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El-Awaisi A, Yakti OH, Elboshra AM, Jasim KH, AboAlward AF, Shalfawi RW, Awaisu A, Rainkie D, Al Mutawa N, Major S. Facilitators and barriers to interprofessional collaboration among health professionals in primary healthcare centers in Qatar: a qualitative exploration using the "Gears" model. BMC PRIMARY CARE 2024; 25:316. [PMID: 39192182 PMCID: PMC11348528 DOI: 10.1186/s12875-024-02537-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Accepted: 07/22/2024] [Indexed: 08/29/2024]
Abstract
BACKGROUND The number of patients seeking medical care is increasing, necessitating more access to primary healthcare services. As several of these patients usually present with complex medical conditions, the need for interprofessional collaboration (IPC) among health professionals in primary care is necessary. IPC is essential for facing the increasing and challenging healthcare demands. Therefore, the facilitators of and the barriers to IPC should be studied in the hope that the results will be used to promote such endeavors. OBJECTIVES This study aimed to explore the perspectives of different health professionals regarding the facilitators of and the barriers to IPC in the primary healthcare settings in Qatar. METHODS A qualitative study using focus groups was conducted within the Primary Health Care Corporation (PHCC) in Qatar. Several health professionals were invited to participate in the focus groups. The focus groups were uniprofessional for general practitioners (GPs), nurses, and dentists, while they were interprofessional for the other health professionals. Focus groups were audio-recorded and transcribed verbatim and validated by the research team. The data were analyzed by deductive thematic analysis using the "Gears" Conceptual Model as a coding framework. RESULTS Fourteen focus groups were conducted involving 58 participants (including 17 GPs, 12 nurses, 15 pharmacists, 3 dentists, and 11 allied health professionals) working in PHCC in Qatar. The findings revealed a spectrum of factors influencing IPC, categorized into four main domains: Macro, Meso, Micro, and individual levels, with each accompanied by relevant barriers and facilitators. Key challenges identified included a lack of communication skills, insufficient professional competencies, and power imbalances, among others. To address these challenges, recommendations were made to implement dedicated training sessions on IPC, reduce hierarchical barriers among different health professionals, and enhance the effectiveness of existing systems. Conversely, it was emphasized that projects and campaigns focused on IPC, alongside the development of enhanced communication skills and the presence of supportive leadership, as essential for facilitating effective IPC in PHCCs. CONCLUSION The interplay between the meso, macro, micro, and individual levels highlight the significance of a multifaceted approach to interventions, aiming to enhance the successes of IPC. While initiatives like interprofessional education training are underway, numerous challenges persist before achieving improved collaboration and more efficient integration of IPC in the PHCC setting.
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Affiliation(s)
- Alla El-Awaisi
- Department of Clinical Pharmacy and Practice, College of Pharmacy, QU Health, Qatar University, Doha, Qatar.
| | | | - Abier Mohamed Elboshra
- Department of Clinical Pharmacy and Practice, College of Pharmacy, QU Health, Qatar University, Doha, Qatar
| | - Kawthar Hasan Jasim
- Department of Clinical Pharmacy and Practice, College of Pharmacy, QU Health, Qatar University, Doha, Qatar
| | - Alzahraa Fathi AboAlward
- Department of Clinical Pharmacy and Practice, College of Pharmacy, QU Health, Qatar University, Doha, Qatar
| | | | - Ahmed Awaisu
- Department of Clinical Pharmacy and Practice, College of Pharmacy, QU Health, Qatar University, Doha, Qatar
| | - Daniel Rainkie
- College of Pharmacy, Dalhousie University, Halifax, Canada
| | - Noora Al Mutawa
- Primary Health Care Corporation, Doha, Qatar
- Department of Clinical Academic Education, College of Medicine, QU Health, Qatar University, Doha, Qatar
| | - Stella Major
- Division of Medical Education, Weill Cornell Medicine - Qatar, Doha, Qatar
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Viljoen A, Leech R, Slater P, Heyns T. Consensus on the definition and attributes of person-centered teamwork: An e-Delphi study. Worldviews Evid Based Nurs 2024; 21:477-485. [PMID: 38576086 DOI: 10.1111/wvn.12724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Revised: 01/18/2024] [Accepted: 03/01/2024] [Indexed: 04/06/2024]
Abstract
BACKGROUND Effective health care relies on person-centeredness and teamwork, which are known to improve outcomes. These two concepts have been defined individually, but we could not find a definition of the combined concept. A preliminary definition was developed through a concept analysis; however, consensus on the concept has not been reached. AIM The aim of this study was to reach consensus on the definition and attributes of person-centered teamwork. METHODS A consensus design allowed experts to collaborate and share their experience and wisdom to refine and reach consensus on the definition and attributes of person-centered teamwork. An e-Delphi was used to engage the experts. RESULTS Three rounds of online engagement with 12 experts were needed to reach consensus on the definition and attributes of person-centered teamwork. The attributes reached consensus of 82% after the first round. The definition had 82% consensus after the three rounds. The definition had been adjusted and refined according to the expert input. The newly adjusted definition was established. LINKING EVIDENCE TO ACTION We successfully used the e-Delphi method to obtain consensus on the attributes and definition of person-centered teamwork. The definition of person-centered teamwork can be further developed and included in clinical practice to guide improved clinical outcomes. The consensus definition of person-centered teamwork provides a clear understanding of the meaning thereof, which may in turn enrich the usability thereof in clinical practice. Person-centered teams improve outcomes for persons receiving care in hospitals. Building person-centered teams are now better understood and the foundation of building these teams defined. We engaged with 12 experts in the academic and clinical field of person-centeredness and teamwork. The use and value of the Delphi method to obtain consensus is now better understood and can assist future research development.
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Affiliation(s)
- Alida Viljoen
- Department of Nursing Science, University of Pretoria, Pretoria, South Africa
| | - Ronell Leech
- Department of Nursing Science, University of Pretoria, Pretoria, South Africa
| | - Paul Slater
- Institute of Nursing and Health Research, Ulster University, Coleraine, Northern Ireland
| | - Tanya Heyns
- Department of Nursing Science, University of Pretoria, Pretoria, South Africa
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Walløe S, Roikjær SG, Hansen SMB, Zangger G, Mortensen SR, Korfitsen CB, Simonÿ C, Lauridsen HH, Morsø L. Content validity of patient-reported measures evaluating experiences of the quality of transitions in healthcare settings-a scoping review. BMC Health Serv Res 2024; 24:828. [PMID: 39039533 PMCID: PMC11265152 DOI: 10.1186/s12913-024-11298-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2024] [Accepted: 07/10/2024] [Indexed: 07/24/2024] Open
Abstract
No reviews so far have been conducted to define the constructs of patient-experienced quality in healthcare transitions or to identify existing generic measures of patients' experience of the quality within healthcare transitions. Our aim was to identify domains relevant for people experiencing healthcare transitions when evaluating the quality of care they have received, map the comprehensiveness of existing patient-reported experience measures (PREM), and evaluate the PREMs' content validity. The method was guided by the Joanna Briggs Institutes' guidance for scoping reviews. The search was performed on 07 December 2021 and updated 27 May 2024, in the electronic databases Medline (Ovid), Embase (Ovid), and Cinahl (EBSCO). The search identified 20,422 publications, and 190 studies were included for review. We identified 30 PREMs assessing at least one aspect of adults' experience of transitions in healthcare. Summarising the content, we consider a model with two domains, organisational and human-relational, likely to be adequate. However, a more comprehensive analysis and adequate definition of the construct is needed. None of the PREMs were considered content valid.
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Affiliation(s)
- Sisse Walløe
- Department of Clinical Research, Research Unit OPEN, University of Southern Denmark, Odense, Denmark.
- Department of Physio- and Occupational Therapy, Research- and Implmentation Unit PROgrez, Næstved-Slagelse-Ringsted Hospitals, Region Zealand, Denmark.
| | - Stine Gundtoft Roikjær
- Department of Physio- and Occupational Therapy, Research- and Implmentation Unit PROgrez, Næstved-Slagelse-Ringsted Hospitals, Region Zealand, Denmark
- Department of Neurology, Center for Neurological Research, Næstved-Slagelse-Ringsted Hospitals, Region Zealand, Denmark
- Department of Health, Institute of Regional Health Research, University of Southern Denmark, Odense, Denmark
| | - Sebrina Maj-Britt Hansen
- Department of Clinical Research, Research Unit OPEN, University of Southern Denmark, Odense, Denmark
| | - Graziella Zangger
- Department of Physio- and Occupational Therapy, Research- and Implmentation Unit PROgrez, Næstved-Slagelse-Ringsted Hospitals, Region Zealand, Denmark
- Department of Sports Science and Clinical Biomechanics, Research Unit for Musculoskeletal Function and Physiotherapy, University of Southern Denmark, Odense, Denmark
| | - Sofie Rath Mortensen
- Department of Physio- and Occupational Therapy, Research- and Implmentation Unit PROgrez, Næstved-Slagelse-Ringsted Hospitals, Region Zealand, Denmark
- Department of Sports Science and Clinical Biomechanics, Research Unit for Exercise Epidemiology, University of Southern Denmark, Odense, Denmark
| | - Christoffer Bruun Korfitsen
- Department of Clinical Research, Research Unit OPEN, University of Southern Denmark, Odense, Denmark
- Department of Clinical Research, Cochrane Denmark & Centre for Evidence-Based Medicine Odense (CEBMO), University of Southern Denmark, Odense, Denmark
| | - Charlotte Simonÿ
- Department of Physio- and Occupational Therapy, Research- and Implmentation Unit PROgrez, Næstved-Slagelse-Ringsted Hospitals, Region Zealand, Denmark
- Department of Health, Institute of Regional Health Research, University of Southern Denmark, Odense, Denmark
| | - Henrik Hein Lauridsen
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Lars Morsø
- Department of Clinical Research, Research Unit OPEN, University of Southern Denmark, Odense, Denmark
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Molina-Prado A, Pérez de Albéniz A, Medin G, Pérez-Alonso V, Carceller E, Huguet-Rodríguez B, Garrido-Colino C. Spanish adolescent patients with cancer and main caregivers: Using perceptions of care to drive change in healthcare. J Healthc Qual Res 2024:S2603-6479(24)00060-5. [PMID: 39043525 DOI: 10.1016/j.jhqr.2024.07.002] [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: 12/11/2023] [Revised: 06/29/2024] [Accepted: 07/01/2024] [Indexed: 07/25/2024]
Abstract
PURPOSE To determine whether there are differences in care experience of adolescent cancer patients and their main caregiver, treated in Adolescent Cancer Units (ACUs), compared to those treated in Non-Adolescent Cancer Units (NACUs), including the COVID-19 pandemic period. METHOD Measurement of Reported Experience in adolescent oncology patients (12-19 years old) and caregivers through ad hoc surveys. The responses of the study group of patients and caregivers treated in Adolescent Units were compared with the group not treated in them. RESULTS It is noted that many respondents consider that they have not been affected by the COVID-19 pandemic. Significant differences were seen in communication, with better perception by the group of patients treated in ACU (87.1%) and caregivers of ACU (97.3%) compared to patients and caregivers of NACU (53.3% and 68.2% respectively). Regarding information received about the side effects, a better perception was observed among patients treated in the ACU than in the NACU (p=0.247). In the transmission of information and the possibility of fertility preservation, a significant difference was observed in favour of ACU in patients and direct caregivers (p=0.010 and p=0.018). CONCLUSIONS ACU represents an improvement in the quality perceived by patients and main caregiver on key points in the comprehensive care of the adolescent with cancer such as information, participation in the process and decision making, approach to side effects, psychological care and help in returning to normal life. However, fertility and strategies for talking about the cancer experience, were identified as areas for future improvement.
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Affiliation(s)
- A Molina-Prado
- Facultad de Medicina, Universidad Complutense Madrid, Spain
| | | | - G Medin
- Adolescent Cancer Unit, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - V Pérez-Alonso
- Adolescent Cancer Unit, Hospital Doce de Octubre, Madrid, Spain
| | - E Carceller
- Adolescent Cancer Unit, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - B Huguet-Rodríguez
- Adolescent Cancer Unit, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - C Garrido-Colino
- Adolescent Cancer Unit, Hospital General Universitario Gregorio Marañón, Madrid, Spain; Instituto Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain.
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Attieh S, Kilpatrick K, Chênevert D, Pomey MP, Loiselle CG. Measuring Team Functioning During the COVID-19 Pandemic: Perspectives of Cancer Care Team Members. J Multidiscip Healthc 2024; 17:2623-2633. [PMID: 38828266 PMCID: PMC11141571 DOI: 10.2147/jmdh.s448985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Accepted: 04/24/2024] [Indexed: 06/05/2024] Open
Abstract
Background In a public health crisis such as COVID-19, cancer teams face significant challenges including acute work disruptions, rapid shifts in clinical practice, and burnout. Within this context, it is crucial to explore team functioning from the perspectives of multiple stakeholders. Objective This quantitative pilot study aimed to 1) measure perceptions of multi-stakeholders on key indicators of team functioning (Team Effectiveness, TE, and Team Relational Coordination, TRC) during COVID-19 and its transition, and 2) document whether patient perceptions of TE/TRC are significantly associated with their cancer care experiences. Methods A descriptive design with repeated measures was used. Through convenience sampling, participants were recruited from two outpatient cancer clinics at a large university-affiliated hospital, in Montréal, Qc, Canada. Sixty-six participants (ie, 13 healthcare professionals, 40 patients, 6 informal caregivers, and 7 volunteers) completed e-measures at T1 (years 2021-2022) and n = 44 at T2 (year 2023). Results At T1, participants reported high perceptions of Team Effectiveness (scale 1 to 6) M = 4.47; SD = 0.7 (Mdn = 4.54; IQR: 4.06-5) and Relational Coordination (scale 1 to 5) M = 3.77; SD = 0.77 (Mdn = 3.81; IQR: 3.12-4.38) with no significant differences in perceptions across the four groups. At T2, no significant changes in TE/TRC perceptions were found. At both time points, patient perceptions of TE/TRC were significantly correlated with positive cancer care experiences (Spearman rank correlation rs ranging from 0.69 and 0.83; p < 0.01). Conclusion To our knowledge, this is the first study documenting perceptions of cancer team functioning amidst the pandemic as reported by multiple stakeholders. Significant relationships between patient perceptions of TE/TRC and their cancer care experiences underscore the importance of including patients' views in team functioning processes. Future work should rely on larger sample sizes to further explore key elements of optimal team functioning.
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Affiliation(s)
- Samar Attieh
- Department of Experimental Medicine, Faculty of Medicine and Health Sciences, McGill University, Montréal, QC, Canada
| | - Kelley Kilpatrick
- Susan E. French Chair in Nursing Research and Innovative Practice, Ingram School of Nursing, Faculty of Medicine and Health Sciences, McGill University, Montréal, QC, Canada
| | - Denis Chênevert
- Department of Human Resources Management, HEC Montréal, Montréal, QC, Canada
| | - Marie-Pascale Pomey
- Research Centre of the University of Montreal Hospital Centre, Montréal, QC, Canada
- Centre d’excellence sur le partenariat avec les patients et le public, Montréal, QC, Canada
- Department of Health Policy, Management and Evaluation, School of Public Health, University of Montréal, Montréal, QC, Canada
| | - Carmen G Loiselle
- Ingram School of Nursing, Faculty of Medicine and Health Sciences, McGill University, Montréal, Canada
- Department of Oncology, Faculty of Medicine and Health Sciences, McGill University, Montréal, Canada
- Segal Cancer Center, Jewish General Hospital, Montréal, Canada
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Ziegler E, Klein J, Kofahl C. Patient experiences and needs in cancer care- results from a nationwide cross-sectional study in Germany. BMC Health Serv Res 2024; 24:572. [PMID: 38698426 PMCID: PMC11067160 DOI: 10.1186/s12913-024-10951-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 04/04/2024] [Indexed: 05/05/2024] Open
Abstract
BACKGROUND Patient-centredness has become a central quality indicator for oncology care. Elements include shared decision-making, patient navigation and integration of psychosocial care, which impact patient-reported and clinical outcomes. Despite efforts to promote patient-centred care in Germany in recent decades, implementation remains fragmented. Further, research on patient experiences with cancer care and its determinants is limited. Therefore, this study examines which patient- and facility-specific factors are associated with patient-centred quality care delivery. METHODS A cross-sectional study was conducted among 1,121 cancer patients in acute treatment, rehabilitation, and aftercare for different cancer entities across Germany. A participatory developed questionnaire was used. Outcome measures were the quality of physician-patient interaction and provision of psychosocial care during acute care. Predictors comprised patient-specific characteristics and treatment facility-specific factors. Multiple linear regression and multivariate binary logistic regression analyses were performed. In addition, a content analysis of open-ended comments on the patients' overall cancer care needs was applied. RESULTS Multiple linear regression analysis showed recent diagnosis (β=-0.12, p = < 0.001), being male (β=-0.11, p = 0.003), and having a preference for passive decision-making (β=-0.10, p = 0.001) to be significantly associated with higher interaction quality, but not age, education and health insurance type. An overall low impact of patient characteristics on interaction quality was revealed (adj. R2 = 0.03). Binary logistic regression analysis demonstrated the availability of central contact persons (OR = 3.10, p < 0.001) followed by recent diagnosis (p < 0.001), having breast cancer (p < 0.001) and being female (OR = 1.68, p < 0.05) to significantly predict offering psycho-oncological counselling to patients in acute care facilities. The availability of peer support visiting services (OR = 7.17, p < 0.001) and central contact persons (OR = 1.87, p < 0.001) in the care facility, breast cancer diagnosis (p < 0.001) and a higher level of education (p < 0.05) significantly increased the odds of patients receiving information about peer support in the treatment facility. Despite relatively satisfactory quality of physician-patient interactions in cancer care (M = 3.5 (± 1.1)), many patients expressed that better patient-centred communication and coordinated, comprehensive cancer care are needed. CONCLUSION The findings reflect effective developments and improvements in cancer care and suggest that patients' social characteristics are less decisive for delivering patient-centred quality care than systemic factors surrounding the care facilities. They can serve to inform oncology care in Germany.
