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Pomey MP, Paquette J, Iliescu-Nelea M, Vialaron C, Mourad R, Bouchard K, Normandin L, Côté MA, Desforges M, Pomey-Carpentier P, Fortin I, Ganache I, Régis C, Rosberger Z, Charpentier D, Bélanger L, Dorval M, Ghadiri DP, Lavoie-Tremblay M, Boivin A, Pelletier JF, Fernandez N, Danino AM, de Guise M. Accompanying patients in clinical oncology teams: Reported activities and perceived effects. Health Expect 2023; 26:847-857. [PMID: 36704843 PMCID: PMC10010089 DOI: 10.1111/hex.13710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 01/04/2023] [Accepted: 01/05/2023] [Indexed: 01/28/2023] Open
Abstract
INTRODUCTION Since 2018, four establishments in Quebec, Canada, have decided to implement the PAROLE-Onco programme, which introduced accompanying patients (APs) in healthcare teams to improve the experience of cancer patients. APs are patient advisors who have had a cancer treatment experience and who conduct consultations to complement the service offered by providing emotional, informational and educational support to patients undergoing treatments (e.g., radiotherapy, chemotherapy, surgery), mostly for breast cancer. We aimed to explore the evolution of APs' perspectives regarding their activities within the clinical oncology teams as well as the perceived effects of their intervention with patients, the clinical team and themselves. METHODS A qualitative study based on semistructured interviews and focus groups was conducted with APs at the beginning of their intervention (T1) and 2 years afterwards (T2). The themes discussed were APs' activities and the perceived effects of their interventions on themselves, on the patients and on the clinical team. RESULTS In total, 20 APs were interviewed. In T2, APs' activities shifted from listening and sharing experiences to empowering patients by helping them become partners in their care and felt generally more integrated into the clinical team. APs help patients feel understood and supported, alleviate stress and become partners in the care they receive. They also alleviate the clinical team's workload by offering a complementary service through emotional support, which, according to them, helps patients feel calmer and more prepared for their appointments with healthcare professionals. They communicate additional information about their patients' health journey, which makes the appointment more efficient for healthcare professionals. When APs accompany patients, they feel as if they can make a difference in patients' lives. Their activities are perceived by some as an opportunity to give back but also as a way of giving meaning to their own experience, in turn serving as a learning experience. CONCLUSION By mobilizing their experiential knowledge, APs provide emotional, informational, cognitive and navigational support, which allows patients to be more empowered in their care and which complements professionals' scientific knowledge, thereby helping to refine their sensitivity to the patients' experiences. PATIENT OR PUBLIC CONTRIBUTION Two patient-researchers have contributed to the study design, the conduct of the study, the data analysis and interpretation, as well as in the preparation and writing of this manuscript.
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Affiliation(s)
- Marie-Pascale Pomey
- Research Centre of the University of Montreal Hospital Centre, Montréal, Quebec, CA.,Centre d'excellence sur le partenariat avec les patients et le public, Montréal, Quebec, CA.,Department of Health Policy, Management and Evaluation, School of Public Health, University of Montréal, Montréal, Quebec, Canada
| | - Jesseca Paquette
- Research Centre of the University of Montreal Hospital Centre, Montréal, Quebec, CA
| | - Monica Iliescu-Nelea
- Research Centre of the University of Montreal Hospital Centre, Montréal, Quebec, CA
| | - Cécile Vialaron
- Research Centre of the University of Montreal Hospital Centre, Montréal, Quebec, CA
| | - Rim Mourad
- Research Centre of the University of Montreal Hospital Centre, Montréal, Quebec, CA
| | - Karine Bouchard
- Centre Hospitalier Universitaire-CHU de Québec-Université Laval, Québec, Québec, Canada
| | - Louise Normandin
- Research Centre of the University of Montreal Hospital Centre, Montréal, Quebec, CA
| | - Marie-Andrée Côté
- Research Centre of the University of Montreal Hospital Centre, Montréal, Quebec, CA
| | - Mado Desforges
- Research Centre of the University of Montreal Hospital Centre, Montréal, Quebec, CA
