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Locatelli M, Flahault C, Roche N, Mateus C, Blot F, Lucile Montalescot, Le Provost JB, Fasse L. [PAL-PRAT study: Healthcare workers' knowledge and perception of palliative practices in a Cancer Center]. Bull Cancer 2024:S0007-4551(24)00044-4. [PMID: 38458927 DOI: 10.1016/j.bulcan.2023.12.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 11/30/2023] [Accepted: 12/07/2023] [Indexed: 03/10/2024]
Abstract
INTRODUCTION The issue of end-of-life care is the subject of a sensitive debate in French society, particularly regarding the possibility for certain patients to have access to medical assistance in dying. The aim of this study was to assess the knowledge and opinion of healthcare providers on the care practices for patients at the end of life, as well as to highlight any specificities in their discourse. METHOD A survey of healthcare providers' opinions, composed of closed and open questions, that were analyzed using a lexicometric approach, was distributed in a cancer center. RESULTS The results of the study reveal a good knowledge of the different procedures. Professionals considered that advance directives should be systematically collected; a majority of them differentiated euthanasia from deep continuous sedation and perceived the latter as a means of relieving patients' suffering without inducing death. The different procedures related to the active assistance in dying were known by a majority of professionals and the survey did not identify a dominant trend concerning the will to practice euthanasia if the legal framework allowed it. Half of the participants considered their training insufficient, indicating the need to fill this gap. DISCUSSION This survey underlines the importance of training and support for the professionals caring for patients in palliative situation and their relatives in France.
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Affiliation(s)
- Marie Locatelli
- LPPS (UR 4057), université Paris cité, 71, avenue Édouard-Vaillant, 92100 Boulogne-Billancourt, France.
| | - Cécile Flahault
- LPPS (UR 4057), université Paris cité, 71, avenue Édouard-Vaillant, 92100 Boulogne-Billancourt, France; Unité de psycho-oncologie, hôpital Gustave-Roussy, 114, rue Édouard-Vaillant, 94805 Villejuif, France
| | - Nicolas Roche
- Unité de psycho-oncologie, hôpital Gustave-Roussy, 114, rue Édouard-Vaillant, 94805 Villejuif, France
| | - Christine Mateus
- Département interdisciplinaire d'organisation du parcours patient (DIOPP), hôpital Gustave-Roussy, 114, rue Édouard-Vaillant, 94805 Villejuif, France
| | - François Blot
- Département interdisciplinaire d'organisation du parcours patient (DIOPP), hôpital Gustave-Roussy, 114, rue Édouard-Vaillant, 94805 Villejuif, France
| | - Lucile Montalescot
- Laboratoire APSY-V, université de Nîmes, rue du Dr-G.-Salan, 30021 Nîmes, France
| | - Jean-Bernard Le Provost
- Unité de psycho-oncologie, hôpital Gustave-Roussy, 114, rue Édouard-Vaillant, 94805 Villejuif, France
| | - Léonor Fasse
- LPPS (UR 4057), université Paris cité, 71, avenue Édouard-Vaillant, 92100 Boulogne-Billancourt, France; Unité de psycho-oncologie, hôpital Gustave-Roussy, 114, rue Édouard-Vaillant, 94805 Villejuif, France
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Papageorgiou L, Le Provost JB, Di Palma M, Langlois M, Salma I, Lopes M, Minvielle E, Abbas M, Scotté F. Supportive Care Needs of Newly Diagnosed Cancer Patients in a Comprehensive Cancer Center: Identifying Care Profiles and Future Perspectives. Cancers (Basel) 2024; 16:1017. [PMID: 38473376 DOI: 10.3390/cancers16051017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2023] [Revised: 02/04/2024] [Accepted: 02/27/2024] [Indexed: 03/14/2024] Open
Abstract
