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Afungchwi GM, Waindim Y, Pondy-Ongotsoyi A, Essono J, Youwa P, Frambo A, Tayou R, Grace NM, Kengang A, Eyambe L, Farida H, Chishugi J, Kouya F, Nkegoum B. Organization of shared care networks and their role in overcoming challenges and enhancing outcomes for childhood cancer: A systematic review. Pediatr Blood Cancer 2024; 71:e31245. [PMID: 39129132 DOI: 10.1002/pbc.31245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2024] [Revised: 07/08/2024] [Accepted: 07/24/2024] [Indexed: 08/13/2024]
Abstract
This systematic review examines shared care networks (SCNs) in pediatric oncology as a strategic response to the healthcare challenges in low- and middle-income countries. SCNs integrate specialized hubs with local satellite centers to enhance accessibility and quality of care. Our methodology included a search of PubMed, Embase, Google Scholar, and Scopus, selecting peer-reviewed articles from the last 20 years. We analyzed nine studies, focusing on SCN definitions, models, and outcomes. Findings reveal that SCNs improve clinical outcomes and patient satisfaction, while reducing economic and emotional burdens through standardized protocols and efficient referral systems. Despite the benefits, challenges remain in maintaining consistent care quality and communication across centers. The review underscores the need for further research to quantify benefits, examine long-term outcomes, and refine operational practices to optimize SCNs' effectiveness in pediatric oncology.
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Affiliation(s)
- Glenn Mbah Afungchwi
- Department of Nursing and Midwifery, Faculty of Health Sciences, The University of Bamenda, Bamenda, Cameroon
- World Child Cancer, Bamenda, Camerooon
| | | | - Angele Pondy-Ongotsoyi
- Department of Pediatrics, Faculty of Medicine and Biomedical Sciences, University of Yaounde 1, Yaounde, Cameroon
- Department of Oncology/Hematology, Mother and Child Center, Chantal Biya Foundation, Yaounde, Cameroon
| | - Justine Essono
- National Committee for the Fight Against Cancer, Ministry of Public Health, Yaounde, Cameroon
| | - Prisca Youwa
- National Committee for the Fight Against Cancer, Ministry of Public Health, Yaounde, Cameroon
| | | | | | - Nyemb Mbog Grace
- Department of Oncology/Hematology, Mother and Child Center, Chantal Biya Foundation, Yaounde, Cameroon
| | - Armelle Kengang
- Department of Oncology/Hematology, Mother and Child Center, Chantal Biya Foundation, Yaounde, Cameroon
| | - Lydia Eyambe
- Department of Oncology, Cameroon Baptist Convention Health Services, Bamenda, Cameroon
| | - Haoua Farida
- Department of Non-Communicable Diseases, Ministry of Public Health, Yaounde, Cameroon
| | | | - Francine Kouya
- Department of Oncology, Cameroon Baptist Convention Health Services, Bamenda, Cameroon
| | - Blaise Nkegoum
- National Committee for the Fight Against Cancer, Ministry of Public Health, Yaounde, Cameroon
- Department of Pathology, University Teaching Hospital, University of Yaounde 1, Yaounde, Cameroon
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Zucchetti G, Ciappina S, Roccia E, Concas D, Giordano M, Battaglini C, Geuna T, Peirolo C, Faretta E, Fernandez I, Quarello P, Fagioli F. EMDR and standard psychotherapy for paediatric cancer patients and their families: a pilot study. Front Psychol 2024; 15:1407985. [PMID: 39045437 PMCID: PMC11263944 DOI: 10.3389/fpsyg.2024.1407985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2024] [Accepted: 06/27/2024] [Indexed: 07/25/2024] Open
Abstract
Introduction This study examined the efficacy of eye movement desensitisation and reprocessing (EMDR) therapy compared with standard psychotherapy (SP) in treating post-traumatic stress disorder (PTSD) in paediatric oncology patients and their families in the early stage of cancer treatment. The secondary aim of this study was to assess whether EMDR therapy has a different impact on post-traumatic growth compared to SP. Methods Forty patients were randomly assigned to EMDR or SP groups. The Impact of Event Scale - Revised (IES-R) and the Distress Thermometer (DT) were used to assess PTSD symptoms at pre-treatment (at cancer diagnosis) and in the post-treatment stages (after 8 sessions). The Post-traumatic Growth Inventory-PTGI was administered in the post-treatment stage in order to evaluate positive changes. Results Both EMDR and SP are effective in reducing PTSD, but EMDR was significantly more effective than the SP in reducing scores on the IES-R, especially regarding the intrusive symptom subscale. Also, in the EMDR group there were higher scores of PTGI than in the standard group. Conclusion EMDR thus represents a promising treatment in the paediatric psycho-oncology setting.
