1
|
Pomey MP, Iliescu Nelea M, Vialaron C, Normandin L, Côté MA, Desforges M, Pomey-Carpentier P, Adjtoutah N, 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, de Guise M. The black box of the relationship between breast cancer patients and accompanying patients: the accompanied patients' point of view. BMC Cancer 2024; 24:822. [PMID: 38987731 PMCID: PMC11234724 DOI: 10.1186/s12885-024-12585-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2024] [Accepted: 07/01/2024] [Indexed: 07/12/2024] Open
Abstract
BACKGROUND The PAROLE-Onco program was introduced in the province of Quebec, Canada in 2019. It integrates accompanying patients (APs), i.e., people who have been affected by cancer, into the clinical team as full members. These APs use their experiential knowledge with people undergoing treatment and with clinical teams. The aim of this paper is to evaluate, within the framework of two university medical centers, the perceptions of breast cancer patients who receive support from APs, particularly in terms of their active involvement in their care trajectory. METHODS A qualitative study based on semi-structured interviews with accompanied patients was performed. Fourteen individual interviews were conducted between July and September 2021 with women presenting different profiles in terms of age, education, professional status, type of treatment, family situation, and clinical background. The data were analyzed using thematic analysis, focusing on patients' perceptions of APs' contributions and suggested improvements for accessing AP support. RESULTS Three themes emerged from the semi-structured interviews: communication modalities used to connect patients with their APs, the characteristics of the support provided by APs, and the perceived effects of this support on the patients. Patients expressed a preference for telephone communication, highlighting its convenience and accessibility. The support provided by APs included emotional and informational support, neutrality, and adaptability. This relationship improved patient communication, reduced anxiety, helped regain control, and enhanced overall quality of life. The results emphasized the added value of APs in complementing the support offered by healthcare professionals. Patients noted the critical role of APs in helping them navigate the healthcare system, better understand their treatment processes, and manage their emotions. The ability of APs to provide practical advice and emotional reassurance was particularly valued. Overall, the findings underscored the significant impact of AP support on patients' experiences and highlighted areas for enhancing this service. CONCLUSION This study highlights, during the care trajectory of people affected by breast cancer, APs' contribution to patients' emotional well-being because they improve, in particular, the management of emotions and communication with health professionals.
Collapse
Affiliation(s)
- 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, Université de Montréal, Montréal, QC, Canada.
| | - Monica Iliescu Nelea
- Research Centre of the University of Montreal Hospital Centre, Montréal, QC, Canada
| | - Cécile Vialaron
- Research Centre of the University of Montreal Hospital Centre, Montréal, QC, Canada
| | - Louise Normandin
- Research Centre of the University of Montreal Hospital Centre, Montréal, QC, Canada
| | - Marie-Andrée Côté
- Research Centre of the University of Montreal Hospital Centre, Montréal, QC, Canada
| | - Mado Desforges
- Research Centre of the University of Montreal Hospital Centre, Montréal, QC, Canada
| | | | - Nesrine Adjtoutah
- Research Centre of the University of Montreal Hospital Centre, Montréal, QC, Canada
| | - Israël Fortin
- Centre Intégré Universitaire de santé et services sociaux de l'Est-de-l'Île-de Montréal, Hôpital de Maisonneuve-Rosemont, Montréal, QC, Canada
| | - Isabelle Ganache
- Institut national d'excellence en santé et services sociaux (INESSS), Montréal, QC, Canada
| | - Catherine Régis
- Faculté de Droit, Université de Montréal, Montréal, QC, Canada
| | - Zeev Rosberger
- Gerald Bronfman Department of Oncology, Lady Davis Institute for Medical Research, Jewish General Hospital & McGill University, Montréal, QC, Canada
