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Minamitani M, Katano A, Mukai T, Ohira S, Nakagawa K. Comparative analysis of treatment decision-making in patients with localized prostate and cervical cancer: what influences receiving surgery or radiotherapy? Support Care Cancer 2024; 32:391. [PMID: 38806815 PMCID: PMC11133204 DOI: 10.1007/s00520-024-08589-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Accepted: 05/17/2024] [Indexed: 05/30/2024]
Abstract
PURPOSE This study focused on identifying the factors influencing the decision-making process in patients with localized prostate and cervical cancer in Japan and specifically examining the choice between surgery and radiotherapy. METHODS Patients with specific cancer stages registered with a healthcare research company for whom radical surgery or radiotherapy was equally effective and recommended participated in this cross-sectional online survey. RESULTS The responses of 206 and 231 patients with prostate and cervical cancer, respectively, revealed that both groups relied heavily on the physicians' recommendations (prostate: odds ratio (OR) = 40.3, p < 0.001; cervical: OR = 5.59, p < 0.001) and their impression of radiotherapy (prostate: OR = 9.22, p < 0.001; cervical: OR = 2.31, p < 0.001). Factors such as hypertension (OR = 6.48, p < 0.05), diabetes mellitus (OR = 9.68, p < 0.05), employment status (OR = 0.08, p < 0.01), and impressions of surgery (OR = 0.14, p < 0.01) also played a significant role in patients with prostate cancer. In contrast, the specialty of the physician (OR = 4.55, p < 0.05) proposing the treatment influenced the decision-making process of patients with cervical cancer. Information sources varied between the two groups: patients with prostate cancer were more inclined towards printed materials, whereas patients with cervical cancer were more inclined towards interpersonal relationships. CONCLUSION Although several limitations, such as the sample and recall bias, were noted, this study emphasizes the role of psychosocial factors in the decision-making process and the requirement for tailored information sources.
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Affiliation(s)
- Masanari Minamitani
- Department of Comprehensive Radiation Oncology, The University of Tokyo, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, 113-0033, Japan.
| | - Atsuto Katano
- Department of Radiology, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, 113-8655, Japan
| | - Tomoya Mukai
- Department of Psychology, Fukuyama University, 985-1Higashimura-Machi, SanzoFukuyama-City, Hiroshima, 729-0292, Japan
| | - Shingo Ohira
- Department of Comprehensive Radiation Oncology, The University of Tokyo, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, 113-0033, Japan
| | - Keiichi Nakagawa
- Department of Comprehensive Radiation Oncology, The University of Tokyo, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, 113-0033, Japan
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Coles CE, Earl H, Anderson BO, Barrios CH, Bienz M, Bliss JM, Cameron DA, Cardoso F, Cui W, Francis PA, Jagsi R, Knaul FM, McIntosh SA, Phillips KA, Radbruch L, Thompson MK, André F, Abraham JE, Bhattacharya IS, Franzoi MA, Drewett L, Fulton A, Kazmi F, Inbah Rajah D, Mutebi M, Ng D, Ng S, Olopade OI, Rosa WE, Rubasingham J, Spence D, Stobart H, Vargas Enciso V, Vaz-Luis I, Villarreal-Garza C. The Lancet Breast Cancer Commission. Lancet 2024; 403:1895-1950. [PMID: 38636533 DOI: 10.1016/s0140-6736(24)00747-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Revised: 12/18/2023] [Accepted: 04/09/2024] [Indexed: 04/20/2024]
Affiliation(s)
| | - Helena Earl
- Department of Oncology, University of Cambridge, Cambridge, UK
| | - Benjamin O Anderson
- Global Breast Cancer Initiative, World Health Organisation and Departments of Surgery and Global Health Medicine, University of Washington, Seattle, WA, USA
| | - Carlos H Barrios
- Oncology Research Center, Hospital São Lucas, Porto Alegre, Brazil
| | - Maya Bienz
- Mount Vernon Cancer Centre, East and North Hertfordshire NHS Trust, London, UK; Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | | | - David A Cameron
- Institute of Genetics and Cancer and Usher Institute, University of Edinburgh, Edinburgh, UK
| | - Fatima Cardoso
- Breast Unit, Champalimaud Clinical Center/Champalimaud Foundation, Lisbon, Portugal
| | - Wanda Cui
- Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia; Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, VIC, Australia
| | - Prudence A Francis
- Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia; Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, VIC, Australia
| | - Reshma Jagsi
- Emory University School of Medicine, Atlanta, GA, USA
| | - Felicia Marie Knaul
- Institute for Advanced Study of the Americas, University of Miami, Miami, FL, USA; Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL, USA; Tómatelo a Pecho, Mexico City, Mexico
| | - Stuart A McIntosh
- School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, UK
| | - Kelly-Anne Phillips
- Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia; Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, VIC, Australia
| | - Lukas Radbruch
- Department of Palliative Medicine, University Hospital Bonn, Bonn, Germany
| | | | | | - Jean E Abraham
- Department of Oncology, University of Cambridge, Cambridge, UK
| | | | | | - Lynsey Drewett
- Royal Devon University Healthcare NHS Foundation Trust, Exeter, UK
| | | | - Farasat Kazmi
- Norfolk and Norwich University Hospitals NHS Foundation Trust, Norwich, UK
| | | | | | - Dianna Ng
- Memorial Sloan Kettering Cancer Center, New York City, NY, USA
| | - Szeyi Ng
- The Institute of Cancer Research, London, UK
| | | | - William E Rosa
- Memorial Sloan Kettering Cancer Center, New York City, NY, USA
| | | | | | | | | | | | - Cynthia Villarreal-Garza
- Breast Cancer Center, Hospital Zambrano Hellion TecSalud, Tecnologico de Monterrey, Monterrey, Mexico
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Ferraris G, Coppini V, Monzani D, Grasso R, Kirac I, Horgan D, Pietrobon R, Galvão V, Pravettoni G. Addressing disparities in European cancer outcomes: a qualitative study Protocol of the BEACON project. Front Psychol 2024; 15:1252832. [PMID: 38469221 PMCID: PMC10925749 DOI: 10.3389/fpsyg.2024.1252832] [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: 07/04/2023] [Accepted: 02/15/2024] [Indexed: 03/13/2024] Open
Abstract
Introduction Health disparities represent a crucial factor in cancer survival rates, awareness, quality of life, and mental health of people receiving a cancer diagnosis and their families. Income, education, geographic location, and ethnicity are some of the most important underlying reasons for health disparities in cancer across Europe. Costs of healthcare, access to information, psycho-oncological support options, integration of cancer research and innovative care, and multidisciplinary cancer teams are the main target areas when it comes to addressing disparities in the cancer context. As part of the Beacon Project (BEACON), we developed a protocol for a qualitative study to explore and identify any relevant reasons for cancer inequalities and disparities in Europe. Methods Our four stakeholders namely, cancer patients, healthcare providers, researchers, and policymakers will be recruited online, facilitated by collaborative efforts with cancer organizations from various European countries, including but not limited to Italy, Croatia, Estonia, and Slovenia. Qualitative online focus group discussions for each stakeholder will be conducted and transcribed. Subsequently, thematic analysis will be used to identify reasons and aspects that may contribute to the existing disparities in cancer outcomes at various levels of engagement and from different stakeholders' perspectives. Results from focus groups will inform a subsequent Delphi study and a SWOT analysis methodology. Discussion Although advances in medical research, cancer screening and treatment options are constantly progressing, disparities in access to and awareness of healthcare in cancer patients are even more noticeable. Thus, mapping the capacity and capability of cancer centres in the European Union, creating decision support tools that will assist the four stakeholders' information needs and improving the quality of European cancer centres will be the main objectives of the BEACON project. The current protocol will outline the methodological and practical procedures to conduct online focus group discussions with different stakeholders.
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Affiliation(s)
- Giulia Ferraris
- Applied Research Division for Cognitive and Psychological Science, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Veronica Coppini
- Applied Research Division for Cognitive and Psychological Science, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Dario Monzani
- Applied Research Division for Cognitive and Psychological Science, IEO, European Institute of Oncology IRCCS, Milan, Italy
- Department of Psychology, Educational Science and Human Movement (SPPEFF), University of Palermo, Palermo, Italy
| | - Roberto Grasso
- Applied Research Division for Cognitive and Psychological Science, IEO, European Institute of Oncology IRCCS, Milan, Italy
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | - Iva Kirac
- Genetic Counseling Unit, University Hospital for Tumors, Sestre Milosrdnice University Hospital Center, Zagreb, Croatia
| | - Denis Horgan
- European Alliance for Personalized Medicine, Maribor, Slovenia
| | | | | | - Gabriella Pravettoni
- Applied Research Division for Cognitive and Psychological Science, IEO, European Institute of Oncology IRCCS, Milan, Italy
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
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Hassan J, Saeed SM, Deka L, Uddin MJ, Das DB. Applications of Machine Learning (ML) and Mathematical Modeling (MM) in Healthcare with Special Focus on Cancer Prognosis and Anticancer Therapy: Current Status and Challenges. Pharmaceutics 2024; 16:260. [PMID: 38399314 PMCID: PMC10892549 DOI: 10.3390/pharmaceutics16020260] [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: 12/08/2023] [Revised: 01/29/2024] [Accepted: 02/07/2024] [Indexed: 02/25/2024] Open
Abstract
The use of data-driven high-throughput analytical techniques, which has given rise to computational oncology, is undisputed. The widespread use of machine learning (ML) and mathematical modeling (MM)-based techniques is widely acknowledged. These two approaches have fueled the advancement in cancer research and eventually led to the uptake of telemedicine in cancer care. For diagnostic, prognostic, and treatment purposes concerning different types of cancer research, vast databases of varied information with manifold dimensions are required, and indeed, all this information can only be managed by an automated system developed utilizing ML and MM. In addition, MM is being used to probe the relationship between the pharmacokinetics and pharmacodynamics (PK/PD interactions) of anti-cancer substances to improve cancer treatment, and also to refine the quality of existing treatment models by being incorporated at all steps of research and development related to cancer and in routine patient care. This review will serve as a consolidation of the advancement and benefits of ML and MM techniques with a special focus on the area of cancer prognosis and anticancer therapy, leading to the identification of challenges (data quantity, ethical consideration, and data privacy) which are yet to be fully addressed in current studies.
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Affiliation(s)
- Jasmin Hassan
- Drug Delivery & Therapeutics Lab, Dhaka 1212, Bangladesh; (J.H.); (S.M.S.)
| | | | - Lipika Deka
- Faculty of Computing, Engineering and Media, De Montfort University, Leicester LE1 9BH, UK;
| | - Md Jasim Uddin
- Department of Pharmaceutical Technology, Faculty of Pharmacy, Universiti Malaya, Kuala Lumpur 50603, Malaysia
| | - Diganta B. Das
- Department of Chemical Engineering, Loughborough University, Loughborough LE11 3TU, UK
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Chen Q, Moore J, Noel L, von Sternberg K, Jones B. Sociodemographic Correlates of Low Health Literacy Skills Among Cancer Survivors: National Findings From BRFSS 2016. Am J Health Promot 2023:8901171231222073. [PMID: 38108189 DOI: 10.1177/08901171231222073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2023]
Abstract
PURPOSE This study aimed to explore associations of sociodemographic factors with difficulties in three health literacy (HL) skills and the severity of low HL skills. DESIGN Cross-sectional secondary data analysis. Subjects: Data came from 17,834 adults who responded to the HL module with a response rate of 47% in the 2016 Behavioral Risk Factor Surveillance System. MEASURES Independent variables included sex, age, race/ethnicity, education, employment and income. Dependent variables are three HL skills: obtaining, understanding oral, and understanding written health information. ANALYSIS We conducted weighted Chi-square tests and multinominal logistic regressions. RESULTS Cancer survivors younger than 65 (aged 18-39: AOR = 4.46, P < .001; aged 40-64: AOR = 2.29, P < .001), Hispanic (AOR = 2.17, CI = 1.61-2.50, P < .01) had higher odds of difficulty obtaining health information. Female cancer survivors had lower odds of difficulty comprehending oral (AOR = .69, CI = .55-.87, P < .01) and written (AOR = .58, CI = .46-.74, P < .001) information. The relative risk ratio of having difficulties in three HL tasks was higher for those who were younger than 65 (aged 18-39: RRR = 10.18, CI = 2.41-4.3, P < .01; aged 40-64: RRR = 4.01, CI = 2.09-7.69, P < .001), Hispanic (RRR = 3.24, CI = 1.66-11.34, P < .01), unemployed (RRR = 6.1, CI = 2.88-12.76, P < .001), education levels lower than some college (some high school: RRR = 4.34, P < .01; high school: RRR = 2.62, P < .05) and household income under $25,000 (RRR = 6.99, CI = 2.8-17.5, P < .001). CONCLUSION Intervention and communication materials need to be tailored for patients with different HL skills considering age, gender, socioeconomic status and cultural backgrounds.
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Affiliation(s)
- Qi Chen
- Silberman School of Social Work, Hunter College, City University of New York, New York, NY, USA
| | - John Moore
- College of Social Work, Florida State University, Tallahassee, FL, USA
| | - Lailea Noel
- Steve Hicks School of Social Work, University of Texas at Austin, Austin, TX, USA
| | - Kirk von Sternberg
- Steve Hicks School of Social Work, University of Texas at Austin, Austin, TX, USA
| | - Barbara Jones
- School of Social Work, Boston University, Boston, MA, USA
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Shah S, Usman A, Zaki S, Qureshi A, Lal K, Uneeb SN, Bari N, Hasnani FB, Shah N, Iqbal SP, Ullah O, Abid S. The role of family and culture in the disclosure of bad news: A multicentre cross-sectional study in Pakistan. PEC INNOVATION 2023; 3:100200. [PMID: 37674774 PMCID: PMC10477806 DOI: 10.1016/j.pecinn.2023.100200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 07/26/2023] [Accepted: 08/20/2023] [Indexed: 09/08/2023]
Abstract
Objectives Disclosure of bad news is distressing for patients and family members. Our aim was to assess patients' perceptions and preferences regarding bad news in the health setting. Methods Cross-sectional, multi-centered study supported by an external grant in 15 Government and Private Hospitals across Pakistan. A sample size of 1673 patients and family members was used. Ethics permission/consent was taken from each participating hospital and participant. Responses were compared across provinces, gender, age, education and income. Results >80% patients preferred their relatives to know the diagnosis first and they wanted the news to be disclosed to them by doctors. Significant association between education level, income and preference for wanting to know the diagnosis was found. Reasons for wanting to know the diagnosis included treatment, prognosis and prevention options whereas reasons for not wanting to know included fear of emotions and God's will. Conclusion The majority of Pakistani patients want to be informed and want the family to know first. Preferences for disclosure vary across, age, education and income level. Innovation First countrywide study on this topic. Identifies need for culturally sensitive guidelines that include the family's role in disclosure of bad news.
