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Yi H, Ou-Yang X, Hong Q, Liu L, Liu M, Wang Y, Zhang G, Ma F, Mu J, Mao Y. Patient-reported outcomes in lung cancer surgery: A narrative review. Asian J Surg 2024:S1015-9584(24)01677-4. [PMID: 39117541 DOI: 10.1016/j.asjsur.2024.07.304] [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: 04/13/2024] [Revised: 07/17/2024] [Accepted: 07/25/2024] [Indexed: 08/10/2024] Open
Abstract
Lung cancer is a leading cause of cancer-related mortality worldwide, profoundly affecting patients' quality of life. Patient-reported outcomes (PROs) provide essential insights from the patients' perspective, a crucial aspect often overlooked by traditional clinical outcomes. This review synthesizes research on the role of PROs in lung cancer surgery to enhance patient care and outcomes. We conducted a comprehensive literature search across PubMed, Scopus, and Web of Science up to March 2024, using terms such as "lung cancer," "Patient Reported Outcome," "lobectomy," "segmentectomy," and "lung surgery." The criteria included original studies on lung cancer patients who underwent surgical treatment and reported on PROs. After screening and removing duplicates, reviews, non-English articles, and irrelevant studies, 36 research articles were selected, supported by an additional 53 publications, totaling 89 references. The findings highlight the utility of PROs in assessing post-surgical outcomes, informing clinical decisions, and facilitating patient-centered care. However, challenges in standardization, patient burden, and integration into clinical workflows remain, underscoring the need for further research and methodological refinement. PROs are indispensable for understanding the quality-of-life post-surgery and enhancing communication and decision-making in clinical practice. Their integration into routine care is vital for a holistic approach to lung cancer treatment, promising significant improvements in patient outcomes and quality of care.
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Affiliation(s)
- Hang Yi
- Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
| | - Xu Ou-Yang
- Shantou University Medical College, Shantou, 515041, China
| | - Qian Hong
- Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
| | - Lu Liu
- Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
| | - Man Liu
- Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
| | - Yan Wang
- The Johns Hopkins University, Bloomberg School of Public Health, Epidemiology, Baltimore, MD, USA
| | - Guochao Zhang
- Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
| | - Fengyan Ma
- Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China.
| | - Juwei Mu
- Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China.
| | - Yousheng Mao
- Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China.
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Drury A, Boland V, Dowling M. Patient-Reported Outcome and Experience Measures in Advanced Nursing Practice: What Are Key Considerations for Implementation and Optimized Use? Semin Oncol Nurs 2024; 40:151632. [PMID: 38658204 DOI: 10.1016/j.soncn.2024.151632] [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: 01/28/2024] [Revised: 03/10/2024] [Accepted: 03/17/2024] [Indexed: 04/26/2024]
Abstract
OBJECTIVE To discuss the opportunities and challenges of implementing patient-reported outcome measures (PROMs) and patient-reported experience measures (PREMs) within advanced practice nursing services in cancer care. METHODS This discussion paper has been informed by an environmental scan of evidence from systematic reviews and primary studies evaluating the use and implementation of PROMs and PREMs. Literature from the contexts of cancer and chronic disease, including nursing and multidisciplinary supportive care literature, has been included. RESULTS Advanced practice nurses are well-positioned to evaluate and respond to PROMs and PREMs data; several studies have highlighted improved patient outcomes concerning quality of life, symptom distress, and functional status within nurse-led services. Nevertheless, the implementation of PROMs and PREMs in cancer care and nurse-led services is variable. Previous studies have highlighted implementation challenges, which can hinder comparability and generalizability of PROMs and PREMs instruments. Advanced practice nurses should consider these challenges, including ways to use standardized PROM instruments. Electronic PROMs, while efficient, may exclude individuals at risk of inequity. Complex, lengthy, and frequent administration of PROMs may also overburden people living with or after cancer, with people affected by cancer expressing preference for flexible use in some studies. Therefore, the involvement of people affected by cancer in planning for PROMs/PREMs implementation may overcome this challenge. Finally, organizational considerations in implementation should address financial investments, including initial costs for technology and training and consideration of the operationalization of PROMs within existing infrastructure for the seamless utilization of PROMs data. CONCLUSION Despite the potential of advanced practice nursing services to enhance patient-reported outcomes and experiences, variability in the implementation of PROMs and PREMs poses challenges. Use of validated measures, electronic or paper-based instruments, and the preferences of people affected by cancer for the use of PROMs and PREMs must be carefully considered in consultation with end users for successful implementation. IMPLICATIONS FOR PRACTICE In planning for the implementation of PROMs and PREMs within nurse-led services, implementation risks may be mitigated through establishing clear guidelines for their use, investment in the development of the required infrastructure, user education, and rigorous implementation processes, including patient involvement in PROMs/PREMs selection.
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Affiliation(s)
- Amanda Drury
- Associate Professor in General Nursing, School of Nursing, Psychotherapy and Community Health, Dublin City University, Glasnevin, Dublin, Ireland.
| | - Vanessa Boland
- Assistant Professor in General Nursing, School of Nursing & Midwifery, Faculty of Health Sciences, Trinity College Dublin, Dublin, Ireland
| | - Maura Dowling
- Associate Professor, School of Nursing and Midwifery, University of Galway, Ireland
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Vieta E, Menchón Magriña JM, Bernardo Arroyo M, Pérez Sola V, Moreno Ruiz C, Arango López C, Bobes García J, Martín Carrasco M, Palao Vidal D, González-Pinto Arrillaga A. Basic quality indicators for clinical care of patients with major depression, schizophrenia, and bipolar disorder. SPANISH JOURNAL OF PSYCHIATRY AND MENTAL HEALTH 2024; 17:103-109. [PMID: 37852877 DOI: 10.1016/j.rpsm.2023.03.001] [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: 10/20/2022] [Revised: 03/08/2023] [Accepted: 03/16/2023] [Indexed: 10/20/2023]
Abstract
OBJECTIVE To identify a set of indicators to monitor the quality of care for patients with major depression, schizophrenia, or bipolar disorder. METHODS A group of 10 experts selected the most automatically applicable indicators from a total of 98 identified in a previous study. Five online sessions and 5 discussion meetings were performed to select the indicators that met theoretical feasibility criteria automatically. Subsequently, feasibility was tested in a pilot study conducted in two hospitals of the Spanish Health Service. RESULTS After evaluating its measurement possibilities in the Spanish Health Service, and the fulfillment of all the quality premises defined, 16 indicators were selected. Three were indicators of major depression, 5 of schizophrenia, 3 of bipolar disorder, and 5 indicators common to all three pathologies. They included measures related to patient safety, maintenance and follow-up of treatment, therapeutic adherence, and adequacy of hospital admissions. After the pilot study, 5 indicators demonstrated potential in the automatic generation of results, with 3 of them related to treatments (clozapine in schizophrenia, lithium for bipolar disorder, and valproate in women of childbearing age). CONCLUSIONS Indicators support the monitoring of the quality of treatment of patients with major depression, schizophrenia, or bipolar disorder. Based on this proposal, each care setting can draw up a balanced scorecard adjusted to its priorities and care objectives, which will allow for comparison between centers.
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Affiliation(s)
- Eduard Vieta
- Hospital Clínic, Bipolar and Depressive Disorders Unit, Neurosciences Institute, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Spain
| | | | | | - Víctor Pérez Sola
- Neuropsychiatry and Addcitions Institute, Hospital del Mar, CIBERSAM, ISCIII, IMIM (Hospital del Mar Institute of Medicine Research), Psychiatry Department, Autonomous University of Barcelona, Barcelona, Spain
| | - Carmen Moreno Ruiz
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, IiSGM, CIBERSAM, School of Medicine, Complutense University of Madrid, Madrid, Spain
| | - Celso Arango López
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, IiSGM, CIBERSAM, School of Medicine, Complutense University of Madrid, Madrid, Spain
| | - Julio Bobes García
- Hospital Universitario Central de Asturias (HUCA), ISPA, INEUROPA, CIBERSAM, ISCIII, University of Oviedo, Oviedo, Spain
| | | | - Diego Palao Vidal
- Hospital Universitario Parc Taulí-Mental Health, I3PT-INc Translational Neuroscience Unit, Autonomous University of Barcelona, CIBERSAM, ISCIII, Sabadell, Barcelona, Spain
| | - Ana González-Pinto Arrillaga
- Department of Psychiatry, BIOARABA, Hospital Universitario de Álava-Santiago, CIBERSAM, ISCIII, University of the Basque Country, Vitoria-Gasteiz, Spain.
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Kenis I, Kinnaer LM, Van Hecke A, Foulon V. How patient-centered is education and counseling of patients treated with oral anticancer drugs? A multicenter cross-sectional study. PATIENT EDUCATION AND COUNSELING 2023; 115:107927. [PMID: 37556896 DOI: 10.1016/j.pec.2023.107927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Revised: 07/26/2023] [Accepted: 07/28/2023] [Indexed: 08/11/2023]
Abstract
OBJECTIVE In this multicenter cross-sectional study, the quality of patient-centered education and counseling for patients treated with oral anticancer drugs was examined. METHODS The CONTACT-Patient-Centered Care Questionnaire was administered to 266 patients, recruited in 11 Flemish hospitals. The questionnaire consists of 80 items, each evaluating the degree of performance of a key element in patient-centered education and counseling. RESULTS In total, 15 key elements were seriously underperformed (degree of performance < 50%). Elements regarding adherence monitoring, specific topics in patient education, and involvement of the community pharmacist and home care nurse received a very low score. Only six key elements were systematically performed (degree of performance ≥ 90%), among which the elements on communication style and involvement of the general practitioner. CONCLUSION This study uncovered three major gaps in patient-centered education and counseling of patients on oral anticancer drugs: unmet patient information needs due to shortcomings in patient education, inadequate adherence monitoring, and lacking collaboration with community pharmacists and home care nurses. PRACTICE IMPLICATIONS This study highlights the need for interdisciplinary and patient-centered education and counseling of patients using OACD, including all key stakeholders: physicians, nurses, hospital pharmacists, general practitioners, community pharmacist and home care nurses.
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Affiliation(s)
- Ilyse Kenis
- Department of Pharmaceutical and Pharmacological Sciences, KU Leuven, Leuven, Belgium; Department of Public Health and Primary Care, Ghent University, Ghent, Belgium.
| | - Lise-Marie Kinnaer
- Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
| | - Ann Van Hecke
- Department of Public Health and Primary Care, Ghent University, Ghent, Belgium; Department of Nursing Director, Ghent University Hospital, Ghent, Belgium
| | - Veerle Foulon
- Department of Pharmaceutical and Pharmacological Sciences, KU Leuven, Leuven, Belgium
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Elkefi S, Asan O. Perceived Patient Workload and Its Impact on Outcomes During New Cancer Patient Visits: Analysis of a Convenience Sample. JMIR Hum Factors 2023; 10:e49490. [PMID: 37594798 PMCID: PMC10474510 DOI: 10.2196/49490] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 07/01/2023] [Accepted: 07/14/2023] [Indexed: 08/19/2023] Open
Abstract
BACKGROUND Studies exploring the workload in health care focus on the doctors' perspectives. The ecology of the health care environment is critical and different for doctors and patients. OBJECTIVE In this study, we explore the patient workload among newly diagnosed patients with cancer during their first visit and its impact on the patient's perceptions of the quality of care (their trust in their doctors, their satisfaction with the care visits, their perception of technology use). METHODS We collected data from the Hackensack Meridian Health, John Theurer Cancer Center between February 2021 and May 2022. The technology use considered during the visit is related to doctors' use of electronic health records. A total of 135 participants were included in the study. Most participants were 50-64 years old (n=91, 67.41%). A majority (n=81, 60%) of them were White, and only (n=16, 11.85%) went to graduate schools. RESULTS The findings captured the significant effect of overall workload on trust in doctors and perception of health IT use within the visits. On the other hand, the overall workload did not impact patients' satisfaction during the visit. A total of 80% (n=108) of patients experienced an overall high level of workload. Despite almost 55% (n=75) of them experiencing a high mental load, 71.1% (n=96) reported low levels of effort, 89% (n=120) experienced low time pressure, 85.2% (n=115) experienced low frustration levels, and 69.6% (n=94) experienced low physical activity. The more overall workload patients felt, the less they trusted their doctors (odds ratio [OR] 0.059, 95% CI 0.001-2.34; P=.007). Low trust was also associated with the demanding mental tasks in the visits (OR 0.055, 95% CI 0.002-2.64; P<.001), the physical load (OR 0.194, 95% CI 0.004-4.23; P<.001), the time load (OR 0.183, 95% CI 0.02-2.35; P=.046) the effort needed to cope with the environment (OR 0.163, 95% CI 0.05-1.69; P<.001), and the frustration levels (OR 0.323, 95% CI 0.04-2.55; P=.03). The patients' perceptions of electronic health record use during the visit were negatively impacted by the overall workload experienced by the patients (OR 0.315, 95% CI 0.08-6.35; P=.01) and the high frustration level experienced (OR 0.111, 95% CI 0.015-3.75; P<.001). CONCLUSIONS The study's findings established pathways for future research and have implications for cancer patients' workload. Better technology design and use can minimize perceived workload, which might contribute to the trust relationship between doctors and patients in this critical environment. Future human factors work needs to explore the workload and driving factors in longitudinal studies and assess whether these workloads might contribute to unintended patient outcomes and medical errors.