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Affiliation(s)
- Elâ Ziegler
- Institute of Medical Sociology, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany.
| | - Jens Klein
- Institute of Medical Sociology, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany
| | - Christopher Kofahl
- Institute of Medical Sociology, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany
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Nusbaum CLM, Wirth M, Obler D, Redlinger-Grosse K, Cirino AL. A qualitative exploration of interprofessional collaborative practice between genetic counselors and mental health providers. J Community Genet 2024; 15:103-117. [PMID: 38066351 PMCID: PMC11031548 DOI: 10.1007/s12687-023-00690-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Accepted: 11/22/2023] [Indexed: 04/20/2024] Open
Abstract
Genetic counselors (GCs) typically provide short-term counseling and assess patient needs, including the need for ongoing psychosocial support. While some patients may benefit from a referral to a mental health provider (MHP), previous research identified barriers to this process due to patient characteristics, the GC work environment, and MHP availability. Adoption of interprofessional collaborative practice (IPCP), a model where multiple healthcare professionals from diverse training disciplines collaborate to deliver patient care, may mitigate these barriers. Evidence suggests that IPCP both increases patient satisfaction and reduces healthcare spending. Anecdotal evidence suggests that GCs and MHPs may use IPCP in select institutions, but there is limited research examining these relationships. This study aims to characterize the benefits, barriers, and limitations of current IPCP practice between GCs and MHPs. Six semi-structured interviews with GCs and MHPs were completed and analyzed thematically. Four themes emerged: (1) mental health concerns in GC sessions and GC scope of practice; (2) establishing and maintaining IPCP between GCs and MHPs; (3) benefits, barriers, and limitations of IPCP; and (4) next steps to develop future IPCP. The findings suggest that there are varying approaches to IPCP that are influenced by perceptions of provider scope of practice. IPCP may mitigate some previously described referral barriers related to logistics, and the availability of trusted MHPs with knowledge of a GCs specialty, thereby improving patient and provider satisfaction.
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Affiliation(s)
- Claire Lily Martha Nusbaum
- Genetic Counseling Program, MGH Institute of Health Professions, Boston, MA, USA.
- Perinatal Associates of the Mid-Atlantic, Part of Pediatrix Medical Group, Rockville, MD, USA.
| | - Megan Wirth
- Department of Obstetrics & Gynecology, Dartmouth Health, Bedford, NH, USA
| | - Dita Obler
- Moving Beyond a Diagnosis Genetic Consultation and Counseling, Cambridge, MA, USA
| | - Krista Redlinger-Grosse
- Department of Genetics, Cell Biology, and Development, Institute of Human Genetics, University of Minnesota, Minneapolis, MN, USA
| | - Allison L Cirino
- Genetic Counseling Program, MGH Institute of Health Professions, Boston, MA, USA
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Pinto N, Soltys C, Fadaak R, Davies JM, Leslie M. Interprofessional Teamwork: A Qualitative Study on Adapting Central Policies to Local Conditions in a Labour and Delivery Unit. JOURNAL OF OBSTETRICS AND GYNAECOLOGY CANADA 2024; 46:102279. [PMID: 37944818 DOI: 10.1016/j.jogc.2023.102279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 10/26/2023] [Accepted: 10/27/2023] [Indexed: 11/12/2023]
Abstract
OBJECTIVES We record the experiences of staff in a labour, delivery, and obstetric services (LD-OBS) unit in Alberta's largest quaternary medical centre-the Foothills Medical Centre (FMC)-as they navigated hospital policies during the COVID-19 pandemic. We examine how unit leadership applied these policies to better align with care delivery realities while staying true to the interprofessional nature of the unit. METHODS A total of 12 semi-structured qualitative interviews were conducted with LD-OBS unit staff. Snowball and purposive sampling strategies were used to capture experiences from key informants. Interview transcripts underwent inductive coding. The themes identified through this process were discussed with members of the authorial team until a consensus was reached. RESULTS FMC LD-OBS team members used 'interprofessional' as a value through which to interpret, adapt, and implement centrally developed COVID-19 policies. These were applied at 3 key moments: reconfiguring the unit, triaging, and rerouting patients, and contesting central personal protective equipment policies. LD-OBS leaders championed the importance of interprofessional collaboration and teamwork in the unit and worked to uphold it as a practice and value. CONCLUSION The COVID-19 pandemic experience of the FMC LD-OBS unit illustrates the importance of considering interprofessionalism as a core value as policy was developed and implemented. Health authorities, hospitals, and other LD-OBS units may wish to consider how interprofessional work affects policy interpretation among health care teams, and how this may be leveraged to successfully adapt policies to local units, under both pandemic and 'normal' conditions.
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Affiliation(s)
- Nicole Pinto
- School of Public Policy at the University of Calgary, Calgary, AB.
| | - Carmen Soltys
- Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Manitoba, Winnipeg, MB
| | - Raad Fadaak
- School of Public Policy at the University of Calgary, Calgary, AB
| | - Jan Marie Davies
- Department of Anesthesiology, Perioperative and Pain Medicine, University of Calgary, Cumming School of Medicine, Calgary, AB
| | - Myles Leslie
- School of Public Policy at the University of Calgary, Calgary, AB
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Li H, Kilgour H, Leung B, Cho M, Pollock J, Culbertson S, Hedges P, Mariano C, Haase KR. Caring for older adults with cancer in Canada: Views from healthcare providers and cancer care allies in the community. Support Care Cancer 2024; 32:157. [PMID: 38358430 DOI: 10.1007/s00520-023-08303-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 12/29/2023] [Indexed: 02/16/2024]
Abstract
BACKGROUND Cancer is common and disproportionately impacts older adults. Moreover, cancer care of older adults is complex, and the current Canadian cancer care system struggles to address all of the dimensions. In this project, our goal was to understand the barriers and facilitators to caring for older adults with cancer from perspectives of healthcare professionals and cancer care allies, which included community groups, seniors' centers, and other community-based supports. METHODS In collaboration with a patient advisory board, we conducted focus groups and interviews with multiple local healthcare professionals and cancer care allies in British Columbia, Canada. We used a descriptive qualitative approach and conducted a thematic analysis using NVivo software. RESULTS A total of 71 participants of various disciplines and cancer care allies participated. They identified both individual and system-level barriers. Priority system-level barriers for older adults included space and staffing constraints and disconnections within healthcare systems, and between healthcare practitioners and cancer care allies. Individual-level barriers relate to the complex health states of older adults, caregiver/support person needs, and the needs of an increasingly diverse population where English may not be a first or preferable language. CONCLUSIONS This study identified key barriers and facilitators that demonstrate aligned priorities among a diverse group of healthcare practitioners and cancer care allies. In conjunction with perspectives from patients and caregivers, these findings will inform future improvements in cancer care. Namely, we emphasize the importance of connections among health systems and community networks, given the outpatient nature of cancer care and the needs of older adults.
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Affiliation(s)
- Hong Li
- Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Heather Kilgour
- School of Nursing, University of British Columbia, Vancouver, BC, Canada
| | - Bonnie Leung
- School of Nursing, University of British Columbia, Vancouver, BC, Canada
- BC Cancer, Vancouver, BC, Canada
| | - Michelle Cho
- School of Nursing, University of British Columbia, Vancouver, BC, Canada
| | | | | | | | | | - Kristen R Haase
- School of Nursing, University of British Columbia, Vancouver, BC, Canada.
- BC Cancer Research Institute, Vancouver, BC, Canada.
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Botchway-Commey E, Muscara F, Greenham M, D'Cruz K, Bonyhady B, Anderson V, Scheinberg A, Knight S. Rehabilitation models of care for children and youth with traumatic brain and/or spinal cord injuries: A focus on service structure, service organization, and the barriers and facilitators of rehabilitation service provision. Neuropsychol Rehabil 2023; 33:1697-1727. [PMID: 36423210 DOI: 10.1080/09602011.2022.2147196] [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: 06/14/2021] [Accepted: 11/08/2022] [Indexed: 11/25/2022]
Abstract
To understand the systems underlying current rehabilitation models of care used with children and youth (0-21years) who sustain traumatic brain and/or spinal cord injuries. This study gathered qualitative data on service structures, service organization, and the barriers and facilitators of service provision in selected medical rehabilitation service(s) (MRS) and community-based rehabilitation service(s) (CBRS). Informants from 11 rehabilitation services were interviewed using a semi-structured interview guide. Interviews were analysed in NVivo using content analysis method. Experiences shared by the service representatives indicated that most services supported children and youth with brain injury, with a limited number also specializing in spinal cord injuries. MRS often delivered care in inpatient or outpatient settings, while CBRS offered home/community-based services. Care planning often started either prior to or shortly after admission from acute care settings, using either multidisciplinary or interdisciplinary teamwork models. Strengths of the services included innovation and provision of family-centred care; while challenges experienced included difficulty translating evidence into practice and poor team communication. Models of care were similar across services, with a focus on providing family-centred care. Several shared challenges were described, and service representatives expressed interest in forming partnerships and collaborations to address these challenges through innovative initiatives.
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Affiliation(s)
- Edith Botchway-Commey
- Brain and Mind, Clinical Sciences, Murdoch Children's Research Institute, Parkville, Australia
- The Royal Children's Hospital, Parkville, Australia
| | - Frank Muscara
- Brain and Mind, Clinical Sciences, Murdoch Children's Research Institute, Parkville, Australia
- The Royal Children's Hospital, Parkville, Australia
- Department of Paediatrics, The University of Melbourne, Melbourne, Australia
| | - Mardee Greenham
- Brain and Mind, Clinical Sciences, Murdoch Children's Research Institute, Parkville, Australia
| | - Kate D'Cruz
- Department of Occupational Therapy, Social Work and Social Policy, School of Allied Health, Human Services and Sport, College of Science, Health and Engineering, La Trobe University, Melbourne, Australia
| | - Bruce Bonyhady
- Melbourne Disability Institute, University of Melbourne, Melbourne, Australia
| | - Vicki Anderson
- Brain and Mind, Clinical Sciences, Murdoch Children's Research Institute, Parkville, Australia
- The Royal Children's Hospital, Parkville, Australia
- Department of Paediatrics, The University of Melbourne, Melbourne, Australia
| | - Adam Scheinberg
- Brain and Mind, Clinical Sciences, Murdoch Children's Research Institute, Parkville, Australia
- The Royal Children's Hospital, Parkville, Australia
- Department of Paediatrics, The University of Melbourne, Melbourne, Australia
- Department of Paediatrics, Monash University, Melbourne, Australia
- Victorian Paediatric Rehabilitation Service, Parkville, Australia
| | - Sarah Knight
- Brain and Mind, Clinical Sciences, Murdoch Children's Research Institute, Parkville, Australia
- The Royal Children's Hospital, Parkville, Australia
- Department of Paediatrics, The University of Melbourne, Melbourne, Australia
- Department of Paediatrics, Monash University, Melbourne, Australia
- Victorian Paediatric Rehabilitation Service, Parkville, Australia
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11
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Mäurer M, Staudacher J, Meyer R, Mäurer I, Lazaridis L, Müther M, Huber T, Sommer NP, Fleischmann DF, Käsmann L, Ziegler S, Kropf-Sanchen C, Wikert J, Pietzner K, Holzgreve A, Nestler T, Siech C, Sturm MJ, Sulzer S, Heinrich K, Stahler A. Importance of interdisciplinarity in modern oncology: results of a national intergroup survey of the Young Oncologists United (YOU). J Cancer Res Clin Oncol 2023; 149:10075-10084. [PMID: 37261525 PMCID: PMC10423150 DOI: 10.1007/s00432-023-04937-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Accepted: 05/24/2023] [Indexed: 06/02/2023]
Abstract
PURPOSE Modern, personalized treatment concepts in oncology require an interdisciplinary and multiprofessional collaboration. In addition to its relevance in patient care, interdisciplinary collaboration is also becoming increasingly important in clinical research as well as medical education and resident training in oncology. METHODS Between November 2021 and March 2022, an online survey was conducted among German early career research groups, represented by Young Oncologists United (YOU). The aim was to identify the status and need for interdisciplinarity at clinic, educational, and research levels. RESULTS A total of 294 participants completed the questionnaire in full. 90.7% of the respondents fully or predominantly agreed with the statement that interdisciplinary work plays a major role in their daily clinical work. 78.9% wished for more interdisciplinary collaboration. Of the 49.7% of participants who have never participated in an interdisciplinary research project, 80.1% said they would like to participate in such a study project in the future. Lack of time resources, too much organizational effort, and possible political conflicts between institutions were identified as factors that make practical implementation difficult. 74.1% declared their willingness to become active in an oncology early career research group. CONCLUSION Interdisciplinary collaboration has become increasingly important in oncology. Networks that span different disciplines could help to promote interdisciplinary research projects among young scientists and improve exchange in professional practice and education with the implication of improved patient care.
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Affiliation(s)
- Matthias Mäurer
- Department of Radiotherapy and Radiation Oncology, University Hospital Jena, Jena, Germany.
| | - Jonas Staudacher
- Department of Gastroenterology, Rheumatology and Infectiology, Charité Universitätsmedizin Berlin, Campus Benjamin Franklin, Berlin, Germany
- Berlin Institute of Health at Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Robert Meyer
- Institute of Human Genetics and Genomic Medicine, University Hospital Aachen, Medical Faculty, RWTH Aachen University, Aachen, Germany
- Department of Hematology, Oncology, Hemostaseology and Stem Cell Transplantation, University Hospital Aachen, Faculty of Medicine, RWTH Aachen University, Aachen, Germany
- Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD), Bonn, Germany
| | - Irina Mäurer
- Department of Neurology, Neurooncology Center, University Hospital Jena, Jena, Germany
| | - Lazaros Lazaridis
- Department of Neurology and Center for Translational Neuro- and Behavioral Sciences (C-TNBS), Division of Clinical Neurooncology, University Medicine Essen, University Duisburg-Essen, Essen, Germany
| | - Michael Müther
- Department of Neurosurgery, University Hospital Münster, Münster, Germany
| | - Tobias Huber
- Department of General, Visceral and Transplant Surgery, University Medical Center Mainz, Mainz, Germany
| | - Nils P Sommer
- Department of General, Visceral, Thoracic and Vascular Surgery, University Hospital Bonn, Bonn, Germany
| | - Daniel F Fleischmann
- Clinic and Polyclinic for Radiotherapy and Radiooncology, LMU Clinic Munich, LMU Munich, Munich, Germany
| | - Lukas Käsmann
- Clinic and Polyclinic for Radiotherapy and Radiooncology, LMU Clinic Munich, LMU Munich, Munich, Germany
| | - Sonia Ziegler
- Clinic and Polyclinic for Radiation Therapy and Radiooncology, University Medical Center Göttingen, Göttingen, Germany
| | | | - Julia Wikert
- Clinic and Polyclinic for Palliative Medicine, LMU Klinikum München, Munich, Germany
| | - Klaus Pietzner
- Department of Gynecology, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Adrien Holzgreve
- Clinic and Polyclinic for Nuclear Medicine, University Hospital Munich, LMU Munich, Munich, Germany
| | - Tim Nestler
- Clinic for Urology, Bundeswehr Central Hospital Koblenz, Koblenz, Germany
| | - Carolin Siech
- Department of Urology, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Max-Johann Sturm
- Department of Radiotherapy and Radiation Oncology, University Hospital Jena, Jena, Germany
| | - Sabrina Sulzer
- Department of Gastroenterology, Gastrointestinal Oncology and Endocrinology, University Medical Center Göttingen, Göttingen, Germany
| | - Kathrin Heinrich
- Medical Clinic and Polyclinic III, University Hospital Munich, LMU Munich, Munich, Germany
| | - Arndt Stahler
- Charité University Medicine, Medical Clinic m. S. Hematology, Oncology and Tumor Immunology, Berlin, Germany
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12
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Yackel HD, Montano ARL. Attitudes Toward Interprofessional Health Care Teams in a Regional Cancer Institute: A Cross-Sectional Survey Study. Semin Oncol Nurs 2023; 39:151468. [PMID: 37385871 DOI: 10.1016/j.soncn.2023.151468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 05/26/2023] [Accepted: 06/07/2023] [Indexed: 07/01/2023]
Abstract
OBJECTIVES Oncology is a rapidly changing clinical setting. Research has shown improved patient outcomes and staff satisfaction following interprofessional collaborative education, but there has been limited research on perceptions of interprofessional collaboration among oncology health care professionals. The aims of this study were to: 1) assess attitudes of health care professionals toward interprofessional teams in oncology care, and 2) assess for differences in attitudes across various demographic and workplace groups. DATA SOURCES The research design was an electronic cross-sectional survey. The main instrument utilized was the Attitudes Toward Interprofessional Health Care Teams (ATIHCT) survey. A total of 187 oncology health care professionals from a regional New England cancer institute completed the survey. The ATIHCT mean score was high (M = 4.07, SD = 0.51). Analysis revealed statistically significant differences in mean score among participant age groups (P = .03). Significant differences (P = .01) were also noted between different professional groups and their time constraints sub-scale score on the ATIHCT scale. A higher mean score occurred in participants who had a current certification (M = 4.13, SD = 0.50) compared to those without (M = 4.05, SD = 0.46). CONCLUSION High overall scores in attitudes toward health care teams suggest that cancer care settings are primed for interprofessional care model implementation. Future studies should examine strategies to improve attitudes among specific groups. IMPLICATIONS FOR NURSING PRACTICE Nurses are in a position to lead interprofessional teamwork in the clinical setting. Further research is necessary to examine best collaborative models in health care to support interprofessional teamwork.