| | | | - Lynda Bélanger
- CHU de Québec, Université Laval Research Centre, Québec, QC, Canada
| | - Michel Dorval
- CHU de Québec, Université Laval Research Centre, Québec, QC, Canada
- Faculté de pharmacie, Université Laval, Québec, QC, Canada
- Centre de recherche du CHU de Québec-Université Laval, Québec, QC, Canada
- Centre de recherche du CISSS Chaudière Appalaches, Lévis, QC, Canada
| | | | - Mélanie Lavoie-Tremblay
- Faculty of Nursing, Université de Montréal, Montréal, QC, Canada
- Institut universitaire en santé mentale de Montréal, Montréal, QC, Canada
| | - Antoine Boivin
- 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 Family and Emergency Medicine, Faculty of Medicine, Université de Montréal, Montréal, QC, Canada
- Canada Research Chair in Partnership with Patients and Communities, Ottawa, Canada
| | - Jean-François Pelletier
- Centre intégré de santé et de services sociaux de la Montérégie-Ouest, St-Hubert, QC, Canada
- Yale Program for Recovery & Community Health, New Haven, CT, USA
| | - Nicolas Fernandez
- Department of Family and Emergency Medicine, Faculty of Medicine, Université de Montréal, Montréal, QC, Canada
| | - Alain M Danino
- Research Centre of the University of Montreal Hospital Centre, Montréal, QC, Canada
- Centre Hospitalier Universitaire de Montréal (CHUM), Montréal, QC, Canada
| | - Michèle de Guise
- Institut national d'excellence en santé et services sociaux (INESSS), Montréal, QC, Canada
| |
Collapse
|
2
|
Sales J, Normandin L, Pomey MP. Care and services partnership in Quebec birthing centres: myth or reality? BMC Pregnancy Childbirth 2024; 24:177. [PMID: 38454331 PMCID: PMC10918890 DOI: 10.1186/s12884-024-06362-w] [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: 10/16/2023] [Accepted: 02/22/2024] [Indexed: 03/09/2024] Open
Abstract
CONTEXT Working with women to best meet their needs has always been central to midwifery in Quebec, Canada. The creation of birthing centres at the end of the 1990s consolidated this desire to prioritize women's involvement in perinatal care and was intended to encourage the establishment of a care and services partnership between care providers and users. The aim of this pilot study is to evaluate the perceptions of clients, midwives and birth assistants of the way in which women are involved in partnership working in Quebec birthing centres. METHODS A single qualitative case and pilot study was conducted with midwives (n = 5), birth assistants (n = 4), a manager (n = 1), clients (n = 5) and members of the users' committee (n = 2) at a birthing centre in Quebec, Canada in July and August 2023. The partnership was evaluated using the dimensions of a validated CADICEE questionnaire. RESULTS The women and professionals stressed that the relationship was established in a climate of trust. The caregivers also attached importance to autonomy, information sharing and decision-making, adaptation to context, empathy and recognition of the couple's expertise. The women confirmed that they establish a relationship of trust with the professionals when the latter show empathy and that they adapt the follow-up to their knowledge and life context. Key factors in establishing this kind of care relationship are the time given, a de-medicalized environment, the comprehensive care received, and professionals who are well-informed about the partnership. In addition, the birthing centre has a users' committee that can put forward ideas but has no decision-making powers. CONCLUSIONS Both the women and the professionals at the birthing centre appear to be working in partnership. However, at the organizational level, the women are not involved in decision-making. A study of all birthing centres in Quebec would provide a more comprehensive picture of the situation.
Collapse
Affiliation(s)
| | - Louise Normandin
- Research Centre, University of Montreal Hospital Centre, Montréal, QC, Canada
| | - Marie-Pascale Pomey
- Research Centre, 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, 7101 Av du Parc 3e étage, Montréal, QC, H3N 1X9, Canada.
- Department of Family Medicine and Emergency, University of Montreal, Montréal, QC, Canada.
