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Volakakis N, Pylli M, Raftopoulos V, Kyrkou I, Xanthos T, Deltsidou A. Exploration of the factors that influence perceived quality of patient centered care among cancer survivors: A systematic review. Eur J Oncol Nurs 2024; 68:102503. [PMID: 38219476 DOI: 10.1016/j.ejon.2024.102503] [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: 08/14/2023] [Revised: 12/07/2023] [Accepted: 01/04/2024] [Indexed: 01/16/2024]
Abstract
PURPOSE The purpose of this study was the estimation of the quality of patient centered care among cancer survivors. METHODS Following the PRISMA guidelines, MEDLINE and Google Scholar were systematically searched using the keywords "quality of patient centered care" and "cancer" from 2012 to 2022. RESULTS In this systematic review 7 articles were included, from which 5557 patients were derived, 3050 of them being females. The majority of them (2553 patients) suffered from haematological malignancies, while a considerable amount of them suffered from breast cancer. Three studies were conducted in Australia and four studies in Mexico. Factors, such as respect to patients' values and preferences, emotional support, management of psychological needs and integrated and coordinated care received a lower score. The characteristics that were statistically significantly related to the dimensions of person-centered care were numerous and were grouped into two major categories: a) socio-demographic such as gender, age, marital status, professional status, level of education, place of residence, type of insurance and b) clinical factors such as type of malignancy, psychiatric comorbidities, time interval of diagnosis, follow-up center, type of treatment. CONCLUSIONS The literature showed that there is a lack of comparative data regarding the perceived quality of patient centered care among cancer survivors. More psychometric tools of quality of patient centered care, or validation of the existed ones among all types of cancer survivors are needed, in order to identify and further improve the aspects of care that are not delivered successfully.
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Affiliation(s)
- N Volakakis
- General Hospital of Athens ''HIPPOCRATIO'', 114 Vas. Sofias Avenue, Athens, Greece; University of West Attica, Department of Midwifery, Saint Spiridonos Str, Athens, Greece.
| | - M Pylli
- National Public Health Organization of Greece, 3 Agrafon Str, Athens, Greece.
| | - V Raftopoulos
- National Public Health Organization of Greece, 3 Agrafon Str, Athens, Greece.
| | - I Kyrkou
- University of West Attica, Department of Midwifery, Saint Spiridonos Str, Athens, Greece.
| | - T Xanthos
- University of West Attica, Department of Midwifery, Saint Spiridonos Str, Athens, Greece.
| | - A Deltsidou
- University of West Attica, Department of Midwifery, Saint Spiridonos Str, Athens, Greece.
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Kenis I, Kinnaer LM, Van Hecke A, Foulon V. How patient-centered is education and counseling of patients treated with oral anticancer drugs? A multicenter cross-sectional study. PATIENT EDUCATION AND COUNSELING 2023; 115:107927. [PMID: 37556896 DOI: 10.1016/j.pec.2023.107927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Revised: 07/26/2023] [Accepted: 07/28/2023] [Indexed: 08/11/2023]
Abstract
OBJECTIVE In this multicenter cross-sectional study, the quality of patient-centered education and counseling for patients treated with oral anticancer drugs was examined. METHODS The CONTACT-Patient-Centered Care Questionnaire was administered to 266 patients, recruited in 11 Flemish hospitals. The questionnaire consists of 80 items, each evaluating the degree of performance of a key element in patient-centered education and counseling. RESULTS In total, 15 key elements were seriously underperformed (degree of performance < 50%). Elements regarding adherence monitoring, specific topics in patient education, and involvement of the community pharmacist and home care nurse received a very low score. Only six key elements were systematically performed (degree of performance ≥ 90%), among which the elements on communication style and involvement of the general practitioner. CONCLUSION This study uncovered three major gaps in patient-centered education and counseling of patients on oral anticancer drugs: unmet patient information needs due to shortcomings in patient education, inadequate adherence monitoring, and lacking collaboration with community pharmacists and home care nurses. PRACTICE IMPLICATIONS This study highlights the need for interdisciplinary and patient-centered education and counseling of patients using OACD, including all key stakeholders: physicians, nurses, hospital pharmacists, general practitioners, community pharmacist and home care nurses.