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Affiliation(s)
- Sameena Shah
- Department of Family Medicine, North Island Hospital Campbell River and District, Island Health, Campbell River, BC, Canada
- Department of Family Medicine, Aga Khan University, Karachi, Pakistan
| | - Asma Usman
- Department of Family Medicine, Aga Khan University, Karachi, Pakistan
| | - Samar Zaki
- Department of Family Medicine, Aga Khan University, Karachi, Pakistan
| | - Asra Qureshi
- Department of Family Medicine, Aga Khan University, Karachi, Pakistan
| | - Karishma Lal
- Aga Khan University Medical College, Karachi, Pakistan
| | | | | | - Fauzia Basaria Hasnani
- Department of Community Health Sciences, Aga Khan University, Karachi, Pakistan
- School of Nursing and Midwifery, Aga Khan University, Karachi, Pakistan
| | - Nasir Shah
- Department of Family Medicine, University of Health Sciences, Lahore, Pakistan
| | - Saima Parwaiz Iqbal
- Division of Family Medicine, Department of Community Health Sciences, Shifa International, Islamabad, Pakistan
| | - Obaid Ullah
- Pakistan Medical Research Council, Peshawar, Pakistan
| | - Sumera Abid
- Pakistan Medical Research Council, Islamabad, Pakistan
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Bach Y, Panov E, Espin‐Garcia O, Chen E, Krzyzanowska M, O'Kane G, Moore M, Prince RM, Knox J, Grant R, Ma LX, Allen MJ, Eng L, Kosyachkova E, Megid TBC, Barron C, Wang X, Saltiel M, Farooq ARR, Jang RW, Elimova E. First impressions: A prospective evaluation of patient-physician concordance and satisfaction following the initial medical oncology consultation. Cancer Med 2023; 12:22293-22303. [PMID: 38063318 PMCID: PMC10757128 DOI: 10.1002/cam4.6758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 09/14/2023] [Accepted: 09/30/2023] [Indexed: 12/31/2023] Open
Abstract
BACKGROUND An especially significant event in the patient-oncologist relationship is the initial consultation, where many complex topics-diagnosis, treatment intent, and often, prognosis-are discussed in a relatively short period of time. This study aimed to measure patients' understanding of the information discussed during their first medical oncology visit and their satisfaction with the communication from medical oncologists. METHODS Between January and August 2021, patients without prior systemic treatment of their gastrointestinal malignancy (GI) attending the Princess Margaret Cancer Centre (PMCC) were approached within 24 h of their initial consultation to complete a paper-based questionnaire assessing understanding of their disease (diagnosis, treatment plan/intent, and prognosis) and satisfaction with the consultation. Medical oncology physicians simultaneously completed a similar questionnaire about the information discussed at the initial visit. Matched patient-physician responses were compared to assess the degree of concordance. RESULTS A total of 184 matched patient-physician surveys were completed. The concordance rates for understanding of diagnosis, treatment plan, treatment intent, and prognosis were 92.9%, 59.2%, 66.8%, and 59.8%, respectively. After adjusting for patient and physician variables, patients who reported treatment intent to be unclear at the time of the consultation were independently associated with lower satisfaction scores (global p = 0.014). There was no statistically significant association between patient satisfaction and whether prognosis was disclosed (p = 0.08). CONCLUSION An in-depth conversation as to what treatment intent and prognosis means is reasonable during the initial medical oncology consultation to ensure patients and caregivers have a better understanding about their cancer.
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Affiliation(s)
- Yvonne Bach
- Princess Margaret Cancer CentreTorontoOntarioCanada
| | - Elan Panov
- Princess Margaret Cancer CentreTorontoOntarioCanada
| | | | - Eric Chen
- Princess Margaret Cancer CentreTorontoOntarioCanada
| | | | | | | | | | | | - Robert Grant
- Princess Margaret Cancer CentreTorontoOntarioCanada
| | - Lucy X. Ma
- Princess Margaret Cancer CentreTorontoOntarioCanada
| | | | - Lawson Eng
- Princess Margaret Cancer CentreTorontoOntarioCanada
| | | | | | - Carly Barron
- Princess Margaret Cancer CentreTorontoOntarioCanada
| | - Xin Wang
- Princess Margaret Cancer CentreTorontoOntarioCanada
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Vicente RS, Freitas AR, Ferreira RMA, Prada SP, Martins TS, Martins TC, Duarte Mendes A, Vitorino MM, Chaves AF, Santos CC, Alpuim Costa D, Custódio MP, Barbosa M. Communication preferences and perceptions of cancer patient during their first medical oncology appointment. Psychooncology 2023; 32:1702-1709. [PMID: 37749768 DOI: 10.1002/pon.6220] [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: 05/03/2023] [Revised: 09/12/2023] [Accepted: 09/14/2023] [Indexed: 09/27/2023]
Abstract
BACKGROUND The first medical oncology appointment serves as a platform for patients to comprehend their diagnosis and prognostic implications of cancer. This study aimed to determine patients' communication preferences during their first medical oncology appointment and to assess the disparities between patients' preferences and perceptions. METHODS A total of 169 cancer patients participated by completing the Communication in First Medical Oncology Appointment Questionnaire (C-FAQ), a two-section questionnaire designed to assess patients' preferences and perceptions regarding Content (information provided and its extent), Facilitation (timing and location of information delivery), and Support (emotional support) during their first medical oncology appointment. A comparative analysis was conducted to assess the variations between preferences and perceptions. RESULTS Content emerged as the most significant dimension compared to Facilitation and Support. The physician's knowledge, honesty, and ability to provide clear information were considered the most important attributes. Patients evaluated most of their preferences as "very important". Patients' perception of the communication dimensions present during their appointment was below preferences for 11 items, indicating significant discrepancies in clinical practice. CONCLUSIONS Patients highly valued their preferences concerning Content, Facilitation, and Support dimensions of communication. However, patient preferences were more prominently oriented towards the Content dimension. The discrepancies between preferences and perceptions should be viewed as an opportunity for enhancing communication skills through training.
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Affiliation(s)
- Rodrigo Santos Vicente
- Hospital Professor Doutor Fernando Fonseca, Medical Oncology, Amadora, Portugal
- Faculty of Medicine, University of Lisbon, Lisbon, Portugal
| | - Ana Rita Freitas
- Hospital Professor Doutor Fernando Fonseca, Medical Oncology, Amadora, Portugal
| | | | - Sofia Parada Prada
- Hospital Professor Doutor Fernando Fonseca, Medical Oncology, Amadora, Portugal
| | - Telma Sofia Martins
- Hospital Professor Doutor Fernando Fonseca, Medical Oncology, Amadora, Portugal
| | | | - Ana Duarte Mendes
- Hospital Professor Doutor Fernando Fonseca, Medical Oncology, Amadora, Portugal
| | | | - Andreia Filipa Chaves
- Hospital Professor Doutor Fernando Fonseca, Medical Oncology, Amadora, Portugal
- CUF Oncologia, Haematology and Medical Oncology, Lisbon, Portugal
| | | | - Diogo Alpuim Costa
- CUF Oncologia, Haematology and Medical Oncology, Lisbon, Portugal
- Hospital de Cascais Dr. José de Almeida, Medical Oncology, Alcabideche, Portugal
- NOVA Medical School, NOVA University Lisbon, Lisbon, Portugal
| | | | - Miguel Barbosa
- Faculty of Psychology, ULisboa CICPSI, Lisbon, Portugal
- ISAMB, Faculty of Medicine, ISAMB, Lisbon, Portugal
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Pappas TN, Bikhazi NB. Babe Ruth's Anaplastic Epidermoid Carcinoma of the Nasopharynx. EAR, NOSE & THROAT JOURNAL 2023:1455613231205518. [PMID: 37830347 DOI: 10.1177/01455613231205518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2023] Open
Affiliation(s)
| | - Nadim B Bikhazi
- Department of Otolaryngology, Ogden Clinic, South Ogden, UT, USA
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Zelina P, Halamkova J, Novacek V. Extraction, Labeling, Clustering, and Semantic Mapping of Segments From Clinical Notes. IEEE Trans Nanobioscience 2023; 22:781-788. [PMID: 37167037 DOI: 10.1109/tnb.2023.3275195] [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: 05/13/2023]
Abstract
This work is motivated by the scarcity of tools for accurate, unsupervised information extraction from unstructured clinical notes in computationally underrepresented languages, such as Czech. We introduce a stepping stone to a broad array of downstream tasks such as summarisation or integration of individual patient records, extraction of structured information for national cancer registry reporting or building of semi-structured semantic patient representations that can be used for computing patient embeddings. More specifically, we present a method for unsupervised extraction of semantically-labeled textual segments from clinical notes and test it out on a dataset of Czech breast cancer patients, provided by Masaryk Memorial Cancer Institute (the largest Czech hospital specialising exclusively in oncology). Our goal was to extract, classify (i.e. label) and cluster segments of the free-text notes that correspond to specific clinical features (e.g., family background, comorbidities or toxicities). Finally, we propose a tool for computer-assisted semantic mapping of segment types to pre-defined ontologies and validate it on a downstream task of category-specific patient similarity. The presented results demonstrate the practical relevance of the proposed approach for building more sophisticated extraction and analytical pipelines deployed on Czech clinical notes.
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Riley CA, Yang N, Gudis DA. Setting the Stage for Olfactory Neuroblastoma. JAMA Otolaryngol Head Neck Surg 2023; 149:845-846. [PMID: 37535387 DOI: 10.1001/jamaoto.2023.1943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/04/2023]
Affiliation(s)
- Charles A Riley
- Department of Otolaryngology-Head and Neck Surgery, Walter Reed National Military Medical Center, Bethesda, Maryland
- Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, Maryland
| | - Nathan Yang
- Department of Otolaryngology-Head and Neck Surgery, McGill University, Centre Intégré de Santé et des Services Sociaux de l'Outaouais, Gatineau, Quebec, Canada
| | - David A Gudis
- Department of Otolaryngology-Head and Neck Surgery, Columbia University Medical Center, New York Presbyterian Hospital, New York, New York
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12
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Nambiar SS. Comparison of the Structured Consent Process Using Modified Delphi Technique with the Standard Process in Obtaining Informed Consent for Procedures in ENT by PHASE III MBBS Students. Indian J Otolaryngol Head Neck Surg 2023; 75:1557-1567. [PMID: 37636684 PMCID: PMC10447763 DOI: 10.1007/s12070-023-03546-2] [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: 08/04/2022] [Accepted: 01/30/2023] [Indexed: 03/17/2023] Open
Abstract
Communication skill is a core competency and the training must begin in the undergraduate period itself. The Phase III MBBS students during their ENT posting are required to obtain informed consent for procedures and surgeries in ENT which forms the basis for efficient communication skills in house-surgency (internship) and residency. Informed consent taking is an important aspect and in the clinical postings, the teaching of communication skills along with history taking and physical examination can go a long way in making a strong foundation to good doctor patient relationships. This study aimed to compare the structured consent process using modified Delphi technique with the standard process in obtaining informed consent for procedures in ENT by PHASE III MBBS students. The need to sensitise the MBBS students on appropriate consent taking procedures with familiarisation of the essential elements of the Kalamazoo consensus statement were raised, accepted and final OSCE assessment attributes decided by the modified Delphi technique. The Modified Delphi technique is a unique means to obtain opinions of experts across the field in various spheres so as to identify lacunae if any in the existing teaching with means to reach a valid and reliable consensus. Our study included Phase III MBBS students posted to the Department of ENT, Govt Medical College Kozhikode during Jan-Feb 2022 wherein one batch of 30 students were taught with 2 classes on informed consent taking by the structured process obtained after Modified Delphi technique and included as; "MD" group and another batch of 30 students from the entire batch taught by the standard process was included as; "T" group respectively. After completion of the clinical postings an assessment was carried out with OSCE stations in Mar 2022; wherein 10 students were evaluated for each of the 6 common ENT procedures, 5 students from "T" group and 5 students from "MD" group respectively. Median total score of MD group was 6.5 (3.25-8) and median score of T group was 4.5 (2.25-6.75). The difference in mean ranks of these scores was statistically significant, p < 0.0001. The feedback assessment using the questionnaire with Likert scale had all 30(100%) students recommend this method of structured consent taking for enhancement of communications skills. However 20% of the students were not satisfied with the teaching learning method expressing the need for more time allocation and demonstrations. Informed consent taking requires the appropriate training in the undergraduate period itself as seen by the improved OSCE scores on assessment after teaching by the structured consent taking process as well as from the feedback of the students.
