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Young K, Xiong T, Pfisterer KJ, Ng D, Jiao T, Lohani R, Nunn C, Bryant-Lukosius D, Rendon R, Berlin A, Bender J, Brown I, Feifer A, Gotto G, Cafazzo JA, Pham Q. A qualitative study on healthcare professional and patient perspectives on nurse-led virtual prostate cancer survivorship care. COMMUNICATIONS MEDICINE 2023; 3:159. [PMID: 37919491 PMCID: PMC10622495 DOI: 10.1038/s43856-023-00387-6] [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: 05/11/2023] [Accepted: 10/12/2023] [Indexed: 11/04/2023] Open
Abstract
BACKGROUND Virtual nurse-led care models designed with health care professionals (HCPs) and patients may support addressing unmet prostate cancer (PCa) survivor needs. Within this context, we aimed to better understand the optimal design of a service model for a proposed nurse-led PCa follow-up care platform (Ned Nurse). METHODS A qualitative descriptive study exploring follow-up and virtual care experiences to inform a nurse-led virtual clinic (Ned Nurse) with an a priori convenience sample of 10 HCPs and 10 patients. We provide a health ecosystem readiness checklist mapping facilitators onto CFIR and Proctor's implementation outcomes. RESULTS We show that barriers within the current standard of care include: fragmented follow-up, patient uncertainty, and long, persisting wait times despite telemedicine modalities. Participants indicate that a nurse-led clinic should be scoped to coordinate care and support patient self-management, with digital literacy considerations. CONCLUSION A nurse-led follow-up care model for PCa is seen by HCPs as acceptable, feasible, and appropriate for care delivery. Patients value its potential to provide role clarity, reinforce continuity of care, enhance mental health support, and increase access to timely and targeted care. These findings inform design, development, and implementation strategies for digital health interventions within complex settings, revealing opportunities to optimally situate these interventions to improve care.
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Affiliation(s)
- Karen Young
- Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, ON, Canada
- Centre for Digital Therapeutics, University Health Network, Toronto, ON, Canada
| | - Ting Xiong
- Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, ON, Canada
- Centre for Digital Therapeutics, University Health Network, Toronto, ON, Canada
| | - Kaylen J Pfisterer
- Centre for Digital Therapeutics, University Health Network, Toronto, ON, Canada
- Systems Design Engineering, University of Waterloo, Waterloo, ON, Canada
| | - Denise Ng
- Centre for Digital Therapeutics, University Health Network, Toronto, ON, Canada
| | - Tina Jiao
- Centre for Digital Therapeutics, University Health Network, Toronto, ON, Canada
| | - Raima Lohani
- Centre for Digital Therapeutics, University Health Network, Toronto, ON, Canada
| | - Caitlin Nunn
- Centre for Digital Therapeutics, University Health Network, Toronto, ON, Canada
| | | | - Ricardo Rendon
- Department of Urology, Queen Elizabeth II Health Sciences Centre, Halifax, ON, Canada
| | - Alejandro Berlin
- Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
| | - Jacqueline Bender
- Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, ON, Canada
- Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Ian Brown
- Division of Urology, Niagara Health System, Saint Catharines, ON, Canada
| | - Andrew Feifer
- Institute for Better Health, Trillium Health Partners, Mississauga, ON, Canada
| | - Geoffrey Gotto
- Division of Urology, University of Calgary, Calgary, AB, Canada
| | - Joseph A Cafazzo
- Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, ON, Canada
- Centre for Digital Therapeutics, University Health Network, Toronto, ON, Canada
| | - Quynh Pham
- Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, ON, Canada.
- Centre for Digital Therapeutics, University Health Network, Toronto, ON, Canada.
- Telfer School of Management, University of Ottawa, Ottawa, ON, Canada.
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Halvorsen U, Bjørnnes AK, Ljosaa TM. Nurse-Led Telephone Follow-Up Intervention for Titrating and Tapering Opioids in Chronic Pain Patients - A Feasibility Study. J Pain Res 2023; 16:1285-1300. [PMID: 37090765 PMCID: PMC10120593 DOI: 10.2147/jpr.s394878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Accepted: 03/08/2023] [Indexed: 04/25/2023] Open
Abstract
Background and Purpose Opioids in chronic non-cancer pain are debated, but remain a part of the pain treatment for selected patients. Research is scarce on the relieving and adverse effects of opioids, and how to deliver opioid treatment in this patient group. This study's purpose was to assess the feasibility of a nurse-led telephone follow-up intervention for titrating or tapering opioids, including a pilot study of the intervention outcomes. Patients and Methods The feasibility assessment and process evaluation were performed according to the UK Medical Research Council (MRC) framework for evaluating complex interventions. A pilot study of the intervention outcomes was also performed. With a retrospective, descriptive, and longitudinal approach, we analyzed reports from 32 patients who titrated or tapered opioids. Information on demography, sleep satisfaction, health status, pain intensity/bothersomeness, opioid doses, and side effects was derived from the Oslo Pain Registry. Descriptive statistics, t-tests, and chi-square tests were used to analyze registry data. Results The study findings indicate that the intervention is feasible. Areas of impact were lack of a sound theory basis, unclear allocation criteria, and inconsistent and non-validated measurement tools. Mechanisms of change were interprofessional collaboration, nurses' knowledge and competencies, predictability, and availability. Statistical analyses showed no between-groups differences in demographical-, clinical-, and pain characteristics, except those who titrated opioids were significantly older than patients tapering opioids (P=0.010). All patients reported poor health and side effects at baseline. Those who tapered opioids had a significant reduction in opioid use (P=0.004). Titrating opioids was associated with a significant increase in side effects (P=0.038). Conclusion Considering the limitations and the strengths of the intervention, the present study indicates that the nurse-led telephone follow-up program is a feasible intervention. With the right adjustments and improvements, the intervention is eligible for a larger efficacy study.
