology and Gynecology Istituto Nazionale Tumori IRCCS ‘Fondazione G. Pascale’ Naples Italy
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
46
|
Roberts NA, Dhillon HM, Paterson C, Schubach K, McJannett M. The impact of coronavirus disease 2019 on genitourinary and prostate cancer care and clinical trials: A qualitative exploration of the Australian and New Zealand experience. Asia Pac J Clin Oncol 2022; 19:337-346. [PMID: 36281656 PMCID: PMC9874658 DOI: 10.1111/ajco.13847] [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: 12/14/2021] [Revised: 08/27/2022] [Accepted: 08/29/2022] [Indexed: 01/27/2023]
Abstract
PURPOSE This qualitative study aimed to understand the impact of the coronavirus disease 2019 pandemic from March to November 2020 on healthcare delivery and clinical trials for genitourinary (GU) cancers in Australia. METHODS Annually a pre-conference workshop is hosted by the Australian New Zealand Urogenital and Prostate Cancer Trials Group for supportive care health professionals. In November 2020, those that selected to attend were invited to participate in a focus group. Workshop and focus group discussions were recorded and transcripts were analyzed thematically. RESULTS Seventy-two individuals involved in GU cancer care and clinical trials took part. Participants described negative changes to GU cancer care and clinical trials from the pandemic due to reduced clinical services and increased wait times. Trial recruitment was paused temporarily during lockdowns, and standard treatment protocols were used to limit hospital visits. Trial process changes included electronic capture of informed consent, home delivery of oral medications, and delegations of assessments. These changes increased administrative activity for clinical trial teams and Human Research Ethics Committees. A transition to telehealth enabled continuity of service delivery and trials but reduced the opportunity for face-to-face patient consultations with increasing concern about the failure to detect supportive care needs. CONCLUSION The pandemic has prompted a critical review of service delivery and clinical trials for people with GU cancers.
Collapse
Affiliation(s)
- Natasha A. Roberts
- Centre for Clinical ResearchUniversity of QueenslandBrisbaneAustralia,Cancer Care ServicesMetro North Health ServiceHerstonAustralia,Australian New Zealand Urogenital and Prostate Cancer Trials GroupSydneyAustralia
| | - Haryana M. Dhillon
- Centre for Medical Psychology and Evidence‐Based Decision‐MakingSchool of Psychology, Faculty of ScienceUniversity of SydneySydneyAustralia,Australian New Zealand Urogenital and Prostate Cancer Trials GroupSydneyAustralia
| | - Catherine Paterson
- School of Nursing, Midwifery and Public HealthUniversity of CanberraCanberraAustralia,Prehabilitation, ActivityCancerExercise and Survivorship (PACES) Research GroupUniversity of CanberraCanberraAustralia,Canberra Health Services and ACT HealthSYNERGY Nursing and Midwifery Research CentreACT Health Directorate Level 3Canberra HospitalCanberraAustralia,Robert Gordon UniversityAberdeenUK,Australian New Zealand Urogenital and Prostate Cancer Trials GroupSydneyAustralia
| | - Kathryn Schubach
- Men's Health MelbourneMelbourneAustralia,Australian and New Zealand Urology Nurses Society (ANZUNS)MarrickvilleAustralia,Australian New Zealand Urogenital and Prostate Cancer Trials GroupSydneyAustralia
| | - Margaret McJannett
- Australian New Zealand Urogenital and Prostate Cancer Trials GroupSydneyAustralia
| | | |
Collapse
|
47
|
Remote Consultations in General Practice - A Systematic Review. Zdr Varst 2022; 61:224-230. [PMID: 36348966 PMCID: PMC9597895 DOI: 10.2478/sjph-2022-0030] [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: 05/04/2022] [Accepted: 09/05/2022] [Indexed: 12/29/2022] Open
Abstract
INTRODUCTION Remote consultations in general practice can be very useful form of telemedicine, which is basically a way to exchange medical information to improve the clinical health of patients when the patient and their general practitioner (GP) are not on the same place at the same time. This concept was developed in the 1980s to provide health care to patients who lived in remote areas. METHODS We were interested in researching what kind of remote consultations are available in general practice and what is the usage of these methods. We used four keywords - remote consultation and general practice or family medicine or primary care - and we searched in four different scientific databases: Medline-PubMed, Scopus, Web of Science and IEEX Xplore. RESULTS We used a PRISMA diagram to identify studies and search the four main databases, we investigated 48 full text articles and when we applied our inclusion and exclusion criteria, 12 studies were included in this systematic review. CONCLUSIONS This systematic review covers the topics of remote consultation versus a traditional or classic physical consultation. Studies have shown its importance prior to the COVID-19 pandemic, and its value while in the mist of the pandemic then caring for infected patients. We have found that remote consultation is necessary, but it must be an improvement on the previous system. Teleconsultations can reduce the number of visits, especially during lockdown situations, with both patients and GPs satisfied with the method, but we should not forget that a physical consultation cannot be fully replaced by a remote consultation due to the limitations of the latter.