| |
Collapse
|
3
|
Pomey MP, Paquette J, Nelea MI, Vialaron C, Mourad R, Bouchard K, Normandin L, Côté MA, Desforges M, Pomey-Carpentier P, Fortin I, Ganache I, Régis C, Rosberger Z, Charpentier D, Vachon MF, Bélanger L, Dorval M, Ghadiri DP, Lavoie-Tremblay M, Boivin A, Pelletier JF, Fernandez N, Danino AM, de Guise M. Integrating accompanying patients into clinical oncology teams: limiting and facilitating factors. BMC Health Serv Res 2024; 24:150. [PMID: 38291443 PMCID: PMC10826234 DOI: 10.1186/s12913-024-10624-w] [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: 04/11/2023] [Accepted: 01/22/2024] [Indexed: 02/01/2024] Open
Abstract
OBJECTIVES Since 2018, four establishments in Quebec have been instrumental in implementing the PAROLE-Onco program, which introduced accompanying patients (APs) into healthcare teams to improve cancer patients' experience. APs are patient advisors who have acquired specific experiential knowledge related to living with cancer, using services, and interacting with healthcare professionals. They are therefore in a unique and reliable position to be able to provide emotional, informational, cognitive and navigational support to patients who are dealing with cancer. We aimed to explore APs' perspectives regarding the limiting and facilitating factors in terms of how they are integrated into the clinical oncology teams. METHODS A qualitative study based on semi-structured interviews and focus groups was conducted with 20 APs at the beginning of their intervention (T1) and, two years later, during a second data collection (T2). Limiting and facilitating factors of APs' integration into clinical teams were analyzed in terms of governance, culture, resources and tools. RESULTS The limited factors raised by APs to be integrated into clinical teams include the following: confusion about the specific roles played by APs, lifting the egos of certain professionals who feel they are already doing what APs typically do, lack of identification of patient needs, absence of APs in project governance organizational boundaries, and team members' availability. Various communication challenges were also raised, resulting in the program being inadequately promoted among patients. Also mentioned as limiting factors were the lack of time, space and compensation. Creating opportunities for team members to meet with APs, building trust and teaching team members how APs' activities complement theirs were enhancing factors. Other facilitators include APs being involved in decision-making committees, being leaders in promoting the PAROLE-Onco program to patients and clinical team members and creating opportunities to communicate with team members to help enhance their work and provide feedback to improve patient services. Awareness of APs' added value for the team and patients is also a key facilitator. Regarding tools, offering accompanying services by telephone allows both patients and APs to benefit from the flexibility they need. CONCLUSION Over time, APs were able to identify optimal factors for successful implementation. Recommendations include APs and professionals working in co-construction on organization, leadership, resources and status factors. This could help catalyze a change in culture within health establishments and allow people dealing with cancer to benefit from the experiential knowledge of other patients within their clinical team.
Collapse
Affiliation(s)
- 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, CA, Canada.
| | - Jesseca Paquette
- Research Centre of the University of Montreal Hospital Centre, Montréal, QC, Canada
| | - Monica Iliescu Nelea
- Research Centre of the University of Montreal Hospital Centre, Montréal, QC, Canada
| | - Cécile Vialaron
- Research Centre of the University of Montreal Hospital Centre, Montréal, QC, Canada
| | - Rim Mourad
- Research Centre of the University of Montreal Hospital Centre, Montréal, QC, Canada
| | - Karine Bouchard
- Centre Hospitalier Universitaire- CHU de Québec-Université Laval, Québec, QC, Canada
| | - Louise Normandin
- Research Centre of the University of Montreal Hospital Centre, Montréal, QC, Canada
| | - Marie-Andrée Côté
- Research Centre of the University of Montreal Hospital Centre, Montréal, QC, Canada
| | - Mado Desforges
- Research Centre of the University of Montreal Hospital Centre, Montréal, QC, Canada
| | | | - Israël Fortin
- Centre Intégré, Universitaire de Santé Et Services Sociaux de L'Est-de-L'Île-de Montréal, Hôpital de Maisonneuve-Rosemont, Montréal, QC, Canada
| | - Isabelle Ganache
- Institut National d'excellence en Santé Et Services Sociaux (INESSS), Montréal, QC, Canada
| | - Catherine Régis
- Université de Montréal - Faculté de droit, Montréal, QC, Canada
| | - Zeev Rosberger
- Gerald Bronfman Department of Oncology, Lady Davis Institute for Medical Research, Jewish General Hospital &, McGill University, Montréal, QC, Canada