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Affiliation(s)
- Unni Halvorsen
- Department of Pain Management and Research, Oslo University Hospital, Oslo, Norway
- Correspondence: Unni Halvorsen, Department of Pain Management and Research, Oslo University Hospital, Pb 4950 Nydalen, Oslo, 0424, Norway, Tel + 47 23 02 61 61, Fax + 47 23 02 74 02, Email
| | - Ann Kristin Bjørnnes
- Institute of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway
| | - Tone Marte Ljosaa
- Department of Pain Management and Research, Oslo University Hospital, Oslo, Norway
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Presentation, follow-up, and outcomes among African/Afro-Caribbean men on active surveillance for prostate cancer: experiences of a high-volume UK centre. Prostate Cancer Prostatic Dis 2021; 24:549-557. [PMID: 33558659 DOI: 10.1038/s41391-020-00313-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Revised: 11/10/2020] [Accepted: 12/04/2020] [Indexed: 11/08/2022]
Abstract
BACKGROUND Experiences of African/Afro-Caribbean men on active surveillance (AS) for prostate cancer (PCa) in the United Kingdom (UK) are not well documented. We compared follow-up appointments, adherence, and clinical outcomes among African/Afro-Caribbean men on AS at a high-volume UK hospital with other ethnicities. METHODS Men with confirmed low-intermediate risk Pca who attended the AS clinic (2005-2016) and had undergone ≥1 follow-up biopsy (n = 458) were included. Non-adherence (defined as >20% missed appointments), suspicion of disease progression (any upgrading, >30% positive cores, cT-stage > 3, PIRADS > 3), any upgrading from diagnostic biopsy and conversion to active treatment (prostatectomy, radiotherapy or hormone therapy) according to ethnicity (African/Afro-Caribbean versus other ethnicities) were assessed using multivariable regression analysis. RESULTS Twenty-three percent of eligible men were recorded as African/Afro-Caribbean, while the remainder were predominantly Caucasian. African/Afro-Caribbean men had slightly lower PSA at diagnosis (median 5.0 vs. 6.0 ng/mL) and more positive cores at diagnosis (median 2 vs. 1). They had a substantially higher rate of non-attendance at scheduled follow-up visits (24% vs. 10%, p < 0.001). Adjusted analyses suggest African/Afro-Caribbean men may be at increased risk of disease progression (hazard ratio [HR]: 1.38; 95% confidence interval [CI] 0.99-1.91, P = 0.054) and upgrading (HR: 1.29; 95% CI 0.87-1.92, P = 0.305), though neither reached statistical significance. No difference in risk of conversion to treatment was observed between ethnic groups (HR: 1.03; 95% CI 0.64-1.47, P = 0.873). CONCLUSIONS African/Afro-Caribbean men on AS for PCa in the UK are less likely to adhere to scheduled appointments, suggesting a more tailored service addressing their specific needs may be required. While African/Afro-Caribbean men were no more likely to convert to treatment than Caucasian/other men, findings of a potentially higher risk of disease progression signal the need for careful selection and monitoring of African/Afro-Caribbean men on AS. Larger prospective, multicentre studies with longer follow-up are required to provide more definitive conclusions.
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4
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Wong A, Glogolia M, Lange PW, Dale S, Chappell M, Soosay Raj T, Hanna D, Devaraja L, Williams C, Williamson J, Conyers R. A nurse-led paediatric oncology fast-track clinic proves a successful ambulatory intervention for patients. Support Care Cancer 2020; 28:4395-4403. [PMID: 31919665 DOI: 10.1007/s00520-019-05250-w] [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: 03/03/2019] [Accepted: 12/16/2019] [Indexed: 11/25/2022]
Abstract
AIM To assess the impact of a pilot nurse-led paediatric oncology fast-track clinic (OFTC) for complications and side effects following chemotherapy within a paediatric tertiary hospital. METHODS Prospective clinical data from the first 100 patients seen in the OFTC were compared with retrospective data of oncology patient presentations to the emergency department (ED) (over a 1-year period, n = 196) who would have been eligible for review in the OFTC. Parent and patient satisfaction of clinical care were also assessed via surveys pre- and post-OFTC implementation. RESULTS Analysis which achieved statistical difference was a reduction in the number of blood tubes taken in OFTC (average 1.9 for those discharged from clinic, 2.9 for those admitted from clinic) in comparison to those seen in the ED (average 3.2) (p = 0.0027). The average number of interventions per patient seen in the ED were 2.1 (standard deviation 1.64) compared with 1.7 (standard deviation 1.55) interventions per patient seen in the OFTC, and who were not admitted following review. This result approached statistical significance with p = 0.0963. Other results which did not meet statistical significance included a reduction in treatment times, hospital admissions and medical oncology reviews. CONCLUSION Our pilot study implementing an OFTC for the triage and assessment of chemotherapy-related complications has proven successful from an operational and consumer perspective. The clinic improved care by ensuring expedited review, more streamlined interventions, and less overall hospital admissions. The improvements in efficiency were also mirrored by increased parent and patient satisfaction.
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Affiliation(s)
- A Wong
- The Children's Cancer Centre, The Royal Children's Hospital, Melbourne, Australia
| | - M Glogolia
- The Children's Cancer Centre, The Royal Children's Hospital, Melbourne, Australia
| | - P W Lange
- Department of Medicine, Melbourne University, Melbourne, Australia
| | - S Dale
- The Children's Cancer Centre, The Royal Children's Hospital, Melbourne, Australia
| | - M Chappell
- The Children's Cancer Centre, The Royal Children's Hospital, Melbourne, Australia
| | - T Soosay Raj
- The Children's Cancer Centre, The Royal Children's Hospital, Melbourne, Australia
| | - D Hanna
- The Children's Cancer Centre, The Royal Children's Hospital, Melbourne, Australia
| | - L Devaraja
- Department of Paediatrics, Melbourne University, Melbourne, Australia
| | - C Williams
- The Children's Cancer Centre, The Royal Children's Hospital, Melbourne, Australia.,The Paediatric Integrated Cancer Service (PICS), Melbourne, Australia
| | - J Williamson
- The Paediatric Integrated Cancer Service (PICS), Melbourne, Australia
| | - R Conyers
- The Children's Cancer Centre, The Royal Children's Hospital, Melbourne, Australia. .,Department of Paediatrics, Melbourne University, Melbourne, Australia. .,Murdoch Children's Research Institute, Melbourne, Australia.
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Effect of Postoperative Telephone Calls on Patient Satisfaction and Scar Satisfaction After Mohs Micrographic Surgery. Dermatol Surg 2019; 45:1459-1464. [DOI: 10.1097/dss.0000000000001913] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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6
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Basketter V, Benney M, Causer L, Fleure L, Hames D, Jones S, Patel K, White L. Continuous, comprehensive and crucial care: The role of the CNS in the metastatic castration-resistant prostate cancer patient pathway. ACTA ACUST UNITED AC 2019; 27:S1-S8. [PMID: 29461871 DOI: 10.12968/bjon.2018.27.sup4b.s1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Several treatment options are now available to men with metastatic castration-resistant prostate cancer (mCRPC). While survival rates for mCRPC continue to improve, patients are faced with increasingly complex treatment pathways and decisions. The clinical nurse specialist (CNS) plays a crucial role in navigating patients with mCRPC through their treatment pathway and fulfils a number of key responsibilities, including providing holistic care and support to patients and their families, educating and communicating with them in a timely and effective manner, and liaising with other healthcare professionals to seamlessly coordinate patient treatment. However, increasing patient caseloads and administrative duties are leaving CNSs with little time to fulfil their supportive role. Additional resources are needed in order to both promote and preserve this supportive role, thus ensuring that mCRPC patients receive the best possible care.
