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Boele F, Rosenlund L, Nordentoft S, Melhuish S, Nicklin E, Rydén I, Williamson A, Donders-Kamphuis M, Preusser M, Le Rhun E, Kiesel B, Minniti G, Furtner J, Dirven L, Taphoorn M, Galldiks N, Rudà R, Chalmers A, Short SC, Piil K. Inequalities in access to neuro-oncology supportive care and rehabilitation: A survey of healthcare professionals' perspectives. Neurooncol Pract 2024; 11:484-493. [PMID: 39006521 PMCID: PMC11241368 DOI: 10.1093/nop/npae023] [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] [Indexed: 07/16/2024] Open
Abstract
Background Neuro-oncology patients and caregivers should have equitable access to rehabilitation, supportive-, and palliative care. To investigate existing issues and potential solutions, we surveyed neuro-oncology professionals to explore current barriers and facilitators to screening patients' needs and referral to services. Methods Members of the European Association of Neuro-Oncology and the European Organisation for Research and Treatment of Cancer Brain Tumor Group (EORTC-BTG) were invited to complete a 39-item online questionnaire covering the availability of services, screening, and referral practice. Responses were analyzed descriptively; associations between sociodemographic/clinical variables and screening/referral practice were explored. Results In total, 103 participants completed the survey (67% women and 57% medical doctors). Fifteen professions from 23 countries were represented. Various rehabilitation, supportive-, and palliative care services were available yet rated "inadequate" by 21-37% of participants. Most respondents with a clinical role (n = 94) declare to screen (78%) and to refer (83%) their patients routinely for physical/cognitive/emotional issues. Survey completers (n = 103) indicated the main reasons for not screening/referring were (1) lack of suitable referral options (50%); (2) shortage of healthcare professionals (48%); and (3) long waiting lists (42%). To improve service provision, respondents suggested there is a need for education about neuro-oncology-specific issues (75%), improving the availability of services (65%) and staff (64%), developing international guidelines (64%), and strengthening the existing evidence-base for rehabilitation (60%). Conclusions Detecting and managing neuro-oncology patients' and caregivers' rehabilitation, supportive,- and palliative care needs can be improved. Better international collaboration can help address healthcare disparities.
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Affiliation(s)
- Florien Boele
- Leeds Institute of Medical Research, St James’s Hospital, University of Leeds, Leeds, UK
- Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | - Lena Rosenlund
- Regional Cancer Centre Stockholm-Gotland, Stockholm, Sweden
| | - Sara Nordentoft
- Department of Neurosurgery, Neurocentre, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Sara Melhuish
- Speech and Language Therapy Department, St Bartholomew’s Hospital, West Smithfield, London, UK
| | - Emma Nicklin
- Leeds Institute of Medical Research, St James’s Hospital, University of Leeds, Leeds, UK
| | - Isabelle Rydén
- Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, University of Gothenburg, Sahlgrenska Academy, Gothenburg, Sweden
| | | | - Marike Donders-Kamphuis
- Department of Neurosurgery, Haaglanden Medisch Centrum, The Hague, The Netherlands
- Department of Neurosurgery, Erasmus MC—University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Matthias Preusser
- Division of Oncology, Department of Medicine, Medical University, Vienna, Austria
| | - Emilie Le Rhun
- Department of Neurosurgery, Clinical Neuroscience Center, University Hospital and University of Zurich, Zurich, Switzerland
- Department of Neurology, Clinical Neuroscience Center, University Hospital and University of Zurich, Zurich, Switzerland
| | - Barbara Kiesel
- Department of Neurosurgery, Medical UniversityVienna, Austria
| | - Giuseppe Minniti
- Department of Radiological Sciences, Oncology and Anatomical Pathology & Sapienza University of Rome, Rome, Italy
- IRCCS Neuromed, Pozzilli, Italy
| | - Julia Furtner
- Faculty of Medicine and Dentistry, Research Center for Medical Image Analysis and Artificial Intelligence (MIAAI), Danube Private University, Krems, Austria
| | - Linda Dirven
- Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands
| | - Martin Taphoorn
- Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands
| | - Norbert Galldiks
- Department of Radiological Sciences, Oncology and Anatomical Pathology & Sapienza University of Rome, Rome, Italy
- IRCCS Neuromed, Pozzilli, Italy
| | - Roberta Rudà
- Division of Neuro-Oncology, Department of Neuroscience, University of Turin, Turin, Italy
| | | | - Susan C Short
