1
|
Särnholm J, Kronish IM. Psychological Distress and Hypertension Diagnostic Testing: Is There Anything to Worry About? Am J Hypertens 2024; 37:18-20. [PMID: 37798140 PMCID: PMC10724523 DOI: 10.1093/ajh/hpad096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Accepted: 10/03/2023] [Indexed: 10/07/2023] Open
Affiliation(s)
- Josefin Särnholm
- Department of Clinical Neuroscience, Division of Psychology, Karolinska Institutet, Stockholm, Sweden
| | - Ian M Kronish
- Department of Medicine, Center for Behavioral Cardiovascular Health, Columbia University Irving Medical Center, New York, New York, USA
| |
Collapse
|
2
|
Ding S, Fontaine T, Serex M, Sá Dos Reis C. Strategies enhancing the patient experience in mammography: A scoping review. Radiography (Lond) 2024; 30:340-352. [PMID: 38141428 DOI: 10.1016/j.radi.2023.11.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 11/10/2023] [Accepted: 11/14/2023] [Indexed: 12/25/2023]
Abstract
INTRODUCTION A positive experience in mammography is essential for increasing patient attendance and reattendance at these examinations, whether conducted for diagnostic or screening purposes. Mammograms indeed facilitate early disease detection, enhance the potential for cure, and consequently reduce breast cancer mortality. The main objective of this review was to identify and map the strategies aiming to improve the patient experience in diagnostic and screening mammography. METHODS This scoping review was performed following the JBI methodology and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). Searches were performed through databases of MEDLINE, Embase.com, CINAHL, APA PsycINFO, Cochrane Central Register of Controlled Trials, Web of Science, ProQuest Dissertation and Theses, and three clinical trial registries. This review considered studies evaluating the effect of interventions, occurring within the mammography department, on the patient experience. RESULTS The literature search yielded 8113 citations of which 60, matching the inclusion criteria, were included. The strategies were classified into eight categories. The most represented one was breast compression and positioning, followed by relaxation techniques and analgesic care, communication and information, screening equipment, examination procedures, patient-related factors, physical environment, and finally staff characteristics. The studied outcomes related to patient experience were mainly pain, anxiety, comfort, and satisfaction. Other types of outcomes were also considered in the studies such as image quality, technical parameters, or radiation dose. Most studies were conducted by radiographers, on female patients, and none mentioned the inclusion of male or transgender patients. CONCLUSION This review outlined a diversity of strategies to improve patient experience, although technique-based interventions were predominant. Further research is warranted, notably on psychological strategies, and on men and transgender people. IMPLICATIONS FOR PRACTICE This scoping review provides guidance to healthcare providers and services for better patient/client-centered care.
Collapse
Affiliation(s)
- S Ding
- Department of Radiologic Medical Imaging Technology, School of Health Sciences (HESAV), HES-SO University of Applied Sciences and Arts Western, Switzerland; BEST JBI Centre of Excellence, Switzerland.
| | - T Fontaine
- Department of Radiologic Medical Imaging Technology, School of Health Sciences (HESAV), HES-SO University of Applied Sciences and Arts Western, Switzerland
| | - M Serex
- Library, School of Health Sciences (HESAV), HES-SO University of Applied Sciences and Arts Western, Switzerland
| | - C Sá Dos Reis
- Department of Radiologic Medical Imaging Technology, School of Health Sciences (HESAV), HES-SO University of Applied Sciences and Arts Western, Switzerland
| |
Collapse
|
3
|
Yang H, Luo W, Du X, Guan Y, Peng W. The implementation and effect evaluation of AIDET standard communication health education mode under the King theory of goal attainment: A randomized control study. Medicine (Baltimore) 2023; 102:e36083. [PMID: 38050312 PMCID: PMC10695492 DOI: 10.1097/md.0000000000036083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Accepted: 10/20/2023] [Indexed: 12/06/2023] Open
Abstract
BACKGROUND This research addresses inadequate understanding of interventional prenatal diagnosis, preoperative anxiety psychological problems in pregnant women undergoing interventional prenatal diagnosis, proposing a health education mode combined AIDET standard communication and King's theory of goal attainment approach to potentially improve health education outcomes, anxiety psychological problems, and patient satisfaction. METHODS A convenient sampling method was used to select a total of 300 pregnant women who were ready to undergo interventional prenatal diagnosis. They were randomly divided into a implementation group and a control group, with 150 pregnant women in each group. The control group used the communication mode of the traditional process of nurse-patient communication. The implementation group used the AIDET standard communication health education model under the King theory of goal attainment in the process of nurse-patient communication and the interventional prenatal diagnosis health education content questionnaire, the pregnant women's satisfaction questionnaire, state anxiety scale, and disease uncertainty scale were used for evaluation. RESULTS The results of the interventional prenatal diagnosis health education questionnaire, the results of pregnant women's anxiety, the results of pregnant women's disease uncertainty, the results of pregnant women's satisfaction, the implementation group all were better than the control group (P < .05). CONCLUSION Using the AIDET standard communication health education model under the King theory of goal attainment in nurse-patient communication is conducive to the rapid establishment of a harmonious and trusting nurse-patient relationship between pregnant women and nurses, helping pregnant women and nurses jointly promote the establishment and implementation of health education goals, helping to improve pregnant women's acceptance of information related to interventional prenatal diagnosis, health education and the procedure of walking on the day of surgery. It helps enhance the effectiveness of health education and satisfaction, reducing pregnant women's uncertainty about the disease, their unfamiliarity with the surgery environment and surgery procedure, and their preoperative anxiety.