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Affiliation(s)
- Ilyse Kenis
- Department of Pharmaceutical and Pharmacological Sciences, KU Leuven, Leuven, Belgium; Department of Public Health and Primary Care, Ghent University, Ghent, Belgium.
| | - Lise-Marie Kinnaer
- Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
| | - Ann Van Hecke
- Department of Public Health and Primary Care, Ghent University, Ghent, Belgium; Department of Nursing Director, Ghent University Hospital, Ghent, Belgium
| | - Veerle Foulon
- Department of Pharmaceutical and Pharmacological Sciences, KU Leuven, Leuven, Belgium
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Mills GS, Di Ciaccio PR, Tang C, Chadwick V, Mason KD, Campbell BA, Shipton MJ, Shanavas M, Morris KL, Greenwood M, Langfield J, Kidson-Gerber G, Eslick R, Badoux X, Yannakou CK, Gangatharan SA, Bilmon I, Hamad N. Capturing the lived experiences of women with lymphoma in pregnancy: a qualitative study. Leuk Lymphoma 2023; 64:319-328. [PMID: 36423348 DOI: 10.1080/10428194.2022.2148376] [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: 11/27/2022]
Abstract
Lymphoma in pregnancy is a rare and challenging diagnosis that complicates ∼1:6000 pregnancies; posing a series of unique therapeutic, social, and ethical challenges to the patient, her family, and the medical professionals involved. These difficulties are compounded by the paucity of real-world data on the management of LIP, and a lack of relevant support systems for women in this setting. We conducted a retrospective multicenter qualitative study, interviewing women aged ≥18 years of age diagnosed with Hodgkin (HL) or non-Hodgkin lymphoma (NHL) during pregnancy or within 12 months postpartum, between 1 January 2009 and 31 December 2020 from 13 Australasian sites. Semi-structured telephone interviews were conducted, recorded, and analyzed using QSR Int NVivo 12 Pro (March 2020, USA) to quantify salient themes. Of the 32 women interviewed, 20 (63%) were diagnosed during pregnancy (16, 34, and 13% in the 1st, 2nd, and 3rd trimesters, respectively), while 12 (37%) were diagnosed post-partum. Women recalled that their chief concerns at diagnosis were the welfare of their child (n = 13, 41%) and a fear of dying (n = 9, 28%). Perceived diagnostic delay attributed to pregnancy was reported by 41% of participants. Other key themes were communication, educational materials, psychosocial supports, and oncofertility issues. To our knowledge this is the first report capturing the lived experiences of survivors of lymphoma during pregnancy, affording a unique opportunity to consider the management, psychosocial supports, and delivery of care to meet the needs of these women.What is the NEW aspect of your work? To our knowledge, this is the first report capturing and analyzing the healthcare experiences of survivors of Lymphoma in Pregnancy (LIP).What is the CENTRAL finding of your work? Women valued clear and empathic communication, provision of tailored educational materials, access to psychosocial supports (particularly childcare and financial supports), and timely oncofertility management in their healthcare journey.What is (or could be) the SPECIFIC clinical relevance of your work? Women's personal accounts of positive and negative experiences of LIP care provide insights into their specific concerns and needs which can shape healthcare policy and development of a specific framework for managing and supporting patients with LIP (and other cancers).