| | | | | | - Lynda Bélanger
- Centre Hospitalier Universitaire- CHU de Québec-Université Laval, Québec, QC, Canada
| | - Michel Dorval
- Faculté de Pharmacie, Université Laval, Québec, QC, Canada
- Centre de Recherche du CHU de Québec-Université Laval, Québec, QC, Canada
- Centre de Recherche du CISSS Chaudière Appalaches, Lévis, QC, Canada
| | | | - Mélanie Lavoie-Tremblay
- Faculté Des Sciences Infirmières, Université de Montréal, Montréal, QC, Canada
- Institut Universitaire en Santé Mentale de Montréal, Montréal, QC, Canada
| | - Antoine Boivin
- 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 Family and Emergency Medicine, Faculté de Médecine, Université de Montréal, Montréal, QC, Canada
| | - Jean-François Pelletier
- Centre Intégré de Santé Et de Services Sociaux de La Montérégie-Ouest, St-Hubert, QC, Canada
- Yale Program for Recovery & Community Health, New Haven, CT, USA
| | - Nicolas Fernandez
- Department of Family and Emergency Medicine, Faculté de Médecine, Université de Montréal, Montréal, QC, Canada
| | - Alain M Danino
- Research Centre of the University of Montreal Hospital Centre, Montréal, QC, Canada
- Centre Hospitalier Universitaire de Montréal (CHUM), Montréal, QC, Canada
| | - Michèle de Guise
- Institut National d'excellence en Santé Et Services Sociaux (INESSS), Montréal, QC, Canada
| |
Collapse
|
4
|
Rivest J, Karazivan P, Desbeaumes Jodoin V, Flora L, Lambert C, Tranulis C, Daneault S. Listening to Cancer Patients' Narratives During Residency: A Pilot Study on a Communication Skills' Workshop Involving Patients-Partners. J Patient Exp 2023; 10:23743735231183674. [PMID: 37441277 PMCID: PMC10334025 DOI: 10.1177/23743735231183674] [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] [Indexed: 07/15/2023] Open
Abstract
The field of cancer care still lacks best practices in communication. Few postgraduate training programs offer formal training to develop such skills. The patient partnership has been used in medical education to increase the sensitivity of the subjective experiences of patients. In our Canadian center, residents and patient-partners participated in an educational workshop on communication focusing on patient's narrative. The aim of this pilot qualitative study was to explore the experiences of participants in the workshop. Using theoretical sampling, we recruited 6 residents and 6 patient-partners. Semi-structured interviews were conducted and transcribed. A thematic analysis was performed. From analysis, 4 themes emerged: (1) lack of communication skills training; (2) barriers to effective communication in cancer care; (3) the empathy of patient-partners towards the communication challenges faced by residents; and (4) the participants' reactions to the workshop. Based on our findings, our communication skills workshop centered on narrative medicine and involving patient-partners appears feasible. Future research could study its pedagogical value and the optimal learning environment required.
Collapse
Affiliation(s)
- Jacynthe Rivest
- Department of Psychiatry, Centre
Hospitalier de l'Université de Montréal (CHUM), Montreal, Canada
- Centre de Recherche du Centre
Hospitalier de l'Université de Montréal (CRCHUM), Montréal, Canada
| | - Philippe Karazivan
- Department of Family Medicine,
University of Montreal Faculty of Medicine, Montreal, Canada
- Center of Excellence for Partnership
with Patients and the Public, University of Montreal, Montreal, Quebec, Canada
| | - Véronique Desbeaumes Jodoin
- Department of Psychiatry, Centre
Hospitalier de l'Université de Montréal (CHUM), Montreal, Canada
- Centre de Recherche du Centre
Hospitalier de l'Université de Montréal (CRCHUM), Montréal, Canada
| | - Luigi Flora
- Center of Excellence for Partnership
with Patients and the Public, University of Montreal, Montreal, Quebec, Canada
- Innovation Center for partnership with
patients and the public, Côte d’Azur University, Clermont-Ferrand, France
| | - Carole Lambert
- Centre de Recherche du Centre
Hospitalier de l'Université de Montréal (CRCHUM), Montréal, Canada
- Department of Radiation Oncology,
University of Montreal Health Center, Montreal, Canada
| | - Constantin Tranulis
- Institut universitaire en santé mentale
de Montréal, Montreal, Quebec, Canada
| | - Serge Daneault
- Department of Family Medicine,
University of Montreal Faculty of Medicine, Montreal, Canada
- Centre de recherche de l’Institut
universitaire de gériatrie de Montréal, Montreal, Canada
| |
Collapse
|
5
|
Pomey MP, Nelea MI, Normandin L, Vialaron C, Bouchard K, Côté MA, Duarte MAR, Ghadiri DP, Fortin I, Charpentier D, Lavoie-Tremblay M, Fernandez N, Boivin A, Dorval M, Desforges M, Régis C, Ganache I, Bélanger L, Rosberger Z, Danino MA, Pelletier JF, Vu TTT, de Guise M. An exploratory cross-sectional study of the effects of ongoing relationships with accompanying patients on cancer care experience, self-efficacy, and psychological distress. BMC Cancer 2023; 23:369. [PMID: 37087438 PMCID: PMC10122087 DOI: 10.1186/s12885-023-10856-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 04/17/2023] [Indexed: 04/24/2023] Open