- Leeds Institute of Medical Research, University of Leeds, Leeds, UK
- Department of Clinical Oncology, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Karin Piil
- Department of Oncology, Centre for Cancer and Organ Diseases, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
- Department of People and Technology, Roskilde University, Roskilde, Denmark
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Guo L, Zhao LQ, Chen JY, Li M. The Impact of Nursing Interventions on the Treatment Outcomes of Renal Cell Carcinoma with Postoperative Interleukin-2 and Recombinant Human Interferon. J Multidiscip Healthc 2024; 17:735-741. [PMID: 38390433 PMCID: PMC10882275 DOI: 10.2147/jmdh.s447537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 01/30/2024] [Indexed: 02/24/2024] Open
Abstract
Objective This study investigates the impact of nursing interventions on treatment outcomes and adverse reaction rates in renal cell carcinoma (RCC) patients treated postoperatively with Interleukin-2 and recombinant human Interferon. Methods In a retrospective analysis of 90 RCC patients, 43 received standard care (control group), while 47 received additional nursing interventions (intervention group), including psychological care, vital signs monitoring, dietary care, adverse reaction management, and post-discharge care. Patients with concurrent major diseases or other malignancies were excluded. Key assessments included clinical symptom improvement, treatment efficacy, and postoperative adverse reactions. Results Among the 90 participants, no significant demographic differences were found between the two groups. The intervention group showed significant improvements in fever resolution, leukocyte normalization, and shorter hospital stays. The overall treatment effectiveness was similar in both groups (90.7% in the intervention group vs 91.5% in the control group). However, the intervention group experienced significantly fewer postoperative adverse reactions, including fever, gastrointestinal symptoms, bone marrow suppression, and neurological abnormalities (6.3% vs 23.2%). Conclusion The study suggests that nursing interventions can improve treatment outcomes by reducing postoperative adverse reactions in RCC patients receiving postoperative Interleukin-2 and recombinant human Interferon. The overall effectiveness of treatment and care was comparable between the groups. Further extensive studies are needed to confirm these findings and fully understand the impact of nursing interventions on RCC patient outcomes.
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Affiliation(s)
- Li Guo
- Third Department of General Surgery (Breast Armor Surgery), Ezhou Central Hospital, Ezhou City, 436000, People's Republic of China
| | - Li-Qin Zhao
- Department of Oncology, Ezhou Central Hospital, Ezhou City, 436000, People's Republic of China
| | - Jin-Yu Chen
- Department of Oncology, Ezhou Central Hospital, Ezhou City, 436000, People's Republic of China
| | - Ming Li
- Department of Oncology, Ezhou Central Hospital, Ezhou City, 436000, People's Republic of China
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Rune KT, Cadet TJ, Davis C. Meeting the needs of rural cancer patients in survivorship: Understanding the role of telehealth. Aust J Rural Health 2024; 32:188-192. [PMID: 37927175 DOI: 10.1111/ajr.13056] [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: 08/02/2022] [Revised: 10/05/2023] [Accepted: 10/15/2023] [Indexed: 11/07/2023] Open
Abstract
OBJECTIVE This study explores perceptions about the role of telehealth in providing health and supportive services to Australian rural/regional cancer patients and survivor during COVID-19 and the quality of these services to inform future practice. DESIGN Data were collected as part of a bi-annual survey on client satisfaction at a rural/regional community cancer wellness centre in Australia. SETTINGS AND PARTICIPANTS Rural/regional cancer patients and survivors (n = 66) completed an online survey. MAIN OUTCOME MEASURES The three main outcome measures were: (1) attitudes towards telehealth; (2) preference for future cancer support services; and (3) experiences with video/telehealth. RESULTS Younger participants were more likely to use allied health services via video/telehealth during COVID-19 than their older counterparts. The preferred format for cancer support services in future was face-to-face (59% for younger and 42% for older participants), telehealth (10% for both groups) and mixed (31% for younger and 48% for older participants). CONCLUSIONS Telehealth has benefits for the delivery of health and supportive services to rural/regional cancer patients and survivors. Nurses can play a key role in assessing the support needs of cancer survivors and facilitating strategies to ensure that survivors have the skills necessary to access telehealth support.