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Affiliation(s)
- Georgia S Mills
- Department of Hematology, Northern Beaches Hospital, Frenchs Forest, Australia.,Northern Beaches Clinical School, Macquarie University, Sydney, Australia.,Department of Hematology and Bone Marrow Transplant, St. Vincent's Hospital, Darlinghurst, Australia
| | - Pietro R Di Ciaccio
- Department of Hematology, Sydney Adventist Hospital, Sydney, Australia.,School of Medicine, University of New South Wales, Sydney, Australia
| | - Catherine Tang
- Department of Hematology, Gosford Hospital, Gosford, Australia.,Department of Haematology, Wellington Hospital, Wellington, New Zealand
| | - Verity Chadwick
- Department of Hematology and Bone Marrow Transplant, St. Vincent's Hospital, Darlinghurst, Australia
| | - Kylie D Mason
- Department of Clinical Hematology, The Royal Melbourne Hospital and Peter MacCallum Cancer Centre, Melbourne, Australia.,Department of Clinical Pathology, The University of Melbourne, Parkville, Australia
| | - Belinda A Campbell
- Department of Clinical Pathology, The University of Melbourne, Parkville, Australia.,Department of Radiation Oncology, Melbourne, Australia.,The Sir Peter MacCallum Department of Oncology, University of Melbourne, Parkville, Australia
| | - Michael J Shipton
- Department of Clinical Hematology, The Royal Melbourne Hospital and Peter MacCallum Cancer Centre, Melbourne, Australia
| | - Mohamed Shanavas
- Department of Haematology, Mater Hospital, Brisbane, Australia.,Department of Medicine, University of Queensland, Brisbane, Australia
| | - Kirk L Morris
- Department of Haematology, Royal Brisbane and Women's Hospital, Brisbane, Australia
| | - Matthew Greenwood
- Department of Haematology, Royal North Shore Hospital, Sydney, Australia.,School of Medicine, University of Sydney, Sydney, Australia
| | - Jenna Langfield
- Department of Haematology, Royal North Shore Hospital, Sydney, Australia.,School of Medicine, University of Sydney, Sydney, Australia
| | - Giselle Kidson-Gerber
- School of Medicine, University of New South Wales, Sydney, Australia.,Department of Haematology, Prince of Wales Hospital and The Royal Hospital for Women, Randwick, Australia
| | - Renee Eslick
- Department of Haematology, The Canberra Hospital, Canberra, Australia
| | - Xavier Badoux
- Department of Haematology, St. George Hospital, Sydney, Australia
| | - Costas K Yannakou
- Department of Molecular Oncology and Cancer Immunology, Epworth HealthCare, Melbourne, Australia
| | - Shane A Gangatharan
- Fiona Stanley Hospital, Murdoch, Australia.,School of Medicine, University of Western Australia, Nedlands, Australia
| | - Ian Bilmon
- Department of Hematology and Bone Marrow Transplant, Westmead Hospital, Westmead, Australia
| | - Nada Hamad
- Department of Hematology and Bone Marrow Transplant, St. Vincent's Hospital, Darlinghurst, Australia.,School of Medicine, University of New South Wales, Sydney, Australia.,School of Medicine, University of Notre Dame, Sydney, Australia
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Chan CMH, Blanch-Hartigan D, Taib NA, Wee LH, Krupat E, Meyer F. Preferences for patient-centered care among cancer survivors 5 years post-diagnosis. PATIENT EDUCATION AND COUNSELING 2020; 103:1601-1605. [PMID: 32143985 DOI: 10.1016/j.pec.2020.02.033] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2019] [Revised: 02/21/2020] [Accepted: 02/22/2020] [Indexed: 06/10/2023]
Abstract
OBJECTIVE Our primary objective was to identify predictors associated with preferences for patient-centered care among cancer survivors and the association between cancer health literacy and patient-centered care preferences. METHODS Cross sectional analyses of N = 345 adult cancer survivors (5 years post cancer diagnosis) attending follow-ups at University Malaya Medical Centre, Malaysia. Face-to face-interviews were conducted using the 30-item Cancer Health Literacy Test and the Patient-Practitioner Orientation Scale to determine preference for patient-centered care. RESULTS Cancer survivors' preference for patient-centered care was associated with a higher cancer health literacy score, higher educational level, being employed, breast cancer diagnosis, and not desiring psychological support [F (14, 327) = 11.25, p < 0.001, R2 = 0.325]. CONCLUSION Findings from this study provide insights into preferences for patient-centered care among cancer survivors during receipt of follow-up care, which remains an understudied phase of cancer care delivery. PRACTICE IMPLICATIONS Efforts are needed to ensure different preferences for care are taken into account particularly in the setting of variable cancer health literacy.
