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Stiefel F, Stiefel F, Terui T, Machino T, Ishitani K, Bourquin C. Spotlight on Japanese physicians: An exploration of their professional experiences elicited by means of narrative facilitators. Work 2019; 63:269-282. [PMID: 31156208 DOI: 10.3233/wor-192928] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND While investigation of physicians' work experience is often limited to issues of satisfaction or burnout, a broader view of their experiences is lacking. OBJECTIVE To explore professional experiences, we asked Japanese physicians (N = 18, 12 men and 6 women) of a general hospital to react to so-called "narrative facilitators". METHODS The narrative facilitators - inspired by clinical psychology, visual sociology and purpose-designed techniques - oriented physicians' narratives towards clinical practise, relationship with peers and context. Transcribed interviews were subject to thematic analysis. RESULTS The thematic analysis of participants' narratives revealed a lonely physician with a tough job, torn between the ideal of patient-centred care and a clinical reality, which limits these aspirations. Patients emerged as anxious and burdensome consumers of medicine. Feeling neither supported by peers nor the institution, physicians also perceived the society as somewhat negligent, delegating its problem to medicine. Communication difficulties, with patients and peers, and the absence of joyful aspects of the profession constituted fundamental elements of their narratives. CONCLUSIONS Comprehensive investigation of physicians' lived professional experience could become a key to conceive ways to support them.
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Affiliation(s)
- F Stiefel
- Psychiatric Liaison Service, University Hospital Lausanne, Switzerland.,Higashi Sapporo Hospital, Sapporo, Japan
| | - Fa Stiefel
- Higashi Sapporo Hospital, Sapporo, Japan
| | - T Terui
- Higashi Sapporo Hospital, Sapporo, Japan
| | - T Machino
- Higashi Sapporo Hospital, Sapporo, Japan
| | - K Ishitani
- Higashi Sapporo Hospital, Sapporo, Japan
| | - C Bourquin
- Psychiatric Liaison Service, University Hospital Lausanne, Switzerland
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Jabbarzadeh Tabrizi F, Rahmani A, Asghari Jafarabadi M, Jasemi M, Allahbakhshian A. Unmet Supportive Care Needs of Iranian Cancer Patients and its Related Factors. J Caring Sci 2016; 5:307-316. [PMID: 28032075 PMCID: PMC5187551 DOI: 10.15171/jcs.2016.032] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2014] [Accepted: 07/17/2015] [Indexed: 11/19/2022] Open
Abstract
Introduction: Investigation of supportive care needs of
cancer patients is important to implement any supportive care programs. There is no
relevant studies investigated supportive care needs of Iranian cancer patients and factors
affecting such needs. So, the aims of present study were to determine the unmet supportive
care needs of Iranian cancer patients and its predictive factors. Methods: In this descriptive- correlational study 274 cancer
patients in one referral medical center in North West of Iran participated. For data
collection, demographic and cancer related information checklist and Supportive Care Needs
Survey (SCNS) was used. Logistic regression was used for data analysis of un-adjusted and
adjusted Odds Ratios (ORs) for patients needs and analysis of variables of study based on
Backward LR procedure SPSS Ver.13. Results: More than fifty percent of participants reported
unmet needs in 18 items of SCNS. Most frequent unmet needs were related to health system
and information domains and most meet needs were related to sexuality and psychological
domains. The result of logistic regression identified predictors of each domain of
supportive care needs. The variable such as sex, age and living situation were most
important predictors of unmet needs. Conclusion: The results showed that Iranian cancer patients
have many supportive care needs in different domains. In general female cancer patients
are at risk of more unmet supportive care needs. So, health care professionals should be
more sensitive to fulfillment of supportive care needs of female.