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13
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Hannoun A, Chafiq N, Raji M, Elkouali M, Razine R. Physicians' perception of health topics covered by traditional media in Morocco: opinion of physicians as consumers of the media. J Public Health Afr 2023; 14:2275. [PMID: 37441121 PMCID: PMC10334434 DOI: 10.4081/jphia.2023.2275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Accepted: 10/19/2022] [Indexed: 07/15/2023] Open
Abstract
Introduction In Morocco, the traditional media allows messages of non-scientific prescriptions for the treatment of diseases and statements criticizing doctors to pass, which are considered by doctors as defamation and attacks on the honor of the medical profession. The aim of this study was to analyze physicians' perception in Morocco regarding health topics in the traditional media (TM). Methods This is a descriptive transversal study of physicians practicing in Morocco. The data were collected using a questionnaire that included questions on reliability, speed, up-to-dateness and influence of TM, also trust and interest in TM, quantity, and quality of health messages in TM. Results A total of 417 physicians responded, among them 234 (56.1%) had little or no interest in health topics in TM; 248 (59.5%) considered the quantity of transmitted messages to be low; 234 (56.1%) considered that health messages in TM are of low quality; 248 (59.5%) had little or no trust in health topics in TM. Also, three-quarters, 314 (75.3%), of the physicians recognized a moderate to strong influence of TM on health behaviors. Conclusions Our results show that physicians have a perception that seems negative towards TM. This may partially explain the chronic tension situation between physicians and journalists/media in Morocco. To better understand this situation and improve this relationship in favor of health promotion, it is necessary to conduct a research addressing the opinion of journalists and the propositions of solutions of both parties.
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Affiliation(s)
- Abdelaziz Hannoun
- Laboratory of Information Sciences and Technologies and Education (LASTIE), Ben M'SICK Faculty of Sciences, Hassan II University of Casablanca
| | - Nadia Chafiq
- Laboratory of Information Sciences and Technologies and Education (LASTIE), Ben M'SICK Faculty of Sciences, Hassan II University of Casablanca
| | - Mohammed Raji
- Laboratory of Information Sciences and Technologies and Education (LASTIE), Ben M'SICK Faculty of Sciences, Hassan II University of Casablanca
| | - M’hamed Elkouali
- Laboratory of Information Sciences and Technologies and Education (LASTIE), Ben M'SICK Faculty of Sciences, Hassan II University of Casablanca
| | - Rachid Razine
- Laboratory of Social Medicine (Public Health, Hygiene and Preventive Medicine), Laboratory of Biostatistics, Clinical Research and Epidemiology (LBRCE), Faculty of Medicine and Pharmacy, University Mohammed V, Rabat, Morocco
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14
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Lundeby T, Finset A, Kaasa S, Wester TE, Hjermstad MJ, Dajani O, Wist E, Aass N. A complex communication skills training program for physicians providing advanced cancer care - content development and barriers and solutions for implementation. JOURNAL OF COMMUNICATION IN HEALTHCARE 2023; 16:46-57. [PMID: 36919800 DOI: 10.1080/17538068.2022.2039468] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Background: Early integration of oncology and patient-centered palliative care is the recommended clinical practice model for patients with advanced cancer. General and specific communication skills are necessary to achieve integrated patient-centered care, but require organized training to be adequately mastered. Challenges and barriers on several levels, i.e. organizational, professional and individual may, however, hamper implementation. The development, implementation, and evaluation of such an educational program focusing on communication skills contain many steps, considerations and lessons learned, which are described in this article.Methods: A multi-professional faculty developed, implemented, and evaluated an educational program through a 5-step approach. The program was part of a Norwegian cluster-randomized controlled trial aiming to test the effect of early integration of oncology and palliative care for patients with advanced cancer.Results: The result is the PALLiON educational program; a multi-faceted, evidence-based, and learner-centered program with a specific focus on physicians' communication skills. Four modules were developed: lectures, discussion groups, skills training, and coaching. These were implemented at the six intervention hospitals using different teaching strategies. Evaluation in a subgroup of participants showed a positive appraisal of the group discussions and skills training.Conclusion:We present our experiences and reflections regarding implementation and lessons learned, which should be considered in future developments and implementations; (1) Include experienced faculty with various backgrounds, (2) Be both evidence-based and learner-centered, (3) Choose teaching strategies wisely, (4) Expect resistance and skepticism, (5) Team up with management and gatekeepers, (6) Expect time to fly, and (7) Plan thorough assessment of the evaluation and effect.Trial registration: ClinicalTrials.gov identifier: NCT03088202.
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Affiliation(s)
- Tonje Lundeby
- European Palliative Care Research Centre (PRC), Department of Oncology, Oslo University Hospital, and Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Department of Oncology, Oslo University Hospital, Oslo, Norway
| | - Arnstein Finset
- Department of Behavioural Medicine, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - Stein Kaasa
- European Palliative Care Research Centre (PRC), Department of Oncology, Oslo University Hospital, and Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Department of Oncology, Oslo University Hospital, Oslo, Norway.,Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Torunn Elin Wester
- European Palliative Care Research Centre (PRC), Department of Oncology, Oslo University Hospital, and Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Department of Oncology, Oslo University Hospital, Oslo, Norway
| | - Marianne Jensen Hjermstad
- European Palliative Care Research Centre (PRC), Department of Oncology, Oslo University Hospital, and Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Department of Oncology, Oslo University Hospital, Oslo, Norway
| | - Olav Dajani
- European Palliative Care Research Centre (PRC), Department of Oncology, Oslo University Hospital, and Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Department of Oncology, Oslo University Hospital, Oslo, Norway
| | - Erik Wist
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Nina Aass
- European Palliative Care Research Centre (PRC), Department of Oncology, Oslo University Hospital, and Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Department of Oncology, Oslo University Hospital, Oslo, Norway.,Institute of Clinical Medicine, University of Oslo, Oslo, Norway
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15
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Lewis ET, Hammill K, Culbert R, van der Merwe M, Sahay A, Turner R, Cardona M. Delivering Prognostic News to Older People with Chronic Disease: What Format Preference and Level of Involvement in Decision Making? A Hospital Survey. Healthcare (Basel) 2023; 11:healthcare11030444. [PMID: 36767019 PMCID: PMC9913994 DOI: 10.3390/healthcare11030444] [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: 11/27/2022] [Revised: 01/19/2023] [Accepted: 01/31/2023] [Indexed: 02/08/2023] Open
Abstract
Shared decision making near end of life is a balancing act of communicating prognosis to patients and their surrogates/families and engaging them in considering value-concordant management choices. This cross-sectional survey aimed to determine the format in which older patients with chronic illnesses would prefer to receive prognostic information on their treatment options and disease progression, and their desired level of engagement in decision making. With a 60% participation rate, 139 inpatients in two hospitals and five surrogates were presented with six hypothetical scenarios with a randomly assigned sequence: verbal and written summary, graph, table, photo, video, and pamphlet. The majority (76%) of respondents chose the traditional verbal communication of prognosis by their doctor with a written summary as a reference and to share with family; the second choice was a condition-specific pamphlet (63%). Many found the graph and photo to be distressing (36% and 42%, respectively). Most (71%) wanted to know everything about their condition trajectory, and 63% chose shared decision making rather than completely autonomous or full delegation to clinicians or family. There were no gender differentials between wanting to know it all, supporting shared decision making or the preferred format for breaking news (p > 0.05). Older hospitalized patients with chronic conditions are willing to discuss end-of-life issues, learn about their prognosis, and be involved in shared decision making. Innovative formats such as graphs, videos, or photos were not welcome as part of the prognostic discussion.
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Affiliation(s)
- Ebony T. Lewis
- School of Population Health, University of New South Wales, Sydney 2052, Australia
- School of Psychology, The University of New South Wales, Sydney 2052, Australia
- Correspondence:
| | - Kathrine Hammill
- School of Science and Health, Western Sydney University, Campbelltown 2560, Australia
| | - Rebekah Culbert
- Occupational Therapy Services, Camden and Campbelltown Hospitals, Campbelltown 2560, Australia
| | | | - Ashlyn Sahay
- School of Nursing, Midwifery and Social Sciences, Central Queensland University, Mackay 4740, Australia
| | - Robin Turner
- Biostatistics Unit, Otago Medical School, University of Otago, Dunedin 9054, New Zealand
| | - Magnolia Cardona
- Institute for Evidence-Based Healthcare, Bond University, Robina 4226, Australia
- EBP Professorial Unit, Gold Coast University Hospital, Southport 4215, Australia
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16
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Yi Y, Chiu DK. Public information needs during the COVID-19 outbreak: a qualitative study in mainland China. LIBRARY HI TECH 2023. [DOI: 10.1108/lht-08-2022-0398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
PurposeThe impact of COVID-19 has led to a surge in the public’s reliance on the Internet for pandemic information, and the policy of home isolation has exacerbated this. This study aimed to investigate public information needs and ways of accessing and disseminating information during COVID-19 in mainland China.Design/methodology/approachThis study used a qualitative research approach to conduct semi-structured interviews with 15 participants from 9 cities in mainland China about information needs and access behaviors during the COVID-19 outbreak. All interview recordings were converted into text and proofread, then coded and summarised in correspondence with the research questions using the grounded theory.FindingsThis study summarized the dynamics of public information needs during the 2.5-year pandemic and identified the difficulties in accessing certain information.Originality/valueAlthough information needs of public health emergencies have been a hot topic during COVID-19, scant studies focus on information needs in specific countries in Asia, especially in mainland China, the first country with a major outbreak and stringent lockdown mandates. Therefore, the current study is well enriched by focusing on information demand behavior in the context of COVID-19. Possible measures for improvement were also given to existing and potential problems, taking into account the participants’ views.
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17
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Offenbacher R, Briggs J, Ronca K, Uong A, Ogidan-Odeseye O, Kim M, Weiser D. Retention of discharge instructions using an interdisciplinary model for at-risk children with cancer: A quality improvement initiative. Pediatr Blood Cancer 2023; 70:e30045. [PMID: 36215215 DOI: 10.1002/pbc.30045] [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: 04/06/2022] [Revised: 09/16/2022] [Accepted: 09/19/2022] [Indexed: 12/25/2022]
Abstract
PURPOSE We sought to improve caregiver retention of critical initial hospital discharge instructions using a multidisciplinary, team-based intervention for newly diagnosed pediatric cancer patients at high risk for unfavorable outcomes. MATERIALS AND METHODS A multidisciplinary team of pediatric residents, nurses, social workers, pharmacists and hematology/oncology faculty implemented practices to optimize teaching of key discharge material as part of four Plan-Do-Study-Act intervention cycles. An 11-question survey distributed at the first post-discharge clinic visit assessed the efficacy of the intervention, as defined by caregiver retention of critical home instructions. RESULTS Thirty-nine caregivers of pediatric cancer patients in an urban academic tertiary-care children's hospital took part in this project. Overall retention of key discharge information was greater in the post-intervention cohort compared to the baseline cohort (median total scores: 89 and 63, respectively; p = .001). Improvements in the proportions of correct responses post-intervention were also observed across all subject matters: from 0.57 to 0.88 for fever guidelines (p = .059), from 0.71 to 0.78 for signs of sepsis (p = .65), from 0.57 to 1.00 for accurate choice of on-call number (p = .004), and from 0.71 to 0.94 for antiemetic management (p = .14). CONCLUSION Initiation of our comprehensive cancer-specific program to improve caregiver retention of discharge instructions at the first post-hospitalization clinic visit has been successful and sustainable. This project demonstrated that a multi-disciplinary collaborative team effort increases caregiver retention of critical health information, and this has potential to lead to improved outcomes for patients.
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Affiliation(s)
| | | | - Kristen Ronca
- Children's Hospital at Montefiore, Bronx, New York, USA
| | - Audrey Uong
- Children's Hospital at Montefiore, Bronx, New York, USA
| | | | - Mimi Kim
- Department of Epidemiology & Population Health Division of Biostatistics, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Daniel Weiser
- Children's Hospital at Montefiore, Bronx, New York, USA.,Departments of Pediatrics and Genetics, Albert Einstein College of Medicine, Bronx, New York, USA
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18
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Sangeorzan I, Andriopoulou P, Davies BM, McNair A. The information needs of people with degenerative cervical myelopathy: A qualitative study to inform patient education in clinical practice. PLoS One 2023; 18:e0285334. [PMID: 37205664 DOI: 10.1371/journal.pone.0285334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Accepted: 04/20/2023] [Indexed: 05/21/2023] Open
Abstract
BACKGROUND Individuals with lifelong illnesses need access to adequate information about their condition to make optimal health decisions. Degenerative Cervical Myelopathy (DCM) is the most common form of spinal cord dysfunction in adults worldwide. Its chronic and debilitating nature, varied impact, clinical trajectory, and management options necessitate appropriate informational support to sustain effective clinical and self-directed care strategies. However, before clinicians can meet patients' information needs, they must first have an understanding of their baseline requirements. This study explores the information needs of people with DCM (PwCM). In doing so, it provides a starting point for the development of patient education and knowledge management strategies in clinical practice. METHODS Semi-structured interviews with PwCM were conducted using an interview guide. Interviews were audio-recorded and transcribed verbatim. Thematic analysis according to Braun and Clarke's six-phase approach was used to analyse the data. Findings were reported according to the Consolidated Criteria for Reporting Qualitative Research (COREQ) guidelines. RESULTS Twenty PwCM (65% female, 35% male), with ages ranging from 39 to 74 years old participated in the interviews. The findings indicated that the provision of information to PwCM during clinical interactions varies. Accordingly, PwCM's information needs were broad-ranging, as was the nature of the information they found useful. Three main themes were identified (1) Variation in the provision of information to PwCM during clinical interactions, (2) Variations in the information needs of PwCM, and (3) Information that PwCM find useful. CONCLUSION Efforts must turn to adequately educating patients at the time of the clinical encounter. A comprehensive and consistent patient-centered information exchange in DCM is necessary to achieve this.