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Affiliation(s)
- Vanessa Basketter
- Advanced Prostate Cancer Nurse Specialist, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Miranda Benney
- Macmillan Uro-oncology Clinical Nurse Specialist, Plymouth Hospitals NHS Trust, Plymouth, UK
| | - Louise Causer
- Clinical Nurse Specialist for Radioisotope Therapy, Royal Marsden NHS Foundation Trust, London, UK
| | - Louisa Fleure
- Lead Urology Clinical Nurse Specialist/Prostate Cancer Advanced Nurse Practitioner, Guy's and St. Thomas' NHS Foundation Trust, London, UK
| | - David Hames
- Advanced Prostate Cancer Specialist Nurse, Leicester Royal Infirmary, Leicester, UK
| | - Sarah Jones
- Prostate Advanced Nurse Practitioner, Clatterbridge Cancer Centre NHS Foundation Trust, Bebington, UK
| | - Kamlesh Patel
- Urology Trainee Nurse Clinician, Christie NHS Foundation Trust, Manchester, UK
| | - Lisa White
- Advanced Prostate Cancer Clinical Nurse Specialist, Leeds Teaching Hospitals NHS Trust, Leeds, UK
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Eldeib HK, Abbassi MM, Hussein MM, Salem SE, Sabry NA. The Effect of Telephone-Based Follow-Up on Adherence, Efficacy, and Toxicity of Oral Capecitabine-Based Chemotherapy. Telemed J E Health 2019; 25:462-470. [DOI: 10.1089/tmj.2018.0077] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Affiliation(s)
- Hend K. Eldeib
- Department of Clinical Pharmacy and Pharmacy Practice, Faculty of Pharmacy, Cairo University, Cairo, Egypt
| | - Maggie M. Abbassi
- Department of Clinical Pharmacy and Pharmacy Practice, Faculty of Pharmacy, Cairo University, Cairo, Egypt
| | - Marwa M. Hussein
- Department of Medical Oncology, National Cancer Institute, Cairo University, Cairo, Egypt
| | - Salem E. Salem
- Department of Medical Oncology, National Cancer Institute, Cairo University, Cairo, Egypt
| | - Nirmeen A. Sabry
- Department of Clinical Pharmacy and Pharmacy Practice, Faculty of Pharmacy, Cairo University, Cairo, Egypt
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8
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Abstract
Differences in health care satisfaction can alter patterns of health care utilization and so affect health outcomes, but little is known about variation in satisfaction in relation to immigration status. Health care satisfaction is analyzed with survey data from state public health program patients. Overall health care satisfaction is higher for first generation Hispanic immigrants and lower among those in the second generation compared to white Americans-consistent with the pattern termed the "healthy migrant effect." This pattern is more pronounced for Portuguese-speaking immigrants and is not explained by self-reported health, communication ability or acculturation. Satisfaction with specific aspects of health care follows different patterns that may be explained by differences in experiences and culture. As anticipated by segmented assimilation theory, we find variation in cross-generational patterns of health care satisfaction both within and between ethnic groups. This variation indicates the importance of distinguishing Portuguese-speakers from Spanish-speakers and of taking into account differences in the ways they are able to communicate with health care providers as well as differences in their orientations toward health care. Our disparate findings with other immigrant groups also reinforce limiting expectations of a "healthy migrant effect" to Latinos. Finally, the variable influences on different satisfaction measures indicate the importance of considering the relative influence of culturally-based orientations and health care experiences on the specific outcomes measured, with particular sensitivity to acceptance of individualized standards of care.
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9
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Meunier-Beillard N, Ponthier N, Lepage C, Gagnaire A, Gheringuelli F, Bengrine L, Boudrant A, Rambach L, Quipourt V, Devilliers H, Lejeune C. Identification of resources and skills developed by partners of patients with advanced colon cancer: a qualitative study. Support Care Cancer 2018; 26:4121-4131. [PMID: 29872944 DOI: 10.1007/s00520-018-4283-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2017] [Accepted: 05/21/2018] [Indexed: 11/28/2022]
Abstract
PURPOSE Family caregivers play an important role in caring for patients with advanced cancer. To become competent, individuals must draw on and mobilise an adequate combination of resources. Our goal was to identify the skills developed by caregivers of patients with advanced cancer and the associated resources mobilised. We chose to do it with partners of patients with colon cancer. METHODS The study used a cross-sectional qualitative design based on 20 individual interviews and a focus group. Partners were recruited from patients treated in three hospitals of France. Semi-structured interviews were conducted until data saturation was achieved. Each interview was transcribed verbatim, and thematic analyses were performed to extract significant themes and subthemes. RESULTS Results from the individual and focus group interviews showed that the skills implemented by the partners (in domains of social relationships and health, domestic, organisational, emotional and well-being dimensions) were singular constructs, dependant on if resources (personal, external and schemes) may have been missing and insufficient. In addition, partners may have had these resources but not mobilised them. CONCLUSION The identification of the skills and associated resources could allow healthcare professionals better identifying and understanding of the difficulties met by partners in taking care of patients. This could enable them to offer appropriate support to help the caregivers in their accompaniment.
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Affiliation(s)
- N Meunier-Beillard
- Centres Georges Chevrier UMR 7366 CNRS-Univ. Bourgogne Franche-Comte, Dijon, France
| | | | - C Lepage
- EPICAD LNC-UMR1231, Burgundy and Franche-Comte University, Dijon, France.,Department of Hepato-Gastroenterology and Digestive Oncology, Dijon University Hospital, BP 87900 21079 Dijon, EPICAD LNC-UMR1231, Burgundy and Franche-Comte University, Dijon, France
| | - A Gagnaire
- Department of Hepato-Gastroenterology and Digestive Oncology, Dijon University Hospital, BP 87900 21079 Dijon, EPICAD LNC-UMR1231, Burgundy and Franche-Comte University, Dijon, France
| | - F Gheringuelli
- Department of Medical Oncology, Center Georges Francois Leclerc Dijon, Dijon, France.,CADIR LNC-UMR1231, Burgundy and Franche-Comte University, Dijon, France
| | - L Bengrine
- Department of Medical Oncology, Center Georges Francois Leclerc Dijon, Dijon, France
| | - A Boudrant
- Department of Hepato-gastroenterology, Wiliam Morey Hospital, Chalon-sur-Saône, France
| | - L Rambach
- CADIR LNC-UMR1231, Burgundy and Franche-Comte University, Dijon, France
| | - V Quipourt
- Hopital de jour gériatrique, centre de Champmaillot, CHU, Dijon, France
| | - H Devilliers
- EPICAD LNC-UMR1231, Burgundy and Franche-Comte University, Dijon, France.,Inserm CIC1432, Clinical Epidemiology Unit, Dijon University Hospital, 7 bd Jeanne d'Arc, BP 87900, 21079, Dijon Cedex, France
| | - Catherine Lejeune
- EPICAD LNC-UMR1231, Burgundy and Franche-Comte University, Dijon, France. .,Inserm CIC1432, Clinical Epidemiology Unit, Dijon University Hospital, 7 bd Jeanne d'Arc, BP 87900, 21079, Dijon Cedex, France.