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Affiliation(s)
- Faranak Jabbarzadeh Tabrizi
- Department of Nursing, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Azad Rahmani
- Hematology and Oncology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mohammad Asghari Jafarabadi
- Department of Statistics and Epidemiology, Faculty of Health, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Madineh Jasemi
- Department of Nursing, Faculty of Nursing and Midwifery, Urmia University of Medical Sciences, Urmia, Iran
| | - Atefeh Allahbakhshian
- Department of Nursing, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
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Malmström M, Ivarsson B, Klefsgård R, Persson K, Jakobsson U, Johansson J. The effect of a nurse led telephone supportive care programme on patients' quality of life, received information and health care contacts after oesophageal cancer surgery-A six month RCT-follow-up study. Int J Nurs Stud 2016; 64:86-95. [PMID: 27701025 DOI: 10.1016/j.ijnurstu.2016.09.009] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2015] [Revised: 09/08/2016] [Accepted: 09/11/2016] [Indexed: 01/22/2023]
Abstract
BACKGROUND Following oesophagectomy, a major surgical procedure, it is known that patients suffer from severely reduced quality of life and have an unmet need for postoperative support. Still, there is a lack of research testing interventions aiming to enhance the patients' life situation after this surgical procedure. AIM The aim of the study was to evaluate the effect of a nurse led telephone supportive care programme on quality of life (QOL), received information and the number of healthcare contacts compared to conventional care following oesophageal resection for cancer. METHOD The study was designed as a randomized controlled trial (RCT) aiming to test the effect of a nurse led telephone supportive care program compared to conventional care. Patient assessments were conducted at discharge, 2 weeks, 2, 4 and 6 months after discharge and comprised evaluation of QOL, received information and the number of health care contacts. Statistical testing were conducted with repeated measurements analysis of variance to test if there were differences between the groups during follow-up. RESULT The results show that the intervention group was significantly more satisfied with received information for items concerning the information they received about things to do to help yourself, written information and for the global information score. The control group scored significantly higher on the item regarding wishing to receive more information and wish to receive less information. No effect of the intervention was shown on QOL or number of health care contacts. CONCLUSION Proactive nurse-led telephone follow-up has a significant positive impact on the patients' experience of received information. This is likely to have a positive effect on their ability to cope with a life that may include remaining side effects and adverse symptoms for a long time after surgery.
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Affiliation(s)
- Marlene Malmström
- Skåne University Hospital, Lund, Sweden; Department of Surgery, Skåne University Hospital, Lund, Sweden; Lund University, Sweden.
| | - Bodil Ivarsson
- Skåne University Hospital, Lund, Sweden; Lund University, Sweden; Department of Cardio-Thoracic Surgery, Skåne University Hospital, Lund, Sweden
| | | | - Kerstin Persson
- Skåne University Hospital, Lund, Sweden; Department of Surgery, Skåne University Hospital, Lund, Sweden
| | - Ulf Jakobsson
- Lund University, Sweden; Center for Primary Health Care Research, Faculty of Medicine, Lund University, Sweden
| | - Jan Johansson
- Skåne University Hospital, Lund, Sweden; Department of Surgery, Skåne University Hospital, Lund, Sweden; Lund University, Sweden
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Rahmani A, Ferguson C, Jabarzadeh F, Mohammadpoorasl A, Moradi N, Pakpour V. Supportive care needs of Iranian cancer patients. Indian J Palliat Care 2014; 20:224-8. [PMID: 25191012 PMCID: PMC4154172 DOI: 10.4103/0973-1075.138400] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background: A supportive needs assessment is an essential component of any care program. There is no research evidence regarding the supportive care needs of cancer patients in Iran or other Middle Eastern countries. Aims: The aim of this study was to determine the supportive care needs of Iranian cancer patients. Materials and Methods: This descriptive study was conducted in a referral medical center in the northwest of Iran. A total of 274 cancer patients completed the Supportive Care Needs Survey (SCNS-59). Descriptive statistics were used for data analysis. Results: In 18 items of the SCNS, more than 50% of the participants reported that their needs were unmet. Most frequently, unmet needs were related to the health system, information, physical, and daily living domains, and most met needs were related to sexuality, patient care, and support domains. Conclusions: Iranian cancer patients experience many unmet needs and there is an urgent need for establishing additional supportive care services in Iran.
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Affiliation(s)
- Azad Rahmani
- Hematology and Oncology Research Center, Nursing and Midwifery Faculty, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Caleb Ferguson
- Centre for Cardiovascular and Chronic Care, Faculty of Health, University of Technology Sydney, Australia
| | - Faranak Jabarzadeh
- Department of Medical and Surgical Nursing, Nursing and Midwifery Faculty, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Asghar Mohammadpoorasl
- Department Human Nutrition and Food Safety, School of Public Health, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Narges Moradi
- Department of Medical and Surgical, Nursing and Midwifery Faculty, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Vahid Pakpour
- Department of Community Nursing, Nursing and Midwifery Faculty, Tabriz University of Medical Sciences, Tabriz, Iran
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Malmström M, Klefsgård R, Johansson J, Ivarsson B. Patients' experiences of supportive care from a long-term perspective after oesophageal cancer surgery – A focus group study. Eur J Oncol Nurs 2013; 17:856-62. [DOI: 10.1016/j.ejon.2013.05.003] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2012] [Revised: 04/22/2013] [Accepted: 05/05/2013] [Indexed: 10/26/2022]
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Stiefel F, Razavi D. Informing about diagnosis, relapse and progression of disease--communication with the terminally III cancer patient. RECENT RESULTS IN CANCER RESEARCH. FORTSCHRITTE DER KREBSFORSCHUNG. PROGRES DANS LES RECHERCHES SUR LE CANCER 2006; 168:37-46. [PMID: 17073190 DOI: 10.1007/3-540-30758-3_4] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
Abstract
This chapter focuses on four crucial situations representing important challenges for physician-patient communication: diagnosis, relapse, progression of disease and terminal illness. The psychological aspects of each situation are discussed and a framework for communication is provided. The aim of the chapter is to invite the oncology clinician to think about these different stages of disease and to support him or her in the communication with the patient. Communication with cancer patients is a difficult task in clinical practice and it is especially challenging when informing about diagnosis and prognosis, when relapse occurs or when the disease is progressing. Physician-patient communication has undergone considerable changes and has become-compared to decades before, when medicine was based on a more paternalistic model of care--a central duty and challenge of the oncology clinician. The following chapter aims to discuss key elements of communication in the above-mentioned specific situations; it is based on our clinical experience as psycho-oncologists and teachers of communication skills training (Razavi and Stiefel 1994; Stiefel and Razavi 1994; Razavi et al. 2003; Berney and Stiefel 2004; Delvaux et al. 2005; Voelter et al. 2005; Bragard et al. 2006).
