WorldWideScience

Sample records for adult cancer care

  1. Home care to Older adult with cancer

    International Nuclear Information System (INIS)

    Objective: Home care of the elderly with cancer. After the development of a program of oncology home care and over a period of five years, we believe that the evaluation allows us to have our proposal and challenges in the continuity of the program. This evidence is based in our old advanced Uruguayan population, and consequently increase this cancer population, we should define which pointed toward our objective, in order to get the best quality life. After one year with a project based on general rules, the evidence threw an evaluation, that we should review the model of care with which we were working. We continue to Auto-care model Dorothea Orem. The main objective became quality of life:Take care as the primary Older Adult; Specific care their cancer to become symptomatic secondary complications to the evolution of tumor biology; Secondary prevention of cause therapeutic effect; Family integration, without changing the pace of life that the elderly had before being with cancer. Nursing challenge: Maintain autonomy achieved in these 5 years. Deepen the social equilibrium that we are committed daily between patient and family.Do not miss the professionalism achieved today.Proposal for nursing: Consider a wide field of nursing and for this achievement is need knowledge of 2nd level of community work, knowledge Clinical knowledge in Oncology Nursing, autonomy in decision making. For older adults with cancer: No out of its middle. Maintain priority habits and customs. Do not let it lose their self-esteem with their own values. Caution changes must take care to better manage the evolution of their illness. Conclusion: Oncology nursing is a specialty. Without this formation will be ever more away the development of these programs in our environment, or fall in applying for only economic convenience, losing professionalism. Our population is increasing

  2. Primary care for young adult cancer survivors: an international perspective

    DEFF Research Database (Denmark)

    Hølge-Hazelton, Bibi; Blake-Gumbs, Lyla; Miedema, Baujke;

    2010-01-01

    PURPOSE: Internationally, family physicians (FP) are not routinely involved in young adult cancer (YAC) care. In this short report, we would like to make a compelling argument for primary care involvement. METHODS: Comparative descriptions and literature review. RESULTS: Cancer among YAs is rare...... psychosocial issues the YA cancer patient may present with. The role of the FP in follow-up care seems to be very limited. CONCLUSIONS: YACs in the western world seem to have comparable medical and psychosocial problems. However, the nature of health insurance is such that it impacts differently on the care of...... this group of cancer patients. Primary care features such as patient-centered, integrated, and comprehensive care over extended periods of time bring the FP into the unique position to provide follow-up for YAC. However, this will require integrating patient's perspectives on their care, professional...

  3. Adolescent and young adult cancer: principles of care

    OpenAIRE

    Ramphal, R; Aubin, S.; Czaykowski, P.; Pauw, S; Johnson, A.; McKillop, S.; Szwajcer, D; Wilkins, K; ROGERS, P.

    2016-01-01

    Adolescents and young adults (ayas) with cancer in active treatment face a number of barriers to optimal care. In the present article, we focus on the 3 critical domains of care for ayas—medical, psychosocial, and research—and how changes to the system could overcome barriers. We summarize the current literature, outline recommended principles of care, raise awareness of barriers to optimal care, and suggest specific changes to the system to overcome those barriers in the Canadian context. Ma...

  4. Supportive Care in Older Adults with Cancer: Across the Continuum.

    Science.gov (United States)

    Koll, Thuy; Pergolotti, Mackenzi; Holmes, Holly M; Pieters, Huibrie C; van Londen, G J; Marcum, Zachary A; MacKenzie, Amy R; Steer, Christopher B

    2016-08-01

    Supportive care is an essential component of anticancer treatment regardless of age or treatment intent. As the number of older adults with cancer increases, and supportive care strategies enable more patients to undergo treatment, greater numbers of older patients will become cancer survivors. These patients may have lingering adverse effects from treatment and will need continued supportive care interventions. Older adults with cancer benefit from geriatric assessment (GA)-guided supportive care interventions. This can occur at any stage across the cancer treatment continuum. As a GA commonly uncovers issues potentially unrelated to anticancer treatment, it could be argued that the assessment is essentially a supportive care strategy. Key aspects of a GA include identification of comorbidities, assessing for polypharmacy, screening for cognitive impairment and delirium, assessing functional status, and screening for psychosocial issues. Treatment-related issues of particular importance in older adults include recognition of increased bone marrow toxicity, management of nausea and vomiting, identification of anemia, and prevention of neurotoxicity. The role of physical therapy and cancer rehabilitation as a supportive care strategy in older adults is important regardless of treatment stage or intent. PMID:27342609

  5. Palliative care for adolescents and young adults with cancer

    Directory of Open Access Journals (Sweden)

    Rosenberg AR

    2013-03-01

    Full Text Available Abby R Rosenberg,1–3 Joanne Wolfe4–61Division of Pediatric Hematology/Oncology, Seattle Children’s Hospital, Seattle, WA; 2Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA; 3Department of Pediatrics, University of Washington, Seattle, WA; 4Department of Psychosocial Oncology and Palliative Care/Division of Pediatric Palliative Care, Dana-Farber Cancer Institute, Boston, MA; 5Department of Medicine/Division of Hematology/Oncology, Boston Children’s Hospital, Boston, MA; 6Department of Pediatrics, Harvard University School of Medicine, Boston, MA, USAAbstract: Adolescents and young adults (AYAs with cancer represent a unique and challenging group of patients with distinct developmental and psychosocial needs that may be unrecognized or unmet during their cancer experience. Palliative care refers to the total care of a patient, regardless of his or her disease status, and aims to improve quality of life by controlling symptoms and alleviating physical, social, psychological, and spiritual suffering. Integrating palliative care into standard oncology practice for AYAs is therefore valuable, if not imperative, in improving their overall cancer experience. In this review, we aimed to describe the scope, benefits, and challenges of palliative care for AYA oncology patients. We provide a broad impression of the existing literature describing or investigating palliative care in this population. Put together, the evidence suggests that palliative care is not only needed, but can also be critically beneficial to patients, families, and health care professionals alike. As we increase public and professional awareness of the needs and applications of palliative care for AYA patients with cancer, we will ultimately enable better psychosocial outcomes of the AYA patients and their larger communities.Keywords: supportive care, end of life, psychosocial outcomes, psychosocial oncology, psychosocial needs, quality of life

  6. Incorporating Geriatric Medicine Providers into the Care of the Older Adult with Cancer.

    Science.gov (United States)

    Magnuson, Allison; Canin, Beverly; van Londen, G J; Edwards, Beatrice; Bakalarski, Pamela; Parker, Ira

    2016-11-01

    A significant proportion of cancer patients and survivors are age 65 and over. Older adults with cancer often have more complex medical and social needs than their younger counterparts. Geriatric medicine providers (GMPs) such as geriatricians, geriatric-trained advanced practice providers, and geriatric certified registered nurses have expertise in caring for older adults, managing complex medical situations, and optimizing function and independence for this population. GMPs are not routinely incorporated into cancer care for older adults; however, their particular skill set may add benefit at many points along the cancer care continuum. In this article, we review the role of geriatric assessment in the care of older cancer patients, highlight specific case scenarios in which GMPs may offer additional understanding and insight in the care of older adults with cancer, and discuss specific mechanisms for incorporating GMPs into oncology care. PMID:27613166

  7. Threading the cloak: palliative care education for care providers of adolescents and young adults with cancer

    Directory of Open Access Journals (Sweden)

    Wiener L

    2015-01-01

    Full Text Available Lori Wiener,1,*,# Meaghann Shaw Weaver,2,3,*,# Cynthia J Bell,4,# Ursula M Sansom-Daly,5–7 1Pediatric Oncology Branch, National Cancer Institute, NIH, Bethesda, MD, USA; 2Department of Oncology, Children’s National Health System, Washington, DC, USA; 3Department of Oncology, St Jude Children’s Research Hospital, Memphis, TN, USA; 4College of Nursing, Wayne State University and Hospice of Michigan Institute, Detroit, MI, USA; 5Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children’s Hospital, Randwick, NSW, Australia; 6Discipline of Paediatrics, School of Women’s and Children’s Health, UNSW Medicine, The University of New South Wales, Kensington, NSW, Australia; 7Sydney Youth Cancer Service, Sydney Children’s/Prince of Wales Hospitals, Randwick, NSW, Australia *These authors have contributed equally to this work #On behalf of the Pediatric Palliative Care Special Interest Group at Children’s National Health System Abstract: Medical providers are trained to investigate, diagnose, and treat cancer. Their primary goal is to maximize the chances of curing the patient, with less training provided on palliative care concepts and the unique developmental needs inherent in this population. Early, systematic integration of palliative care into standard oncology practice represents a valuable, imperative approach to improving the overall cancer experience for adolescents and young adults (AYAs. The importance of competent, confident, and compassionate providers for AYAs warrants the development of effective educational strategies for teaching AYA palliative care. Just as palliative care should be integrated early in the disease trajectory of AYA patients, palliative care training should be integrated early in professional development of trainees. As the AYA age spectrum represents sequential transitions through developmental stages, trainees experience changes in their learning needs during their progression through sequential

  8. Reimagining care for adolescent and young adult cancer programs: Moving with the times.

    Science.gov (United States)

    Gupta, Abha A; Papadakos, Janet K; Jones, Jennifer M; Amin, Leila; Chang, Eugene K; Korenblum, Chana; Mina, Daniel Santa; McCabe, Lianne; Mitchell, Laura; Giuliani, Meredith E

    2016-04-01

    Literature regarding the development of adolescent and young adult (AYA) cancer programs has been dominantly informed by pediatric centers and practitioners. However, the majority of young adults are seen and treated at adult cancer centers, in which cancer volumes afford the development of innovative supportive care services. Although the supportive care services in adult cancer centers are helpful to AYAs, some of the most prominent and distinct issues faced by AYAs are not adequately addressed through these services alone. This article describes how the AYA Program at Princess Margaret Cancer Centre has collaborated with existing supportive care services in addition to supplying its own unique services to meet the comprehensive needs of AYAs in the domains of: symptom management (sexuality and fatigue), behavior modification (return to work and exercise), and health services (advanced cancer and survivorship). These collaborations are augmented by patient education interventions and timely referrals. The objective of this article was to assist other centers in expanding existing services to address the needs of AYA patients with cancer. Cancer 2016;122:1038-1046. © 2016 American Cancer Society. PMID:26848554

  9. Model of Care for Adolescents and Young Adults with Cancer: The Youth Project in Milan.

    Science.gov (United States)

    Magni, Chiara; Veneroni, Laura; Silva, Matteo; Casanova, Michela; Chiaravalli, Stefano; Massimino, Maura; Clerici, Carlo Alfredo; Ferrari, Andrea

    2016-01-01

    Adolescents and young adults (AYA) with cancer form a particular group of patients with unique characteristics, who inhabit a so-called "no man's land" between pediatric and adult services. In the last 10 years, the scientific oncology community has started to pay attention to these patients, implementing dedicated programs. A standardized model of care directed toward patients in this age range has yet to be developed and neither the pediatric nor the adult oncologic systems perfectly fit these patients' needs. The Youth Project of the Istituto Nazionale Tumori in Milan, dedicated to AYA with pediatric-type solid tumors, can be seen as a model of care for AYA patients, with its heterogeneous multidisciplinary staff and close cooperation with adult medical oncologists and surgeons. Further progress in the care of AYA cancer patients is still needed to improve their outcomes. PMID:27606308

  10. Model of Care for Adolescents and Young Adults with Cancer: The Youth Project in Milan

    Science.gov (United States)

    Magni, Chiara; Veneroni, Laura; Silva, Matteo; Casanova, Michela; Chiaravalli, Stefano; Massimino, Maura; Clerici, Carlo Alfredo; Ferrari, Andrea

    2016-01-01

    Adolescents and young adults (AYA) with cancer form a particular group of patients with unique characteristics, who inhabit a so-called “no man’s land” between pediatric and adult services. In the last 10 years, the scientific oncology community has started to pay attention to these patients, implementing dedicated programs. A standardized model of care directed toward patients in this age range has yet to be developed and neither the pediatric nor the adult oncologic systems perfectly fit these patients’ needs. The Youth Project of the Istituto Nazionale Tumori in Milan, dedicated to AYA with pediatric-type solid tumors, can be seen as a model of care for AYA patients, with its heterogeneous multidisciplinary staff and close cooperation with adult medical oncologists and surgeons. Further progress in the care of AYA cancer patients is still needed to improve their outcomes. PMID:27606308

  11. Providers' Perspectives of Survivorship Care for Young Adult Survivors of Childhood Cancer.

    Science.gov (United States)

    Berg, Carla; Stratton, Erin; Esiashvili, Natia; Mertens, Ann; Vanderpool, Robin C

    2016-03-01

    We examined healthcare providers' perceptions of the goals of survivorship care and survivor programs, systems-level barriers and individual patient-level barriers to engaging patients in survivorship care, and potential resources for increasing engagement. In 2012, we recruited 21 healthcare providers of young adult survivors of childhood cancers from a children's hospital and a cancer center in the Southeastern USA to complete telephone-based semi-structured interviews. The sample was 45.95 years old (SD = 7.57) on average, 52.4 % female, and 81.0 % MDs. The major goals of survivorship programs identified were medical care management (e.g., addressing late and long-term effects, providing survivorship care plans (SCPs), assisting in transition of care) and holistic care including addressing psychosocial issues and promoting healthy lifestyles. Systems-level barriers to engagement in survivorship care included limited resources (e.g., time), role confusion (e.g., within cancer centers, from treatment team to survivorship care, role of primary care providers), communication challenges within the medical system (e.g., limited tracking of patients, lack of understanding of the role of survivorship clinic), communication challenges with patients (e.g., setting expectations regarding transition to survivorship care), and lack of insurance coverage. Perceived patient-level factors included psychological barriers (e.g., fear, avoidance), resistance to survivorship care, and physical barriers (e.g., distance from survivorship clinics). Resources to address these barriers included increased access to information, technology-based resources, and ensuring valuable services. There are several systems-level and patient-level barriers to survivorship care, thus requiring multilevel interventions to promote engagement in care among young adult survivors of childhood cancer. PMID:25943901

  12. Survivorship Care in Reducing Symptoms in Young Adult Cancer Survivors

    Science.gov (United States)

    2016-04-05

    Breast Carcinoma; Cancer Survivor; Depression; Fatigue; Leukemia; Lymphoma; Malignant Bone Neoplasm; Malignant Digestive System Neoplasm; Malignant Female Reproductive System Neoplasm; Malignant Male Reproductive System Neoplasm; Pain; Sleep Disorder; Soft Tissue Sarcoma

  13. Young Adult Cancer Survivors' Experience with Cancer Treatment and Follow-Up Care and Perceptions of Barriers to Engaging in Recommended Care.