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Affiliation(s)
- Hayley Dunnack Yackel
- Clinical Research Nurse and Scientist, Hartford HealthCare Cancer Institute, Hartford, Connecticut, USA.
| | - Anna-Rae L Montano
- Program Director of Inpatient Geriatric Services, Hartford Hospital, Hartford, Connecticut, USA
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13
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Tremblay D, Beaupère S, Biaudet J, Castel P, Fervers B, Galvez C, Sontag P, Usher S, Wilhelmy C. Resilience at Work among Healthcare Professionals in Oncology during and beyond the Pandemic: Report from A Deliberative Multi-Stakeholder Reflexive Symposium. Curr Oncol 2023; 30:6986-6995. [PMID: 37504366 PMCID: PMC10377963 DOI: 10.3390/curroncol30070506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Revised: 07/10/2023] [Accepted: 07/18/2023] [Indexed: 07/29/2023] Open
Abstract
The chronic distress faced by healthcare professionals (HCPs) in oncology was exacerbated by the COVID-19 pandemic, heightening the need to improve their resilience. The Entretiens Jacques Cartier symposium provided an opportunity for participants from France and Quebec to share perspectives on resilience at work and discuss interventions at individual and organizational levels to support HCP health and well-being. Fifty-eight stakeholders were invited to the symposium, including HCPs, government decision-makers, researchers, and patient representatives. The symposium began with presentations on the nature of professional resilience at work in oncology and promising interventions developed in France and Quebec. Participants were then engaged in deliberation on how evidence and experiential knowledge could contribute to workplace strategies to strengthen resilience. Small-group reflexive sessions using the photovoice method, and an intersectoral roundtable, elicited the expression and deliberation of multiple perspectives on the nature and building blocks of resilience. Four main themes emerged from the discussions: (1) that resilience remains a muddy concept and can be associated pejoratively with "happycracy"; (2) that resilience must contend with bounded autonomy and captors; (3) that it relies on a sense of coherence at work; and (4) that patients play a role in improving HCP resilience. Stakeholders from healthcare systems in different countries view resilience at work as a means of equipping teams to handle chronic and punctual stresses in cancer care. The symposium emphasized the importance of better defining what resilience at work means and pursuing explorations of multicomponent interventions to support oncology HCPs and the patients they care for. The themes raised by participants at the symposium suggest pathways for furthering this exploration.
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Affiliation(s)
- Dominique Tremblay
- Faculty of Medicine and Health Sciences, Université de Sherbrooke, Longueuil, QC J4K 0A8, Canada
- Centre de Recherche Charles-Le Moyne, Longueuil, QC J4K 0A8, Canada
| | | | - Julien Biaudet
- Cancéropôle Lyon Auvergne Rhône-Alpes, 69007 Lyon, France
| | - Patrick Castel
- Sciences Po, Centre de Sociologie des Organisations (CSO), CNRS, 75007 Paris, France
| | - Béatrice Fervers
- Département Prévention Cancer Environnement, Centre Léon Bérard, 69008 Lyon, France
| | | | | | - Susan Usher
- Commissaire à la Santé et au Bien-Être, Quebec, QC G1S 2L2, Canada
| | - Catherine Wilhelmy
- Centre de Recherche du Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, QC J1H 5N4, Canada
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14
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Thomas C, Faghy MA, Owen R, Yates J, Ferraro F, Bewick T, Haggan K, Ashton REM. Lived experience of patients with Long COVID: a qualitative study in the UK. BMJ Open 2023; 13:e068481. [PMID: 37185640 PMCID: PMC10151237 DOI: 10.1136/bmjopen-2022-068481] [Citation(s) in RCA: 15] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/17/2023] Open
Abstract
BACKGROUND Long COVID is a rapidly evolving global health crisis requiring interdisciplinary support strategies that incorporate the lived experience of patients. Currently, there is a paucity of research documenting the day-to-day experiences of patients living with Long COVID. OBJECTIVE To explore the lived experience of Long COVID patients. STUDY DESIGN Longitudinal, observation study. SETTING An inductive, data-driven, qualitative approach was used to evaluate hand-written diaries obtained from individuals who had been referred to a Derbyshire Long COVID clinic. PARTICIPANTS 12 participants (11 females, age 49±10 years, 11 Caucasians) were recruited. Participants were included if they had a previous confirmed or suspected COVID-19 infection with ongoing recovery, >18 years old, understood the study requirements and provided informed consent. METHOD Participants were directed to complete self-report diaries over 16 weeks. Responses were transcribed verbatim and analysed using thematic analysis. RESULTS Three key themes were highlighted: (1) understanding who helps patients manage symptoms, (2) daily activities and the impact on quality of life and health status and (3) the effect of turbulent and episodic symptom profiles on personal identity and recovery. CONCLUSIONS The novel challenges presented by Long COVID are complex with varying inter-related factors that are broadly impacting functional status and quality of life. Support mechanisms must incorporate the lived experiences and foster true collaborations between health professionals, patients and researchers to improve patient outcomes. TRIAL REGISTRATION NUMBER NCT04649957.
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Affiliation(s)
- Callum Thomas
- School of Human Sciences, University of Derby, Derby, UK
- Healthy Living for Pandemic Event Protection (HL - PIVOT) Network, Chicago, Illinois, USA
| | - Mark A Faghy
- School of Human Sciences, University of Derby, Derby, UK
- Healthy Living for Pandemic Event Protection (HL - PIVOT) Network, Chicago, Illinois, USA
| | - Rebecca Owen
- School of Human Sciences, University of Derby, Derby, UK
- Healthy Living for Pandemic Event Protection (HL - PIVOT) Network, Chicago, Illinois, USA
| | - James Yates
- School of Human Sciences, University of Derby, Derby, UK
- Healthy Living for Pandemic Event Protection (HL - PIVOT) Network, Chicago, Illinois, USA
| | - Francesco Ferraro
- School of Human Sciences, University of Derby, Derby, UK
- Healthy Living for Pandemic Event Protection (HL - PIVOT) Network, Chicago, Illinois, USA
| | - Tom Bewick
- Respiratory Medicine, University Hospitals of Derby and Burton NHS Foundation Trust, Derby, UK
| | - Kate Haggan
- Respiratory Medicine, University Hospitals of Derby and Burton NHS Foundation Trust, Derby, UK
| | - Ruth E M Ashton
- School of Human Sciences, University of Derby, Derby, UK
- Healthy Living for Pandemic Event Protection (HL - PIVOT) Network, Chicago, Illinois, USA
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15
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Sasnal M, Lorenz KA, McCaa M, Wu A, Morris AM, Schenker Y, Shreve ST, Giannitrapani KF. "It's Not Us Versus Them": Building Cross-Disciplinary Relationships in the Perioperative Period. J Pain Symptom Manage 2023; 65:263-272. [PMID: 36646332 DOI: 10.1016/j.jpainsymman.2022.12.140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 12/20/2022] [Accepted: 12/26/2022] [Indexed: 01/15/2023]
Abstract
CONTEXT Palliative care (PC) interventions improve quality outcomes for surgical patients, yet they are underutilized in the perioperative period. Developing cross-disciplinary provider relationships increases PC consults. However, the attributes of collaborative relationships and how they evolve are unclear. OBJECTIVES To identify perceptions of PC providers and surgeons on how collaborative cross-disciplinary relationships are built and maintained in the perioperative period. METHODS This cross-sectional multiphase qualitative study included 23 semistructured interviews with 10 PC teams (20 providers) and 13 surgeons at geographically distributed Veteran Health Administration (VHA) sites. An analytic approach relied on team-based thematic analysis with a dual review (Krippendorf α above 0.8). RESULTS Respondents defined successful collaborative work relationships between PC and surgeons as having the following features: 1) mutual trust; 2) mutual respect; 3) perceived usefulness; 4) shared clinical objectives; 5) effective communication; and 6) organizational enablers. In addition, the analysis elucidated a framework of six strategies for developing collaborative relationships between PC and surgical teams in the perioperative period: 1) being present, available, and responsive; 2) understanding roles; 3) establishing communication; 4) recognizing an intermediary and connecting role of supporting team members; 5) working as a team; and 6) building on previous experiences. CONCLUSION The study informs future interventions to improve the quality of care for seriously ill patients by better-involving PC in the perioperative period. Future work will extend this approach to incorporate the perspectives of patients on their providers' collaboration and how it impacts patient-related outcomes at the intersection of PC and surgery.
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Affiliation(s)
- Marzena Sasnal
- Stanford Medicine, Surgery Policy Improvement Research & Education Center (M.S., A.M.M.), Stanford California, USA
| | - Karl A Lorenz
- VA Quality Improvement Resource Center for Palliative Care (K.A.L., M.M., K.F.G.), Menlo Park, California, USA; Stanford Medicine, Primary Care and Population Health (K.A.L., K.F.G.), Stanford, California, USA
| | - Matthew McCaa
- VA Quality Improvement Resource Center for Palliative Care (K.A.L., M.M., K.F.G.), Menlo Park, California, USA
| | - Adela Wu
- Department of Neurosurgery, Stanford Medicine (A.W.), Stanford, California, USA
| | - Arden M Morris
- Stanford Medicine, Surgery Policy Improvement Research & Education Center (M.S., A.M.M.), Stanford California, USA
| | - Yael Schenker
- Section of Palliative Care and Medical Ethics, Palliative Research Center (PaRC), University of Pittsburgh (Y.S.), Pittsburgh, Pennsylvania, USA
| | - Scott T Shreve
- United States Department of Veterans Affairs, VA Palliative Care (S.T.S.), Lebanon, Pennsylvania, USA
| | - Karleen F Giannitrapani
- VA Quality Improvement Resource Center for Palliative Care (K.A.L., M.M., K.F.G.), Menlo Park, California, USA; Stanford Medicine, Primary Care and Population Health (K.A.L., K.F.G.), Stanford, California, USA.
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16
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Cho H, Han K, Baek H, Ju J. Translations and psychometric validation of the Korean version of the Nursing Teamwork Survey. Res Nurs Health 2023; 46:242-250. [PMID: 36694925 DOI: 10.1002/nur.22297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 01/04/2023] [Accepted: 01/16/2023] [Indexed: 01/26/2023]
Abstract
Enhancing nursing teamwork benefits both patients and nurses. The Nursing Teamwork Survey is a reliable, valid tool to evaluate nursing teamwork. This study was conducted to translate and psychometrically validate the Nursing Teamwork Survey for nurses in Korea. In Phase 1, the Nursing Teamwork Survey was translated into Korean using forward and backward translations. Content and face validity were determined using expert review and pilot testing, respectively. In Phase 2, we evaluated construct and convergent validity and internal consistency, and test-retest reliability. We used survey data from 1119 hospital nursing staff; 98 of whom completed the Korean version of the Nursing Teamwork Survey after 2 weeks. Confirmatory factor analysis showed an acceptable fit (χ2 /df ratio = 3.96, root mean square error of approximation = 0.05, standardized root mean square residual = 0.05, comparative fit index = 0.91, and Tucker-Lewis index = 0.90) with good internal consistency (Cronbach's α = 0.76-93) and test-retest reliability (rs = 0.63-0.83). Convergent validity was supported by the correlation between the subscales of the Korean version of the Nursing Teamwork Survey and the Teamwork Within Units subscale of the Hospital Survey on Patient Safety Culture (rs = 0.45-0.69, ps < 0.01). These findings indicate that the Korean version of the Nursing Teamwork Survey is a reliable and valid measurement for assessing nursing teamwork. The Korean version of the Nursing Teamwork Survey can inform management strategies to promote nursing teamwork and improve patient safety and nurses' well-being.
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Affiliation(s)
- Hyeonmi Cho
- Chung-Ang University College of Nursing, Seoul, South Korea
| | - Kihye Han
- Chung-Ang University College of Nursing, Seoul, South Korea
| | - Hyang Baek
- University of Maryland School of Nursing, Baltimore, MD, USA
| | - Jieun Ju
- Chung-Ang University Graduate School Department of Nursing, Seoul, South Korea
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17
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Witjes VM, Braspenning JCC, Hoogerbrugge N, Smolders YHCM, Hermkens DMA, Mourits MJE, Ligtenberg MJL, Ausems MGEM, de Hullu JA. Healthcare professionals' perspectives on implementation of universal tumor DNA testing in ovarian cancer patients: multidisciplinary focus groups. Fam Cancer 2023; 22:1-11. [PMID: 35570228 PMCID: PMC9829642 DOI: 10.1007/s10689-022-00294-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Accepted: 04/19/2022] [Indexed: 01/13/2023]
Abstract
Universal tumor DNA testing in epithelial ovarian cancer patients can function not only as an efficient prescreen for hereditary cancer testing, but may also guide treatment choices. This innovation, introduced as Tumor-First workflow, offers great opportunities, but ensuring optimal multidisciplinary collaboration is a challenge. We investigated factors that were relevant and important for large-scale implementation. In three multidisciplinary online focus groups, healthcare professionals (gynecologic oncologists, pathologists, clinical geneticists, and clinical laboratory specialists) were interviewed on factors critical for the implementation of the Tumor-First workflow. Recordings were transcribed for analysis in Atlas.ti according to the framework of Flottorp that categorizes seven implementation domains. Healthcare professionals from all disciplines endorse implementation of the Tumor-First workflow, but more detailed standardization and advice regarding the logistics of the workflow were needed. Healthcare professionals explored ways to stay informed about the different phases of the workflow and the results. They emphasized the importance of including all epithelial ovarian cancer patients in the workflow and monitoring this inclusion. Overall, healthcare professionals would appreciate supporting material for the implementation of the Tumor-First workflow in the daily work routine. Focus group discussions have revealed factors for developing a tailored implementation strategy for the Tumor-First workflow in order to optimize care for epithelial ovarian cancer patients. Future innovations affecting multidisciplinary oncology teams including clinical geneticists can benefit from the lessons learned.
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Affiliation(s)
- Vera M. Witjes
- grid.10417.330000 0004 0444 9382Department of Human Genetics, Radboud Institute for Molecular Life Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Jozé C. C. Braspenning
- grid.10417.330000 0004 0444 9382Scientific Center for Quality of Healthcare, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Nicoline Hoogerbrugge
- grid.10417.330000 0004 0444 9382Department of Human Genetics, Radboud Institute for Molecular Life Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Yvonne H. C. M. Smolders
- grid.10417.330000 0004 0444 9382Department of Human Genetics, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Dorien M. A. Hermkens
- grid.10417.330000 0004 0444 9382Department of Human Genetics, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Marian J. E. Mourits
- grid.4494.d0000 0000 9558 4598Department of Gynecology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Marjolijn J. L. Ligtenberg
- grid.10417.330000 0004 0444 9382Department of Human Genetics, Radboud Institute for Molecular Life Sciences, Radboud University Medical Center, Nijmegen, The Netherlands ,grid.10417.330000 0004 0444 9382Department of Pathology, Radboud Institute for Molecular Life Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Margreet G. E. M. Ausems
- grid.7692.a0000000090126352Division Laboratories, Pharmacy and Biomedical Genetics, Department of Genetics, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Joanne A. de Hullu
- grid.10417.330000 0004 0444 9382Department of Obstetrics and Gynecology, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
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18
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Wantonoro W, Komarudin K, Imania DR, Harun S, Nguyen TV. The Influence of 6-Month Interdisciplinary Accompaniment on Family Caregivers’ Knowledge and Self-Efficacy Regarding Diabetic Wound Care. SAGE Open Nurs 2023; 9:23779608231167801. [PMID: 37050936 PMCID: PMC10084543 DOI: 10.1177/23779608231167801] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 01/29/2023] [Accepted: 03/18/2023] [Indexed: 04/08/2023] Open
Abstract
Introduction Diabetes mellitus (DM) is a global health issue. Diabetic wounds have become a severe health complication. Interdisciplinary education and the use of homecare have led to improvements in the health of patients with chronic disease. The family caregiver's knowledge and self-efficacy positively impact the DM patient's self-care in the physical and psychological dimensions. There is still a need for interdisciplinary education to enhance family caregivers’ knowledge and self-efficacy regarding diabetic wound care. Objective To determine the effect of 6 months of interdisciplinary education on family caregivers’ knowledge and self-efficacy regarding diabetic wound care. Methods A quantitative longitudinal study with a quasi-experimental, one-group, pretest–posttest design was conducted. Family caregivers received 6 months of interdisciplinary education regarding diabetic wound care. The Foot Care Confidence Scale (FCCS) was used to measure the family caregivers’ knowledge and self-efficacy regarding diabetic wound care. The dependent samples t test and the Wilcoxon signed-rank test were used for statistical analysis. Results Sixteen caregivers of patients with diabetic ulcer wounds in the homecare unit participated in this intervention with a 6-month follow-up. Six months of interdisciplinary education significantly increased the family caregivers’ knowledge ( p = 0.001) and self-efficacy ( p = 0.001). However, there was no significant correlation between self-efficacy and gender, age, education level, or duration of wound care ( p = 0.91; 0.93; 0.38; 0.40, respectively). Long-term interdisciplinary education improved caregiver performance across genders, ages, education levels, and wound care experience durations. Conclusion Long-term interdisciplinary education of family caregivers is recommended as one method to enhance the family support system with respect to diabetic ulcer care management. In addition, interprofessional collaboration could be performed to enhance the understanding of healthcare, especially diabetic ulcer care.