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Affiliation(s)
- F Stiefel
- Service de Psychiatrie de Liaison, Lausanne University Hospital, Switzerland
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Fincham L, Copp G, Caldwell K, Jones L, Tookman A. Supportive care: experiences of cancer patients. Eur J Oncol Nurs 2005; 9:258-68. [PMID: 16112527 DOI: 10.1016/j.ejon.2004.08.004] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
The aim of this study was to explore how cancer patients with progressive disease perceived and experienced supportive care at the different stages of their cancer journey and to compare this to the perceptions of health care professionals. It was a single centre study using qualitative data obtained from two focus group interviews in an independent centre for specialist palliative care. Eight patients attending the centre were interviewed in two focus groups to ascertain their views on the supportive care that they had experienced during the course of their illness, focusing on: time of diagnosis, acute treatment phase and palliative care phase. Themes that emerged from the analysis of the interview transcripts using the QSR NUD*IST (version 4) software package included the following: manner in which diagnosis was revealed, information made available to family and friends, patients' acceptance of cancer; service provision such as a named contact person, choices in treatment and care, problems of limited resources; feelings of being unsupported, and ways in which supportive care could be improved.
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Affiliation(s)
- Lorraine Fincham
- King's College London, 5th Floor, Waterloo Bridge Wing, Franklin Wilkins Building, 150 Stanford Street, London SE1 9NN, UK.
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Abstract
Palliative services in Australia have grown and evolved rapidly over the past 20 years. They now offer care to people facing life-limiting illness and to their families long before the stage of terminal care. A coordinated, interdisciplinary approach is most useful, but models of care vary greatly across the country. There is still unmet need, particularly among people with non-cancer illnesses and in particular regions. Choices about place of care (community or inpatient setting) may be limited by factors such as funding policies for medications.
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Di Mola G, Borsellino P, Brunelli C, Gallucci M, Gamba A, Lusignani M, Regazzo C, Santosuosso A, Tamburini M, Toscani F. Attitudes toward euthanasia of physician members of the Italian Society for Palliative Care. Ann Oncol 1996; 7:907-11. [PMID: 9006740 DOI: 10.1093/oxfordjournals.annonc.a010792] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND The problems related to requests for euthanasia by terminal patients; the variations in attitude of palliative care physicians and the possibility that availability of the best palliative care might obviate the problem by eliminating requests for euthanasia, are under discussion. DESIGN A mailed survey with no possibility of follow-up of all 685 physician members of the Italian Society for Palliative Care (SICP) in 1994. RESULTS Of the 359 (52.4%) responders, 139 (39%) had received requests for euthanasia; 16 of them (4% of the responders but 11.5% of those who received requests) had complied at least once, while 216 (60%) had not; 125 (35%) thought that euthanasia was 'wrong' under all circumstances; 115 (32%) thought that situations could occur, even in the context of palliative care, in which euthanasia might be ethically 'correct'; 185 (52%) thought that the best palliative care might solve the problem of euthanasia, while 109 (30%) believed otherwise. The variable most strongly associated with a negative attitude toward euthanasia and with the opinion that the best palliative care might be a solution to the problem is religious belief (P < 0.0001). CONCLUSIONS The attitudes of physicians practising palliative care in Italy are not different from those reported by previous studies which investigated the attitude of other health professionals. There was no agreement about whether the best palliative care might reduce requests for euthanasia by terminal patients.
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Affiliation(s)
- G Di Mola
- Ethics Committee, c/o Fondazione Floriani, Milan, Italy
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Sessa C. Palliative care versus euthanasia? Ann Oncol 1996; 7:645. [PMID: 8879385 DOI: 10.1093/oxfordjournals.annonc.a010688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
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