2
|
Seely D, Ennis JE, McDonell E, Fazekas A, Zhao L, Asmis T, Auer RC, Fergusson D, Kanji S, Maziak DE, Ramsay T, Chamberland P, Spooner C, Threader J, Seely A. Intervention Development Process for a Pragmatic Randomized Controlled Trial: The Thoracic Peri-Operative Integrative Surgical Care Evaluation Trial. J Altern Complement Med 2019; 25:S112-S123. [PMID: 30870012 DOI: 10.1089/acm.2018.0419] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Use of complementary therapies is high among people with cancer despite research gaps. The Thoracic Peri-Operative Integrative Surgical Care Evaluation (POISE) Trial will evaluate the impact of an integrative care intervention delivered by naturopathic doctors (NDs) in conjunction with usual care for patients undergoing surgery for lung, gastric, and esophageal cancer. OBJECTIVES To describe the multistep, multidisciplinary process of defining the integrative care intervention to be used in the Thoracic POISE trial using a principle-based approach that is pragmatic, holistic, safe, feasible, evidence driven, and consensus based. METHODS An Intervention Development Committee (IDC) made up of a multidisciplinary team of health care providers (NDs, surgeons, oncologists, nurses, dietitians, physiotherapists, pharmacists, and psychologists), researchers, and patients was established to oversee the process. Potential intervention components were identified through a clinical practice survey and expert opinion. Systematic literature reviews were conducted and scores assigned based on the following criteria: usage, safety, goals, feasibility/scalability, and evidence. The IDC selected an intervention to be piloted that consists of a standard palette including core and optional components. Safety, known risks, and interactions with pharmaceuticals were evaluated using industry and professional monographs, a scoping literature review, and consultations with hospital pharmacists. RESULTS The clinical practice survey and expert opinion identified 28 components for consideration. Following literature reviews, scoring, consensus from the IDC, and safety and interaction considerations, an intervention palette consisting of core and optional components was defined. The intervention options vary based on the patient's phase of treatment and symptom-specific needs. The intervention includes supplements, physical recommendations (exercise), nutritional counseling, and psychological support (audio scripts). CONCLUSION Through a multistep, multidisciplinary process an integrative care intervention was developed for the Thoracic POISE trial. The intervention will be piloted in a single-arm feasibility study, followed by a single-center randomized controlled trial (RCT), and finally a multicenter RCT.
Collapse
Affiliation(s)
- Dugald Seely
- 1 Canadian College of Naturopathic Medicine, Toronto, Canada.,2 Ottawa Integrative Cancer Centre, Ottawa, Canada.,3 Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada
| | - Julie E Ennis
- 1 Canadian College of Naturopathic Medicine, Toronto, Canada.,2 Ottawa Integrative Cancer Centre, Ottawa, Canada
| | - Ellen McDonell
- 1 Canadian College of Naturopathic Medicine, Toronto, Canada.,2 Ottawa Integrative Cancer Centre, Ottawa, Canada
| | - Anna Fazekas
- 3 Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada
| | - Linlu Zhao
- 2 Ottawa Integrative Cancer Centre, Ottawa, Canada
| | - Tim Asmis
- 4 Ottawa Hospital, General Campus, Ottawa, Canada
| | - Rebecca C Auer
- 3 Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada.,4 Ottawa Hospital, General Campus, Ottawa, Canada
| | - Dean Fergusson
- 3 Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada
| | - Salmaan Kanji
- 3 Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada.,4 Ottawa Hospital, General Campus, Ottawa, Canada
| | | | - Tim Ramsay
- 3 Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada
| | | | | | | | - Andrew Seely
- 3 Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada.,4 Ottawa Hospital, General Campus, Ottawa, Canada
| |
Collapse
|
3
|
King J, Chamberland P, Rawji A, Ager A, Léger R, Michaels R, Poitras R, Skelton D, Warren M. Patient educational needs of patients undergoing surgery for lung cancer. J Cancer Educ 2014; 29:802-807. [PMID: 24756546 PMCID: PMC4210657 DOI: 10.1007/s13187-014-0658-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
There often exists a discrepancy between the information health care professionals (HCPs) provide to patients in preoperative teaching sessions and the information patients perceive as important. This study's purpose was to determine what information patients undergoing a lung cancer surgical resection wanted to learn before and after their surgery and also to uncover the information HCPs currently provide to these patients. Ten patients were interviewed preoperatively and postoperatively, and eleven HCPs involved in both their preoperative and postoperative care were interviewed. Emerging themes were noted. Patients reported that the most helpful aspects of the preoperative education included surgical details and the importance of physiotherapy, including exercises. Postoperatively, patients wished they had known more about postoperative pain. HCPs provided information that they felt prepared, informed and empowered their patients. Overall, patients expressed satisfaction with the information they received; they felt prepared for their surgery but not for postoperative pain control.
Collapse
Affiliation(s)
- Judy King
- Faculty of Health Sciences, School of Rehabilitation Sciences, Physiotherapy, University of Ottawa, 451 Smyth Road, Ottawa, ON, K1N 6 N5, Canada,
| | | | | | | | | | | | | | | | | |
Collapse
|
4
|
Abstract
We report the recent occurrence of spontaneous humeral shaft fractures in 12 pitchers. The subjects were interviewed over the telephone using a standard questionnaire. Radiographs and medical records were solicited from their physicians. Their average age was 36 years and they had pitched an average of 11.4 years with an average layoff of 14 years (range, 7 to 24). Mean time between games pitched was 21 days (range, 3 to 56). The average number of pitches before the fracture occurred was 38 (range, 10 to 100). Pain was experienced at some point before the fracture in 75% of the pitchers and 75% of the fractures were spiral. These fractures were most probably spontaneous fractures brought on by accumulated fatigue damage. The period of buildup after a prolonged period of layoff was probably insufficient time for proper bone remodeling to occur in these men. While a large percentage of these men had pain before their injury, suggesting a predisposing stress fracture, there is no doubt that their fractures could still be caused by a sudden torsional load without the presence of a stress fracture.
Collapse
Affiliation(s)
- T Branch
- Department of Orthopedic Surgery, Emory University, Atlanta, Georgia
| | | | | | | | | |
Collapse
|