Collapse
Affiliation(s)
- Hao Yang
- Department of Medical Genetics Nursing, West China Second University Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, Sichuan, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, Sichuan, China
| | - Wanying Luo
- Department of Medical Genetics Nursing, West China Second University Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, Sichuan, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, Sichuan, China
| | - Xue Du
- Department of Medical Genetics Nursing, West China Second University Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, Sichuan, China
| | - Yujia Guan
- Department of Pediatric Kidney Nursing, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Wentao Peng
- Department of Nursing, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China
| |
Collapse
|
4
|
Paalimäki-Paakki K, Virtanen M, Henner A, Vähänikkilä H, Nieminen MT, Schroderus-Salo T, Kääriäinen M. Effects of a 360° virtual counselling environment on patient anxiety and CCTA process time: A randomised controlled trial. Radiography (Lond) 2023; 29 Suppl 1:S13-S23. [PMID: 36280541 DOI: 10.1016/j.radi.2022.09.013] [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: 08/22/2022] [Revised: 09/27/2022] [Accepted: 09/30/2022] [Indexed: 11/07/2022]
Abstract
INTRODUCTION This study investigated whether a 360° virtual counselling environment (360°VCE) was more effective at decreasing patients' anxiety than routine standard of care counselling for patients undergoing coronary computed tomography angiography (CCTA), and if there was any difference in the process times for both of these groups. METHODS A total of 86 patients underwent CCTA in this randomised controlled trial. Patients were randomly assigned to intervention and control groups. The 360°VCE was developed using spherical panoramic images and non-immersive 360° technology. The primary outcome, anxiety, was measured using the State-Trait Anxiety Inventory (STAI). The secondary outcome, CCTA process time, was measured from the time of arrival in the department until end of examination. RESULTS Pre-scan anxiety was lower among patients in the 360°VCE group immediately before CCTA in comparison to patients in the control group (p = 0.015). Women demonstrated higher levels of anxiety than men in both groups. No between-group differences were discerned in CCTA process time. CONCLUSION Access to 360°VCE can reduce patients' pre-CCTA anxiety levels. IMPLICATIONS FOR PRACTICE The presented results can be used to improve patient counselling and care, reduce anxiety among patients undergoing CCTA, and optimise the CCTA examination procedure.
Collapse
Affiliation(s)
- Karoliina Paalimäki-Paakki
- Research Unit of Nursing Science and Health Management, University of Oulu, Oulu, Finland; Degree Programme of Radiography and Radiation Therapy, Oulu University of Applied Sciences, Oulu, Finland.