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Affiliation(s)
| | | | - Benjamin M Davies
- Myelopathy.org, Cambridge, Cambridgeshire, United Kingdom
- Academic Neurosurgery Unit, Department of Clinical Neurosurgery, University of Cambridge, Cambridge, Cambridgeshire, United Kingdom
| | - Angus McNair
- Centre for Surgical Research, Bristol Medical School, University of Bristol, United Kingdom
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19
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McDonnell S, Breslin T, Mascan B, Shahruddin NS, Elnour M, Fanning M, Galvin A, Moore J, Ravi N, Reynolds JV, Donohoe CL. Translating evidence in a priority setting partnership: knowledge gaps between healthcare providers and oesophageal cancer patients. Support Care Cancer 2023; 31:126. [PMID: 36680653 PMCID: PMC9860237 DOI: 10.1007/s00520-022-07523-3] [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: 01/04/2022] [Accepted: 11/26/2022] [Indexed: 01/22/2023]
Abstract
INTRODUCTION Despite the fact that health information is now more accessible than ever, knowledge gaps remain between patients and healthcare providers (HCPs). To date, the patients' need for information following a diagnosis of oesophageal cancer has not been adequately met. PURPOSE The purpose of this study was to identify why knowledge gaps exist between oesophageal cancer patients and HCPs and how to address them. METHODS Purposive sampling of a group of people living with and after oesophageal cancer who had participated in a priority-setting partnership where 45% of questions from patients had existing evidence-based answers. A 7-set question series was developed for use in a patient/HCP focus group in addition to 11 individual phone interviews with survivors of oesophageal cancer. Qualitative semistructured interviews were conducted to explore oesophageal cancer patients' access to information. The data was analysed thematically, which involved coding all patient transcripts before identifying and reviewing key themes. RESULTS The three primary themes that emerged were as follows: opportunity (HCP team factors and relationship development), ability (patient factors) and priority (pacing of information delivery). CONCLUSION Effective communication between patients and HCPs was identified as an integral component of the enhancement of patient knowledge. HCPs should continue to refine and improve methods of information delivery and encourage conversations regarding information preferences.
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Affiliation(s)
- Sarah McDonnell
- grid.8217.c0000 0004 1936 9705School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Tara Breslin
- grid.8217.c0000 0004 1936 9705School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Bianca Mascan
- grid.8217.c0000 0004 1936 9705School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Nur Shuhada Shahruddin
- grid.8217.c0000 0004 1936 9705School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Mawaheb Elnour
- grid.8217.c0000 0004 1936 9705School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Michelle Fanning
- Department of Clinical Nutrition and Dietetics, Trinity St James Cancer Institute, Dublin, Ireland
| | - Anthony Galvin
- Department of Surgery, National Centre for Oesophageal and Gastric Cancer, Trinity St James Cancer Institute, Dublin, Ireland
| | - Jennifer Moore
- Department of Surgery, National Centre for Oesophageal and Gastric Cancer, Trinity St James Cancer Institute, Dublin, Ireland
| | - Narayansamy Ravi
- Department of Surgery, National Centre for Oesophageal and Gastric Cancer, Trinity St James Cancer Institute, Dublin, Ireland
| | - John V. Reynolds
- Department of Surgery, National Centre for Oesophageal and Gastric Cancer, Trinity St James Cancer Institute, Dublin, Ireland
| | - Claire L. Donohoe
- Department of Surgery, National Centre for Oesophageal and Gastric Cancer, Trinity St James Cancer Institute, Dublin, Ireland
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20
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Okhovati M, Bagherinezhad Z, Gavgani VZ, Safizadeh H. Physician-directed information prescription service. A scoping review. PATIENT EDUCATION AND COUNSELING 2022; 105:3369-3380. [PMID: 35985907 DOI: 10.1016/j.pec.2022.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/17/2022] [Revised: 07/31/2022] [Accepted: 08/03/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVE This scoping review aims to identify and map the characteristics of research studies, types, delivery methods, and team members of physician-directed information prescription services. METHODS Following the PRISMA-ScR checklist, a systematic search was performed on Web of Science, Scopus, Library, Information Science & Technology Abstracts (LISTA), and PubMed/Medline from 1990 to 2021. RESULTS 37 studies were included in the final analysis. Five types of providing information prescription were recognized: typical, oral, web-based, electronic, and mixed methods. Physicians, nurses, and librarians were the most agreed-upon professionals in information prescription delivery teams. The steps of prescribing information were needs assessment, content production, information evaluation, prescribing information, follow-up, and documentation. DISCUSSION This review presents a synthesis of the process of information prescription. It is suggested to determine the effective information prescription type, provide methods and develop the service according to patients' preferences and characteristics. PRACTICE IMPLICATIONS Results of this study can be used to identify the challenges, the competent individuals, roles, and steps of information prescription service, as well as design and develop the protocol, model, and flowchart of it.
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Affiliation(s)
- Maryam Okhovati
- Student Research Committee, Faculty of Management and Medical Information Sciences, Kerman University of Medical Sciences, Kerman, Islamic Republic of Iran.
| | - Zohreh Bagherinezhad
- Student Research Committee, Faculty of Management and Medical Information Sciences, Kerman University of Medical Sciences, Kerman, Islamic Republic of Iran; Kerman University of Medical Sciences, Medical University Campus, Haft Bagh Highway, Kerman, Islamic Republic of Iran.
| | - Vahideh Zarea Gavgani
- School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Islamic Republic of Iran.
| | - Hossein Safizadeh
- Research Center for Social Determinants of Health, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Islamic Republic of Iran.
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21
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Hardman D. Pretending to care. JOURNAL OF MEDICAL ETHICS 2022:jme-2022-108562. [PMID: 36319081 DOI: 10.1136/jme-2022-108562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 10/18/2022] [Indexed: 06/16/2023]
Abstract
On one hand, it is commonly accepted that clinicians should not deceive their patients, yet on the other there are many instances in which deception could be in a patient's best interest. In this paper, I propose that this conflict is in part driven by a narrow conception of deception as contingent on belief. I argue that we cannot equate non-deceptive care solely with introducing or sustaining a patient's true belief about their condition or treatment, because there are many instances of clinical care which are non-doxastic and non-deceptive. Inasmuch as this is true, better understanding of non-doxastic attitudes, such as hope and pretence, could improve our understanding of deception in clinical practice.
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Affiliation(s)
- Doug Hardman
- Department of Psychology, Bournemouth University, Poole, UK
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22
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van de Graaf DL, Vlooswijk C, Bol N, Krahmer EJ, Bijlsma R, Kaal S, Sleeman SHE, van der Graaf WTA, Husson O, van Eenbergen MC. AYAs' online information and eHealth needs: A comparison with healthcare professionals' perceptions. Cancer Med 2022; 12:2016-2026. [PMID: 35879825 PMCID: PMC9883566 DOI: 10.1002/cam4.5048] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Revised: 03/15/2022] [Accepted: 07/07/2022] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Adolescents and young adults (AYAs) diagnosed with cancer fulfill their cancer-related information needs often via the Internet. Healthcare professionals (HCPs) have a crucial role in guiding patients in finding appropriate online information and eHealth sources, a role that is often overlooked. Misperceptions of AYAs' needs by HCPs may lead to suboptimal guidance. We aimed to examine the extent to which AYAs' online information and eHealth needs corresponded with HCPs' perceptions of these needs. METHODS Two cross-sectional online surveys (AYAs, n = 299; HCP, n = 80) on online information and eHealth needs were conducted. HCPs provided indications of their perceptions of AYA's needs. RESULTS AYAs reported significantly more online information needs compared with HCPs' perceptions regarding: survival rates (AYA = 69%, HCP = 35%, p < 0.001), treatment guidelines (AYA = 65%, HCP = 41%, p < 0.001), return of cancer (AYA = 76%, HCP = 59%, p = 0.004), "what can I do myself" (AYA = 68%, HCP = 54%, p = 0.029), and metastases (AYA = 64%, HCP = 50%, p = 0.040). Significantly more unmet eHealth needs were reported by AYAs compared with HCPs relating to access to own test results (AYA = 25, HCP = 0%, p < 0.001), request tests (AYA = 30%, HCP = 7%, p < 0.001), medical information (AYA = 22%, HCP = 0%, p = 0.001), e-consult with nurses (AYA = 30%, HCP = 10%, p < 0.001), e-consult with physicians (AYA = 38%, HCP = 13%, p = 0.001), and request prescriptions (AYA = 33%, HCP = 21%, p = 0.009). CONCLUSION AYAs' online information and eHealth needs are partially discrepant with the impression HCPs have, which could result in insufficient guidance related to AYAs' needs. AYAs and HCPs should get guidance regarding where to find optimal information in a language they understand. This may contribute to AYAs' access, understanding, and satisfaction regarding online information and eHealth.
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Affiliation(s)
- Daniëlle L. van de Graaf
- CoRPS ‐ Center of Research on Psychological disorders and Somatic diseases, Department of Medical and Clinical PsychologyTilburg UniversityTilburgThe Netherlands,Department of Research and DevelopmentNetherlands Comprehensive Cancer Organisation (IKNL)UtrechtThe Netherlands
| | - Carla Vlooswijk
- Department of Research and DevelopmentNetherlands Comprehensive Cancer Organisation (IKNL)UtrechtThe Netherlands
| | - Nadine Bol
- Tilburg Center for Cognition and Communication (TiCC)Tilburg UniversityTilburgThe Netherlands
| | - Emiel J. Krahmer
- Tilburg Center for Cognition and Communication (TiCC)Tilburg UniversityTilburgThe Netherlands
| | - Rhodé Bijlsma
- Department of Medical OncologyUniversity Medical CenterUtrechtThe Netherlands
| | - Suzanne Kaal
- Department of Medical OncologyRadboud University Medical CenterNijmegenThe Netherlands
| | | | - Winette T. A. van der Graaf
- Department of Surgical OncologyNetherlands Cancer InstituteAmsterdamThe Netherlands,Department of Medical OncologyErasmus MC Cancer Institute, Erasmus MCRotterdamThe Netherlands
| | - Olga Husson
- Division of Psychosocial Research and EpidemiologyNetherlands Cancer InstituteAmsterdamThe Netherlands,Department of Surgical OncologyErasmus MC Cancer Institute, Erasmus MCRotterdamThe Netherlands,Division of Clinical StudiesInstitute of Cancer ResearchLondonUK
| | - Mies C. van Eenbergen
- Department of Research and DevelopmentNetherlands Comprehensive Cancer Organisation (IKNL)UtrechtThe Netherlands,Tilburg Center for Cognition and Communication (TiCC)Tilburg UniversityTilburgThe Netherlands
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23
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Bernstein MT, Reynolds KA, Jakobson LS, Stoesz BM, Alcolado GM, Furer P. Examining Anxiety Treatment Information Needs: Web-Based Survey Study. JMIR Form Res 2022; 6:e31338. [PMID: 35551056 PMCID: PMC9136655 DOI: 10.2196/31338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2021] [Revised: 02/21/2022] [Accepted: 03/26/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Several treatments for anxiety are available, which can make treatment decisions difficult. Resources are often produced with limited knowledge of what information is of interest to consumers. This is a problem because there is limited understanding of what people want to know when considering help for anxiety. OBJECTIVE This study aimed to examine the information needs and preferences concerning treatment options for anxiety by assessing the following: what information people consider to be important when they are considering treatment options for anxiety, what information people have received on psychological and medication treatment in the past, how they received this information in the past, and whether there are any differences in information needs between specific samples and demographic groups. METHODS Using a web-based survey, we recruited participants from a peer-support association website (n=288) and clinic samples (psychology, n=113; psychiatry, n=64). RESULTS Participants in all samples wanted information on a broad range of topics pertaining to anxiety treatment. However, they reported that they did not receive the desired amount of information. Participants in the clinic samples rated the importance of information topics higher than did those in the self-help sample. When considering the anxiety treatment information received in the past, most respondents indicated receiving information from informational websites, family doctors, and mental health practitioners. In terms of what respondents want to learn about, high ratings of importance were given to topics concerning treatment effectiveness, how it works, advantages and disadvantages, what happens when it stops, and common side effects. CONCLUSIONS It is challenging for individuals to obtain anxiety-related information on the range of topics they desire through currently available information sources. It is also difficult to provide comprehensive information during typical clinical visits. Providing evidence-based information on the web and in a brochure format may help consumers make informed choices and support the advice provided by health professionals.
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Affiliation(s)
| | | | - Lorna S Jakobson
- Department of Psychology, University of Manitoba, Winnipeg, MB, Canada
| | - Brenda M Stoesz
- Department of Psychology, University of Manitoba, Winnipeg, MB, Canada.,Centre for the Advancement of Teaching and Learning, University of Manitoba, Winnipeg, MB, Canada
| | - Gillian M Alcolado
- Department of Clinical Health Psychology, University of Manitoba, Winnipeg, MB, Canada
| | - Patricia Furer
- Department of Clinical Health Psychology, University of Manitoba, Winnipeg, MB, Canada
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Navarro Jiménez JM, Cruzado JA, Dominguez Cruz A, García García B, Horando López Y, Boya Cristia MJ. Los deseos de información en pacientes con cáncer avanzado. PSICOONCOLOGIA 2022. [DOI: 10.5209/psic.80803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Objetivo: Comprobar los deseos de información, y las variables asociadas a ello, en los pacientes con cáncer avanzado atendidos por un Equipo de Soporte Hospitalario de Cuidados Paliativos. Método: Noventa pacientes con cáncer avanzado, fueron evaluados, mediante una entrevista estructurada sobre si tenían información sobre su enfermedad de los siguientes tipos: diagnóstico, curación, gravedad, objetivos del tratamiento y final de vida, y de su deseo de tener información en cada uno de esto cinco tipos de información. Además, se recogieron los datos sociodemográficos y clínicos, y se administraron: la Escala de Capacidad Funcional, el Índice de Comorbilidad de Charlson, y la Escala de Ansiedad y Depresión Hospitalaria. Resultados. Los resultados muestraron que la mayoría de los pacientes estaban informados del diagnóstico, y de la gravedad, pero no de los objetivos de tratamiento, la curación y el final de vida. De los pacientes no informados el 77,8% (14) deseaban conocer el diagnostico, el 60,0% (11) la gravedad, el 77,8% (35) el objetivo del tratamiento, el 76,7% (24) la curación y un 34,4% (10) el final de vida. Las variables asociadas al deseo de: a) información diagnóstica fueron: tener un cuidador principal más joven (p=,023); con pareja (p=,018), no religiosos (p=,025) y mayor número de visitas a urgencias (p=,004); b) información sobre gravedad fueron: ser joven (p=,009); con pareja (p=,04), y mejor estado ánimo (p=,009); c). Información sobre objetivos del tratamiento: ser joven (p=,001), Con pareja (p=,04), mejor estado ánimo (p=,001). d) información sobre curación: ser hombre (p=,018), con pareja (p=,04), no religiosos (p=,023). En el caso de información sobre el tiempo de vida no se encontró ninguna diferencia significativa. Conclusiones: es necesario valorar los deseos información que tienen los pacientes de forma individualizada y en las diferentes variables de información, y por ello la creación de una herramienta estandarizada en futuras investigaciones es una prioridad. La mayoría de los pacientes con cáncer avanzado están informados del diagnóstico y gravedad, pero existe un déficit de información en curación, objetivos del tratamiento y especialmente en la información del final de vida y destaca más aun, que un alto porcentaje de los pacientes no informados sí desearían recibir información, principalmente sobre los objetivos del tratamiento, sobre todo los más jóvenes, con pareja y no religiosos y con mejor estado de ánimo. Una calidad asistencial óptima en pacientes con cáncer avanzado requiere cubrir sus deseos de información.
