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Loiselle CG, Attieh S, Cook E, Tardif L, Allard M, Rousseau C, Thomas D, Saha-Chaudhuri P, Talbot D. L'infirmière pivot associée à une expérience de soins oncologiques positive et à une satisfaction accrue des patients. Can Oncol Nurs J 2020; 30:54-60. [PMID: 33118969 DOI: 10.5737/236880763015460] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Contexte et objectifs Un nombre croissant de résultats probants indique que l'infirmière pivot en oncologie (IPO) joue un rôle de premier plan dans l'optimisation des processus et des résultats de soins. Il faudra toutefois mener des études d'envergure pour comparer les perceptions de l'expérience de soins liés au cancer des patients traités par des infirmières pivots et de ceux qui n'ont pas bénéficié de ce type de suivi. Méthodologie Des participants (N = 2 858) traités au cours des six derniers mois dans un centre de traitement du cancer situé à Montréal, au Québec, et affilié à une université ont répondu au sondage sur la satisfaction des patients en traitement anticancéreux ambulatoire, c'est-à-dire le Ambulatory Oncology Patient Satisfaction Survey (AOPSS). Résultats L'expérience des soins oncologiques était significativement plus positives et la satisfaction plus élevée dans le groupe suivi par une infirmière pivot (n = 2 003) pour les six domaines de soins (différences moyennes de 3,32 à 8,95) et les quatre fonctions infirmières (différences moyennes de 5,64 à 10,39), comparativement au groupe sans IPO (n = 855). Discussion L'infirmière pivot joue un rôle important dans l'amélioration de l'expérience de soins et la satisfaction des patients. Les recherches futures devront explorer les potentielles relations de cause à effet entre les infirmières pivots, les processus de soins et les résultats des patients.
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Affiliation(s)
- Carmen G Loiselle
- (aut. et chercheuse principale), Université McGill, Département d'oncologie, École de sciences infirmières Ingram, Montréal (Québec) ; Centre du cancer Segal, Hôpital général juif (Québec), Canada
| | - Samar Attieh
- (aut. principale), Université McGill, Département de médecine, Division de médecine expérimentale, Montréal (Québec), Canada
| | - Erin Cook
- Centre du cancer Segal, Hôpital général juif, Montréal (Québec), Canada
| | - Lucie Tardif
- Centre universitaire de santé McGill, Centre du cancer des Cèdres, Montréal (Québec), Canada
| | - Manon Allard
- Centre intégré universitaire de santé et de service sociaux de l'Ouest-de-l'île-de-Montréal (Québec), Canada ; Centre hospitalier de St. Mary, Montréal (Québec), Canada
| | | | - Doneal Thomas
- Réseau de cancérologie Rossy, Montréal (Québec), Canada
| | - Paramita Saha-Chaudhuri
- Université McGill, Département d'épidémiologie, de biostatistique et de santé au travail, Montréal (Québec) Canada
| | - Denis Talbot
- Université Laval, Département de médecine sociale et préventive, Québec (Québec), Canada
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Loiselle CG, Attieh S, Cook E, Tardif L, Allard M, Rousseau C, Thomas D, Saha-Chaudhuri P, Talbot D. The nurse pivot-navigator associated with more positive cancer care experiences and higher patient satisfaction. Can Oncol Nurs J 2020; 30:48-53. [PMID: 33118978 DOI: 10.5737/236880763014853] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Background and objectives Growing evidence indicates that the nurse navigator-pivot (NN), is key to optimizing care processes and outcomes. However, large scale studies are needed to examine how patients exposed to NNs (as opposed to non-NN) differentially perceived their cancer care experiences. Method Participants (N = 2,858) treated for cancer in the last six months at university-affiliated cancer centres in Montréal, Québec, completed the Ambulatory Oncology Patient Satisfaction Survey (AOPSS). Results Cancer care experiences and satisfaction were significantly higher in the NN group (n = 2,003) for all six care domains (Ds from 3.32 to 8.95) and all four nursing functions (Ds from 5.64 to 10.39) when compared to the non-NN group (n = 855). Discussion The NN role is significantly related to enhanced cancer care experiences and higher patient satisfaction. Future research should explore potential causal effects between NNs and care processes, as well as patient outcomes.