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Affiliation(s)
- Wantonoro Wantonoro
- Department of Nursing, Universitas ‘Aisyiyah Yogyakarta, Yogyakarta, Indonesia
| | - Komarudin Komarudin
- Department of Physiology, Universitas ‘Aisyiyah Yogyakarta, Yogyakarta, Indonesia
| | - Dika Rizki Imania
- Department of Physiotherapy, Universitas ‘Aisyiyah Yogyakarta, Yogyakarta, Indonesia
| | - Sigit Harun
- Department of Nursing, Universitas ‘Aisyiyah Yogyakarta, Yogyakarta, Indonesia
- Unit Homecare PKU Muhammadiyah Yogyakarta, Yogyakarta, Indonesia
| | - Tuan Van Nguyen
- Department of Nursing, Faculty of Nursing and Medical Technology, Can Tho University of Medicine and Pharmacy, Can Tho City, Vietnam
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19
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Espinel-Flores V, Tiburcio-Lara G, Vargas I, Eguiguren P, Mogollón-Pérez AS, Ferreira-de-Medeiros-Mendes M, López-Vázquez J, Bertolotto F, Amarilla D, Vázquez ML. Relational Continuity of Chronic Patients with Primary and Secondary Care Doctors: A Study of Public Healthcare Networks of Six Latin American Countries. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13008. [PMID: 36293587 PMCID: PMC9602030 DOI: 10.3390/ijerph192013008] [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: 09/01/2022] [Revised: 10/05/2022] [Accepted: 10/07/2022] [Indexed: 06/16/2023]
Abstract
Despite relational continuity (RC) with the doctor being key to care quality for chronic patients, particularly in fragmented healthcare systems, like many in Latin America (LA), little is known about RC and its attributes, particularly regarding specialists. Aim: We aim to analyse chronic patients' perceptions of RC with primary (PC) and secondary (SC) care doctors, and record changes between 2015 and 2017 in the public healthcare networks of six LA countries. An analysis of two cross-sectional studies applying the CCAENA questionnaire to chronic patients (N = 4881) was conducted in Argentina, Brazil, Chile, Colombia, Mexico, and Uruguay. The dependent variables of RC with PC and SC doctors were: consistency, trust, effective communication, and synthetic indexes based on RC attributes. Descriptive and multivariate analyses were performed. Although the RC index was high in 2015, especially in PC in all countries, and at both levels in Argentina and Uruguay, low perceived consistency of PC and SC doctors in Colombia and Chile and of SC doctors in Mexico revealed important areas for improvement. In 2017 the RC index of SC doctors increased in Chile and Mexico, while SC doctors' consistency in Colombia decreased. This study reveals important gaps in achieving RC with doctors, particularly in SC, which requires further structural and organisational reforms.
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Affiliation(s)
- Verónica Espinel-Flores
- Health Policy and Health Services Research Group, Health Policy Research Unit, Consortium for Health Care and Social Services of Catalonia, Avinguda Tibidabo 21, ES08022 Barcelona, Spain
| | - Gabriela Tiburcio-Lara
- Health Policy and Health Services Research Group, Health Policy Research Unit, Consortium for Health Care and Social Services of Catalonia, Avinguda Tibidabo 21, ES08022 Barcelona, Spain
| | - Ingrid Vargas
- Health Policy and Health Services Research Group, Health Policy Research Unit, Consortium for Health Care and Social Services of Catalonia, Avinguda Tibidabo 21, ES08022 Barcelona, Spain
| | - Pamela Eguiguren
- Escuela de Salud Pública Dr. Salvador Allende Gossens, Universidad de Chile, Independencia 939, Santiago de Chile, Chile
| | - Amparo-Susana Mogollón-Pérez
- Escuela de Medicina y Ciencias de la Salud, Universidad del Rosario, Cra 24 No. 63C-69, Quinta Mutis, Bogotá 11001, Colombia
| | - Marina Ferreira-de-Medeiros-Mendes
- Grupo de Estudos de Gestão e Avaliação em Saúde, Instituto de Medicina Integral Professor Fernando Figueira, Rua Dos Coelhos No. 300, Boa Vista, Recife 50070-550, Brazil
| | - Julieta López-Vázquez
- Instituto de Salud Pública, Universidad Veracruzana, Av. Dr. Luis Castelazo Ayala s/n Col. Industrial Ánimas, Xalapa 91190, Mexico
| | - Fernando Bertolotto
- Facultad de Enfermería, Universidad de la República, Avenida 18 de Julio 124, Montevideo 11200, Uruguay
| | - Delia Amarilla
- Maestría en Salud Pública, Centro de Estudios Interdisciplinarios, Universidad Nacional de Rosario, Maipú 1065, Rosario 2000, Argentina
| | - María-Luisa Vázquez
- Health Policy and Health Services Research Group, Health Policy Research Unit, Consortium for Health Care and Social Services of Catalonia, Avinguda Tibidabo 21, ES08022 Barcelona, Spain
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Dimensions of Proximity: An Actionable Framework to Better Understand Integrated Practices in Cancer Networks. Int J Integr Care 2022; 22:9. [PMID: 36060829 PMCID: PMC9389948 DOI: 10.5334/ijic.6434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Accepted: 08/03/2022] [Indexed: 11/30/2022] Open
Abstract
Introduction: This study empirically explores how dimensions of proximity that support integrated care emerge from deliberate actions within a cancer network in Quebec (Canada). Methods: We conduct a supplementary analysis of qualitative data from a primary multi-case study focused on collaborative governance and cancer care integration. Data from semi-structured interviews, documents and observation are analysed to find out how relationships take shape through actions that create different dimensions of proximity, and how these contribute to integrated practices. Results: Deliberate actions at different levels within the network create dimensions of proximity. The creation of committees and communities of practice at national and local level establish geographic proximity. Relational proximity among actors emerges to different degrees in these venues. Cognitive proximity is generated by consistent promotion of the national cancer plan and person-centred care. The priority of cancer care at policy level and prescription of common standards enhance organizational proximity. Synergy between dimensions of proximity appears essential to the emergence of integrated practices. Insufficient efforts to create technological and institutional proximity contribute to inconsistent clinical and professional integration. Conclusion: The concept of proximity appears a promising complement to existing models of integration, especially in complex contexts such as cancer networks. Highlights The multiple dimensions of proximity appear a promising complement to existing models of integration, especially in complex contexts such as cancer networks.
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21
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Danielis M, Iob R, Achil I, Palese A. Family Visiting Restrictions and Postoperative Clinical Outcomes: A Retrospective Analysis. NURSING REPORTS 2022; 12:583-588. [PMID: 35997465 PMCID: PMC9397009 DOI: 10.3390/nursrep12030057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 08/02/2022] [Accepted: 08/09/2022] [Indexed: 11/16/2022] Open
Abstract
In the last two years, all hospitals have adopted restricted visitation policies due to the coronavirus disease 2019. The objective of this study was to assess the consequences of hospital visitation restrictions on the most common outcome measures on adult patients who underwent surgery. A retrospective study design was conducted according to the STrengthening the Reporting of OBservational studies in Epidemiology statements in 2021. Forty patients exposed to a no-visitors policy and forty unexposed patients (1:1) were enrolled. Patients who were not allowed to receive family visits were more likely to report disorientation/agitation episodes (n = 25, 62.5% vs. n = 12, 30.0%; p < 0.01), spend more sleepless nights (n = 10, 25.0% vs. n = 1, 2.5%; p < 0.01), be restrained (n = 8, 20.0% vs. n = 1, 2.5%; p = 0.02), incur device-removal incidents (n = 14, 35.0% vs. n = 5, 12.5%; p = 0.01) compared to unexposed patients. Conversely, pain episodes were significantly more frequent in the unexposed group (n = 7.1, SD = 7.9 vs. n = 2.4, SD = 2.8; p < 0.01), and there was lower clinical deterioration risk (NEWS of 0−4 average 19.5, SD = 12.2 evaluations vs. 12.3, SD = 8.6; p < 0.01) compared to exposed patients. According to the results, family visiting restrictions should be measured against their possible advantages in order to prevent negative outcomes for surgical patients and to improve the quality of care.
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22
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Nakayama G, Masumoto S, Haruta J, Maeno T. [Relationship between the use of home-visit nursing services and family caregivers' experience of interprofessional care]. Nihon Ronen Igakkai Zasshi 2022; 59:209-218. [PMID: 35650054 DOI: 10.3143/geriatrics.59.209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
AIM To examine the relationship between the use of home-visit nursing services (VNS) for patients and their family caregivers' experience of interprofessional care, which is an indicator of the care process. METHODS We used data from a cross-sectional survey in Japan, 2020. Family caregivers 40-74 years old and caring for community-dwelling patients with chronic conditions were recruited. The outcome variable was family caregivers' experience, reflecting the quality of interprofessional care for patients and their caregivers. We used the Japanese version of the Caregivers' Experience Instrument (J-IEXPAC CAREGIVERS), which includes two domains: attention for the patient and attention for the caregiver. The main factor was the use of VNS, and covariates were socioeconomic factors of the caregivers and the use of other health and social care services. J-IEXPAC CAREGIVERS scores were divided into two groups by median values and analyzed by multivariate logistic regression analyses. RESULTS A total of 566 caregivers were included in the analysis. The median age was 62 years old. VNS was used in 86 cases (15.2%). Logistic regression analyses revealed that the use of VNS was significantly associated with a higher total score group for J-IEXPAC CAREGIVERS (odds ratio = 3.02; 95% confidence interval 1.54-5.91). Of the J-IEXPAC CAREGIVERS domains, attention for the patient was significant. CONCLUSIONS We found that the use of VNS was likely to provide a better experience among family caregivers. Our findings suggest that visiting nurses fulfill their expected role as core members of a multidisciplinary team.
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Affiliation(s)
- Gen Nakayama
- Department of Primary Care and Medical Education, Faculty of Medicine, University of Tsukuba
| | - Shoichi Masumoto
- Department of Family Medicine, General Practice and Community Health, Faculty of Medicine, University of Tsukuba
| | - Junji Haruta
- Department of Primary Care and Medical Education, Faculty of Medicine, University of Tsukuba.,Medical Education Center, School of Medicine, Keio University
| | - Tetsuhiro Maeno
- Department of Primary Care and Medical Education, Faculty of Medicine, University of Tsukuba
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23
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von Spreckelsen R, Gerdes S, Mrowietz U, Emmert H. Zugang und Inanspruchnahme psychosomatischer Versorgung aus ärztlicher Sicht: Eine qualitative Interviewstudie. AKTUELLE DERMATOLOGIE 2022. [DOI: 10.1055/a-1754-4332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Zusammenfassung
Hintergrund Chronisch entzündliche Hauterkrankungen sind häufig mit psychosozialen Beeinträchtigungen und einer reduzierten Lebensqualität vergesellschaftet. Ziel dieser Studie war es zu erfassen, wie spezialisiertes medizinisches Personal eines universitären Haut-Entzündungszentrums die Zugangswege und die Inanspruchnahme psychosomatischer Sondierungsgespräche oder Kurzzeitinterventionen bei PatientInnen mit chronisch entzündlichen Hauterkrankungen wahrnimmt.
Methoden Es wurden qualitative Erhebungen in Form von 10 Einzelinterviews mit medizinischem Personal durchgeführt, das zum Zeitpunkt der Befragung im Zentrum für entzündliche Hauterkrankungen der Uni-Hautklinik tätig war. Die Daten wurden inhaltsanalytisch mithilfe einer qualitativen Analysesoftware ausgewertet.
Ergebnisse Die Ergebnisse aus den geführten Einzelinterviews ergaben, dass die Einbindung einer psychosomatischen Versorgung innerhalb eines dermatologischen Entzündungszentrums vom ärztlichen Personal als durchweg positiv bewertet wurde. Die Option auf ein zeit- und zentrumsnahes Gesprächsangebot nimmt dabei eine besondere Rolle ein. Experten fühlen sich mit der ortsnahen Einbindung psychosomatischer Expertise sicherer im Umgang mit belasteten Patient*innen. Der holistische Ansatz scheint einen positiven Einfluss auf die individuelle Behandlung und die Beziehungsgestaltung mit den Patient*innen zu nehmen. Dabei zeigten sich keine wesentlichen Unterschiede im Geschlecht und über verschiedene Altersgruppen hinweg.
Diskussion Die Möglichkeit zur zentrumsnahen Anbindung von belasteten Patient*innen in Form von zusätzlichen psychosomatischen Sondierungsgesprächen wie auch dem Einsatz von adaptierten Kurzzeitinterventionen trägt zur holistischen Behandlung bei, scheint einen günstigen Einfluss auf den somatischen Behandlungsverlauf zu nehmen und unterstützt Ärzt*innen in ihrer Behandlung.
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Affiliation(s)
- Regina von Spreckelsen
- Zentrum für entzündliche Hauterkrankungen, Klinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Schleswig-Holstein (UKSH), Campus Kiel, Kiel
- Klinik für Psychotherapie und Psychosomatik, Universitätsklinikum Schleswig-Holstein (UKSH), Campus Kiel, Kiel
| | - Sascha Gerdes
- Zentrum für entzündliche Hauterkrankungen, Klinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Schleswig-Holstein (UKSH), Campus Kiel, Kiel
| | - Ulrich Mrowietz
- Zentrum für entzündliche Hauterkrankungen, Klinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Schleswig-Holstein (UKSH), Campus Kiel, Kiel
| | - Hila Emmert
- Zentrum für entzündliche Hauterkrankungen, Klinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Schleswig-Holstein (UKSH), Campus Kiel, Kiel
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24
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Bourque MA, Loiselle CG. Patients' cancer care perceptions conceptualized through the Cancer Experience Measurement Framework. BMC Health Serv Res 2022; 22:693. [PMID: 35606765 PMCID: PMC9125953 DOI: 10.1186/s12913-022-07946-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Accepted: 04/11/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Research on patients' perceptions of cancer care often documents sub-optimal experiences. Cancer care quality issues include restricted service access, lack of care coordination, gaps in follow-up and "generic" rather than person-centered care. Recent reports underscore that proactively and periodically seeking user feedback is crucial for timely care quality improvement. The present study aimed to analyze and thematically organize a large amount of feedback from patients who had been treated for cancer within the last 6 months. METHODS Randomly selected participants (N = 3,278) from 3 University-affiliated cancer centres in Montreal, Quebec, Canada completed the Ambulatory Oncology Patient Satisfaction Survey (AOPSS) and an open-ended question on their perceptions of the care they received. 692 participants responded to the latter. Guided by the Cancer Experience Measurement Framework (CEMF), their feedback was analyzed using a qualitative thematic approach. RESULTS Cancer care perceptions included sub-themes of care access and coordination, continuity/transition, and perceived appropriateness/personalisation of care. The most salient theme was captured by care access and coordination with 284 comments (44%) directly addressing these issues. The ways in which health care services were structured including setting, schedule, and location were often raised as cause for concerns. Issues surrounding cancer information/education, emotional support, and physical comfort were frequently reported as unmet needs. In addition, limited access to cancer services led patients to seek alternatives such as going to emergency departments and/or private care. CONCLUSIONS These findings are timely as they show that most patients are well aware of quality issues in cancer care and are willing to report candidly on these. Patient feedback also underscore the importance for cancer care institutions to periodically gather patient-reported data so that systems can re-calibrate their service offerings according to these data. Ultimately, patient reports will translate into enhanced quality, personalization, and safer cancer care provision.
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Affiliation(s)
- Michaela A Bourque
- Department of Psychiatry, McGill University, Montreal, Canada
- Department of Psychology, Crandall University, Moncton, Canada
| | - Carmen G Loiselle
- Department of Oncology, McGill University, Montreal, Canada.
- Ingram School of Nursing, McGill University, Montreal, Canada.
- Segal Cancer Centre, Jewish General Hospital, Centre Intégré Universitaire de Santé Et de Services Sociaux (CIUSSS), 680 Sherbrooke, Centre-Ouest, Montreal, QC, Canada.
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Tremblay D, Touati N, Kilpatrick K, Durand MJ, Turcotte A, Prady C, Poder TG, Richard PO, Soldera S, Berbiche D, Généreux M, Roy M, Laflamme B, Lessard S, Landry M, Giordano É. Building resilience in oncology teams: Protocol for a realist evaluation of multiple cases. PLoS One 2022; 17:e0268393. [PMID: 35551336 PMCID: PMC9098052 DOI: 10.1371/journal.pone.0268393] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 04/28/2022] [Indexed: 11/23/2022] Open
Abstract
Background Teams caring for people living with cancer face many difficult clinical situations that are compounded by the pandemic and can have serious consequences on professional and personal life. This study aims to better understand how a multi-component intervention builds resilience in oncology teams. The intervention is based on a salutogenic approach, theories and empirical research on team resilience at work. This intervention research involves partnership between researchers and stakeholders in defining situations of adversity and solutions appropriate to context. Methods The principles of realist evaluation are used to develop context-mechanism-outcome configurations of a multi-component intervention developed by researchers and field partners concerned with the resilience of oncology teams. The multiple case study involves oncology teams in natural contexts in four healthcare establishments in Québec (Canada). Qualitative and quantitative methods are employed. Qualitative data from individual interviews, group interviews and observation are analyzed using thematic content analysis. Quantitative data are collected through validated questionnaires measuring team resilience at work and its effect on teaming processes and cost-effectiveness. Integration of these data enables the elucidation of associations between intervention, context, mechanism and outcome. Discussion The study will provide original data on contextual factors and mechanisms that promote team resilience in oncology settings. It suggests courses of action to better manage difficult situations that arise in a specialized care sector, minimize their negative effects and learn from them, during and after the waves of the pandemic. The mechanisms for problem resolution and arriving at realistic solutions to professional workforce and team effectiveness challenges can help improve practices in other settings.