| | - Mari Virtanen
- School of Rehabilitation and Examination, Helsinki Metropolia University of Applied Sciences, Helsinki, Finland
| | - Anja Henner
- Degree Programme of Radiography and Radiation Therapy, Oulu University of Applied Sciences, Oulu, Finland
| | - Hannu Vähänikkilä
- Northern Finland Birth Cohorts, Arctic Biobank, Infrastructure for Population Studies, Faculty of Medicine, University of Oulu, Oulu, Finland
| | - Miika T Nieminen
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland; Research Unit of Medical Imaging, Physics and Technology, University of Oulu, Oulu, Finland; Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland
| | - Tanja Schroderus-Salo
- Degree Programme of Radiography and Radiation Therapy, Oulu University of Applied Sciences, Oulu, Finland
| | - Maria Kääriäinen
- Research Unit of Nursing Science and Health Management, University of Oulu, Oulu, Finland; Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland; Oulu University Hospital, Oulu, Finland
| |
Collapse
|
5
|
Vanderwal A, Lewis J, Basil J, Atzinger C, Widmeyer K. Factors that influence the management recommendations breast surgeons provide to women with pathogenic variants in moderate penetrance breast cancer susceptibility genes. J Genet Couns 2023. [PMID: 36642783 DOI: 10.1002/jgc4.1674] [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: 05/29/2022] [Revised: 12/20/2022] [Accepted: 12/24/2022] [Indexed: 01/17/2023]
Abstract
Pathogenic variants in moderate penetrance breast cancer susceptibility genes, such as ATM and CHEK2, confer a two- to five-fold increased lifetime risk for breast cancer. The National Comprehensive Cancer Network has guidelines for breast surgeons to utilize when counseling women with pathogenic variants in these genes; however, previous studies indicate that other factors impact breast surgeons' recommendations to patients. This study investigated factors influencing management recommendations presented by breast surgeons to women with pathogenic variants in moderate penetrance breast cancer susceptibility genes. Focus groups and interviews were conducted with breast surgeons practicing in Ohio, Kentucky, and Indiana. A total of 15 breast surgeons from eight different hospitals participated in five focus groups and three individual interviews. Participants discussed factors they consider when making management recommendations for risk reduction in women with pathogenic variants in moderate penetrance breast cancer susceptibility genes. Participants provided risk management recommendations for given scenarios. Patient motivation/opinion, family history, patient current health status, patient personal preference, and patient anxiety level were among the most common factors mentioned. It appeared that how these factors are valued and applied in practice varies. There was no consensus among breast surgeons on which risk-reducing management options they would recommend in each scenario. There are many factors breast surgeons take into consideration when making recommendations for this patient population. This information could inform future research on decision making around treatment for individuals with pathogenic variants in moderate penetrance breast cancer susceptibility genes.
Collapse
Affiliation(s)
- April Vanderwal
- Division of Human Genetics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.,Department of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, Ohio, USA
| | - Jaime Lewis
- Department of Surgery, College of Medicine, University of Cincinnati, Cincinnati, Ohio, USA
| | - Janet Basil
- Precision Medicine Program, The Christ Hospital Health Network, Cincinnati, Ohio, USA
| | - Carrie Atzinger
- Division of Human Genetics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.,Department of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, Ohio, USA
| | - Kimberly Widmeyer
- Division of Human Genetics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| |
Collapse
|
6
|
Kuo CP, Li PC, Chuang HL, Lee SH, Liao WC, Lee MS. The effect of multimedia health education on pain and anxiety in women undergoing mammography in Taiwan. Taiwan J Obstet Gynecol 2021; 60:1084-1089. [PMID: 34794742 DOI: 10.1016/j.tjog.2021.09.021] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/15/2021] [Indexed: 10/19/2022] Open
Abstract
OBJECTIVE Breast cancer is the most common cancer among women in Taiwan. However, the discomfort of receiving mammograms reduces the willingness to screen. MATERIALS AND METHODS This study using a quasi-experimental design and recruited 150 participants in a medical center, Taiwan. In the control group, only provided traditional health education sheets, the experimental group has joined the intervention of multimedia health education. State-Trait Anxiety Inventory and Visual Analogue Scale, respectively, were used to compare the differences in anxiety and pain between the two groups before and after receiving mammography. RESULTS After the intervention, the experimental group's state anxiety score was significantly lower than that of the control group (30.63 ± 8.43 vs. 33.77 ± 10.74, p < .05). However, there was no significant difference in pain scores (4.13 ± 2.37 vs. 4.57 ± 2.31; p = .25). CONCLUSIONS Younger, prior experience with mammography, and high trait anxiety affect pain and state anxiety of women undergoing mammography. The multimedia health education intervention could reduce anxiety effectively, but it does not significantly relieve the pain undergoing mammography.