| | | | - Israël Fortin
- Centre Intégré Universitaire de santé et services sociaux de l'Est-de-l'Île-de Montréal, Hôpital de Maisonneuve-Rosemont, Montréal, Québec, Canada
| | - Isabelle Ganache
- Institut national d'excellence en santé et services sociaux (INESSS), Montréal, Québec, Canada
| | - Catherine Régis
- Université de Montréal-Faculté de Droit, Montréal, Québec, Canada
| | - Zeev Rosberger
- Gerald Bronfman Department of Oncology, Lady Davis Institute for Medical Research, Jewish General Hospital & McGill University, Montréal, Québec, Canada
| | | | - Lynda Bélanger
- Centre Hospitalier Universitaire-CHU de Québec-Université Laval, Québec, Québec, Canada
| | - Michel Dorval
- Centre Hospitalier Universitaire-CHU de Québec-Université Laval, Québec, Québec, Canada.,Université Laval-Faculté de pharmacie, Québec, Québec, Canada.,Centre de recherche du CHU de Québec-Université Laval, Québec, Québec, Canada.,Centre de recherche du CISSS Chaudière Appalaches, Lévis, Québec, Canada
| | | | - Mélanie Lavoie-Tremblay
- Faculté des sciences infirmières, Université de Montréal, Montréal, Québec, Canada.,Institut universitaire en santé mentale de Montréal, Montréal, Québec, Canada
| | - Antoine Boivin
- Research Centre of the University of Montreal Hospital Centre, Montréal, Quebec, CA.,Centre d'excellence sur le partenariat avec les patients et le public, Montréal, Quebec, CA.,Department of Family and Emergency Medicine, Faculté de Médecine, Université de Montréal, Montréal, Québec, Canada
| | - Jean-François Pelletier
- Centre intégré de santé et de services sociaux de la Montérégie-Ouest, St-Hubert, Québec, Canada.,Yale Program for Recovery & Community Health, New Haven, Connecticut, USA
| | - Nicolas Fernandez
- Department of Family and Emergency Medicine, Faculté de Médecine, Université de Montréal, Montréal, Québec, Canada
| | - Alain M Danino
- Research Centre of the University of Montreal Hospital Centre, Montréal, Quebec, CA.,Centre Hospitalier Universitaire de Montréal (CHUM), Montréal, Québec, Canada
| | - Michèle de Guise
- Institut national d'excellence en santé et services sociaux (INESSS), Montréal, Québec, Canada
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Sigmon LB, Reis PJ, Woodard EK, Hinkle JF. Patient and family perceptions of interprofessional collaborative teamwork: An integrative review. J Clin Nurs 2022; 32:2102-2113. [PMID: 35322493 DOI: 10.1111/jocn.16295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Revised: 01/07/2022] [Accepted: 03/02/2022] [Indexed: 11/28/2022]
Abstract
AIMS To understand the patient and family perceptions of teamwork by synthesising existing evidence using the Interprofessional Education Collaborative Core Competencies for Interprofessional Collaborative Practice as a guiding framework. BACKGROUND Advances in healthcare have resulted in more people living longer with health conditions, and patients and families have become the primary caregivers. The role of the interprofessional collaborative team supports a paradigm shift to a care model with the patient and family at the centre of healthcare decisions. However, patient and family views of interprofessional collaborative team care have rarely been studied. METHODS The authors applied Whittmore and Knafl's methodology to conduct an integrative review of the literature. Databases searched included Cumulative Index to Nursing and Allied Health Literature, PubMed and PsycINFO along with reference searches. The studies included were those related to patient and family perceptions of teamwork published from 2000 to 2020. The IPEC Core Competencies for Interprofessional Collaborative Practice served as the guiding framework for analysis. A PRISMA flow chart documented the search, inclusion and exclusion criteria for the review. RESULTS Seventeen articles met the inclusion criteria. The findings identified differing perspectives by patients of the impact of the interprofessional collaborative team in their care which suggests that interventions to increase knowledge about interprofessional collaborative team care from the patient and family perspective may be beneficial. CONCLUSIONS There is limited research on understanding IPC teams from the patient and family viewpoint. This review reveals incongruencies in patient and provider perspectives of IPC teams and suggests the need for additional research about patient and family perspectives of teamwork. To fully implement the IPC team vision, perceptions of teamwork must be fully understood.