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Affiliation(s)
- Dominique Tremblay
- Faculty of Medicine and Health Sciences, Université de Sherbrooke, Longueuil, Québec, Canada
- Centre de Recherche Charles-Le Moyne, Longueuil, Québec, Canada
- * E-mail:
| | - Nassera Touati
- École Nationale d’administration Publique, Montréal, Québec, Canada
| | - Kelley Kilpatrick
- Faculty of Medicine and Health Sciences, McGill University, Montréal, Québec, Canada
- Susan E. French Chair in Nursing Research and Innovative Practice, Montréal, Québec, Canada
| | - Marie-José Durand
- Faculty of Medicine and Health Sciences, Université de Sherbrooke, Longueuil, Québec, Canada
- Centre de Recherche Charles-Le Moyne, Longueuil, Québec, Canada
| | - Annie Turcotte
- Faculty of Medicine and Health Sciences, Université de Sherbrooke, Longueuil, Québec, Canada
- Centre de Recherche Charles-Le Moyne, Longueuil, Québec, Canada
| | - Catherine Prady
- Faculty of Medicine and Health Sciences, Université de Sherbrooke, Longueuil, Québec, Canada
| | - Thomas G. Poder
- Department of Management, Evaluation and Health Policy, School of Public Health, Université de Montréal, Montréal, Québec, Canada
- Centre de Recherche de l’Institut Universitaire en Santé Mentale de Montréal, Centre Intégré Universitaire de Santé et de Services Sociaux de l’Est-de-l’Île-de-Montréal, Montréal, Québec, Canada
| | - Patrick O. Richard
- Faculty of Medicine and Health Sciences, Université de Sherbrooke, Longueuil, Québec, Canada
| | - Sara Soldera
- Faculty of Medicine and Health Sciences, Université de Sherbrooke, Longueuil, Québec, Canada
| | - Djamal Berbiche
- Faculty of Medicine and Health Sciences, Université de Sherbrooke, Longueuil, Québec, Canada
- Centre de Recherche Charles-Le Moyne, Longueuil, Québec, Canada
| | - Mélissa Généreux
- Faculty of Medicine and Health Sciences, Université de Sherbrooke, Longueuil, Québec, Canada
| | - Mathieu Roy
- Faculty of Medicine and Health Sciences, Université de Sherbrooke, Longueuil, Québec, Canada
- Institut National de Santé Publique du Québec, Montréal, Québec, Canada
| | | | - Sylvie Lessard
- Faculty of Medicine and Health Sciences, Université de Sherbrooke, Longueuil, Québec, Canada
- Centre de Recherche Charles-Le Moyne, Longueuil, Québec, Canada
| | - Marjolaine Landry
- Department of Nursing, Université du Québec à Trois-Rivières, Trois-Rivières, Québec, Canada
- Centre de Recherche du CHUS, Sherbrooke, Québec, Canada
| | - Émilie Giordano
- Faculty of Medicine and Health Sciences, Université de Sherbrooke, Longueuil, Québec, Canada
- Centre de Recherche Charles-Le Moyne, Longueuil, Québec, Canada
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26
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Sigmon LB, Reis PJ, Woodard EK, Hinkle JF. Patient and family perceptions of interprofessional collaborative teamwork: An integrative review. J Clin Nurs 2022; 32:2102-2113. [PMID: 35322493 DOI: 10.1111/jocn.16295] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Revised: 01/07/2022] [Accepted: 03/02/2022] [Indexed: 11/28/2022]
Abstract
AIMS To understand the patient and family perceptions of teamwork by synthesising existing evidence using the Interprofessional Education Collaborative Core Competencies for Interprofessional Collaborative Practice as a guiding framework. BACKGROUND Advances in healthcare have resulted in more people living longer with health conditions, and patients and families have become the primary caregivers. The role of the interprofessional collaborative team supports a paradigm shift to a care model with the patient and family at the centre of healthcare decisions. However, patient and family views of interprofessional collaborative team care have rarely been studied. METHODS The authors applied Whittmore and Knafl's methodology to conduct an integrative review of the literature. Databases searched included Cumulative Index to Nursing and Allied Health Literature, PubMed and PsycINFO along with reference searches. The studies included were those related to patient and family perceptions of teamwork published from 2000 to 2020. The IPEC Core Competencies for Interprofessional Collaborative Practice served as the guiding framework for analysis. A PRISMA flow chart documented the search, inclusion and exclusion criteria for the review. RESULTS Seventeen articles met the inclusion criteria. The findings identified differing perspectives by patients of the impact of the interprofessional collaborative team in their care which suggests that interventions to increase knowledge about interprofessional collaborative team care from the patient and family perspective may be beneficial. CONCLUSIONS There is limited research on understanding IPC teams from the patient and family viewpoint. This review reveals incongruencies in patient and provider perspectives of IPC teams and suggests the need for additional research about patient and family perspectives of teamwork. To fully implement the IPC team vision, perceptions of teamwork must be fully understood.
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Affiliation(s)
- Lorie B Sigmon
- School of Nursing, University of North Carolina Wilmington, Wilmington, North Carolina, USA
| | - Pamela J Reis
- College of Nursing, East Carolina University, Greenville, North Carolina, USA
| | - Elizabeth K Woodard
- School of Nursing, University of North Carolina Wilmington, Wilmington, North Carolina, USA
| | - Julie F Hinkle
- School of Nursing, University of North Carolina Wilmington, Wilmington, North Carolina, USA
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27
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Furka A, Simkó C, Kostyál L, Szabó I, Valikovics A, Fekete G, Tornyi I, Oross E, Révész J. Treatment Algorithm for Cancerous Wounds: A Systematic Review. Cancers (Basel) 2022; 14:cancers14051203. [PMID: 35267512 PMCID: PMC8909326 DOI: 10.3390/cancers14051203] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Revised: 02/14/2022] [Accepted: 02/24/2022] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND In advanced cancer stage the incidence of cancerous wounds is about 5%, and the estimated life expectancy is not more than 6 to 12 months. Without interdisciplinary and individualized treatment strategy, symptoms progress, and adversely influence quality of life. METHODS Authors collected different treatment algorithms for cancerous wound published by wide scale of medical expertise, and summarized surgical, oncological, radiation oncological, nursing and palliative care aspects based on radiological information. RESULTS Interdisciplinary approach with continuous consultation between various specialists can solve or ease the hopeless cases. CONCLUSIONS This distressing condition needs a comprehensive treatment solution to alleviate severe symptoms. Non-healing fungating wounds without effective therapy are severe socio-economic burden for all participants, including patients, caregivers, and health services. In this paper authors collected recommendations for further guideline that is essential in the near future.
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Affiliation(s)
- Andrea Furka
- Centre of Clinical Oncology and Radiotherapy, Borsod-Abaúj-Zemplén County Hospital and University Teaching Hospital, 3526 Miskolc, Hungary; (I.S.); (A.V.); (G.F.); (E.O.); (J.R.)
- Department of Clinical Radiology, Faculty of Health Care, Institute of Practical Methodology and Diagnostics, University of Miskolc, 3526 Miskolc, Hungary;
- Correspondence: ; Tel.: +36-309988499
| | - Csaba Simkó
- Erzsébet Hospice, Borsod-Abaúj-Zemplén County Hospital and University Teaching Hospital Miskolc, 3526 Miskolc, Hungary;
| | - László Kostyál
- Department of Clinical Radiology, Faculty of Health Care, Institute of Practical Methodology and Diagnostics, University of Miskolc, 3526 Miskolc, Hungary;
- Department of Diagnostic Imaging, Borsod-Abaúj-Zemplén County Hospital and University Teaching Hospital Miskolc, 3526 Miskolc, Hungary
| | - Imre Szabó
- Centre of Clinical Oncology and Radiotherapy, Borsod-Abaúj-Zemplén County Hospital and University Teaching Hospital, 3526 Miskolc, Hungary; (I.S.); (A.V.); (G.F.); (E.O.); (J.R.)
| | - Anikó Valikovics
- Centre of Clinical Oncology and Radiotherapy, Borsod-Abaúj-Zemplén County Hospital and University Teaching Hospital, 3526 Miskolc, Hungary; (I.S.); (A.V.); (G.F.); (E.O.); (J.R.)
| | - Gábor Fekete
- Centre of Clinical Oncology and Radiotherapy, Borsod-Abaúj-Zemplén County Hospital and University Teaching Hospital, 3526 Miskolc, Hungary; (I.S.); (A.V.); (G.F.); (E.O.); (J.R.)
| | - Ilona Tornyi
- Department of Human Genetics, University of Debrecen, 4032 Debrecen, Hungary;
- Biosystems Immunolab Zrt., 4032 Debrecen, Hungary
| | - Endre Oross
- Centre of Clinical Oncology and Radiotherapy, Borsod-Abaúj-Zemplén County Hospital and University Teaching Hospital, 3526 Miskolc, Hungary; (I.S.); (A.V.); (G.F.); (E.O.); (J.R.)
| | - János Révész
- Centre of Clinical Oncology and Radiotherapy, Borsod-Abaúj-Zemplén County Hospital and University Teaching Hospital, 3526 Miskolc, Hungary; (I.S.); (A.V.); (G.F.); (E.O.); (J.R.)
- Department of Clinical Radiology, Faculty of Health Care, Institute of Practical Methodology and Diagnostics, University of Miskolc, 3526 Miskolc, Hungary;
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28
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Espinel-Flores V, Vargas I, Eguiguren P, Mogollón-Pérez AS, Ferreira de Medeiros Mendes M, López-Vázquez J, Bertolotto F, Vázquez ML. Assessing the Impact of Clinical Coordination Interventions on the Continuity of Care for Patients With Chronic Conditions: Participatory Action Research in Five Latin American Countries. Health Policy Plan 2021; 37:1-11. [PMID: 34718564 PMCID: PMC8757491 DOI: 10.1093/heapol/czab130] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 08/05/2021] [Accepted: 10/28/2021] [Indexed: 11/14/2022] Open
Abstract
Although fragmentation in the provision of services is considered an obstacle to effective health care, there is scant evidence on the impact of interventions to improve care coordination between primary care and secondary care in terms of continuity of care -i.e. from the patient perspective- particularly in Latin America (LA). Within the framework of the Equity-LA II project, interventions to improve coordination across care levels were implemented in five LA countries (Brazil, Chile, Colombia, Mexico and Uruguay) through a participatory action research (PAR) process. This paper analyses the impact of these PAR interventions on the cross-level continuity of care of chronic patients in public healthcare networks. A quasi-experimental study was performed with measurements based on two surveys of a sample of patients with chronic conditions (392 per network; 800 per country). Both the baseline (2015) and evaluation (2017) surveys were conducted using the CCAENA questionnaire. In each country, two comparable public healthcare networks were selected, one intervention and one control. Outcomes were cross-level continuity of information and of clinical management. Descriptive analyses were conducted and Poisson regression models with robust variance fitted to estimate changes. With differences between countries, the results showed improvements in cross-level continuity of clinical information (transfer of clinical information) and of clinical management (care coherence). These results are consistent with those of previous studies on the effectiveness of the interventions implemented in each country in improving care coordination in Brazil, Chile, and Colombia. Differences between countries are probably related to particular contextual factors and events that occurred during the implementation process. This supports the notion that certain context and process factors are needed to improve continuity of care. The results provide evidence that, although the interventions were designed to enhance care coordination and aimed at health professionals, patients report improvements in continuity of care.
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Affiliation(s)
- Verónica Espinel-Flores
- Health Policy and Health Services Research Group, Health Policy Research Unit, Consortium for Health Care and Social Services of Catalonia, Avinguda Tibidabo 21, ES08022 Barcelona, Spain
| | - Ingrid Vargas
- Health Policy and Health Services Research Group, Health Policy Research Unit, Consortium for Health Care and Social Services of Catalonia, Avinguda Tibidabo 21, ES08022 Barcelona, Spain
| | - Pamela Eguiguren
- Escuela de Salud Pública Dr. Salvador Allende Gossens, Universidad de Chile, Independencia, 939, Santiago de Chile, Chile
| | - Amparo-Susana Mogollón-Pérez
- Escuela de Medicina y Ciencias de la Salud, Universidad del Rosario, Cra 24 No. 63C-69, Quinta Mutis, 11001 Bogotá, Colombia
| | - Marina Ferreira de Medeiros Mendes
- Grupo de Estudos de Gestão e Avaliação em Saúde, Instituto de Medicina Integral Prof. Fernando Figueira, Rua Dos Coelhos No. 300, Boa Vista, 50070-550 Recife, Brazil
| | - Julieta López-Vázquez
- Instituto de Salud Pública, Universidad Veracruzana, Av. Dr. Luis Castelazo Ayala s/n Col. Industrial Ánimas, 91190 Xalapa, Veracruz, Mexico
| | - Fernando Bertolotto
- Facultad de Enfermería, Universidad de la República, Avenida 18 de Julio 124, 11200 Montevideo, Uruguay
| | - María Luisa Vázquez
- Health Policy and Health Services Research Group, Health Policy Research Unit, Consortium for Health Care and Social Services of Catalonia, Avinguda Tibidabo 21, ES08022 Barcelona, Spain
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Chollette V, Doose M, Sanchez J, Weaver SJ. Teamwork competencies for interprofessional cancer care in multiteam systems: A narrative synthesis. J Interprof Care 2021; 36:617-625. [PMID: 34311658 DOI: 10.1080/13561820.2021.1932775] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Numerous teamwork competency frameworks are designed for co-located, procedure-driven teams delivering care in acute settings. Little is known about their applicability or evaluation among larger teams-of-teams, known as multiteam systems (MTS), involved in delivering care for complex chronic conditions like cancer. In this review we aimed to identify studies examining teamwork competencies or teamwork competency frameworks developed or tested in healthcare teams, identify the extent to which they have been applied or evaluated in cancer care, and understand their applicability to larger MTSs involved in coordinating cancer care. We identified 107 relevant original articles, consensus statements, and prior systematic reviews published from 2013-2019. Most original papers (n = 96) were intervention studies of inpatient acute care teams (52, 54%). Fifty-eight articles (60%) used existing frameworks to define competency domains. Four original articles and two consensus statements addressed teamwork competencies for cancer care. Few frameworks or interprofessional education (IPE) curricula specifically addressed teamwork among larger, distributed teams or examined competencies necessary to overcome care coordination challenges in cancer care MTSs. Research guiding the development of frameworks and IPE that consider challenges to effective coordination among larger MTSs and studies of their impact on patient and clinical outcomes is essential to optimal, high-quality care.
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Affiliation(s)
- Veronica Chollette
- Health Systems and Interventions Research Branch, Healthcare Delivery Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD, USA
| | - Michelle Doose
- Health Systems and Interventions Research Branch, Healthcare Delivery Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD, USA
| | - Janeth Sanchez
- Health Systems and Interventions Research Branch, Healthcare Delivery Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD, USA
| | - Sallie J Weaver
- Health Systems and Interventions Research Branch, Healthcare Delivery Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD, USA
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Ibraheem AF, Giurcanu M, Sowunmi AC, Awolude O, Habeebu M, Popoola A, Sanni F, Agaga LA, Olopade O, Polite BN. Formal Assessment of Teamwork Among Cancer Health Care Professionals in Three Large Tertiary Centers in Nigeria. JCO Glob Oncol 2021; 6:560-568. [PMID: 32255716 PMCID: PMC7193769 DOI: 10.1200/jgo.19.00233] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE There are strategies to bring quality cancer care to underserved patients, but poor use of the principles of teamwork is a major barrier to achieving quality services. The intent of this study was to assess teamwork as perceived by health care workers caring for patients with cancer. METHODS We conducted a survey among health care professionals in cancer care at 3 tertiary centers in southwestern Nigeria from July to November 2016. Respondents rated teamwork using the Safety Attitudes Questionnaire; we focused on the teamwork climate subscale comparing health care providers and institutions using analysis of variance and on collaboration using logistic regression. RESULTS Three hundred seventy-three professionals completed the survey: 177 physicians (47%), 51 nurses (14%), 21 pharmacists (6%), 31 laboratory technicians (8%), and 88 others (24%); 5 (1%) participants had missing professional information. The average teamwork climate score across all professionals in the study was 70.5 (SD = 24.2). Pharmacists rated the teamwork climate the lowest, with a mean score of 63.9 (SD = 29.5); nurses and laboratory technicians rated teamwork higher, with means of 74.5 (SD = 21.7) and 74.2 (SD = 27.1), respectively; and physicians rated teamwork 66.0 (SD = 23.6). Collaboration with other health care providers was reported as poorer by physicians compared with nurses and pharmacists. CONCLUSION Although overall teamwork scores were consistent with ambulatory studies in the United States, important subgroup variations provide targets for intervention. Physicians rated collaboration as poor both intra- and interprofessionally. Pharmacists rated interprofessional teamwork with nurses as poor. Efforts to transform cancer care must focus on building trust among the key stakeholders. This is critical in low-resource settings, which must maximize the use of limited resources to improve patient outcomes.
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Affiliation(s)
| | - Mihai Giurcanu
- Department of Public Health Sciences, The University of Chicago, Chicago, IL
| | - Anthonia Chima Sowunmi
- Department of Radiation Biology, Radiotherapy & Radiodiagnosis, University of Lagos, Akoka, Lagos, Nigeria
| | - Olutosin Awolude
- Department of Obstetrics and Gynecology, Faculty of Clinical Sciences, College of Medicine, University of Ibadan/University College Hospital, Ibadan, Nigeria
| | - Muhammad Habeebu
- Department of Radiation Biology, Radiotherapy & Radiodiagnosis, University of Lagos, Akoka, Lagos, Nigeria
| | - Abiodun Popoola
- Department of Radiology, Oncology Unit, Lagos State University, College of Medicine, Lagos, Nigeria
| | - Felix Sanni
- Department of Radiology, Oncology Unit, Lagos State University, College of Medicine, Lagos, Nigeria
| | - Luther A Agaga
- Department of Medicine, Olabisi Onabanjo University, Shagamu, Ogun State, Nigeria
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Bultz BD, Watson L. Lessons learned about virtual cancer care and distress screening in the time of COVID-19. Support Care Cancer 2021; 29:7535-7540. [PMID: 34114098 PMCID: PMC8192106 DOI: 10.1007/s00520-021-06322-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Accepted: 05/28/2021] [Indexed: 11/29/2022]
Abstract
Purpose Cancer-related biopsychosocial distress is highly prevalent across the cancer care continuum. The implementation of screening patients for biopsychosocial distress has become a standard of practice in cancer care. With the presence of COVID-19, clinical care has shifted from in-person care to virtual care in many instances. One of the realities of COVID-19 is the significant decrease in screening patients for biopsychosocial symptom burden. Methods Given that screening for distress has become an accreditation standard in many cancer programs, in the province of Alberta, Canada, all patients are screened for distress with every visit to the cancer centre. Given the presence of COVID-19, much of cancer care has shifted to being delivered virtually (through mediums such as Zoom). In this paper, we present pre- and post-COVID data on the frequency of distress screening and its impact on patient care. Results A review of pre- and post-COVID-19 screening for distress questionnaires revealed that patients who received virtual care were less satisfied in the areas of emotional support and received less resources and referrals to supportive care. Conclusion The rapid integration of virtual care without the inclusion of a standardized distress screening tool was akin to a natural experiment, as two groups (virtual and in-person clinic patients) received different levels of care and interventions. Without the inclusion of distress screening, the clinical conversation around symptoms is less likely to occur and results in fewer referrals to best practices in supportive care services. Lessons learned about virtual cancer care without distress screening in the time of COVID-19 demonstrates significantly fewer patients being screened for distress and subsequently has resulted in less supportive care referrals. Going forward, we must find ways to ensure that virtual cancer care continues to support distress screening and best patient-centric care.