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Affiliation(s)
- Giulia Zucchetti
- Department of Paediatric Onco-Haematology, Regina Margherita Children’s Hospital, AOU Città della Salute e della Scienza, Turin, Italy
| | - Sabrina Ciappina
- Department of Paediatric Onco-Haematology, Regina Margherita Children’s Hospital, AOU Città della Salute e della Scienza, Turin, Italy
| | - Elvia Roccia
- Department of Paediatric Onco-Haematology, Regina Margherita Children’s Hospital, AOU Città della Salute e della Scienza, Turin, Italy
| | - Deborah Concas
- Department of Paediatric Onco-Haematology, Regina Margherita Children’s Hospital, AOU Città della Salute e della Scienza, Turin, Italy
| | - Mario Giordano
- Department of Paediatric Onco-Haematology, Regina Margherita Children’s Hospital, AOU Città della Salute e della Scienza, Turin, Italy
| | - Chiara Battaglini
- Department of Paediatric Onco-Haematology, Regina Margherita Children’s Hospital, AOU Città della Salute e della Scienza, Turin, Italy
| | - Tiziana Geuna
- Department of Paediatric Onco-Haematology, Regina Margherita Children’s Hospital, AOU Città della Salute e della Scienza, Turin, Italy
| | - Claudia Peirolo
- Department of Paediatric Onco-Haematology, Regina Margherita Children’s Hospital, AOU Città della Salute e della Scienza, Turin, Italy
| | | | | | - Paola Quarello
- Department of Paediatric Onco-Haematology, Regina Margherita Children’s Hospital, AOU Città della Salute e della Scienza, Turin, Italy
- University of Turin, Turin, Italy
| | - Franca Fagioli
- Department of Paediatric Onco-Haematology, Regina Margherita Children’s Hospital, AOU Città della Salute e della Scienza, Turin, Italy
- University of Turin, Turin, Italy
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Zucchetti G, Ciappina S, Bottigelli C, Campione G, Parrinello A, Piu P, Lijoi S, Quarello P, Fagioli F. Reiki intervention for supporting healthcare professional care behaviors in pediatric palliative care: A pilot study. Palliat Support Care 2024; 22:493-498. [PMID: 38131135 DOI: 10.1017/s1478951523001852] [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] [Indexed: 12/23/2023]
Abstract
OBJECTIVES Pediatric healthcare professionals (HCPs) working in a palliative setting may experience challenges during their clinical practice in addressing the complex end-of-life phase of children and their families. Nurses, especially, have a frontline role in providing assistance, thereby becoming at risk of physical and psychological burden. Pediatric psychologists have an ethical responsibility to help colleagues by proposing self-care interventions that will improve their well-being and, indirectly, the work climate. This study investigated the impact of a complementary therapy, delivered by a pediatric psychologist and a nurse, on physical and psychological variables among nurses at the Paediatric Hospice of the Regina Margherita Children's Hospital in Italy. METHODS Thirty-five nurses participated in 5 weeks of Reiki sessions for an overall total of 175 sessions. The effect of the sessions was analyzed through a paired t-test analysis comparing the values of heart rate, oxygen saturation, and systolic and diastolic pressure collected before and after each session. The same test was conducted comparing the values of the 3 burnout subscales for each of the 35 nurses collected before the beginning of the first session with those collected at the end of the last session 2 months later. RESULTS Results underlined a positive short-term effect with a significant decrease in heart rate before and after each session (t = 11.5, p < .001) and in systolic pressure (t = 2, p < .05). In addition, a decrease in emotional exhaustion symptoms was found (t = 2.3, p < .05) at the end of the intervention. SIGNIFICANCE OF RESULTS Reiki could be a valid strategy to complement traditional pediatric psychology clinical practice designed to protect HCPs from emotional and physical demands and to create a more supportive workplace for staff and patients alike.