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Affiliation(s)
- Safa Elkefi
- School of Systems and Enterprises, Stevens Institute of Technology, Hoboken, NJ, United States
| | - Onur Asan
- School of Systems and Enterprises, Stevens Institute of Technology, Hoboken, NJ, United States
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van Dongen A, Stewart D, Garry J, McCambridge J. Measurement of person-centred consultation skills among healthcare practitioners: a systematic review of reviews of validation studies. BMC MEDICAL EDUCATION 2023; 23:211. [PMID: 37016379 PMCID: PMC10074817 DOI: 10.1186/s12909-023-04184-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Accepted: 03/21/2023] [Indexed: 06/19/2023]
Abstract
BACKGROUND Person-centred care is integral to high-quality health service provision, though concepts vary and the literature is complex. Validated instruments that measure person-centred practitioner skills, and behaviours within consultations, are needed for many reasons, including in training programmes. We aimed to provide a high-level synthesis of what was expected to be a large and diverse literature through a systematic review of existing reviews of validation studies a of instruments that measure person-centred practitioner skills and behaviours in consultations. The objectives were to undertake a critical appraisal of these reviews, and to summarise the available validated instruments and the evidence underpinning them. METHODS A systematic search of Medline, EMBASE, PsycINFO and CINAHL was conducted in September 2020. Systematic reviews of validation studies of instruments measuring individual practitioner person-centred consultation skills or behaviours which report measurement properties were included. Review quality was assessed with the Joanna Briggs Institute Critical Appraisal Checklist for Systematic Reviews and Research Syntheses. Details of the reviews, the included validation studies, and the instruments themselves are tabulated, including psychometric data, and a narrative overview of the reviews is provided. RESULTS Four reviews were eligible for inclusion. These used different conceptualisations of person-centredness and targeted distinct, sometimes mutually exclusive, practitioners and settings. The four reviews included 68 unique validation studies examining 42 instruments, but with very few overlaps. The critical appraisal shows there is a need for improvements in the design of reviews in this area. The instruments included within these reviews have not been subject to extensive validation study. DISCUSSION There are many instruments available which measure person-centred skills in healthcare practitioners and this study offers a guide to what is available to researchers and research users. The most relevant and promising instruments that have already been developed, or items within them, should be further studied rigorously. Validation study of existing material is needed, not the development of new measures.
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Affiliation(s)
- Anne van Dongen
- Department of Psychology, Health, and Technology, University of Twente, Enschede, the Netherlands.
| | - Duncan Stewart
- School of Social Sciences and Professions, London Metropolitan University, London, UK
| | - Jack Garry
- Department of Health Sciences, University of York, York, UK
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Kenis I, Janssen R, Wuyts SCM, Van Hecke A, Foulon V. CONTACT-Patient-Centred Care Questionnaire to assess care for patients treated with oral anticancer drugs: Development and psychometric validation. Eur J Cancer Care (Engl) 2022; 31:e13643. [PMID: 35793704 DOI: 10.1111/ecc.13643] [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: 02/03/2022] [Revised: 04/21/2022] [Accepted: 06/06/2022] [Indexed: 11/27/2022]
Abstract
OBJECTIVE Instruments to measure quality of patient-centred care (PCC) for the rapidly growing population of patients treated with oral anticancer drugs (OACD) are lacking. The aim of this study was to develop a valid and reliable instrument to assess PCC in the context of OACD. METHODS The CONTACT-Patient-Centred Care Questionnaire (CONTACT-PCCQ) was developed based on a validated set of key elements (KEs) for patient-centred education and counselling in patients taking OACD, and face validity was evaluated by means of cognitive interviews. In 16 Belgian hospitals, adult patients treated with OACD were asked to complete the questionnaire. Construct validity was investigated through exploratory factor analyses (EFAs) and internal consistency of the subscales was examined using Cronbach's alpha. RESULTS The initial 86-item instrument was completed by 464 patients. Each EFA confirmed the a priori PCC-based structure of the subscales. However, EFA revealed more than one factor for two of the subscales. Therefore, multiple subsections within these subscales were created. Based on factor loadings and item content, six items were removed. This resulted in a final 80-item instrument with seven subscales and five subsections. Cronbach's alpha for the subscales and subsections ranged between 0.732 and 0.918, which implies adequate internal consistency. CONCLUSION A final instrument with 80 items divided into seven subscales, covering all six dimensions of PCC, was obtained. The CONTACT-PCCQ has acceptable psychometric properties, supporting its use as a measure to assess care experiences of patients treated with OACD.
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Affiliation(s)
- Ilyse Kenis
- Department of Pharmaceutical and Pharmacological Sciences, Clinical Pharmacology and Pharmacotherapy, KU Leuven, Leuven, Belgium.,Department of Public Health and Primary Care, University Centre for Nursing and Midwifery, Ghent University, Ghent, Belgium
| | - Rianne Janssen
- Faculty of Psychology and Educational Sciences, Centre of Educational Effectiveness and Evaluation, KU Leuven, Leuven, Belgium
| | - Stephanie C M Wuyts
- Hospital Pharmacy, University Hospital Brussels, Brussels, Belgium.,Research Group Clinical Pharmacology and Clinical Pharmacy, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Brussels, Belgium
| | - Ann Van Hecke
- Department of Public Health and Primary Care, University Centre for Nursing and Midwifery, Ghent University, Ghent, Belgium.,Department of Nursing, Ghent University Hospital, Ghent, Belgium
| | - Veerle Foulon
- Department of Pharmaceutical and Pharmacological Sciences, Clinical Pharmacology and Pharmacotherapy, KU Leuven, Leuven, Belgium
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Silveira A, Sequeira T, Gonçalves J, Lopes Ferreira P. Patient reported outcomes in oncology: changing perspectives-a systematic review. Health Qual Life Outcomes 2022; 20:82. [PMID: 35597948 PMCID: PMC9124403 DOI: 10.1186/s12955-022-01987-x] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 05/10/2022] [Indexed: 12/24/2022] Open
Abstract
In public health context, oncology is associated with severe negative impact on patients and on their relatives’ quality of life. Over the last decades, survival has remained at 50% worldwide for some tumor locations. Patient reported outcomes (PROs) assessment and, the corresponding use in clinical practice, help establishing patient individualized profiling involving caregivers. The purpose of this systematic review was to examine critical success factors for PROs assessment in daily clinical oncology practice. Additionally, we investigated how PROs collection can change oncology perspectives for patients and caregivers. According to PRISMA guidelines, 83 studies were included in this systematic review, whether related with implementation in daily clinical practice or associated with its use in oncology. PROs assessment gathers multi-professional teams, biomedical and clinical expertise, patients, families and caregivers. Institutional involvement, first line for caregiver’s adherence, team continuous formation, encompassing training and support, design of clear workflows, continuous monitoring, and data analysis are crucial for implementation. PROs measures are decisive in oncology. Several items were improved, including caregiver–patient–physician communication, patient risk groups identification, unmet problems and needs detection, disease course and treatment tracking, prognostic markers, cost-effectiveness measurement and comfort/support provision for both patients and caregivers. Routine assessment and implementation of PROs in clinical practice are a major challenge and a paradigm transformation for future.
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Affiliation(s)
- Augusta Silveira
- Health Sciences Faculty, Fernando Pessoa University (UFP-FCS), Rua Carlos da Maia, 296, 4200-150, Porto, Portugal.,Centre for Health Studies and Research of University of Coimbra, Centre for Innovative Biomedicine and Biotechnology, Avenida Dias da Silva, 165, 3004-512, Coimbra, Portugal
| | - Teresa Sequeira
- Health Sciences Faculty, Fernando Pessoa University (UFP-FCS), Rua Carlos da Maia, 296, 4200-150, Porto, Portugal.,Centre for Health Studies and Research of University of Coimbra, Centre for Innovative Biomedicine and Biotechnology, Avenida Dias da Silva, 165, 3004-512, Coimbra, Portugal
| | - Joaquim Gonçalves
- 2Ai - Applied Artificial Intelligence Laboratory, School of Technology of Polytechnic Institute of Cávado and Ave, R. de São Martinho, 4750-810, Vila Frescainha, Barcelos, Portugal
| | - Pedro Lopes Ferreira
- Centre for Health Studies and Research of University of Coimbra, Centre for Innovative Biomedicine and Biotechnology, Avenida Dias da Silva, 165, 3004-512, Coimbra, Portugal. .,Faculty of Economics, University of Coimbra, Av. Dr. Dias da Silva, 165, 3004-512, Coimbra, Portugal.
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Lopez-Soto C, Bates E, Anderson C, Saha S, Adams L, Aulakh A, Bowtell F, Buckel M, Emms T, Shebl M, Metaxa V. The Role of a Liaison Team in ICU Family Communication During the COVID 19 Pandemic. J Pain Symptom Manage 2021; 62:e112-e119. [PMID: 33892123 PMCID: PMC8057931 DOI: 10.1016/j.jpainsymman.2021.04.008] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2021] [Revised: 04/09/2021] [Accepted: 04/14/2021] [Indexed: 11/18/2022]
Abstract
CONTEXT In the name of public safety, a general suspension on hospital visiting was imposed in the U.K., prohibiting family and friends to visit hospitalized patients, even if they were critically ill. OBJECTIVES we aimed to assess the impact of the FLT on the communication with patients' family and friends (PFF), especailly around end-of-life care, and their interaction with CC clinicians. METHODS A retrospective, mixed-methods analysis of a family liaison team (FLT) formed by redeployed clinicians in critical care (CC) during the first surge of the 2020 COVID 19 pandemic. RESULTS The FLT was constituted predominantly of non-ICU consultants (30/39, 77%). Following two one-hourly webinars around basic communication skills, the FLT facilitated over 12,000 video and telephone calls with 172 patients' family and friends (PFF). The majority of the PFF interviewed were mostly, very or extremely satisfied with the frequency, ease, understanding, honesty, completeness, and consistency of the information provided. Approximately 5% of the interviewees reported to be slightly or very dissatisfied in one or more of the following 3 categories: frequency, consistency, and ease of getting the information. The thematic analysis identified 3 themes: 1) being there with/ for the patient; 2) breakdown in communication; 3) disbelief at the speed of deterioration. In 14.9% of cases there was documented discrepancy between the information transmitted by the CC team and that by the FLT, particularly around the severity of the patient's illness and their imminent death. CONCLUSION The formation of a dedicated FLT was feasible and associated with high levels of satisfaction by the PFF. Friction was created when communication was not consistent and did not convey the severity of the patient's condition, to prepare the PFF for a bad outcome.
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Affiliation(s)
- Carmen Lopez-Soto
- Department of Critical Care, King's College Hospital NHS Foundation Trust, London, UK
| | - Eleanor Bates
- Department of Critical Care, King's College Hospital NHS Foundation Trust, London, UK
| | - Charlotte Anderson
- Department of Critical Care, King's College Hospital NHS Foundation Trust, London, UK
| | - Sian Saha
- Department of Critical Care, King's College Hospital NHS Foundation Trust, London, UK
| | - Laura Adams
- Department of Critical Care, King's College Hospital NHS Foundation Trust, London, UK
| | - Alex Aulakh
- Guy's and St Thomas' Hospital NHS Foundation Trust, London, UK
| | - Francesca Bowtell
- Department of Critical Care, King's College Hospital NHS Foundation Trust, London, UK
| | - Marie Buckel
- The National Hospital for Neurology and Neurosurgery, London, UK
| | - Thomas Emms
- Ashford & St Peter's Hospital NHS Trust, Ashford, UK
| | - Moustafa Shebl
- Department of Critical Care, King's College Hospital NHS Foundation Trust, London, UK
| | - Victoria Metaxa
- Department of Critical Care, King's College Hospital NHS Foundation Trust, London, UK.
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PROMIS Global Health: Feasibility in home health. Qual Life Res 2021; 30:2551-2561. [PMID: 33893932 DOI: 10.1007/s11136-021-02845-x] [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: 04/07/2021] [Indexed: 10/21/2022]
Abstract
PURPOSE This feasibility study assessed if the Patient-Reported Outcomes Measurement Information System (PROMIS®) 10-item Global Health Survey (PROMIS-10) could be a reliable and valid patient-reported outcome measure (PROM) for a population of cognitively intact home health (HH) patients. METHODS The Centers for Medicare and Medicaid Services (CMS) along with their measurement contractor, Abt Associates, held a field test (2016-2017) to test the feasibility of the PROMIS-10 in in the Outcome and Assessment Information Set (OASIS). Home Health clinician data collectors (registered nurses and physical therapists) were trained to complete the PROMIS-10 along with procedures to facilitate patient self-administration of PROMIS-10. These clinicians provided feedback about their experiences at a focus group at the end of data collection. RESULTS 213 HH patients comprised the field test sample, 150 of whom completed PROMIS-10 surveys. Clinicians reported they found the PROMIS-10 relevant and acceptable for their HH patients, and noted the surveys provided insight into patients' views of their health. The PROMIS-10 measured the full range of patient-reported health and was sensitive to change between admission and discharge. CONCLUSIONS The study confirmed that the PROMIS-10 can be implemented in the HH setting, opening the door for consideration for implementing the PROMIS-10 in post-acute care (PAC) settings. This study is a first step toward establishing an assessment that captures the patient's voice and could be reported by the CMS PAC quality reporting programs.
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Milnes SL, Mantzaridis Y, Simpson NB, Dunning TL, Kerr DC, Ostaszkiewicz JB, Keely GT, Corke C, Orford NR. Values, preferences and goals identified during shared decision making between critically ill patients and their doctors. CRIT CARE RESUSC 2021; 23:76-85. [PMID: 38046387 PMCID: PMC10692567 DOI: 10.51893/2021.1.oa7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Objective: Examine values, preferences and goals elicited by doctors following goals-of-care (GOC) discussions with critically ill patients who had life-limiting illnesses. Design: Descriptive qualitative study using four-stage latent content analysis. Setting: Tertiary intensive care unit (ICU) in South Western Victoria. Participants: Adults who had life-limiting illnesses and were admitted to the ICU with documented GOC, between October 2016 and July 2018. Intervention: The iValidate program, a shared decision-making clinical communication education and clinical support program, for all ICU registrars in August 2015. Main outcome measures: Matrix of themes and subthemes categorised into values, preferences and goals. Results: A total of 354 GOC forms were analysed from 218 patients who had life-limiting illnesses and were admitted to the ICU. In the categories of values, preferences and goals, four themes were identified: connectedness and relational autonomy, autonomy of decision maker, balancing quality and quantity of life, and physical comfort. The subthemes - relationships, sense of place, enjoyment of activities, independence, dignity, cognitive function, quality of life, longevity and physical comfort - provided a matrix of issues identified as important to patients. Relationship, place, independence and physical comfort statements were most frequently identified; longevity was least frequently identified. Conclusion: Our analysis of GOC discussions between medical staff and patients who had life-limiting illnesses and were admitted to the ICU, using a shared decision-making training and support program, revealed a framework of values, preferences and goals that could provide a structure to assist clinicians to engage in shared decision making.