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Affiliation(s)
- Karina T Rune
- University of the Sunshine Coast, Sippy Downs, Queensland, Australia
| | - Tamara J Cadet
- School of Social Policy and Practice, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Cindy Davis
- University of the Sunshine Coast, Sippy Downs, Queensland, Australia
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de Lima Melo B, Vieira DCA, de Oliveira GC, Valente J, Sanchez Z, Ferrari G, Magalhães LP, Rezende LFM. Adherence to healthy lifestyle recommendations in Brazilian cancer survivors. J Cancer Surviv 2023; 17:1751-1759. [PMID: 35739376 DOI: 10.1007/s11764-022-01228-6] [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: 04/20/2022] [Accepted: 06/14/2022] [Indexed: 10/17/2022]
Abstract
PURPOSE We aimed to describe the adherence to healthy lifestyle recommendations (regular consumption of fruits, vegetables, and salad greens; limit the consumption of red and processed meat, fast food, sugary and alcoholic beverages; keeping a healthy body weight, being physically activity, and not smoking) of 2314 cancer survivors and 86,517 adults without cancer diagnosis (general population) from the Brazilian National Health Survey, 2019. METHODS We developed a score including eight healthy lifestyle recommendations proposed by the World Cancer Research Fund (i.e., the score ranged from 0 to 8; being 0 did not follow any recommendation and 8 followed all recommendations). RESULTS Cancer survivors had higher healthy lifestyle score than the general population. In contrast, they presented similar adherence to the recommendations of physical activity, healthy body weight, and quitting smoking. Among cancer survivors, women (OR 1.52; 95%CI 1.12 to 2.06) and widows (OR 1.49; 95%CI 1.02 to 2.18) had greater odds of adherence to healthy lifestyle recommendations, adjusted for other sociodemographic characteristics. However, cancer survivors with complete primary education (OR 0.64; 95%CI 0.44 to 0.94) and higher education (OR 0.58; 95%CI 0.40 to 0.83) had lower adherence to the recommendations. CONCLUSION Our findings may be useful to support counseling and interventions aimed at promoting healthy lifestyles for Brazilian cancer survivors. IMPLICATIONS FOR CANCER SURVIVORS Healthy lifestyle may reduce mortality and cancer recurrence, and improve quality of life in cancer survivors. Identifying factors associated with the adherence to healthy lifestyle in cancer survivors may be useful to support actions and interventions.
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Affiliation(s)
- Bruna de Lima Melo
- Multiprofessional Internship Program in Oncology, Department of Clinical and Experimental Oncology, Escola Paulista de Medicina, Universidade Federal de São Paulo, Sao Paulo, Brazil
| | - Dayara Cristina Amaro Vieira
- Multiprofessional Internship Program in Oncology, Department of Clinical and Experimental Oncology, Escola Paulista de Medicina, Universidade Federal de São Paulo, Sao Paulo, Brazil
| | - Gabriela Coelho de Oliveira
- Multiprofessional Internship Program in Oncology, Department of Clinical and Experimental Oncology, Escola Paulista de Medicina, Universidade Federal de São Paulo, Sao Paulo, Brazil
| | - Juliana Valente
- Department of Psychiatry, Escola Paulista de Medicina, Universidade Federal de São Paulo, Sao Paulo, Brazil
| | - Zila Sanchez
- Department of Preventive Medicine, Escola Paulista de Medicina, Universidade Federal de São Paulo, Sao Paulo, Brazil
| | - Gerson Ferrari
- Universidad de Santiago de Chile (USACH), Escuela de Ciencias de la Actividad Física, el Deporte y la Salud, Santiago, Chile
- Laboratorio de Rendimiento Humano, Grupo de Estudio en Educación, Actividad Física Y Salud (GEEAFyS), Universidad Católica del Maule, Talca, Chile
| | - Lidiane Pereira Magalhães
- Department of Clinical and Experimental Oncology, Escola Paulista de Medicina, Universidade Federal de São Paulo, Sao Paulo, Brazil
| | - Leandro F M Rezende
- Department of Preventive Medicine, Escola Paulista de Medicina, Universidade Federal de São Paulo, Sao Paulo, Brazil.