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Affiliation(s)
- Giulia Zucchetti
- Pediatric Oncohematology Unit, Regina Margherita Children's Hospital, Turin, Italy
| | - Sabrina Ciappina
- Pediatric Oncohematology Unit, Regina Margherita Children's Hospital, Turin, Italy
| | | | | | | | - Paola Piu
- Regina Margherita Children's Hospital, Turin, Italy
| | - Stefano Lijoi
- Pediatric Oncohematology Unit, Regina Margherita Children's Hospital, Turin, Italy
| | - Paola Quarello
- Pediatric Oncohematology Unit, Regina Margherita Children's Hospital, Turin, Italy
- University of Turin, Italy
| | - Franca Fagioli
- Pediatric Oncohematology Unit, Regina Margherita Children's Hospital, Turin, Italy
- University of Turin, Italy
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Ciappina S, Roccia E, Concas D, Faretta E, Fernandez I, Quarello P, Zucchetti G, Fagioli F. EMDR in pediatric hospital setting: a case report of an adolescent with cancer. Front Psychol 2024; 15:1347822. [PMID: 38586287 PMCID: PMC10996851 DOI: 10.3389/fpsyg.2024.1347822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Accepted: 01/12/2024] [Indexed: 04/09/2024] Open
Abstract
Introduction Childhood cancer is rare, but it is the most frequent serious event with a high risk of traumatization for children, adolescents, parents and siblings. EMDR is widely studied as clinical intervention that addressed cancer-related stressors among cancer adult population, but to our knowledge, no researches have been conducted among children and adolescent with cancer. Methods The purpose of this case study is to describe for the first time the application of the EMDR protocol in a pediatric hospital setting with a 17-years-old Italian adolescent who received a diagnosis of leukemia. He accessed the psychological support service complaining of feelings of anxiety and general discomfort. EMDR protocol started after the diagnosis and ended after the usual eight phases. The Impact of Event Scale-Revised (IES-R) was used to assess stress disorders symptoms as outcome at the baseline (before the First Phase) and at the end of the EMDR protocol (after the Eight Phase). Results By using EMDR protocol the patient reported a decrease of emotional activation after a few EMDR sessions. Conclusion EMDR protocol may be effective for pediatric cancer patients in treating stress disorders symptoms and it can be proposed immediately after diagnosis as a standard care also in pediatric hospital setting.