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Najafi Ghezeljeh T, Sharifian S, Nasr Isfahani M, Haghani H. Comparing the effects of education using telephone follow-up and smartphone-based social networking follow-up on self-management behaviors among patients with hypertension. Contemp Nurse 2018; 54:362-373. [PMID: 29451091 DOI: 10.1080/10376178.2018.1441730] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND Little is known about the benefits of social networks in the management of patients. OBJECTIVE The aim of this study was to compare the effects of self-management (SM) education using telephone follow-up and mobile phone-based social networking on SM behaviors among patients with hypertension. METHODS This randomized clinical trial was conducted with 100 patients. They were randomly allocated to four groups: (i) control, (ii) SM training without follow-up, (iii) telephone follow-up and (iv) smartphone-based social networking follow-up. The hypertension SM behavior questionnaire was used for data collection before and six weeks after the study. RESULTS Those patients who underwent SM education training (with and without follow-up) had statistically significant differences from those in the control group in terms of SM behaviors (p < .001). There was no statistically significant difference between different types of follow-up. CONCLUSION SM education using telephone follow-up and/or smartphone-based social networking follow-up influenced SM behaviors among patients with hypertension.
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Affiliation(s)
- Tahereh Najafi Ghezeljeh
- a Department of Critical Care Nursing, School of Nursing and Midwifery , Iran University of Medical Sciences , Rashid Yasemi St., Valiasr St., Tehran , Iran
| | - Sanaz Sharifian
- b Department of Medical-Surgical Nursing, School of Nursing and Midwifery , Iran University of Medical Sciences , Rashid Yasemi St., Valiasr St., Tehran , Iran
| | - Mehdi Nasr Isfahani
- c Department of Emergency Medicine , Emergency Medicine Research Center, Al-Zahra Research Institute, Isfahan University of Medical Sciences , Isfahan , Iran
| | - Hamid Haghani
- d Statistic and Mathematics Department, School of Nursing and Midwifery , Iran University of Medical Sciences , Tehran , Iran
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11
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Casey RG, Powell L, Braithwaite M, Booth CM, Sizer B, Corr JG. Nurse-Led Phone Call Follow-Up Clinics Are Effective for Patients With Prostate Cancer. J Patient Exp 2017; 4:114-120. [PMID: 28959716 PMCID: PMC5593262 DOI: 10.1177/2374373517706613] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Introduction: The rising cost of healthcare requires rethinking in terms of resource utilisation care delivery. Nurse-led PSA phone follow-up clinics may provide a suitable option. Materials and methods: 815 patients were recruited for the nurse-led stable prostate cancer telephone follow-up service. A convenience sample was selected for postal questionnaire assessment of their satisfaction. Results: 815 patients had 3683 phone-call follow ups over 10 years. Patients’ own understanding of condition varied from average (76.3%) and good (9.2%) in the majority. 87.2% found the service convenient and 75.6% informative. 95.3% found the telephone assessment preferable to attending the outpatient department. 87.2% were keen on savings on transport/travel. 53.5% found it more reassuring. 91.9% of patients felt that everything they wanted to talk about was covered. Discussion: This service can be delivered in a high volume nurse-led service, with high levels of patient satisfaction, as an innovative service development.
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Affiliation(s)
- RG Casey
- Department of Urologic Oncology, Essex Cancer Centre, Colchester University Hospital NHS Foundation Trust, Colchester, Essex, United Kingdom
- RG Casey, Department of Urologic Oncology, Colchester University Hospital NHS Foundation Trust, Turner Road, Colchester, Essex CO45JL, United Kingdom.
| | - L Powell
- Department of Urologic Oncology, Essex Cancer Centre, Colchester University Hospital NHS Foundation Trust, Colchester, Essex, United Kingdom
| | - M Braithwaite
- Department of Urologic Oncology, Essex Cancer Centre, Colchester University Hospital NHS Foundation Trust, Colchester, Essex, United Kingdom
| | - CM Booth
- Department of Urologic Oncology, Essex Cancer Centre, Colchester University Hospital NHS Foundation Trust, Colchester, Essex, United Kingdom
| | - B Sizer
- Department of Radiation and Medical Oncology, Essex County Hospital and Essex Cancer Centre, Colchester University Hospital NHS Foundation Trust, Colchester, Essex, United Kingdom
| | - JG Corr
- Department of Urologic Oncology, Essex Cancer Centre, Colchester University Hospital NHS Foundation Trust, Colchester, Essex, United Kingdom
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12
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Lai XB, Ching SSY, Wong FKY. Nurse-led cancer care: A scope review of the past years (2003-2016). Int J Nurs Sci 2017; 4:184-195. [PMID: 31406741 PMCID: PMC6626125 DOI: 10.1016/j.ijnss.2017.02.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2016] [Revised: 01/23/2017] [Accepted: 02/21/2017] [Indexed: 12/25/2022] Open
Affiliation(s)
- Xiao Bin Lai
- School of Nursing, Fudan University, Shanghai, China
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13
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Liptrott S, Bee P, Lovell K. Acceptability of telephone support as perceived by patients with cancer: A systematic review. Eur J Cancer Care (Engl) 2017; 27. [PMID: 28134475 DOI: 10.1111/ecc.12643] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/05/2016] [Indexed: 12/31/2022]
Abstract
Telephone-based interventions can increase accessibility to healthcare and are increasingly used as a convenient method of providing support. We conducted a systematic review of published literature reporting adult patients' perceptions of the acceptability of, and satisfaction with, telephone-based interventions during or post-treatment for cancer. Systematic searches identified 4,855 articles. Forty-eight articles describing 50 studies were included in the review. Three intervention categories were identified post hoc: (1) telephone follow-up in lieu of routine hospital follow-up, (2) telephone interventions for treatment side-effect monitoring and toxicity management supplementary to usual care, and (3) supplementary psycho-educational telephone interventions. Across studies, some consistent findings emerged. Positive perceptions emphasised the convenience of telephone interventions and increased accessibility to care. Conflicting perceptions of the quality of the support received, the impact of telecare on the patient-healthcare professional relationship and the need for such interventions emerged. In conclusion, the evidence base relating to patients' perceptions of telephone-based interventions is increasing. Interpretation of findings is currently limited by methodological limitations in the primary research. The instruments chosen to assess patient satisfaction quantitatively do not always reflect the patient-centred priorities that emerge from qualitative data. Subsequent research would benefit from well-designed qualitative studies and patient-centred outcome measures to ensure that the individuality of participants' positive and negative experiences is captured.