    Science.gov (United States)

    Berg, Carla J; Stratton, Erin; Esiashvili, Natia; Mertens, Ann

    2016-09-01

    We examined correlates of low engagement in the healthcare system, experiences with survivorship care, barriers to follow-up care, and potential resources for promoting follow-up care among young adult survivors of childhood cancers. We conducted a mixed-method study involving surveys of 106 survivors of childhood cancer aged 18-34 recruited from a university-affiliated children's hospital and an NCI-designated cancer center in the Southeastern USA. Phone-based semistructured interviews were then conducted in a subset of 26. Assessments included health factors, psychosocial factors, healthcare system interaction, and interest in resources to promote engagement in healthcare. Survey participants were on average 22.14 (SD = 3.16) years old, 50.0 % female, and 77.4 % White. Overall, 46.0 % had attended survivorship clinic, 47.2 % reported receiving a treatment summary, 68.9 % had a primary care provider, and 17.0 % reported no interaction with healthcare in the past 2 years. Correlates of less than annual healthcare provider visits included being older (p = 0.003), being male (p adult care. Participants highlighted the need for educational and psychosocial resources, particularly technology-based resources. Multilevel interventions are needed to increase engagement in survivorship care among young adult cancer survivors. Technology-based resources addressing social support and mental well-being are intervention possibilities. PMID:25948413

  14. Young Adult Cancer Survivors’ Experience with Cancer Treatment and Follow-Up Care and Perceptions of Barriers to Engaging in Recommended Care

    Science.gov (United States)

    Stratton, Erin; Esiashvili, Natia; Mertens, Ann

    2016-01-01

    We examined correlates of low engagement in the healthcare system, experiences with survivorship care, barriers to follow-up care, and potential resources for promoting follow-up care among young adult survivors of childhood cancers. We conducted a mixed-method study involving surveys of 106 survivors of childhood cancer aged 18–34 recruited from a university-affiliated children’s hospital and an NCI-designated cancer center in the Southeastern USA. Phone-based semistructured interviews were then conducted in a subset of 26. Assessments included health factors, psychosocial factors, healthcare system interaction, and interest in resources to promote engagement in healthcare. Survey participants were on average 22.14(SD=3.16) years old, 50.0 % female, and 77.4 % White. Overall, 46.0 % had attended survivorship clinic, 47.2 % reported receiving a treatment summary, 68.9 % had a primary care provider, and 17.0 % reported no interaction with healthcare in the past 2 years. Correlates of less than annual healthcare provider visits included being older (p=0.003), being male (pneed for educational and psychosocial resources, particularly technology-based resources. Multilevel interventions are needed to increase engagement in survivor-ship care among young adult cancer survivors. Technology-based resources addressing social support and mental well-being are intervention possibilities. PMID:25948413

  15. Cancer treatment, symptom monitoring, and self-care in adults: pilot study.

    Science.gov (United States)

    Williams, Phoebe Dauz; Piamjariyakul, Ubolrat; Ducey, Kathleen; Badura, Jody; Boltz, Kristin D; Olberding, Karmen; Wingate, Anita; Williams, Arthur R

    2006-01-01

    A descriptive study was conducted on self-reported symptoms and self-care by 37 adults receiving chemotherapy primarily for leukemia, lymphomas, or breast cancer or radiation therapy for head and neck or lung cancers. The Therapy-Related Symptom Checklist and demographic and interview forms on self-care for identified symptoms were used. Severe symptoms on the Therapy-Related Symptom Checklist subscales fatigue, eating, nausea, pain, numbness in fingers/toes, hair loss, and constipation were reported by patients on chemotherapy. Those on radiation therapy reported severe symptoms on the eating, fatigue, skin changes, oropharynx, and constipation subscales.Self-care strategies were in the following categories, using complementary medicine as framework: diet/nutrition/lifestyle change (eg, use of nutritional supplements; modifications of food and of eating habits; naps, sleep, and rest); mind/body control (eg, relaxation methods, prayer, music, attending granddaughter's sports events); biologic treatments (vitamins); herbal treatments (green mint tea); and ethnomedicine (lime juice and garlic). The first category was predominantly used by patients in both treatment types. Medications were prescribed also to help control symptoms (eg, pain and nausea). Symptom monitoring and self-care for symptoms identified may be facilitated by the Therapy-Related Symptom Checklist; based on reported symptom severity, care providers may prioritize interventions. A larger study needs to be done on (a) the use of the Therapy-Related Symptom Checklist as a clinical tool to assess symptoms that oncology patients experience during therapy; (b) whether care providers, based on patient-reported symptom severity, can prioritize interventions--and how this influences the efficiency of care; (c) the self-care strategies used by patients on chemotherapy or radiation therapy or both; and (d) how useful these strategies are in alleviating symptoms. PMID:17006107

  16. Sex, drugs, and rock 'n' roll: caring for adolescents and young adults with cancer.

    Science.gov (United States)

    Morgan, Sue; Davies, Simon; Palmer, Susan; Plaster, Meg

    2010-11-10

    Adolescents and young adults (AYAs) with cancer are a distinct group whose needs have been poorly addressed within health care systems. This imbalance is being addressed in some countries, and this growing specialty is now receiving the recognition it requires in order to develop further. This article discusses some of the psychosocial issues of AYAs and, with reference to the phrase of sex, drugs, and rock and roll, highlights the various rites of passage that young people experience. It also discusses how services and professionals can work alongside AYAs, enabling them to feel a part of the process by providing age-appropriate environment and expertise. PMID:20498401

  17. The Affordable Care Act and Cancer Stage at Diagnosis Among Young Adults.

    Science.gov (United States)

    Han, Xuesong; Zang Xiong, Ka; Kramer, Michael R; Jemal, Ahmedin

    2016-09-01

    The Affordable Care Act-dependent coverage expansion provision implemented in 2010 allows young adults to be covered under their parents' health insurance until age 26 years, and millions of young adults have gained insurance as a result. The impact of this policy on cancer patients has yet to be determined. Using 2007 to 2012 data from 18 registries of the Surveillance, Epidemiology, and End Results Program, comparing cancer patients age 19 to 25 years to a control group of patients age 26 to 34 years who were not affected by the provision, we observed a 2.0 (95% confidence interval [CI] = 0.7 to 3.4) percentage point decrease in uninsured rate and a 2.7 (95% CI = 0.6 to 4.8) percentage point increase in diagnosis at stage I disease for patients age 19-25 years. Further analyses by specific cancer site revealed that the statistically significant shifts were confined to carcinoma of cervix (21.2, 95% CI = 9.6 to 32.7 percentage points) and osseous and chondromatous neoplasms (14.4, 95% CI = 0.3 to 28.5 percentage points), which are detectable by either screening or clinical manifestation. These early observations suggest the policy has had positive benefits in cancer outcomes. PMID:27140956

  18. In a unique position or squeezed out? The professional roles of general practitioners in cancer care in general and of young adult cancer patients in particular

    DEFF Research Database (Denmark)

    Hølge-Hazelton, B.; Christensen, I.

    2009-01-01

    BACKGROUND: Exploring experiences of general practitioners (GPs), regarding roles in cancer care of young adults (YAs). METHODS: Ten qualitative interviews with GPs were theoretically analyzed against professional characteristics. FINDINGS: The GPs tended to make general statements, using everyday...... language, they experience that their patients disappear, they are seldom involved, and they lack knowledge. CONCLUSIONS: GPs have few experiences with YA cancer patients, but they have a potentially unique role in general primary cancer care if they develop their vocational vocabulary, relate more to...

  19. Primary care providers' perspective on prescribing opioids to older adults with chronic non-cancer pain: A qualitative study

    OpenAIRE

    Turner Barbara J; Granieri Evelyn; Papaleontiou Maria; Moore Alison A; Spitz Aerin; Reid M

    2011-01-01

    Abstract Background The use of opioid medications as treatment for chronic non-cancer pain remains controversial. Little information is currently available regarding healthcare providers' attitudes and beliefs about this practice among older adults. This study aimed to describe primary care providers' experiences and attitudes towards, as well as perceived barriers and facilitators to prescribing opioids as a treatment for chronic pain among older adults. Methods Six focus groups were conduct...

  20. Older adults' attitudes about continuing cancer screening later in life: a pilot study interviewing residents of two continuing care communities

    Directory of Open Access Journals (Sweden)

    Walter Louise C

    2006-08-01

    Full Text Available Abstract Background Individualized decision making has been recommended for cancer screening decisions in older adults. Because older adults' preferences are central to individualized decisions, we assessed older adults' perspectives about continuing cancer screening later in life. Methods Face to face interviews with 116 residents age 70 or over from two long-term care retirement communities. Interview content included questions about whether participants had discussed cancer screening with their physicians since turning age 70, their attitudes about information important for individualized decisions, and their attitudes about continuing cancer screening later in life. Results Forty-nine percent of participants reported that they had an opportunity to discuss cancer screening with their physician since turning age 70; 89% would have preferred to have had these discussions. Sixty-two percent believed their own life expectancy was not important for decision making, and 48% preferred not to discuss life expectancy. Attitudes about continuing cancer screening were favorable. Most participants reported that they would continue screening throughout their lives and 43% would consider getting screened even if their doctors recommended against it. Only 13% thought that they would not live long enough to benefit from cancer screening tests. Factors important to consider stopping include: age, deteriorating or poor health, concerns about the effectiveness of the tests, and doctors recommendations. Conclusion This select group of older adults held positive attitudes about continuing cancer screening later in life, and many may have had unrealistic expectations. Individualized decision making could help clarify how life expectancy affects the potential survival benefits of cancer screening. Future research is needed to determine whether educating older adults about the importance of longevity in screening decisions would be acceptable, affect older adults

  1. Primary Care Use before Cancer Diagnosis in Adolescents and Young Adults - A Nationwide Register Study

    DEFF Research Database (Denmark)

    Ahrensberg, Jette Møller; Fenger-Grøn, Morten; Vedsted, Peter

    2016-01-01

    ) was measured during the two years preceding the diagnosis (index date), and collected data were analysed in a negative binomial regression model. RESULTS: The cases generally increased their use of primary care already from 8 months before a cancer diagnosis, whereas a similar trend was not found for...... little is known about their pre-diagnostic healthcare use. This study investigates the use of primary care among AYAs during the two years preceding a cancer diagnosis. METHODS: The study is a retrospective population-based matched cohort study using Danish nationwide registry data. All persons diagnosed...... with cancer during 2002-2011 in the age group 15-39 years were included (N = 12,306); each participant was matched on gender, age and general practice with 10 randomly selected references (N = 123,060). The use of primary healthcare services (face-to-face contacts, blood tests and psychometric tests...

  2. [Bioethics and nutrition in adult patients with cancer in palliative care].

    Science.gov (United States)

    Benarroz, Monica de Oliveira; Faillace, Giovanna Borges Damião; Barbosa, Leandro Augusto

    2009-09-01

    Cancer constitutes a major group of chronic diseases and is the second leading cause of death in the developed countries. Palliative care proposes to offer comprehensive support to control symptoms and improve quality of life for patients and their families. Nutrition is an important tool in palliative care, helping patients with their physical, psychological, and social issues and promoting comfort and quality of life. However, in the context of palliative care, nutritional support rarely achieves its role of fully recovering and assuring nutritional status. At this point, the nutritionist must consider the individual patient's needs, preferences, and eating habits, which are essential both for controlling symptoms and assuring satisfaction and comfort. The impossibility of conventionally applying established management and the development of a new perception of the patient often raise dilemmas for professional nutritionists. PMID:19750375

  3. Spinal opioids in adult patients with cancer pain: a systematic review: a European Palliative Care Research Collaborative (EPCRC) opioid guidelines project

    DEFF Research Database (Denmark)

    Kurita, Geana Paula; Kaasa, Stein; Sjøgren, Per

    2011-01-01

    A systematic review, undertaken according to an initiative to revise European Association for Palliative Care guidelines on the use of opioids for cancer pain, which aimed to analyse analgesic efficacy and side effects of spinal opioids in adult cancer patients previously treated with systemic...

  4. Primary care providers' perspective on prescribing opioids to older adults with chronic non-cancer pain: A qualitative study

    Directory of Open Access Journals (Sweden)

    Turner Barbara J

    2011-07-01

    Full Text Available Abstract Background The use of opioid medications as treatment for chronic non-cancer pain remains controversial. Little information is currently available regarding healthcare providers' attitudes and beliefs about this practice among older adults. This study aimed to describe primary care providers' experiences and attitudes towards, as well as perceived barriers and facilitators to prescribing opioids as a treatment for chronic pain among older adults. Methods Six focus groups were conducted with a total of 23 physicians and three nurse practitioners from two academically affiliated primary care practices and three community health centers located in New York City. Focus groups were audiotape recorded and transcribed. The data were analyzed using directed content analysis; NVivo software was used to assist in the quantification of identified themes. Results Most participants (96% employed opioids as therapy for some of their older patients with chronic pain, although not as first-line therapy. Providers cited multiple barriers, including fear of causing harm, the subjectivity of pain, lack of education, problems converting between opioids, and stigma. New barriers included patient/family member reluctance to try an opioid and concerns about opioid abuse by family members/caregivers. Studies confirming treatment benefit, validated tools for assessing risk and/or dosing for comorbidities, improved conversion methods, patient education, and peer support could facilitate opioid prescribing. Participants voiced greater comfort using opioids in the setting of delivering palliative or hospice care versus care of patients with chronic pain, and expressed substantial frustration managing chronic pain. Conclusions Providers perceive multiple barriers to prescribing opioids to older adults with chronic pain, and use these medications cautiously. Establishing the long-term safety and efficacy of these medications, generating improved prescribing methods

  5. Cancer-Related Pain in Older Adults Receiving Palliative Care: Patient and Family Caregiver Perspectives on the Experience of Pain

    OpenAIRE

    McPherson, Christine J; Hadjistavropoulos, Thomas; Lobchuk, Michelle M; Kilgour, Kelly N

    2013-01-01

    BACKGROUND: Despite an emphasis on pain management in palliative care, pain continues to be a common problem for individuals with advanced cancer. Many of those affected are older due to the disproportionate incidence of cancer in this age group. There remains little understanding of how older patients and their family caregivers perceive patients’ cancer-related pain, despite its significance for pain management in the home setting.OBJECTIVES: To explore and describe the cancer pain percepti...

  6. Improving Palliative Cancer Care

    OpenAIRE

    Del Ferraro, Catherine; Ferrell, Betty; Van Zyl, Carin; Freeman, Bonnie; Klein, Linda

    2014-01-01

    Over a decade ago, the Institute of Medicine (IOM) presented Ensuring Quality Cancer Care in the United States, with recommendations for change (IOM, 1999). However, barriers to integrating palliative care (PC) to achieve high-quality care in cancer still remain. As novel therapeutic agents evolve, patients are living longer, and advanced cancer is now considered a chronic illness. In addition to complex symptom concerns, patients and family caregivers are burdened with psychological, social,...