The prompt introduction of supportive care for patients with cancer leads to a better quality of life, potential survival benefits, and improvements in treatment safety. Considering that patients' needs vary, descriptive assessments could serve as a compass for an efficient and prompt healthcare response. The aim of this study was to identify supportive care needs in newly diagnosed patients according to cancer type. A retrospective study was conducted by collecting data from the case consultation and medical records of a comprehensive cancer center in France. Patients' needs were divided into twelve domains: nutrition, psychological support, psychiatric support, social care, physiotherapy, addictology, pain management, palliative care, pharmacology, complementary and alternative practice (CAM), sexual health, and speech therapy. Out of 6217 newly diagnosed patients of various cancer types who sought medical care at Gustave Roussy in 2021, 2541 (41%) required supportive cancer care (SCC), and of them, 1331 patients (52%) required two or more different SCC specialist interventions. The top five interventions were dietary (for 60% of patients), physiotherapy (33%), psychology (29%), social care (28%), and pain management (16%). Subgroup analysis according to cancer department highlighted additional specific needs: CAM for breast cancer patients (11%), speech specialist (27%) and addictologist (22%) interventions for ENT patients, psychiatry consultations for neurological patients (16%), and palliative care for dermatology patients (23%). The aforementioned data suggest that an early, multidisciplinary supportive care intervention should be required. Assembling human resources at the time of diagnosis within a dedicated day unit would be the next appropriate step in developing personalized care pathways related to the highlighted needs.
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Affiliation(s)
| | | | - Mario Di Palma
- Patient Pathway Division, Gustave Roussy, 94805 Villejuif, France
| | | | - Israa Salma
- Patient Pathway Division, Gustave Roussy, 94805 Villejuif, France
- i3-CRG, École Polytechnique, CNRS, Institut Polytechnique de Paris, 91762 Palaiseau, France
| | - Manuella Lopes
- Patient Pathway Division, Gustave Roussy, 94805 Villejuif, France
| | - Etienne Minvielle
- Patient Pathway Division, Gustave Roussy, 94805 Villejuif, France
- i3-CRG, École Polytechnique, CNRS, Institut Polytechnique de Paris, 91762 Palaiseau, France
| | - Maya Abbas
- Patient Pathway Division, Gustave Roussy, 94805 Villejuif, France
| | - Florian Scotté
- Patient Pathway Division, Gustave Roussy, 94805 Villejuif, France
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Roche N, Le Provost JB, Borinelli-Franzoi MA, Boinon D, Martin E, Menvielle G, Dumas A, Rivera S, Conversano A, Matias M, Viansone A, Di Meglio A, Delaloge S, Vaz-Duarte-Luis IM, Pistilli B, Fasse L. Facing points of view: Representations on adjuvant endocrine therapy of premenopausal patients after breast cancer and their healthcare providers in France. The FOR-AD study. Eur J Oncol Nurs 2023; 62:102259. [PMID: 36623339 DOI: 10.1016/j.ejon.2022.102259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Revised: 12/06/2022] [Accepted: 12/14/2022] [Indexed: 12/28/2022]
Abstract
PURPOSE Adjuvant endocrine therapy (ET) for 5-10 years is the backbone of the therapeutic strategy in patients with hormone receptor positive (HR+) early breast cancer (BC). However, long-term adherence to adjuvant ET represents a major challenge for most patients. According to prior studies, side effects of adjuvant ET are an important reason for poor adherence. In contrast, better communication and relational bond between patients and healthcare providers (HCPs) may improve adherence. The FOR-AD (Focus on non-adherence) study aimed at better understanding the representation of adjuvant ET by patients and their HCPs, in order to improve the care process. METHODS Three focus groups of premenopausal women (receiving adjuvant ET for variable amount of time) and two focus groups of HCPs (including oncologists, pharmacists, and nurses) were conducted, each including around ten participants. Thematic analyses using a general inductive approach were constructed to report participants' representations. RESULTS Two main themes emerged across groups, and appeared of major importance. Representations on adjuvant ET were often homogenous within each group, but differed between patients and their HCPs. The relationship between both groups was considerably discussed, particularly its importance in facilitating adherence to adjuvant ET. Suggestions on improving the care process were also given, such as systematically including psychologists in follow-up care paths and having a nurse navigator follow patients under treatment with adjuvant ET. CONCLUSION The present qualitative exploration may help buildi future tailored interventions to improve adherence to adjuvant ET, in particular regarding the role of nurse navigators.