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Affiliation(s)
- Lorie B Sigmon
- School of Nursing, University of North Carolina Wilmington, Wilmington, North Carolina, USA
| | - Pamela J Reis
- College of Nursing, East Carolina University, Greenville, North Carolina, USA
| | - Elizabeth K Woodard
- School of Nursing, University of North Carolina Wilmington, Wilmington, North Carolina, USA
| | - Julie F Hinkle
- School of Nursing, University of North Carolina Wilmington, Wilmington, North Carolina, USA
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Mazurenko O, Blackburn J, Bair MJ, Kara AY, Harle CA. Receipt of opioids and patient care experiences among nonsurgical hospitalized adults. Health Serv Res 2021; 55:651-659. [PMID: 33460113 DOI: 10.1111/1475-6773.13556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE To examine the association between receipt of opioids and patient care experiences among nonsurgical hospitalized adults. DATA SOURCES A total of 17 691 patient-level responses to the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) patient care experience survey linked to medical records from nonsurgical hospitalizations in an 11-hospital health care system in a Midwestern state, years 2011-2016. STUDY DESIGN We conducted a pooled cross-sectional study that used propensity score matching analyses and logistic regression to estimate the relationship between patients' care experience measures (overall and pain-specific) and their receipt of opioids while hospitalized. In supplementary analyses, we used the same propensity score matching methods to estimate the relationship between patient care experience measures and receipt of opioids in four patient subgroups based on average patient-reported pain during hospitalization (no pain; mild pain; moderate pain; and severe pain). PRINCIPAL FINDINGS Receipt of opioids was not associated with patient care experience measures in our main analysis. In our supplementary analysis, we found lower ratings for pain control among hospitalizations for patients who reported moderate pain (Marginal Effects = -4.5 percent; P value = .015). CONCLUSIONS Counter to some previous studies, we observed that receipt of opioids was not associated with patient care experience measures for nonsurgical hospitalized adults. These findings may be due to different pain experiences of adults hospitalized for nonsurgical versus surgical reasons.
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Affiliation(s)
- Olena Mazurenko
- Department of Health Policy and Management, Indiana University Richard M. Fairbanks School of Public Health, Indianapolis, Indiana
| | - Justin Blackburn
- Department of Health Policy and Management, Indiana University Richard M. Fairbanks School of Public Health, Indianapolis, Indiana
| | - Matthew J Bair
- Division of General Internal Medicine, VA Center for Health Information and Communication, Indiana University School of Medicine, Richard L. Roudebush VA Medical Center, Indianapolis, Indiana
| | - Areeba Y Kara
- Division of Clinical Medicine, Indiana University School of Medicine, Methodist Hospital, Indianapolis, Indiana
| | - Christopher A Harle
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, Florida
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Noël PH, Jones S, Parchman ML. Patient Experience in an Era of Primary Care Transformation: Revisiting the PACIC. Eur J Pers Cent Healthc 2016; 4:528-540. [PMID: 27746917 PMCID: PMC5060942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
RATIONALE Aims and Objective: The validation study of the Patient Assessment of Chronic Illness Care (PACIC) questionnaire suggested a 5-factor structure determined a priori, but subsequent analyses have questioned the validity of the original factor structure. This study analyzed the factor structure of the PACIC using a large and diverse patient sample, and evaluated the identified factors through the lens of recent transformational initiatives in primary care. METHODS Convenience samples of adults completed surveys in waiting rooms during clinic visits. Primary care patients with 1 or more chronic illnesses with complete PACIC responses at baseline from 39 clinics (n=1,567) and at follow-up from 36 clinics (n=1,536) participated. Exploratory and confirmatory factor analyses were conducted on baseline and follow-up patient questionnaire data from a cluster randomized controlled trial. Identified factors were evaluated in terms of item loadings, content, reliability, and the extent to which items reflected advances in the delivery of chronic illness care. RESULTS Analyses supported the use of the PACIC summary score. Although a 5-factor model was retained, factor loadings were different from the original PACIC validation study. All factors had sufficient reliability, but findings suggested potential revisions to enhance the factor structure. CONCLUSIONS It may be time to revise the PACIC to enhance the stability of the subscales (factors) and better reflect recent transformations in the delivery of chronic illness care.
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Affiliation(s)
- Polly Hitchcock Noël
- University of Texas Health Science Center at San Antonio, South Texas Veterans Health Care System, 7703 Floyd Curl Drive, San Antonio, TX 78229, 210-394-0360
| | - Salene Jones
- MacColl Center for Healthcare Innovation, Group Health Research Institute, Group Health Cooperative, 1730 Minor Avenue, Suite 1600, Seattle, WA 98101 206-287-2704
| | - Michael L. Parchman
- MacColl Center for Healthcare Innovation, Group Health Research Institute, Group Health Cooperative, 1730 Minor Avenue, Suite 1600, Seattle, WA 98101, 206-287-2704
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