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Affiliation(s)
- Barry D Bultz
- Division of Psychosocial Oncology, Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada. .,Department of Psychosocial Oncology, Tom Baker Cancer Centre, 2202 2nd Street SW, Calgary, AB, T2S-3C1, Canada. .,School of Medicine & Public Health, University of Newcastle, NSW, Callaghan, Australia.
| | - Linda Watson
- Cancer Research and Analytics, Cancer Care Alberta, Alberta Health Services, Calgary, AB, Canada
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Geerts PAF, van der Weijden T, Savelberg W, Altan M, Chisari G, Launert DR, Mesters H, Pisters Y, van Heumen M, Hermanns R, Bos GMJ, Moser A. The Next Step Toward Patient-Centeredness in Multidisciplinary Cancer Team Meetings: An Interview Study with Professionals. J Multidiscip Healthc 2021; 14:1311-1324. [PMID: 34113119 PMCID: PMC8187002 DOI: 10.2147/jmdh.s286044] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Accepted: 01/29/2021] [Indexed: 12/15/2022] Open
Abstract
Background Patient-centeredness is essential in complex oncological multidisciplinary team decision-making. Improvement seems to be needed, while there is a lack of knowledge about health care providers’ needs for improvement. Objective To explore multidisciplinary team members’ perspectives on the need to improve patient-centeredness in complex decision-making, and subsequently the strategies to enhance it. Methods This was a qualitative descriptive interview study. The participants were twenty-four professionals who attended multidisciplinary cancer team meetings weekly. The setting was five multidisciplinary teams (gastrointestinal, gynecological, urological, head and neck, and hematological cancer) in a Dutch academic hospital. Data were collected by semi-structured interviews and were analyzed with a combination of inductive and deductive content analysis. Results The participants voiced the need for additional information (patient-centered information, patients’s needs and preferences, individualized medical information) during the multidisciplinary team meeting, to be more patient-centered in the decision-making conversation with the patient following the meeting, and for more information following the meeting to support patient-centeredness. The strategies, which mostly originated from the needs, were categorized as organization, decision-making, and communication. The most prominent strategies were those aimed at collecting and using patient-centered information, and to facilitate the decision-making conversation with the patient following the multidisciplinary team meeting. Conclusion Our findings highlighted the need to improve patient-centeredness in oncological multidisciplinary teams and provided a comprehensive overview of strategies for improvement, supported by multidisciplinary team members. These strategies emphasize involvement of patients throughout the continuous process of decision-making for patients with cancer. These strategies may be implemented in other oncological multidisciplinary teams, taking in mind the local needs. Future research may help to prioritize the strategies and to determine and evaluate the effect on endpoints, like patient or professional satisfaction, shared decision-making, and on the decision that was made.
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Affiliation(s)
- Paulus A F Geerts
- Department of Internal Medicine, Division of Hematology and School GROW, Maastricht University Medical Centre, Maastricht, the Netherlands
| | - Trudy van der Weijden
- Department of Family Medicine, Maastricht University, School CAPHRI, Maastricht, the Netherlands
| | - Wilma Savelberg
- Oncology Centre, Maastricht University Medical Centre, Maastricht, the Netherlands
| | - Melis Altan
- Faculty of Health, Medicine and Life Sciences (FHML), Maastricht University, Maastricht, the Netherlands
| | - Giorgio Chisari
- Faculty of Health, Medicine and Life Sciences (FHML), Maastricht University, Maastricht, the Netherlands
| | - Diana Ricarda Launert
- Faculty of Health, Medicine and Life Sciences (FHML), Maastricht University, Maastricht, the Netherlands
| | - Hannah Mesters
- Faculty of Health, Medicine and Life Sciences (FHML), Maastricht University, Maastricht, the Netherlands
| | - Ylva Pisters
- Faculty of Health, Medicine and Life Sciences (FHML), Maastricht University, Maastricht, the Netherlands
| | - Mike van Heumen
- Faculty of Health, Medicine and Life Sciences (FHML), Maastricht University, Maastricht, the Netherlands
| | - Raoul Hermanns
- Faculty of Health, Medicine and Life Sciences (FHML), Maastricht University, Maastricht, the Netherlands
| | - Gerard M J Bos
- Department of Internal Medicine, Division of Hematology and School GROW, Maastricht University Medical Centre, Maastricht, the Netherlands
| | - Albine Moser
- Department of Family Medicine, Maastricht University, School CAPHRI, Maastricht, the Netherlands.,Zuyd University of Applied Sciences, Heerlen, the Netherlands
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Siekkinen M, Kuokkanen L, Kuusisto H, Leino-Kilpi H, Rautava P, Rekunen M, Seppänen L, Stolt M, Walta L, Sulosaari V. Work empowerment among cancer care professionals: a cross-sectional study. BMC Health Serv Res 2021; 21:502. [PMID: 34034734 PMCID: PMC8146678 DOI: 10.1186/s12913-021-06528-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Accepted: 05/13/2021] [Indexed: 12/09/2022] Open
Abstract
BACKGROUND There is a growing understanding that empowerment of interprofessional personnel is linked to job satisfaction levels and quality of care, but little is known about empowerment in the context of cancer care. This study describes how interprofessional cancer care personnel perceive their performance and factors that promote work empowerment. METHODS This cross-sectional study enrolled 475 (45.2%) of the 1050 employees who work at a regional cancer centre. The participants used two self-administered questionnaires - the Performance of an Empowered Personnel (PEN) questionnaire and Work Empowerment Promoting Factors (WEP) questionnaire - to report perceptions of work empowerment. Both questionnaires' categories comprise moral principles, personal integrity, expertise, future orientation, and sociality. The data were analyzed using IBM SPSS Statistics, Versions 24 and 25. RESULTS Overall, the performance of work empowerment was evaluated as being rather high (overall sum score mean: 4.05; range: 3.51-4.41; scale: 1-5). The category that rated highest was moral principles (4.41), and the one rated lowest was the social category (3.51). The factors that promoted work empowerment also ranked high (3.93; range: 3.55-4.08; scale: 1-5), with personal integrity (4.08) the highest and future orientation (3.55) the lowest. Performance and factors that promoted work empowerment correlated positively, moderately, and highly statistically significantly (r = 0.531; p < 0.001). Statistically significant associations also were found between empowered performance of personnel and empowerment promoting factors (sex, education, leadership position, belonging to an interprofessional team, and time elapsed since training in interprofessional cooperation). CONCLUSION The personnel rated their performance and the factors perceived to promote work empowerment rather highly. Personal empowerment can be promoted through teamwork training and supportive management in interprofessional cancer care.
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Affiliation(s)
- Mervi Siekkinen
- Turku University Hospital, FICAN West Cancer Centre, P.O. Box 52, FI-20521, Turku, Finland.
| | | | | | - Helena Leino-Kilpi
- University of Turku, Department of Nursing Science, Turku University Hospital, Turku, Finland
| | - Päivi Rautava
- University of Turku, Public Health and Turku University Hospital, Clinical Research Services, Turku, Finland
| | - Maijastiina Rekunen
- Turku University Hospital, FICAN West Cancer Centre, P.O. Box 52, FI-20521, Turku, Finland
| | - Laura Seppänen
- Finnish Institute of Occupational Health, Helsinki, Finland
| | - Minna Stolt
- University of Turku, Department of Nursing Science, Turku University Hospital, Turku, Finland
| | - Leena Walta
- Turku University of Applied Sciences, Turku, Finland
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Cazeau N. Interprofessional Communication: Integrating Evidence to Enhance Systems During a Pandemic. Clin J Oncol Nurs 2021; 25:56-60. [PMID: 33480871 DOI: 10.1188/21.cjon.56-60] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND The COVID-19 pandemic placed challenges on interprofessional communication patterns among clinical care teams at a time when effective communication was greatly needed. The development of enhanced systems for communication that integrate the latest evidence and communication technologies can offer a solution to this crisis. OBJECTIVES This article provides a framework for ways in which nursing teams can develop evidence-based enhanced interprofessional communication systems during a pandemic. METHODS Based on communication models and related technologies, this article reviews strategies to enhance interprofessional communication. Two case studies are included that illustrate how nursing teams can enhance communication during a pandemic. FINDINGS To improve communication during a pandemic, clinicians can incorporate interprofessional communication models in clinical practice and apply enhanced communication strategies.
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Frakking T, Michaels S, Orbell-Smith J, Le Ray L. Framework for patient, family-centred care within an Australian Community Hospital: development and description. BMJ Open Qual 2021; 9:bmjoq-2019-000823. [PMID: 32354755 PMCID: PMC7213886 DOI: 10.1136/bmjoq-2019-000823] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Revised: 03/31/2020] [Accepted: 04/18/2020] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVE To describe the development of a patient and family-centred care (PFCC) conceptual framework within a small community Australian Hospital. METHODS A scoping review of scientific and grey literature and community hospital stakeholder discussions were used to identify and design a conceptual framework for PFCC across five core pillars of leadership, engagement, service delivery, learning and environment. RESULTS 107 publications were identified and 76 were included for data extraction. A draft framework was constructed and modified following consultation with hospital stakeholders across a small Australian Community Hospital. The 'Caring Together' framework outlines three core layers: (1) the focus of our care is the experiences of our consumers and staff; (2) concepts of leadership, environment, service delivery, engagement and learning; and (3) the overarching fundamental values of being heard, respected, valued and supported by staff and consumers at all levels in an organisation. CONCLUSIONS The conceptual Caring Together framework structures key PFCC concepts across organisational priority areas within an Australian healthcare setting and can be used to guide implementation of PFCC at other small hospital facilities. Changes to national and state healthcare funding may help facilitate improved hospital facility implementation of PFCC, and ultimately improve consumer healthcare satisfaction and clinical outcomes.
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Affiliation(s)
- Thuy Frakking
- Research Development Unit, Metro North Hospital and Health Service, Herston, Queensland, Australia .,School of Health and Rehabilitation Sciences, The University of Queensland, Saint Lucia, Queensland, Australia
| | - Suzanne Michaels
- Engagement & Integration, Caboolture Hospital, Metro North Hospital and Health Service, Caboolture, Queensland, Australia
| | - Jane Orbell-Smith
- Education & Training, Caboolture Hospital, Metro North Hospital and Health Service, Caboolture, Queensland, Australia
| | - Lance Le Ray
- Executive Management, Caboolture Hospital, Metro North Hospital and Health Service, Caboolture, Queensland, Australia
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Pomey MP, de Guise M, Desforges M, Bouchard K, Vialaron C, Normandin L, Iliescu-Nelea M, Fortin I, Ganache I, Régis C, Rosberger Z, Charpentier D, Bélanger L, Dorval M, Ghadiri DP, Lavoie-Tremblay M, Boivin A, Pelletier JF, Fernandez N, Danino AM. The patient advisor, an organizational resource as a lever for an enhanced oncology patient experience (PAROLE-onco): a longitudinal multiple case study protocol. BMC Health Serv Res 2021; 21:10. [PMID: 33397386 PMCID: PMC7780212 DOI: 10.1186/s12913-020-06009-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Accepted: 12/09/2020] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND Quebec is one of the Canadian provinces with the highest rates of cancer incidence and prevalence. A study by the Rossy Cancer Network (RCN) of McGill university assessed six aspects of the patient experience among cancer patients and found that emotional support is the aspect most lacking. To improve this support, trained patient advisors (PAs) can be included as full-fledged members of the healthcare team, given that PA can rely on their knowledge with experiencing the disease and from using health and social care services to accompany cancer patients, they could help to round out the health and social care services offer in oncology. However, the feasibility of integrating PAs in clinical oncology teams has not been studied. In this multisite study, we will explore how to integrate PAs in clinical oncology teams and, under what conditions this can be successfully done. We aim to better understand effects of this PA intervention on patients, on the PAs themselves, the health and social care team, the administrators, and on the organization of services and to identify associated ethical and legal issues. METHODS/DESIGN We will conduct six mixed methods longitudinal case studies. Qualitative data will be used to study the integration of the PAs into clinical oncology teams and to identify the factors that are facilitators and inhibitors of the process, the associated ethical and legal issues, and the challenges that the PAs experience. Quantitative data will be used to assess effects on patients, PAs and team members, if any, of the PA intervention. The results will be used to support oncology programs in the integration of PAs into their healthcare teams and to design a future randomized pragmatic trial to evaluate the impact of PAs as full-fledged members of clinical oncology teams on cancer patients' experience of emotional support throughout their care trajectory. DISCUSSION This study will be the first to integrate PAs as full-fledged members of the clinical oncology team and to assess possible clinical and organizational level effects. Given the unique role of PAs, this study will complement the body of research on peer support and patient navigation. An additional innovative aspect of this study will be consideration of the ethical and legal issues at stake and how to address them in the health care organizations.
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Affiliation(s)
- M P Pomey
- Centre de recherche du Centre Hospitalier de l'Université de Montréal (CR-CHUM), 850, rue Saint-Denis, Montréal, Québec, H2X 0A9, Canada.
- Centre d'Excellence pour le Partenariat avec les Patients et le Public, 900, rue Saint-Denis, Porte S03.900, Montréal, Québec, H2X 0A9, Canada.
- École de santé publique de l'université de Montréal-Département de gestion, évaluation et politique de santé, 7101 Av du Parc, Montréal, Québec, H3N 1X9, Canada.
- Université de Montréal - Faculté de Médecine, 2900 boulevard Edouard-Montpetit, Montréal, Québec, H3T 1J4, Canada.
- Institut national d'excellence en santé et services sociaux (INESSS), 2021, avenue Union, 12e étage, bureau 1200, Montréal, Québec, H3A 2S9, Canada.
| | - M de Guise
- Institut national d'excellence en santé et services sociaux (INESSS), 2021, avenue Union, 12e étage, bureau 1200, Montréal, Québec, H3A 2S9, Canada
| | - M Desforges
- Centre Intégré Universitaire de santé et services sociaux de l'Est-de-l'Île-de Montréal, Hôpital de Maisonneuve-Rosemont, 5415, boulevard de l'Assomption, Montréal, Québec, H1T 2M4, Canada
| | - K Bouchard
- CHU de Québec-Université Laval, 10, Rue de l'Espinay, Québec, Québec, G1L 3L5, Canada
| | - C Vialaron
- Centre de recherche du Centre Hospitalier de l'Université de Montréal (CR-CHUM), 850, rue Saint-Denis, Montréal, Québec, H2X 0A9, Canada
| | - L Normandin
- Centre de recherche du Centre Hospitalier de l'Université de Montréal (CR-CHUM), 850, rue Saint-Denis, Montréal, Québec, H2X 0A9, Canada
| | - M Iliescu-Nelea
- Centre de recherche du Centre Hospitalier de l'Université de Montréal (CR-CHUM), 850, rue Saint-Denis, Montréal, Québec, H2X 0A9, Canada
| | - I Fortin
- Centre Intégré Universitaire de santé et services sociaux de l'Est-de-l'Île-de Montréal, Hôpital de Maisonneuve-Rosemont, 5415, boulevard de l'Assomption, Montréal, Québec, H1T 2M4, Canada
| | - I Ganache
- Institut national d'excellence en santé et services sociaux (INESSS), 2021, avenue Union, 12e étage, bureau 1200, Montréal, Québec, H3A 2S9, Canada
| | - C Régis
- Université de Montréal - Faculté de Droit, 3101 chemin de la Tour, Montréal, Québec, H3T 1J7, Canada
| | - Z Rosberger
- Lady Davis Institute for Medical Research, Jewish General Hospital & McGill University, Gerald Bronfman Department of Oncology, 5100 de Maisonneuve Blvd West, Montréal, Québec, H4A 3T2, Canada
| | - D Charpentier
- Centre Hospitalier Universitaire de Montréal (CHUM), 1000 rue Saint-Denis, Montréal, Québec, H2X 0C1, Canada
| | - L Bélanger
- CHU de Québec-Université Laval, 10, Rue de l'Espinay, Québec, Québec, G1L 3L5, Canada
| | - M Dorval
- CHU de Québec-Université Laval, 10, Rue de l'Espinay, Québec, Québec, G1L 3L5, Canada
- Université Laval - Faculté de pharmacie, 050, avenue de la Médecine, Québec, Québec, G1V 0A6, Canada
- Centre de recherche du CHU de Québec-Université Laval, 1050 chemin Sainte-Foy, Québec, Québec, G1S4L8, Canada
- Centre de recherche du CISSS Chaudière Appalaches, 143 rue Wolfe, Lévis, Québec, G6V 3Z1, Canada
| | - D P Ghadiri
- HEC Montréal, Department of management, 3000, chemin de la Côte-Sainte-Catherine, Montréal, Québec, H3T 2A7, Canada
| | - M Lavoie-Tremblay
- McGill University, Ingram School of Nursing (IsoN), 680 Sherbrooke Street West, Montreal, Québec, H3A 2M7, Canada
- Centre Universitaire de Santé McGill (CUSM), 1650, avenue Cedar, Montréal, Québec, H3G 1A4, Canada
| | - A Boivin
- Centre de recherche du Centre Hospitalier de l'Université de Montréal (CR-CHUM), 850, rue Saint-Denis, Montréal, Québec, H2X 0A9, Canada
- Centre d'Excellence pour le Partenariat avec les Patients et le Public, 900, rue Saint-Denis, Porte S03.900, Montréal, Québec, H2X 0A9, Canada
- Université de Montréal - Faculté de Médecine, 2900 boulevard Edouard-Montpetit, Montréal, Québec, H3T 1J4, Canada
| | - J F Pelletier
- Université de Montréal - Faculté de Médecine, 2900 boulevard Edouard-Montpetit, Montréal, Québec, H3T 1J4, Canada
- Centre de Recherche de l'Institut universitaire en santé mentale de Montréal, 7331 Rue Hochelaga, Montréal, Québec, H1N 3V2, Canada
| | - N Fernandez
- Université de Montréal - Faculté de Médecine, 2900 boulevard Edouard-Montpetit, Montréal, Québec, H3T 1J4, Canada
| | - A M Danino
- Centre de recherche du Centre Hospitalier de l'Université de Montréal (CR-CHUM), 850, rue Saint-Denis, Montréal, Québec, H2X 0A9, Canada
- Centre Hospitalier Universitaire de Montréal (CHUM), 1000 rue Saint-Denis, Montréal, Québec, H2X 0C1, Canada
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Graetz DE, Chen Y, Devidas M, Antillon-Klussmann F, Fu L, Quintero K, Fuentes-Alabi SL, Gassant PY, Kaye EC, Baker JN, Rodriguez Galindo C, Mack JW. Interdisciplinary care of pediatric oncology patients in Central America and the Caribbean. Cancer 2020; 127:2579-2586. [PMID: 33237591 DOI: 10.1002/cncr.33339] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 10/12/2020] [Accepted: 10/27/2020] [Indexed: 12/24/2022]
Abstract
BACKGROUND Interdisciplinary teamwork supports high-quality cancer care and effective utilization of limited resources. This study purposed to examine the value, structure, process, and effectiveness of interdisciplinary care (IDC) among pediatric oncology providers in low-income and middle-income countries in Central America and the Caribbean. METHODS A cross-sectional survey was disseminated to pediatric oncology providers at 5 centers participating in the Pediatric Hematology-Oncology Association of Central America. The survey included previously validated items and novel questions assessing the value (importance), structure (multidisciplinary meeting attendance), process (team climate), and effectiveness (job satisfaction, quality of care and communication) of IDC. RESULTS The survey was completed by 174 providers, including 22 oncologists, 9 pathologists, 9 radiologists, 5 radiation oncologists, 12 surgeons, 35 subspecialists, 60 nurses, 20 psychosocial providers, and 2 other staff. Participants agreed that IDC benefits team members (95%) and patients (96%). IDC structure and processes varied across the region. Multidisciplinary meeting attendance differed by center (P = .005) and discipline (P < .0001). Participants who frequently attended multidisciplinary meetings reported a more positive team climate (P = .0003). Team climate was positively associated with job satisfaction (P < .001). In multivariable analyses, team climate was predictive of an improved perception of communication between professionals (P < .0001), with families (P < .0001), and with patients (P = .0005), as well as with quality of the care environment (P = .006) and overall care quality (P < .0001). CONCLUSIONS Nearly all surveyed participants valued IDC, and the structure and processes supporting IDC varied by center. Associations between a collaborative professional climate, job satisfaction, and the perception of quality care encourage continued investigation and prioritization of IDC in these settings.