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McPeake K, Jeanes L, Nelson D, Selby P, Cooke S, Gussy M, Kane R. Developing a 'Living with Cancer' programme in a rural and coastal setting: Experiences of collaborative and innovative co-production across an Integrated Health System. J Cancer Policy 2023; 38:100452. [PMID: 37931888 DOI: 10.1016/j.jcpo.2023.100452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 10/10/2023] [Accepted: 10/30/2023] [Indexed: 11/08/2023]
Abstract
INTRODUCTION With projected increases in cancer prevalence, and demonstrated unmet need, there is an urgency for a collaborative approach to improving the lives of those living with cancer particularly in rural and coastal areas where cancer survivors face unique challenges. We report on an innovative 'Living with Cancer' (LWC) programme in the rural and coastal English county of Lincolnshire. METHODS In 2016, the Lincolnshire LWC programme was established to develop person-centred, local support for people living with cancer, their carers and significant others in Lincolnshire. This article reports on the setup of the LWC programme, our innovative approach to delivering cancer care in a rural and coastal setting, as well as our most salient achievements. RESULTS This work, developed within a policy context of tackling health inequalities and personalised approaches to care, started with stakeholder and community engagement where people described the challenges to living well after cancer and the need to focus on 8 themes further exacerbated by rurality. Recognising the limitations of conventional approaches, led to the development of a strategy underpinned by a shared set of principles and a philosophy of the importance of a transformative, whole-system, place-based, asset-based, and person-centred approaches. The strategy is now being coordinated and delivered across all cancer pathways and Lincolnshire communities. In 2022, permanent funding was secured, and our success was also demonstrated by a national Macmillan Integration Excellence award. DISCUSSION The initial success of the LWC programme in Lincolnshire is a result of an explicit focus on 'transformation' rather than 'improvement', and a programme not solely situated in an acute setting, which needed a whole systems approach with a focus on person-centred support and community engagement.
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Affiliation(s)
- Kathie McPeake
- National Health Service Lincolnshire Integrated Care Board, Sleaford, UK; Macmillan Cancer Support, London, UK
| | - Louise Jeanes
- National Health Service Lincolnshire Integrated Care Board, Sleaford, UK
| | - David Nelson
- Macmillan Cancer Support, London, UK; Lincoln International Institute for Rural Health, University of Lincoln, Lincoln, UK.
| | - Peter Selby
- School of Medicine, University of Leeds, Leeds, UK; Lincoln Medical School, Universities of Nottingham and Lincoln, Lincoln, UK
| | - Samuel Cooke
- School of Health and Social Care, University of Lincoln, Lincoln, UK
| | - Mark Gussy
- Lincoln International Institute for Rural Health, University of Lincoln, Lincoln, UK
| | - Ros Kane
- School of Health and Social Care, University of Lincoln, Lincoln, UK
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de Vries M, Stewart T, Ireton T, Keelan K, Jordan J, Robinson BA, Dachs GU. Patients' and carers' priorities for cancer research in Aotearoa/New Zealand. PLoS One 2023; 18:e0290321. [PMID: 37607163 PMCID: PMC10443847 DOI: 10.1371/journal.pone.0290321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 08/07/2023] [Indexed: 08/24/2023] Open
Abstract
BACKGROUND Discrepancies have been reported between what is being researched, and what patients/families deem important to be investigated. Our aim was to understand research priorities for those who live with cancer in Aotearoa/New Zealand, with emphasis on Māori. METHODS Adult outpatients with cancer and their whānau/family completed a survey (demographics, selecting keywords, free-text comments) at Christchurch hospital. Quantitative and qualitative data were evaluated using standard statistical and thematic analyses, respectively. RESULTS We recruited 205 participants, including both tūroro/patients (n = 129) and their whānau/family/carer (n = 76). Partnership with Māori health workers enabled greater recruitment of Māori participants (19%), compared to the proportion of Māori in Canterbury (9%). Cancer research was seen as a priority by 96% of participants. Priorities were similar between Māori and non-Māori participants, with the keywords 'Cancer screening', 'Quality of Life' and 'Development of new drugs' chosen most often. Free-text analysis identified three themes; 'Genetics and Prevention', 'Early Detection and Treatment', and 'Service Delivery', with some differences by ethnicity. CONCLUSIONS Cancer research is a high priority for those living with cancer. In addition, participants want researchers to listen to their immediate and practical needs. These findings may inform future cancer research in Aotearoa. MāORI TERMS AND TRANSLATION Aotearoa (New Zealand) he aha ō whakaaro (what are your thoughts) hui (gathering) mate pukupuku (cancer) mokopuna (descendent) Ōtautahi (Christchurch) rongoā (traditional healing) tāne (male) te reo (Māori language) Te Whatu Ora (weaving of wellness, Health New Zealand) tikanga (methods, customary practices) tūroro (patients) (alternative terms used: whānau affected by cancer or tangata whaiora (person seeking health)) wahine (female) Waitaha (Canterbury) whakapapa (genealogy) whānau ((extended) family, based on whakapapa, here also carer).