  7. Palliative Care in Cancer

    Science.gov (United States)

    ... care that is given to a person when cancer therapies are no longer controlling the disease. It focuses on caring, not curing. When a person has a terminal diagnosis (usually defined as having a life expectancy ...

  8. Improving Palliative Cancer Care.

    Science.gov (United States)

    Del Ferraro, Catherine; Ferrell, Betty; Van Zyl, Carin; Freeman, Bonnie; Klein, Linda

    2014-01-01

    Over a decade ago, the Institute of Medicine (IOM) presented Ensuring Quality Cancer Care in the United States, with recommendations for change (IOM, 1999). However, barriers to integrating palliative care (PC) to achieve high-quality care in cancer still remain. As novel therapeutic agents evolve, patients are living longer, and advanced cancer is now considered a chronic illness. In addition to complex symptom concerns, patients and family caregivers are burdened with psychological, social, and spiritual distress. Furthermore, data show that PC continues to be underutilized and inaccessible, and current innovative models of integrating PC into standard cancer care lack uniformity. The aim of this article is to address the existing barriers in implementing PC into our cancer care delivery system and discuss how the oncology advanced practice nurse plays an essential role in providing high-quality cancer care. We also review the IOM recommendations; highlight the work done by the National Consensus Project in promoting quality PC; and discuss a National Cancer Institute-funded program project currently conducted at a National Comprehensive Cancer Center, "Palliative Care for Quality of Life and Symptoms Concerns in Lung Cancer," which serves as a model to promote high-quality care for patients and their families. PMID:26114013

  9. Cancer Care and Control

    OpenAIRE

    Schneidman, Miriam; Jeffers, Joanne; Duncan, Kalina

    2015-01-01

    Worldwide, deaths from cancer exceed those caused by human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS), tuberculosis, and malaria combined. Seventy percent of deaths due to cancer occur in low-and middle-income countries, which are often poorly prepared to deal with the growing burden of chronic disease. Over a period of 18 months, the cancer care and control...

  10. Adult Cancers in Adolescents and Young Adults.

    Science.gov (United States)

    Laurence, Valérie; Marples, Maria; Stark, Daniel P

    2016-01-01

    The pattern of cancer seen in young people changes with increasing age, transitioning from childhood- to adult-type cancer in adolescence and the third decade. The risk factors, presentation and biology of cancer in young adults differ from those in the older adult population. Factors of particular significance in adolescents and young adults (AYAs) include genetic predisposition to adult-type cancer, diagnostic uncertainty, long-term morbidity and considerations of fertility. New systemic therapies are being introduced that can prolong life and even increase the chance of cure, but the impact on AYAs is uncertain, as these patients are often under-represented in clinical trials. Here, we discuss the management of AYAs with 3 of the most common cancers affecting adults, when they emerge in the AYA populations, and therefore are currently met by medical oncologists - breast cancer, colorectal cancer and melanoma. PMID:27595357

  11. Adolescents and Young Adults with Cancer

    Science.gov (United States)

    ... Adults with Cancer Reports, Research, and Literature Quiz Adolescents and Young Adults with Cancer Types of Cancers ... Fund for Young Adults Vital Options Teens and Adolescents CureSearch Starlight Children's Foundation Teens Living with Cancer ...

  12. CancerCare

    Science.gov (United States)

    ... E-News Blog En Español Facebook Twitter YouTube Instagram LinkedIn Patient Access & Engagement Report Research representing the ... HOPE (4673) info@cancercare.org Facebook Twitter YouTube Instagram LinkedIn © 2016 Cancer Care ® — All Rights Reserved Back ...

  13. Communication in Cancer Care (PDQ)

    Science.gov (United States)

    ... Finished Treatment Questions to Ask About Cancer Research Communication in Cancer Care (PDQ®)–Patient Version Overview Go ... fewer procedures and better quality of life. Good communication between patients, family caregivers, and the health care ...

  14. Screening for psychological distress in adult primary brain tumor patients and caregivers: considerations for cancer care coordination

    Directory of Open Access Journals (Sweden)

    Wafa eTrad

    2015-09-01

    Full Text Available IntroductionThis study aimed to assess psychological distress (PD as scored by the Distress Thermometer (DT in adult primary brain tumor (PBT patients and caregivers in a clinic setting, and ascertain if any high risk sub-groups for PD exist. Material and MethodsFrom May 2012 to August 2013, n=96 patients and n=32 caregivers (CG underwent DT screening at diagnosis, and a differing cohort of n=12 patients and n=14 caregivers at first recurrence. Groups were described by diagnosis (high grade, low grade and benign, and English versus non-English speaking. Those with DT score≥4 met caseness criteria for referral to psycho-oncology services. One-way ANOVA tests were conducted to test for between group differences where appropriate.ResultsAt diagnosis and first recurrence, 37.5% and 75.0% (respectively of patients had DT scores above the cut-off for distress. At diagnosis, 78.1% of caregivers met caseness criteria for distress. All caregivers at recurrence met distress criterion. Patients with high grade glioma had significantly higher scores than those with a benign tumor. For patients at diagnosis, non-English speaking participants did not report significantly higher DT scores than English speaking participants.DiscussionPsychological distress is particularly elevated in caregivers, and in patients with high grade glioma at diagnosis. Effective PD screening, triage and referral by skilled care coordinators is vital to enable timely needs assessment, psychological support and effective intervention.

  15. Gaps in nutritional research among older adults with cancer

    Science.gov (United States)

    Presley, Carolyn J.; Dotan, Efrat; Soto-Perez-de-Celis, Enrique; Jatoi, Aminah; Mohile, Supriya G.; Won, Elizabeth; Alibhai, Shabbir; Kilari, Deepak; Harrison, Robert; Klepin, Heidi D.; Wildes, Tanya M.; Mustian, Karen; Demark-Wahnefried, Wendy

    2016-01-01

    Nutritional issues among older adults with cancer are an understudied area of research despite significant prognostic implications for treatment side effects, cancer-specific mortality, and overall survival. In May of 2015, the National Cancer Institute and the National Institute on Aging co-sponsored a conference focused on future directions in geriatric oncology research. Nutritional research among older adults with cancer was highlighted as a major area of concern as most nutritional cancer research has been conducted among younger adults, with limited evidence to guide the care of nutritional issues among older adults with cancer. Cancer diagnoses among older adults are increasing, and the care of the older adult with cancer is complicated due to multimorbidity, heterogeneous functional status, polypharmacy, deficits in cognitive and mental health, and several other non-cancer factors. Due to this complexity, nutritional needs are dynamic, multifaceted, and dependent on the clinical scenario. This manuscript outlines the proceedings of this conference including knowledge gaps and recommendations for future nutritional research among older adults with cancer. Three common clinical scenarios encountered by oncologists include (1) weight loss during anti-cancer therapy, (2) malnutrition during advanced disease, and (3) obesity during survivorship. In this manuscript, we provide a brief overview of relevant cancer literature within these three areas, knowledge gaps that exist, and recommendations for future research. PMID:27197919

  16. Gaps in nutritional research among older adults with cancer.

    Science.gov (United States)

    Presley, Carolyn J; Dotan, Efrat; Soto-Perez-de-Celis, Enrique; Jatoi, Aminah; Mohile, Supriya G; Won, Elizabeth; Alibhai, Shabbir; Kilari, Deepak; Harrison, Robert; Klepin, Heidi D; Wildes, Tanya M; Mustian, Karen; Demark-Wahnefried, Wendy

    2016-07-01

    Nutritional issues among older adults with cancer are an understudied area of research despite significant prognostic implications for treatment side effects, cancer-specific mortality, and overall survival. In May of 2015, the National Cancer Institute and the National Institute on Aging co-sponsored a conference focused on future directions in geriatric oncology research. Nutritional research among older adults with cancer was highlighted as a major area of concern as most nutritional cancer research has been conducted among younger adults, with limited evidence to guide the care of nutritional issues among older adults with cancer. Cancer diagnoses among older adults are increasing, and the care of the older adult with cancer is complicated due to multimorbidity, heterogeneous functional status, polypharmacy, deficits in cognitive and mental health, and several other non-cancer factors. Due to this complexity, nutritional needs are dynamic, multifaceted, and dependent on the clinical scenario. This manuscript outlines the proceedings of this conference including knowledge gaps and recommendations for future nutritional research among older adults with cancer. Three common clinical scenarios encountered by oncologists include (1) weight loss during anti-cancer therapy, (2) malnutrition during advanced disease, and (3) obesity during survivorship. In this manuscript, we provide a brief overview of relevant cancer literature within these three areas, knowledge gaps that exist, and recommendations for future research. PMID:27197919

  17. Palliative Care in Lung Cancer.

    Science.gov (United States)

    Shinde, Arvind M; Dashti, Azadeh

    2016-01-01

    Lung cancer is the most common cancer worldwide and is the leading cause of cancer death for both men and women in the USA. Symptom burden in patients with advanced lung cancer is very high and has a negative impact on their quality of life (QOL). Palliative care with its focus on the management of symptoms and addressing physical, psychosocial, spiritual, and existential suffering, as well as medically appropriate goal setting and open communication with patients and families, significantly adds to the quality of care received by advanced lung cancer patients. The Provisional Clinical Opinion (PCO) of American Society of Clinical Oncology (ASCO) as well as the National Cancer Care Network's (NCCN) clinical practice guidelines recommends early integration of palliative care into routine cancer care. In this chapter, we will provide an overview of palliative care in lung cancer and will examine the evidence and recommendations with regard to a comprehensive and interdisciplinary approach to symptom management, as well as discussions of goals of care, advance care planning, and care preferences. PMID:27535397

  18. Medicaid Adult Health Care Quality Measures

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Affordable Care Act (Section 1139B) requires the Secretary of HHS to identify and publish a core set of health care quality measures for adult Medicaid...

  19. Comorbidity in older adults with cancer.

    Science.gov (United States)

    Williams, Grant R; Mackenzie, Amy; Magnuson, Allison; Olin, Rebecca; Chapman, Andrew; Mohile, Supriya; Allore, Heather; Somerfield, Mark R; Targia, Valerie; Extermann, Martine; Cohen, Harvey Jay; Hurria, Arti; Holmes, Holly

    2016-07-01

    Comorbidity is an issue of growing importance due to changing demographics and the increasing number of adults over the age of 65 with cancer. The best approach to the clinical management and decision-making in older adults with comorbid conditions remains unclear. In May 2015, the Cancer and Aging Research Group, in collaboration with the National Cancer Institute and the National Institute on Aging, met to discuss the design and implementation of intervention studies in older adults with cancer. A presentation and discussion on comorbidity measurement, interventions, and future research was included. In this article, we discuss the relevance of comorbidities in cancer, examine the commonly used tools to measure comorbidity, and discuss the future direction of comorbidity research. Incorporating standardized comorbidity measurement, relaxing clinical trial eligibility criteria, and utilizing novel trial designs are critical to developing a larger and more generalizable evidence base to guide the management of these patients. Creating or adapting comorbidity management strategies for use in older adults with cancer is necessary to define optimal care for this growing population. PMID:26725537

  20. Preferences for end-of-life care among community-dwelling older adults and patients with advanced cancer: A discrete choice experiment.

    Science.gov (United States)

    Finkelstein, Eric A; Bilger, Marcel; Flynn, Terry N; Malhotra, Chetna

    2015-11-01

    Singapore is in the midst of several healthcare reforms in efforts to finance and deliver health services for a rapidly aging population. The primary focus of these reforms is to make healthcare services, including those at the end of life (EOL), affordable. Given the increasingly high health care costs at the EOL, policy makers need to consider how best to allocate resources. One strategy is to allocate resources based on the preferences of sub-populations most likely to be affected. This paper thus aims to quantify preferences for EOL care both among community dwelling older adults (CDOAs) and among patients with a life-limiting illness. A discrete choice experiment was administered to CDOAs and advanced cancer patients in Singapore and willingness to pay (WTP) for specific EOL improvements was estimated. We find that patients have a higher WTP for nearly all EOL attributes compared with CDOAs. We also show that, for both groups, moderate life extension is not the most important consideration; WTP for one additional life year is lower than common thresholds for cost-effectiveness. Irrespective of whose preference are considered, the results highlight the importance of pain management and supporting home deaths at the EOL, perhaps at the expense of public funding for costly but only marginally effective treatments. PMID:26421597

  1. Integrating palliative care into comprehensive cancer care.

    Science.gov (United States)

    Abrahm, Janet L

    2012-10-01

    While there are operational, financial, and workforce barriers to integrating oncology with palliative care, part of the problem lies in ourselves, not in our systems. First, there is oncologists' "learned helplessness" from years of practice without effective medications to manage symptoms or training in how to handle the tough communication challenges every oncologist faces. Unless they and the fellows they train have had the opportunity to work with a palliative care team, they are unlikely to be fully aware of what palliative care has to offer to their patients at the time of diagnosis, during active therapy, or after developing advanced disease, or may believe that, "I already do that." The second barrier to better integration is the compassion fatigue many oncologists develop from caring for so many years for patients who, despite the oncologists' best efforts, suffer and die. The cumulative grief oncologists experience may go unnamed and unacknowledged, contributing to this compassion fatigue and burnout, both of which inhibit the integration of oncology and palliative care. Solutions include training fellows and practicing oncologists in palliative care skills (eg, in symptom management, psychological disorders, communication), preventing and treating compassion fatigue, and enhancing collaboration with palliative care specialists in caring for patients with refractory distress at any stage of disease. As more oncologists develop these skills, process their grief, and recognize the breadth of additional expertise offered by their palliative care colleagues, palliative care will become integrated into comprehensive cancer care. PMID:23054873

  2. How childhood cancers are different from adult cancers

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/patientinstructions/000845.htm How childhood cancers are different from adult cancers To use ... children with cancer can be cured. Types of Childhood Cancers Cancer in children is rare, but some ...