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Affiliation(s)
- Sharyn L. Milnes
- University Hospital Geelong, Barwon Health, Geelong, Australia
- Centre for Quality and Patient Safety Research, School of Nursing and Midwifery, Deakin University, Geelong, Australia
- School of Medicine, Deakin University, Geelong, Australia
| | | | - Nicholas B. Simpson
- University Hospital Geelong, Barwon Health, Geelong, Australia
- School of Medicine, Deakin University, Geelong, Australia
| | - Trisha L. Dunning
- Centre for Quality and Patient Safety Research, School of Nursing and Midwifery, Deakin University, Geelong, Australia
| | - Debra C. Kerr
- Centre for Quality and Patient Safety Research, School of Nursing and Midwifery, Deakin University, Geelong, Australia
| | | | - Gerry T. Keely
- University Hospital Geelong, Barwon Health, Geelong, Australia
| | - Charlie Corke
- University Hospital Geelong, Barwon Health, Geelong, Australia
| | - Neil R. Orford
- University Hospital Geelong, Barwon Health, Geelong, Australia
- School of Medicine, Deakin University, Geelong, Australia
- Australian and New Zealand Intensive Care Research Centre (ANZIC-RC), Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia
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12
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Mitchell KAR, Brassil KJ, Rodriguez SA, Tsai E, Fujimoto K, Krause KJ, Shay LA, Springer AE. Operationalizing patient-centered cancer care: A systematic review and synthesis of the qualitative literature on cancer patients' needs, values, and preferences. Psychooncology 2020; 29:1723-1733. [PMID: 32715542 PMCID: PMC7901502 DOI: 10.1002/pon.5500] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Revised: 07/06/2020] [Accepted: 07/22/2020] [Indexed: 12/30/2022]
Abstract
OBJECTIVE Efficiently addressing patient priorities and concerns remains a challenge in oncology. Systematic operationalization of patient-centered care (PCC) can support improved assessment and practice of PCC in this unique care setting. This review aimed to synthesize the qualitative empirical literature exploring the National Academy of Medicine (NAM)'s PCC constructs of values, needs, and preferences among patients' during their cancer treatment experiences. METHODS A systematic review of qualitative studies published between 2002 and 2018 addressing adult patient values, needs, and preferences during cancer treatment was conducted. Medline, EMBASE, PsycINFO, and SCOPUS databases were searched on September 10, 2018. Methodological rigor was assessed using a modified version of the Evaluation Tool for Qualitative Studies. Included study findings were analyzed using line-by-line coding; and the emergent themes were compared to the National Academy of Medicine (NAM)'s PCC dimensions. RESULTS Twenty-nine primary studies were included in the synthesis. Descriptive themes for values (autonomy, being involved, family, hope, normality, and sincerity), needs (care coordination, information, privacy, support of physical well-being, emotional support (family/friends, peer, provider), and self-support), and preferences (care coordination, decision-making, information delivery, source of social support, and treatment) were identified. "Cancer care context" emerged as an important domain in which these constructs are operationalized. This thematic framework outlines PCC attributes that oncology care stakeholders can evaluate to improve patient experiences. CONCLUSIONS These findings build on previous PCC research and may contribute to the systematic assessment of patient priorities and the improvement of oncology care quality from the patient perspective.
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Affiliation(s)
- Kerri-Anne R. Mitchell
- Department of Health Behavior and Policy, Virginia
Commonwealth University School of Medicine, Richmond, Virginia
| | | | - Serena A. Rodriguez
- Department of Population and Data Sciences, University of
Texas Southwestern Medical Center, Dallas, Texas
| | - Edward Tsai
- Division of Public Health Sciences, Department of Surgery,
Washington University School of Medicine, St. Louis, Missouri
| | - Kayo Fujimoto
- Department of Health Promotion & Behavioral Sciences,
The University of Texas Health Science Center at Houston (UTHealth) School of Public
Health, Houston, Texas
| | - Kate J. Krause
- Research Medical Library, The University of Texas MD
Anderson Cancer Center, Houston, Texas
| | - L. Aubree Shay
- Department of Health Promotion & Behavioral Sciences,
UTHealth School of Public Health, San Antonio, Texas
| | - Andrew E. Springer
- Michael & Susan Dell Center for Healthy Living,
Department of Health Promotion & Behavioral Sciences, UTHealth School of Public
Health, Austin, Texas
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13
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Doubova SV, Martinez-Vega IP, Gutiérrez-De-la-Barrera M, Infante-Castañeda C, Aranda-Flores CE, Monroy A, Gómez-Laguna L, Knaul FM, Pérez-Cuevas R. Psychometric validation of a Patient-Centred Quality of Cancer Care Questionnaire in Mexico. BMJ Open 2020; 10:e033114. [PMID: 32184306 PMCID: PMC7076235 DOI: 10.1136/bmjopen-2019-033114] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVES To develop and validate a Patient-Centred Quality of Cancer Care Questionnaire in Spanish (PCQCCQ-S) appropriate to the Mexican context. DESIGN Psychometric validation of a questionnaire. SETTING Two public oncology hospitals in Mexico City. PARTICIPANTS 1809 patients with cancer aged ≥18 years. SOURCE OF INFORMATION Cross-sectional survey. METHODS The validation procedures comprised (1) content validity through a group of experts and patients; (2) item reduction and evaluation of the factor structure, through an exploratory factor analysis based on the polychoric correlation matrix; (3) internal consistency using Cronbach's alpha; (4) convergent validity between the PCQCCQ-S and supportive care needs scale; (5) correlation analysis between the PCQCCQ-S and quality of life scale by calculating Spearman's rank-correlation coefficient; and (6) differentiation by 'known groups' through the Wilcoxon rank-sum test. RESULTS The PCQCCQ-S has 30 items with the following five factors accounting for 96.5% of the total variance: (1) timely care; (2) clarity of the information; (3) information for treatment decision-making; (4) activities to address biopsychosocial needs; and (5) respectful and coordinated care. Cronbach's alpha values ranged from 0.73 to 0.90 among the factors. PCQCCQ-S has moderate convergent validity with supportive care needs scale, revealing that higher quality is correlated with lower patient needs. PCQCCQ-S has acceptable ability to differentiate by 'known groups', showing that older patients and those with low levels of education perceived lower total quality of care as compared with their counterparts. CONCLUSION PCQCCQ-S has acceptable psychometric properties and can be used to measure quality of patient-centred cancer care in Mexico and serve as a reference to develop PCQCCQ-S in other Spanish-speaking countries.
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Affiliation(s)
- Svetlana V Doubova
- Epidemiology and Health Services Research Unit CMN Siglo XXI, Mexican Institute of Social Security, Mexico City, Mexico
| | - Ingrid Patricia Martinez-Vega
- Epidemiology and Health Services Research Unit CMN Siglo XXI, Mexican Institute of Social Security, Mexico City, Mexico
| | | | | | - Carlos E Aranda-Flores
- Servicio de Oncología, Hospital General de México Dr Eduardo Liceaga, Mexico City, Mexico
| | - Adriana Monroy
- Servicio de Oncología, Hospital General de México Dr Eduardo Liceaga, Mexico City, Mexico
| | - Laura Gómez-Laguna
- Servicio de Oncología, Hospital General de México Dr Eduardo Liceaga, Mexico City, Mexico
| | - Felicia Marie Knaul
- Sylvester Comprehensive Cancer Center, University of Miami, Miami, Florida, USA
| | - Ricardo Pérez-Cuevas
- Division of Social Protection and Health, Inter-American Development Bank, Kingston, Jamaica
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14
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Mitchell KAR, Brassil KJ, Fujimoto K, Fellman BM, Shay LA, Springer AE. Exploratory Factor Analysis of a Patient-Centered Cancer Care Measure to Support Improved Assessment of Patients' Experiences. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2020; 23:351-361. [PMID: 32197731 PMCID: PMC7086403 DOI: 10.1016/j.jval.2019.10.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/13/2018] [Revised: 08/26/2019] [Accepted: 10/20/2019] [Indexed: 06/01/2023]
Abstract
OBJECTIVE To increase the understanding of patient-centered care (PCC) and address the need for cross-cutting quality cancer care measures that are relevant to both patients and providers. METHODS An exploratory factor analysis (EFA) was performed on a short version of the Patients and the Cancer Care Experience Survey, a patient-reported measure of perceived importance of social, emotional, physical, and informational aspects of care, administered to adult patients (n = 104) at a National Cancer Institute-designated comprehensive cancer center. Relationships between PCC dimensions and patient characteristics were also assessed. Principal axis factoring was applied and bivariate analyses were performed using Wilcoxon rank-sum tests. RESULTS Most of our sample was over 60 years old (63.4%), female (57.4%), and white (74.2%), with either breast (41.2%) or prostate cancer (27.5%). A 5-factor model was identified: (1) quality of life (α = .91), (2) provider social support (α = .83), (3) psychosocial needs (α = .91), (4) nonprovider social support (α = .79), and (5) health information and decision-making support (α = .88). No statistically significant associations were found between these factors and patients' characteristics. CONCLUSIONS A preliminary factor structure for a cancer PCC measure was identified. Our findings reinforce the interrelated nature of PCC dimensions. The lessons learned from this study may be used to develop a single PCC measure that identifies patient priorities across the cancer care continuum. Data collected from such a measure can be used to support patient engagement in treatment planning and decision-making.
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Affiliation(s)
- Kerri-Anne R Mitchell
- Department of Health Behavior and Policy, Virginia Commonwealth University School of Medicine, Richmond, VA, USA.
| | | | - Kayo Fujimoto
- Department of Health Promotion & Behavioral Sciences, University of Texas Health Science Center at Houston School of Public Health, Houston, TX, USA; Department of Biostatistics and Data Science, University of Texas Health Science Center at Houston School of Public Health, Houston, TX, USA
| | - Bryan M Fellman
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Laura Aubree Shay
- Department of Health Promotion & Behavioral Sciences, University of Texas Health Science Center at Houston School of Public Health, San Antonio, TX, USA
| | - Andrew E Springer
- Department of Health Promotion and Behavioral Sciences, Michael & Susan Dell Center for Healthy Living, University of Texas Health Science Center at Houston School of Public Health, Austin, TX, USA
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15
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Okado I, Cassel K, Pagano I, Holcombe RF. Development and psychometric evaluation of a questionnaire to measure cancer patients' perception of care coordination. BMC Health Serv Res 2020; 20:52. [PMID: 31964391 PMCID: PMC6975072 DOI: 10.1186/s12913-020-4905-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Accepted: 01/13/2020] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Although the importance of care coordination (CC) is well-recognized, cancer patients often receive poorly coordinated care across varied care settings and different oncology providers. Efforts to improve cancer care are hampered by lack of adequate measures. In this two-part, mixed-method study, we describe the development, refinement, and validation of a new care coordination instrument (CCI) designed to assess cancer patients' perception of CC. METHODS In Study 1, an initial CCI was developed incorporating questions based on literature review. The items were then modified following four field tests conducted in a large academic hospital with oncology nurses (n = 20) and cancer patients (n = 120). This modified instrument was used to determine whether the CCI was able to distinguish CC between two practices (30 GI and 30 myeloma patients) within the same hospital setting. In Study 2, 68 patients receiving community-based care participated in seven focus groups. Based on these discussions, the CCI items were again refined, and psychometric evaluation was conducted to assess the quality of the instrument. RESULTS Based on field tests, 3 domains of the CCI, Communication, Navigation, and Operational, were defined as critical components of CC. The Operational domain evaluates efficiency of care and is unique to this CCI. The field test demonstrated that GI patients reported significantly better CC Overall and for the Communication and Navigation domains (all p < .05). In Study 2, patients expressed concordance with the CCI items and their CC experiences, establishing validity of the CCI. Qualitative analysis of the focus group discussions indicated that the items with the highest frequencies of participants' comments were related to the concepts of Navigator, Team, Survey, and Communication. Quantitative analysis identified items with a limited response range or high rates of "neutral" responses; accordingly, those items were removed. The final CCI survey is a 29 item, multiple-choice questionnaire with excellent reliability, Cronbach's α = .922. CONCLUSIONS We developed a novel, patient-centered tool with excellent psychometric properties that can be utilized across varied practice settings to assess patients' perception of cancer care coordination. TRIAL REGISTRATION Not required; retrospectively registered ClinicalTrials.gov NCT03594006 20 July 2018.
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Affiliation(s)
- Izumi Okado
- University of Hawai'i Cancer Center, 701 Ilalo St. 6th Floor, Honolulu, HI, 96813, USA.
| | - Kevin Cassel
- University of Hawai'i Cancer Center, 701 Ilalo St. 6th Floor, Honolulu, HI, 96813, USA
| | - Ian Pagano
- University of Hawai'i Cancer Center, 701 Ilalo St. 6th Floor, Honolulu, HI, 96813, USA
| | - Randall F Holcombe
- University of Hawai'i Cancer Center, 701 Ilalo St. 6th Floor, Honolulu, HI, 96813, USA
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16
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Kiwanuka F, Shayan SJ, Tolulope AA. Barriers to patient and family-centred care in adult intensive care units: A systematic review. Nurs Open 2019; 6:676-684. [PMID: 31367389 PMCID: PMC6650666 DOI: 10.1002/nop2.253] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2018] [Revised: 07/04/2018] [Accepted: 01/15/2019] [Indexed: 11/10/2022] Open
Abstract
AIM Despite remarkable theoretical evidence of positive outcomes of patient and family-centred care, it is rarely performed in the intensive care setting. The aim of this review was to assess the barriers to patient and family-centred care among healthcare providers, patients and family members in adult intensive care units. DESIGN A systematic review of both qualitative and quantitative studies. METHODS The search strategy sought for published peer-reviewed research papers limited to English language from conception to 2018. The review protocol was registered in the CRD Prospero database (CRD42018086838). Literature search was carried out in four databases: EMBASE, Cochrane Library, PubMed and Scopus where keywords "barriers," "patient and family centered care," "patient-centered care" and "intensive care unit" appeared in any part of the reference. Hand search of reference lists of identified papers was also done to capture all pertinent materials. Each study was assessed by three independent reviewers against the inclusion criteria. Evidence was graded according to sampling quality, quantity and measurement of intended outcomes. Screening of studies and citations resulted in seven studies that were included in the analysis. RESULTS Barriers to patient and family-centred care broadly fall under four categories; lack of understanding of what is needed to achieve patient and family-centred care, organizational barriers, individual barriers and interdisciplinary barriers.