Abstract
BACKGROUND Centre hospitalier de l'Université de Montréal in Canada introduced accompanying patients (APs) into the breast cancer care trajectory. APs are patients who have been treated for breast cancer and have been integrated into the clinical team to expand the services offered to people affected by cancer. This study describes the profiles of the people who received the support and explores whether one-offs vs ongoing encounters with APs influence their experience of care, on self-efficacy in coping with cancer, and on their level of psychological distress. METHODS An exploratory cross-sectional study was carried out among patients to compare patients who had one encounter with an AP (G1) with those who had had several encounters (G2). Five questionnaires were administered on socio-demographic characteristics, care pathway, evaluation of the support experience, self-efficacy in coping with cancer, and level of psychological distress. Logbooks, completed by the APs, determined the number of encounters. Linear regression models were used to evaluate the associations between the number of encounters, patient characteristics, care pathway, number of topics discussed, self-efficacy measures in coping with cancer, and level of psychological distress. RESULTS Between April 2020 and December 2021, 60% of 535 patients who were offered support from an AP accepted. Of these, one hundred and twenty-four patients participated in the study. The study aimed to recruit a minimum of 70 patients with the expectation of obtaining at least 50 participants, assuming a response rate of 70%. There were no differences between G1 and G2 in terms of sociodemographic data and care pathways. Statistical differences were found between G1 and G2 for impacts on and the return to daily life (p = 0.000), the return to the work and impacts on professional life (p = 0.044), announcement of a diagnosis to family and friends (p = 0.033), and strategies for living with treatment under the best conditions (p = 0.000). Significant differences were found on the topics of cancer (p = 0.000), genetic testing (p = 0.023), therapeutic options (p = 0.000), fatigue following treatment (p = 0.005), pain and discomfort after treatment or surgery (p = 0.000), potential emotions and their management (p = 0.000) and the decision-making processes (p = 0.011). A significant relationship was found between the two groups for patients' ability to cope with cancer (p = 0.038), and their level of psychological distress at different stages of the care pathway (p = 0.024). CONCLUSIONS This study shows differences between one-time and ongoing support for cancer patients. It highlights the potential for APs to help patients develop self-efficacy and cope with the challenges of cancer treatment.
Collapse
Affiliation(s)
- Marie-Pascale Pomey
- Innovation Axis, Research Center of the Centre Hospitalier de L'Université de Montréal, (CHUM), Montréal, QC, Canada.
- Department of Health Management, Evaluation, and Policy, School of Public Health, Université de Montreal, 7101 Av du Parc 3E Étage, Montréal, QC, H3N 1X9, Canada.
- Research Chair in Evaluation of State-of-the-Art Technologies and Methods, Montréal, QC, Canada.
- Center of Excellence On Patient Partnership and the Public, Montréal, QC, Canada.
| | - Monica Iliescu Nelea
- Innovation Axis, Research Center of the Centre Hospitalier de L'Université de Montréal, (CHUM), Montréal, QC, Canada
| | - Louise Normandin
- Innovation Axis, Research Center of the Centre Hospitalier de L'Université de Montréal, (CHUM), Montréal, QC, Canada
| | - Cécile Vialaron
- Innovation Axis, Research Center of the Centre Hospitalier de L'Université de Montréal, (CHUM), Montréal, QC, Canada
| | - Karine Bouchard
- Centre Hospitalier Universitaire - CHU de Québec- Université Laval, Québec, QC, Canada
| | - Marie-Andrée Côté
- Innovation Axis, Research Center of the Centre Hospitalier de L'Université de Montréal, (CHUM), Montréal, QC, Canada
| | | | | | - Israël Fortin
- Centre Intégré Universitaire de Santé Et Services Sociaux de L'Est-de-L'Île-de-Montréal, Hôpital Maisonneuve-Rosemont, Montréal, QC, Canada
| | | | - Mélanie Lavoie-Tremblay
- Faculty of Nursing, Université de Montréal, Montréal, QC, Canada
- Institut Universitaire en Santé Mentale de Montréal, Montréal, QC, Canada
| | - Nicolas Fernandez
- Department of Family and Emergency Medicine, Faculty of Medicine, Université de Montréal, Montréal, QC, Canada
| | - Antoine Boivin
- Innovation Axis, Research Center of the Centre Hospitalier de L'Université de Montréal, (CHUM), Montréal, QC, Canada