  3. Experiences of Parents and General Practitioners with End-of-Life Care in Adolescents and Young Adults with Cancer.

    Science.gov (United States)

    Kaal, Suzanne E J; Kuijken, Noortje M J; Verhagen, Constant A H H V M; Jansen, Rosemarie; Servaes, Petra; van der Graaf, Winette T A

    2016-03-01

    This study aims to analyze the experiences of Dutch bereaved parents and general practitioners (GPs) with palliative care of AYAs (18-35 years) in the terminal stage. Fifteen parents and nine GPs involved with nine deceased AYAs filled out questionnaires and were interviewed by telephone, respectively. In general, the parents were satisfied with the emotional care they themselves received and the medical care that their child received. The GPs were very satisfied with the cooperation with the palliative team. Gaps are present in the areas of symptom control, communication between hospital professionals and parents, aftercare, and transition between hospital and GP. PMID:26812457

  4. Screening for Psychological Distress in Adult Primary Brain Tumor Patients and Caregivers: Considerations for Cancer Care Coordination

    OpenAIRE

    Trad, Wafa; Koh, Eng-Siew; Daher, Maysaa; Bailey, Alanah; Kastelan, Marina; Legge, Dianne; Fleet, Marcia; Simpson, Grahame K.; Hovey, Elizabeth

    2015-01-01

    Introduction This study aimed to assess psychological distress (PD) as scored by the Distress Thermometer (DT) in adult primary brain tumor patients and caregivers (CGs) in a clinic setting and ascertain if any high-risk subgroups for PD exist. Material and methods From May 2012 to August 2013, n = 96 patients and n = 32 CG underwent DT screening at diagnosis, and a differing cohort of n = 12 patients and n = 14 CGs at first recurrence. Groups were described by diagnosis (high grad...

  5. Preventive Care in Older Cancer Survivors

    Science.gov (United States)

    Lowenstein, Lisa M.; Ouellet, Jennifer Andreozzi; Dale, William; Fan, Lin; Mohile, Supriya Gupta

    2016-01-01

    Objective To study factors that influence receipt of preventive care in older cancer survivors. Methods We analyzed a nationally representative sample of 12,458 older adults from the 2003 Medicare Current Beneficiary Survey. Factors associated with non-receipt of preventive care were explored among cancer and non-cancer survivors, using logistic regression. Results Among cancer survivors, 1,883 were diagnosed >one year at survey completion. A cancer history was independently associated with receipt of mammogram (AOR=1.57, 95%CI=1.34–1.85), flu shot (AOR=1.33, 95%CI=1.16–1.53), measurement of total cholesterol in the previous six months (AOR=1.20, 95%CI=1.07–1.34), pneumonia vaccination (AOR=1.33, 95%CI=1.18–1.49), bone mineral density (BMD) testing (AOR=1.38, 95%CI=1.21–1.56) and lower endoscopy (AOR=1.46, 95%CI=1.29–1.65). However, receipt of preventive care was not optimal among older cancer survivors with only 51.2% of female cancer survivors received a mammogram, 63.8% of all cancer survivors received colonoscopy, and 42.5% had BMD testing. Among cancer survivors, factors associated with non-receipt of mammogram included age ≥85 years (AOR=0.43, 95%CI=0.26–0.74) and scoring ≥three points on the Vulnerable Elders Survey-13 (AOR=0.94, 95%CI=0.80–1.00). Factors associated with non-receipt of colonoscopy included low education (AOR=0.43, 95%CI=0.27–0.68) and rural residence (AOR=0.51, 95%CI=0.34–0.77). Factors associated with non-receipt of BMD testing included age ≥70 (AOR=0.59, 95%CI=0.39–0.90), African American race (AOR=0.51, 95%CI=0.27–0.95), low education (AOR=0.23, 95%CI=0.14–0.38) and rural residence (AOR=0.43, 95%CI=0.27–0.70). Conclusion Although older cancer survivors are more likely to receive preventive care services than other older adults, the prevalence of receipt of preventive care services is low. PMID:25547206

  6. Modularity in Cancer Care Provision

    DEFF Research Database (Denmark)

    Gobbi, Chiara; Hsuan, Juliana

    2012-01-01

    The paper presents the findings of a case study research conducted within the Danish healthcare system aimed at analyzing how modularity is deployed in the process of delivery cancer care. Three cancer packages are presented into detailed describing the process of defining the diagnosis and...... treatment service. Customization is obtained by combining different components in the diagnosis phase (examinations) and different treatment options in the treating phase. Findings show that the process of delivery cure for cancer is highly modularized and customization is driven by cancer specificity (type...

  7. Strategies for Sustainable Cancer Care.

    Science.gov (United States)

    Kerr, David J; Jani, Anant; Gray, Sir Muir

    2016-01-01

    There is an increasing focus on the relative cost-effectiveness and sustainability of delivering high-quality cancer care, with most emphasis, debatably, given to cost control of innovative treatments. It is difficult to calculate all the direct and indirect contributors to the total cost of cancer treatment, but it is estimated that cancer drugs constitute 10% to 30% of the total cost of cancer care. A 2007 study in France showed the contribution of drug costs was less than 20%, with approximately 70% of the total expenditure on cancer accounted for by health care resource use, such as hospitalization. The U.K. government established the National Institute for Health and Care Excellence (NICE)-the dominant function of which is technology appraisal-to assess the clinical and cost-effectiveness of new pharmaceutical and biopharmaceutical products. This is to ensure that all National Health Service (NHS) patients have equitable access to the most clinically effective and cost-effective treatments that are viable. NICE has developed a transparent, public process to judge incremental cost-effectiveness using the quality-adjusted life year (QALY), which allows comparisons of cost-effectiveness across medical specialties. NICE has been both lauded and criticized-especially when it passes judgment on marginally effective but expensive anticancer drugs-but it provides a route to "rational rationing" and, therefore, may contribute to sustainable cancer care by highlighting the issue of affordable medicine. This implies a challenge to the wider oncology community as to how we might cooperate to introduce the concept of value-driven cancer care. PMID:27249712

  8. Spirituality in childhood cancer care.

    Science.gov (United States)

    Lima, Nádia Nara Rolim; do Nascimento, Vânia Barbosa; de Carvalho, Sionara Melo Figueiredo; Neto, Modesto Leite Rolim; Moreira, Marcial Moreno; Brasil, Aline Quental; Junior, Francisco Telésforo Celestino; de Oliveira, Gislene Farias; Reis, Alberto Olavo Advíncula

    2013-01-01

    To deal with the suffering caused by childhood cancer, patients and their families use different coping strategies, among which, spirituality appears a way of minimizing possible damage. In this context, the purpose of the present study was to analyze the influence of spirituality in childhood cancer care, involving biopsychosocial aspects of the child, the family, and the health care team facing the disease. To accomplish this purpose, a nonsystematic review of literature of articles on national and international electronic databases (Scientific Electronic Library Online [SciELO], PubMed, and Latin American and Caribbean Health Sciences Literature [LILACS]) was conducted using the search terms "spirituality," "child psychology," "child," and "cancer," as well as on other available resources. After the search, 20 articles met the eligibility criteria and were included in the final sample. Our review showed that the relation between spirituality and health has lately become a subject of growing interest among researchers, as a positive influence of spirituality in the people's welfare was noted. Studies that were retrieved using the mentioned search strategy in electronic databases, independently assessed by the authors according to the systematic review, showed that spirituality emerges as a driving force that helps pediatric patients and their families in coping with cancer. Health care workers have been increasingly attentive to this dimension of care. However, it is necessary to improve their knowledge regarding the subject. The search highlighted that spirituality is considered a source of comfort and hope, contributing to a better acceptance of his/her chronic condition by the child with cancer, as well as by the family. Further up-to-date studies facing the subject are, thus, needed. It is also necessary to better train health care practitioners, so as to provide humanized care to the child with cancer. PMID:24133371

  9. Practices of healthcare professionals from the perspective of older adults living with cancer

    OpenAIRE

    Lucimara Sonaglio Rocha; Margrid Beuter; Eliane Tatsch Neves; Juliane Elis Both; Miriam da Silveira Perrando; Larissa Venturini

    2016-01-01

    Objective: understanding the care practices of health professionals caring for older adults living with cancer in outpatient treatment. Methods: a qualitative research conducted in a hematology oncology outpatient clinic in southern Brazil. A semi-structured interview was conducted with 15 older adults. Data were submitted to thematic analysis. Results: a category of care practice of health professionals amongst older adults living with cancer emerged with two subcategories: disclosure of the...

  10. Snapshot of Adolescent and Young Adult Cancer

    Science.gov (United States)

    ... of cancer, AYA cancer survivors have excess medical expenditures greater than $3,000 per person and excess annual productivity losses greater than $2,000 per person. [PubMed Abstract] Additional Resources for AYA Cancers NCI Adolescents and Young Adults with Cancer Portal Information about cancer in ...

  11. Spirituality in childhood cancer care

    Directory of Open Access Journals (Sweden)

    Lima NN

    2013-10-01

    Full Text Available Nádia Nara Rolim Lima,1 Vânia Barbosa do Nascimento,1 Sionara Melo Figueiredo de Carvalho,1 Modesto Leite Rolim Neto,2 Marcial Moreno Moreira,2 Aline Quental Brasil,2 Francisco Telésforo Celestino Junior,2 Gislene Farias de Oliveira,2 Alberto Olavo Advíncula Reis3 1Health Sciences Postgraduate Program, ABC Region Medical School, Santo André, São Paulo, Brazil; 2Department of Medicine, Federal University of Ceará, Barbalha, Ceará, Brazil; 3Public Health Postgraduate Program, University of São Paulo, São Paulo, Brazil Abstract: To deal with the suffering caused by childhood cancer, patients and their families use different coping strategies, among which, spirituality appears a way of minimizing possible damage. In this context, the purpose of the present study was to analyze the influence of spirituality in childhood cancer care, involving biopsychosocial aspects of the child, the family, and the health care team facing the disease. To accomplish this purpose, a nonsystematic review of literature of articles on national and international electronic databases (Scientific Electronic Library Online [SciELO], PubMed, and Latin American and Caribbean Health Sciences Literature [LILACS] was conducted using the search terms “spirituality,” “child psychology,” “child,” and “cancer,” as well as on other available resources. After the search, 20 articles met the eligibility criteria and were included in the final sample. Our review showed that the relation between spirituality and health has lately become a subject of growing interest among researchers, as a positive influence of spirituality in the people's welfare was noted. Studies that were retrieved using the mentioned search strategy in electronic databases, independently assessed by the authors according to the systematic review, showed that spirituality emerges as a driving force that helps pediatric patients and their families in coping with cancer. Health care workers

  12. Cannabis in cancer care.

    Science.gov (United States)

    Abrams, D I; Guzman, M

    2015-06-01

    Cannabis has been used in medicine for thousands of years prior to achieving its current illicit substance status. Cannabinoids, the active components of Cannabis sativa, mimic the effects of the endogenous cannabinoids (endocannabinoids), activating specific cannabinoid receptors, particularly CB1 found predominantly in the central nervous system and CB2 found predominantly in cells involved with immune function. Delta-9-tetrahydrocannabinol, the main bioactive cannabinoid in the plant, has been available as a prescription medication approved for treatment of cancer chemotherapy-induced nausea and vomiting and anorexia associated with the AIDS wasting syndrome. Cannabinoids may be of benefit in the treatment of cancer-related pain, possibly synergistic with opioid analgesics. Cannabinoids have been shown to be of benefit in the treatment of HIV-related peripheral neuropathy, suggesting that they may be worthy of study in patients with other neuropathic symptoms. Cannabinoids have a favorable drug safety profile, but their medical use is predominantly limited by their psychoactive effects and their limited bioavailability. PMID:25777363

  13. [Transition in health care, from pediatrics to adult care].

    Science.gov (United States)

    De Cunto, Carmen L

    2012-08-01

    The number of adolescent patients with chronic diseases and special heath needs are increasing, and they are reaching adulthood. Sometimes the passage to the adult health care is abrupt, depending upon the chronological age reached or because of an acute health problem that requires hospitalization. In order to facilitate the transition process, preparation of the child, the family and the health professionals involved is needed, as well as the coordination between the pediatric group and the adult team that will be incharge of the patient. This review shows the obstacles to this process and the recommended implementation steps required to a successful transition. It also describes the main aspects of a program that we implemented at the Hospital Italiano de Buenos Aires in conjunction with some departments of adult health care high lighting the main steps to follow before and during program´s implementation. PMID:22859330

  14. Shared care in prostate cancer

    DEFF Research Database (Denmark)

    Lund, Anette Svarre; Lund, Lars; Jønler, Morten;

    2016-01-01

    OBJECTIVE: The aim of this study was to investigate 3 year follow-up in patients with stable prostate cancer (PCa) managed in a shared care program by general practitioners (GPs) in collaboration with urological departments. PCa patients who have undergone curative treatment or endocrine therapy...... require long-term follow-up. Until recently, follow-up has primarily been managed by urologists at hospital-based outpatient clinics. However, new organizational strategies are needed to meet the needs of the growing number of elderly, comorbid cancer patients. These new organizational strategies target...

  15. Sexual minority cancer survivors' satisfaction with care.

    Science.gov (United States)

    Jabson, Jennifer M; Kamen, Charles S

    2016-01-01

    Satisfaction with care is important to cancer survivors' health outcomes. Satisfaction with care is not equal for all cancer survivors, and sexual minority (i.e., lesbian, gay, and bisexual) cancer survivors may experience poor satisfaction with care. Data were drawn from the 2010 LIVESTRONG national survey. The final sample included 207 sexual minority cancer survivors and 4,899 heterosexual cancer survivors. Satisfaction with care was compared by sexual orientation, and a Poisson regression model was computed to test the associations between sexual orientation and satisfaction with care, controlling for other relevant variables. Sexual minority cancer survivors had lower satisfaction with care than did heterosexual cancer survivors (B = -0.12, SE = 0.04, Wald χ(2) = 9.25, phealth disparities reported among sexual minority cancer survivors. PMID:26577277

  16. Young Adults Seeking Medical Care: Do Race and Ethnicity Matter?

    Science.gov (United States)

    ... Reports from the National Medical Care Utilization and Expenditure Survey Clearinghouse on Health Indexes Statistical Notes for Health Planners ... Adults Seeking Medical Care: Do Race and Ethnicity ...

  17. Perception of older adults receiving palliative care

    Directory of Open Access Journals (Sweden)

    Fernanda Laporti Seredynskyj

    2014-06-01

    Full Text Available The present study aimed at understanding the perception of older adults who are receiving palliative oncological care on self care in relation to different stages of the disease and how such perception affected their lives. This is a qualitative study using oral history conducted with 15 older adults receiving palliative chemotherapy treatment in a health institution. The following categories emerged: social network, perspectives for confronting life, changes and spirituality. It is necessary for nursing staff to understand this process so that the measures implemented take into account all of the implications of the disease and aim at improving quality of life.   doi: 10.5216/ree.v16i2.22795.