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Affiliation(s)
- Sabrina Ciappina
- Pediatric Oncology Department, Regina Margherita Children's Hospital, AOU Città della Salute e della Scienza, Turin, Italy
| | - Elvia Roccia
- Pediatric Oncology Department, Regina Margherita Children's Hospital, AOU Città della Salute e della Scienza, Turin, Italy
| | - Deborah Concas
- Pediatric Oncology Department, Regina Margherita Children's Hospital, AOU Città della Salute e della Scienza, Turin, Italy
| | | | | | - Paola Quarello
- Pediatric Oncology Department, Regina Margherita Children's Hospital, AOU Città della Salute e della Scienza, Turin, Italy
- Department of Sciences of Public Health and Pediatrics, University of Turin, Turin, Italy
| | - Giulia Zucchetti
- Pediatric Oncology Department, Regina Margherita Children's Hospital, AOU Città della Salute e della Scienza, Turin, Italy
| | - Franca Fagioli
- Pediatric Oncology Department, Regina Margherita Children's Hospital, AOU Città della Salute e della Scienza, Turin, Italy
- Department of Sciences of Public Health and Pediatrics, University of Turin, Turin, Italy
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Zucchetti G, Ciappina S, Dionisi-Vici M, Giordano M, Varetto A, Biasin E, Felicetti F, Fagioli F. Emotional Distress, Self-Management Skills, and Expectations Among Adolescents and Young Adult Childhood Cancer Survivors in Transition from Pediatric to Adult Care: A Brief Report. J Adolesc Young Adult Oncol 2023; 12:906-911. [PMID: 36867153 DOI: 10.1089/jayao.2022.0166] [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] [Indexed: 03/04/2023] Open
Abstract
The transition from pediatric to adult care poses several emotional and personal challenges to adolescents and young adult (AYA) childhood cancer survivors (CCSs), which need attention to avoid the risk of nonadherence and medical dropout. This brief report describes the condition of AYA-CCSs at the moment of transition in terms of emotional state, personal autonomy, and expectations regarding future care. The results provide insights for clinicians dealing with survivorship care, to enhance AYA-CCSs emotional resilience and to support them in being in charge of their health, thus facilitating their transition to adulthood.
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Affiliation(s)
- Giulia Zucchetti
- Pediatric Oncohematology Department, Regina Margherita Children's Hospital, AOU Città Della Salute e Della Scienza di Torino, Turin, Italy
| | - Sabrina Ciappina
- Pediatric Oncohematology Department, Regina Margherita Children's Hospital, AOU Città Della Salute e Della Scienza di Torino, Turin, Italy
| | - Margherita Dionisi-Vici
- Transition Unit for Childhood Cancer Survivors, AOU Città Della Salute e Della Scienza, Turin, Italy
| | - Mario Giordano
- Pediatric Oncohematology Department, Regina Margherita Children's Hospital, AOU Città Della Salute e Della Scienza di Torino, Turin, Italy
| | - Antonella Varetto
- Transition Unit for Childhood Cancer Survivors, AOU Città Della Salute e Della Scienza, Turin, Italy
| | - Eleonora Biasin
- Pediatric Oncohematology Department, Regina Margherita Children's Hospital, AOU Città Della Salute e Della Scienza di Torino, Turin, Italy
| | - Francesco Felicetti
- Transition Unit for Childhood Cancer Survivors, AOU Città Della Salute e Della Scienza, Turin, Italy
| | - Franca Fagioli
- Pediatric Oncohematology Department, Regina Margherita Children's Hospital, AOU Città Della Salute e Della Scienza di Torino, Turin, Italy
- Department of Public Health and Paediatric Sciences, University of Torino, Turin, Italy
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Zucchetti G, Battaglini C, Ciappina S, Geuna T, Giordano M, Peirolo C, Roccia E, Asaftei S, Quarello P, Fagioli F. The Ukrainian children emergency: How the Pediatric Oncology Unit of Turin supports cancer patients and their families who have escaped war. Pediatr Blood Cancer 2022; 69:e29769. [PMID: 35592947 DOI: 10.1002/pbc.29769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Accepted: 04/22/2022] [Indexed: 11/05/2022]
Abstract
Due to the war in Ukraine, many children have been killed and those who suffer from severe diseases, such as oncological pathologies, are facing serious challenges as their treatment is interrupted. The objective of this report is to describe one of the first Italian humanitarian expeditions launched to rescue children and their families to provide them with the best possible cancer care. The Pediatric Oncology Unit of Turin has welcomed 60 Ukrainians who are patients, caregivers and siblings. This report underlines the activities that have been implemented to offer this new type of patient the best possible care.
