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Ruiz Sancho E, Pérez Nieto MÁ, Román FJ, León Mateos L, Sánchez Escamilla F, Enrech Francés S, Pérez Escutia MÁ, Juez Mertel I, Pérez-Segura P, Aguirre Herrero A, Redondo Delgado M. Differences in the Communication of Cancer Diagnoses by Different Health Professionals and the Impact of Oncologist Communication on Patients' Emotions. Cancers (Basel) 2024; 16:2444. [PMID: 39001506 PMCID: PMC11240351 DOI: 10.3390/cancers16132444] [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: 04/25/2024] [Revised: 06/28/2024] [Accepted: 06/28/2024] [Indexed: 07/16/2024] Open
Abstract
The field of healthcare is increasingly adopting a humanistic perspective in the physician-patient relationship. One of the more salient aspects being studied is the communication between the two. This study serves a dual purpose. Our initial aim was to study how a cancer diagnosis is disclosed to patients by different physicians (GPs/other specialists/oncologists). Secondly, we set out to study how the way in which oncologists normally communicate with their patients impacts variables such as a patient's anxiety, depression, coping mechanisms, and perception of both their health and their quality of life. A total of 177 patients answered a battery of questionnaires on sociodemographic and disease data: the SPIKES protocol, the EORTCQLQ-COMU26, and the ADAF screening questionnaire. The analyses recorded medium or high scores for some of the steps in the SPIKES protocol when delivering the diagnosis, and significant differences were observed for some of them among different physicians. The level of a cancer patient's satisfaction with the communication by oncologists was related to their levels of anxiety, depression, vulnerability, and perception of their health and quality of life. Better communication strategies are called for among all healthcare professionals to facilitate the task of breaking bad news to their patients.
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Affiliation(s)
- Elena Ruiz Sancho
- HM Faculty of Health Sciences, Universidad Camilo Jose Cela, 28692 Madrid, Spain; (M.Á.P.N.); (L.L.M.); (M.R.D.)
| | - Miguel Ángel Pérez Nieto
- HM Faculty of Health Sciences, Universidad Camilo Jose Cela, 28692 Madrid, Spain; (M.Á.P.N.); (L.L.M.); (M.R.D.)
| | - Francisco J. Román
- Department of Biological and Health Psychology, Universidad Autónoma de Madrid, 28692 Madrid, Spain;
| | - Leticia León Mateos
- HM Faculty of Health Sciences, Universidad Camilo Jose Cela, 28692 Madrid, Spain; (M.Á.P.N.); (L.L.M.); (M.R.D.)
| | - Francisco Sánchez Escamilla
- HM Faculty of Health Sciences, Universidad Camilo Jose Cela, 28692 Madrid, Spain; (M.Á.P.N.); (L.L.M.); (M.R.D.)
| | - Santos Enrech Francés
- Department of Medical Oncology, Hospital Universitario de Getafe, 28692 Madrid, Spain
| | | | - Ignacio Juez Mertel
- Department of Medical Oncology, Hospital Universitario de Fuenlabrada, 28692 Madrid, Spain
| | - Pedro Pérez-Segura
- Department of Medical Oncology and IdISSC, Hospital Universitario Clínico San Carlos, 28692 Madrid, Spain
| | - Andrea Aguirre Herrero
- Researcher del Instituto de Psicología de Emoción y Salud, Institute of Psychology of Emotion and Health, 28692 Madrid, Spain
| | - Marta Redondo Delgado
- HM Faculty of Health Sciences, Universidad Camilo Jose Cela, 28692 Madrid, Spain; (M.Á.P.N.); (L.L.M.); (M.R.D.)