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Affiliation(s)
- Frank Kiwanuka
- International CampusTehran University of Medical SciencesTehranIran
| | - Shah Jahan Shayan
- School of NursingKabul University of Medical SciencesKabolAfghanistan
| | - Agbele Alaba Tolulope
- Department of Medical Physics, School of MedicineTehran University of Medical SciencesTehran, Iran
- Department of Basic Medical SciencesCollege of Health Sciences and TechnologyIjero‐EkitiNigeria
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17
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Langberg EM, Dyhr L, Davidsen AS. Development of the concept of patient-centredness - A systematic review. PATIENT EDUCATION AND COUNSELING 2019; 102:1228-1236. [PMID: 30846206 DOI: 10.1016/j.pec.2019.02.023] [Citation(s) in RCA: 112] [Impact Index Per Article: 22.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/14/2018] [Revised: 02/21/2019] [Accepted: 02/22/2019] [Indexed: 05/10/2023]
Abstract
OBJECTIVE Patient-centredness is often linked to high-quality patient care, but the concept is not well-defined. This study aims to provide an overview of how patient-centredness has been defined in the literature since Mead and Bower's review in 2000, and to provide an updated definition of the concept. METHOD & DESIGN We performed a systematic literature search in PubMed to identify original articles with a sufficient definition of patient-centredness. We analysed extracted data defining patient-centredness. RESULTS Eighty articles were included. The dimensions "biopsychosocial", "patient-as-person", "sharing power and responsibility" and "therapeutic alliance" corresponded to four of five dimensions described by Mead and Bower. "Coordinated care" was a new dimension. CONCLUSION The identified dimensions are encompassed by three elements: the patient, the doctor-patient relationship and the framework of care i.e. the health care system. The additional focus on coordinated care could reflect increasing complexity of the health care system. PRACTICE IMPLICATIONS Narrowing down the understanding of patient-centredness to these three focus areas, viz. 1) understanding of the patients' experience of the illness in their life situation, 2) the professional's relationship with the patient, and 3) coordination of care in the system, could make the operationalisation and implementation of a patient-centred approach more manageable.
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Affiliation(s)
- Emil Mørup Langberg
- The Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, 1014, Copenhagen K, Denmark.
| | - Lise Dyhr
- The Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, 1014, Copenhagen K, Denmark.
| | - Annette Sofie Davidsen
- The Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, 1014, Copenhagen K, Denmark.
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18
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Ofili EO, Schanberg LE, Hutchinson B, Sogade F, Fergus I, Duncan P, Hargrove J, Artis A, Onyekwere O, Batchelor W, Williams M, Oduwole A, Onwuanyi A, Ojutalayo F, Cross JA, Seto TB, Okafor H, Pemu P, Immergluck L, Foreman M, Mensah EA, Quarshie A, Mubasher M, Baker A, Ngare A, Dent A, Malouhi M, Tchounwou P, Lee J, Hayes T, Abdelrahim M, Sarpong D, Fernandez-Repollet E, Sodeke SO, Hernandez A, Thomas K, Dennos A, Smith D, Gbadebo D, Ajuluchikwu J, Kong BW, McCollough C, Weiler SR, Natter MD, Mandl KD, Murphy S. The Association of Black Cardiologists (ABC) Cardiovascular Implementation Study (CVIS): A Research Registry Integrating Social Determinants to Support Care for Underserved Patients. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E1631. [PMID: 31083298 PMCID: PMC6539418 DOI: 10.3390/ijerph16091631] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/16/2018] [Revised: 02/14/2019] [Accepted: 02/28/2019] [Indexed: 01/12/2023]
Abstract
African Americans, other minorities and underserved populations are consistently under- represented in clinical trials. Such underrepresentation results in a gap in the evidence base, and health disparities. The ABC Cardiovascular Implementation Study (CVIS) is a comprehensive prospective cohort registry that integrates social determinants of health. ABC CVIS uses real world clinical practice data to address critical gaps in care by facilitating robust participation of African Americans and other minorities in clinical trials. ABC CVIS will include diverse patients from collaborating ABC member private practices, as well as patients from academic health centers and Federally Qualified Health Centers (FQHCs). This paper describes the rationale and design of the ABC CVIS Registry. The registry will: (1) prospectively collect socio-demographic, clinical and biospecimen data from enrolled adults, adolescents and children with prioritized cardiovascular diseases; (2) Evaluate the safety and clinical outcomes of new therapeutic agents, including post marketing surveillance and pharmacovigilance; (3) Support National Institutes of Health (NIH) and industry sponsored research; (4) Support Quality Measures standards from the Center for Medicare and Medicaid Services (CMS) and Commercial Health Plans. The registry will utilize novel data and technology tools to facilitate mobile health technology application programming interface (API) to health system or practice electronic health records (EHR). Long term, CVIS will become the most comprehensive patient registry for underserved diverse patients with cardiovascular disease (CVD) and co morbid conditions, providing real world data to address health disparities. At least 10,000 patients will be enrolled from 50 sites across the United States.
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Affiliation(s)
- Elizabeth O Ofili
- Department of Clinical Research Center, Morehouse School of Medicine, 720 Westview Drive, SW, Atlanta, GA 30310, USA.
| | - Laura E Schanberg
- Department of Pediatrics, Duke Clinical Research Institute, Duke University School of Medicine, 2400 Pratt St., Durham, NC 27705, USA.
| | - Barbara Hutchinson
- Association of Black Cardiologists,2400 N Street, Suite 200, Washington, DC 20037, USA.
| | - Felix Sogade
- Association of Black Cardiologists,2400 N Street, Suite 200, Washington, DC 20037, USA.
| | - Icilma Fergus
- Association of Black Cardiologists,2400 N Street, Suite 200, Washington, DC 20037, USA.
| | - Phillip Duncan
- Association of Black Cardiologists,2400 N Street, Suite 200, Washington, DC 20037, USA.
| | - Joe Hargrove
- Department of Pediatrics, Duke Clinical Research Institute, Duke University School of Medicine, 2400 Pratt St., Durham, NC 27705, USA.
| | - Andre Artis
- Association of Black Cardiologists,2400 N Street, Suite 200, Washington, DC 20037, USA.
| | - Osita Onyekwere
- Association of Black Cardiologists,2400 N Street, Suite 200, Washington, DC 20037, USA.
| | - Wayne Batchelor
- Association of Black Cardiologists,2400 N Street, Suite 200, Washington, DC 20037, USA.
| | - Marcus Williams
- Association of Black Cardiologists,2400 N Street, Suite 200, Washington, DC 20037, USA.
| | - Adefisayo Oduwole
- Department of Clinical Research Center, Morehouse School of Medicine, 720 Westview Drive, SW, Atlanta, GA 30310, USA.
| | - Anekwe Onwuanyi
- Department of Clinical Research Center, Morehouse School of Medicine, 720 Westview Drive, SW, Atlanta, GA 30310, USA.
| | - Folake Ojutalayo
- Department of Clinical Research Center, Morehouse School of Medicine, 720 Westview Drive, SW, Atlanta, GA 30310, USA.
| | - Jo Ann Cross
- Department of Clinical Research Center, Morehouse School of Medicine, 720 Westview Drive, SW, Atlanta, GA 30310, USA.
| | - Todd B Seto
- Department of Academic Affairs and Research, The Queen's Medical Center, 1301 Punchbowl Street, Honolulu, HI 96813, USA.
| | - Henry Okafor
- Department of Medicine, Meharry Medical College,1818 Albion St, Nashville, TN 37208, USA.
| | - Priscilla Pemu
- Department of Clinical Research Center, Morehouse School of Medicine, 720 Westview Drive, SW, Atlanta, GA 30310, USA.
| | - Lilly Immergluck
- Department of Clinical Research Center, Morehouse School of Medicine, 720 Westview Drive, SW, Atlanta, GA 30310, USA.
| | - Marilyn Foreman
- Department of Clinical Research Center, Morehouse School of Medicine, 720 Westview Drive, SW, Atlanta, GA 30310, USA.
| | - Ernest Alema Mensah
- Department of Clinical Research Center, Morehouse School of Medicine, 720 Westview Drive, SW, Atlanta, GA 30310, USA.
| | - Alexander Quarshie
- Department of Clinical Research Center, Morehouse School of Medicine, 720 Westview Drive, SW, Atlanta, GA 30310, USA.
| | - Mohamed Mubasher
- Department of Clinical Research Center, Morehouse School of Medicine, 720 Westview Drive, SW, Atlanta, GA 30310, USA.
| | - Almelida Baker
- Department of Clinical Research Center, Morehouse School of Medicine, 720 Westview Drive, SW, Atlanta, GA 30310, USA.
| | - Alnida Ngare
- RCMI Data Coordinating Center, Jackson State University, 1400 John R. Lynch Street, Jackson, MS 39217, USA.
| | - Andrew Dent
- RCMI Data Coordinating Center, Jackson State University, 1400 John R. Lynch Street, Jackson, MS 39217, USA.
| | - Mohamad Malouhi
- RCMI Data Coordinating Center, Jackson State University, 1400 John R. Lynch Street, Jackson, MS 39217, USA.
| | - Paul Tchounwou
- RCMI Data Coordinating Center, Jackson State University, 1400 John R. Lynch Street, Jackson, MS 39217, USA.
| | - Jae Lee
- RCMI Data Coordinating Center, Jackson State University, 1400 John R. Lynch Street, Jackson, MS 39217, USA.
| | - Traci Hayes
- RCMI Data Coordinating Center, Jackson State University, 1400 John R. Lynch Street, Jackson, MS 39217, USA.
| | - Muna Abdelrahim
- RCMI Data Coordinating Center, Jackson State University, 1400 John R. Lynch Street, Jackson, MS 39217, USA.
| | - Daniel Sarpong
- Department of Biostatistics, College of Pharmacy, Xavier University of Louisiana, 1 Drexel Drive, New Orleans, LA 70125, USA.
| | - Emma Fernandez-Repollet
- Department of Pharmacology and Toxicology, University of Puerto Rico Medical Sciences Campus, P.O. Box 365067, San Juan, PR 00936, Puerto Rico.
| | - Stephen O Sodeke
- Department of Bioethics, Tuskegee University, 1200 W. Montgomery Rd., Tuskegee, AL 36088, USA.
| | - Adrian Hernandez
- Department of Pediatrics, Duke Clinical Research Institute, Duke University School of Medicine, 2400 Pratt St., Durham, NC 27705, USA.
| | - Kevin Thomas
- Department of Pediatrics, Duke Clinical Research Institute, Duke University School of Medicine, 2400 Pratt St., Durham, NC 27705, USA.
| | - Anne Dennos
- Department of Pediatrics, Duke Clinical Research Institute, Duke University School of Medicine, 2400 Pratt St., Durham, NC 27705, USA.
| | - David Smith
- Association of Black Cardiologists,2400 N Street, Suite 200, Washington, DC 20037, USA.
| | - David Gbadebo
- Association of Black Cardiologists,2400 N Street, Suite 200, Washington, DC 20037, USA.
| | - Janet Ajuluchikwu
- Association of Black Cardiologists,2400 N Street, Suite 200, Washington, DC 20037, USA.
- Department of Medicine, College of Medicine of the University of Lagos, Private Mail Bag 12003, Idi Araba, Lagos, Nigeria.
| | - B Waine Kong
- Association of Black Cardiologists,2400 N Street, Suite 200, Washington, DC 20037, USA.
| | - Cassandra McCollough
- Association of Black Cardiologists,2400 N Street, Suite 200, Washington, DC 20037, USA.
| | - Sarah R Weiler
- Department of Pediatrics and Computational Health Informatics, Harvard Medical School, 300 Longwood Avenue, Boston, MA 02115, USA.
| | - Marc D Natter
- Department of Pediatrics and Computational Health Informatics, Harvard Medical School, 300 Longwood Avenue, Boston, MA 02115, USA.
| | - Kenneth D Mandl
- Department of Pediatrics and Computational Health Informatics, Harvard Medical School, 300 Longwood Avenue, Boston, MA 02115, USA.
| | - Shawn Murphy
- Department of Pediatrics and Computational Health Informatics, Harvard Medical School, 300 Longwood Avenue, Boston, MA 02115, USA.
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Sanson-Fisher R, Fakes K, Waller A, Mackenzie L, Bryant J, Herrmann A. Assessing patients' experiences of cancer care across the treatment pathway: a mapping review of recent psychosocial cancer care publications. Support Care Cancer 2019; 27:1997-2006. [PMID: 30891626 DOI: 10.1007/s00520-019-04740-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Accepted: 03/07/2019] [Indexed: 01/09/2023]
Abstract
PURPOSE Patients are a critical source of information about the quality of the components of cancer care that contributes to optimal psychosocial outcomes. Recently published research was examined to determine the: (1) proportion of studies that examined at least one of 14 components of cancer care, (2) the proportion of studies that included multiple components of care, and (3) the phase of the cancer care pathway in which data collection occurred (i.e. pre-, during and post-treatment). METHODS MEDLINE was searched to retrieve all data-based publications indexed for two international psychosocial cancer care journals (Supportive Care in Cancer and Psycho-Oncology) over a 2-year period. A total of 333 publications yielded 214 eligible publications that were assessed against the 14 components of care for which measurement by healthcare providers at multiple phases during cancer care is recommended. Publications were coded based on the: (1) specific component/s of care focused upon in the research, (2) number of components examined and (3) timing of data collection. RESULTS The most frequently assessed component of care was physical and psychosocial screening (n = 198, 93%). Most studies (n = 187, 87%) examined a single component of care. No studies assessed all 14 components. Only seven studies (2.1%) examined components of care across multiple phases of the care pathway. CONCLUSIONS Recently published studies have examined limited segments of patients' experiences of cancer care. To improve psychosocial outcomes among people living with and beyond cancer, there should be a greater focus on patients' experiences across multiple components and the whole care pathway.