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25
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Older adults’ mental health information preferences: a call for more balanced information to empower older adults’ mental health help-seeking. AGEING & SOCIETY 2022. [DOI: 10.1017/s0144686x21001896] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Abstract
A small minority of older adults seek psychological help when they need it. Barriers to mental health service use among older adults include low mental health literacy and reduced opportunities for shared decision-making in health care. There is a gap in the literature examining the mental health information preferences of older adults. The objectives of this study were to describe the information preferences and predictors of preferences among older adults. In total, 229 adults aged 50 years and older in central Canada responded to a questionnaire investigating socio-demographic, psycho-social and health-related characteristics, as well as mental health information preferences. Descriptive analysis quantified participants’ ratings of information preferences and hierarchical linear regression analysis determined predictors of their preferences. Older adults rated all mental health content items as very important. Most participants preferred detailed information (two to six pages) on all treatment options (psychological, pharmacological, combined and self-help). Older adults significantly preferred discussion with a heath-care provider and written information, in comparison to other formats. Older adults also significantly preferred to consult family, friends and heath-care professionals over other sources. Socio-demographic and psycho-social characteristics accounted for some of the variance in predicting older adults’ information preferences. Findings highlight older adults’ desire to be involved in decisions concerning mental health supports. Providing balanced information concerning mental health treatment may increase empowerment in mental health help-seeking.
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26
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Li W, Hill C, Cashell A, Hindle D, Feuz C, Rosewall T. Could knowledge of patient demographics facilitate a personalized approach to radiation therapy patient education? J Med Imaging Radiat Sci 2022; 53:41-50. [DOI: 10.1016/j.jmir.2021.12.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 12/09/2021] [Accepted: 12/15/2021] [Indexed: 12/20/2022]
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27
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Fares J, Chung KSK. Effects of support network structure and position on cancer care experience. SOCIAL NETWORK ANALYSIS AND MINING 2021. [DOI: 10.1007/s13278-021-00740-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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Wang Y, Gao Y, Yuan L, Zhang J, Wang R. RETRACTED: Psychological needs and associated factors among perioperative patients with oral cancer. Oral Oncol 2021; 123:105615. [PMID: 34742003 DOI: 10.1016/j.oraloncology.2021.105615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 10/28/2021] [Accepted: 10/28/2021] [Indexed: 10/19/2022]
Abstract
This article has been retracted: please see Elsevier Policy on Article Withdrawal (http://www.elsevier.com/locate/withdrawalpolicy). This article has been retracted at the request of the Editor-in-Chief, as well as the authors. After concerns about research data were raised by a reader, the journal's editorial board requested a response from the authors, who confirmed errors in analysing and editing the original data. Specifically, a series of 104 survey entries were duplicated during data input. Therefore the authors and the Editor required a retraction of the article.
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Affiliation(s)
- Yujing Wang
- Department of Nursing, School and Hospital of Stomatology, China Medical University, Liaoning Provincial Key Laboratory of Oral Diseases, Shenyang, People's Republic of China.
| | - Yuqin Gao
- Department of Nursing, School and Hospital of Stomatology, China Medical University, Liaoning Provincial Key Laboratory of Oral Diseases, Shenyang, People's Republic of China
| | - Lulu Yuan
- Department of Nursing, School and Hospital of Stomatology, China Medical University, Liaoning Provincial Key Laboratory of Oral Diseases, Shenyang, People's Republic of China
| | - Jiamei Zhang
- Department of Nursing, School and Hospital of Stomatology, China Medical University, Liaoning Provincial Key Laboratory of Oral Diseases, Shenyang, People's Republic of China
| | - Runzi Wang
- Department of Nursing, School and Hospital of Stomatology, China Medical University, Liaoning Provincial Key Laboratory of Oral Diseases, Shenyang, People's Republic of China
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Chhabra S, Girija S. Communicating bad news of COVID-19: An empirical study of patients' preferences in India. Health Mark Q 2021; 38:205-221. [PMID: 34652984 DOI: 10.1080/07359683.2021.1987017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
The study aims to assess patients' preferences regarding physicians communicating bad news of COVID-19. Based on the data collected from 74 patients with COVID-19 in India, this study assesses "how" patients want bad news to be delivered. Key aspects of the physician-patient interaction were identified from the literature. Regression tests proved that three main constructs contribute significantly toward patient outcomes. Content of the message and facilitation were most crucial, however too much emotional support was not desirable by patients. Also, the patient's gender and educational background should be considered before breaking bad news . Thus, to increase patient compliance full disclosure and patient-centered methods of communication can be used.
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Affiliation(s)
| | - Smitha Girija
- Marketing at GITAM University, Visakhapatnam, Andhra Pradesh
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30
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Vaitiekunas L, Coomer K, Turner C, Brown A, Sabesan S. Medical Oncology Care Plan: a tool for improving the provision of clinical information to patients. Intern Med J 2021; 51:1332-1335. [PMID: 34423549 DOI: 10.1111/imj.15449] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Revised: 01/05/2021] [Accepted: 01/08/2021] [Indexed: 11/28/2022]
Abstract
Improving clinical communication between patient and clinician through the provision of written information empowers patients to make informed decisions, underpinning patient-centred care and leading to greater health outcomes. The Townsville Cancer Centre has formulated a holistic care plan template for each patient as a tool to enhance this communication. Using questionnaire-based and qualitative surveys, understanding of the patient's cancer and perspectives of clinicians were examined. The results demonstrate that patients generally have a firm knowledge base of their disease with the predominant finding being that patients wish to be more informed with written information about their diagnosis and alternatives for treatment. While initially time consuming, completion of care plans had many benefits for clinicians; they prompted them to collect holistic information, engage in discussions to capture patient goals and document details about prognosis, treatment options and management of side-effects. Medical oncology care plans provide a sustainable method to provide clinicians a practical template to gather vital information and encourage patients to participate in the decision-making process for healthcare.
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Affiliation(s)
- Laurence Vaitiekunas
- Department of Medical Oncology, The Townsville University Hospital, Townsville, Queensland, Australia
| | - Keegan Coomer
- Department of Medical Oncology, The Townsville University Hospital, Townsville, Queensland, Australia.,College of Medicine and Dentistry, James Cook University, Townsville, Queensland, Australia
| | - Cassie Turner
- Department of Medical Oncology, The Townsville University Hospital, Townsville, Queensland, Australia
| | - Amy Brown
- Department of Medical Oncology, The Townsville University Hospital, Townsville, Queensland, Australia.,College of Medicine and Dentistry, James Cook University, Townsville, Queensland, Australia
| | - Sabe Sabesan
- Department of Medical Oncology, The Townsville University Hospital, Townsville, Queensland, Australia.,College of Medicine and Dentistry, James Cook University, Townsville, Queensland, Australia
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31
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Lange-Drenth L, Schulz H, Endsin G, Bleich C. Patients With Cancer Searching for Cancer- or Health-Specific Web-Based Information: Performance Test Analysis. J Med Internet Res 2021; 23:e23367. [PMID: 34398801 PMCID: PMC8406111 DOI: 10.2196/23367] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Revised: 10/16/2020] [Accepted: 05/24/2021] [Indexed: 12/01/2022] Open
Abstract
Background Searching the internet for cancer-related information helps patients with cancer satisfy their unmet information needs and empowers them to play a more active role in the management of their disease. However, to benefit from the search, patients need a sufficient level of skill to search, select, appraise, and apply web-based health information. Objective We aim to study the operational, navigational, information, and evaluation skills and problems of patients with cancer performing cancer-related search tasks using the internet. Methods A total of 21 patients with cancer were recruited during their stay at the rehabilitation clinic for oncological rehabilitation. Participants performed eight cancer-related search tasks using the internet. The participants were asked to think aloud while performing the tasks, and the screen activities were recorded. The types and frequencies of performance problems were identified and coded into categories following an inductive coding process. In addition, the performance and strategic characteristics of task execution were summarized descriptively. Results All participants experienced problems or difficulties in executing the tasks, and a substantial percentage of tasks (57/142, 40.1%) could not be completed successfully. The participants’ performance problems were coded into four categories, namely operating the computer and web browser, navigating and orientating, using search strategies, and evaluating the relevance and reliability of web-based information. The most frequent problems occurred in the third and fourth categories. A total of 90% (19/21) of participants used nontask-related search terms or nonspecific search terms. A total of 95% (20/21) of participants did not control for the source or topicality of the information found. In addition, none of the participants verified the information on 1 website with that on another website for each task. Conclusions A substantial group of patients with cancer did not have the necessary skills to benefit from cancer-related internet searches. Future interventions are needed to support patients in the development of sufficient internet-searching skills, focusing particularly on information and evaluation skills.
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Affiliation(s)
- Lukas Lange-Drenth
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Holger Schulz
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Gero Endsin
- VAMED Rehabilitation Clinic Lehmrade, Lehmrade, Germany
| | - Christiane Bleich
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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He C, Zhu WX, Tang Y, Bai Y, Luo Z, Xu J, Wang H, Xu S, Xu J, Xiao L, Zhang R, Wang Y, Du J, Huang Y, Li X, Su T. Knowledge of a cancer diagnosis is a protective factor for the survival of patients with breast cancer: a retrospective cohort study. BMC Cancer 2021; 21:739. [PMID: 34176477 PMCID: PMC8237449 DOI: 10.1186/s12885-021-08512-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Accepted: 06/15/2021] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND The health burden of breast cancer is rising in China. The effect of informed diagnosis on long-term survival is not fully understood. This retrospective cohort study aims to explore the association between early informed diagnosis and survival time in breast cancer patients. METHODS A total of 12,327 breast cancer patients were enrolled between October 2002 and December 2016. Potential factors, including knowing the cancer diagnosis status, sex, age, clinical stage, surgery history, grade of reporting hospital and diagnostic year were, analyzed. We followed up all participants every 6 months until June 2017. Propensity score matching (PSM) was used to balance the clinicopathologic characteristics between patients who knew their diagnosis and those who did not. RESULTS By June 2017, 18.04% of the participants died of breast cancer. Before PSM, both the 3-year and 5-year survival rates of patients who knew their cancer diagnosis were longer (P < 0.001). After PSM, the above conclusion was still established. By stratified analysis, except for the subgroups of male patients and stage III patients, patients who knew their diagnosis showed a better prognosis in all the other subgroups (P < 0.05). Cox regression analysis showed that knowing a cancer diagnosis was an independent risk factor for survival in breast cancer patients (P < 0.001). CONCLUSIONS Being aware of their cancer diagnosis plays a protective role in extending the survival time of breast cancer patients, which suggests that medical staff and patients' families should disclose the cancer diagnosis to patients in a timely manner. Further prospective studies need to be made to validate our findings.
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Affiliation(s)
- Chen He
- Department of Medical Psychology, College of Psychology, Naval Medical University, 800 Xiangyin Rd, Shanghai, 200433, China
| | - Wen Xi Zhu
- School of Nursing and Health Management, Shanghai University of Medicine & Health Sciences, Shanghai, China
| | - Yunxiang Tang
- Department of Medical Psychology, College of Psychology, Naval Medical University, 800 Xiangyin Rd, Shanghai, 200433, China
| | - Yonghai Bai
- Department of Medical Psychology, Changzheng Hospital Affiliated to Naval Medical University, Shanghai, China
| | - Zheng Luo
- Zhoupu Hospital affiliated to Shanghai University of Medicine & Health Sciences, Shanghai, China
| | - Jinfang Xu
- Department of Health Statistics, Naval Medical University, Shanghai, China
| | - Hao Wang
- Department of Medical Psychology, College of Psychology, Naval Medical University, 800 Xiangyin Rd, Shanghai, 200433, China
| | - Shuyu Xu
- Department of Medical Psychology, College of Psychology, Naval Medical University, 800 Xiangyin Rd, Shanghai, 200433, China
| | - Jingzhou Xu
- Department of Medical Psychology, College of Psychology, Naval Medical University, 800 Xiangyin Rd, Shanghai, 200433, China
| | - Lei Xiao
- Department of Medical Psychology, College of Psychology, Naval Medical University, 800 Xiangyin Rd, Shanghai, 200433, China
| | - Ruike Zhang
- Department of Medical Psychology, College of Psychology, Naval Medical University, 800 Xiangyin Rd, Shanghai, 200433, China
| | - Yajing Wang
- Department of Medical Psychology, College of Psychology, Naval Medical University, 800 Xiangyin Rd, Shanghai, 200433, China
| | - Jing Du
- Department of Medical Psychology, College of Psychology, Naval Medical University, 800 Xiangyin Rd, Shanghai, 200433, China
| | - Yujia Huang
- Department of Medical Psychology, College of Psychology, Naval Medical University, 800 Xiangyin Rd, Shanghai, 200433, China
| | - Xiaopan Li
- Department of Cancer Prevention and Vital Statistics, Center for Disease Control and Prevention, Pudong New Area, Shanghai, China.