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Affiliation(s)
| | | | | | - Lei Hum Wee
- Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Malaysia.
| | - Edward Krupat
- Beth Israel Deaconess Medical Centre, Boston, MA, USA
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Palmer NR, Avis NE, Fino NF, Tooze JA, Weaver KE. Rural cancer survivors' health information needs post-treatment. PATIENT EDUCATION AND COUNSELING 2020; 103:1606-1614. [PMID: 32147307 PMCID: PMC7311274 DOI: 10.1016/j.pec.2020.02.034] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Revised: 02/03/2020] [Accepted: 02/26/2020] [Indexed: 06/10/2023]
Abstract
OBJECTIVE This study describes the most common cancer-related health information needs among rural cancer survivors and characteristics associated with reporting more information needs. METHODS Rural breast, prostate, and colorectal cancer survivors, two to five years post-diagnosis, identified from an institutional cancer registry, completed a mailed/telephone-administered survey. Respondents were asked about 23 health information needs in eight domains (tests and treatment, side effects and symptoms, health promotion, fertility, interpersonal, occupational, emotional, and insurance). Poisson regression models were used to assess relationships between number of health information needs and demographic and cancer characteristics. RESULTS Participants (n = 170) reported an average of four health information needs, with the most common domains being: side effects and symptoms (58 %), health promotion (54 %), and tests and treatment (41 %). Participants who were younger (compared to 5-year increase, rate ratio [RR] = 1.11, 95 % CI = 1.02-1.21), ethnic minority (RR = 1.89, 95 % CI = 1.17-3.06), less educated (RR = 1.49, 95 % CI = 1.00-2.23), and financially stressed (RR = 1.87, 95 % CI = 1.25-2.81) had a greater number of information needs. CONCLUSIONS Younger, ethnic minority, less educated, and financially strained rural survivors have the greatest need for informational support. PRACTICE IMPLICATIONS The provision of health information for rural cancer survivors should consider type of cancer, treatments received, and sociocultural differences to tailor information provided.
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Affiliation(s)
- Nynikka R Palmer
- Department of Medicine, University of California San Francisco, San Francisco, CA, USA.
| | - Nancy E Avis
- Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Nora F Fino
- Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Janet A Tooze
- Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Kathryn E Weaver
- Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, NC, USA
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Doubova SV, Terreros-Muñoz E, Delgado-Lòpez N, Montaño-Figueroa EH, Infante-Castañeda C, Pérez-Cuevas R. Experiences with health care and health-related quality of life of patients with hematologic malignancies in Mexico. BMC Health Serv Res 2020; 20:644. [PMID: 32650770 PMCID: PMC7353677 DOI: 10.1186/s12913-020-05498-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Accepted: 07/01/2020] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND In Mexico, patients with hematologic malignancies (HMs) are characterized by being at high risk and advanced stages at diagnosis and by having a low cure rate; yet information on their experiences with health care and health-related quality of life (HRQL) is scarce. We aimed to evaluate experiences with health care and HRQL of patients with HMs and the association between these patient-reported measures. METHODS We conducted a cross-sectional survey in two public oncology hospitals in Mexico City. The study included outpatient cancer patients aged ≥18 years with a diagnosis of leukemia, lymphoma, or multiple myeloma. We used a patient-centered quality of cancer care questionnaire to assess patient experiences with receiving 1) timely care; 2) clear information; 3) information for treatment decision-making; 4) care to address biopsychosocial needs; and 5) respectful and coordinated care. We applied the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) to measure HRQL. We performed a multiple linear regression to evaluate the association between patient-reported experiences (independent variables) and the QLQ-C30 summary score (dependent variable). RESULTS Of the 515 participating HM patients, 46.6% had lymphoma, 34% leukemia, and 19.4% multiple myeloma; 70.9% were at advanced stages or at high risk. Additionally, 15.1% had anxiety and 12.8% had depression. Over one third (35.9%) reported receiving clear information, 28.5% timely care, 20.6% information for treatment decision-making, 23.7% care that addressed their biopsychosocial needs, and 31% respectful and coordinated care. The mean QLQ-C30 summary score was 71.9 points. Timely care, clear information, and care that addresses biopsychosocial needs were associated with higher HRQL. CONCLUSIONS Health care services for HM patients at public oncology hospitals in Mexico need improvement. Notably, providing timely care, clear information, and care that addresses patients' biopsychosocial needs can increase the likelihood of better HRQL. Health care providers should measure and improve the experiences of HM patients with health care.