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Bilodeau K, Henriksen C, Aloisio Alves C, Piché L, Pepin J, Lee V, Vachon MF, Folch N, Pomey MP, Fernandez N. Learning to provide humanistic care and support in the context of chronic illness: Insights from the narratives of healthcare professionals in hemato-oncology. Eur J Oncol Nurs 2024; 69:102522. [PMID: 38382155 DOI: 10.1016/j.ejon.2024.102522] [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: 12/14/2023] [Revised: 01/11/2024] [Accepted: 01/31/2024] [Indexed: 02/23/2024]
Abstract
PURPOSE To document the process by which healthcare professionals (HCPs) support people living with and beyond hematological cancer and detail how they learned from their personal and clinical experience. METHOD Using a narrative approach, we conducted nine semi-structured interviews with HCPs, including nurses, from a specialized care centre who support patients with hematological cancer. Interviews aimed to capture experiential learning gained from their practice. We performed a hybrid inductive/deductive content analysis on data using a framework based on sociological and educational models of experiential learning. RESULTS Among healthcare professionals, analysis revealed the need to provide care and support that is 'humane' and adapted to each patient. Learning to provide this type of care proved to be challenging. Over the course of their clinical experience, healthcare professionals learned to adapt the support they provided by straddling a boundary between sympathy and empathy. Learning outcomes were associated with personal-professional development among participants. CONCLUSION Our findings bring to light an overlooked facet of patient support in the context of cancer care, which is the acquisition of the soft skills required to deliver humanistic care and support. This learning process requires time and involves navigating between the realms of sympathy and empathy. Experiential learning is intertwined with the complexity of the often long-term patient-professional relationship that characterizes hemato-oncology. This unique relationship offers rewards for healthcare professionals on both personal and professional fronts.
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Affiliation(s)
- Karine Bilodeau
- Faculty of Nursing, University of Montreal, PO Box 6128, Station Centre-ville, Montreal, Quebec, H3C 3J7, Canada; Maisonneuve-Rosemont Hospital Research Center, 5415 Assomption Blvd, Montreal, Quebec, H1T 2M4, Canada.
| | - Cynthia Henriksen
- Maisonneuve-Rosemont Hospital Research Center, 5415 Assomption Blvd, Montreal, Quebec, H1T 2M4, Canada.
| | - Camila Aloisio Alves
- Petrópolis Medical College (FMP/UNIFASE), Av. Barão do Rio Branco, 1003 - Centro, Petrópolis, Rio de Janeiro, 25680-120, Brazil.
| | - Lynda Piché
- Centre Hospitalier de l'Université de Montréal, 1051 Rue Sanguinet, Montreal, Quebec, H2X 3E4, Canada.
| | - Jacinthe Pepin
- Faculty of Nursing, University of Montreal, PO Box 6128, Station Centre-ville, Montreal, Quebec, H3C 3J7, Canada.
| | - Virginia Lee
- McGill University Health Center (Glen site), 1001 Decarie Blvd, Montreal, Quebec, H4A 3J1, Canada.
| | - Marie-France Vachon
- Centre Hospitalier de l'Université de Montréal, 1051 Rue Sanguinet, Montreal, Quebec, H2X 3E4, Canada.
| | - Nathalie Folch
- Centre Hospitalier de l'Université de Montréal, 1051 Rue Sanguinet, Montreal, Quebec, H2X 3E4, Canada.
| | - Marie-Pascale Pomey
- Centre Hospitalier de l'Université de Montréal, 1051 Rue Sanguinet, Montreal, Quebec, H2X 3E4, Canada; Department of Management, Evaluation and Health Policy of the School of Public Health, University of Montreal, 7101 Av du Parc, Montréal, Quebec, H3N 1X9, Canada.
| | - Nicolas Fernandez
- Department of Family Medicine and Emergency Medicine, Faculty of Medicine, University of Montreal, 2900 Edouard Montpetit Blvd, Montreal, Quebec, H3T 1J4, Canada.
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Passamonti F, Corrao G, Castellani G, Mora B, Maggioni G, Della Porta MG, Gale RP. Using real-world evidence in haematology. Best Pract Res Clin Haematol 2024; 37:101536. [PMID: 38490764 DOI: 10.1016/j.beha.2024.101536] [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: 07/06/2023] [Revised: 12/26/2023] [Accepted: 01/15/2024] [Indexed: 03/17/2024]
Abstract
Most new drug approvals are based on data from large randomized clinical trials (RCTs). However, there are sometimes contradictory conclusions from seemingly similar trials and generalizability of conclusions from these trials is limited. These considerations explain, in part, the gap between conclusions from data of RCTs and those from registries termed real world data (RWD). Recently, real-world evidence (RWE) from RWD processed by artificial intelligence has received increasing attention. We describe the potential of using RWD in haematology concluding RWE from RWD may complement data from RCTs to support regulatory decisions.