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Affiliation(s)
- S Liptrott
- European Institute of Oncology, Milan, Italy
| | - P Bee
- School of Nursing, Midwifery and Social Work, University of Manchester, Manchester, UK
| | - K Lovell
- School of Nursing, Midwifery and Social Work, University of Manchester, Manchester, UK
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14
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da Mata LRF, da Silva AC, Pereira MDG, de Carvalho EC. Telephone follow-up of patients after radical prostatectomy: a systematic review. Rev Lat Am Enfermagem 2016; 22:337-45. [PMID: 26107844 PMCID: PMC4292600 DOI: 10.1590/0104-1169.3314.2421] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2013] [Accepted: 09/23/2013] [Indexed: 03/09/2023] Open
Abstract
OBJECTIVE to assess and summarize the best scientific evidence from randomized controlled clinical trials about telephone follow-up of patients after radical prostatectomy, based on information about how the phone calls are made and the clinical and psychological effects for the individuals who received this intervention. METHOD the search was undertaken in the electronic databases Medline, Web of Science, Embase, Cinahl, Lilacs and Cochrane. Among the 368 references found, five were selected. RESULTS two studies tested interventions focused on psychological support and three tested interventions focused on the physical effects of treatment. The psychoeducative intervention to manage the uncertainty about the disease and the treatment revealed statistically significant evidences and reduced the level of uncertainty and anguish it causes. CONCLUSION the beneficial effects of telephone follow-up could be determined, as a useful tool for the monitoring of post-prostatectomy patients.
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Zhou ES, Bober SL, Nekhlyudov L, Hu JC, Kantoff PW, Recklitis CJ. Physical and emotional health information needs and preferences of long-term prostate cancer survivors. PATIENT EDUCATION AND COUNSELING 2016; 99:2049-2054. [PMID: 27439668 PMCID: PMC5675563 DOI: 10.1016/j.pec.2016.07.017] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/04/2016] [Revised: 06/22/2016] [Accepted: 07/12/2016] [Indexed: 05/24/2023]
Abstract
OBJECTIVE Many men diagnosed with prostate cancer (PC) will experience physical and psychosocial late effects of treatment. Their interest/preferences for receiving information about addressing common sequelae is not well understood. We examined long-term PC survivors' level of interest, whether this differed based upon symptomatology, and their preferred coping information source. METHODS N=615 PC survivors (3-8 years post-diagnosis) completed a survey on physical and psychological health and their information interests and preferences related to late effects of cancer treatment. RESULTS Over half of PC survivors reported interest in information about late effects of treatment or sexual health, while approximately a quarter were interested in emotional health information. Survivors preferred to receive information about late effects of treatment from their oncologists, sexual health information from their primary care providers (PCP), oncologist, or written/online resources, and emotional health information from their PCP. Information needs were more commonly reported among men with poorer domain-specific health functioning. CONCLUSION Long-term PC survivors report significant interest in receiving information about their physical, sexual, and emotional health. PRACTICE IMPLICATIONS Medical providers caring for these men should inquire about survivors' information needs and future intervention efforts should consider who delivers the information, dependent upon the type of dysfunction reported.
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Affiliation(s)
- Eric S Zhou
- Perini Family Survivors' Center, Dana-Farber Cancer Institute, 450 Brookline Avenue, Boston, MA, USA; Department of Pediatrics, Harvard Medical School, 25 Shattuck Street, Boston, MA, USA.
| | - Sharon L Bober
- Perini Family Survivors' Center, Dana-Farber Cancer Institute, 450 Brookline Avenue, Boston, MA, USA; Department of Pediatrics, Harvard Medical School, 25 Shattuck Street, Boston, MA, USA.
| | - Larissa Nekhlyudov
- Perini Family Survivors' Center, Dana-Farber Cancer Institute, 450 Brookline Avenue, Boston, MA, USA; Department of Pediatrics, Harvard Medical School, 25 Shattuck Street, Boston, MA, USA.
| | - Jim C Hu
- Department of Urology, Weill Cornell Medical Center, 1300 York Avenue, New York, NY, USA.
| | - Philip W Kantoff
- Department of Medicine, Memorial Sloan Kettering Cancer Center, 600 Third Avenue, New York, NY, USA.
| | - Christopher J Recklitis
- Perini Family Survivors' Center, Dana-Farber Cancer Institute, 450 Brookline Avenue, Boston, MA, USA; Department of Pediatrics, Harvard Medical School, 25 Shattuck Street, Boston, MA, USA.
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Yassaie O, McLaughlin B, Perera M, Manning T, Lawrentschuk N, Malcolm A. Primary care follow-up of radical prostatectomy patients: A regional New Zealand experience. Prostate Int 2016; 4:136-139. [PMID: 27995112 PMCID: PMC5153434 DOI: 10.1016/j.prnil.2016.07.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2016] [Revised: 07/20/2016] [Accepted: 07/25/2016] [Indexed: 11/29/2022] Open
Abstract
Background Contemporary recommendations regarding the duration of follow-up after radical prostatectomy (RP) are highly heterogeneous. Protocol-based follow-up schemes have been implemented to facilitate the expeditious identification of patients with recurrence. The aim of this study is to assess the reliability and comfort of general practitioners (GPs) in follow-up of RP. Methods Following institutional ethical approval, we performed a retrospective review in patients undergoing follow-up after RP between January 2004 and December 2010. Patient factors, disease variables, and follow-up prostate specific antigen (PSA) compliance was collected. “Noncompliant” follow-up care was defined as: patients that had not received a PSA for a 14 month period within 5 years of prostatectomy. Patient and disease-based risk factors for noncompliant follow-up were assessed. GPs were also surveyed in their follow-up practice of RP patients, to assess their familiarity in caring for these patients. Results In total, 65 cases were identified that met the inclusion criteria. At 60 months of follow-up, 66% (43/65) of patients had a compliant follow-up regime. For patients with noncompliant follow-up at 60 months, median time of compliance did not differ significantly when assessing preoperative PSA, Gleason sum, extraprostatic extension, or surgical margin status. Of the GPs surveyed, 68% of GPs felt comfortable in follow-up of RP patients. Some 62% of GPs would expect the PSA to be < 0.1 and 25% of GPs would measure the PSA annually. Conclusion Our study identified that follow-up by GPs after RP is insufficient. Accordingly, there is a requirement for formal educational programs if primary care is to take a greater role in follow-up of these patients.