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Affiliation(s)
- Rob Sanson-Fisher
- Health Behaviour Research Collaborative, School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, HMRI Building Level 4, Callaghan, NSW, 2308, Australia. .,Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, NSW, Australia. .,Hunter Medical Research Institute, New Lambton Heights, NSW, Australia.
| | - Kristy Fakes
- Health Behaviour Research Collaborative, School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, HMRI Building Level 4, Callaghan, NSW, 2308, Australia.,Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, NSW, Australia.,Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
| | - Amy Waller
- Health Behaviour Research Collaborative, School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, HMRI Building Level 4, Callaghan, NSW, 2308, Australia.,Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, NSW, Australia.,Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
| | - Lisa Mackenzie
- Health Behaviour Research Collaborative, School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, HMRI Building Level 4, Callaghan, NSW, 2308, Australia.,Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, NSW, Australia.,Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
| | - Jamie Bryant
- Health Behaviour Research Collaborative, School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, HMRI Building Level 4, Callaghan, NSW, 2308, Australia.,Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, NSW, Australia.,Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
| | - Anne Herrmann
- Health Behaviour Research Collaborative, School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, HMRI Building Level 4, Callaghan, NSW, 2308, Australia.,Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, NSW, Australia.,Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
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Umeh KF. Ethnic inequalities in doctor-patient communication regarding personal care plans: the mediating effects of positive mental wellbeing. ETHNICITY & HEALTH 2019; 24:57-72. [PMID: 28385036 DOI: 10.1080/13557858.2017.1315056] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
OBJECTIVE There is limited understanding of ethnic inequalities in doctor-patient communication regarding personal care plans (PCPs). This study investigated the mediating effects of positive mental wellbeing on differences in PCP-related doctor-patient communication amongst South Asian and Caucasian UK residents. DESIGN Data from 10,980 respondents to the 2013 Health Survey for England was analysed using bootstrapping methods. Constructs from the WEMWBS (Warwick and Edinburgh Mental Wellbeing Scale) (Stewart-Brown, S., and K. Janmohamed. 2008. Warwick, UK) were assessed as mediators of relations between ethnicity and several doctor-patient communication variables, including PCP-related interactions; (a) had a PCP-related discussion about a long-term condition with a doctor/nurse, and (b) had this conversation within the past year, (c) agreed to a PCP with a health professional; and (d) talked to a doctor in the past 2 weeks. RESULTS Bootstrapped mediation analysis (Hayes, A. F. 2013. Introduction to Mediation, Moderation, and Conditional Process Analysis: A Regression-based Approach. New York, NY: The Guilford Press) showed that three positive mind-sets mediated associations between ethnicity and doctor-patient contact, including PCP-related communication. Being able to make up one's mind (ab = -0.05; BCa CI [-0.14, 0.01]) mediated the effect of ethnicity on agreeing to a PCP, while having energy to spare (ab = 0.07; BCa CI [-0.04, 0.12]), and feeling good about oneself (ab = 0.03; BCa CI [0.01, 0.07]), mediated ethnic effects on talking to a doctor during the past fortnight. The mediating effect of reported energy persisted after controlling for medical history, perceived health, and other covariates. CONCLUSIONS Ethnic disparities in doctor-patient interaction, including PCP-related communication, are partly explained by positive mental wellbeing. Gauging positive psychological moods in patients, particularly self-worth, self-perceived vigour and decisiveness, are relevant to addressing ethnic inequalities in doctor-patient communication. As PCPs may have direct implications for patient health it is important for health professionals to address deficits in psychological functioning that may precipitate ethnic inequalities in setting up PCPs.
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Affiliation(s)
- Kanayo F Umeh
- a School of Natural Sciences & Psychology , Liverpool John Moores University , Liverpool , UK
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21
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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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22
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Amin AP, Miller S, Rahn B, Caruso M, Pierce A, Sorensen K, Kurz H, Zajarias A, Bach R, Singh J, Lasala JM, Kulkarni H, Crimmins-Reda P. Reversing the "Risk-Treatment Paradox" of Bleeding in Patients Undergoing Percutaneous Coronary Intervention: Risk-Concordant Use of Bleeding Avoidance Strategies Is Associated With Reduced Bleeding and Lower Costs. J Am Heart Assoc 2018; 7:e008551. [PMID: 30376760 PMCID: PMC6404202 DOI: 10.1161/jaha.118.008551] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
Background Bleeding is a common, morbid, and costly complication of percutaneous coronary intervention. While bleeding avoidance strategies ( BAS ) are effective, they are used paradoxically less in patients at high risk of bleeding. Whether a patient-centered approach to specifically increase the risk-concordant use of BAS and, thus, reverse the risk-treatment paradox is associated with reduced bleeding and costs is unknown. Methods and Results We implemented an intervention to reverse the bleeding risk-treatment paradox at Barnes-Jewish Hospital, St. Louis, MO, and examined: (1) the temporal trends in BAS use and (2) the association of risk-concordant BAS use with bleeding and hospital costs of percutaneous coronary intervention. Among 3519 percutaneous coronary interventions, there was a significantly increasing trend ( P=0.002) in risk-concordant use of BAS . The bleeding incidence was 2% in the risk-concordant group versus 9% in the risk-discordant group (absolute risk difference, 7%; number needed to treat, 14). Risk-concordant BAS use was associated with a 67% (95% confidence interval, 52-78%; P<0.001) reduction in the risk of bleeding and a $4738 (95% confidence interval, 3353-6122; P<0.001) reduction in per-patient percutaneous coronary intervention hospitalization costs (21.6% cost-savings). Conclusions In this study, patient-centered care directly aimed to make treatment-related decisions based on predicted risk of bleeding, led to more risk-concordant use of BAS and reversal of the risk-treatment paradox. This, in turn, was associated with a reduction in bleeding and hospitalization costs. Larger multicentered studies are needed to corroborate these results. As clinical medicine moves toward personalization, both patients and hospitals can benefit from a simple practice change that encourages objectivity and mitigates variability in care.
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Affiliation(s)
- Amit P Amin
- 1 Cardiovascular Division Washington University School of Medicine St. Louis MO.,2 Barnes-Jewish Hospital St. Louis MO.,3 Center for Value and Innovation Washington University School of Medicine St. Louis MO
| | - Samantha Miller
- 2 Barnes-Jewish Hospital St. Louis MO.,3 Center for Value and Innovation Washington University School of Medicine St. Louis MO
| | - Brandon Rahn
- 2 Barnes-Jewish Hospital St. Louis MO.,3 Center for Value and Innovation Washington University School of Medicine St. Louis MO
| | - Mary Caruso
- 2 Barnes-Jewish Hospital St. Louis MO.,3 Center for Value and Innovation Washington University School of Medicine St. Louis MO
| | | | - Katrine Sorensen
- 1 Cardiovascular Division Washington University School of Medicine St. Louis MO
| | - Howard Kurz
- 1 Cardiovascular Division Washington University School of Medicine St. Louis MO.,2 Barnes-Jewish Hospital St. Louis MO
| | - Alan Zajarias
- 1 Cardiovascular Division Washington University School of Medicine St. Louis MO.,2 Barnes-Jewish Hospital St. Louis MO
| | - Richard Bach
- 1 Cardiovascular Division Washington University School of Medicine St. Louis MO.,2 Barnes-Jewish Hospital St. Louis MO
| | - Jasvindar Singh
- 1 Cardiovascular Division Washington University School of Medicine St. Louis MO.,2 Barnes-Jewish Hospital St. Louis MO
| | - John M Lasala
- 1 Cardiovascular Division Washington University School of Medicine St. Louis MO.,2 Barnes-Jewish Hospital St. Louis MO
| | | | - Patricia Crimmins-Reda
- 2 Barnes-Jewish Hospital St. Louis MO.,3 Center for Value and Innovation Washington University School of Medicine St. Louis MO
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Insight into Patients' Experiences of Cancer Care in Taiwan: An Instrument Translation and Cross-Cultural Adaptation Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15081772. [PMID: 30126140 PMCID: PMC6121327 DOI: 10.3390/ijerph15081772] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/18/2018] [Revised: 08/09/2018] [Accepted: 08/14/2018] [Indexed: 11/16/2022]
Abstract
Background: Since Taiwan launched the Cancer Prevention Act in 2003, several prevention strategies and early detection programs have been implemented to reduce the incidence, morbidity and mortality rates of cancer. However, most of the programs have concentrated on healthcare providers. Evaluations from the patient’s perspective have been lacking. Thus, in this study a cancer patient experience questionnaire was developed in the Taiwanese context and a preliminary nationwide investigation was conducted on the status of cancer care from the patient’s perspective. Methods: An extensive literature review was first conducted to collect information on the existing instruments used to measure the cancer patient’s experience. Thereafter, a multidisciplinary expert panel was convened to select an optimal instrument based on the IOM’s six domains for evaluating patient-centered care. The European Organisation for Research and Treatment of Cancer (EORTC) translation procedure was applied to the questionnaire for cross-cultural adaptation. A nationwide field test was then implemented at certificated cancer care hospitals. Results: Fifteen questionnaires were collected for the literature review. The expert panel selected the National Cancer Patient Experience Survey based on the IOM’s recommendations. After cross-cultural translation of the questionnaire, a total of 4000 questionnaires were administered in 19 certificated cancer care hospitals and two major cancer patient associations, with 1010 being returned (25.25% response rate). Most of the respondents were middle-aged, and 70% were female. The respondents reported they had a good experience with cancer care, except for “Home care and support” and “Finding out what was wrong with you”. Stratified analysis was conducted, with the results showing that the cancer patients’ experiences varied depending on their sociodemographic and cancer-related characteristics. Conclusions: A Taiwanese version of the cancer patient experience survey questionnaire was developed. Its results showed that the cancer patient’s experiences varied, depending on the patient’s age, cancer type, and cancer history. This study can be used as a basis to establish a patient-centered care model for cancer care in Taiwan.
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Quality of Patient-Centered Care Provided to Patients Attending Hematological Cancer Treatment Centers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15030549. [PMID: 29562704 PMCID: PMC5877094 DOI: 10.3390/ijerph15030549] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/22/2017] [Revised: 03/02/2018] [Accepted: 03/16/2018] [Indexed: 11/16/2022]
Abstract
The Institute of Medicine has recommended that improvements are needed in patient-centered care. This study examined hematological cancer patients' perceptions of which aspects of cancer care were being delivered well and areas that required improvement, and whether patient characteristics, or the treatment center they attended, were associated with quality of patient-centered care. Participants were recruited via three Australian hematological cancer treatment centers and completed a paper-and-pen survey assessing sociodemographic, disease, and psychological and treatment characteristics at recruitment. A second survey that contained the Quality of Patient-Centered Cancer Care measure was completed one month after recruitment (n = 215). The most frequently delivered feature of patient-centered cancer care was hospital staff showing respect for patients (91.0%). The area of care reported most commonly as not being delivered was hospital staff helping the patient find other cancer patients to talk to (29.8%). Patients without depression reported higher perceived quality of treatment decision-making, co-ordinated and integrated care, emotional support, follow-up care, respectful communication, and cancer information than patients with depression. The treatment center that was attended was associated only with the quality of cancer information patients received. Privacy issues may hinder staff connecting patients directly but this could be overcome via referrals to cancer organizations that offer peer support services.
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Quality indicators in the treatment of patients with depression, bipolar disorder or schizophrenia. Consensus study. REVISTA DE PSIQUIATRIA Y SALUD MENTAL 2018; 11:66-75. [PMID: 29317210 DOI: 10.1016/j.rpsm.2017.09.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/29/2017] [Revised: 07/18/2017] [Accepted: 09/18/2017] [Indexed: 11/21/2022]
Abstract
OBJECTIVE To define a set of indicators for mental health care, monitoring quality assurance in schizophrenia, depression and bipolar disorders in Spain. MATERIAL AND METHOD Qualitative research. Consensus-based study involving 6 psychiatrists on the steering committee and a panel of 43 psychiatrists working in several health services in Spain. An initial proposal of 44 indicators for depression, 42 for schizophrenia and 58 for bipolar disorder was elaborated after reviewing the literature. This proposal was analysed by experts using the Delphi technique. The valuation of these indicators in successive rounds allowed those with less degree of consensus to be discarded. Feasibility, sensitivity and clinical relevance were considered. The study was carried out between July 2015 and March 2016. RESULTS Seventy indicators were defined by consensus: 17 for major depression, 16 for schizophrenia, 17 for bipolar disorder and 20 common to all three pathologies. These indicators included measures related to adequacy, patient safety, exacerbation, mechanical restraint, suicidal behaviour, psychoeducation, adherence, mortality and physical health. CONCLUSIONS This set of indicators allows quality monitoring in the treatment of patients with schizophrenia, depression or bipolar disorder. Mental health care authorities and professionals can use this proposal for developing a balanced scorecard adjusted to their priorities and welfare objectives.
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26
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Gonzales MJ, Gross DM, Cooke E. Psychosocial Aspects of Hematologic Disorders. Hematology 2018. [DOI: 10.1016/b978-0-323-35762-3.00090-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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27
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Brédart A, Anota A, Young T, Tomaszewski KA, Arraras JI, Moura De Albuquerque Melo H, Schmidt H, Friend E, Bergenmar M, Costantini A, Vassiliou V, Hureaux J, Marchal F, Tomaszewska IM, Chie WC, Ramage J, Beaudeau A, Conroy T, Bleiker E, Kulis D, Bonnetain F, Aaronson NK. Phase III study of the European Organisation for Research and Treatment of Cancer satisfaction with cancer care core questionnaire (EORTC PATSAT-C33) and specific complementary outpatient module (EORTC OUT-PATSAT7). Eur J Cancer Care (Engl) 2017; 27. [PMID: 29094784 DOI: 10.1111/ecc.12786] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/20/2017] [Indexed: 11/27/2022]
Abstract
Advances in cancer care delivery require revision and further development of questionnaires assessing patients' perceived quality of care. This study pre-tested the revised EORTC satisfaction with cancer care core questionnaire applicable in both the cancer inpatient and outpatient settings, and its new, outpatient-specific complementary module. The process of revision, development of the extended application, and pre-testing of these questionnaires was based on phases I to III of the "EORTC Quality of Life Group Module Development Guidelines." In phase III, patients in 11 countries in four European regions, South America and Asia completed provisional versions of the questionnaires. Fifty-seven relevant issues selected from literature reviews and input from experts were operationalized into provisional items, and subsequently translated into ten languages. Assessment of understanding, acceptability, redundancy and relevance by patients (n = 151) from oncology inpatient wards, and outpatient chemotherapy, radiotherapy and consultation settings, led to retention of, deletion of and merging of 40, 14 and 6 items respectively. Cronbach's alpha coefficients for hypothesized questionnaire scales were above 0.80. Our results provide preliminary support for the 33-item EORTC Satisfaction with cancer care core questionnaire and the 7-item complementary module specific for the outpatient care setting. A large scale phase IV cross-cultural psychometric study is now underway.