  18. Severe Obesity in Cancer Care.

    Science.gov (United States)

    Streu, Erin

    2016-05-01

    Increasing weight and body fat composition has an impact on cancer detection and staging. Obese women are less likely to engage in breast and cervical screening practices. Excessive adipose tissue makes physical assessment more difficult, and patients with a BMI greater than 35 kg/m2 may have deeper and wider pelvic structures, which make internal examinations problematic. A retrospective review of 324 primary surgical patients found that patients with a BMI greater than 40 kg/m2 are seven times less likely to undergo complete surgical staging for endometrial cancer compared with individuals with a BMI less than 40 kg/m2. In addition, healthcare provider bias against the need for screening, feelings of discomfort and embarrassment, as well as patient's fears of guilt, humiliation, and shame pose significant barriers to addressing the issue of obesity in clinical care with patients and family members. 
. PMID:27105188

  19. Integrating yoga into cancer care.

    Science.gov (United States)

    DiStasio, Susan A

    2008-02-01

    Although yoga has been practiced in Eastern culture for thousands of years as part of life philosophy, classes in the United States only recently have been offered to people with cancer. The word yoga is derived from the Sanskrit root yuj, meaning to bind, join, and yoke. This reflection of the union of the body, mind, and spirit is what differentiates yoga from general exercise programs. Yoga classes in the United States generally consist of asanas (postures), which are designed to exercise every muscle, nerve, and gland in the body. The postures are combined with pranayama, or rhythmic control of the breath. As a complementary therapy, yoga integrates awareness of breath, relaxation, exercise, and social support--elements that are key to enhancing quality of life in patients with cancer. Yoga practice may assist cancer survivors in managing symptoms such as depression, anxiety, insomnia, pain, and fatigue. As with all exercise programs, participants need to be aware of potential risks and their own limitations. The purpose of this article is to familiarize nurses with yoga as a complementary therapy, including current research findings, types of yoga, potential benefits, safety concerns, teacher training, and ways to integrate yoga into cancer care. PMID:18258582

  20. The impact of informal care-giving networks on adult children's care-giver burden

    OpenAIRE

    Tolkacheva, N.; Broese van Groenou, M. I.; Boer; Tilburg, van, P.J.A.

    2011-01-01

    Previous research on the care-giver burden experienced by adult children has typically focused on the adult child and parent dyad. This study uses information on multiple informal care-givers and examines how characteristics of the informal care-giving network affect the adult child's care-giver burden. In 2007, 602 Dutch care-givers who were assisting their older parents reported on parental and personal characteristics, care activities, experienced burden and characteristics of other inform...

  1. Music therapy in supportive cancer care

    OpenAIRE

    Stanczyk, Malgorzata Monika

    2011-01-01

    The purpose of this paper is to show some aspects of music therapy application in cancer care and to present the integration of music therapy program into a continuous supportive cancer care for inpatients. A cancer diagnosis is one of the most feared and serious life events that causes stress in individuals and families. Cancer disrupts social, physical and emotional well-being and results in a range of emotions, including anger, fear, sadness, guilt, embarrassment and shame. Music therapy i...

  2. Nationwide quality improvement in lung cancer care

    DEFF Research Database (Denmark)

    Jakobsen, Erik Winther; Green, Anders; Oesterlind, Kell;

    2013-01-01

    To improve prognosis and quality of lung cancer care the Danish Lung Cancer Group has developed a strategy consisting of national clinical guidelines and a clinical quality and research database. The first edition of our guidelines was published in 1998 and our national lung cancer registry was...... opened for registrations in 2000. This article describes methods and results obtained by multidisciplinary collaboration and illustrates how quality of lung cancer care can be improved by establishing and monitoring result and process indicators....

  3. Ten years of specialized adult care for phenylketonuria

    OpenAIRE

    Mütze, Ulrike; Thiele, Alena Gerlinde; Baerwald, Christoph; Ceglarek, Uta; Kiess, Wieland; Beblo, Skadi

    2016-01-01

    Background: Specialized adult care of phenylketonuria (PKU) patients is of increasing importance. Adult outpatient clinics for inherited errors of metabolism can help to achieve this task, but experience is limited. Ten years after establishment of a coordinated transition process and specialised adult care for inherited metabolic diseases, adult PKU care was evaluated with respect to metabolic control, therapy satisfaction, life satisfaction, sociodemographic data, economical welfare as well...

  4. Integration of genomics in cancer care

    DEFF Research Database (Denmark)

    Santos, Erika Maria Monteiro; Edwards, Quannetta T; Floria-Santos, Milena;

    2013-01-01

    PURPOSE: The article aims to introduce nurses to how genetics-genomics is currently integrated into cancer care from prevention to treatment and influencing oncology nursing practice. ORGANIZING CONSTRUCT: An overview of genetics-genomics is described as it relates to cancer etiology, hereditary...... cancer syndromes, epigenetics factors, and management of care considerations. METHODS: Peer-reviewed literature and expert professional guidelines were reviewed to address concepts of genetics-genomics in cancer care. FINDINGS: Cancer is now known to be heterogeneous at the molecular level, with genetic......: Rapidly developing advances in genetics-genomics are changing all aspects of cancer care, with implications for nursing practice. CLINICAL RELEVANCE: Nurses can educate cancer patients and their families about genetic-genomic advances and advocate for use of evidence-based genetic-genomic practice...

  5. Diabetes care for emerging adults: transition from pediatric to adult diabetes care systems

    OpenAIRE

    Lee, Young Ah

    2013-01-01

    With the increasing prevalence of diabetes mellitus in children, transitioning patients from childhood to adulthood are increasing. High-risk behaviors and poor glycemic control during the transition period increase the risk for hypoglycemia and hyperglycemia as well as chronic microvascular and macrovascular complications. Discussions regarding complications and preparations for transition must take place before the actual transition to adult care systems. Pediatric care providers should foc...

  6. Cancer Patient Navigator Tasks across the Cancer Care Continuum

    OpenAIRE

    Braun, Kathryn L; Kagawa-Singer, Marjorie; Holden, Alan E. C.; Burhansstipanov, Linda; Tran, Jacqueline H.; Seals, Brenda F.; Corbie-Smith, Giselle; Tsark, JoAnn U.; Harjo, Lisa; Foo, Mary Anne; Ramirez, Amelie G.

    2012-01-01

    Cancer patient navigation (PN) programs have been shown to increase access to and utilization of cancer care for poor and underserved individuals. Despite mounting evidence of its value, cancer patient navigation is not universally understood or provided. We describe five PN programs and the range of tasks their navigators provide across the cancer care continuum (education and outreach, screening, diagnosis and staging, treatment, survivorship, and end-of-life). Tasks are organized by their ...

  7. Optimizing Cancer Care Delivery through Implementation Science

    Directory of Open Access Journals (Sweden)

    Heather B Neuman

    2016-01-01

    Full Text Available The 2013 Institute of Medicine report investigating cancer care concluded that the cancer care delivery system is in crisis due to an increased demand for care, increasing complexity of treatment, decreasing work force and rising costs. Engaging patients and incorporating evidence-based care into routine clinical practice are essential components of a high quality cancer delivery system. However, a gap currently exists between the identification of beneficial research findings and application in clinical practice. Implementation research strives to address this gap. In this review, we discuss key components of high quality implementation research. We then apply these concepts to a current cancer care delivery challenge in women’s health, specifically the implementation of a surgery decision aid for women newly diagnosed with breast cancer.

  8. Supportive care needs of Iranian cancer patients

    Directory of Open Access Journals (Sweden)

    Azad Rahmani

    2014-01-01

    Full Text Available 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.

  9. The Affordable Care Act and implications for young adult health

    OpenAIRE

    Monaghan, Maureen

    2013-01-01

    In the USA, young adults are most likely to be uninsured and least likely to report a usual source of medical care than any age group. The Patient Protection and Affordable Care Act (ACA) recognizes the critical need for expanded insurance coverage for this age group, and multiple provisions of the ACA address insurance coverage and health care utilization in young adults. This paper presents a brief overview of the challenges of maintaining health insurance coverage and accessing health care...

  10. The Clinician's Toolbox: Assessing the Sexual Impacts of Cancer on Adolescents and Young Adults with Cancer (AYAC

    Directory of Open Access Journals (Sweden)

    Sylvie Aubin, PhD

    2015-09-01

    Conclusion: Cancer can have a significant impact on numerous domains of AYAC sexuality. The assessment of and attention to the impact of sexuality on AYAC is crucial in order to provide effective and comprehensive quality patient cancer care. Aubin S and Perez S. The clinician's toolbox: assessing the sexual impacts of cancer on adolescents and young adults with cancer (AYAC. Sex Med 2015;3:198–212.

  11. Diarrhea - what to ask your health care provider - adult

    Science.gov (United States)

    What to ask your health care provider about diarrhea - adult; Loose stools - what to ask your health care provider - adult ... Questions you should ask: Can I eat dairy foods? What foods can make my problem worse? Can I have greasy or spicy foods? ...

  12. Home Care Nursing Improves Cancer Symptom Management

    Science.gov (United States)

    Home care nursing (HCN) improves the management of symptoms in breast and colorectal cancer patients who take the oral chemotherapy drug capecitabine, according to a study published online November 16 in the Journal of Clinical Oncology.

  13. 13A. Integrative Cancer Care: The Life Over Cancer Model

    OpenAIRE

    Block, Keith; Block, Penny; Gyllenhaal, Charlotte; Shoham, Jacob

    2013-01-01

    Focus Areas: Integrative Algorithms of Care Integrative cancer treatment fully blends conventional cancer treatment with integrative therapies such as diet, supplements, exercise and biobehavioral approaches. The Life Over Cancer model comprises three spheres of intervention: improving lifestyle, improving biochemical environment (terrain), and improving tolerance of conventional treatment. These levels are applied within the context of a life-affirming approach to cancer patients and treatme...

  14. Supportive and Palliative Care of Pancreatic Cancer

    OpenAIRE

    Salman Fazal; Muhammad Wasif Saif

    2007-01-01

    Pancreatic cancer is one of the most lethal malignancies. An estimated 32,300 patients will die of pancreatic cancer in year 2006. It is the tenth most common malignancy in the United State. Despite recent advances in pathology, molecular basis and treatment, the overall survival rate remains 4% for all stages and races. Palliative care represents an important aspect of care in patient with pancreatic malignancy. Identifying and treating disease related symptomology are priorities. As a physi...

  15. Up Close and Personal: Theorising Care Work in Adult Education

    Science.gov (United States)

    John, Vaughn M.

    2016-01-01

    How do we account for the close personal bonds and deeply caring relationships forged by educators with learners in many adult educational encounters? The literature is relatively silent on the emotional and relational basis to adult educator work. This is a serious silence, given the stressful nature of adult education in developing contexts such…

  16. Smoking in Cancer Care (PDQ)

    Science.gov (United States)

    ... of having a second cancer. Quitting smoking is helpful after cancer is diagnosed. Studies have found that ... find help online. The following websites may be helpful: Smokefree.gov : Information about quitting smoking. Clearing the ...

  17. Innovative fertility preservation strategies and programs for young adults with cancer

    OpenAIRE

    Johnson RH

    2016-01-01

    Rebecca H Johnson Division of Pediatric Hematology/Oncology, Department of Pediatrics, Mary Bridge Hospital, MultiCare Health System, Tacoma, WA, USA Abstract: Preservation of fertility is a key issue for young adults newly diagnosed with cancer. Up to 90% of cancer patients under the age of 45 are at risk for fertility impairment following cancer therapy. Cancer patients who are not offered fertility preservation (FP) and those who become infertile following therapy may experience long-term...

  18. Primary Care of the Prostate Cancer Survivor.

    Science.gov (United States)

    Noonan, Erika M; Farrell, Timothy W

    2016-05-01

    This summary of the American Cancer Society Prostate Cancer Survivorship Care Guidelines targets primary care physicians who coordinate care of prostate cancer survivors with subspecialists. Prostate cancer survivors should undergo prostate-specific antigen screening every six to 12 months and digital rectal examination annually. Surveillance of patients who choose watchful waiting for their prostate cancer should be conducted by a subspecialist. Any hematuria or rectal bleeding must be thoroughly evaluated. Prostate cancer survivors should be screened regularly for urinary incontinence and sexual dysfunction. Patients with predominant urge incontinence symptoms, which can occur after surgical and radiation treatments, may benefit from an anticholinergic agent. If there is difficulty with bladder emptying, a trial of an alpha blocker may be considered. A phosphodiesterase type 5 inhibitor can effectively treat sexual dysfunction following treatment for prostate cancer. Osteoporosis screening should occur before initiation of androgen deprivation therapy, and patients treated with androgen deprivation therapy should be monitored for anemia, metabolic syndrome, and vasomotor symptoms. Healthy lifestyle choices should be encouraged, including weight management, regular physical activity, proper nutrition, and smoking cessation. Primary care physicians should be vigilant for psychosocial distress, including depression, among prostate cancer survivors, as well as the potential impact of this distress on patients' family members and partners. PMID:27175954

  19. Depression in Older Adults in Primary Care: An Integrative Approach to Care.

    Science.gov (United States)

    Lill, Sheila

    2015-09-01

    Depression in older adults is a problem often encountered in primary care. While depression is evident in all populations in the primary care setting, assessment and care are more complicated in the older adult due to factors such as comorbidities, clinical presentation, adverse drug effects and drug interactions, and psychosocial factors. Due to these complications, it is essential to incorporate both conventional and alternative methods in assessment and treatment. This article aims to define depression in older adults, present the epidemiology, discuss clinical presentation and screening, and offer an integrative approach to intervention, including both pharmacological and nonpharmacological methods. Providing holistic and integrative care to older adults diagnosed with depression in the primary care setting is essential to promote healing and recovery. This article aims to provide insight for nurses, nurse practitioners, and other providers regarding the holistic and integrative care of depression in older adults in the primary care setting. PMID:25673577

  20. Cancer: Unique to Older Adults

    Science.gov (United States)

    ... Tuesday, August 11, 2015 Join our e-newsletter! Aging & Health A to Z Cancer Unique to Older ... effect of your narcotic medications. These include: antidepressants anti-epileptic (anti-seizure) drugs steroids. Radiation for pain ...