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Affiliation(s)
- Omid Yassaie
- Department of Surgery, Nelson Marlborough District Health Board, Nelson, New Zealand; Department of Surgery, Capital and Coast District Health Board, Wellington, New Zealand
| | - Ben McLaughlin
- Department of Surgery, Nelson Marlborough District Health Board, Nelson, New Zealand
| | - Marlon Perera
- Department of Surgery, Austin Health, University of Melbourne, Australia
| | - Todd Manning
- Department of Surgery, Austin Health, University of Melbourne, Australia
| | - Nathan Lawrentschuk
- Department of Surgery, Austin Health, University of Melbourne, Australia; Olivia Newton-John Cancer Research Institute, Melbourne, Australia; Department of Surgical Oncology, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - Andrew Malcolm
- Department of Surgery, Nelson Marlborough District Health Board, Nelson, New Zealand
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Belun-Vieira I, McInness D, Sheriff MK. In the case of prostate cancer patients, are there advantages in cancer nurse-led follow-up? INTERNATIONAL JOURNAL OF UROLOGICAL NURSING 2016. [DOI: 10.1111/ijun.12112] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Wade J, Holding PN, Bonnington S, Rooshenas L, Lane JA, Salter CE, Tilling K, Speakman MJ, Brewster SF, Evans S, Neal DE, Hamdy FC, Donovan JL. Establishing nurse-led active surveillance for men with localised prostate cancer: development and formative evaluation of a model of care in the ProtecT trial. BMJ Open 2015; 5:e008953. [PMID: 26384727 PMCID: PMC4577970 DOI: 10.1136/bmjopen-2015-008953] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2015] [Revised: 08/18/2015] [Accepted: 08/21/2015] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVES To develop a nurse-led, urologist-supported model of care for men managed by active surveillance or active monitoring (AS/AM) for localised prostate cancer and provide a formative evaluation of its acceptability to patients, clinicians and nurses. Nurse-led care, comprising an explicit nurse-led protocol with support from urologists, was developed as part of the AM arm of the Prostate testing for cancer and Treatment (ProtecT) trial. DESIGN Interviews and questionnaire surveys of clinicians, nurses and patients assessed acceptability. SETTING Nurse-led clinics were established in 9 centres in the ProtecT trial and compared with 3 non-ProtecT urology centres elsewhere in UK. PARTICIPANTS Within ProtecT, 22 men receiving AM nurse-led care were interviewed about experiences of care; 11 urologists and 23 research nurses delivering ProtecT trial care completed a questionnaire about its acceptability; 20 men managed in urology clinics elsewhere in the UK were interviewed about models of AS/AM care; 12 urologists and three specialist nurses working in these clinics were also interviewed about management of AS/AM. RESULTS Nurse-led care was commended by ProtecT trial participants, who valued the flexibility, accessibility and continuity of the service and felt confident about the quality of care. ProtecT consultant urologists and nurses also rated it highly, identifying continuity of care and resource savings as key attributes. Clinicians and patients outside the ProtecT trial believed that nurse-led care could relieve pressure on urology clinics without compromising patient care. CONCLUSIONS The ProtecT AM nurse-led model of care was acceptable to men with localised prostate cancer and clinical specialists in urology. The protocol is available for implementation; we aim to evaluate its impact on routine clinical practice. TRIAL REGISTRATION NUMBERS NCT02044172; ISRCTN20141297.
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Affiliation(s)
- Julia Wade
- School of Social and Community Medicine, University of Bristol, UK
| | - Peter N Holding
- Nuffield Department of Surgical Sciences, University of Oxford, Churchill Hospital, Oxford, UK
| | - Susan Bonnington
- Nuffield Department of Surgical Sciences, University of Oxford, Churchill Hospital, Oxford, UK
| | - Leila Rooshenas
- School of Social and Community Medicine, University of Bristol, UK
| | - J Athene Lane
- School of Social and Community Medicine, University of Bristol, UK
| | | | - Kate Tilling
- School of Social and Community Medicine, University of Bristol, UK
| | - Mark J Speakman
- Department of Urology, Musgrove Park Hospital, Taunton and Somerset NHS Foundation Trust, Taunton, UK
| | - Simon F Brewster
- Department of Urology, Churchill Hospital, Oxford University Hospitals NHS Trust, Oxford, UK
| | - Simon Evans
- Department of Urology, Royal United Hospitals Bath NHS Foundation Trust, Bath, UK
| | - David E Neal
- University Department of Oncology, Addenbrooke's Hospital, University of Cambridge, UK
| | - Freddie C Hamdy
- Nuffield Department of Surgical Sciences, University of Oxford, Churchill Hospital, Oxford, UK
| | - Jenny L Donovan
- School of Social and Community Medicine, University of Bristol, UK
- NIHR Collaboration for Leadership in Applied Health Research and Care West at University Hospitals Bristol NHS Trust, Bristol, UK
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Patient and family experiences with accessing telephone cancer treatment symptom support: a descriptive study. Support Care Cancer 2015; 24:893-901. [PMID: 26275766 DOI: 10.1007/s00520-015-2859-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2015] [Accepted: 07/13/2015] [Indexed: 12/19/2022]
Abstract
PURPOSE Assess patient and family member experiences with telephone cancer treatment symptom support. METHODS Descriptive study guided by the Knowledge-to-Action Framework. Patients and family members who received telephone support for a cancer treatment symptom within the last month at one of three ambulatory cancer programs (Nova Scotia, Ontario, Quebec) were eligible. An adapted Short Questionnaire for Out-of-hours Care instrument was analyzed with univariate statistics. RESULTS Of 105 participants, 83 % telephoned about themselves and 17 % for a family member. Participants received advice over the telephone (90 %) and were advised to go to emergency (13 %) and/or the clinic (9 %). Two left a message and were not called back. Participants were "very satisfied" with the manner of nurse or doctor (58 %), explanation about problem (56 %), treatment/advice given (54 %), way call was handled (48 %), getting through (40 %), and wait time to speak to a nurse or doctor (38 %). The proportion "dissatisfied" or "very dissatisfied" for the above items was 4, 5, 9, 11, 10, and 14 %, respectively. Suggestions were shorter call back time, weekend access to telephone support, more knowledgeable advice on self-care strategies, more education at discharge, and shared documentation on calls to avoid repetition and improve continuity. CONCLUSIONS Most patients and family members who responded to the survey were satisfied with telephone-based cancer treatment symptom support. Programs could improve telephone support services by providing an estimated time for callback, ensuring that nurses have access to and use previous call documentation, and enhancing patient education on self-care strategies for managing and triaging treatment-related symptoms.