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Affiliation(s)
- A Brédart
- Institut Curie, Psycho-Oncology Unit, Paris, France.,University Paris Descartes, Boulogne Billancourt, France.,Quality of Life and Cancer Clinical Research Platform, CHU Besançon, France
| | - A Anota
- Methodology and Quality of Life in Oncology unit (INSERM UMR 1098), Quality of Life and Cancer Clinical Research Platform, CHU Besançon, France
| | - T Young
- Lynda Jackson Macmillan Centre, East& North Hertfordshire NHS Trust including Mount Vernon Cancer Centre, London, UK
| | - K A Tomaszewski
- Health Outcomes Research Unit, Department of Gerontology, Geriatrics and Social Work, Faculty of Education, Ignatianum Academy, Krakow, Poland
| | - J I Arraras
- Departments of Oncology, Complejo Hospitalario of Navarre, Pamplona, Spain
| | | | - H Schmidt
- Institute for Health and Nursing Science, Martin Luther University Halle-Wittenberg, Germany
| | - E Friend
- Basingstoke & North Hampshire Hospital, Basingstoke, UK
| | - M Bergenmar
- Department of Oncology-Pathology, Karolinska Institutet, Center for Digestive Diseases, Karolinska University Hospital, Stockholm, Sweden
| | - A Costantini
- Faculty of Medicine and Psychology, Psychoncology Unit, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | - V Vassiliou
- Bank of Cyprus Oncology Centre, Nicosia, Cyprus
| | - J Hureaux
- CHU Angers, Pulmonology Department and Angers University, Angers, France
| | - F Marchal
- Institut de Cancérologie de Lorraine, Surgery Department, CRAN, UMR 7039, Université de Lorraine, CNRS, Vandoeuvre-lès-Nancy, France
| | - I M Tomaszewska
- Department of Medical Education, Jagiellonian University Medical College, Krakow, Poland
| | - W-C Chie
- Institute of Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - J Ramage
- Basingstoke & North Hampshire Hospital, Basingstoke, UK
| | - A Beaudeau
- Institut Curie, Psycho-Oncology Unit, Paris, France.,University Paris Descartes, Boulogne Billancourt, France.,Quality of Life and Cancer Clinical Research Platform, CHU Besançon, France
| | - T Conroy
- Institut de Cancérologie de Lorraine, Medical Oncology Department and EA 4360, Lorraine University, Vandoeuvre-lès-Nancy, France
| | - E Bleiker
- Division of Psychosocial Research & Epidemiology, the Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - D Kulis
- EORTC Quality of Life Department, Brussels, Belgium
| | - F Bonnetain
- Methodology and Quality of Life in Oncology unit (INSERM UMR 1098), Quality of Life and Cancer Clinical Research Platform, CHU Besançon, France
| | - N K Aaronson
- Division of Psychosocial Research & Epidemiology, the Netherlands Cancer Institute, Amsterdam, The Netherlands
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Chiu C, Bishop M, Pionke J, Strauser D, Santens RL. Barriers to the Accessibility and Continuity of Health-Care Services in People with Multiple Sclerosis: A Literature Review. Int J MS Care 2017; 19:313-321. [PMID: 29270089 PMCID: PMC5734715 DOI: 10.7224/1537-2073.2016-016] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
BACKGROUND Individuals with multiple sclerosis (MS) face a range of barriers to accessing and using health-care services. The aim of this review was to identify specific barriers to accessing and using health-care services based on a continuum of the health-care delivery system. METHODS Literature searches were conducted in the PubMed, PsycINFO, CINAHL, and Web of Science databases. The following terms were searched as subject headings, key words, or abstracts: health care, access, barriers, physical disability, and multiple sclerosis. The literature search produced 361 potentially relevant citations. After screening titles, abstracts, and citations, eight citations were selected for full-text review. RESULTS Health-care barriers were divided into three continuous phases of receiving health care. In the before-visit phase, the most commonly identified barrier was transportation. In the during-visit phase, communication quality was the major concern. In the after-visit phase, discontinued referral was the major barrier encountered. CONCLUSIONS There are multiple interrelated barriers to accessing and using health-care services along the health-care delivery continuum for people with MS and its associated physical disabilities, ranging from complex and long-recognized barriers that will likely require extended advocacy to create policy changes to issues that can and should be addressed through relatively minor changes in health-care delivery practices, improved care coordination, and increased provider awareness, education, and responsiveness to patients' needs.
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Tremblay D, Roberge D, Touati N, Maunsell E, Berbiche D. Effects of interdisciplinary teamwork on patient-reported experience of cancer care. BMC Health Serv Res 2017; 17:218. [PMID: 28320372 PMCID: PMC5360056 DOI: 10.1186/s12913-017-2166-7] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2016] [Accepted: 03/16/2017] [Indexed: 11/30/2022] Open
Abstract
Background Interdisciplinary teamwork (ITW) is deemed necessary for quality cancer care practices. Nevertheless, variation in ITW intensity among cancer teams is understudied, and quantitative evidence of the effect of different ITW intensities among cancer teams on patients’ perceived experience of care is limited. This study aims to compare patient-reported experience measures (PREMs) of cancer outpatients followed by teams characterized by high vs. low ITW intensity. Methods The study is designed as an ex post facto quasi-experimental study. Participants (n = 1379) were recruited in nine outpatient oncology clinics characterized by different ITW intensities. ITW intensities were evaluated using the characteristics of structure (team composition and size) and process (interactions among team members), as per West’s seminal work on team effectiveness. ITW intensity was dichotomized (high vs. low ITW intensity). PREMs were classified and measured using validated scales corresponding to six dimensions: Prompt access to care, Person-centred response, Quality of patient-professional communication, Quality of the care environment, Continuity of care, and Results of care. Dichotomous variables were created for each dimension (positive vs. less positive experience). Multiple logistic regression analyses were performed to assess the association between ITW intensities and the six PREMs dimensions, while controlling for patient and organizational characteristics. PROC GENMOD was used to fit logistic models for categorical variables. Results Outpatients treated by teams characterized by high ITW intensity reported almost four times more positive perceptions of Prompt access to care compared to patients treated by low ITW intensity teams (OR = 3.99; CI = 1.89–8.41). High ITW intensity also positively affected patients’ perceptions of Quality of patient-professional communication (OR = 2.37; CI = 1.25–4.51), Person-centred response (OR = 2.11; CI = 1.05–4.24], and Continuity of care (OR = 2.18; CI = 1.07–4.45). No significant association was found between ITW intensity and perceived Results of care (OR = 1.31; CI = 0.68–2.52) or Quality of the care environment (OR = 0.66; CI = 0.31–1.39). Conclusions This study provides empirical evidence, from the patient’s perspective, that ITW intensity affects some critical aspects of patient-reported quality of care. Future research will allow explaining how and why ITW structure and processes may contribute to positive cancer care experiences. Electronic supplementary material The online version of this article (doi:10.1186/s12913-017-2166-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Dominique Tremblay
- Nursing School, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Longueuil, Quebec, Canada. .,Charles-Le Moyne Hospital Research Center, Greenfield Park, Quebec, Canada.
| | - Danièle Roberge
- Charles-Le Moyne Hospital Research Center, Greenfield Park, Quebec, Canada.,Department of Community Health Sciences, Faculty of Medicine and Health Sciences, Université de Sherbrooke (Longueuil Campus), Longueuil, Quebec, Canada
| | - Nassera Touati
- École nationale d'administration publique, Montreal, Quebec, Canada
| | - Elizabeth Maunsell
- Department of Social and Preventive Medicine, Faculty of Medicine, Université Laval, Québec City, Quebec, Canada
| | - Djamal Berbiche
- Charles-Le Moyne Hospital Research Center, Greenfield Park, Quebec, Canada
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Tzelepis F, Hanna JH, Paul CL, Boyes AW, Carey ML, Regan T. Quality of patient-centred care: Medical oncology patients' perceptions and characteristics associated with quality of care. Psychooncology 2017; 26:1998-2001. [PMID: 28101971 DOI: 10.1002/pon.4380] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2016] [Revised: 12/29/2016] [Accepted: 01/15/2017] [Indexed: 11/06/2022]
Affiliation(s)
- Flora Tzelepis
- Priority Research Centre for Health Behaviour, University of Newcastle & Hunter Medical Research Institute (HMRI), Callaghan, NSW, Australia
| | | | - Christine L Paul
- Priority Research Centre for Health Behaviour, University of Newcastle & Hunter Medical Research Institute (HMRI), Callaghan, NSW, Australia
| | - Allison W Boyes
- Priority Research Centre for Health Behaviour, University of Newcastle & Hunter Medical Research Institute (HMRI), Callaghan, NSW, Australia
| | - Mariko L Carey
- Priority Research Centre for Health Behaviour, University of Newcastle & Hunter Medical Research Institute (HMRI), Callaghan, NSW, Australia
| | - Timothy Regan
- Priority Research Centre for Health Behaviour, University of Newcastle & Hunter Medical Research Institute (HMRI), Callaghan, NSW, Australia
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Clinton-McHarg T, Yoong SL, Tzelepis F, Regan T, Fielding A, Skelton E, Kingsland M, Ooi JY, Wolfenden L. Psychometric properties of implementation measures for public health and community settings and mapping of constructs against the Consolidated Framework for Implementation Research: a systematic review. Implement Sci 2016; 11:148. [PMID: 27821146 PMCID: PMC5100177 DOI: 10.1186/s13012-016-0512-5] [Citation(s) in RCA: 58] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2016] [Accepted: 10/20/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Recent reviews have synthesised the psychometric properties of measures developed to examine implementation science constructs in healthcare and mental health settings. However, no reviews have focussed primarily on the properties of measures developed to assess innovations in public health and community settings. This review identified quantitative measures developed in public health and community settings, examined their psychometric properties, and described how the domains of each measure align with the five domains and 37 constructs of the Consolidated Framework for Implementation Research (CFIR). METHODS MEDLINE, PsycINFO, EMBASE, and CINAHL were searched to identify publications describing the development of measures to assess implementation science constructs in public health and community settings. The psychometric properties of each measure were assessed against recommended criteria for validity (face/content, construct, criterion), reliability (internal consistency, test-retest), responsiveness, acceptability, feasibility, and revalidation and cross-cultural adaptation. Relevant domains were mapped against implementation constructs defined by the CFIR. RESULTS Fifty-one measures met the inclusion criteria. The majority of these were developed in schools, universities, or colleges and other workplaces or organisations. Overall, most measures did not adequately assess or report psychometric properties. Forty-six percent of measures using exploratory factor analysis reported >50 % of variance was explained by the final model; none of the measures assessed using confirmatory factor analysis reported root mean square error of approximation (<0.06) or comparative fit index (>0.95). Fifty percent of measures reported Cronbach's alpha of <0.70 for at least one domain; 6 % adequately assessed test-retest reliability; 16 % of measures adequately assessed criterion validity (i.e. known-groups); 2 % adequately assessed convergent validity (r > 0.40). Twenty-five percent of measures reported revalidation or cross-cultural validation. The CFIR constructs most frequently assessed by the included measures were relative advantage, available resources, knowledge and beliefs, complexity, implementation climate, and other personal resources (assessed by more than ten measures). Five CFIR constructs were not addressed by any measure. CONCLUSIONS This review highlights gaps in the range of implementation constructs that are assessed by existing measures developed for use in public health and community settings. Moreover, measures with robust psychometric properties are lacking. Without rigorous tools, the factors associated with the successful implementation of innovations in these settings will remain unknown.
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Affiliation(s)
- Tara Clinton-McHarg
- School of Medicine and Public Health, The University of Newcastle, Callaghan, NSW 2308 Australia
- Hunter Medical Research Institute, New Lambton Heights, NSW 2305 Australia
| | - Sze Lin Yoong
- School of Medicine and Public Health, The University of Newcastle, Callaghan, NSW 2308 Australia
- Hunter Medical Research Institute, New Lambton Heights, NSW 2305 Australia
- Hunter New England Population Health, Wallsend, NSW 2287 Australia
| | - Flora Tzelepis
- School of Medicine and Public Health, The University of Newcastle, Callaghan, NSW 2308 Australia
- Hunter Medical Research Institute, New Lambton Heights, NSW 2305 Australia
- Hunter New England Population Health, Wallsend, NSW 2287 Australia
| | - Tim Regan
- School of Medicine and Public Health, The University of Newcastle, Callaghan, NSW 2308 Australia
- Hunter Medical Research Institute, New Lambton Heights, NSW 2305 Australia
| | - Alison Fielding
- School of Medicine and Public Health, The University of Newcastle, Callaghan, NSW 2308 Australia
| | - Eliza Skelton
- School of Medicine and Public Health, The University of Newcastle, Callaghan, NSW 2308 Australia
| | - Melanie Kingsland
- School of Medicine and Public Health, The University of Newcastle, Callaghan, NSW 2308 Australia
- Hunter New England Population Health, Wallsend, NSW 2287 Australia
| | - Jia Ying Ooi
- School of Medicine and Public Health, The University of Newcastle, Callaghan, NSW 2308 Australia
| | - Luke Wolfenden
- School of Medicine and Public Health, The University of Newcastle, Callaghan, NSW 2308 Australia
- Hunter Medical Research Institute, New Lambton Heights, NSW 2305 Australia
- Hunter New England Population Health, Wallsend, NSW 2287 Australia
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Fradgley EA, Paul CL, Bryant J, Collins N, Ackland SP, Bellamy D, Levi CR. Collaborative Patient-Centered Quality Improvement. Eval Health Prof 2016; 39:475-495. [DOI: 10.1177/0163278716659524] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Identification of patients’ and health professionals’ quality improvement preferences is an essential first step in collaborative improvement models. This includes experience-based codesign (EBCD), where service change is strategically introduced following stakeholder consultation. This study compared the number and types of improvement initiatives selected by outpatients and health professionals. Using electronic surveys designed to inform EBCD studies, 541 outpatients (71.1% consent) and 124 professionals (47.1% response) selected up to 23 general initiatives. On average, outpatients selected 2.4 (median = 1, interquartile range = 1–3) initiatives and professionals selected 10.7 (median = 10; interquartile range = 6–15) initiatives. Outpatients demonstrated a strong preference for improvements to clinic organization, such as appointment scheduling and clinic contact. Outpatients selected relatively fewer initiatives potentially reducing the complexity of service change and resources required to address preferences. Comparatively, professionals indicated a greater degree of change is needed and selected initiatives related to communication with patients and other professionals, including coordinating multidisciplinary care. Improvements to information provision were commonly selected by both groups and offered a strategic opportunity to address patients’ and professionals’ preferences. By quantifying the ways in which preferences differed, this study emphasizes the need for collaborative approaches to health service change and may be used to initiate an informed discussion on patients’ and professionals’ quality improvement preferences in tertiary care.