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Affiliation(s)
- Millie de Vries
- Mackenzie Cancer Research Group, Department of Pathology and Biomedical Science, University of Otago, Christchurch, New Zealand (NZ)
| | - Tiria Stewart
- Te Pūtahi Mātai Toto o Te Waipounamu, Christchurch Hospital, Christchurch, NZ (Nga Puhi, Ngāti Porou)
| | - Theona Ireton
- Māori Health Services, Christchurch Hospital, Te Whatu Ora, Waitaha/Canterbury, Christchurch, NZ (Ngā Wairiki, Ngāti Porou)
| | - Karen Keelan
- Te Aho o Te Kahu–Cancer Control Agency, Ministry of Health, NZ (Ngāti Porou)
| | - Jennifer Jordan
- Psychological Medicine, University of Otago, Christchurch, NZ
- Specialist Mental Health Service Clinical Research Unit, Te Whatu Ora, Waitaha/Canterbury, Christchurch, NZ
| | - Bridget A. Robinson
- Mackenzie Cancer Research Group, Department of Pathology and Biomedical Science, University of Otago, Christchurch, New Zealand (NZ)
- Canterbury Regional Cancer and Haematology Service, Te Whatu Ora, Waitaha/Canterbury, Christchurch, NZ
| | - Gabi U. Dachs
- Mackenzie Cancer Research Group, Department of Pathology and Biomedical Science, University of Otago, Christchurch, New Zealand (NZ)
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Maulidawati D, Rochmawati E, Granel N. Non-pharmacological management for chemotherapy-induced nausea and vomiting in patients with cancer: a scoping review †. FRONTIERS OF NURSING 2023. [DOI: 10.2478/fon-2023-0002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
Abstract
Abstract
Objective
This review aimed to map and summarize published studies that tested non-pharmacological management for chemotherapy-induced nausea and vomiting (CINV).
Methods
We searched for eligible studies in 5 electronic databases and screened the retrieved studies using the inclusion and exclusion criteria. Data were then collated according to the types of interventions, measurement tool, and outcomes.
Results
The search yielded 2343 records, of which 11 were included. Four categories of non-pharmacological CINV management were made; manipulative and body-based therapy (n = 5 studies); mind–body therapy (n = 3 studies); biologically based practice (n = 1 study), and energy therapy (n = 2 studies). Seven different scales were used to measure CINV. Nine studies reported improvement in CINV.
Conclusions
This scoping review demonstrates the breadth of non-pharmacological management to address CINV. Various types of CINV scales were used to measure CINV severity. The management and scale can be utilized to improve nursing care, particularly in cancer care.
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Affiliation(s)
- Dewi Maulidawati
- a Department of Medical Surgical Nursing, Nursing Program , Universitas Muhammadiyah Yogyakarta, Jl Brawijaya , Tamantirto, Kasihan, Bantul , Indonesia
| | - Erna Rochmawati
- a Department of Medical Surgical Nursing, Nursing Program , Universitas Muhammadiyah Yogyakarta, Jl Brawijaya , Tamantirto, Kasihan, Bantul , Indonesia
| | - Nina Granel
- b Department of Nursing , Universitat Autònoma de Barcelona , Cerdanyola del Valles , Spain
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Sheldrick H, Houghton L, Fleming C, Crane J. An integrated care systems model approach for speech and language therapy head and neck cancer services in England: service development and re-design in Cheshire and Merseyside. Curr Opin Otolaryngol Head Neck Surg 2022; 30:177-181. [PMID: 35635112 DOI: 10.1097/moo.0000000000000800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE OF REVIEW The incidence of head and neck cancer (HNC) is increasing globally and changes in treatment mean that patients are living longer with the condition. It is recognised that while there have been improvements at the diagnostic phase of the pathway, follow-up and on-going care can be fragmented and inequitable. Integrated care models (ICMs) are acknowledged as beneficial. The National Health Service in England is moving to a model whereby services are being re-organised to integrated care systems. This paper reviews the literature and discusses potential models of care to enhance speech and language therapy (SLT) provision for patients with HNC in line with the emerging ICS. RECENT FINDINGS The COVID-19 pandemic has provided an opportunity to review service provision and SLT teams quickly adapted to offering remote support. Discussions are currently on-going to explore the potential for patient initiated follow-up via the PETNECK 2 trial and the Buurtzorg 'neighbourhood model' holds promise. SUMMARY ICMs put the patient at the centre of care and have reported benefits for experience of care and clinical outcomes. Navigating organisational structures is complex. The Buurtzorg model provides a practical and theoretical framework to support organisational change.