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Affiliation(s)
- Nicolas Roche
- Supportive Care Department, Gustave Roussy Hospital, Villejuif, France.
| | | | - Maria-Alice Borinelli-Franzoi
- Department of Medical Oncology, Gustave Roussy Hospital, Villejuif, France; INSERM Unit 981, Molecular Predictors and New Targets in Oncology, Gustave Roussy, Villejuif, France
| | - Diane Boinon
- Supportive Care Department, Gustave Roussy Hospital, Villejuif, France; Laboratoire de Psychopathologie et Processus de Santé, F 92100, Université de Paris, Boulogne-Billancourt, France
| | - Elise Martin
- INSERM Unit 981, Molecular Predictors and New Targets in Oncology, Gustave Roussy, Villejuif, France
| | - Gwenn Menvielle
- Inserm, Institut Pierre Louis d'Epidémiologie et Santé Publique (IPLESP), Sorbonne Université, Paris, France
| | - Agnès Dumas
- Inserm Unit 1123, Unité ECEVE, Université de Paris, France
| | - Sofia Rivera
- Radiotherapy Department, Gustave Roussy Hospital, Villejuif, France
| | - Angelica Conversano
- Oncological and Reconstructive Plastic Surgery Department, Gustave Roussy Hospital, Villejuif, France
| | - Margarida Matias
- Department of Medical Oncology, Gustave Roussy Hospital, Villejuif, France
| | | | - Antonio Di Meglio
- INSERM Unit 981, Molecular Predictors and New Targets in Oncology, Gustave Roussy, Villejuif, France
| | - Suzette Delaloge
- Department of Medical Oncology, Gustave Roussy Hospital, Villejuif, France
| | - Ines-Maria Vaz-Duarte-Luis
- Department of Medical Oncology, Gustave Roussy Hospital, Villejuif, France; INSERM Unit 981, Molecular Predictors and New Targets in Oncology, Gustave Roussy, Villejuif, France
| | - Barbara Pistilli
- Department of Medical Oncology, Gustave Roussy Hospital, Villejuif, France
| | - Léonor Fasse
- Supportive Care Department, Gustave Roussy Hospital, Villejuif, France; Laboratoire de Psychopathologie et Processus de Santé, F 92100, Université de Paris, Boulogne-Billancourt, France
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Le Provost JB, Bartres-Faz D, Paillere-Martinot ML, Artiges E, Pappata S, Recasens C, Perez-Gomez M, Bernardo M, Baeza I, Bayle F, Martinot JL. Paracingulate sulcus morphology in men with early-onset schizophrenia. Br J Psychiatry 2003; 182:228-32. [PMID: 12611786 DOI: 10.1192/bjp.182.3.228] [Citation(s) in RCA: 60] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND Cingulate dysfunction has been reported in schizophrenia. Although the paracingulate sulcus (PCS) is known to be asymmetric in healthy people, little information is available about its morphology in schizophrenia. AIMS To search for morphological anomalies of the PCS in men with early-onset schizophrenia. METHOD The PCS was examined in magnetic resonance images of the brains of men with schizophrenia and 100 healthy men. RESULTS A significant asymmetry was found in the brains of healthy volunteers, whose sulci were more frequent and more marked in the left hemisphere. In contrast, the sulcus was as frequent in the right as in the left hemisphere in the patient group. Moreover, patients displayed significantly more rightward asymmetry, and overall less-asymmetrical patterns than the comparison group. CONCLUSIONS Since the PCS has developed at 36 weeks of gestation, these findings suggest an impaired maturation of the cingulate region during the third trimester.
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