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Affiliation(s)
- Giulia Zucchetti
- Pediatric Oncology Unit, Regina Margherita Children's Hospital, AOU Città della Salute e della Scienza, Torino, Italy.,University of Torino, turin, Italy
| | - Chiara Battaglini
- Pediatric Oncology Unit, Regina Margherita Children's Hospital, AOU Città della Salute e della Scienza, Torino, Italy
| | - Sabrina Ciappina
- Pediatric Oncology Unit, Regina Margherita Children's Hospital, AOU Città della Salute e della Scienza, Torino, Italy
| | - Tiziana Geuna
- Pediatric Oncology Unit, Regina Margherita Children's Hospital, AOU Città della Salute e della Scienza, Torino, Italy
| | - Mario Giordano
- Pediatric Oncology Unit, Regina Margherita Children's Hospital, AOU Città della Salute e della Scienza, Torino, Italy
| | - Claudia Peirolo
- Pediatric Oncology Unit, Regina Margherita Children's Hospital, AOU Città della Salute e della Scienza, Torino, Italy
| | - Elvia Roccia
- Pediatric Oncology Unit, Regina Margherita Children's Hospital, AOU Città della Salute e della Scienza, Torino, Italy
| | - Sebastian Asaftei
- Pediatric Oncology Unit, Regina Margherita Children's Hospital, AOU Città della Salute e della Scienza, Torino, Italy
| | - Paola Quarello
- Pediatric Oncology Unit, Regina Margherita Children's Hospital, AOU Città della Salute e della Scienza, Torino, Italy.,University of Torino, turin, Italy
| | - Franca Fagioli
- Pediatric Oncology Unit, Regina Margherita Children's Hospital, AOU Città della Salute e della Scienza, Torino, Italy.,University of Torino, turin, Italy
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7
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Evolving pancreatic cancer treatment: From diagnosis to healthcare management. Crit Rev Oncol Hematol 2021; 169:103571. [PMID: 34923121 DOI: 10.1016/j.critrevonc.2021.103571] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Accepted: 12/13/2021] [Indexed: 12/12/2022] Open
Abstract
The prognosis of pancreatic ductal adenocarcinoma is still the worst among solid tumors. In this review, a panel of experts addressed the main unanswered questions about the clinical management of this disease, with the aim of providing practical decision support for physicians. On the basis of the evidence available from the literature, the main topics concerning pancreatic cancer are discussed: the diagnosis, as the need for a pathological characterization and the role for germ-line and somatic molecular profiling; the therapeutic management of resectable disease, as the role of upfront surgery or neoadjuvant chemotherapy, the post-operative restaging and the optimal timing foradjuvant chemotherapy, the management of the borderline resectable and locally advanced disease; the metastatic disease and the role of surgery for the management of patients with isolated metastasis and the use of biomarkers of metastatic potential; the role of supportive care and the healthcare management of pancreatic ductal adenocarcinoma.
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Zecca M, Ferrari A, Quarello P, Rabusin M, Balduzzi A, Buldini B, Rostagno E, Prete A, Favre C, Massimino M, Biondi A, Porta F, Biffi A, Locatelli F, Pession A, Fagioli F. Childhood cancer in Italy: background, goals, and achievements of the Italian Paediatric Hematology Oncology Association (AIEOP). TUMORI JOURNAL 2021; 107:370-375. [PMID: 33876662 DOI: 10.1177/03008916211007934] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This article reviews the primary goals and achievements of the Italian Association for Pediatric Hematology-Oncology (Associazione Italiana Ematologia Oncologia Pediatrica [AIEOP]), a national cooperative group that has been working for children and adolescents with cancer in Italy since 1975.