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Affiliation(s)
- Elizabeth A. Fradgley
- Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, New South Wales, Australia
- Hunter Medical Research Institute, University of Newcastle, Callaghan, New South Wales, Australia
| | - Christine L. Paul
- Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, New South Wales, Australia
- Hunter Medical Research Institute, University of Newcastle, Callaghan, New South Wales, Australia
| | - Jamie Bryant
- Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, New South Wales, Australia
- Hunter Medical Research Institute, University of Newcastle, Callaghan, New South Wales, Australia
| | - Nicolas Collins
- Department of Cardiovascular Medicine, John Hunter Hospital, Hunter New England Local Health District, New Lambton, New South Wales, Australia
| | - Stephen P. Ackland
- Hunter Medical Research Institute, University of Newcastle, Callaghan, New South Wales, Australia
- Department of Medical Oncology, Calvary Mater Newcastle, Waratah, New South Wales, Australia
| | - Douglas Bellamy
- Cancer Network, Hunter New England Local Health District, New Lambton, New South Wales, Australia
| | - Christopher R. Levi
- Department of Neurology, John Hunter Hospital and Research Support and Development Unit, Hunter New England Local Health District, New Lambton, New South Wales, Australia
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Lofters A, Guilcher S, Maulkhan N, Milligan J, Lee J. Patients living with disabilities: The need for high-quality primary care. CANADIAN FAMILY PHYSICIAN MEDECIN DE FAMILLE CANADIEN 2016; 62:e457-e464. [PMID: 27521411 PMCID: PMC4982744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
OBJECTIVE To compare the potential risk factors for lower-quality primary care, the potential markers of unmet needs in primary care, and the willingness to participate in future research among primary care patients with versus without physical disabilities. DESIGN A waiting room survey using a convenience sample. SETTING A family health team (FHT) in Kitchener-Waterloo, Ont, with a designated Mobility Clinic. PARTICIPANTS A total of 40 patients seen at the FHT Mobility Clinic and 80 patients from the general patient population of the same FHT. MAIN OUTCOME MEASURES Socioeconomic status and social capital, number of self-reported emergency department visits and hospitalizations in the preceding year, and willingness of the patients in the 2 groups to participate in future research studies. RESULTS Patients from the Mobility Clinic were more than twice as likely to be receiving benefits or social assistance (75.0% vs 32.1%, P < .001), were twice as likely to report an annual household income of less than $40000 (58.6% vs 29.2%, P = .006), and were more likely to report their health status to be fair or poor (42.5% vs 16.2%, P = .002). Half of Mobility Clinic patients had visited the emergency department at least once in the preceding year, compared with 29.7% in the general patient population (P = .027). When asked if they would be willing to provide their health card number in the future so that it could be linked to health care data for research, 82.5% of Mobility Clinic patients agreed versus 55.0% of those in the general patient population (P = .004). CONCLUSION In this study, patients with disabilities were at a social disadvantage compared with their peers without disabilities and were more likely to use the emergency department, suggesting that they had unmet health needs. Future research should continue to explore this patient population and to investigate if an interprofessional primary health care team approach focused on patients with disabilities can help to increase quality of care.
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Affiliation(s)
- Aisha Lofters
- Scientist with the Centre for Urban Health Solutions of the Li Ka Shing Knowledge Institute at St Michael's Hospital in Toronto, Ont.
| | - Sara Guilcher
- Assistant Professor with the Leslie Dan Faculty of Pharmacy at the University of Toronto
| | - Niraj Maulkhan
- Research assistant with the Centre for Family Medicine Family Health Team at the time of this research
| | - James Milligan
- Family physician with the Centre for Family Medicine Family Health Team
| | - Joseph Lee
- Family physician with the Centre for Family Medicine Family Health Team
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Li M, Macedo A, Crawford S, Bagha S, Leung YW, Zimmermann C, Fitzgerald B, Wyatt M, Stuart-McEwan T, Rodin G. Easier Said Than Done: Keys to Successful Implementation of the Distress Assessment and Response Tool (DART) Program. J Oncol Pract 2016; 12:e513-26. [DOI: 10.1200/jop.2015.010066] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Purpose: Systematic screening for distress in oncology clinics has gained increasing acceptance as a means to improve cancer care, but its implementation poses enormous challenges. We describe the development and implementation of the Distress Assessment and Response Tool (DART) program in a large urban comprehensive cancer center. Method: DART is an electronic screening tool used to detect physical and emotional distress and practical concerns and is linked to triaged interprofessional collaborative care pathways. The implementation of DART depended on clinician education, technological innovation, transparent communication, and an evaluation framework based on principles of change management and quality improvement. Results: There have been 364,378 DART surveys completed since 2010, with a sustained screening rate of > 70% for the past 3 years. High staff satisfaction, increased perception of teamwork, greater clinical attention to the psychosocial needs of patients, patient-clinician communication, and patient satisfaction with care were demonstrated without a resultant increase in referrals to specialized psychosocial services. DART is now a standard of care for all patients attending the cancer center and a quality performance indicator for the organization. Conclusion: Key factors in the success of DART implementation were the adoption of a programmatic approach, strong institutional commitment, and a primary focus on clinic-based response. We have demonstrated that large-scale routine screening for distress in a cancer center is achievable and has the potential to enhance the cancer care experience for both patients and staff.
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Affiliation(s)
- Madeline Li
- Princess Margaret Cancer Centre, University Health Network; University of Toronto, Toronto, Ontario; and BC Children's and Women's Hospital and Health Centre, Vancouver, British Columbia, Canada
| | - Alyssa Macedo
- Princess Margaret Cancer Centre, University Health Network; University of Toronto, Toronto, Ontario; and BC Children's and Women's Hospital and Health Centre, Vancouver, British Columbia, Canada
| | - Sean Crawford
- Princess Margaret Cancer Centre, University Health Network; University of Toronto, Toronto, Ontario; and BC Children's and Women's Hospital and Health Centre, Vancouver, British Columbia, Canada
| | - Sabira Bagha
- Princess Margaret Cancer Centre, University Health Network; University of Toronto, Toronto, Ontario; and BC Children's and Women's Hospital and Health Centre, Vancouver, British Columbia, Canada
| | - Yvonne W. Leung
- Princess Margaret Cancer Centre, University Health Network; University of Toronto, Toronto, Ontario; and BC Children's and Women's Hospital and Health Centre, Vancouver, British Columbia, Canada
| | - Camilla Zimmermann
- Princess Margaret Cancer Centre, University Health Network; University of Toronto, Toronto, Ontario; and BC Children's and Women's Hospital and Health Centre, Vancouver, British Columbia, Canada
| | - Barbara Fitzgerald
- Princess Margaret Cancer Centre, University Health Network; University of Toronto, Toronto, Ontario; and BC Children's and Women's Hospital and Health Centre, Vancouver, British Columbia, Canada
| | - Martha Wyatt
- Princess Margaret Cancer Centre, University Health Network; University of Toronto, Toronto, Ontario; and BC Children's and Women's Hospital and Health Centre, Vancouver, British Columbia, Canada
| | - Terri Stuart-McEwan
- Princess Margaret Cancer Centre, University Health Network; University of Toronto, Toronto, Ontario; and BC Children's and Women's Hospital and Health Centre, Vancouver, British Columbia, Canada
| | - Gary Rodin
- Princess Margaret Cancer Centre, University Health Network; University of Toronto, Toronto, Ontario; and BC Children's and Women's Hospital and Health Centre, Vancouver, British Columbia, Canada
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Brédart A, Beaudeau A, Young T, Moura De Alberquerque Melo H, Arraras JI, Friend L, Schmidt H, Tomaszewski KA, Bergenmar M, Anota A, Costantini A, Marchal F, Tomaszewska IM, Vassiliou V, Chie WC, Hureaux J, Conroy T, Ramage J, Bonnetain F, Kulis D, Aaronson NK. The European organization for research and treatment of cancer - satisfaction with cancer care questionnaire: revision and extended application development. Psychooncology 2016; 26:400-404. [DOI: 10.1002/pon.4127] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2015] [Revised: 02/05/2016] [Accepted: 03/07/2016] [Indexed: 11/11/2022]
Affiliation(s)
- Anne Brédart
- Psycho-Oncology Unit; Institut Curie; Paris France
- University Paris Descartes; Boulogne Billancourt France
| | | | - Teresa Young
- Lynda Jackson Macmillan Centre; Mount Vernon Cancer Centre; London UK
| | | | | | - Liz Friend
- Basingstoke and North Hampshire Hospital; Basingstoke UK
| | - Heike Schmidt
- Institute for Health and Nursing Science; Martin Luther University Halle-Wittenberg; Halle-Wittenberg Germany
| | - Krzysztof A. Tomaszewski
- Department of Anatomy; Jagiellonian University Medical College; Krakow Poland
- 5 Military Clinical Hospital; Krakow Poland
| | - Mia Bergenmar
- Department of Oncology-Pathology, Karolinska Institutet, Center for Digestive Diseases; Karolinska University Hospital; Stockholm Sweden
| | - Amélie Anota
- Methodology and Quality of Life in Oncology Unit (EA 3181), National Quality of Life and Cancer Clinical Research Platform; CHU; Besançon France
| | - Anna Costantini
- Psychoncology Unit, Sant'Andrea Hospital, Faculty of Medicine and Psychology; Sapienza University of Rome; Rome Italy
| | - Frédéric Marchal
- Institut de Cancérologie de Lorraine, Surgery Department, CRAN, UMR 7039; Lorraine University, CNRS; Vandoeuvre-lès-Nancy France
| | - Iwona M. Tomaszewska
- Department of Medical Education; Jagiellonian University Medical College; Krakow Poland
| | | | - Wei-Chu Chie
- Institute of Preventive Medicine, College of Public Health; National Taiwan University; Taipei Taiwan
| | - José Hureaux
- Pneumology Department; CHU Angers; Angers France
- Angers University; Angers France
| | - Thierry Conroy
- Institut de Cancérologie de Lorraine, Medical Oncology Department and EA 4360; Lorraine University; Vandoeuvre-lès-Nancy France
| | - John Ramage
- Basingstoke and North Hampshire Hospital; Basingstoke UK
| | - Franck Bonnetain
- Methodology and Quality of Life in Oncology Unit (EA 3181), National Quality of Life and Cancer Clinical Research Platform; CHU; Besançon France
| | | | - Neil K. Aaronson
- Division of Psychosocial Research and Epidemiology; The Netherlands Cancer Institute; Amsterdam The Netherlands
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Saunders C, Carter DJ, Jordan A, Duffield C, Bichel-Findlay J. Cancer patient experience measures: An evidence review. J Psychosoc Oncol 2016; 34:200-22. [PMID: 26983680 DOI: 10.1080/07347332.2016.1157717] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
OBJECTIVES This research investigates the instruments currently available to measure the cancer patient experience of health care. An investigation of the number of instruments, the domains covered by the instruments, and the structure and psychometric performance of instruments is undertaken. METHODS A narrative synthesis approach is used to gather evidence from multiple studies and explain the findings. Purposely broad search terms and strategies are used to capture studies with cancer patients at all stages of disease and across a range of cancer types and health care settings. RESULTS The majority of identified instruments were originally designed for the oncology field. Twelve of the studies developed new cancer patient measures; eight studies adapted existing or utilized items from existing instruments, and seven studies assessed the psychometric properties of existing instruments or assessed validated tools under different conditions (e.g., cross-cultural adaptation). The number of instruments assessing cancer patient experience that have sound psychometric properties across items was found to be low. The properties least tested are test-retest reliability, construct, convergent and discriminant validity, scale variability (floor/ceiling effects), and interpretability. CONCLUSION This review examined 10 years of research on the development of instruments to measure the cancer patient experience of health care. It found that research in this area is still in early stages of development. Further inquiry based on development and validation of cancer patient experience measures is required to support improvements in cancer care based on the perspective of cancer patients.