- Pudong Institute of Preventive Medicine, Fudan University, Shanghai, China.
| | - Tong Su
- Department of Medical Psychology, College of Psychology, Naval Medical University, 800 Xiangyin Rd, Shanghai, 200433, China.
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Fischbeck S, Petrowski K, Renovanz M, Nesbigall R, Haaf J, Ringel F. Anxiety is associated with unfulfilled information needs and pain at the informed consent consultation of spine surgery patients: a longitudinal study. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2021; 30:2360-2367. [PMID: 34089353 DOI: 10.1007/s00586-021-06824-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Revised: 02/18/2021] [Accepted: 03/20/2021] [Indexed: 11/30/2022]
Abstract
PURPOSE Meeting the information needs of patients adequately is of high importance in informed consent consultations in surgery. However, information needs often remain unmet in the informed consent consultation. The aim of this study was to assess anxiety and pain in relation to the patients' information needs fulfillment perioperatively. METHODS We applied a question prompt list (QPL) for patients undergoing spine surgery (SN-QPL) before (t1) and a question answering list (SN-QAL) after (t2) the informed consent consultation. The patients additionally completed the "State-Trait Anxiety Operation Inventory" (STOA, cognitive and affective scale) at t1, as well as a pain numerical rating scale (NRS) at t2 and postoperative (t3). We analyzed (1) the association between anxiety, information needs and pain and (2) anxiety and pain scores regarding information needs fulfillment after the consent consultation. RESULTS A total of n = 118 patients was included. Affective and cognitive state anxiety was only reduced postoperatively (affective p < .001, cognitive p < .05). The higher trait anxiety was, the more patients longed for information at t1-t3 (t1: r = .58/r = .74, each p < .001), (t2: r = .38/r = .49, each p < .001) and (t3: r = .29, p < .01/r = 34, p < .001). Higher grades of trait anxiety resulted in lower information needs fulfilment. Higher state anxiety levels were associated with higher pain levels. Information needs more often remained unfulfilled in high trait and state anxiety patients. CONCLUSION Patients' anxiety was associated with (un)fulfilled information needs. Meeting information needs should be optimized in the process of surgeon-patient communication. Adapting the information to the patients' anxiety levels seem to be an effective way to reduce anxiety.
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Affiliation(s)
- Sabine Fischbeck
- Klinik und Poliklinik für Psychosomatische Medizin und Psychotherapie, Medizinische Psychologie und Medizinische Soziologie, Universitätsmedizin Mainz, Saarstr. 21, 55099, Mainz, Germany.
| | - Katja Petrowski
- Klinik und Poliklinik für Psychosomatische Medizin und Psychotherapie, Medizinische Psychologie und Medizinische Soziologie, Universitätsmedizin Mainz, Saarstr. 21, 55099, Mainz, Germany
| | - Mirjam Renovanz
- Interdisziplinäre Sektion Neuroonkologie, Zentrum für Neurologie & Klinik für Neurochirurgie, Universitätsklinikum Tübingen, Hertie-Institut für Klinische Hirnforschung, Hoppe-Seyler-Str. 3, 72076, Tübingen, Germany
| | - Rebecca Nesbigall
- Klinik und Poliklinik für Psychosomatische Medizin und Psychotherapie, Medizinische Psychologie und Medizinische Soziologie, Universitätsmedizin Mainz, Saarstr. 21, 55099, Mainz, Germany
| | - Julian Haaf
- Klinik und Poliklinik für Psychosomatische Medizin und Psychotherapie, Medizinische Psychologie und Medizinische Soziologie, Universitätsmedizin Mainz, Saarstr. 21, 55099, Mainz, Germany
| | - Florian Ringel
- Klinik und Poliklinik für Neurochirurgie, Universitätsmedizin der Johannes Gutenberg-Universität Mainz, Langenbeckstraße 1, 55131, Mainz, Germany
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Zhong T, Quong WL, Cheng T, Kerrebijn I, Butler K, Hofer SOP, O'Neill AC, Cil TD, Metcalfe KA. Preconsultation Educational Group Intervention Can Address the Knowledge Gap in Postmastectomy Breast Reconstruction. Ann Plast Surg 2021; 86:695-700. [PMID: 33252432 PMCID: PMC8132608 DOI: 10.1097/sap.0000000000002603] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Accepted: 09/29/2020] [Indexed: 11/26/2022]
Abstract
BACKGROUND Whether to undergo postmastectomy breast reconstruction (PMBR) is a challenging, preference-sensitive decision. It is therefore paramount to optimize decision quality through ensuring patients' knowledge and aligning treatments with their personal preferences. This study assessed the effects of a preconsultation educational group intervention (PEGI) on patient knowledge, state-trait anxiety, and decisional conflict (patient uncertainty in decision making) during the decision-making process. METHODS This phase 3 randomized controlled trial assessed effects of a PEGI in women without active breast cancer undergoing delayed PMBR, or prophylactic mastectomy with immediate PMBR. Both groups underwent routine education before consultation. In addition, the intervention group underwent a PEGI composed of presentations from a plastic surgeon and nurse, a value clarification exercise, and shared experiences from PMBR patients before the consultation with the plastic surgeon. Before and 1-week after consultation, outcome measures were assessed using the Decisional Conflict Scale, State-Trait Anxiety Inventory, and the BREAST-Q. RESULTS Of the 219 women deemed eligible, a total of 156 women were recruited and randomized. Treatment fidelity was 96% and retention was 88%. At baseline, there were no significant differences in terms of demographic or clinical status, knowledge, state-trait anxiety, and decisional conflict. Patient knowledge about PMBR improved in both groups; however, the degree of knowledge attainment was significantly greater in the PEGI group (24.5% improvement in the intervention group compared with 13.5% in the routine education group, P < 0.001). The reduction in decisional conflict from baseline to follow-up was greater in the intervention group compared with the routine education; however, the difference only approached significance (P = 0.09). CONCLUSIONS The provision of a preconsultation educational group intervention has been shown to significantly close the knowledge gap on PMBR in patients seeking delayed breast reconstruction or prophylactic mastectomy with immediate breast reconstruction compared with routine education alone.
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Affiliation(s)
- Toni Zhong
- From the Division of Plastic Surgery, Department of Surgery and Surgical Oncology, University Health Network
| | - Whitney L. Quong
- Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Toronto
| | - Terry Cheng
- Social Work, Cancer Survivorship Program, Princess Margaret Hospital, University Health Network
| | - Isabel Kerrebijn
- From the Division of Plastic Surgery, Department of Surgery and Surgical Oncology, University Health Network
| | - Kate Butler
- From the Division of Plastic Surgery, Department of Surgery and Surgical Oncology, University Health Network
| | - Stefan O. P. Hofer
- From the Division of Plastic Surgery, Department of Surgery and Surgical Oncology, University Health Network
| | - Anne C. O'Neill
- From the Division of Plastic Surgery, Department of Surgery and Surgical Oncology, University Health Network
| | - Tulin D. Cil
- Department of Surgery, Division of General Surgery, Faculty of Nursing
| | - Kelly A. Metcalfe
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
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van Someren JL, Lehmann V, Stouthard JM, Stiggelbout AM, Smets EMA, Hillen MA. Oncologists' Communication About Uncertain Information in Second Opinion Consultations: A Focused Qualitative Analysis. Front Psychol 2021; 12:635422. [PMID: 34135806 PMCID: PMC8201772 DOI: 10.3389/fpsyg.2021.635422] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 04/30/2021] [Indexed: 11/13/2022] Open
Abstract
Introduction: Uncertainty is omnipresent in cancer care, including the ambiguity of diagnostic tests, efficacy and side effects of treatments, and/or patients' long-term prognosis. During second opinion consultations, uncertainty may be particularly tangible: doubts and uncertainty may drive patients to seek more information and request a second opinion, whereas the second opinion in turn may also affect patients' level of uncertainty. Providers are tasked to clearly discuss all of these uncertainties with patients who may feel overwhelmed by it. The aim of this study was to explore how oncologists communicate about uncertainty during second opinion consultations in medical oncology. Methods: We performed a secondary qualitative analysis of audio-recorded consultations collected in a prospective study among cancer patients (N = 69) who sought a second opinion in medical oncology. We purposively selected 12 audio-recorded second opinion consultations. Any communication about uncertainty by the oncologist was double coded by two researchers and an inductive analytic approach was chosen to allow for novel insights to arise. Results: Seven approaches in which oncologists conveyed or addressed uncertainty were identified: (1) specifying the degree of uncertainty, (2) explaining reasons of uncertainty, (3) providing personalized estimates of uncertainty to patients, (4) downplaying or magnifying uncertainty, (5) reducing or counterbalancing uncertainty, and (6) providing support to facilitate patients in coping with uncertainty. Moreover, oncologists varied in their (7) choice of words/language to convey uncertainty (i.e., "I" vs. "we"; level of explicitness). Discussion: This study identified various approaches of how oncologists communicated uncertain issues during second opinion consultations. These different approaches could affect patients' perception of uncertainty, emotions provoked by it, and possibly even patients' behavior. For example, by minimizing uncertainty, oncologists may (un)consciously steer patients toward specific medical decisions). Future research is needed to examine how these different ways of communicating about uncertainty affect patients. This could also facilitate a discussion about the desirability of certain communication strategies. Eventually, practical and evidence-based guidance needs to be developed for clinicians to optimally inform patients about uncertain issues and support patients in dealing with these.
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Affiliation(s)
- Jamie L van Someren
- Department of Medical Psychology, Amsterdam Public Health, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, Netherlands
| | - Vicky Lehmann
- Department of Medical Psychology, Amsterdam Public Health, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, Netherlands
| | | | - Anne M Stiggelbout
- Medical Decision Making, Department of Biomedical Data Sciences, Leiden University Medical Center, Leiden, Netherlands
| | - Ellen M A Smets
- Department of Medical Psychology, Amsterdam Public Health, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, Netherlands
| | - Marij A Hillen
- Department of Medical Psychology, Amsterdam Public Health, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, Netherlands
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Bongelli R, Bertolazzi A, Piccioni L, Burro R. Italian onco-haematological patients' preferences in bad news communication: a preliminary investigation. BMC Cancer 2021; 21:555. [PMID: 34001021 PMCID: PMC8127256 DOI: 10.1186/s12885-021-08181-0] [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: 04/19/2020] [Accepted: 04/13/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The manner in which bad news is communicated in oncological contexts can affect patients' engagement, their coping strategies and therapeutic compliance. Although this topic has been broadly investigated since the nineties, to the best of our knowledge, little has been written about Italian patients' experiences and preferences concerning what the oncologists should disclose and how they should intimate patients about their health conditions in different stages of oncological disease. METHODS In an attempt to fill this gap, an online self-report questionnaire was administered to a sample of Italian onco-haematological patients. Data were analysed both qualitatively (by a content analysis) and quantitatively (by descriptive analysis and Generalized Linear Mixed Model). RESULTS While the majority of patients elected to know the truth during their clinical course, a polarisation between those arguing that the truth be fully disclosed and those claiming that the truth be communicated in a personalised way was observed at the attitude level. Among demographic variables accounted for, age seems to most affect patients' preferences. Indeed, younger Italian patients decidedly reject concealment of the truth, even when justified by the beneficence principle. This result could be a reaction to some protective and paternalistic behaviours, but it could even reflect a relation according to which the more the age increases the more the fear of knowing rises, or an intergenerational change due to different ways of accessing the information. The qualitative analysis of the final open-ended question revealed three main sources of problems in doctor-patient encounters: scarcity of time, absence of empathy and use of not-understandable language that makes it difficult for patients to assume a more active role. CONCLUSIONS The results of the present study, which represents a preliminary step in the subject investigation, will be deployed for the construction and validation of a more sophisticated questionnaire. Better awareness of the Italian onco-haematological patients' preferences concerning bad news communication and truth-telling could be useful in adopting more suitable medical practices and improving doctor-patient relationships.
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Affiliation(s)
- Ramona Bongelli
- Department of Political Science, Communication and International Relations, University of Macerata, Via Don Minzoni 22/A, 62100, Macerata, Italy.
| | - Alessia Bertolazzi
- Department of Political Science, Communication and International Relations, University of Macerata, Via Don Minzoni 22/A, 62100, Macerata, Italy
| | - Ludovica Piccioni
- Department of Political Science, Communication and International Relations, University of Macerata, Via Don Minzoni 22/A, 62100, Macerata, Italy
| | - Roberto Burro
- Department of Human Sciences, University of Verona, Verona, Italy
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Chapman SJ, Czoski Murray C, Lonsdale MDS, Boyes S, Tiernan JP, Jayne DG. Information needs for recovery after colorectal surgery: a patient focus group study. Colorectal Dis 2021; 23:975-981. [PMID: 33249732 DOI: 10.1111/codi.15459] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Revised: 09/22/2020] [Accepted: 10/13/2020] [Indexed: 12/31/2022]
Abstract
AIM The provision of information to patients is an important part of recovery after colorectal surgery. This study aimed to define patient information needs, barriers to effective understanding and insights into how information provision may be improved. METHOD A patient focus group was convened. This comprised a broad, convenience sample of 11 participants from across the United Kingdom with experience of major colorectal surgery. A semistructured topic guide was used to facilitate discussion about previous experiences of information provision and how this may be improved. Data were analysed thematically and are presented as major themes. RESULTS Overall, participants felt that their information needs are poorly prioritized by healthcare professionals. Barriers to understanding and retaining information include highly emotional situations (such as receiving bad news) and inappropriate information design (such as the use of inaccessible language). Participants expressed how information resources should: (a) address patients' individual information needs; (b) empower patients to take an active role in their recovery; (c) support patients with meaningful education and sign-posted resources; and (d) recognize patients' heightened need for information during recovery at home. CONCLUSION This study provides key insights into the information needs of patients undergoing colorectal surgery. These should inform the development of future information resources, whose format, timing and design are currently supported by low-quality evidence.