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Affiliation(s)
- Marco Zecca
- Pediatric Hematology/Oncology, Fondazione IRCCS Policlinico San Matteo, Pavia, Lombardia, Italy
| | - Andrea Ferrari
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | - Paola Quarello
- Pediatric Onco-Hematology, Stem Cell Transplantation and Cellular Therapy Division, Regina Margherita Children's Hospital, Azienda Ospedaliera-Universitaria Città della Salute e della Scienza, University of Torino, Piemonte, Italy
| | - Marco Rabusin
- Institute for Maternal and Child Health, "IRCCS Burlo Garofolo" Trieste, Trieste, Friuli-Venezia Giulia, Italy
| | - Adriana Balduzzi
- Pediatric Department, University of Milano Bicocca, MBBM Foundation, ASST Monza Ospedale San Gerardo, Monza, Lombardia, Italy
| | - Barbara Buldini
- Division of Pediatric Hematology, Oncology and Stem Cell Transplant, Mother and Child's Health Department, University of Padova, Padova, Veneto, Italy
| | - Elena Rostagno
- Hematology-Oncology Unit, Department of Pediatrics - IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Arcangelo Prete
- Hematology-Oncology Unit, Department of Pediatrics - IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Claudio Favre
- Paediatric Haematology/Oncology and HSCT Department, Anna Meyer Children's University Hospital, Firenze, Toscana, Italy
| | - Maura Massimino
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | - Andrea Biondi
- Pediatric Department, University of Milano Bicocca, MBBM Foundation, ASST Monza Ospedale San Gerardo, Monza, Lombardia, Italy
| | - Fulvio Porta
- Pediatric Haematology Oncology and BMT Unit, Ospedale dei Bambini, ASST-Spedali Civili of Brescia, Brescia, Lombardia, Italy
| | - Alessandra Biffi
- Division of Pediatric Hematology, Oncology and Stem Cell Transplant, Mother and Child's Health Department, University of Padova, Padova, Veneto, Italy
| | - Franco Locatelli
- Department of Pediatric Hematology and Oncology, Bambino Gesù Children's Hospital, Roma, Lazio, Italy
| | - Andrea Pession
- Hematology-Oncology Unit, Department of Pediatrics - IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Franca Fagioli
- Pediatric Onco-Hematology, Stem Cell Transplantation and Cellular Therapy Division, Regina Margherita Children's Hospital, Azienda Ospedaliera-Universitaria Città della Salute e della Scienza, University of Torino, Piemonte, Italy
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Zucchetti G, Bertolotti M, Fagioli F. How paediatric psycho-oncology is changing during the COVID-19 epidemic in Italy: New approaches. Psychooncology 2020; 29:1384-1386. [PMID: 32539199 PMCID: PMC7323114 DOI: 10.1002/pon.5444] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2020] [Revised: 05/26/2020] [Accepted: 06/06/2020] [Indexed: 01/10/2023]
Affiliation(s)
- Giulia Zucchetti
- Pediatric Oncology Division, Regina Margherita Children's Hospital, AOU Città della Salute e della Scienza di Torino, Turin, Italy
| | - Marina Bertolotti
- Pediatric Oncology Division, Regina Margherita Children's Hospital, AOU Città della Salute e della Scienza di Torino, Turin, Italy
| | - Franca Fagioli
- Pediatric Oncology Division, Regina Margherita Children's Hospital, AOU Città della Salute e della Scienza di Torino, Turin, Italy.,Department of Public Health and Paediatric Sciences, University of Torino, Turin, Italy
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Takes RP, Halmos GB, Ridge JA, Bossi P, Merkx MAW, Rinaldo A, Sanabria A, Smeele LE, Mäkitie AA, Ferlito A. Value and Quality of Care in Head and Neck Oncology. Curr Oncol Rep 2020; 22:92. [PMID: 32651680 PMCID: PMC7351804 DOI: 10.1007/s11912-020-00952-5] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
PURPOSE OF REVIEW The concept of value-based health care (VBHC) was articulated more than a decade ago. However, its clinical implementation remains an on-going process and a particularly demanding one for the domain of head and neck cancer (HNC). These cancers often present with fast growing tumors in functionally and cosmetically sensitive sites and afflict patients with differing circumstances and comorbidity. Moreover, the various treatment modalities and protocols have different effects on functional outcomes. Hence, the interpretation of what constitutes VBHC in head and neck oncology remains challenging. RECENT FINDINGS This monograph reviews developments in specific aspects of VBHC for HNC patients, including establishment of registries and quality indices (such as infrastructure, process, and outcome indicators). It emphasizes the importance of the multidisciplinary team, "time to treatment intervals," and adherence to guidelines. The discussion addresses major indicators including survival, quality of life and functional outcomes, and adverse events. Also, strengths and weaknesses of nomograms, prognostic and decision models, and variation of care warrant attention. Health care professionals, together with patients, must properly define quality and relevant outcomes, both for the individual patient as well as the HNC population. It is essential to capture and organize the relevant data so that they can be analyzed and the results used to improve both outcomes and value.