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Affiliation(s)
- Dylan E Graetz
- Department of Oncology, St Jude Children's Research Hospital, Memphis, Tennessee.,Department of Global Pediatric Medicine, St Jude Children's Research Hospital, Memphis, Tennessee
| | - Yichen Chen
- Department of Global Pediatric Medicine, St Jude Children's Research Hospital, Memphis, Tennessee
| | - Meenakshi Devidas
- Department of Global Pediatric Medicine, St Jude Children's Research Hospital, Memphis, Tennessee
| | - Federico Antillon-Klussmann
- National Unit of Pediatric Oncology, Francisco Marroquin University School of Medicine, Guatemala City, Guatemala
| | - Ligia Fu
- Pediatric Hematology and Oncology Unit, Tegucigalpa School Hospital, Tegucigalpa, Honduras
| | - Karina Quintero
- Pediatric Oncology Unit, Dr Jose Renan Esquivel Children's Hospital, Panama City, Panama
| | - Soad L Fuentes-Alabi
- Department of Oncology, Benjamin Bloom National Children's Hospital, El Salvador City, El Salvador
| | | | - Erica C Kaye
- Department of Oncology, St Jude Children's Research Hospital, Memphis, Tennessee.,Division of Palliative and End of Life Care, St Jude Children's Research Hospital, Memphis, Tennessee
| | - Justin N Baker
- Division of Palliative and End of Life Care, St Jude Children's Research Hospital, Memphis, Tennessee
| | - Carlos Rodriguez Galindo
- Department of Global Pediatric Medicine, St Jude Children's Research Hospital, Memphis, Tennessee
| | - Jennifer W Mack
- Pediatric Oncology/Oncology, Dana Farber Cancer Institute and Boston Children's Hospital, Boston, Massachusetts
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Lejeune J, Chevalier S, Fouquereau E, Chenevert D, Coillot H, Binet A, Gillet N, Mokounkolo R, Michon J, Dupont S, Rachieru P, Gandemer V, Colombat P. Relationships Between Managerial and Organizational Practices, Psychological Health at Work, and Quality of Care in Pediatric Oncology. JCO Oncol Pract 2020; 16:e1112-e1119. [PMID: 32539649 DOI: 10.1200/jop.19.00583] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE Psychological health at work for care providers is an important issue, because they are directly involved in quality of patient care. Managerial and organizational determinants have been found to be indicators of psychological health at work. The main objective of this study was to explore the relationships between the psychological health at work of pediatric oncology care workers with managerial and organizational determinants and with quality of care. MATERIALS AND METHODS We performed regression analysis between psychological health at work (quality of work life [QWL], job satisfaction, and so on), managerial determinants (transformational leadership, perceived autonomy support), organizational determinants (organizational support, organizational justice, and participatory approach), and perceived quality of care. RESULTS Participants were 510 health care professionals working in French pediatric oncology centers. No significant differences in the psychological health at work of the participants were found based on age, sex, length of employment, or professional discipline. In simple regression, significant associations were found between psychological health at work with all managerial and organizational determinants. In multiple regression, a significant link was found between QWL and perceived organizational support (β = .21; P < .001), organizational justice (β = .20, P < .001), and overall participatory approach (β = .10; P < .02). Job satisfaction was also related to perceived organizational support (β = .16; P < .01). Finally, perceived quality of care was linked to QWL (β = .15; P < .01) and job satisfaction (β = .30; P < .001). CONCLUSION These results emphasize the importance of the role of managers and the organization in psychological health at work of health care providers and also in the quality of patient care.
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Affiliation(s)
- Julien Lejeune
- Qualipsy EE 1901, Université de Tours, Tours, France.,Service d'Onco-Hématologie Pédiatrique, Hôpital Clocheville, Tours, France
| | | | | | - Denis Chenevert
- Ecole des Hautes Etudes Commerciales, Montreal, Québec, Canada
| | | | - Aurélien Binet
- Service de Chirurgie Pédiatrique, Hôpital Clocheville, Tours, France
| | | | | | - Jean Michon
- Département de Pédiatrie, Institut Curie, Paris, France
| | - Sophie Dupont
- Qualipsy EE 1901, Université de Tours, Tours, France
| | - Petronela Rachieru
- Unité Douleur-Soins de Support-Soins Palliatifs, CHU Angers, Angers, France
| | - Virginie Gandemer
- Service d'Onco-Hématologie Pédiatrique, CHU Hôpital Sud, Rennes, France
| | - Philippe Colombat
- Qualipsy EE 1901, Université de Tours, Tours, France.,Service d'Onco-Hématologie Pédiatrique, Hôpital Clocheville, Tours, France
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Tremblay D, Touati N, Poder T, Vasiliadis HM, Bilodeau K, Berbiche D, Denis JL, Pomey MP, Hébert J, Roch G, Prady C, Lévesque L. Collaborative governance in the Quebec Cancer Network: a realist evaluation of emerging mechanisms of institutionalization, multi-level governance, and value creation using a longitudinal multiple case study design. BMC Health Serv Res 2019; 19:752. [PMID: 31653231 PMCID: PMC6814997 DOI: 10.1186/s12913-019-4586-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Accepted: 10/09/2019] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND People living with and beyond cancer (PLC) receive various forms of specialty care at different locations and many interventions concurrently or over time. They are affected by the operation of professional and organizational silos. This results in undue delays in access, unmet needs, sub-optimal care experiences and clinical outcomes, and human and financial costs for PLCs and healthcare systems. National cancer control programs advocate organizing in a network to coordinate actions, solve fragmentation problems, and thus improve clinical outcomes and care experiences for every dollar invested. The variable outcomes of such networks and factors explaining them have been documented. Governance is the "missing link" for understanding outcomes. Governance refers to the coordination of collective action by a body in a position of authority in pursuit of a common goal. The Quebec Cancer Network (QCN) offers the opportunity to study in a natural environment how, why, by whom, for whom, and under what conditions collaborative governance contributes to practices that produce value-added outcomes for PLCs, healthcare providers, and the healthcare system. METHODS/DESIGN The study design consists of a longitudinal case study, with multiple nested cases (4 local networks nested in the QCN), mobilizing qualitative and quantitative data and mixed data from various sources and collected using different methods, using the realist evaluation approach. Qualitative data will be used for a thematic analysis of collaborative governance. Quantitative data from validated questionnaires will be analyzed to measure relational coordination and teamwork, care experience, clinical outcomes, and health-related health-related quality of life, as well as a cost analysis of service utilization. Associations between context, governance mechanisms, and outcomes will be sought. Robust data will be produced to support decision-makers to guide network governance towards optimized clinical outcomes and the reduction of the economic toxicity of cancer for PLCs and health systems.
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Affiliation(s)
- Dominique Tremblay
- Faculté de médecine et des sciences de la santé, Campus de Longueuil - Université de Sherbrooke, 150 Place Charles-Le Moyne, Longueuil, Québec, J4K 0A8 Canada
- Centre de recherche Charles-Le Moyne - Saguenay–Lac-Saint-Jean sur les innovations en santé (CR-CSIS), Centre intégré de santé et de services sociaux de la Montérégie-Centre, 150 Place Charles-Le Moyne, Longueuil, Québec, J4K 0A8 Canada
| | - Nassera Touati
- Centre de recherche Charles-Le Moyne - Saguenay–Lac-Saint-Jean sur les innovations en santé (CR-CSIS), Centre intégré de santé et de services sociaux de la Montérégie-Centre, 150 Place Charles-Le Moyne, Longueuil, Québec, J4K 0A8 Canada
- École Nationale d’Administration Publique, 4750 Henri-Julien Avenue, Montréal, Québec, H2T 3E5 Canada
| | - Thomas Poder
- Département de gestion, d’évaluation et de politique de santé, École de santé publique, Université de Montréal, 7101, avenue du Parc, 3e étage, Montréal, Québec, H3N 1X9 Canada
- Centre de recherche de l’Institut Universitaire en Santé Mentale de Montréal, 7331, rue Hochelaga, Montréal, Québec, H1N 3V2 Canada
- École de gestion, Université de Sherbrooke, 2500, boulevard de l’Université, Sherbrooke, Québec, J1K 2R1 Canada
- Centre de recherche du Centre Hospitalier de l’Université de Sherbrooke (CR-CHUS), 3001, 12e Avenue Nord, Sherbrooke, Québec, J1H 5N4 Canada
| | - Helen-Maria Vasiliadis
- Faculté de médecine et des sciences de la santé, Campus de Longueuil - Université de Sherbrooke, 150 Place Charles-Le Moyne, Longueuil, Québec, J4K 0A8 Canada
- Centre de recherche Charles-Le Moyne - Saguenay–Lac-Saint-Jean sur les innovations en santé (CR-CSIS), Centre intégré de santé et de services sociaux de la Montérégie-Centre, 150 Place Charles-Le Moyne, Longueuil, Québec, J4K 0A8 Canada
| | - Karine Bilodeau
- Faculté des sciences infirmières, Université de Montréal, 2375 chemin Côte-Ste-Catherine, Montréal, Québec, H3T 1A8 Canada
| | - Djamal Berbiche
- Centre de recherche Charles-Le Moyne - Saguenay–Lac-Saint-Jean sur les innovations en santé (CR-CSIS), Centre intégré de santé et de services sociaux de la Montérégie-Centre, 150 Place Charles-Le Moyne, Longueuil, Québec, J4K 0A8 Canada
| | - Jean-Louis Denis
- Centre de recherche du Centre hospitalier de l’Université de Montréal (CR-CHUM), 850, rue Saint-Denis, Montréal, Québec, H2X 0A9 Canada
- École de santé publique, Université de Montréal, 7101, avenue du Parc, Montréal, Québec, H3N 1X9 Canada
- Centre de recherche en droit public, Université de Montréal, 3101, chemin de la Tour, Montréal, Québec, H3T 1J7 Canada
- Institut de recherche en santé publique de l’Université de Montréal (IRSPUM), Université de Montréal, 7101, avenue du Parc, Montréal, Montréal, Québec, H3N 1X9 Canada
| | - Marie-Pascale Pomey
- Centre de recherche du Centre hospitalier de l’Université de Montréal (CR-CHUM), 850, rue Saint-Denis, Montréal, Québec, H2X 0A9 Canada
- École de santé publique, Université de Montréal, 7101, avenue du Parc, Montréal, Québec, H3N 1X9 Canada
- Institut de recherche en santé publique de l’Université de Montréal (IRSPUM), Université de Montréal, 7101, avenue du Parc, Montréal, Montréal, Québec, H3N 1X9 Canada
| | - Johanne Hébert
- Département des sciences infirmières, Campus de Lévis - Université du Québec à Rimouski (UQAR, 1595, boulevard Alphonse-Desjardins, Lévis, Québec, G6V 0A6 Canada
- Hôtel-Dieu de Lévis, Centre de recherche du CISSS de Chaudière-Appalaches, 143, rue Wolfe, Lévis, Québec, G6V 3Z1 Canada
- Centre de recherche du Centre hospitalier universitaire de Québec (CRCHUQ), 11 Côte du Palais, Québec, Québec, G1R 2J6 Canada
- Équipe de recherche Michel-Sarrazin en oncologie psychosociale et soins palliatifs (ERMOS), Maison Michel-Sarrazin, 9, rue McMahon, Québec, Québec, G1R 3S3 Canada
| | - Geneviève Roch
- Hôtel-Dieu de Lévis, Centre de recherche du CISSS de Chaudière-Appalaches, 143, rue Wolfe, Lévis, Québec, G6V 3Z1 Canada
- Centre de recherche du Centre hospitalier universitaire de Québec (CRCHUQ), 11 Côte du Palais, Québec, Québec, G1R 2J6 Canada
- Faculté des sciences infirmières, Université Laval, 1050, avenue de la Médecine, Pavillon Ferdinand-Vandry, Québec, Québec, G1V 0A6 Canada
- Axe Santé des populations et pratiques optimales en santé, Centre de recherche du CHU de Québec-Université Laval, 10, rue de l’Espinay, Québec, Québec, G1L 3L5 Canada
- Centre de recherche sur les soins et les services de première ligne de l’Université Laval (CERSSPL‐UL), 2525, chemin de la Canardière, Québec, Québec G1J 0A4 Canada
| | - Catherine Prady
- Faculté de médecine et des sciences de la santé, Campus de Longueuil - Université de Sherbrooke, 150 Place Charles-Le Moyne, Longueuil, Québec, J4K 0A8 Canada
- Centre de recherche Charles-Le Moyne - Saguenay–Lac-Saint-Jean sur les innovations en santé (CR-CSIS), Centre intégré de santé et de services sociaux de la Montérégie-Centre, 150 Place Charles-Le Moyne, Longueuil, Québec, J4K 0A8 Canada
- Centre intégré de santé et de services sociaux de la Montérégie-Centre, 3120 boulevard Taschereau, Greenfield Park, Québec, J4V 2H1 Canada
- Centre intégré de cancérologie de la Montérégie, 3120 Boulevard Taschereau, Greenfield Park, Québec, J4V 2G9 Canada
| | - Lise Lévesque
- Faculté de médecine et des sciences de la santé, Campus de Longueuil - Université de Sherbrooke, 150 Place Charles-Le Moyne, Longueuil, Québec, J4K 0A8 Canada
- Centre de recherche Charles-Le Moyne - Saguenay–Lac-Saint-Jean sur les innovations en santé (CR-CSIS), Centre intégré de santé et de services sociaux de la Montérégie-Centre, 150 Place Charles-Le Moyne, Longueuil, Québec, J4K 0A8 Canada
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Dayer LE, McDade ER, Harrington S. Pharmacist-Delivered Patient Care in an Interdisciplinary Team-Based Institutional Palliative Care Clinic, 2012 to 2018. J Palliat Care 2019; 36:188-193. [PMID: 31496358 DOI: 10.1177/0825859719869614] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Palliative care services offered in the United States have grown substantially since the year 2000. These types of services have been shown to improve a patient's quality of life when presented with a serious or life-threatening disease or illness. An important characteristic of a quality palliative care service is the presence of an interdisciplinary team to utilize different areas of expertise to address multiple aspects of patient care. An important member of this team is the pharmacist. The services presented in this interprofessional education and practice guide describe pharmacist-delivered palliative care services offered in an institutional ambulatory palliative care setting from 2012 to 2018.