Collapse
|
48
|
Ryan A, Young AL, Tait J, McCarter K, McEnallay M, Day F, McLennan J, Segan C, Blanchard G, Healey L, Avery S, White S, Vinod S, Bradford L, Paul CL. Building staff capability, opportunity, and motivation to provide smoking cessation to people with cancer in Australian cancer treatment centres: development of an implementation intervention framework for the Care to Quit cluster randomised controlled trial. HEALTH SERVICES AND OUTCOMES RESEARCH METHODOLOGY 2022; 23:1-33. [PMID: 36193179 PMCID: PMC9517978 DOI: 10.1007/s10742-022-00288-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2022] [Revised: 07/26/2022] [Accepted: 08/12/2022] [Indexed: 11/24/2022]
Abstract
Few rigorous studies provide a clear description of the methodological approach of developing an evidence-based implementation intervention, prior to implementation at scale. This study describes the development, mapping, rating, and review of the implementation strategies for the Care to Quit smoking cessation trial, prior to application in nine cancer services across Australia. Key stakeholders were engaged in the process from conception through to rating, reviewing and refinement of strategies and principles. An initial scoping review identified 21 barriers to provision of evidence-based smoking cessation care to patients with cancer, which were mapped to the Theoretical Domains Framework and Behaviour Change Wheel (BCW) to identify relevant intervention functions. The mapping identified 26 relevant behaviour change techniques, summarised into 11 implementation strategies. The implementation strategies were rated and reviewed against the BCW Affordability, Practicality, Effectiveness and cost-effectiveness, Acceptability, Side-effects/safety, and Equity criteria by key stakeholders during two interactive workshops to facilitate a focus on feasible interventions likely to resonate with clinical staff. The implementation strategies and associated intervention tools were then collated by form and function to provide a practical guide for implementing the intervention. This study illustrates the rigorous use of theories and frameworks to arrive at a practical intervention guide, with potential to inform future replication and scalability of evidence-based implementation across a range of health service settings. Supplementary Information The online version contains supplementary material available at 10.1007/s10742-022-00288-6.