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Stanciu MA, Morris C, Makin M, Watson E, Bulger J, Evans R, Hiscock J, Hoare Z, Edwards RT, Neal RD, Wilkinson C. A pilot randomised controlled trial of personalised care after treatment for prostate cancer (TOPCAT-P): nurse-led holistic-needs assessment and individualised psychoeducational intervention: study protocol. BMJ Open 2015; 5:e008470. [PMID: 26112224 PMCID: PMC4486944 DOI: 10.1136/bmjopen-2015-008470] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Prostate cancer is common and the incidence is increasing, but more men are living longer after diagnosis, and die with their disease rather than of it. Nonetheless, specific and substantial physical, sexual, emotional and mental health problems often lead to a poor quality of life. Urology services increasingly struggle to cope with the demands of follow-up care, and primary care is likely to play the central role in long-term follow-up. The present phase II trial will evaluate the feasibility and acceptability of a nurse-led, person-centred psychoeducational intervention, delivered in community or primary care settings. METHODS AND ANALYSIS Prostate cancer survivors diagnosed in the past 9-48 months and currently biochemically stable will be identified from hospital records by their treating clinician. Eligible men would have either completed radical treatment, or would be followed up with prostate specific antigen monitoring and symptom reporting. We will recruit 120 patients who will be randomised to receive either an augmented form of usual care, or an additional nurse-led intervention for a period of 36 weeks. Following the health policy in Wales, the intervention is offered by a key worker, is promoting prudent healthcare and is using a holistic needs assessment. Outcome measures will assess physical symptoms, psychological well-being, confidence in managing own health and quality of life. Healthcare service use will be measured over 36 weeks. Feedback interviews with patients and clinicians will further inform the acceptability of the intervention. Recruitment, attrition, questionnaire completion rates and outcome measures variability will be assessed, and results will inform the design of a future phase III trial and accompanying economic evaluation. ETHICS AND DISSEMINATION Ethics approval was granted by Bangor University and North Wales REC (13/WA/0291). Results will be reported in peer-reviewed publications, at scientific conferences, and directly through national cancer and primary care networks. TRIAL REGISTRATION NUMBER ISRCTN 34516019.
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Affiliation(s)
| | | | - Matt Makin
- Betsi Cadwaladr University Health Board, Wrexham, UK
| | - Eila Watson
- Department of Clinical Health Care, Oxford Brookes University, Oxford, UK
| | - Jenna Bulger
- North Wales Centre for Primary Care Research, Bangor University, Wrexham, UK
| | - Richard Evans
- North Wales Centre for Primary Care Research, Bangor University, Wrexham, UK
| | - Julia Hiscock
- North Wales Centre for Primary Care Research, Bangor University, Wrexham, UK
| | - Zoë Hoare
- North Wales Organisation for Randomised Trials in Health, Bangor University, Bangor, UK
| | | | - Richard David Neal
- North Wales Centre for Primary Care Research, Bangor University, Wrexham, UK
| | - Clare Wilkinson
- North Wales Centre for Primary Care Research, Bangor University, Wrexham, UK
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Hand KE, Cunningham RS. Telephone calls postdischarge from hospital to home: a literature review. Clin J Oncol Nurs 2015; 18:45-52. [PMID: 24325957 DOI: 10.1188/14.cjon.18-01ap] [Citation(s) in RCA: 3] [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
The oncology population is particularly affected by hospital readmissions because hospitalized patients with cancer often have complex needs. The complexity and diversity of care requirements create substantial challenges in planning for appropriate postdischarge support. Implementing postdischarge telephone calls in the population of patients with cancer could offer a low-cost intervention to address the complex needs of patients during the transition from hospital to home. The goal of the current literature review is to provide an understanding about postdischarge telephone calls in patients with cancer. Findings from this review support the notion that discharge phone calls could improve care continuity for patients transitioning from hospital to home. The literature review outlines information related to telephone call content, timing, and structure for healthcare systems that want to use a postdischarge telephone intervention for patients with cancer. However, additional research is needed to develop and test cancer-specific protocols.
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Affiliation(s)
- Kristin E Hand
- Hospital of the University of Pennsylvania, Philadelphia
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McPhillips D, Evans R, Ryan D, Daneshvar C, Sarkar SA, Breen D. The role of a nurse specialist in a modern lung-cancer service. ACTA ACUST UNITED AC 2015; 24:S21-7. [DOI: 10.12968/bjon.2015.24.sup4.s21] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Affiliation(s)
| | - Ruth Evans
- Interventional Pulmonology Nurse Navigator, Department of Pulmonary Medicine, Franklin Square Hospital, Baltimore
| | - Daniel Ryan
- Respiratory Specialist Registrar, Rapid Access Lung Clinic, Galway University Hospitals
| | - Cyrus Daneshvar
- Consultant Respiratory Physician, Department of Respiratory Medicine, Plymouth Hospitals NHS Trust
| | - Saiyad A Sarkar
- Pulmonary and Critical Care Medicine, Department of Pulmonary Medicine, Franklin Square Hospital, Baltimore
| | - David Breen
- Consultant Respiratory Physician, Rapid Access Lung Clinic, Galway University Hospitals
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Verma R, Treasure P, Hughes R. Development and evaluation of radiographer led telephone follow up following radical radiotherapy to the prostate. A report of a Macmillan Cancer Support Sponsored Pilot project at Mount Vernon Hospital. Radiography (Lond) 2015. [DOI: 10.1016/j.radi.2014.05.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Underhill M, Chicko L, Berry D. A Nurse-Led Evidence-Based Practice Project to Monitor and Improve the Management of Chemotherapy-Induced Nausea and Vomiting. Clin J Oncol Nurs 2015; 19:38-40. [DOI: 10.1188/15.cjon.38-40] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Kumar R, DeBono L, Sharma P, Basu S. The general surgical care practitioner improves surgical outpatient streamlining and the delivery of elective surgical care. J Perioper Pract 2013; 23:138-41. [PMID: 23909166 DOI: 10.1177/175045891302300603] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The feasibility of implementing a surgical care practitioner (SCP) role for the delivery of secondary care within the general surgery department of a district general hospital was evaluated. Streamlining patients into an SCP-led 'one-stop' gallbladder clinic for symptomatic uncomplicated cholelithiasis led to a reduction in follow-up clinic workload for major elective laparoscopic work and more appropriate triaging of primary care referrals. Each of these improvements contributed to an efficient service model.
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de Leeuw J, Larsson M. Nurse-led follow-up care for cancer patients: what is known and what is needed. Support Care Cancer 2013; 21:2643-9. [DOI: 10.1007/s00520-013-1892-6] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2013] [Accepted: 06/24/2013] [Indexed: 11/29/2022]
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Parkes C, Lennon J, Harper R. Is telephone review feasible and potentially effective in low vision services? BRITISH JOURNAL OF VISUAL IMPAIRMENT 2013. [DOI: 10.1177/0264619613481588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Purpose: Demographic transformations within the UK population combine to contribute to a substantial increase in demand for low vision (LV) services, creating a pressing need to reconsider the appropriate methods for service provision. In this study, we evaluate the feasibility of using telephone triage to assess the need for, and timing of, LV follow-up appointments. Methods: A cohort of new patients attending the LV Clinic at Manchester Royal Eye Hospital (MREH) was recruited, independent of vision or visual impairment (VI) registration status. Four weeks after this initial clinic assessment, each patient was telephoned and a structured review was conducted. All patients were subsequently followed up at 3 months in the LV clinic. Results: A total of 52 patients were recruited, with the corrected ‘better-eye’ visual acuity (VA) ranging from 0.18 logMAR (6/9.5 + 1) to 1.36 logMAR (6/152 + 2) with a mean of 0.66 logMAR (6/30 + 2). In total, 36 patients completed all aspects of the study. At telephone review, 70 (93%) of the low vision aids (LVAs) loaned were reported to have been used on at least one occasion. Ten patients (22%) were deemed to not require follow-up, 15 (33%) were judged to benefit from an earlier (1 month) review, and 16 (35%) were judged to require 3-month follow-up. Reminding patients at telephone review provided a significant increase in adherence with advice to bring any loaned devices to clinic review ( p < 0.01). Face-to-face clinic review outcomes at 3 months permitted some insight into the effectiveness of telephone triage. Conclusions: Implementing telephone review is feasible for triaging LV follow-up requirements. A number of patient issues can be dealt with immediately and effectively at telephone review, potentially negating the need for a face-to-face clinic review for some patients while identifying a more pressing need for earlier review in others, factors that might improve cost-effectiveness of service provision if subjected to formal health economic evaluation.