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Affiliation(s)
- Carmen G Loiselle
- (Senior and corresponding author), McGill University, Department of Oncology and Ingram School of Nursing, Montreal, QC; Segal Cancer Centre, Jewish General Hospital, Montreal, QC
| | - Samar Attieh
- (Senior author), McGill University, Department of Medicine, Division of Experimental Medicine, Montreal, QC
| | - Erin Cook
- Segal Cancer Centre, Jewish General Hospital, Montreal, QC
| | - Lucie Tardif
- McGill University Health Centre, Cedars Cancer Centre, Montreal, QC
| | - Manon Allard
- Centre intégré universitaire de santé et de service sociaux de l'Ouest-de-l'île-de-Montréal, QC ; Centre hospitalier de St. Mary, Montreal, QC
| | | | | | - Paramita Saha-Chaudhuri
- McGill University, Department of Epidemiology, Biostatistics & Occupational Health, Montreal QC
| | - Denis Talbot
- Laval University, Department of Social and Preventive Medicine, Quebec City, QC
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Jalal S, Lloyd ME, Khosa F, I-Hsuan Hsu G, Nicolaou S. Exploratory data analysis for pre and post 24/7/365 attending radiologist coverage support in an emergency department: fundamentals of data science. Emerg Radiol 2019; 27:233-251. [PMID: 31840209 DOI: 10.1007/s10140-019-01737-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2019] [Accepted: 10/22/2019] [Indexed: 10/25/2022]
Abstract
OBJECTIVE To present a detailed exploratory data analysis for critically investigating the patterns in medical doctor (MD) to disposition time, pre and post 24/7/365 attending radiologist coverage, for patients presenting to an emergency department (ED). MATERIALS AND METHODS The process involved presenting several modeling techniques. To share an understanding of concepts and techniques, we used proportions, medians, and means, Mann-Whitney U test, Kaplan-Meier's (KM) survival analysis, linear and log-linear regression, log-ranked test, Cox proportional hazards model, Weibull parametric survival models and tertile analysis. Retrospective chart review was conducted to obtain a data set which was used to determine the trends in MD to disposition time. Data comprised of patients who had visited the emergency department (ED) during two distinct time periods and whose imaging studies were read by an attending emergency and trauma radiologist. RESULTS Median provided more insight into the data as compared with the mean. The Mann-Whitney U test was appropriate to evaluate MD to disposition time, but provided limited information. The Kaplan-Meier (KM) was able to offer more insight into the data since it did not assume an underlying model and that is the reason why it was appropriate. However, KM had limited ability to handle measured confounders and was unable to describe the magnitude of difference between curves. The Cox proportional hazards semi-parametric model or some other parametric model such as the Weibull could handle multiple measured confounders and described the magnitude of difference between two (survival) groups in the data set. However, both methods assumed underlying models that may not apply to the data set such as the one used in this study. Linear regression was unlikely to be appropriate due to the shape of survival time distributions, but log transforming the outcome could address the distribution issue. Nearly all the results of the KM subgroup analyses were consistent with the results of the log-transformed linear regression subgroup analyses and the interpretation of the results was the same for both. CONCLUSION Different statistical procedures may be applied to conduct exploratory subgroup analysis for a data set from a pre and post 24/7/365 attending coverage model. This could guide potential areas of further research to compare trends in MD to disposition time in ED. Pattern analysis provides evidence for various stakeholders to rethink the discourse about trends in MD to disposition time, pre and post 24/7/365 attending coverage. Graphical Illustration: The role of Emergency and Trauma Radiology in an Emergency Department.