- Center of Excellence On Patient Partnership and the Public, Montréal, QC, Canada
- Department of Family and Emergency Medicine, Faculty of Medicine, Université de Montréal, Montréal, QC, Canada
| | - Michel Dorval
- Centre Hospitalier Universitaire - CHU de Québec- Université Laval, Québec, QC, Canada
- Université Laval - Faculty of Pharmacy, Québec, QC, Canada
- Centre de Recherche du CHU de Québec - Université Laval, Québec, QC, Canada
- Centre de Recherche du CISSS Chaudière Appalaches, Lévis, QC, Canada
| | - Mado Desforges
- Innovation Axis, Research Center of the Centre Hospitalier de L'Université de Montréal, (CHUM), Montréal, QC, Canada
| | - Catherine Régis
- Université de Montréal - Faculty of Law, Montréal, QC, Canada
| | - Isabelle Ganache
- Institut National d'excellence en Santé Et Services Sociaux (INESSS), Montréal, QC, Canada
| | - Lynda Bélanger
- Centre Hospitalier Universitaire - CHU de Québec- Université Laval, Québec, QC, Canada
| | - Zeev Rosberger
- Gerald Bronfman Department of Oncology, Lady Davis Institute for Medical Research, Jewish General Hospital &, McGill University, Montréal, QC, Canada
| | - Michel Alain Danino
- Innovation Axis, Research Center of the Centre Hospitalier de L'Université de Montréal, (CHUM), Montréal, QC, Canada
- Centre Hospitalier de L'Université de Montréal, Montréal, QC, Canada
| | - Jean-François Pelletier
- Centre Intégré de Santé Et de Services Sociaux de La Montérégie-Ouest, St-Hubert, QC, Canada
- Yale Program for Recovery & Community Health, New Haven, CT, USA
| | - Thi Trinh Thuc Vu
- Centre Hospitalier de L'Université de Montréal, Montréal, QC, Canada
| | - Michèle de Guise
- Institut National d'excellence en Santé Et Services Sociaux (INESSS), Montréal, QC, Canada
| |
Collapse
|
6
|
Pomey MP, Paquette J, Iliescu-Nelea M, Vialaron C, Mourad R, Bouchard K, Normandin L, Côté MA, Desforges M, Pomey-Carpentier P, 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, de Guise M. Accompanying patients in clinical oncology teams: Reported activities and perceived effects. Health Expect 2023; 26:847-857. [PMID: 36704843 PMCID: PMC10010089 DOI: 10.1111/hex.13710] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 01/04/2023] [Accepted: 01/05/2023] [Indexed: 01/28/2023] Open
Abstract
INTRODUCTION Since 2018, four establishments in Quebec, Canada, have decided to implement the PAROLE-Onco programme, which introduced accompanying patients (APs) in healthcare teams to improve the experience of cancer patients. APs are patient advisors who have had a cancer treatment experience and who conduct consultations to complement the service offered by providing emotional, informational and educational support to patients undergoing treatments (e.g., radiotherapy, chemotherapy, surgery), mostly for breast cancer. We aimed to explore the evolution of APs' perspectives regarding their activities within the clinical oncology teams as well as the perceived effects of their intervention with patients, the clinical team and themselves. METHODS A qualitative study based on semistructured interviews and focus groups was conducted with APs at the beginning of their intervention (T1) and 2 years afterwards (T2). The themes discussed were APs' activities and the perceived effects of their interventions on themselves, on the patients and on the clinical team. RESULTS In total, 20 APs were interviewed. In T2, APs' activities shifted from listening and sharing experiences to empowering patients by helping them become partners in their care and felt generally more integrated into the clinical team. APs help patients feel understood and supported, alleviate stress and become partners in the care they receive. They also alleviate the clinical team's workload by offering a complementary service through emotional support, which, according to them, helps patients feel calmer and more prepared for their appointments with healthcare professionals. They communicate additional information about their patients' health journey, which makes the appointment more efficient for healthcare professionals. When APs accompany patients, they feel as if they can make a difference in patients' lives. Their activities are perceived by some as an opportunity to give back but also as a way of giving meaning to their own experience, in turn serving as a learning experience. CONCLUSION By mobilizing their experiential knowledge, APs provide emotional, informational, cognitive and navigational support, which allows patients to be more empowered in their care and which complements professionals' scientific knowledge, thereby helping to refine their sensitivity to the patients' experiences. PATIENT OR PUBLIC CONTRIBUTION Two patient-researchers have contributed to the study design, the conduct of the study, the data analysis and interpretation, as well as in the preparation and writing of this manuscript.