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Affiliation(s)
- Francesco Passamonti
- Università Degli Stu di di Milano, Milan, Italy; Fondazione I.R.C.C.S. Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy
| | - Giovanni Corrao
- Department of Statistics and Quantitative Methods, Laboratory of Healthcare Research & Pharmacoepidemiology, University of Milano-Bicocca, Milan, Italy
| | - Gastone Castellani
- Department of Physics and Astronomy, University of Bologna, Bologna, Italy
| | - Barbara Mora
- Hematology, ASST Sette Laghi, Ospedale di Circolo, Varese, Italy
| | - Giulia Maggioni
- Center for Accelerating Leukemia/Lymphoma Research (CALR) - IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy; Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
| | - Matteo Giovanni Della Porta
- Center for Accelerating Leukemia/Lymphoma Research (CALR) - IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy; Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
| | - Robert Peter Gale
- Haematology Research Centre, Department of Immunolgy and Inflammation, Imperial College London, London, UK.
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Krug K, Bossert J, Möllinger S, Deis N, Unsöld L, Siegle A, Villalobos M, Hagelskamp L, Jung C, Thomas M, Wensing M. Factors related to implementation of an interprofessional communication concept in thoracic oncology: a mixed-methods study. Palliat Care 2022; 21:89. [PMID: 35614425 PMCID: PMC9134656 DOI: 10.1186/s12904-022-00977-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Accepted: 05/16/2022] [Indexed: 11/17/2022] Open
Abstract
Background An innovative patient-centred interprofessional communication concept with advanced lung cancer patients (Heidelberg Milestone Communication Approach, MCA) has been developed and implemented. Role changes and interprofessional communication are challenging in a busy outpatient oncology service. The aim of the study was to present attitudes to interprofessional collaboration of professions in thoracic oncology during the implementation of MCA and to explore factors and experiences healthcare team members associate with its implementation. Methods In a longitudinal study, 3 of the 4 subscales of the validated German translation of the University of the West of England Interprofessional Questionnaire (UWE-IP-D) were collected prior to implementation of MCA (t0) with follow-up data collections at 4 months (t1), 10 months (t2) and 17 months (t3). Descriptive analysis included calculating subscale sum scores and categorizing each subscale into positive, neutral and negative attitudes. Interviews and focus groups on implementation and interprofessional collaboration in the context of MCA were conducted with healthcare staff. The topics were analysed deductively, guided by the Professional Interactions factor of the Tailored Implementation for Chronic Diseases (TICD) framework. Results The survey with 87 staff (44 nurses, 13 physicians, 12 psycho-social staff, 7 therapists, and 11 others) participating at least once found heterogeneous attitudes. ‘Communication and Teamwork’ and ‘Interprofessional Relationships’ were characterized by primarily positive attitudes. Neutral attitudes to ‘Interprofessional Interaction’ were indicated by the majority of respondents. There were no differences between collection times. Fifteen staff members participated in the interviews and focus groups. The main interprofessional interaction factors associated with implementation concerned the knowledge of the MCA and the impact of the intervention on team roles, on information sharing and on transfer processes between wards. Adaptive processes led to a shift in the perception of responsibilities and interprofessional collaboration. Conclusions Positive experiences and potential shortfalls in the implementation were observed. Future introductions of interprofessional communication concepts require further activities which should address the attitudes of healthcare professionals towards interprofessional care. Trial registration DRKS00013469 / Date of registration: 22/12/2017. Supplementary Information The online version contains supplementary material available at 10.1186/s12904-022-00977-6.