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Affiliation(s)
- Sabeena Jalal
- Emergency & Trauma Radiology, Department of Radiology, Vancouver General Hospital, Vancouver, Canada. .,McGill University, Montréal, Canada.
| | | | - Faisal Khosa
- Emergency & Trauma Radiology, Department of Radiology, Vancouver General Hospital, Vancouver, Canada
| | | | - Savvas Nicolaou
- Emergency & Trauma Radiology, Department of Radiology, Vancouver General Hospital, Vancouver, Canada
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Abstract
Diagnostic tests have wide clinical applications, including screening, diagnosis, measuring treatment effect, and determining prognosis. Interpreting diagnostic test results requires an understanding of key statistical concepts used to evaluate test efficacy. This review explains descriptive statistics and discusses probability, including mutually exclusive and independent events and conditional probability. In the inferential statistics section, a statistical perspective on study design is provided, together with an explanation of how to select appropriate statistical tests. Key concepts in recruiting study samples are discussed, including representativeness and random sampling. Variable types are defined, including predictor, outcome, and covariate variables, and the relationship of these variables to one another. In the hypothesis testing section, we explain how to determine if observed differences between groups are likely to be due to chance. We explain type I and II errors, statistical significance, and study power, followed by an explanation of effect sizes and how confidence intervals can be used to generalize observed effect sizes to the larger population. Statistical tests are explained in four categories: t tests and analysis of variance, proportion analysis tests, nonparametric tests, and regression techniques. We discuss sensitivity, specificity, accuracy, receiver operating characteristic analysis, and likelihood ratios. Measures of reliability and agreement, including κ statistics, intraclass correlation coefficients, and Bland-Altman graphs and analysis, are introduced.
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Affiliation(s)
- Arash Anvari
- From the Department of Radiology, Ultrasound Division, Massachusetts General Hospital, Harvard Medical School, 55 Fruit St, White 270, Boston, MA 02114
| | - Elkan F Halpern
- From the Department of Radiology, Ultrasound Division, Massachusetts General Hospital, Harvard Medical School, 55 Fruit St, White 270, Boston, MA 02114
| | - Anthony E Samir
- From the Department of Radiology, Ultrasound Division, Massachusetts General Hospital, Harvard Medical School, 55 Fruit St, White 270, Boston, MA 02114
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Zhou W, Langsetmo L, Berger C, Adachi JD, Papaioannou A, Ioannidis G, Webber C, Atkinson SA, Olszynski WP, Brown JP, Hanley DA, Josse R, Kreiger N, Prior J, Kaiser S, Kirkland S, Goltzman D, Davison KS. Normative bone mineral density z-scores for Canadians aged 16 to 24 years: the Canadian Multicenter Osteoporosis Study. J Clin Densitom 2010; 13:267-76. [PMID: 20554232 PMCID: PMC5104562 DOI: 10.1016/j.jocd.2010.04.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2009] [Revised: 04/22/2010] [Accepted: 04/22/2010] [Indexed: 10/19/2022]
Abstract
The objectives of the study were to develop bone mineral density (BMD) reference norms and BMD Z-scores at various skeletal sites, to determine whether prior fracture and/or asthma were related to BMD, and to assess possible geographic variation of BMD among Canadian youth aged 16-24 yr. Z-Scores were defined as the number of standard deviations from the mean BMD of a healthy population of the same age, race, and sex. Z-Scores were calculated using the reference sample defined as Canadian Caucasian participants without asthma or prior fracture. Reference standards were created for lumbar spine (L1-L4), femoral neck, total hip, and greater trochanter, by each year of age (16-24 yr), and by sex. The Z-score norms were developed for groups noted earlier. Mean Z-scores between the asthma or fracture subgroups compared with the mean Z-scores in the reference sample were not different. There were minor differences in mean BMD across different Canadian geographic regions. This study provides age, sex, and skeletal site-specific Caucasian reference norms and formulae for the calculation of BMD Z-scores for Canadian youth aged 16-24 yr. This information will be valuable to help to identify individuals with clinically meaningful low BMD.