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Affiliation(s)
| | | | | | - Julie Crane
- Sohool of Health Sciences, University of Liverpool, Liverpool, UK
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Mead KH, Wang Y, Cleary S, Arem H, Pratt-Chapman ML. Defining a patient-centered approach to cancer survivorship care: development of the patient centered survivorship care index (PC-SCI). BMC Health Serv Res 2021; 21:1353. [PMID: 34922530 PMCID: PMC8684610 DOI: 10.1186/s12913-021-07356-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Accepted: 11/25/2021] [Indexed: 01/22/2023] Open
Abstract
Purpose This study presents the validation of an index that defines and measures a patient-centered approach to quality survivorship care. Methods We conducted a national survey of 1,278 survivors of breast, prostate, and colorectal cancers to identify their priorities for cancer survivorship care. We identified 42 items that were “very important or absolutely essential” to study participants. We then conducted exploratory and confirmatory factor analyses (EFA/CFA) to develop and validate the Patient-Centered Survivorship Care Index (PC-SCI). Results A seven-factor structure was identified based on EFA on a randomly split half sample and then validated by CFA based on the other half sample. The seven factors include: (1) information and support in survivorship (7 items), (2) having a medical home (10 items) (3) patient engagement in care (3 items), (4) care coordination (5 items), (5) insurance navigation (3 items), (6) care transitions from oncologist to primary care (3 items), and (7) prevention and wellness services (5 items). All factors have excellent composite reliabilities (Cronbach’s alpha 0.84-0.94, Coefficient of Omega: 0.81-0.94). Conclusions Providing quality post-treatment care is critical for the long-term health and well-being of survivors. The PC-SCI defines a patient-centered approach to survivorship care to complement clinical practice guidelines. The PC-SCI has acceptable composite reliability, providing the field with a valid instrument of patient-centered survivorship care. The PC-SCI provides cancer centers with a means to guide, measure and monitor the development of their survivorship care to align with patient priorities of care. Trial registration ClinicalTrials.gov ID: NCT02362750, 13 February 2015 Supplementary Information The online version contains supplementary material available at 10.1186/s12913-021-07356-6.
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Affiliation(s)
- K Holly Mead
- Milken Institute School of Public Health, George Washington University, 950 New Hampshire Ave, Washington, DC, 20052, USA
| | - Yan Wang
- Milken Institute School of Public Health, George Washington University, 950 New Hampshire Ave, Washington, DC, 20052, USA
| | - Sean Cleary
- Milken Institute School of Public Health, George Washington University, 950 New Hampshire Ave, Washington, DC, 20052, USA
| | - Hannah Arem
- Healthcare Delivery Research, MedStar Health Research Institute, Washington, DC, 20008, USA.,Department of Oncology, Georgetown Medical School, Washington, DC, 20007, USA
| | - Mandi L Pratt-Chapman
- George Washington University Cancer Center, George Washington University, 2600 Virginia Ave, NW, #300, Washington, DC, 20037, USA.