Collapse
Affiliation(s)
- Ching-Pyng Kuo
- School of Nursing, Chung Shan Medical University, Taichung, Taiwan; Department of Nursing, Chung Shan Medical University Hospital, Taichung, Taiwan.
| | - Pei-Ching Li
- School of Nursing, Chung Shan Medical University, Taichung, Taiwan.
| | - Hsiao-Ling Chuang
- School of Nursing, Chung Shan Medical University, Taichung, Taiwan; Department of Nursing, Chung Shan Medical University Hospital, Taichung, Taiwan.
| | - Shu-Hsin Lee
- School of Nursing, Chung Shan Medical University, Taichung, Taiwan; Department of Nursing, Chung Shan Medical University Hospital, Taichung, Taiwan.
| | - Wen-Chun Liao
- School of Nursing and Graduate Institute of Nursing, China Medical University, Department of Nursing, China Medical University Hospital, Taichung, Taiwan; Department of Nursing, Asian University, Taichung, Taiwan.
| | - Maw-Sheng Lee
- Institute of Medicine, Chung Shan Medical University, Department of Obstetrics and Gynecology, Chung Shan Medical University Hospital, Taichung, Taiwan.
| |
Collapse
|
7
|
Monticciolo DL, Malak SF, Friedewald SM, Eby PR, Newell MS, Moy L, Destounis S, Leung JWT, Hendrick RE, Smetherman D. Breast Cancer Screening Recommendations Inclusive of All Women at Average Risk: Update from the ACR and Society of Breast Imaging. J Am Coll Radiol 2021; 18:1280-1288. [PMID: 34154984 DOI: 10.1016/j.jacr.2021.04.021] [Citation(s) in RCA: 96] [Impact Index Per Article: 32.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Accepted: 04/27/2021] [Indexed: 11/25/2022]
Abstract
Breast cancer remains the most common nonskin cancer, the second leading cause of cancer deaths, and the leading cause of premature death in US women. Mammography screening has been proven effective in reducing breast cancer deaths in women age 40 years and older. A mortality reduction of 40% is possible with regular screening. Treatment advances cannot overcome the disadvantage of being diagnosed with an advanced-stage tumor. The ACR and Society of Breast Imaging recommend annual mammography screening beginning at age 40, which provides the greatest mortality reduction, diagnosis at earlier stage, better surgical options, and more effective chemotherapy. Annual screening results in more screening-detected tumors, tumors of smaller sizes, and fewer interval cancers than longer screening intervals. Screened women in their 40s are more likely to have early-stage disease, negative lymph nodes, and smaller tumors than unscreened women. Delaying screening until age 45 or 50 will result in an unnecessary loss of life to breast cancer and adversely affects minority women in particular. Screening should continue past age 74 years, without an upper age limit unless severe comorbidities limit life expectancy. Benefits of screening should be considered along with the possibilities of recall for additional imaging and benign biopsy and the less tangible risks of anxiety and overdiagnosis. Although recall and biopsy recommendations are higher with more frequent screening, so are life-years gained and breast cancer deaths averted. Women who wish to maximize benefit will choose annual screening starting at age 40 years and will not stop screening prematurely.
Collapse
Affiliation(s)
- Debra L Monticciolo
- Vice-chair for Research, Department of Radiology, and Section Chief, Breast Imaging, Texas A&M University Health Sciences, Baylor Scott & White Healthcare-Central Texas, Temple, Texas.
| | | | - Sarah M Friedewald
- Chief of Breast and Women's Imaging; Vice Chair of Operations, Department of Radiology; Medical Director, Lynn Sage Comprehensive Breast Center, Northwestern Memorial Hospital, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Peter R Eby
- Chief of Breast Imaging, Radiology Representative to the Cancer Committee, Virginia Mason Medical Center, Seattle, Washington
| | - Mary S Newell
- Associate Division Director; Associate Director of Breast Center, Department of Radiology and Imaging Sciences, Emory University, Atlanta, Georgia
| | - Linda Moy
- Laura and Isaac Perlutter Cancer Center, NYU School of Medicine, New York City, New York
| | - Stamatia Destounis
- Chair of Clinical Research and Medical Outcomes Department, Elizabeth Wende Breast Care, Rochester, New York
| | - Jessica W T Leung
- Deputy Chair of Department of Breast Imaging, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - R Edward Hendrick
- Department of Radiology, University of Colorado School of Medicine, Aurora, Colorado
| | - Dana Smetherman
- Department Chair and Associate Medical Director of the Medical Specialties, Department of Radiology, Ochsner Medical Center, New Orleans, Louisiana
| |
Collapse
|
8
|
Loving VA, Aminololama-Shakeri S, Leung JWT. Anxiety and Its Association With Screening Mammography. JOURNAL OF BREAST IMAGING 2021; 3:266-272. [PMID: 38424779 DOI: 10.1093/jbi/wbab024] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Indexed: 03/02/2024]
Abstract
Anxiety is often cited as a risk of screening mammography, and organizations such as the U.S. Preventive Services Task Force list anxiety as a screening-associated "harm" that should be mitigated. However, the level of mammography-related anxiety risk is difficult to assign clearly for myriad reasons, including the variability of individuals' baseline susceptibility to anxiety, the self-reported nature of subjective anxiety states, and the multiple sources of breast cancer screening-related anxiety. In addition, anxiety measures differ between studies and psychological responses to screening mammography vary across racial and ethnic groups. Nonetheless, breast radiology practices should acknowledge the existence of mammography-associated anxiety and consider strategies to decrease it. These strategies include immediate screening interpretations, patient education efforts, and relaxation techniques.