Collapse
Affiliation(s)
- Annika Ryan
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW Australia
- Hunter Medical Research Institute, John Hunter Hospital, Level 4 West, New Lambton Heights, Newcastle, NSW Australia
| | - Alison Luk Young
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW Australia
| | - Jordan Tait
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW Australia
- Hunter Medical Research Institute, John Hunter Hospital, Level 4 West, New Lambton Heights, Newcastle, NSW Australia
| | - Kristen McCarter
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW Australia
- Hunter Medical Research Institute, John Hunter Hospital, Level 4 West, New Lambton Heights, Newcastle, NSW Australia
- Priority Research Centre for Cancer Research, Innovation and Translation, University of Newcastle, 2308, Callaghan, NSW Australia
- Hunter Cancer Research Alliance, John Hunter Hospital, New Lambton Heights, Newcastle, NSW Australia
| | - Melissa McEnallay
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW Australia
- Hunter Medical Research Institute, John Hunter Hospital, Level 4 West, New Lambton Heights, Newcastle, NSW Australia
- Priority Research Centre for Cancer Research, Innovation and Translation, University of Newcastle, 2308, Callaghan, NSW Australia
- Hunter Cancer Research Alliance, John Hunter Hospital, New Lambton Heights, Newcastle, NSW Australia
| | - Fiona Day
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW Australia
- Hunter Cancer Research Alliance, John Hunter Hospital, New Lambton Heights, Newcastle, NSW Australia
- Calvary Mater Newcastle, Corner Edith and Platt Streets, Waratah, NSW 2289 Australia
| | - James McLennan
- St Vincent’s Hospital Sydney, 390 Victoria Street, Darlinghurst, NSW 2010 Australia
| | - Catherine Segan
- Cancer Council Victoria, Melbourne, VIC Australia
- School of Population and Global Health, Centre for Health Policy, The University of Melbourne, MelbourneMelbourne, VIC Australia
| | - Gillian Blanchard
- Calvary Mater Newcastle, Corner Edith and Platt Streets, Waratah, NSW 2289 Australia
- School of Nursing and Midwifery, University of Newcastle, Callaghan, NSW Australia
| | - Laura Healey
- Calvary Mater Newcastle, Corner Edith and Platt Streets, Waratah, NSW 2289 Australia
| | - Sandra Avery
- South Western Sydney Local Health District, Elizabeth Street, Liverpool, NSW 2170 Australia
- Cancer Therapy Centre, Liverpool Hospital, Liverpool, NSW Australia
| | - Sarah White
- Department of Health Quitline, 615 St Kilda Rd, Melbourne, VIC 3004 Australia
| | - Shalini Vinod
- Cancer Therapy Centre, Liverpool Hospital, Liverpool, NSW Australia
- South Western Sydney Clinical School and Ingham Institute for Applied Medical Research, Liverpool, NSW Australia
| | - Linda Bradford
- The Alfred, 55 Commercial Rd, Melbourne, VIC 3004 Australia
| | - Christine L. Paul
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW Australia
- Hunter Medical Research Institute, John Hunter Hospital, Level 4 West, New Lambton Heights, Newcastle, NSW Australia
- Priority Research Centre for Cancer Research, Innovation and Translation, University of Newcastle, 2308, Callaghan, NSW Australia
- Hunter Cancer Research Alliance, John Hunter Hospital, New Lambton Heights, Newcastle, NSW Australia
| |
Collapse
|
49
|
The Effects of Multimodal Prehabilitation Interventions in Men Affected by Prostate Cancer on Physical, Clinical and Patient Reported Outcome Measures: A Systematic Review. Semin Oncol Nurs 2022; 38:151333. [PMID: 35999090 DOI: 10.1016/j.soncn.2022.151333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVES To synthesize existing evidence on the effects of multimodal prehabilitation interventions in men affected by prostate cancer on physical, clinical, and patient-reported outcome measures. DATA SOURCES A systematic review was conducted according to the PRISMA 2020 Statement Guidelines. Electronic databases (ie, Medline, Embase, CINAHL and Cochrane CENTRAL, and clinicaltrials.gov) were searched using key search terms. Articles were assessed according to prespecified eligibility criteria. Data extraction and quality appraisal was conducted. The findings were integrated in a narrative synthesis. CONCLUSION Of the 5863 publications screened, 118 articles were assessed in full text and 17 studies met the prescreening eligibility criteria. There were a range of study designs that included randomized controlled clinical trials (n = 11), quasi experimental (n = 4), cohort (n = 1), and case series (n = 1), covering a total of 1739 participants. The prehabilitation interventions included physical activity, peer support, pelvic floor muscle training, diet, nurse-led prehabilitation, psychological, and prehabilitation administration of phosphodiesterase-5 inhibitors. IMPLICATIONS FOR NURSING PRACTICE Significant heterogeneity existed in the prehabilitation intervention programs for men affected by prostate cancer in terms of the composition, duration, method of administration, and the outcomes measured to quantify their impact. This systematic review has identified that multimodal prehabilitation interventions are an emerging area for practice and research among men affected by prostate cancer. Importantly, there has been a lack of focus on the inclusion of partners as critical companions during this distressing phase of the cancer care continuum. For the moment, all members of the multidisciplinary team caring for people affected by prostate cancer are encouraged to use the findings in this review to inform holistic models of care.