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Experiences of being a family caregiver to a patient treated for oesophageal cancer-1 year after surgery. Support Care Cancer 2021; 30:915-921. [PMID: 34414468 PMCID: PMC8636407 DOI: 10.1007/s00520-021-06501-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Accepted: 08/10/2021] [Indexed: 11/13/2022]
Abstract
Purpose There is a need to put family caregivers on the cancer survivorship research agenda. Therefore, the aim of this is study is to explore the experiences of being a family caregiver to a patient treated for oesophageal cancer. Method This qualitative study was based on the ongoing nationwide and prospective Oesophageal Surgery on Cancer patients – Adaptation and Recovery study (OSCAR) including patients surgically treated for oesophageal cancer in Sweden and their closest family caregiver. One year after the patient’s surgery, each family caregiver received a self-report questionnaire kit to fill in. For the purpose of this study, the responses to the open-ended question “Is there anything else you would like to share?” were used and analysed by conducting thematic analysis. Results In total, 112 responses to the open-ended question were transcribed and analysed. The text rendered three themes: Discontinued support from healthcare—mostly a positive experience before surgery and in the acute survivorship phase. However, after discharge from the hospital, the family caregiver felt as though they were left alone, fully responsible for the patient’s care. A changed life—unprepared for life-changing situation after the patient received the cancer diagnosis. A feeling that nothing will ever be the same and like your sense of self is lost. Psychological distress—was described as a feeling of being alone. Family caregivers felt invisible and no longer important to family and friends. The patient was the one that mattered. Conclusion This study indicates that patients and family caregivers would benefit from a more family-centred healthcare, where the patients’ as well as the caregivers’ perspectives would be acknowledged.
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Brown CM, Richards KM, Vohra Y, Kanu C, Stevens L, Sasane R, Balu S, McAneny B. Evaluation of access to care issues in patients with breast cancer. J Med Econ 2021; 24:38-45. [PMID: 33317379 DOI: 10.1080/13696998.2020.1858580] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
AIMS System-level efforts have been deployed to improve oncology care and access while reducing utilization and costs. Understanding the nature of access to care from the perspective of patients themselves is an unmet need. This study examined access to care in a population of women with breast cancer and its relationship to overall patient satisfaction. MATERIALS AND METHODS Patients with breast cancer from six oncology clinics in five states completed a survey during routine office visits. Access to care (higher scores indicated increasing access barriers), overall patient satisfaction, and patient demographic/clinical characteristics were measured. The relationships between access (composite and factor scores) and satisfaction were assessed using multivariable analyses controlling for age (the only significant characteristic from bivariate analyses). RESULTS A total of 180 patients completed the survey. Factor analysis of access to care items revealed an 8-factor measure - Insurance, Health System, Emotional, Holistic Treatment, Family Support, Knowledge/Understanding, Information Quality, and Financial Support - with high reliability (Composite: Cronbach alpha = 0.93; Factors: Cronbach alpha range = 0.85-0.91). Access composite score was moderately low (mean = 1.90), indicating an overall low level of access barriers, and overall patient satisfaction was high (mean = 4.59). The composite score (p < .001) and the Health System and Knowledge/Understanding factors (p < .01) were significant and negative predictors of overall satisfaction. LIMITATIONS Study sites were high functioning clinics and all, but one, are Oncology Care Model practices. Thus, the scope of access to care issues for patients of under-resourced clinics might not be well addressed. CONCLUSIONS Access to care overall and by factor was significantly predictive of patient satisfaction with care. In addition, access to care factors varied across several demographic and clinical characteristics. Future strategies that address access to care challenges should consider these modifiable, patient-centric, and system-based issues.