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Affiliation(s)
- Lindsey E Dayer
- Department of Pharmacy Practice, 12215University of Arkansas for Medical Sciences College of Pharmacy, Markham, Little Rock, AR, USA
| | - Elizabeth R McDade
- Department of Pharmacy Practice, 12215University of Arkansas for Medical Sciences College of Pharmacy, Knoxville, TN, USA
| | - Sarah Harrington
- Division of Palliative Medicine, Department of Internal Medicine, 12215University of Arkansas for Medical Sciences College of Medicine, Little Rock, AR, USA. Dayer is now with UT Medical Center, Knoxville, TN, USA
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Chandrashekar A, Mohan J. Preparing for the National Health Service: the importance of teamwork training in the United Kingdom medical school curriculum. ADVANCES IN MEDICAL EDUCATION AND PRACTICE 2019; 10:679-688. [PMID: 31686942 PMCID: PMC6709809 DOI: 10.2147/amep.s203333] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Accepted: 06/27/2019] [Indexed: 06/10/2023]
Abstract
Doctors are required to work in teams every day at every stage in their careers. In the United Kingdom (UK), with a drive towards an integrated healthcare system, teamwork has become a major focus amongst healthcare professionals and their skill set must reflect this. For doctors, the art of teamwork needs to be developed from the early stages of training, in order to minimise fragmentation of care and its detrimental impact on patients. The World Health Organisation emphasises the importance of doctors adopting a multi-disciplinary team approach, yet amongst medical students, collaborative work is often disregarded. Fundamentally, the system that produces future doctors overlooks the importance of teamwork. Therefore, the undergraduate curriculum must be reshaped to embed teamwork within its principles. Future doctors will thus be equipped with lifelong abilities to collaborate closely amongst peers in order to deliver care holistically. Adapting medical school curricula across the UK will present inevitable challenges and these must be understood, in order to generate strategies that cultivate a culture of teamwork amongst the doctors of the future.
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Affiliation(s)
| | - Jenanan Mohan
- Imperial College London Faculty of Medicine, Imperial College London, London, UK
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42
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When oncologic treatment options outpace the existing evidence: Contributing factors and a path forward. J Cancer Policy 2019. [DOI: 10.1016/j.jcpo.2019.100188] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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Hustoft M, Biringer E, Gjesdal S, Moen VP, Aβmus J, Hetlevik Ø. The effect of team collaboration and continuity of care on health and disability among rehabilitation patients: a longitudinal survey-based study from western Norway. Qual Life Res 2019; 28:2773-2785. [PMID: 31144204 PMCID: PMC6761089 DOI: 10.1007/s11136-019-02216-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/23/2019] [Indexed: 12/25/2022]
Abstract
PURPOSE The purpose of this study was to investigate how changes in patient-rated health and disability from baseline to after rehabilitation were associated with communication and relationships in rehabilitation teams and patient-rated continuity of care. METHODS Linear models were used to assess the associations between relational coordination [RC] and Nijmegen Continuity Questionnaire-Norwegian version [NCQ-N] with changes in the World Health Association Disability Assessment Schedule 2.0 [WHODAS 2.0] and EuroQol EQ-VAS [EQ-VAS]. To express change in WHODAS 2.0 and EQ-VAS, the model was adjusted for WHODAS 2.0 and EQ-VAS baseline scores. Analyses for possible slopes for the various diagnosis groups were performed. RESULTS A sample of 701 patients were included in the patient cohort, followed from before rehabilitation to 1 year after a rehabilitation stay involving treatment by 15 different interprofessional teams. The analyses revealed associations between continuity of care and changes in patient-rated health, measured with EQ-VAS (all p values < 0.01). RC communication was associated with more improvement in functioning in neoplasms patient group, compared to improvement of health among included patient groups. The results revealed no associations between NCQ-N and WHODAS 2.0 global score, or between RC in the rehabilitation teams treating the patients and changes in WHODAS 2.0 global score. CONCLUSION The current results revealed that better personal, team and cross-boundary continuity of rehabilitation care was associated with better patient health after rehabilitation at 1-year follow-up. Measures of patient experiences with different types of continuity of care may provide a promising indicator of the quality of rehabilitation care.
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Affiliation(s)
- Merethe Hustoft
- Centre for Habilitation and Rehabilitation in Western Norway, Haukeland University Hospital, Bergen, Norway.
- Department of Global Health and Primary Health Care, University of Bergen, Bergen, Norway.
| | - Eva Biringer
- Section of Research and Innovation, Helse Fonna Local Health Authority, Haugesund/Stord, Norway
| | - Sturla Gjesdal
- Department of Global Health and Primary Health Care, University of Bergen, Bergen, Norway
| | - Vegard Pihl Moen
- Centre for Habilitation and Rehabilitation in Western Norway, Haukeland University Hospital, Bergen, Norway
| | - Jörg Aβmus
- Centre for Clinical Research, Haukeland University Hospital, Bergen, Norway
| | - Øystein Hetlevik
- Department of Global Health and Primary Health Care, University of Bergen, Bergen, Norway
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Palese A, Gonella S, Brugnolli A, Mansutti I, Saiani L, Terzoni S, Destrebecq A, Zannini L, Grassetti L, Dimonte V. Nursing students' interprofessional educational experiences in the clinical context: findings from an Italian cross-sectional study. BMJ Open 2019; 9:e025575. [PMID: 30898820 PMCID: PMC6475187 DOI: 10.1136/bmjopen-2018-025575] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVE To explore nursing students' interprofessional educational (IPE) experiences during their most recent clinical rotation and to explore the factors supporting IPE experiences. DESIGN National cross-sectional study on data collected in 2016. SETTING 95 Bachelor of Nursing Sciences programmes; 27 Italian Universities. PARTICIPANTS Students who (a) were attending or just completed their clinical rotations lasting at least 2 weeks in the same unit, and (b) willing to participate in the study. PRIMARY AND SECONDARY OUTCOMES First to measure the occurrence of IPE experiences in the most recent clinical rotation; the secondary outcome was to discover factors associated with IPE occurrence. MEASURES The primary outcome was measured using questions based on a 4-point Likert scale (from 0='never' to 3='always'). Explanatory variables were collected at both individual and regional levels with items included in the same questionnaire. RESULTS 9607 out of 10 480 students took part in the study. Overall, 666 (6.9%) perceived not having had any IPE experience, while 3248 (33.8%), 3653 (38%) and 2040 (21.3%) reported having experienced IPE opportunities 'only a little', to 'some extent' or 'always', respectively. From the multilevel analysis performed using the generalised linear mixed model, factors promoting the occurrence of IPE experiences were mainly set at (a) the clinical learning environment level (high: learning environment quality, self-directed learning encouragement, learning opportunities, quality of safety and nursing care and quality of tutorial strategies); and (b) the regional level, where significant differences emerged across regions. In contrast, male gender was negatively associated with the perception of having had IPE experiences. CONCLUSIONS A large number of nursing students experienced either 'never' or 'only a little' IPE opportunities, thus suggesting that nursing education tends to remain within the nursing profession. Limiting students' interprofessional exposure during education can prevent future collaborative approaches that have been shown to be essential in providing best patient care. In order to increase IPE exposure, it is necessary to develop strategies designed both at the singular unit and regional levels.
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Affiliation(s)
- Alvisa Palese
- Department of Medical Sciences, University of Udine, Udine, Italy
| | - Silvia Gonella
- Department of Clinical and Biological Sciences, AOU Città della Salute e della Scienza di Torino, Torino, Italy
| | - Anna Brugnolli
- Department of Public Health, Azienda Provinciale per i Servizi Sanitari, Trento, Italy
| | - Irene Mansutti
- Department of Medical Science, University of Udine, Udine, Friuli-Venezia Giulia, Italy
| | - Luisa Saiani
- Department of Public Health, Verona University, Verona, Italy
| | - Stefano Terzoni
- Biomedical Sciences for Health, University of Milan, Milano, Italy
| | - Anne Destrebecq
- Biomedical Sciences for Health, University of Milan, Milano, Italy
| | - Lucia Zannini
- Biomedical Sciences for Health, University of Milan, Milano, Italy
| | - Luca Grassetti
- Department of Economic and Statistical Sciences, University of Udine, Udine, Italy
| | - Valerio Dimonte
- Department of Clinical and Biological Sciences, University of Torino, Torino, Italy
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Best practices on team communication: interprofessional practice in oncology. Curr Opin Support Palliat Care 2019; 13:69-74. [DOI: 10.1097/spc.0000000000000412] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Comerford D, Shah R. Ambulatory approach to cancer care. Part 2: the role of nurses and the multidisciplinary team and safety. BRITISH JOURNAL OF NURSING (MARK ALLEN PUBLISHING) 2019; 28:S20-S26. [PMID: 30811233 DOI: 10.12968/bjon.2019.28.4.s20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Ambulatory care (AC) involves providing inpatient chemotherapy and supportive care as an outpatient service. Nurses and the multidisciplinary team (MDT) have a major role in this. AC at a major London teaching hospital trust is a nurse-led service, headed by specialist cancer nurses with excellent knowledge of the needs and priorities of patients undergoing intensive treatment. An experienced MDT, including administrative support, maintains safety and continuity of care. The nurses, MDT and patient work closely to promote the patient's wellbeing, self-management and trust. A scenario is analysed in this article to illustrate potential concerns around a patient's safety and suitability for AC. This is the second article of a three-part series; the previous article discussed AC at a major London teaching hospital and improving the patient experience.
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Affiliation(s)
- Diana Comerford
- Lead Haematology Practice Development Nurse at King's College Hospital Foundation Trust, London. She was previously at University College London Hospitals NHS Foundation Trust
| | - Raakhee Shah
- Lead Haematology Pharmacist, University College London Hospitals NHS Foundation Trust, London
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Kilpatrick K, Tchouaket É, Paquette L, Guillemette C, Jabbour M, Desmeules F, Landry V, Fernandez N. Measuring patient and family perceptions of team processes and outcomes in healthcare teams: questionnaire development and psychometric evaluation. BMC Health Serv Res 2019; 19:9. [PMID: 30612571 PMCID: PMC6322340 DOI: 10.1186/s12913-018-3808-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2018] [Accepted: 12/11/2018] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND There is a lack of validated instruments examining dimensions of team functioning from the perspective of patients and families consistent with a conceptual framework. The study aimed to develop and assess the psychometric properties of the Patient-Perceptions of Team Effectiveness (PTE) questionnaire. METHODS A cross-sectional survey was undertaken in three studies. Data were collected from May-October 2016 for Study 1, April 2018-ongoing for Study 2, and October 2016 to June 2017 for Study 3. Online and paper versions of the self-administered questionnaire were available in English and in French. The initial questionnaire included 41 items. Study 1 included 320 respondents. Reliability was assessed using Cronbach alpha. Face validity (n = 250) was assessed using a structured questionnaire. Content validity was examined using subject matter experts and Spearman's item-total correlations. Construct validity was examined using known group comparisons (i.e., clinical specialty, education, length of follow-up, reason of consultation). Content analysis was used for open-ended questions. RESULTS The questionnaire took 10 to 15 min to complete. Positive assessments were noted for instructions, formatting, font size and logical ordering of questions. In Study 1, reliability indices for the PTE-Overall, Team Processes and Outcomes subscales ranged from 0.72 to 0.84. Item-total correlations ranged from 0.551 to 0.794 (p < 0.001). Differences were noted between clinical specialties, education, length of follow-up, reason of consultation, low and high functioning teams. No differences were noted between English and French language respondents. Psychometric properties were re-assessed in Study 2 and 3 after unclear questions were reworked. Reliability indices for the subscales ranged from 0.76 to 0.94 and differences remained significant between low and high functioning teams. CONCLUSION The final 43-item instrument is easy to administer to patients and families. The studies provide evidence of validity to support the propositions in the conceptual framework. The patient-level measures can be aggregated to the team, organizational or system level. The information can be used to assess healthcare team functioning in acute and primary care and determine the role patients and families are playing in teams. Further testing is needed with patients and families who are hospitalized or receiving care from teams in rural areas.
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Affiliation(s)
- Kelley Kilpatrick
- Susan E. French Chair in Nursing Research and Innovative Practice, Ingram School of Nursing, McGill University, Montréal, Canada
- Centre intégré universitaire de santé et de services sociaux de l’Est-de-l’Île-de-Montréal-Hôpital Maisonneuve-Rosemont (CIUSSS-EMTL), Montréal, Canada
| | | | - Lysane Paquette
- Faculty of Nursing, Université de Montréal, Montréal, Canada
| | - Claudel Guillemette
- Centre intégré universitaire de santé et de services sociaux de l’Est-de-l’Île-de-Montréal-Hôpital Maisonneuve-Rosemont (CIUSSS-EMTL), Montréal, Canada
| | - Mira Jabbour
- Centre intégré universitaire de santé et de services sociaux de l’Est-de-l’Île-de-Montréal-Hôpital Maisonneuve-Rosemont (CIUSSS-EMTL), Montréal, Canada
| | - François Desmeules
- School of Rehabilitation, Faculty of Medicine, Université de Montréal, Montréal, Canada
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Patel S, O'Brien BC, Dulay M, Earnest G, Shunk RL. Team Retreats for Interprofessional Trainees and Clinic Staff: Accelerating the Development of High-Functioning Teams. MEDEDPORTAL : THE JOURNAL OF TEACHING AND LEARNING RESOURCES 2018; 14:10786. [PMID: 30800986 PMCID: PMC6354790 DOI: 10.15766/mep_2374-8265.10786] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/26/2018] [Accepted: 11/10/2018] [Indexed: 05/29/2023]
Abstract
Introduction Teams are critical to managing the health care needs of patients with part-time trainee providers. High-functioning teams require trusting relationships among trainees and staff and opportunities to learn and practice skills together. Irregular trainee schedules, time-limited training programs, and lack of protected time for team development during clinic can hinder development of high-functioning teams. Methods To provide time for team development, we created an annual half-day team retreat for interprofessional trainees and staff at three San Francisco Veterans Affairs primary care clinics. We used principles of high-functioning teams and relationship-centered communication to develop retreat content, then trained interprofessional faculty members to facilitate and role-model this content. Retreat objectives and content focused on building relationships, establishing team goals, clarifying roles, and learning communication skills. Postretreat surveys and qualitative content analysis of comments and team goals evaluated retreat objectives and opportunities for improvement. Results Between 2011 and 2017, 16 team retreats were attended by 232 interprofessional trainees and 77 unique staff (some attended multiple times). Thirty-seven faculty facilitated. Most participants strongly agreed that they knew their team members better personally and professionally after the retreat (M = 4.7 out of 5, n = 368); 78% of teams (n = 65) submitted SMART goals addressing high-functioning teams. Participants' comments consistently reflected the benefits of protected time for team building. Discussion This team retreat supports team development among trainees and staff on primary care teams by promoting relationship building, role clarity, communication, and team processes. It can be valuable for all interprofessional participants.
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Affiliation(s)
- Shalini Patel
- Associate Professor, Department of Medicine, University of California, San Francisco, School of Medicine; Chief of Primary Care, San Francisco VA
| | - Bridget C. O'Brien
- Associate Professor, Department of Medicine, University of California, San Francisco, School of Medicine; Director of Scholarship and Evaluation, Center of Excellence in Primary Care Education, San Francisco VA
| | - Maya Dulay
- Associate Professor, Department of Medicine, University of California, San Francisco, School of Medicine; Associate Director for Clinical Care and Education, San Francisco VA
| | - Gillian Earnest
- Research Data Analyst, University of California, San Francisco, School of Medicine; Research Data Analyst, San Francisco VA
| | - Rebecca L. Shunk
- Professor, Department of Medicine, University of California, San Francisco, School of Medicine; Associate Chief of Staff for Education, San Francisco VA; Co-Director, Center of Excellence for Primary Care Education, San Francisco VA
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Kaiser L, Bartz S, Neugebauer EAM, Pietsch B, Pieper D. Interprofessional collaboration and patient-reported outcomes in inpatient care: protocol for a systematic review. Syst Rev 2018; 7:126. [PMID: 30126451 PMCID: PMC6102939 DOI: 10.1186/s13643-018-0797-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Accepted: 08/10/2018] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND Interprofessional collaboration (IPC) is a core demand of policymakers, funding parties, and health care professionals in practice. Although the causal mechanism from increased IPC to improved patient outcomes seems to be intuitive, there is a lack of credible causal evidence concerning the effects not only on the objective but also on the subjective patient outcomes. The aim of the planned systematic review is to focus on the effect of IPC on patient-reported outcomes and experiences in inpatient care. METHODS A systematic literature review will be undertaken by searching the following electronic databases: PubMed, Web of Science/Social Science Citation Index, Cochrane Library (CENTRAL), Current Contents (LIVIVO), CINAHL, and EMBASE. Additional studies will be identified through forward and backward citation tracking, manually searching the Internet and Google Scholar, and consultation of experts. Data will be synthesized through narrative description, grouping, and thematic analysis of the extracted data. If heterogeneity for some studies and outcomes is sufficiently low, a quantitative meta-analysis of effect sizes and standard errors will be applied. DISCUSSION The systematic review will synthesize the evidence regarding the effectiveness of IPC and how it is perceived by patients in inpatient care. As the patients' perspective becomes increasingly relevant in the context of quality improvement, the results can help decision-makers in policy- and health care institutions to understand and develop strategies to ensure a high quality of care. SYSTEMATIC REVIEW REGISTRATION PROSPERO registration number: CRD42017073900 ; date of registration in PROSPERO 07 August 2017.
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Affiliation(s)
- Laura Kaiser
- Witten/Herdecke University, Witten, Germany
- The Federal Joint Committee, Berlin, Germany
| | - Sina Bartz
- The Federal Joint Committee, Berlin, Germany
| | - Edmund A. M. Neugebauer
- Witten/Herdecke University, Witten, Germany
- Brandenburg Medical School Theodor Fontane, Neuruppin, Germany
| | | | - Dawid Pieper
- Witten/Herdecke University, Witten, Germany
- Institute for Research in Operative Medicine, Witten, Germany
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Mollica MA, Adjei B, Duffin R, Peters E, Thomas M, Asfeldt T, Castro K. Influencing Quality Reporting: Using the Rapid Quality Reporting System in a Community Network
. Clin J Oncol Nurs 2017; 21:561-566. [PMID: 28945724 DOI: 10.1188/17.cjon.561-566] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Value-based cancer care warrants an exploration of ways that nurses can influence quality for patients with cancer, particularly in the community setting, where the majority of patients with cancer are treated.
. OBJECTIVES The purpose is to explore how community cancer centers met and sustained key quality breast cancer care indicators through implementation of the National Cancer Institute Community Cancer Centers Program Rapid Quality Reporting System (RQRS) and patient navigation projects.
. METHODS The authors identified and interviewed staff at three sites that achieved significant increases in concordance with three breast cancer outcome measures. FINDINGS Three main themes emerged through analysis.
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