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Affiliation(s)
- Stephen J Chapman
- Leeds Institute of Medical Research at St James's, University of Leeds, Leeds, UK
| | | | | | - Sheila Boyes
- Leeds Institute of Medical Research at St James's, University of Leeds, Leeds, UK
| | - Jim P Tiernan
- John Goligher Colorectal Unit, St James's University Hospital, Leeds, UK
| | - David G Jayne
- Leeds Institute of Medical Research at St James's, University of Leeds, Leeds, UK
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Nakaganda A, Solt K, Kwagonza L, Driscoll D, Kampi R, Orem J. Challenges faced by cancer patients in Uganda: Implications for health systems strengthening in resource limited settings. J Cancer Policy 2021; 27:100263. [DOI: 10.1016/j.jcpo.2020.100263] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2020] [Revised: 11/04/2020] [Accepted: 11/18/2020] [Indexed: 12/24/2022]
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Marziliano A, Applebaum A, Moyer A, Pessin H, Rosenfeld B, Breitbart W. The Impact of Matching to Psychotherapy Preference on Engagement in a Randomized Controlled Trial for Patients With Advanced Cancer. Front Psychol 2021; 12:637519. [PMID: 33732196 PMCID: PMC7959844 DOI: 10.3389/fpsyg.2021.637519] [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: 12/03/2020] [Accepted: 02/01/2021] [Indexed: 11/13/2022] Open
Abstract
Objective: This study examined whether patients who were randomly assigned to their preferred therapy arm had stronger engagement with their treatment than those who were randomly assigned to a non-preferred therapy arm. Method: Data were drawn from a RCT comparing Individual Meaning-Centered Psychotherapy (IMCP), with Individual Supportive Psychotherapy (ISP), in patients with advanced cancer. Treatment engagement was operationalized as patients' perceptions of the therapeutic alliance with their therapist and therapy sessions attended. Two 2 by 2 Analysis of Variance (ANOVA) models were used, with treatment preference (IMCP vs. ISP) and treatment assignment (IMCP vs. ISP) as the independent variables and working alliance and number of sessions attended as outcome variables. Results: Patients who preferred and were assigned to IMCP reported a significantly stronger alliance than those who preferred IMCP but were assigned to ISP. Conclusions: The findings from this study have broader implications for research on psychotherapy beyond the appeal of IMCP in advanced cancer patients. Patients who prefer a novel psychotherapy that they cannot engage in elsewhere, but receive the standard treatment may experience weaker alliance than patients who prefer the standard but receive the novel therapy. Trial registration: Clinicaltrial.gov ID: NCT01323309.
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Affiliation(s)
- Allison Marziliano
- Department of Medicine, Center for Health Innovations and Outcomes Research, Northwell Health, New York, NY, United States
| | - Allison Applebaum
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, United States
| | - Anne Moyer
- Department of Psychology, Stony Brook University, New York, NY, United States
| | - Hayley Pessin
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, United States
| | - Barry Rosenfeld
- Department of Psychology, Fordham University, New York, NY, United States
| | - William Breitbart
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, United States
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Theis S, Schäfer K, Schäfer D, Jochems N, Nitsch V, Mertens A. The Relationship Between Individual Coping and the Need to Have and Seek Health Information Among Older Adults: Exploratory Mixed Methods Study. JMIR Hum Factors 2021; 8:e15858. [PMID: 33522973 PMCID: PMC7884216 DOI: 10.2196/15858] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Revised: 02/27/2020] [Accepted: 04/04/2020] [Indexed: 11/13/2022] Open
Abstract
Background The need to have and seek information shapes the context of computing systems. When it comes to health, individual coping influences human behavior. Therefore, the relationship between individual coping and the need to have and seek health information plays a crucial role in the development of digital health systems. Objective This study aims to examine the relationship between individual coping and the need to have and seek health information among older adults. Methods Questionnaires and semistructured interviews investigated the health information need (HIN) and health information–seeking behavior (HISB) in relation to the individual coping strategies of 26 older Germans. Results The mean age of the interviewed group was 71 years (SD 7). Quantitatively, a trend was found for a negative correlation between the avoidance-oriented coping and HIN (rs=−0.37895; bias-corrected and accelerated bootstrap 95% BCa CI −0.730 to 0.092; P=.05). The qualitative results supported this finding. For some participants, information and exchange was part of dealing with their health situation, whereas others wanted to learn as little as possible to avoid a decline in their health status. The older adults acquired, collected, and exchanged paper-based health data to augment clinical information sources and support information exchange with professionals. Conclusions Individual coping strategies are relevant for the design of digital health systems. They can support older adults in coping with their health situation, although it remains unclear how systems must be designed for people with an avoidance coping strategy to achieve the same acceptance.
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Affiliation(s)
- Sabine Theis
- Institut für Arbeitswissenschaft, RWTH Aachen University, Aachen, Germany
| | - Katharina Schäfer
- Institut für Arbeitswissenschaft, RWTH Aachen University, Aachen, Germany
| | - Dajana Schäfer
- Institut für Arbeitswissenschaft, RWTH Aachen University, Aachen, Germany
| | - Nicole Jochems
- Institut für Multimediale und Interaktive Systeme, Universität zu Lübeck, Lübeck, Germany
| | - Verena Nitsch
- Institut für Arbeitswissenschaft, RWTH Aachen University, Aachen, Germany
| | - Alexander Mertens
- Institut für Arbeitswissenschaft, RWTH Aachen University, Aachen, Germany
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Shaverdian N, Gillespie EF, Cha E, Kim SY, Benvengo S, Chino F, Kang JJ, Li Y, Atkinson TM, Lee N, Washington CM, Cahlon O, Gomez DR. Impact of Telemedicine on Patient Satisfaction and Perceptions of Care Quality in Radiation Oncology. J Natl Compr Canc Netw 2021; 19:1174-1180. [PMID: 33395627 DOI: 10.6004/jnccn.2020.7687] [Citation(s) in RCA: 44] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Accepted: 11/17/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND The COVID-19 pandemic has transformed cancer care with the rapid expansion of telemedicine, but given the limited use of telemedicine in oncology, concerns have been raised about the quality of care being delivered. We assessed the patient experience with telemedicine in routine radiation oncology practice to determine satisfaction, quality of care, and opportunities for optimization. PATIENTS AND METHODS Patients seen within a multistate comprehensive cancer center for prepandemic office visits and intrapandemic telemedicine visits in December 2019 through June 2020 who completed patient experience questionnaires were evaluated. Patient satisfaction between office and telemedicine consultations were compared, patient visit-type preferences were assessed, and factors associated with an office visit preference were determined. RESULTS In total, 1,077 patients were assessed (office visit, n=726; telemedicine, n=351). The telemedicine-consult survey response rate was 40%. No significant differences were seen in satisfaction scores between office and telemedicine consultations, including the appointment experience versus expectation, quality of physician's explanation, and level of physician concern and friendliness. Among telemedicine survey respondents, 45% and 34% preferred telemedicine and office visits, respectively, and 21% had no preference for their visit type. Most respondents found their confidence in their physician (90%), understanding of the treatment plan (88%), and confidence in their treatment (87%) to be better or no different than with an office visit. Patients with better performance status and who were married/partnered were more likely to prefer in-person office visit consultations (odds ratio [OR], 1.04 [95% CI, 1.00-1.08]; P=.047, and 2.41 [95% CI, 1.14-5.47]; P=.009, respectively). Patients with telephone-only encounters were more likely to report better treatment plan understanding with an office visit (OR, 2.25; 95% CI, 1.00-4.77; P=.04). CONCLUSIONS This study is the first to assess telemedicine in routine radiation oncology practice, and found high patient satisfaction and confidence in their care. Optimization of telemedicine in oncology should be a priority, specifically access to audiovisual capabilities that can improve patient-oncologist communication.
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Affiliation(s)
| | | | | | - Soo Young Kim
- 2Department of Psychiatry and Behavior Sciences, and
| | | | | | | | - Yuelin Li
- 2Department of Psychiatry and Behavior Sciences, and.,3Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York
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Physician-patient agreement on physicians’
communication skills and visit satisfaction
in dermatology clinics: a one-with-many design. HEALTH PSYCHOLOGY REPORT 2021. [DOI: 10.5114/hpr.2021.110574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Kostagiolas P, Milkas A, Kourouthanassis P, Dimitriadis K, Tsioufis K, Tousoulis D, Niakas D. The impact of health information needs' satisfaction of hypertensive patients on their clinical outcomes. ASLIB J INFORM MANAG 2020. [DOI: 10.1108/ajim-03-2020-0082] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PurposeThe ultimate aim of this study is to investigate how health information needs’ satisfaction actually makes a difference to the patients' management of a chronic clinical condition. The literature falls short of providing evidence on the interaction between patients' health information seeking behaviour and the successful management of a clinical condition. On the other hand, patient education and good information seeking practices are deemed necessary for hypertension management daily decisions.Design/methodology/approachA specially designed questionnaire study was developed: The survey design was informed by the information seeking behaviour model of Wilson for studying hypertension patients' information needs, information resources and obstacles patients face while seeking hypertension-related information. Moreover, clinical information was collected in order to make associations and inference on the impact of information seeking on patients' clinical outcomes.FindingsThe study included 111 patients submitted to the outpatient hypertension clinic of a university hospital in Athens for a 24-h ambulatory blood pressure measurement (ABPM). The analysis showed that those reporting higher satisfaction level of their information needs achieved lower values in ABPM (ABPM<130/80mmHg, p = 0.049). Stepwise the logistic regression analysis revealed three independent factors to predict the possibility of being optimally treated (ABPM<130/80mmHg). Dipping status (OR: 14.052, 95% CI: 4.229–46.688, p = 0.0001) patients with high satisfaction level of their disease (OR: 13.450, 95% CI: 1.364–132.627, p = 0.026) and interpersonal relationships were used as the main source of information (OR: 1.762, 95% CI: 1.024–3.031, p = 0.41).Originality/valueHypertensive patients with high satisfaction level of information achieve better disease control. Among different sources of information, interpersonal relationships emerge as the most appropriate factor for patients' disease control.
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Meinhardt AL, Eggeling M, Cress U, Kimmerle J, Bientzle M. The impact of a physician's recommendation and gender on informed decision making: A randomized controlled study in a simulated decision situation. Health Expect 2020; 24:269-281. [PMID: 33274816 PMCID: PMC8077152 DOI: 10.1111/hex.13161] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2020] [Revised: 09/17/2020] [Accepted: 10/29/2020] [Indexed: 12/18/2022] Open
Abstract
Objective This study examined the influence of physicians’ recommendations and gender on the decision‐making process in a preference‐sensitive situation. Methods N = 201 participants were put in a hypothetical scenario in which they suffered from a rupture of the anterior cruciate ligament (ACL). They received general information on two equally successful treatment options for this injury (surgery vs physiotherapy) and answered questions regarding their treatment preference, certainty and satisfaction regarding their decision and attitude towards the treatment options. Then, participants watched a video that differed regarding physician's recommendation (surgery vs physiotherapy) and physician's gender (female vs male voice and picture). Afterwards, they indicated again their treatment preference, certainty, satisfaction and attitude, as well as the physician's professional and social competence. Results Participants changed their treatment preferences in the direction of the physician's recommendation (P < .001). Decision certainty (P < .001) and satisfaction (P < .001) increased more strongly if the physician's recommendation was congruent with the participant's prior attitude than if the recommendation was contrary to the participant's prior attitude. Finally, participants’ attitudes towards the recommended treatment became more positive (surgery recommendation: P < .001; physiotherapy recommendation: P < .001). We found no influence of the physician's gender on participants’ decisions, attitudes, or competence assessments. Conclusion This research indicates that physicians should be careful with recommendations when aiming for shared decisions, as they might influence patients even if the patients have been made aware that they should take their personal preferences into account. This could be particularly problematic if the recommendation is not in line with the patient's preferences.
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Affiliation(s)
- Anna Lea Meinhardt
- Knowledge Construction Lab, Leibniz-Institut fuer Wissensmedien, Tuebingen, Germany
| | - Marie Eggeling
- Knowledge Construction Lab, Leibniz-Institut fuer Wissensmedien, Tuebingen, Germany
| | - Ulrike Cress
- Knowledge Construction Lab, Leibniz-Institut fuer Wissensmedien, Tuebingen, Germany.,Department of Psychology, University of Tuebingen, Tuebingen, Germany
| | - Joachim Kimmerle
- Knowledge Construction Lab, Leibniz-Institut fuer Wissensmedien, Tuebingen, Germany.,Department of Psychology, University of Tuebingen, Tuebingen, Germany
| | - Martina Bientzle
- Knowledge Construction Lab, Leibniz-Institut fuer Wissensmedien, Tuebingen, Germany
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Lam C, Mattson M. “I would get real people involved”: The perspectives of end users in policymaking. HEALTH POLICY OPEN 2020. [DOI: 10.1016/j.hpopen.2020.100008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Cardoso F, Paluch-Shimon S, Senkus E, Curigliano G, Aapro MS, André F, Barrios CH, Bergh J, Bhattacharyya GS, Biganzoli L, Boyle F, Cardoso MJ, Carey LA, Cortés J, El Saghir NS, Elzayat M, Eniu A, Fallowfield L, Francis PA, Gelmon K, Gligorov J, Haidinger R, Harbeck N, Hu X, Kaufman B, Kaur R, Kiely BE, Kim SB, Lin NU, Mertz SA, Neciosup S, Offersen BV, Ohno S, Pagani O, Prat A, Penault-Llorca F, Rugo HS, Sledge GW, Thomssen C, Vorobiof DA, Wiseman T, Xu B, Norton L, Costa A, Winer EP. 5th ESO-ESMO international consensus guidelines for advanced breast cancer (ABC 5). Ann Oncol 2020; 31:1623-1649. [PMID: 32979513 PMCID: PMC7510449 DOI: 10.1016/j.annonc.2020.09.010] [Citation(s) in RCA: 669] [Impact Index Per Article: 167.3] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Revised: 09/15/2020] [Accepted: 09/16/2020] [Indexed: 01/09/2023] Open
Affiliation(s)
- F Cardoso
- Breast Unit, Champalimaud Clinical Centre/Champalimaud Foundation, Lisbon, Portugal.