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Affiliation(s)
- Claire Parkes
- Wolverhampton and Midland Counties Eye Infirmary, UK
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Nurse-led follow-up care for head and neck cancer patients: a quasi-experimental prospective trial. Support Care Cancer 2012; 21:537-47. [DOI: 10.1007/s00520-012-1553-1] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2012] [Accepted: 07/23/2012] [Indexed: 11/26/2022]
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Leahy M, Krishnasamy M, Herschtal A, Bressel M, Dryden T, Tai KH, Foroudi F. Satisfaction with nurse-led telephone follow up for low to intermediate risk prostate cancer patients treated with radical radiotherapy. A comparative study. Eur J Oncol Nurs 2012; 17:162-9. [PMID: 22608878 DOI: 10.1016/j.ejon.2012.04.003] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2011] [Revised: 03/28/2012] [Accepted: 04/03/2012] [Indexed: 11/29/2022]
Abstract
PURPOSE OF THE RESEARCH As the number of men living with prostate cancer is increasing worldwide, the requirement for follow up care also grows. This study was undertaken to evaluate nurse-led, telephone follow up, for men with low to intermediate risk prostate cancer treated with radical radiotherapy when compared with medical follow up. METHODS AND SAMPLE A non-randomized, two-cohort, comparative study. 169 men diagnosed with prostate cancer were recruited from outpatient clinics at a tertiary cancer centre in Australia. 83 men were recruited to cohort 1 (control) (51 low to intermediate risk; 32 high risk) and 86 to cohort 2 (intervention) (51 low to intermediate risk; 35 high risk). High risk patients, regardless of cohort, received medical follow up. Low to intermediate risk patients in cohort 2 were triaged to nurse-led review for their six month review appointment. Nurse-led follow up consisted of six monthly telephone consultations and PSA testing. MEASURES Participants completed the Satisfaction with Consultation Scale, the Brief Distress Thermometer and the Expanded Prostate Cancer Index Composite. KEY RESULTS There was no statistically significant difference in patient satisfaction on any of the study measures between the nurse-led and standard medical follow up at six months following treatment completion. However, where there was a trend towards significance (p=0.051), it favoured the nurse-led follow up regimen. CONCLUSIONS Nurse-led telephone consultation provides an acceptable model of follow-up for men diagnosed with low to intermediate risk prostate cancer. Multi-centre randomised controlled trials are needed to support the efficacy of nurse-led, telephone follow up services.
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Affiliation(s)
- Mary Leahy
- Division of Nursing, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
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Burch J, Taylor C. Patients' need for nursing telephone follow-up after enhanced recovery. ACTA ACUST UNITED AC 2012. [DOI: 10.12968/gasn.2012.10.4.51] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Affiliation(s)
| | - Claire Taylor
- Florence Nightingale School of Nursing and Midwifery, King's College London
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Sack C, Phan VA, Grafton R, Holtmann G, van Langenberg DR, Brett K, Clark M, Andrews JM. A chronic care model significantly decreases costs and healthcare utilisation in patients with inflammatory bowel disease. J Crohns Colitis 2012; 6:302-10. [PMID: 22405166 DOI: 10.1016/j.crohns.2011.08.019] [Citation(s) in RCA: 79] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2011] [Revised: 08/15/2011] [Accepted: 08/31/2011] [Indexed: 02/07/2023]
Abstract
INTRODUCTION Inflammatory bowel disease (IBD) is a chronic condition, yet the model of care is often reactive. We sought to examine whether a formal IBD service (IBDS) reduced inpatient healthcare utilisation or lowered costs for inpatient care. MATERIAL AND METHODS With protocols, routine nurse phone follow-up a help-line, more proactive care was delivered, with many symptoms and concerns dealt with prior to routine presentation. Over two five month periods before (2007/8) and after (2009/10) introducing a formal IBDS two discrete cohorts of admitted IBD patients were identified at a single centre. Each patient was assigned five contemporaneously admitted, age and gender matched controls. Inpatient healthcare utilisation was compared between patients and controls and disease-specific factors amongst the two IBD cohorts. RESULTS The initial audit captured 102 admitted IBD patients (510 controls, median age 44 years, 57% female); the second audit 95 patients (475 controls, median age 46 years, 45.3% female). In 2009/10, the number of admissions was lower in IBD patients than in controls (mean 1.53+/-1.03 vs. 2.54+/-2.35; p<0.0001). This contrasts with the first audit, where IBD patients had more admissions than controls. Following IBDS introduction, the mean total cost of inpatient care was lower for IBD patients than controls (US$12,857.48 (US$15,236.79) vs. US$ 30,467.78 (US$ 53,760.20), p=0.005). In addition, patients known to a specialist gastroenterologist (GE) and the IBD Service tended to have the lowest mean number of admissions (GE and IBDS 1.14 (+/-0.36) vs. no GE/IBDS 1.64 (+/-1.25)). CONCLUSIONS Healthcare utilisation and disease burden in IBD decreased significantly since introducing an IBDS. These data suggest that proactive management improved outcomes. Contact with a gastroenterologist and IBDS seemed to give best results.
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Affiliation(s)
- C Sack
- IBD Service, Department of Gastroenterology & Hepatology, Royal Adelaide Hospital, Australia
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Cunniffe N, Robson J, Mazhar D, Williams M. Clinical Examination Does Not Assist in the Detection of Systemic Relapse of Testicular Germ Cell Tumour. Clin Oncol (R Coll Radiol) 2012; 24:39-42. [DOI: 10.1016/j.clon.2011.06.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2010] [Revised: 05/03/2011] [Accepted: 05/05/2011] [Indexed: 10/18/2022]
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Jensen BT, Kristensen SA, Christensen SV, Borre M. Efficacy of tele-nursing consultations in rehabilitation after radical prostatectomy: a randomised controlled trial study. INTERNATIONAL JOURNAL OF UROLOGICAL NURSING 2011. [DOI: 10.1111/j.1749-771x.2011.01130.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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