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Affiliation(s)
- Svetlana V Doubova
- Epidemiology and Health Services Research Unit CMN Siglo XXI, Mexican Institute of Social Security, Av. Cuauhtemoc 330, Col. Doctores, Del. Cuauhtemoc, CP 06720, Mexico City, Mexico.
| | - Eduardo Terreros-Muñoz
- Servicio de Hematología, Hospital de Especialidades, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Ciudad de México, Mexico
| | - Nancy Delgado-Lòpez
- Servicio de Hematología, Hospital de Especialidades, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Ciudad de México, Mexico
| | - Efreen Horacio Montaño-Figueroa
- Departamento de Hematología, Hospital General de México "Dr. Eduardo Liceaga". Secretaría de Salud, Ciudad de México, Mexico
| | - Claudia Infante-Castañeda
- Instituto de Investigaciones Sociales, Universidad Nacional Autónoma de México, Ciudad de México, Mexico
| | - Ricardo Pérez-Cuevas
- Division of Social Protection and Health, Jamaica Country Office, Interamerican Development Bank, Kingston, Jamaica
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Structured multi-disciplinary psychosocial care for cancer patients and the perceived quality of care from the patient perspective: a cluster-randomized trial. J Cancer Res Clin Oncol 2019; 145:2845-2854. [DOI: 10.1007/s00432-019-03018-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Accepted: 09/03/2019] [Indexed: 10/26/2022]
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Gumpert M, Reese JP. Quality Management Systems in the Ambulant Sector: An Analytical Comparison of Different Quality Management Systems. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E444. [PMID: 30717424 PMCID: PMC6388389 DOI: 10.3390/ijerph16030444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/13/2019] [Accepted: 01/31/2019] [Indexed: 06/09/2023]
Abstract
BACKGROUND Since 1 January 2004, all physicians, psychotherapists, and medical care centers that are under contract to statutory healthcare in Germany are obliged, according to § 135a Section 2 of the Fifth Social Security Statute Book, to introduce an intra-institutional quality management system. METHODS A total of 24 medical practices were chosen through random sampling. In total, there were 12 family physicians and specialist practices each and eight practices each per quality management system. The analysis was carried out with the help of three specially developed questionnaires (physician, employee, and patient). A total of 26 quality categories with different questions were available in the three survey groups (physicians, employees, and patients). The Kruskal⁻Wallis test checked the extent to which the different scores between the quality management systems were significant and effective for specialists or family physicians. RESULTS "Quality and Development in Practices (QEP)" had the highest average score. Due to a specific family practitioner specialism, "Quality management in Saxony medical practices (QisA)" followed with good average scores. The individual quality categories in the quality management systems, such as the "range of services" or "allocation of appointments", received the highest average scores among the specialists. In contrast, categories such as "telephone enquiries" and "external cooperation and communication" received the highest average scores among the family physicians. CONCLUSION Differences in the evaluation of quality management systems and medical groups (specialists/family physicians) were found in the study. The reasons for these differences could be found in the quality categories.
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Affiliation(s)
- Marcus Gumpert
- Medical Faculty, Philipps-University of Marburg, Karl-von-Frisch-Strasse 4, 35043 Marburg, Germany.
- Department of Quality Assurance/Quality Management, Association of Statutory Health Insurance Physicians in Saxony, Schützenhöhe 12, 01099 Dresden, Germany.
| | - Jens-Peter Reese
- Coorsinating Center for Clinical Trials, Philipps-University of Marburg, Karl-von-Frisch-Strasse 4, 35043 Marburg, Germany.
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