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Affiliation(s)
- Robert P Takes
- Department of Otolaryngology/Head and Neck Surgery, Radboud University Medical Center, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands.
| | - Gyorgy B Halmos
- Department of Otorhinolaryngology - Head and Neck Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - John A Ridge
- Department of Surgical Oncology, Fox Chase Cancer Center, Philadelphia, PA, USA
| | - Paolo Bossi
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, ASST Spedali Civili, Brescia, Italy
| | - Matthias A W Merkx
- Department of Oral and Maxillofacial Surgery, Radboud University Medical Centre, Nijmegen, The Netherlands
| | | | - Alvaro Sanabria
- Department of Surgery, School of Medicine, Hospital Universitario San Vicente Fundacion. CEXCA Centro de Excelencia en Enfermedades de Cabeza y Cuello, Universidad de Antioquia, Medellín, Colombia
| | - Ludi E Smeele
- Department of Head and Neck Oncology and Surgery, Antoni Van Leeuwenhoek Hospital, Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands.,Department of Oral and Maxillofacial Surgery, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | - Antti A Mäkitie
- Department of Otorhinolaryngology - Head and Neck Surgery, University of Helsinki and HUS Helsinki University Hospital, Helsinki, Finland
| | - Alfio Ferlito
- International Head and Neck Scientific Group, Padua, Italy
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11
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Zucchetti G, Ambrogio G, Bertolotti M, Besenzon L, Borghino F, Candela F, Galletto C, Fagioli F. Effects of a high-intensity psychosocial intervention among child-parent units in pediatric oncology. TUMORI JOURNAL 2020; 106:362-368. [PMID: 32539655 DOI: 10.1177/0300891620926226] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
AIM To compare the efficacy of a high-intensity psychosocial intervention with standardized usual care in countering psychosocial complexity among child-parent units in a pediatric oncology setting. METHODS Two hundred pediatric oncology patients and their parents were recruited from Italian hospitals. A total of 81 child-parent units were assigned to the high-intensity psychosocial intervention and 119 child-parent units to standardized usual care. Psychosocial factors were assessed before and 1 year after intervention to measure efficacy. RESULTS More improvements over time were observed in the high-intensity intervention group of child-parent units compared to the standard intervention group. CONCLUSION An intensive, structured, and tailored high-intensity intervention positively affects the psychosocial factors of child-parent units. Patients and families should have access to intensive psychosocial support throughout the cancer trajectory.
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Affiliation(s)
- Giulia Zucchetti
- Pediatric Oncology Division, Azienda Ospedaliera-Universitaria Città della Salute e della Scienza, Turin, Italy.,University of Turin, Turin, Italy
| | | | - Marina Bertolotti
- Pediatric Oncology Division, Azienda Ospedaliera-Universitaria Città della Salute e della Scienza, Turin, Italy
| | | | | | | | | | - Franca Fagioli
- Pediatric Oncology Division, Azienda Ospedaliera-Universitaria Città della Salute e della Scienza, Turin, Italy.,University of Turin, Turin, Italy
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