| | - S Paluch-Shimon
- Sharett Division of Oncology, Hadassah University Hospital, Jerusalem, Israel
| | - E Senkus
- Department of Oncology and Radiotherapy, Medical University of Gdansk, Gdansk, Poland
| | - G Curigliano
- Department of Oncology and Hemato-Oncology, European Institute of Oncology, IRCCS, Division of Early Drug Development, University of Milan, Milan, Italy
| | - M S Aapro
- Breast Center, Clinique de Genolier, Genolier, Switzerland
| | - F André
- Department of Medical Oncology, Institut Gustave Roussy, Villejuif, France
| | - C H Barrios
- Latin American Cooperative Oncology Group (LACOG), Grupo Oncoclínicas, Porto Alegre, Brazil
| | - J Bergh
- Department of Oncology-Pathology, Karolinska Institute & University Hospital, Stockholm, Sweden
| | - G S Bhattacharyya
- Department of Medical Oncology, Salt Lake City Medical Centre, Kolkata, India
| | - L Biganzoli
- Department of Medical Oncology, Nuovo Ospedale di Prato - Istituto Toscano Tumori, Prato, Italy
| | - F Boyle
- The Pam McLean Centre, Royal North Shore Hospital, St Leonards, Australia
| | - M-J Cardoso
- Breast Unit, Champalimaud Clinical Centre/Champalimaud Foundation, Lisbon, Portugal; Nova Medical School, Lisbon, Portugal
| | - L A Carey
- Department of Hematology and Oncology, UNC Lineberger Comprehensive Cancer Center, Chapel Hill, USA
| | - J Cortés
- IOB Institute of Oncology, Quiron Group, Madrid & Barcelona, Spain; Department of Oncology, Vall d'Hebron Institute of Oncology, Barcelona, Spain
| | - N S El Saghir
- Division of Hematology Oncology, Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - M Elzayat
- Europa Donna, The European Breast Cancer Coalition, Milan, Italy
| | - A Eniu
- Interdisciplinary Oncology Service (SIC), Riviera-Chablais Hospital, Rennaz, Switzerland
| | - L Fallowfield
- SHORE-C, Brighton & Sussex Medical School, University of Sussex, Brighton, UK
| | - P A Francis
- Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - K Gelmon
- Medical Oncology Department, BC Cancer Agency, Vancouver, Canada
| | - J Gligorov
- Breast Cancer Expert Center, University Cancer Institute APHP, Sorbonne University, Paris, France
| | - R Haidinger
- Brustkrebs Deutschland e.V., Munich, Germany
| | - N Harbeck
- Breast Centre, Department of Obstetrics and Gynaecology, University of Munich (LMU), Munich, Germany
| | - X Hu
- Department of Medical Oncology, Fudan University Shanghai Cancer Center, Shanghai, China
| | - B Kaufman
- Department of Oncology, Sheba Medical Center, Ramat Gan, Israel
| | - R Kaur
- Breast Cancer Welfare Association Malaysia, Petaling Jaya, Malaysia
| | - B E Kiely
- NHMRC Clinical Trials Centre, Sydney Medical School, Sydney, Australia
| | - S-B Kim
- Department of Oncology, Asan Medical Centre, University of Ulsan College of Medicine, Seoul, South Korea
| | - N U Lin
- Susan Smith Center for Women's Cancers - Breast Oncology Center, Dana-Farber Cancer Institute, Boston, USA
| | - S A Mertz
- Metastatic Breast Cancer Network, Inverness, USA
| | - S Neciosup
- Department of Medical Oncology, National Institute of Neoplastic Diseases, Lima, Peru
| | - B V Offersen
- Department of Oncology, Aarhus University Hospital, Aarhus, Denmark
| | - S Ohno
- Breast Oncology Centre, Cancer Institute Hospital, Tokyo, Japan
| | - O Pagani
- Medical School, Geneva University Hospital, Geneva, Switzerland
| | - A Prat
- Department of Medical Oncology, Hospital Clinic of Barcelona, Barcelona, Spain; Translational Genomics and Targeted Therapies in Solid Tumors, IDIBAPS, Barcelona; Department of Medicine, University of Barcelona, Barcelona
| | - F Penault-Llorca
- Department of Biopathology, Centre Jean Perrin, Clermont-Ferrand, France; University Clermont Auvergne/INSERM U1240, Clermont-Ferrand, France
| | - H S Rugo
- Breast Oncology Clinical Trials Education, UCSF Helen Diller Family Comprehensive Cancer Center, San Francisco, USA
| | - G W Sledge
- Division of Oncology, Stanford School of Medicine, Stanford, USA
| | - C Thomssen
- Department of Gynaecology, Martin Luther University Halle-Wittenburg, Halle, Germany
| | - D A Vorobiof
- Oncology Research Unit, Belong.Life, Tel Aviv, Israel
| | - T Wiseman
- Department of Applied Health Research in Cancer Care, The Royal Marsden Hospital NHS Foundation Trust, London, UK
| | - B Xu
- Department of Medical Oncology, Cancer Hospital Chinese Academy of Medical Sciences, Beijing, China
| | - L Norton
- Breast Cancer Medicine Service, Memorial Sloan-Kettering Cancer Center, New York, USA
| | - A Costa
- European School of Oncology, Milan, Italy; European School of Oncology, Bellinzona, Switzerland
| | - E P Winer
- Susan Smith Center for Women's Cancers - Breast Oncology Center, Dana-Farber Cancer Institute, Boston, USA
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Decisional involvement and information preferences of patients with hematologic malignancies. Blood Adv 2020; 4:5492-5500. [PMID: 33166406 DOI: 10.1182/bloodadvances.2020003044] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Accepted: 10/13/2020] [Indexed: 11/20/2022] Open
Abstract
Understanding decisional involvement and information preferences in patients with hematologic malignancies may help to optimize physician-patient communication about treatment decisions and align the decision-making processes with patients' preferences. We described and examined factors associated with preferences of patients with hematologic malignancies for decisional involvement, information sources, and presentation of information. In a multicenter observational study, we recruited 216 patients with hematologic malignancies of any stage from September 2003 to June 2007. Patients were asked about their decisional involvement preferences (Control Preferences Scale), information sources (including most useful source of information), and preferences for their oncologists' presentation of treatment success information. We used multivariate logistic regressions to identify factors associated with decisional involvement preferences and usefulness of information sources (physicians vs nonphysicians). Patient-directed, shared, and physician-directed approaches were preferred in 34%, 38%, and 28% of patients, respectively. Physicians and computer/Internet were the most common information sources; 42% perceived physicians as the most useful source. On multivariate analysis, patients with less than a college education (vs postgraduate education) were less likely to perceive their physician as the most useful source (adjusted odds ratio [AOR], 0.46; 95% confidence interval (CI), 0.21-1.00), whereas patients with acute leukemia (vs other blood cancers) were more likely to perceive their physician as the most useful source (AOR, 2.49; 95% CI, 1.07-5.80). In terms of communicating treatment success rates, 70% preferred ≥1 method(s), and 88% preferred presentation in percentages. Our study suggests that decisional involvement and information preferences vary and should be assessed explicitly as part of each decision-making encounter.
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van Ballegooie C. Assessment of Canadian patient education material for oncology pharmaceutics. J Oncol Pharm Pract 2020; 27:1578-1587. [DOI: 10.1177/1078155220960823] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Introduction Health literacy is an individual’s ability to access, understand, and utilize information in order to create an informed decision regarding their health. Readability plays an integral role in health literacy as complex health information may be inaccessible to those with low health literacy. The aim of this study is to determine the readability of Canadian patient education material (PEM) for oncology related pharmaceutics. Methods Eighty PEMs from Cancer Care Ontario (CCO) and BC Cancer (BCC) were evaluated for their reading level using a Ford, Caylor, Sticht (FORCAST) analysis. Twenty therapies were then randomly selected and converted to plain text to be analyzed further using the Flesch-Kincaid Grade Level (FKGL), the Simple Measure of Gobbledygook (SMOG) Index, the Coleman-Liau Index (CLI), and the Gunning Fog Index (GFI). Results Both PEMs from CCO and BCC were above the recommended reading level with PEMs from CCO, on average, requiring a higher reading level. Within the text, the section which describes side effects was found to be the most complex section of the representative PEMs from BCC. PEMs from BCC which described antibody-based therapies were, on average, more difficult to read than small molecule-based therapies regardless from which section the PEM was being analyzed. These observations were not seen in CCO PEMs. Conclusions Overall, online PEMs from major Canadian cancers associations were written above the recommended reading level. Consideration should be given to revision of these materials, with emphasis on the therapies’ side effects, to allow for greater comprehension amongst a wider target audience.
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Affiliation(s)
- Courtney van Ballegooie
- Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
- Experimental Therapeutics, BC Cancer Research Center, Vancouver, BC, Canada
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Sakai H, Koyama A, Tanaka K, Watanabe S, Nakura M, Yasuda T, Hayashi M, Endo M, Nakagawa K. Psychosocial effects of appearance changes due to cancer treatment and needs for information and supportive care in Japanese cancer patients. Asia Pac J Clin Oncol 2020; 16:e185-e191. [DOI: 10.1111/ajco.13333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Accepted: 02/27/2020] [Indexed: 10/24/2022]
Affiliation(s)
- Hitomi Sakai
- Department of Medical Oncology Kindai University Faculty of Medicine Ōsakasayama Osaka Japan
| | - Atsuko Koyama
- Department of Psychosomatic Medicine Kindai University Faculty of Medicine Ōsakasayama Osaka Japan
| | - Kaoru Tanaka
- Department of Medical Oncology Kindai University Faculty of Medicine Ōsakasayama Osaka Japan
| | - Satomi Watanabe
- Department of Medical Oncology Kindai University Faculty of Medicine Ōsakasayama Osaka Japan
| | - Miki Nakura
- Department of Psychosomatic Medicine Kindai University Faculty of Medicine Ōsakasayama Osaka Japan
| | - Toshiko Yasuda
- Department of Psychosomatic Medicine Kindai University Faculty of Medicine Ōsakasayama Osaka Japan
| | - Makiko Hayashi
- Department of Nursing Kindai University Hospital Ōsakasayama Osaka Japan
| | - Miyuki Endo
- Department of Nursing Kindai University Hospital Ōsakasayama Osaka Japan
| | - Kazuhiko Nakagawa
- Department of Medical Oncology Kindai University Faculty of Medicine Ōsakasayama Osaka Japan
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Mazzi MA, Perlini C, Deledda G, Ghilardi A, Buizza C, Bottacini A, Goss C, Del Piccolo L. Employment status and information needs of patients with breast cancer: a multicentre cross-sectional study of first oncology consultations. BMJ Open 2020; 10:e038543. [PMID: 32994250 PMCID: PMC7526300 DOI: 10.1136/bmjopen-2020-038543] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVES To investigate the early information needs of women with a recent diagnosis of breast cancer (BC) according to their employment status. DESIGN Cross-sectional. SETTING Secondary-care patients attending three outpatient oncology clinics in northern Italy. PARTICIPANTS 377 women with a recent diagnosis of early-stage, non-metastatic BC aged 18-75 were recruited. Of them, 164 were employed, 103 non-employed and 110 retired. OUTCOME MEASURES The first consultation visit with an oncologist was audio-recorded and analysed for the number and type of questions asked. Linear regression models considering consultations' and patients' characteristics as confounding variables were applied. RESULTS Employed patients asked significantly more questions than non-employed and retired patients (17 vs 13 and 14; F=6.04; p<0.01). When age and education were included in the statistical model, the significance of employment status was rearranged among all the variables and was no more significant (b=1.2, p=0.44). Employed women asked more questions concerning disease prognosis (0.7 vs 0.4 and 0.6; F=3.5; p=0.03), prevention (1.4 vs 0.6 and 0.7; F=10.7; p<0.01), illness management (7.2 vs 6 and 5.4; F=3.8; p=0.02) and social functioning (37% vs 18% and 20%; χ2=14.3; p<0.01) compared with the other two groups. Finally, they attended more frequently the consultation alone (37% vs 18% and 25%; χ2=10.90, p<0.01), were younger (50 vs 58 and 67 years; F=63.8; p<0.01) and with a higher level of education (77% vs 27% and 45%; χ2=68.2; p<0.01). CONCLUSIONS Employment status is related to the type of questions asked during the first consultation. Also, it interrelates with other patients' characteristics like age and education in determining the number of questions asked. Patients' characteristics including employment status could be considered in tailoring work and social-related information provided during the first oncological consultation. Future studies could explore potential differences in information needs according to the different kinds of work.
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Affiliation(s)
- Maria Angela Mazzi
- Department of Neurosciences, Biomedicine and Movement Sciences, Section of Clinical Psychology, University of Verona, Verona, Italy
| | - Cinzia Perlini
- Department of Neurosciences, Biomedicine and Movement Sciences, Section of Clinical Psychology, University of Verona, Verona, Italy
| | - Giuseppe Deledda
- Clinical Psychological Service, UO of Clinical Psychology, Scientific Institute for Research, Hospitalisation and Health Care (IRCCS) "Sacro Cuore - Don Calabria", Negrar di Valpolicella, Verona, Italy
| | - Alberto Ghilardi
- Department of Clinical and Experimental Sciences, Unit of Clinical Psychology, University of Brescia, Brescia, Italy
| | - Chiara Buizza
- Department of Clinical and Experimental Sciences, Unit of Clinical Psychology, University of Brescia, Brescia, Italy
| | - Alessandro Bottacini
- Department of Neurosciences, Biomedicine and Movement Sciences, Section of Clinical Psychology, University of Verona, Verona, Italy
| | - Claudia Goss
- Department of Neurosciences, Biomedicine and Movement Sciences, Section of Clinical Psychology, University of Verona, Verona, Italy
| | - Lidia Del Piccolo
- Department of Neurosciences, Biomedicine and Movement Sciences, Section of Clinical Psychology, University of Verona, Verona, Italy
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