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Affiliation(s)
- Carolyn M Brown
- Texas Center for Health Outcomes Research and Education (TxCORE), College of Pharmacy, The University of Texas at Austin, Austin, TX, USA
| | - Kristin M Richards
- Texas Center for Health Outcomes Research and Education (TxCORE), College of Pharmacy, The University of Texas at Austin, Austin, TX, USA
| | - Yogesh Vohra
- Texas Center for Health Outcomes Research and Education (TxCORE), College of Pharmacy, The University of Texas at Austin, Austin, TX, USA
| | - Chisom Kanu
- RTI Health Solutions, Research Triangle Park, NC, USA
| | - Laura Stevens
- Innovative Oncology Business Solutions, Albuquerque, NM, USA
| | | | | | - Barbara McAneny
- New Mexico Oncology Hematology Consultants, Albuquerque, NM, USA
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Benjamin LS. Holistic Nursing Upon the Knowledge on Care During Myelosuppression among Cancer Patients. Asian Pac J Cancer Prev 2020; 21:1089-1096. [PMID: 32334475 PMCID: PMC7445969 DOI: 10.31557/apjcp.2020.21.4.1089] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Indexed: 12/24/2022] Open
Abstract
Background: A study was conducted to assess the effectiveness of holistic nursing intervention upon the knowledge regarding care during myelosupression among patients with cancer at a selected hospital in Chennai, India. Methods: A quantitative research approach of quasi experimental non-equivalent with control group before –after design (non randomized) was used. The investigator included 204 participants by using purposive sampling technique which included 102 each in study and comparison group. Pre-test was done before the intervention of holistic nursing to both comparison and study group participants. Holistic nursing intervention was implemented for study group whereas comparison group received routine care. Post test was done by using the structured questionnaire after 1month. The responses from the participants were coded and statistically analyzed by using descriptive and inferential statistics. Results: The knowledge scores obtained by study group was significantly higher (13.32+2.94) when compared to comparison group (8.12+2.04). There was a statistically significant difference between study and comparison group participants, at p< 0.001. With regard to the dimensions of knowledge related to disease condition and signs and symptoms were higher in the study group when compared to the comparison group. The difference was statistically significant at p<0.001. With regard to the management and prevention, the scores were almost similar in both the groups. Conclusion: The researcher concludes with the fact that holistic nursing is a non invasive intervention, which allows cancer patients to relax, improves compliance to therapeutic regimen during myelosuppression.
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Yang K, Wu J, Santos S, Liu Y, Zhu L, Lin F. Recent development of portable imaging platforms for cell-based assays. Biosens Bioelectron 2019; 124-125:150-160. [DOI: 10.1016/j.bios.2018.10.024] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2018] [Revised: 10/06/2018] [Accepted: 10/13/2018] [Indexed: 12/22/2022]
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Ke Y, Ng T, Chan A. Survivorship care models for breast cancer, colorectal cancer, and adolescent and young adult (AYA) cancer survivors: a systematic review. Support Care Cancer 2018; 26:2125-2141. [PMID: 29696424 DOI: 10.1007/s00520-018-4197-y] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2017] [Accepted: 04/09/2018] [Indexed: 01/08/2023]
Abstract
BACKGROUND Well-elucidated survivorship care models are pertinent in the long-term management of cancer survivors. This review aims to update existing literature and evaluate the key components of such models with a focus on breast, colorectal, and adolescent and young adult (AYA) cancer survivors. METHODS The PubMed electronic database were searched comprehensively for relevant publications in English through February 2017. Additional manual searches were conducted for reference lists and official guidelines published by oncology societies. Included studies addressed the correct cancer type, elaborated on each model's structure and provided patient-related outcome data to support its model's effectiveness if applicable. RESULTS Among the 25 included studies, six articles described survivorship models applicable to all cancer types, and the remaining focused on breast cancer (n = 10), colorectal cancer (n = 3), and AYA cancer survivors (n = 6). Shared-care model was largely described for all cancer types whereas multidisciplinary model predominated for AYA cancer survivors. Upon evaluation, these models described the essential components of survivorship care fairly well except for the care coordination component. Also, the definition of time points of care was vague and noncomprehensive. CONCLUSION The reviewed survivorship model studies were comprehensive but were limited by a lack of existing rigorous evaluation efforts to assess their effectiveness. This review further provided valuable recommendations for future methodological evaluation of such models. This review has highlighted care coordination as an area for improvement and emphasized the importance of obtaining data on the effectiveness of these survivorship models to ensure satisfactory quality of life and health outcomes.
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Affiliation(s)
- Yu Ke
- Department of Pharmacy, National University of Singapore, Blk S4A level 3, 18 Science Drive 4, Singapore, 117543, Singapore
| | - Terence Ng
- Department of Pharmacy, National University of Singapore, Blk S4A level 3, 18 Science Drive 4, Singapore, 117543, Singapore
| | - Alexandre Chan
- Department of Pharmacy, National University of Singapore, Blk S4A level 3, 18 Science Drive 4, Singapore, 117543, Singapore. .,Department of Pharmacy, National Cancer Centre Singapore, 11 Hospital Drive, Singapore, 169610, Singapore. .,Duke-NUS Graduate Medical School Singapore, 8 College Road, Singapore, 169857, Singapore.
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