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Passamonti F, Corrao G, Castellani G, Mora B, Maggioni G, Gale RP, Della Porta MG. The future of research in hematology: Integration of conventional studies with real-world data and artificial intelligence. Blood Rev 2021; 54:100914. [PMID: 34996639 DOI: 10.1016/j.blre.2021.100914] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 12/13/2021] [Accepted: 12/14/2021] [Indexed: 12/26/2022]
Abstract
Most national health-care systems approve new drugs based on data of safety and efficacy from large randomized clinical trials (RCTs). Strict selection biases and study-entry criteria of subjects included in RCTs often do not reflect those of the population where a therapy is intended to be used. Compliance to treatment in RCTs also differs considerably from real world settings and the relatively small size of most RCTs make them unlikely to detect rare but important safety signals. These and other considerations may explain the gap between evidence generated in RCTs and translating conclusions to health-care policies in the real world. Real-world evidence (RWE) derived from real-world data (RWD) is receiving increasing attention from scientists, clinicians, and health-care policy decision-makers - especially when it is processed by artificial intelligence (AI). We describe the potential of using RWD and AI in Hematology to support research and health-care decisions.
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Affiliation(s)
- Francesco Passamonti
- Department of Medicine and Surgery, University of Insubria, Varese, Italy; Hematology, ASST Sette Laghi, Ospedale di Circolo, Varese, Italy.
| | - Giovanni Corrao
- Department of Statistics and Quantitative Methods, Division of Biostatistics, Epidemiology and Public Health, University of Milano-Bicocca, Milan, Italy
| | - Gastone Castellani
- Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | - Barbara Mora
- Department of Medicine and Surgery, University of Insubria, Varese, Italy; Hematology, ASST Sette Laghi, Ospedale di Circolo, Varese, Italy
| | - Giulia Maggioni
- IRCCS Humanitas Clinical and Research Center, Rozzano, Italy
| | - Robert Peter Gale
- Haematology Research Centre, Department of Immunolgy and Inflammation, Imperial College London, London, UK
| | - Matteo Giovanni Della Porta
- IRCCS Humanitas Clinical and Research Center, Rozzano, Italy; Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy
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Bilodeau K, Tremblay D. How oncology teams can be patient-centred? opportunities for theoretical improvement through an empirical examination. Health Expect 2018; 22:235-244. [PMID: 30411450 PMCID: PMC6433320 DOI: 10.1111/hex.12847] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Revised: 09/16/2018] [Accepted: 10/18/2018] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND In the context of interprofessional practice, a patient-centred approach is recommended, which generally means power-sharing, shared decision making and involving patients as part of the health-care team. These aspects, which are essential to "patient-centred" practice, do not appear to be sufficient to illustrate the full richness of this practice. OBJECTIVE This article aimed to understand how interprofessional patient-centred (IPPC) practice in oncology teams contributes to creating a more positive experience for patients. Objectives were to (a) describe the IPPC practice of oncology teams using the IPPC Practice Framework; (b) determine the usefulness of this framework; and (c) offer alternative proposals for expanding our understanding of IPPC practice. DESIGN A secondary analysis was performed with data from a multicase study designed to explore the effects of interdisciplinary work among oncology teams. Data were provided from six focus groups with professionals (n = 22) and patients diagnosed with cancer (n = 16). An iterative content analysis was performed. RESULTS Applying the theoretical framework to data analysis enabled us to distinguish between the IPPC practice of the different teams and structure the data collected in order to show the processes and place them in context. However, it proved to be difficult to describe the central component of the theoretical framework, patient-centred processes. This situation raises new hypotheses for representing practice in a real-life context. An alternative perspective for illustrating IPPC practice is therefore proposed. CONCLUSION This study emphasizes the importance of exploring the utility of theoretical frameworks and refining them in order to broaden our understanding of IPPC practice.
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Affiliation(s)
- Karine Bilodeau
- Faculty of Nursing, University of Montreal, Montreal, QC, Canada
| | - Dominique Tremblay
- Faculty of Medicine and Health Sciences, University of Sherbrooke, Longueuil, QC, Canada.,Hôpital Charles-LeMoyne Research Center, Longueuil, Quebec, Canada
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