Collapse
Affiliation(s)
- Marie-Pascale Pomey
- Research Centre of the University of Montreal Hospital Centre, Montréal, Quebec, CA.,Centre d'excellence sur le partenariat avec les patients et le public, Montréal, Quebec, CA.,Department of Health Policy, Management and Evaluation, School of Public Health, University of Montréal, Montréal, Quebec, Canada
| | - Jesseca Paquette
- Research Centre of the University of Montreal Hospital Centre, Montréal, Quebec, CA
| | - Monica Iliescu-Nelea
- Research Centre of the University of Montreal Hospital Centre, Montréal, Quebec, CA
| | - Cécile Vialaron
- Research Centre of the University of Montreal Hospital Centre, Montréal, Quebec, CA
| | - Rim Mourad
- Research Centre of the University of Montreal Hospital Centre, Montréal, Quebec, CA
| | - Karine Bouchard
- Centre Hospitalier Universitaire-CHU de Québec-Université Laval, Québec, Québec, Canada
| | - Louise Normandin
- Research Centre of the University of Montreal Hospital Centre, Montréal, Quebec, CA
| | - Marie-Andrée Côté
- Research Centre of the University of Montreal Hospital Centre, Montréal, Quebec, CA
| | - Mado Desforges
- Research Centre of the University of Montreal Hospital Centre, Montréal, Quebec, CA
| | | | - Israël Fortin
- Centre Intégré Universitaire de santé et services sociaux de l'Est-de-l'Île-de Montréal, Hôpital de Maisonneuve-Rosemont, Montréal, Québec, Canada
| | - Isabelle Ganache
- Institut national d'excellence en santé et services sociaux (INESSS), Montréal, Québec, Canada
| | - Catherine Régis
- Université de Montréal-Faculté de Droit, Montréal, Québec, Canada
| | - Zeev Rosberger
- Gerald Bronfman Department of Oncology, Lady Davis Institute for Medical Research, Jewish General Hospital & McGill University, Montréal, Québec, Canada
| | | | - Lynda Bélanger
- Centre Hospitalier Universitaire-CHU de Québec-Université Laval, Québec, Québec, Canada
| | - Michel Dorval
- Centre Hospitalier Universitaire-CHU de Québec-Université Laval, Québec, Québec, Canada.,Université Laval-Faculté de pharmacie, Québec, Québec, Canada.,Centre de recherche du CHU de Québec-Université Laval, Québec, Québec, Canada.,Centre de recherche du CISSS Chaudière Appalaches, Lévis, Québec, Canada
| | | | - Mélanie Lavoie-Tremblay
- Faculté des sciences infirmières, Université de Montréal, Montréal, Québec, Canada.,Institut universitaire en santé mentale de Montréal, Montréal, Québec, Canada
| | - Antoine Boivin
- Research Centre of the University of Montreal Hospital Centre, Montréal, Quebec, CA.,Centre d'excellence sur le partenariat avec les patients et le public, Montréal, Quebec, CA.,Department of Family and Emergency Medicine, Faculté de Médecine, Université de Montréal, Montréal, Québec, Canada
| | - Jean-François Pelletier
- Centre intégré de santé et de services sociaux de la Montérégie-Ouest, St-Hubert, Québec, Canada.,Yale Program for Recovery & Community Health, New Haven, Connecticut, USA
| | - Nicolas Fernandez
- Department of Family and Emergency Medicine, Faculté de Médecine, Université de Montréal, Montréal, Québec, Canada
| | - Alain M Danino
- Research Centre of the University of Montreal Hospital Centre, Montréal, Quebec, CA.,Centre Hospitalier Universitaire de Montréal (CHUM), Montréal, Québec, Canada
| | - Michèle de Guise
- Institut national d'excellence en santé et services sociaux (INESSS), Montréal, Québec, Canada
| |
Collapse
|
7
|
Rivest J, Rouly G, Brouillette MJ, Nguyen O, Desbeaumes Jodoin V. Improving Palliative Care and Medical Assistance in Dying Practice in Canada: How Patients-Partners Could Contribute to Continuing Medical Education. Palliat Med Rep 2023; 4:116-119. [PMID: 37095864 PMCID: PMC10122257 DOI: 10.1089/pmr.2023.0008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/23/2023] [Indexed: 04/26/2023] Open
Abstract
Medical Assistance in Dying (MAiD) is still considered an evolving practice in Canada. Practitioners are facing the challenge of staying up to date and hence need efficient continuing medical education (CME). A patient-partner has been recently invited as a keynote speaker to CME activities in Canada to share her perspectives and views about patient engagement in palliative care and MAiD practice, calling for compassion. To our knowledge, few data exist on patient-partners' contribution to CME on these topics. Based on that experience, we discuss different issues on patient engagement's contribution in such CME events and call for further research.