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Affiliation(s)
- Wei Zhou
- CaMos Methods Centre, McGill University, Montreal, Quebec, Canada
| | - Lisa Langsetmo
- CaMos Methods Centre, McGill University, Montreal, Quebec, Canada
| | - Claudie Berger
- CaMos Methods Centre, McGill University, Montreal, Quebec, Canada
| | - Jonathan D. Adachi
- Departments of Clinical Epidemiology and Biostatistics and Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Alexandra Papaioannou
- Departments of Clinical Epidemiology and Biostatistics and Medicine, McMaster University, Hamilton, Ontario, Canada
| | - George Ioannidis
- Departments of Clinical Epidemiology and Biostatistics and Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Colin Webber
- Departments of Clinical Epidemiology and Biostatistics and Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Stephanie A. Atkinson
- Departments of Clinical Epidemiology and Biostatistics and Medicine, McMaster University, Hamilton, Ontario, Canada
| | | | - Jacques P. Brown
- Department of Rheumatology and Immunology, Laval University, Quebec City, Quebec, Canada
| | - David A. Hanley
- Departments of Medicine and Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
| | - Robert Josse
- Departments of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Nancy Kreiger
- CaMos National Coordinating Centre, McGill University, Montreal, Quebec, Canada
- Department of Public Health Sciences, University of Toronto, Toronto, Ontario, Canada
| | - Jerilynn Prior
- Department of Medicine and Endocrinology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Stephanie Kaiser
- Department of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Susan Kirkland
- Department of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
| | - David Goltzman
- CaMos National Coordinating Centre, McGill University, Montreal, Quebec, Canada
- Department of Medicine, McGill University, Montreal, Quebec, Canada
| | - Kenneth Shawn Davison
- Department of Rheumatology and Immunology, Laval University, Quebec City, Quebec, Canada
- Address correspondence to: Kenneth Shawn Davison, PhD, 2086 Byron St Victoria, BC V8R 1L9, Canada.
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Hopman WM, Berger C, Joseph L, Towheed T, Prior JC, Anastassiades T, Poliquin S, Zhou W, Adachi JD, Hanley DA, Papadimitropoulos EA, Tenenhouse A. Health-related quality of life in Canadian adolescents and young adults: normative data using the SF-36. Canadian Journal of Public Health 2010. [PMID: 20209739 DOI: 10.1007/bf03404342] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
OBJECTIVES Normative data for the SF-36 measure of health-related quality of life (HRQOL) exist for those over 25 years of age, based on data from the population-based Canadian Multicentre Osteoporosis Study (CaMos). CaMos recently recruited a sample of young Canadians aged between 16 and 24 years. The purpose of this study was to develop normative SF-36 data for this age group. METHODS After direct standardization to the Canadian population, means, standard deviations (SD), 95% confidence intervals and percentage at floor and ceiling were produced for the eight domain and two summary scores of the SF-36. Domains are scored from 0 (poor) to 100 (excellent). Summary scores are standardized to a mean of 50, with scores over 50 representing better than average and below 50 poorer than average function. Separate analyses were completed for men and women, and for those 16-19 years and 20-24 years. RESULTS The 1,001 community-based participants consisted of 474 men and 527 women from nine CaMos centres across Canada. Mean Physical Component Summary scores were 53.9 (SD = 6.9) and 53.3 (SD = 5.7) for young men and women, respectively. The equivalent Mental Component Summary scores were 49.3 (SD = 9.7) and 48.8 (SD = 8.9). In general, men scored somewhat higher than women, and younger (16-19 years) women scored higher than older (20-24 years) women, although the differences were small. CONCLUSION HRQOL is good in this cohort of young Canadians. Both men and women scored somewhat better on physically than mentally oriented domains. In general, Canadian scores were similar to those of the US, while a comparable Swedish sample scored higher than both countries on most domains. Results underscore the importance of taking country, age and gender into consideration when using normative data.
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Affiliation(s)
- Wilma M Hopman
- Clinical Research Centre, Kingston General Hospital, Angada 4, Room 5-426, 76 Stuart Street, Kingston ON K7L 2V7.
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Affiliation(s)
- Nandini Dendukuri
- Technology Assessment Unit, Royal Victoria Hospital, Montreal, QC H3A 1A1, Canada.
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Affiliation(s)
- Lawrence Joseph
- Division of Clinical Epidemiology, Montreal General Hospital, Department of Medicine, 1650 Cedar Ave., Montreal, QC H3G 1A4, Canada.
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