  1. Care in the perception of cancer patients

    Directory of Open Access Journals (Sweden)

    Carolina Henriques

    2011-08-01

    Full Text Available Introduction: Being a cancer patient is a unique and singular. The cancer disease associated with pain and suffering is a challenging process for the sufferer, for whom have around or for those caring for the sick. Pain, considered the 5 th vital sign, is often identified as the main complaint of our patients suffering from cancer. We dare to say that to explore the essence of the care provided by nurses and primary health care to cancer patients with prolonged pain at the time found in his home and family, we would be helping to build a know -how by itself, with positive externalities for patients, families, professionals and nursing itself. Methods: Ask "What does Care for Nurses and primary health care for cancer patients with prolonged pain in time for your family?" we may lead the cornerstone of our problems, by studying quantitative nature using a questionnaire and a significance level of care. Results: the average age is 59.27 years, mostly women, 51% are married and in 29.8% of studies has only completed the first cycle of education. The majority of cancer patients who participated in this study share a room with a relative. In regard to aspects of their pain, cancer patients referred to 47.1% of cases, that their pain started weeks ago and 38.5% even refers to the pain persists for months. The pain felt by these patients is not the severe type, in 68.3% of cases, and has an average intensity of 5, although we have 25% of these patients with pain greater than a 6.75. The Meaning of Caring scale applied to the group of nurses who provide care at primary health reveals an alpha of 0.8857 and 0.9025 standardized alpha. The Meaning of Caring scale applied to the group of cancer patients with prolonged pain at the time they are at home shows an alpha of 0.6672and 0.7374 standardized alpha. The Meaning of Caring scale applied to the group of cancer family patients with prolonged pain shows an alpha of 0.6712 and an alpha standardized 0

  2. Quality of care indicators in rectal cancer.

    Science.gov (United States)

    Demetter, P; Ceelen, W; Danse, E; Haustermans, K; Jouret-Mourin, A; Kartheuser, A; Laurent, S; Mollet, G; Nagy, N; Scalliet, P; Van Cutsem, E; Van Den Eynde, M; Van de Stadt, J; Van Eycken, E; Van Laethem, J L; Vindevoghel, K; Penninckx, F

    2011-09-01

    Quality of health care is a hot topic, especially with regard to cancer. Although rectal cancer is, in many aspects, a model oncologic entity, there seem to be substantial differences in quality of care between countries, hospitals and physicians. PROCARE, a Belgian multidisciplinary national project to improve outcome in all patients with rectum cancer, identified a set of quality of care indicators covering all aspects of the management of rectal cancer. This set should permit national and international benchmarking, i.e. comparing results from individual hospitals or teams with national and international performances with feedback to participating teams. Such comparison could indicate whether further improvement is possible and/or warranted. PMID:22103052

  3. The financial burden of cancer: Estimates from patients undergoing cancer care in a tertiary care hospital

    OpenAIRE

    Zaidi Adnan A; Ansari Tayyaba Z; Khan Aziz

    2012-01-01

    Abstract Introduction The emotional burden associated with the diagnosis of cancer is sometimes overshadowed by financial burden sustained by patient and the family. This is especially relevant for a developing country as there is limited state support for cancer treatment. We conducted this study to estimate the cost of cancer care for two major types of cancer and to assess the perception of patients and families regarding the burden of the cost for undergoing cancer treatment at a private ...

  4. American Cancer Society Head and Neck Cancer Survivorship Care Guideline.

    Science.gov (United States)

    Cohen, Ezra E W; LaMonte, Samuel J; Erb, Nicole L; Beckman, Kerry L; Sadeghi, Nader; Hutcheson, Katherine A; Stubblefield, Michael D; Abbott, Dennis M; Fisher, Penelope S; Stein, Kevin D; Lyman, Gary H; Pratt-Chapman, Mandi L

    2016-05-01

    Answer questions and earn CME/CNE The American Cancer Society Head and Neck Cancer Survivorship Care Guideline was developed to assist primary care clinicians and other health practitioners with the care of head and neck cancer survivors, including monitoring for recurrence, screening for second primary cancers, assessment and management of long-term and late effects, health promotion, and care coordination. A systematic review of the literature was conducted using PubMed through April 2015, and a multidisciplinary expert workgroup with expertise in primary care, dentistry, surgical oncology, medical oncology, radiation oncology, clinical psychology, speech-language pathology, physical medicine and rehabilitation, the patient perspective, and nursing was assembled. While the guideline is based on a systematic review of the current literature, most evidence is not sufficient to warrant a strong recommendation. Therefore, recommendations should be viewed as consensus-based management strategies for assisting patients with physical and psychosocial effects of head and neck cancer and its treatment. CA Cancer J Clin 2016;66:203-239. © 2016 American Cancer Society. PMID:27002678

  5. Cancer patients, emergencies service and provision of palliative care

    Directory of Open Access Journals (Sweden)

    Bruno Miranda

    2016-06-01

    Full Text Available SUMMARY Objective: To describe the clinical and sociodemographic profile of cancer patients admitted to the Emergency Center for High Complexity Oncologic Assistance, observing the coverage of palliative and home care. Method: Cross sectional study including adult cancer patients admitted to the emergency service (September-December/2011 with a minimum length of hospital stay of two hours. Student’s t-test and Pearson chi-square test were used to compare the means. Results: 191 patients were enrolled, 47.6% elderly, 64.4% women, 75.4% from the city of Recife and greater area. The symptom prevalent at admission was pain (46.6%. 4.2% of patients were linked to palliative care and 2.1% to home care. The most prevalent cancers: cervix (18.3%, breast (13.6% and prostate (10.5%; 70.7% were in advanced stages (IV, 47.1%; 39.4% without any cancer therapy. Conclusion: Patients sought the emergency service on account of pain, probably due to the incipient coverage of palliative and home care. These actions should be included to oncologic therapy as soon as possible to minimize the suffering of the patient/family and integrate the skills of oncologists and emergency professionals.

  6. Transition from Pediatric to Adult OI Care

    Science.gov (United States)

    ... example, preparing for adult employment begins with the process of learning responsibility by doing chores and helping at home. As ... Similarly, developing satisfying adult relationships is a gradual process that begins ... social experiences in school and throughout adolescence. Some of ...

  7. Danish cancer patients’ perspective on health care

    DEFF Research Database (Denmark)

    Sandager, Mette; Sperling, Cecilie; Jensen, Henry;

    2015-01-01

    Patient’s experiences and patient surveys are increasingly being used for the evaluation of the quality of health care. Patient information is valuable input when we aim to improve healthcare services. The aim of this study was to assess Danish cancer patients’ experiences and assessment of the...... health care they have received, in regard to access to diagnostics, coordination and continuity of care, information and communication and involvement of patients and relatives. Questions and the opportunity to comment in free text were distributed to 6,720 newly diagnosed cancer patients in the summer...... better involvement of patient and relatives. The study indicates that women, younger and higher educated patients tend to be less satisfied with the health care they received. This study shows that even though the majority of patients are satisfied with the quality of health care, there is room for...

  8. American Cancer Society/American Society of Clinical Oncology Breast Cancer Survivorship Care Guideline.

    Science.gov (United States)

    Runowicz, Carolyn D; Leach, Corinne R; Henry, N Lynn; Henry, Karen S; Mackey, Heather T; Cowens-Alvarado, Rebecca L; Cannady, Rachel S; Pratt-Chapman, Mandi L; Edge, Stephen B; Jacobs, Linda A; Hurria, Arti; Marks, Lawrence B; LaMonte, Samuel J; Warner, Ellen; Lyman, Gary H; Ganz, Patricia A

    2016-02-20

    The purpose of the American Cancer Society/American Society of Clinical Oncology Breast Cancer Survivorship Care Guideline is to provide recommendations to assist primary care and other clinicians in the care of female adult survivors of breast cancer. A systematic review of the literature was conducted using PubMed through April 2015. A multidisciplinary expert workgroup with expertise in primary care, gynecology, surgical oncology, medical oncology, radiation oncology, and nursing was formed and tasked with drafting the Breast Cancer Survivorship Care Guideline. A total of 1,073 articles met inclusion criteria; and, after full text review, 237 were included as the evidence base. Patients should undergo regular surveillance for breast cancer recurrence, including evaluation with a cancer-related history and physical examination, and should be screened for new primary breast cancer. Data do not support performing routine laboratory tests or imaging tests in asymptomatic patients to evaluate for breast cancer recurrence. Primary care clinicians should counsel patients about the importance of maintaining a healthy lifestyle, monitor for post-treatment symptoms that can adversely affect quality of life, and monitor for adherence to endocrine therapy. Recommendations provided in this guideline are based on current evidence in the literature and expert consensus opinion. Most of the evidence is not sufficient to warrant a strong evidence-based recommendation. Recommendations on surveillance for breast cancer recurrence, screening for second primary cancers, assessment and management of physical and psychosocial long-term and late effects of breast cancer and its treatment, health promotion, and care coordination/practice implications are made.This guideline was developed through a collaboration between the American Cancer Society and the American Society of Clinical Oncology and has been published jointly by invitation and consent in both CA: A Cancer Journal for

  9. The Relationships Among Pain, Non-pain Symptoms, and Quality of Life Measures in Older Adults with Cancer Receiving Hospice Care

    OpenAIRE

    Black, Brianne; Hartford, John A.; Herr, Keela; Fine, Perry; Sanders, Sara; Tang, Xiongwen; Bergen-Jackson, Kimberly; Titler, Marita; Forcucci, Chris

    2011-01-01

    Gathering first hand or reported information about patients in the final stages of terminal cancer is difficult due to patient frailty, cognitive impairment, excessive fatigue and severity of illness, as well as gatekeeping by hospice providers and caregivers, and highly variable documentation practices.

  10. Yoga in adult cancer: an exploratory, qualitative analysis of the patient experience

    OpenAIRE

    McCall, Marcy; Thorne, Sally; Ward, Alison; Heneghan, Carl

    2015-01-01

    Background Some patients receiving treatment in conventional health care systems access therapeutic yoga outside their mainstream care to improve cancer symptoms. Given the current knowledge gap around patient preferences and documented experiences of yoga in adult cancer, this study aimed to describe patient-reported benefits, barriers and characteristics of programming for yoga practice during conventional treatment. Methods In depth semi-structured interviews (n = 10) were conducted in men...

  11. An opportunity for coordinated cancer care: intersection of health care reform, primary care providers, and cancer patients.

    Science.gov (United States)

    Collins, Lauren G; Wender, Richard; Altshuler, Marc

    2010-01-01

    The US health care system has become increasingly unsustainable, threatened by poor quality and spiraling costs. Many Americans are not receiving recommended preventive care, including cancer screening tests. Passage of the Affordable Care Act in March 2010 has the potential to reverse this course by increasing access to primary care providers, extending coverage and affordability of health insurance, and instituting proven quality measures. In order for health care reform to succeed, it will require a stronger primary care workforce, a new emphasis on patient-centered care, and payment incentives that reward quality over quantity. Innovations such as patient-centered medical homes, accountable care organizations, and improved quality reporting methods are central features of a redesigned health care delivery system and will ultimately change the face of cancer care in the United States. PMID:21131791

  12. The experience of transition in adolescents and young adults transferring from paediatric to adult care

    DEFF Research Database (Denmark)

    Fegran, Liv; Ludvigsen, Mette Spliid; Aagaard, Hanne;

    Introduction: Despite research and implementation of transition models in the last decades, transfer from paediatric to adult care still poses great challenges. Predominantly studies on health care transition have been based on the perspective of experts or health care professionals. Aim: To...... synthesize qualitative studies on how adolescents and young adults with chronic diseases experience transition from paediatric to adult care. Methods: Literature search in major databases covering the years from 1999 to November 2010 was performed. Further forward citation snowballing search was conducted in...

  13. Foster Care Experiences and Educational Outcomes of Young Adults Formerly Placed in Foster Care

    Science.gov (United States)

    Havalchak, Anne; White, Catherine Roller; O'Brien, Kirk; Pecora, Peter J.; Sepulveda, Martin

    2009-01-01

    This study contributes to the body of research on the educational outcomes of young adults who were formerly placed in foster care. Telephone interviews were conducted with 359 young adults (a 54.6% response rate). Participants must have been served for at least one year by one private foster care agency in one of its twenty-two offices. Results…

  14. Diarrhea - what to ask your health care provider - adult

    Science.gov (United States)

    What to ask your health care provider about diarrhea - adult; Loose stools - what to ask your health ... medicines, vitamins, herbs, or supplements I take cause diarrhea? Should I stop taking any of them? What ...

  15. Keep Your Mouth Healthy: Oral Care for Older Adults

    Science.gov (United States)

    ... please review our exit disclaimer . Subscribe Keep Your Mouth Healthy Oral Care for Older Adults Oral health ... decay. You can take steps to keep your mouth healthy throughout your lifetime. And if you’re ...

  16. Diabetes Self-Care and the Older Adult

    OpenAIRE

    Weinger, Katie; Beverly, Elizabeth A.; Smaldone, Arlene

    2014-01-01

    The prevalence of diabetes is highest in older adults, a population that is increasing. Diabetes self-care is complex with important recommendations for nutrition, physical activity, checking glucose levels, and taking medication. Older adults with diabetes have unique issues which impact self-care. As people age, their health status, support systems, physical and mental abilities, and nutritional requirements change. Furthermore, comorbidities, complications, and polypharmacy complicate diab...

  17. [Palliative Care for Non-cancer Patients].

    Science.gov (United States)

    Ikegaki, Junichi

    2016-03-01

    Although palliative care has been developed and implemented as care for cancer pain, it is holistic care for suffering that includes physical, psychosocial and spiritual pain of life-threatening illness. It turned out that non-cancer patients in the end-stage are also suffering from various pain that should be treated as cancer patients. Trajectories of illness in non-cancer patients are with more gradual decline than those of cancer patients with steady progression and it is often difficult to make decision about end-of-life. The purpose of advance care planning was originally to help describe legal documents. This process is proved to contribute to improving QOL of patients and their families to discuss preference, hope, economic problems, spiritual question as well as medical treatment In Japan guideline of decision making process in end-of-life stage has been established. A program of communication training in end-of-life discussion has been made. Under current situation some comments on the role of anesthesiologists are also mentioned. PMID:27097506

  18. Optimizing Health Care for Adults with Spina Bifida

    Science.gov (United States)

    Webb, Thomas S.

    2010-01-01

    Survival into adulthood for individuals with spina bifida has significantly improved over the last 40 years with the majority of patients now living as adults. Despite this growing population of adult patients who have increased medical needs compared to the general population, including spina bifida (SB)-specific care, age-related secondary…

  19. Dental Care among Young Adults with Intellectual Disability

    Science.gov (United States)

    Kancherla, Vijaya; Van Naarden Braun, Kim; Yeargin-Allsopp, Marshalyn

    2013-01-01

    Dental care among young adults with intellectual disability (ID) is poorly documented and largely unmet. By using population-based data from the Metropolitan Atlanta Developmental Disabilities Follow-Up Study, we assessed factors associated with at least one or two dental visits per year among young adults with and without ID. Significantly fewer…

  20. Quality of Cancer Care Among Foreign-Born and US-Born Patients With Lung or Colorectal Cancer

    DEFF Research Database (Denmark)

    Nielsen, Signe Smith; He, Yulei; Ayanian, John Z.;

    2010-01-01

      BACKGROUND: Disparities in care have been documented for foreign-born cancer patients in the United States. However, few data are available regarding patients with lung and colorectal cancer. In the current study, the authors assessed whether patient-reported quality and receipt of recommended...... care differed between US-born and foreign-born cancer patients. METHODS: The authors collected surveys and medical records for a population-based cohort including white, Hispanic, and Asian adults (2205 US-born and 890 foreign-born individuals) with lung or colorectal cancer diagnosed in California...... from 2003 through 2005. Logistic regression was used to assess the association between nativity and patient-reported quality of care and receipt of recommended treatments (adjuvant chemotherapy for stage III colon cancer, adjuvant chemotherapy and radiotherapy for stage II/III rectal cancer, and...