Collapse
Affiliation(s)
- Vilert A Loving
- Banner MD Anderson Cancer Center, Division of Diagnostic Imaging, Gilbert, AZ, USA
| | | | - Jessica W T Leung
- The University of Texas MD Anderson Cancer Center, Department of Breast Imaging, Houston, TX, USA
| |
Collapse
|
9
|
Shang Y, Song ZW, Du L, Yang LP, Zhang ZG. Intervention for reducing anxiety during screening mammography: A protocol for systematic review and meta-analysis. Medicine (Baltimore) 2020; 99:e22382. [PMID: 33031273 PMCID: PMC7544373 DOI: 10.1097/md.0000000000022382] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Mammography is considered a fundamental part of diagnosis in modern health care services. It provides low dose images of normal structures and pathological soft tissues in the breast. Many reports suggested that intervention is playing a positive role in anxiety related to mammography, but there is no high-quality evidence to prove its effects. This paper reports the protocol of a systematic review (SR) and meta-analysis (MA) to clarify effectiveness of intervention during screening mammography. METHODS A systematic literature search will be performed in the Cochrane Library, PubMed, Embase and Web of Science from inception to July 2020. Randomized controlled trials (RCTs) will be included to evaluate any interventions in the treatment of anxiety related to mammography screening. The main outcome measure is the impact on patient anxiety, and the impact on patient breast cancer worry, the impact on patient satisfaction are the additional outcome measure. Risk of bias assessment of the included RCTs will be carried out using Cochrane Collaboration's tool for RCTs. The Review Manager 5.4 for Windows will be used to perform the MA and generate the result figures. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) will be used to evaluate the quality of evidence. Subgroup analysis and sensitivity analysis will be conducted to assess the robustness of the results. RESULTS A total of 782 English studies of anxiety related to mammography screening were obtained through search. After preliminary screening, 773 non-conforming studies were excluded. Finally, nine English studies of anxiety related to mammography screening will be included for full-text assessment. We will submit the results of this SR and MA to a peer-reviewed journal for publication. CONCLUSIONS This study will provide reliable evidence for intervention for reducing anxiety in women receiving screening mammography. INPLASY REGISTRATION NUMBER INPLASY202070131.
Collapse
Affiliation(s)
- Yi Shang
- Department of General Surgery, Lanzhou University Second Affiliated Hospital
| | - Zi-Wei Song
- Evidence-Based Nursing Center, School of Nursing, Lanzhou University
| | - Li Du
- Department of Psychiatry, Lanzhou University Second Affiliated Hospital, Lanzhou, Gansu Province, China
| | - Li-Ping Yang
- Department of General Surgery, The First Hospital of Lanzhou University
| | - Zhi-Gang Zhang
- School of Nursing, Lanzhou University
- Intensive Care Unit, The First Hospital of Lanzhou University, Lanzhou, China
| |
Collapse
|
10
|
Michaelides A, Constantinou C. Integration of longitudinal psychoeducation programmes during the phases of diagnosis, management and survivorship of breast cancer patients: A narrative review. J Cancer Policy 2020. [DOI: 10.1016/j.jcpo.2019.100214] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
|
11
|
Affiliation(s)
| | - Fay J Hlubocky
- University of Chicago Medicine, Maclean Center for Clinical Medical Ethics, Program for Supportive Oncology, Chicago, IL
| |
Collapse
|