Collapse
Affiliation(s)
- Jacynthe Rivest
- Department of Psychiatry, Centre Hospitalier de l'Universite de Montreal (CHUM) and Centre de Recherche du CHUM (CRCHUM), Montreal, Québec, Canada
- Address correspondence to: Jacynthe Rivest, MD, MA(Ed), FRCPC, Department of Psychiatry, Centre Hospitalier de l'Universite de Montreal (CHUM) and Centre de Recherche du CHUM (CRCHUM), 1051 rue Sanguinet, Montreal, Québec H2X 0C1, Canada.
| | - Ghislaine Rouly
- Centre of Excellence on Partnership with Patients and the Public, Montreal, Québec, Canada
| | - Marie-Josée Brouillette
- Division of Infectious Diseases and Chronic Viral Illness Service, Department of Medicine, McGill University Health Centre, Montreal, Québec, Canada
- Department of Psychiatry, McGill University Health Centre, Montreal, Québec, Canada
| | - Olivia Nguyen
- Palliative Care Division, CIUSSS du Nord-de-l'Île-de-Montréal, Montreal, Québec, Canada
- Department of Family Medicine and Emergency Medicine, Université de Montréal, Montreal, Québec, Canada
| | - Véronique Desbeaumes Jodoin
- Department of Psychiatry, Centre Hospitalier de l'Universite de Montreal (CHUM) and Centre de Recherche du CHUM (CRCHUM), Montreal, Québec, Canada
| |
Collapse
|
8
|
Rivest J, Desbeaumes Jodoin V, Martineau JT, Folch N, Charpentier D. “I Want to Help Others Like Me”: A Pilot Qualitative Study on Patients’ Participation in a Screening for Distress Program. J Patient Exp 2022; 9:23743735221106593. [PMID: 35719417 PMCID: PMC9203945 DOI: 10.1177/23743735221106593] [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] [Indexed: 11/17/2022] Open
Abstract
Screening for distress was implemented in our academic hospital with the engagement of patients as partners. Little is known about how they appreciate such participation. This pilot qualitative study aimed to explore their experience. Six participants completed a semi-structured interview, which was transcribed verbatim. Thematic analysis was performed on the transcripts. Four themes emerged: “opinions about their participation”, “working with others”, “role of patient partners”, and “barriers encountered”. Mean global satisfaction reported on a Likert scale reached 8.92 over 10. Our preliminary findings suggest that patients-as-partners appreciated their participation, and also identified barriers that should be explored in future quality improvement (QI) projects.
Collapse
Affiliation(s)
- Jacynthe Rivest
- Department of Psychiatry, Centre Hospitalier de l'Université de Montréal (CHUM), Montréal, Canada
| | | | | | - Nathalie Folch
- Nursing Directorate (ND), Centre Hospitalier de l'Université de Montréal (CHUM), Montréal, Québec, Canada
| | - Danielle Charpentier
- Department of Medicine, Centre Hospitalier de l'Université de Montréal (CHUM), Montréal, Canada
| |
Collapse
|
9
|
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. Correction to: The patient advisor, an organizational resource as a lever for an enhanced oncology patient experience (PAROLEonco): a longitudinal multiple case study protocol. BMC Health Serv Res 2021; 21:67. [PMID: 33446153 PMCID: PMC7807428 DOI: 10.1186/s12913-021-06065-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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 Pomey et al. BMC Health Services Research (2021) 21:10 Page 10 of 12 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, Montréal, 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
| |
Collapse
|