  1. Child Nutrition Programs: Child and Adult Care Food Program. Family Day Care Home Handbook.

    Science.gov (United States)

    Oklahoma State Dept. of Education, Oklahoma City.

    This handbook details requirements for family day care homes in Oklahoma for providing child nutrition through the Child and Adult Care Food Program. The handbook includes contact information for state consultants. The basic responsibilities for sponsors of family day care home child nutrition programs are outlined, and the sponsoring organization…

  2. In palliative cancer care symptoms mean everything

    NARCIS (Netherlands)

    Teunissen, S.C.C.M.

    2007-01-01

    The thesis aims to provide deeper insight into symptoms of cancer patients in palliative care, in order to improve the adequacy of decision-making for optimizing symptom control. Several aspects of symptoms and symptom management were investigated as were some aspects of communication and consultati

  3. Inequity in Cancer Care: A Global Perspective

    International Nuclear Information System (INIS)

    The strategies of United Nations system organizations such as the International Atomic Energy Agency (IAEA) and the World Health Organization (WHO) are based on guiding principles, the attainment of health equality being an important one. Therefore, their strategies focus on the needs of low and middle income countries and of vulnerable and marginalized populations. The IAEA is committed to gender equality. In keeping with the United Nations policies and agreements on both gender equality and gender mainstreaming, the IAEA has the responsibility of integrating gender equality into its programmes, as well as for contributing to worldwide gender equality. In addition, the IAEA strongly emphasizes the attainment of the United Nations Millennium Development Goals, of which gender equality is a central tenet. This publication focuses on the issue of inequality (disparity) as it applies to cancer care in general, and access to prevention, screening, palliative and treatment services in particular. The problem of inequality in access to radiation oncology services is addressed in detail. Access to cancer care and radiotherapy services for women and children is specifically considered, reflecting the currently published literature. The report is aimed at radiotherapy professionals, health programme managers and decision makers in the area of cancer control. It was developed to create awareness of the role of socioeconomic inequality in access to cancer care, and to eventually mobilize resources to be equitably allocated to public health programmes in general, and to cancer control and radiotherapy programmes in particular

  4. The role of chiropractic care in older adults

    Directory of Open Access Journals (Sweden)

    Dougherty Paul E

    2012-02-01

    Full Text Available Abstract There are a rising number of older adults; in the US alone nearly 20% of the population will be 65 or older by 2030. Chiropractic is one of the most frequently utilized types of complementary and alternative care by older adults, used by an estimated 5% of older adults in the U.S. annually. Chiropractic care involves many different types of interventions, including preventive strategies. This commentary by experts in the field of geriatrics, discusses the evidence for the use of spinal manipulative therapy, acupuncture, nutritional counseling and fall prevention strategies as delivered by doctors of chiropractic. Given the utilization of chiropractic services by the older adult, it is imperative that providers be familiar with the evidence for and the prudent use of different management strategies for older adults.

  5. Primary Care of Adult Women: Common Dermatologic Conditions.

    Science.gov (United States)

    Ruiz de Luzuriaga, Arlene M; Mhlaba, Julie; Roman, Carly

    2016-06-01

    Dermatologic disease often presents in the primary care setting. Therefore, it is important for the primary care provider to be familiar with the presentation, diagnosis, and treatment of common skin conditions. This article provides an overview of acne, rosacea, melasma, vitiligo, alopecia, nonmelanoma, and melanoma skin cancer, dermatitis, and lichen sclerosus. PMID:27212088

  6. Care of Adult Refugees with Chronic Conditions.

    Science.gov (United States)

    Terasaki, Genji; Ahrenholz, Nicole Chow; Haider, Mahri Z

    2015-09-01

    Refugees share a common experience of displacement from their country of origin, migration, and resettlement in an unfamiliar country. More than 17 million people have fled their home countries due to war, generalized violence, and persecution. US primary care physicians must care for their immediate and long-term medical needs. Challenges include (1) language and cultural barriers, (2) high rates of mental health disorders, (3) higher prevalence of latent infections, and (4) different explanatory models for chronic diseases. This article discusses management strategies for common challenges that arise in the primary care of refugees. PMID:26320045

  7. 78 FR 45176 - Child and Adult Care Food Program: National Average Payment Rates, Day Care Home Food Service...

    Science.gov (United States)

    2013-07-26

    ... Food and Nutrition Service Child and Adult Care Food Program: National Average Payment Rates, Day Care... Day Care Homes for the Period July 1, 2013 Through June 30, 2014 AGENCY: Food and Nutrition Service...-risk afterschool care centers, and adult day care centers; the food service payment rates for meals...

  8. Preventive Care Recommendations for Adults with MS

    Science.gov (United States)

    ... Examination Every 6 months. (Note: Make sure your dentist has a current list of all the medications ... care provider) Self Breast Exam Mammogram Prostate exam (digital rectal exam) PSA (prostate specific antigen) test Clinical ...

  9. Social support, self-care, and quality of life in cancer patients receiving radiotherapy in Thailand

    International Nuclear Information System (INIS)

    The purpose of the study was two-fold: (1) to examine the relationships among self-care, social support, and quality of life in adult cancer patients receiving radiotherapy while the selected basic conditioning factors of age, marital and socio-economic status, living arrangement, stage and site of cancer were statistically controlled; and (2) to test a theoretical model which postulated that (a) quality of life was predicted jointly by the selected basic conditioning factors, social support and self-care, and (b) self-care was predicted jointly by the selected basic conditioning factors and social support. A convenience sample of 112 adult cervical and head/neck cancer patients receiving radiotherapy was obtained from radiotherapy outpatient clinic in three hospitals located in Bangkok, Thailand. Results of the study indicated positive relationships among self-care, social support, and quality of life. Socio-economic status, site of cancer, and self-care were significant predictors for reported quality of life. Social support appeared to be a significant predictor of quality of life indirectly through self-care. Socio-economic status and social support were also significant predictors of self-care, whereas, stage and site of cancer seemed to predict self-care indirectly through social support

  10. Integrating Adolescents and Young Adults into Adult-Centered Care for IBD.

    Science.gov (United States)

    Trivedi, Itishree; Holl, Jane L; Hanauer, Stephen; Keefer, Laurie

    2016-05-01

    Planned healthcare transition, initiated in pediatric care, is a gradual process aimed at fostering the adolescent patient's disease knowledge and skills with the ultimate objective of preparing patients and families for adult-centered care. The process is critical in inflammatory bowel diseases (IBD) where there is an increased risk of non-adherence, hospitalizations, and emergency department use as young adult patients graduate from pediatric to adult-centered care. While evidence for healthcare transition in IBD is mounting, important gaps remain in the understanding of this process from the perspective of the adult gastroenterologist. This paper summarizes what is known about healthcare transition in IBD and explores the unanswered questions-a conceptual and methodological framework for transition interventions, relevant outcomes that define successful transition, and key stakeholder perspectives. For the adult gastroenterologist managing the young adult patient population, this paper presents the paradigm of "care integration"-a process of ongoing, multi-modality support for the patient, initiated in the adult care setting, with the goal of improving self-management skills and active participation in medical decision-making. PMID:27086002

  11. Cancer patient supportive care and pain management. Special listing

    International Nuclear Information System (INIS)

    This Special Listing of Current Cancer Research Projects is a publication of the International Cancer Research Data Bank (ICRDB) Program of the National Cancer Institute. Each Listing contains descriptions of ongoing projects in one selected cancer research area. The research areas include: Infectious disease in cancer patients; Immunological aspects of supportive care of cancer patients; Nutritional evaluation and support of cancer patients; Pain management of cancer patients

  12. Teenagers and young adults with cancer in Europe: from national programmes to a European integrated coordinated project

    DEFF Research Database (Denmark)

    Stark, D; Bielack, S; Brugieres, L;

    2016-01-01

    Over 14 000 patients aged 15-24 are estimated to be diagnosed with cancer in the European Union (EU) each year. Teenagers and young adults (TYA) often fall down gaps between children's and adults cancer services. The specific challenges of providing optimal care to them are described, but we...... features of a high-quality service that can improve outcomes for TYA with cancer, including the primacy of collaboration between adult and paediatric services to eliminate the gap in the management of TYA with cancer....

  13. Care participation and burden among informal caregivers of older adults with care needs and associations with dementia

    OpenAIRE

    Vaingankar, Janhavi Ajit; Chong, Siow Ann; Abdin, Edimansyah; Picco, Louisa; Jeyagurunathan, Anitha; Zhang, Yunjue; Sambasivam, Rajeswari; Chua, Boon Yiang; Ng, Li Ling; Prince, Martin; Subramaniam, Mythily

    2015-01-01

    Background: Few studies have estimated care burden in large, representative, multi-ethnic Asian population-based informal caregivers of older adults with care needs. This study describes informal caregivers’ care participation for a population-based sample of older adults with care needs in Singapore, investigates differences by dementia status, and examines correlates of caregivers’ burden. Methods: Data collected from 693 pairs of older adults, aged 60 to 100 years, having any care needs, a...

  14. Integrating Primary Care in Cancer Survivorship Programs: Models of Care for a Growing Patient Population

    OpenAIRE

    Nekhlyudov, Larissa

    2014-01-01

    The author describes the primary care physician’s role in caring for cancer survivors who are transitioning from oncology settings to primary care settings. Four scenarios are addressed and advantages and disadvantages of each are listed.

  15. Care of the Adult Hodgkin Lymphoma Survivor

    OpenAIRE

    Thompson, Carrie A.; Mauck, Karen; Havyer, Rachel; Bhagra, Anjali; Kalsi, Henna; Hayes, Sharonne N.

    2011-01-01

    Of those individuals diagnosed with Hodgkin lymphoma, 85% will survive and may be affected by residual effects of their cancer and its therapy (chemotherapy, radiation therapy, stem cell transplantation). Hodgkin lymphoma survivors are at risk of developing secondary malignancies, cardiovascular disease, pulmonary disease, thyroid disease, infertility, premature menopause, chronic fatigue, and psychosocial issues. These conditions usually have a long latency and therefore present years or dec...

  16. The European initiative for quality management in lung cancer care

    DEFF Research Database (Denmark)

    Blum, Torsten G; Rich, Anna; Baldwin, David;

    2014-01-01

    Lung cancer is the commonest cause of cancer-related death worldwide and poses a significant respiratory disease burden. Little is known about the provision of lung cancer care across Europe. The overall aim of the Task Force was to investigate current practice in lung cancer care across Europe....... The Task Force undertook four projects: 1) a narrative literature search on quality management of lung cancer; 2) a survey of national and local infrastructure for lung cancer care in Europe; 3) a benchmarking project on the quality of (inter)national lung cancer guidelines in Europe; and 4) a...... feasibility study of prospective data collection in a pan-European setting. There is little peer-reviewed literature on quality management in lung cancer care. The survey revealed important differences in the infrastructure of lung cancer care in Europe. The European guidelines that were assessed displayed...

  17. Prioritization of care in adults with diabetes and comorbidity

    OpenAIRE

    Laiteerapong, Neda; Huang, Elbert S.; Chin, Marshall H

    2011-01-01

    Approximately half of adults with diabetes have at least one comorbid condition. However, diabetes care guidelines focus on diabetes-specific care, and their recommendations may not be appropriate for many patients with diabetes and comorbidity. We describe Piette and Kerr's typology of comorbid conditions, which categorizes conditions based on if they are clinically dominant (eclipse diabetes management), symptomatic versus asymptomatic, and concordant (similar pathophysiologic processes as ...

  18. Cultural aspects of communication in cancer care.

    Science.gov (United States)

    Surbone, Antonella

    2008-03-01

    Cultural competence in oncology requires the acquisition of specific knowledge, clinical skills, and attitudes that facilitate effective cross-cultural negotiation in the clinical setting, thus, leading to improved therapeutic outcomes and decreased disparities in cancer care. Cultural competence in oncology entails a basic knowledge of different cultural attitudes and practices of communication of the truth and of decision-making styles throughout the world. Cultural competence always presupposes oncology professionals' awareness of their own cultural beliefs and values. To be able to communicate with cancer patients in culturally sensitive ways, oncologists should have knowledge of the concept of culture in its complexity and of the risks of racism, classism, sexism, ageism, and stereotyping that must be avoided in clinical practice. Oncologists should develop a sense of appreciation for differences in health care values, based on the recognition that no culture can claim hegemony over others and that cultures are evolving under their reciprocal influence on each other. Medical schools and oncology training can teach communication skills and cultural competence, while fostering in all students and young doctors those attitudes of humility, empathy, curiosity, respect, sensitivity, and awareness that are needed to deliver effective and culturally sensitive cancer care. PMID:18196291

  19. The Quality of Cancer Care Initiative in the Netherlands

    OpenAIRE

    Wouters, Michel W. J. M.; Jansen-Landheer, Marlies L. E. A.; van de Velde, Cornelis J. H.

    2010-01-01

    Abstract Background In 2007 the Dutch Cancer Society formed a `Quality of Cancer Care? taskforce comprising medical specialists, from all disciplines involved in the care for cancer patients. This taskforce was charged with the evaluation of quality of cancer care in the Netherlands and the development of strategies for improvement. Objective The experts first focused on the relation between procedural volume and patient outcome and later aimed to i...

  20. 76 FR 43254 - Child and Adult Care Food Program: National Average Payment Rates, Day Care Home Food Service...

    Science.gov (United States)

    2011-07-20

    ..., 2010, at 75 FR 41793. Child and Adult Care Food Program (CACFP) [Per meal rates in whole or fractions... Food and Nutrition Service Child and Adult Care Food Program: National Average Payment Rates, Day Care... Day Care Homes for the Period July 1, 2011 Through June 30, 2012 AGENCY: Food and Nutrition...

  1. 75 FR 41793 - Child and Adult Care Food Program: National Average Payment Rates, Day Care Home Food Service...

    Science.gov (United States)

    2010-07-19

    ..., 2009, at 74 FR 34295. Child and Adult Care Food Program (CACFP) Lunch and Centers Breakfast supper \\1... Food and Nutrition Service Child and Adult Care Food Program: National Average Payment Rates, Day Care... Day Care Homes for the Period July 1, 2010 Through June 30, 2011 AGENCY: Food and Nutrition...