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Affiliation(s)
- Carla Saunders
- a Faculty of Health, Centre for Health Services Management, University of Technology Sydney , Sydney , Australia
| | - David J Carter
- a Faculty of Health, Centre for Health Services Management, University of Technology Sydney , Sydney , Australia
| | - Amy Jordan
- a Faculty of Health, Centre for Health Services Management, University of Technology Sydney , Sydney , Australia
| | - Christine Duffield
- a Faculty of Health, Centre for Health Services Management, University of Technology Sydney , Sydney , Australia
| | - Jen Bichel-Findlay
- a Faculty of Health, Centre for Health Services Management, University of Technology Sydney , Sydney , Australia
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37
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Jeong A, Shin DW, Kim SY, Yang HK, Park JH. Avoidance of cancer communication, perceived social support, and anxiety and depression among patients with cancer. Psychooncology 2016; 25:1301-1307. [DOI: 10.1002/pon.4060] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2015] [Revised: 10/16/2015] [Accepted: 12/06/2015] [Indexed: 01/06/2023]
Affiliation(s)
- Ansuk Jeong
- Department of Psychology; University of Utah Asia Campus; Incheon Korea
| | - Dong Wook Shin
- Department of Family Medicine/Cancer Survivorship Clinic; Seoul National University Hospital; Seoul Korea
- Laboratory of Health Promotion and Health Behavior, Biomedical Research Institute; Seoul National University Hospital; Seoul Korea
| | - So Young Kim
- Chungbuk Regional Cardiocerebrovascular Center; Chungbuk National University Hospital; Cheong-ju Korea
- Cancer Policy Branch, National Cancer Control Research Institute; National Cancer Center; Goyang Korea
| | - Hyung Kook Yang
- Cancer Policy Branch, National Cancer Control Research Institute; National Cancer Center; Goyang Korea
| | - Jong-Hyock Park
- Cancer Policy Branch, National Cancer Control Research Institute; National Cancer Center; Goyang Korea
- College of Medicine; Chungbuk National University; Cheong-ju Korea
- Graduate School of Health Science Business Convergence; Chungbuk National University; Cheong-ju Korea
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38
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Weaver MS, Reeve BB, Baker JN, Martens CE, McFatrich M, Mowbray C, Palma D, Sung L, Tomlinson D, Withycombe J, Hinds P. Concept-elicitation phase for the development of the pediatric patient-reported outcome version of the Common Terminology Criteria for Adverse Events. Cancer 2015; 122:141-8. [PMID: 26421973 DOI: 10.1002/cncr.29702] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2015] [Revised: 08/11/2015] [Accepted: 08/26/2015] [Indexed: 11/08/2022]
Abstract
BACKGROUND Symptoms arising from disease or treatment are subjective experiences. Insight into pediatric oncology treatment side effects or symptoms is ideally obtained from direct inquiry to the ill child. A concept-elicitation phase in a patient-reported outcome (PRO) instrument design provides an opportunity to elicit children's voices to shape cancer symptom selection and terminology. METHODS Through semistructured, one-on-one, voice-recorded interviews, symptom data were collected from 96 children with cancer between the ages of 7 and 20 years who were undergoing oncologic treatment at 7 pediatric oncology sites in the United States and Canada. RESULTS The mean number of symptoms reported per child over the prior 7 days was 1.49 (range, 0-7; median, 1; standard deviation, 1.56). The most common symptoms across all age groups were tiredness or fatigue, nausea or vomiting, aches or pains, and weakness. There was not a statistically significant correlation between self-reported wellness and the number of reported symptoms (r = -0.156, n = 65, P = .215) or the number of symptoms reported by age group or diagnosis type. Forty participants reported experiencing a change in their body in the past week, with one-third of these changes unanticipated. Only through direct questions about feelings were emotional symptoms revealed because 90.6% of interviewees who discussed feelings (48 of 53) did so only in the context of direct questioning on feelings. Adolescents were more likely than younger children to discuss feelings as part of the interview. CONCLUSIONS Concept elicitation from children and adolescents has the potential to enable researchers to develop age-appropriate, accurately representative PRO measures.
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Affiliation(s)
- Meaghann S Weaver
- Department of Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee.,Department of Oncology, Children's National Health Systems, Washington, DC
| | - Bryce B Reeve
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, North Carolina.,Department of Health Policy and Management, Gillings School of Global Public Health, Chapel Hill, North Carolina
| | - Justin N Baker
- Department of Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Christa E Martens
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, North Carolina
| | - Molly McFatrich
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, North Carolina
| | - Catriona Mowbray
- Department of Oncology, Children's National Health Systems, Washington, DC
| | - Diana Palma
- Children's Center for Cancer and Blood Diseases, Children's Hospital Los Angeles, Los Angeles, California
| | - Lillian Sung
- Child Health Evaluative Sciences, Hospital for Sick Children, Toronto, Canada.,Division of Hematology/Oncology, Hospital for Sick Children, Toronto, Canada
| | - Deborah Tomlinson
- Child Health Evaluative Sciences, Hospital for Sick Children, Toronto, Canada
| | - Janice Withycombe
- Palmetto Health Children's Hospital, Columbia, South Carolina.,Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia
| | - Pamela Hinds
- Department of Nursing Research and Quality Outcomes, Children's National Health Systems, Washington, DC.,Department of Pediatrics, George Washington University, Washington, DC
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Petersen GS, Knudsen JL, Vinter MM. Cancer patients' preferences of care within hospitals: a systematic literature review. Int J Qual Health Care 2015; 27:384-95. [PMID: 26265160 DOI: 10.1093/intqhc/mzv059] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/09/2015] [Indexed: 11/14/2022] Open
Abstract
PURPOSE Knowledge about cancer patients' preferences in health care is important because it enables care to be patient centered. However, the literature does not provide an overview. The aim of this study was to identify the dimensions of hospital-based cancer care that patients evaluate the most important using Patient-rated importance as a method. DATA SOURCE PubMed was searched in 2013/2014. STUDY SELECTION Studies were identified, if they were in accordance with specific search terms and focused on hospital-based cancer care. Totally, 11 studies were found. DATA EXTRACTION The 11 studies comprised a total of 598 items. Of these, 592 items were categorized into 19 care dimensions. The highest rated quartile of items was identified as care elements patients evaluated to be the most important. Identification of the most important dimensions was done by calculating the percentages of items within each dimension that were within the highest quartile. RESULTS OF DATA SYNTHESIS The 11 studies varied a lot in regard to aim and patient characteristics. The three most important dimensions were as follows: Rapid diagnosis and treatment; High professional standard; and Information about treatment and side(effects)/consequences. Within four dimensions, Psychosocial support, Physical facilities, Waiting time and Transparency in care, no items were within the highest quartile. CONCLUSION Patient-rated importance was a useful method in identifying the care patients preferred. Due to a limited number of studies and great diversity within studies evaluated, interpretation of results should be cautious. However, it seems that cancer patients treated in hospitals with a curative intent find treatment-related information, professional standard and short delay of diagnosis and treatment most important.
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Affiliation(s)
| | - Janne Lehmann Knudsen
- Danish Cancer Society, Documentation & Quality, Strandboulevarden 49, Copenhagen DK-2100, Denmark
| | - Mette Marianne Vinter
- Danish Cancer Society, Documentation & Quality, Strandboulevarden 49, Copenhagen DK-2100, Denmark
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40
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Tzelepis F, Sanson-Fisher RW, Zucca AC, Fradgley EA. Measuring the quality of patient-centered care: why patient-reported measures are critical to reliable assessment. Patient Prefer Adherence 2015; 9:831-5. [PMID: 26150703 PMCID: PMC4484696 DOI: 10.2147/ppa.s81975] [Citation(s) in RCA: 94] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
PURPOSE The Institute of Medicine (IOM) identified patient-centeredness as crucial to quality health care. The IOM endorsed six patient-centeredness dimensions that stipulated that care must be: respectful to patients' values, preferences, and expressed needs; coordinated and integrated; provide information, communication, and education; ensure physical comfort; provide emotional support; and involve family and friends. Patient-reported measures examine the patient's perspective and are essential to the accurate assessment of patient-centered care. This article's objectives are to: 1) use the six IOM-endorsed patient-centeredness dimensions as a framework to outline why patient-reported measures are crucial to the reliable measurement of patient-centered care; and 2) to identify existing patient-reported measures that assess each patient-centered care dimension. METHODS For each IOM-endorsed patient-centeredness dimension, the published literature was searched to highlight the essential role of patients in assessing patient-centered care and informing quality improvement efforts. Existing literature was also searched to identify examples of patient-reported measures that assess each patient-centeredness dimension. CONCLUSION Patient-reported measures are arguably the best way to measure patient-centeredness. For instance, patients are best positioned to determine whether care aligns with patient values, preferences, and needs and the Measure of Patient Preferences is an example of a patient-reported measure that does so. Furthermore, only the patient knows whether they received the level of information desired, and if information was understood and can be recalled. Patient-reported measures that examine information provision include the Lung Information Needs Questionnaire and the EORTC QLQ-INFO25. In relation to physical comfort, only patients can report the severity of physical symptoms and whether medications provide adequate relief. Patient-reported measures that investigate physical comfort include the Pain Care Quality Survey and the Brief Pain Inventory. Using patient-reported measures to regularly measure patient-centered care is critical to identifying areas of health care where improvements are needed.
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Affiliation(s)
- Flora Tzelepis
- Priority Research Centre for Health Behaviour, University of Newcastle and Hunter Medical Research Institute, Newcastle, NSW, Australia
| | - Robert W Sanson-Fisher
- Priority Research Centre for Health Behaviour, University of Newcastle and Hunter Medical Research Institute, Newcastle, NSW, Australia
| | - Alison C Zucca
- Priority Research Centre for Health Behaviour, University of Newcastle and Hunter Medical Research Institute, Newcastle, NSW, Australia
| | - Elizabeth A Fradgley
- Priority Research Centre for Health Behaviour, University of Newcastle and Hunter Medical Research Institute, Newcastle, NSW, Australia
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41
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Tzelepis F, Sanson-Fisher RW, Hall AE, Carey ML, Paul CL, Clinton-McHarg T. Development and psychometric evaluation of the Quality of Patient-Centered Cancer Care measure with hematological cancer survivors. Cancer 2015; 121:2383-92. [DOI: 10.1002/cncr.29384] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2014] [Revised: 10/16/2014] [Accepted: 03/06/2015] [Indexed: 11/09/2022]
Affiliation(s)
- Flora Tzelepis
- Priority Research Centre for Health Behaviour, University of Newcastle; Callaghan Australia
- Hunter Medical Research Institute; Newcastle Australia
| | - Robert W. Sanson-Fisher
- Priority Research Centre for Health Behaviour, University of Newcastle; Callaghan Australia
- Hunter Medical Research Institute; Newcastle Australia
| | - Alix E. Hall
- Priority Research Centre for Health Behaviour, University of Newcastle; Callaghan Australia
- Hunter Medical Research Institute; Newcastle Australia
| | - Mariko L. Carey
- Priority Research Centre for Health Behaviour, University of Newcastle; Callaghan Australia
- Hunter Medical Research Institute; Newcastle Australia
| | - Christine L. Paul
- Priority Research Centre for Health Behaviour, University of Newcastle; Callaghan Australia
- Hunter Medical Research Institute; Newcastle Australia
| | - Tara Clinton-McHarg
- Priority Research Centre for Health Behaviour, University of Newcastle; Callaghan Australia
- Hunter Medical Research Institute; Newcastle Australia
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Tzelepis F, Sanson-Fisher RW, Hall AE, Carey ML, Paul CL, Clinton-McHarg T. The quality of patient-centred care: haematological cancer survivors' perceptions. Psychooncology 2014; 24:796-803. [PMID: 25504965 DOI: 10.1002/pon.3728] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2014] [Revised: 09/21/2014] [Accepted: 10/29/2014] [Indexed: 12/24/2022]
Abstract
OBJECTIVE Patient-reported outcome measures (PROMs) that assess the quality of patient-centred cancer care have failed to measure all six patient-centredness dimensions endorsed by the Institute of Medicine (IOM). This study is the first to use the Quality of Patient-Centered Cancer Care (QPCCC) measure that covers all six IOM patient-centredness dimensions to examine haematological cancer survivors' perceptions of care and characteristics associated with perceived quality of care. METHODS Haematological cancer survivors diagnosed in the last 6 years and aged 18-80 years were recruited from two Australian state population-based cancer registries. Survivors were mailed the 48-item QPCCC measure. RESULTS Overall, 545 haematological cancer survivors completed the measure. Areas of care most commonly identified as delivered were hospital staff showing respect to survivors (93%) and making sure the correct treatment was received (93%). Aspects of care most frequently nominated as not delivered were hospital staff helping family and friends (34%) or the survivor (32%) to find other people with similar experiences to talk to. Characteristics associated with survivors perceiving higher quality care was delivered included being employed, having private health insurance, being younger, a Non-Hodgkin lymphoma diagnosis and more recent diagnosis. Being depressed or stressed was associated with perceived lower quality of care. CONCLUSIONS Provision of peer support programs that allow haematological cancer survivors and families and friends to talk to others in similar situations could be improved. Using PROMs to identify areas where cancer survivors perceive improvements are needed is essential to quality improvement efforts.
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Affiliation(s)
- Flora Tzelepis
- Priority Research Centre for Health Behaviour, University of Newcastle & Hunter Medical Research Institute, Callaghan, New South Wales, Australia
| | - Robert W Sanson-Fisher
- Priority Research Centre for Health Behaviour, University of Newcastle & Hunter Medical Research Institute, Callaghan, New South Wales, Australia
| | - Alix E Hall
- Priority Research Centre for Health Behaviour, University of Newcastle & Hunter Medical Research Institute, Callaghan, New South Wales, Australia
| | - Mariko L Carey
- Priority Research Centre for Health Behaviour, University of Newcastle & Hunter Medical Research Institute, Callaghan, New South Wales, Australia
| | - Christine L Paul
- Priority Research Centre for Health Behaviour, University of Newcastle & Hunter Medical Research Institute, Callaghan, New South Wales, Australia
| | - Tara Clinton-McHarg
- Priority Research Centre for Health Behaviour, University of Newcastle & Hunter Medical Research Institute, Callaghan, New South Wales, Australia
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Brédart A, Kop JL, Efficace F, Beaudeau A, Brito T, Dolbeault S, Aaronson N. Quality of care in the oncology outpatient setting from patients' perspective: a systematic review of questionnaires' content and psychometric performance. Psychooncology 2014; 24:382-94. [DOI: 10.1002/pon.3661] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2014] [Revised: 07/17/2014] [Accepted: 08/01/2014] [Indexed: 11/09/2022]
Affiliation(s)
- A. Brédart
- Institut Curie; Paris France
- University Paris Descartes; Boulogne Billancourt France
| | - J.-L. Kop
- Inter-Psy; Lorraine University; Nancy France
| | - F. Efficace
- Health Outcomes Research Unit; Italian Group for Adult Hematologic Diseases (GIMEMA) Data Center; Rome Italy
| | | | - T. Brito
- University Paris Descartes; Boulogne Billancourt France
| | - S. Dolbeault
- Institut Curie; Paris France
- Inserm U669; Paris
- Univ Paris-Sud and Univ Paris Descartes, UMR-S0669; Paris France
| | - N. Aaronson
- Division of Psychosocial Research and Epidemiology; The Netherlands Cancer Institute; Amsterdam The Netherlands
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44
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Zucca A, Sanson-Fisher R, Waller A, Carey M. Patient-centred care: making cancer treatment centres accountable. Support Care Cancer 2014; 22:1989-97. [DOI: 10.1007/s00520-014-2221-4] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2014] [Accepted: 03/14/2014] [Indexed: 11/29/2022]
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