Collapse
|
50
|
Arthur EK, Pisegna J, Oliveri JM, Aker H, Krok-Schoen JL. Older cancer survivors' perspectives and use of telehealth in their cancer survivorship care in the United States: A ResearchMatch® sample. J Geriatr Oncol 2022; 13:1223-1229. [PMID: 35985929 DOI: 10.1016/j.jgo.2022.08.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 06/06/2022] [Accepted: 08/09/2022] [Indexed: 10/15/2022]
Abstract
INTRODUCTION COVID-19 has resulted in reliance on telecommunication technologies for the provision of supportive cancer care. However, research on the use of these resources among older adults, who are the majority of cancer survivors, is limited. The objective of this study was to gather information on older cancer survivors' perspectives and use of telehealth their cancer survivorship care in the United States. MATERIALS AND METHODS Potential participants were recruited through ResearchMatch® from December 2020-January 2021. Online semi-structured interviews were conducted. Descriptive statistics were used to analyze the participants' demographic and health characteristics. Content analysis were conducted by two independent coders for identification of common themes. Coding agreement was reached through consensus, and count comparisons of participant responses were made. RESULTS The majority of respondents (n = 21; mean age = 73.5 ± 4.9) were female (57%), White (90%), and had a variety of cancer diagnoses. Participants reported using a variety of technology devices and telehealth products. Older cancer survivors (n = 10) endorsed telehealth video use for physical health concerns and basic check-ups, but some (n = 4) preferred in-person visits for major concerns and sensitive issues (e.g., mental health). Half of participants reported mobile health app use; however, ten participants did not use these apps as they felt the technology was not useful. Barriers to health technology use included missing face-to-face connections with providers, lack of familiarity with the technology, and perceived lack of utility and personalized telehealth platforms. Lastly, video-based conferencing and social media site use among seventeen participants was reported for social interaction during the COVID-19 pandemic. DISCUSSION These findings suggest that older cancer survivors utilize online platforms for their general health; however, they prefer in-person visits for serious issues and value personalization with telehealth. Despite from a highly educated sample of ResearchMatch® participants, these results can be used to inform clinicians and researchers about the appropriateness and provision of telehealth-based supportive care among older cancer survivors.
Collapse
Affiliation(s)
- Elizabeth K Arthur
- Comprehensive Cancer Center, The Ohio State University, 460 W. 10(th) Ave, Columbus, OH 43210, USA; College of Nursing, The Ohio State University, 1585 Neil Ave., Columbus, OH 43210, USA
| | - Janell Pisegna
- Physical Therapy Program, University of Colorado Anschutz Medical Campus, 13001 E 17th Ave., Aurora, CO 80045, USA
| | - Jill M Oliveri
- Recruitment, Intervention and Survey Shared Resource, Comprehensive Cancer Center, The Ohio State University, 1590 N. High St, Suite 525, Columbus, OH 43201, USA
| | - Heather Aker
- Recruitment, Intervention and Survey Shared Resource, Comprehensive Cancer Center, The Ohio State University, 1590 N. High St, Suite 525, Columbus, OH 43201, USA
| | - Jessica L Krok-Schoen
- Comprehensive Cancer Center, The Ohio State University, 460 W. 10(th) Ave, Columbus, OH 43210, USA; Division of Health Sciences, School of Health and Rehabilitation Sciences, College of Medicine, The Ohio State University, 453 W. 10th Ave, 228 Atwell Hall, Columbus, OH 43210, USA.
| |
Collapse
|