  2. Implementing the chronic care model for frail older adults in the Netherlands: study protocol of ACT (frail older adults: care in transition)

    OpenAIRE

    Muntinga Maaike E; Hoogendijk Emiel O; van Leeuwen Karen M; van Hout Hein PJ; Twisk Jos WR; van der Horst Henriette E; Nijpels Giel; Jansen Aaltje PD

    2012-01-01

    Abstract Background Care for older adults is facing a number of challenges: health problems are not consistently identified at a timely stage, older adults report a lack of autonomy in their care process, and care systems are often confronted with the need for better coordination between health care professionals. We aim to address these challenges by introducing the geriatric care model, based on the chronic care model, and to evaluate its effects on the quality of life of community-dwelling...

  3. Medication risk communication with cancer patients in a Middle East cancer care setting

    Science.gov (United States)

    Wilbur, Kerry; Al-Okka, Maha; Jumaat, Ebaa; Eissa, Nesma; Elbashir, Merwa; Al-Yafei, Sumaya M Al Saadi

    2016-01-01

    Purpose Cancer treatments are frequently associated with adverse effects, but there may be a cultural reluctance by care providers to be forthcoming with patients regarding these risks for fear of promoting nonadherence. Conversely, research in a number of countries indicates high levels of patient desire for this information. We sought to explore cancer patient experiences, satisfaction, and preferences for medication risk communication in a Middle East care setting. Methods We developed and administered a ten-item questionnaire (Arabic and English) to a convenience sample of consenting adult patients receiving treatment at the National Center for Cancer Care and Research in Qatar. Results One hundred and forty-three patients were interviewed. Most (88%) stated that the level of side effect information they received was sufficient, with physicians (86%) followed by pharmacists (39%) as the preferred sources. The majority (97%) agreed that knowing about possible side effects would help them recognize and manage the reaction, and 92% agreed that it would help them understand how to minimize or prevent the risks. Eighteen percent indicated that this information would make them not want to take treatment. Two-thirds (65%) had previously experienced intolerance to their cancer treatment regimen. Conclusion Most patients surveyed expressed preference for the details of possible side effects they may encounter in their treatment. However, one in five considered such information a factor for nonadherence, indicating the need for patient-specific approaches when communicating medication risks. PMID:27175061

  4. Cancer Pharmacogenomics: Integrating Discoveries in Basic, Clinical and Population Sciences to Advance Predictive Cancer Care

    Science.gov (United States)

    Cancer Pharmacogenomics: Integrating Discoveries in Basic, Clinical and Population Sciences to Advance Predictive Cancer Care, a 2010 workshop sponsored by the Epidemiology and Genomics Research Program.

  5. Childhood height, adult height, and the risk of prostate cancer

    DEFF Research Database (Denmark)

    Bjerregaard, Lise Geisler; Aarestrup, Julie; Gamborg, Michael; Lange, Theis; Tjønneland, Anne; Baker, Jennifer L

    2016-01-01

    PURPOSE: We previously showed that childhood height is positively associated with prostate cancer risk. It is, however, unknown whether childhood height exerts its effects independently of or through adult height. We investigated whether and to what extent childhood height has a direct effect on...... the risk of prostate cancer apart from adult height. METHODS: We included 5,871 men with height measured at ages 7 and 13 years in the Copenhagen School Health Records Register who also had adult (50-65 years) height measured in the Danish Diet, Cancer and Health study. Prostate cancer status was...... obtained through linkage to the Danish Cancer Registry. Direct and total effects of childhood height on prostate cancer risk were estimated from Cox regressions. RESULTS: From 1996 to 2012, 429 prostate cancers occurred. Child and adult heights were positively and significantly associated with prostate...

  6. Adult Basic Education. Child Care, Transportation, Support Services Workbook.

    Science.gov (United States)

    Porter, Deborah; Morris, Jamie, Ed.

    This workbook focuses on two primary needs of adult basic education (ABE) students--child care and transportation--and provides ideas to assist program administrators (especially in Texas) to develop appropriate, workable, community-based strategies to meet these needs. The book contains five chapters. Each chapter addresses a particular aspect of…

  7. Adult Day Care Program(高二适用)

    Institute of Scientific and Technical Information of China (English)

    孙启禄

    2004-01-01

    David Brown and Anne are two patients in the Adult Day Care Pro-gram at Mercy Hospitals. David Brown is seventy-two years old. He'sfriendly and likes to talk. He lives with his wife in the city. But David is

  8. Understanding Cancer Prognosis

    Medline Plus

    Full Text Available ... Services Advance Directives Using Trusted Resources Cancer Types Adolescents and Young Adults with Cancer Reports, Research, and Literature Quiz Cancers by Body Location/System Childhood Cancers Late Effects of Childhood Cancer Treatment Pediatric Supportive Care Unusual ...

  9. Determinants of increased primary health care use in cancer survivors.

    NARCIS (Netherlands)

    Heins, M.; Schellevis, F.; Rijken, M.; Hoek, L. van der; Korevaar, J.

    2012-01-01

    Purpose: The number of cancer survivors is increasing, and patients with cancer often experience long-lasting consequences of cancer and its treatment. Because of the variety of health problems and high prevalence of comorbidity, primary care physicians (PCPs) seem obvious candidates to take care of

  10. Primary care providers' judgments of opioid analgesic misuse in a community-based cohort of HIV-infected indigent adults

    OpenAIRE

    Vijayaraghavan, M.; Penko, J; D. Guzman; Miaskowski, C; Kushel, MB

    2011-01-01

    BACKGROUND: Primary care providers (PCPs) must balance treatment of chronic non-cancer pain with opioid analgesics with concerns about opioid misuse. OBJECTIVE: We co-enrolled community-based indigent adults and their PCPs to determine PCPs' accuracy of estimating opioid analgesic misuse and illicit substance use. DESIGN: Patient-provider dyad study. PARTICIPANTS: HIV-infected, community-based indigent adults ('patients') and their PCPs. MAIN MEASURES: Using structured interviews, we queried ...

  11. Caring for independent lives: geographies of caring for young adults with intellectual disabilities.

    Science.gov (United States)

    Power, Andrew

    2008-09-01

    This paper engages with the emerging disciplinary clash between 'care' and 'independence' within disability studies by examining the geography of home care for young adults with intellectual disabilities. The care system as a whole is viewed as central to disablist structures within disability studies (see Thomas, C. (2007). Sociologies of disability and illness: Contested ideas in disability studies and medical sociology. Hampshire: Palgrave Macmillan.). However, despite the theorisation of dependency as being in antipathy to the goals of the disability movement, caregiving at home still continues to dominate community care. The paper attempts to address how family carers are 'caught-in-the-middle' between their 'duty' to care and at the same time, perpetuating dependency; the reality being that parents have to deal with issues of being overprotective and confronting various social assumptions about disability. It examines the narratives from 25 family caregivers in Ireland who provide personal assistance to young adults with intellectual disabilities. PMID:18573581

  12. Young Cancer Patients' Perceptions of a Video Game Used to Promote Self Care

    Science.gov (United States)

    Beale, Ivan L.; Marin-Bowling, Veronica M.; Guthrie, Nicole: Kato, Pamela M.

    2006-01-01

    A video game called "Re-Mission" has recently been investigated with adolescent and young adult cancer patients enrolled in a multi-site randomized controlled evaluation of the game as a psycho-educational intervention. The main focus of the trial was to determine effects of the game on self-care and other health-related outcomes. It was also…

  13. Geriatric assessment with management in cancer care: Current evidence and potential mechanisms for future research

    Science.gov (United States)

    Magnuson, Allison; Allore, Heather; Cohen, Harvey Jay; Mohile, Supriya G.; Williams, Grant R.; Chapman, Andrew; Extermann, Martine; Olin, Rebecca L.; Targia, Valerie; Mackenzie, Amy; Holmes, Holly M.; Hurria, Arti

    2016-01-01

    Older adults with cancer represent a complex patient population. Geriatric assessment (GA) is recommended to evaluate the medical and supportive care needs of this group. “GA with management” is a term encompassing the resultant medical decisions and interventions implemented in response to vulnerabilities identified on GA. In older, non-cancer patients, GA with management has been shown to improve a variety of outcomes, such as reducing functional decline and health care utilization. However, the role of GA with management in the older adult with cancer is less well established. Rigorous clinical trials of GA with management are necessary to develop an evidence base and support its use in the routine oncology care of older adults. At the recent U-13 conference, “Design and Implementation of Intervention Studies to Improve or Maintain Quality of Survivorship in Older and/or Frail Adults with Cancer,” a session was dedicated to developing research priorities in GA with management. Here we summarize identified knowledge gaps in GA with management studies for older patients with cancer and propose areas for future research. PMID:27197915

  14. Geriatric assessment with management in cancer care: Current evidence and potential mechanisms for future research.

    Science.gov (United States)

    Magnuson, Allison; Allore, Heather; Cohen, Harvey Jay; Mohile, Supriya G; Williams, Grant R; Chapman, Andrew; Extermann, Martine; Olin, Rebecca L; Targia, Valerie; Mackenzie, Amy; Holmes, Holly M; Hurria, Arti

    2016-07-01

    Older adults with cancer represent a complex patient population. Geriatric assessment (GA) is recommended to evaluate the medical and supportive care needs of this group. "GA with management" is a term encompassing the resultant medical decisions and interventions implemented in response to vulnerabilities identified on GA. In older, non-cancer patients, GA with management has been shown to improve a variety of outcomes, such as reducing functional decline and health care utilization. However, the role of GA with management in the older adult with cancer is less well established. Rigorous clinical trials of GA with management are necessary to develop an evidence base and support its use in the routine oncology care of older adults. At the recent U-13 conference, "Design and Implementation of Intervention Studies to Improve or Maintain Quality of Survivorship in Older and/or Frail Adults with Cancer," a session was dedicated to developing research priorities in GA with management. Here we summarize identified knowledge gaps in GA with management studies for older patients with cancer and propose areas for future research. PMID:27197915

  15. Primary Care Endocrinology in the Adult Woman.

    Science.gov (United States)

    Thomas, Celeste C; Zeytinoglu, Meltem

    2016-06-01

    Diabetes mellitus, thyroid disorders, and osteoporosis are endocrine conditions affecting a significant proportion of women presenting to the obstetrician-gynecologist. Obstetrician-gynecologists are often the first health-care providers that young women see in adulthood, and thus, have a critical opportunity to identify women at risk for gestational and overt diabetes and manage the condition in those who have developed it. The obstetrician-gynecologist should be aware of the appropriate therapeutic options and treatment goals (eg, hemoglobin A1c) for women with diabetes. Thyroid disorders often present with menstrual irregularities or infertility, can affect pregnancy outcomes, and contribute to cardiovascular and bone disorders as women age. Finally, osteoporosis and low bone mineral density affect a substantial proportion of older women and some younger women with risk factors for secondary osteoporosis. The morbidity and mortality of osteoporotic fractures is substantial. There are many lifestyle interventions and therapeutic options available for these conditions, and the gynecologist plays a key role in optimizing risk factor assessment, screening, and providing treatment when appropriate. PMID:27212095

  16. Hospitalists caring for patients with advanced cancer: An experience-based guide.

    Science.gov (United States)

    Koo, Douglas J; Tonorezos, Emily S; Kumar, Chhavi B; Goring, Tabitha N; Salvit, Cori; Egan, Barbara C

    2016-04-01

    Every year, nearly 5 million adults with cancer are hospitalized. Limited evidence suggests that hospitalization of the cancer patient is associated with adverse morbidity and mortality. Hospitalization of the patient with advanced cancer allows for an intense examination of health status in the face of terminal illness and an opportunity for defining goals of care. This experience-based guide reports what is currently known about the topic and outlines a systematic approach to maximizing opportunities, improving quality, and enhancing the well-being of the hospitalized patient with advanced cancer. Journal of Hospital Medicine 2016;11:292-296. © 2015 Society of Hospital Medicine. PMID:26588430

  17. Edmonton Regional Palliative Care Program: impact on patterns of terminal cancer care

    OpenAIRE

    Bruera, E; Neumann, C M; Gagnon, B.; Brenneis, C; Kneisler, P; Selmser, P; J Hanson

    1999-01-01

    The Edmonton Regional Palliative Care Program was established in July 1995 to measure the access of patients with terminal cancer to palliative care services, decrease the number of cancer-related deaths in acute care facilities and increase the participation of family physicians in the care of terminally ill patients. In this retrospective study the authors compared the pattern of care and site of deaths before establishment of the program (1992/93) and during its second year of operation (1...

  18. Update on the Management of Pancreatic Cancer in Older Adults.

    Science.gov (United States)

    Lee, Shin Yin; Sissoko, Moussa; Hartshorn, Kevan L

    2016-10-01

    Pancreatic cancer is more common in older adults, who are underrepresented in clinical trials and frequently under treated. Chronological age alone should not deter clinicians from offering treatment to geriatric patients, as they are a heterogeneous population. Geriatric assessment, frailty assessment tools, and toxicity risk scores help clinicians select appropriate patients for therapy. For resectable disease, surgery can be safe but should be done at a high-volume center. Adjuvant therapy is important; though there remains controversy on the role of radiation, chemotherapy is well studied and efficacious. In locally advanced unresectable disease, chemoradiation or chemotherapy alone is an option. Neoadjuvant therapy improves the chances of resectability in borderline resectable disease. Chemotherapy extends survival in metastatic disease, but treatment goals and risk-benefit ratios have to be clarified. Adequate symptom management and supportive care are important. There are now many new treatment strategies and novel therapies for this disease. PMID:27492426

  19. Mind-body practices in cancer care.

    Science.gov (United States)

    Chaoul, Alejandro; Milbury, Kathrin; Sood, Anil K; Prinsloo, Sarah; Cohen, Lorenzo

    2014-12-01

    Being diagnosed with a life-threatening disease such as cancer and undergoing treatment can cause unwanted distress and interferes with quality of life. Uncontrolled stress can have a negative effect on a number of biological systems and processes leading to negative health outcomes. While some distress is normal, it is not benign and must be addressed, as failure to do so may compromise health and QOL outcomes. We present the evidence for the role of stress in cancer biology and mechanisms demonstrating how distress is associated with worse clinical outcomes. The National Comprehensive Cancer Network states that all patients be screened with the single-item distress thermometer and to also indicate the source of distress and to get appropriate referral. In addition to the many conventional approaches for managing distress from the fields of psychology and psychiatry, many patients are seeking strategies to manage their distress that are outside conventional medicine such as mind-body techniques. Mind-body techniques such as meditation, yoga, tai chi, and qigong have been found to lower distress and lead to improvements in different aspects of quality of life. It is essential that the standard of care in oncology include distress screening and the delivery of different techniques to help patients manage the psychosocial challenges of diagnosis and treatment of cancer. PMID:25325936

  20. Caring for young adults on a paediatric ward.

    Science.gov (United States)

    Heaton, Paul A J; Routley, Christine; Paul, Siba Prosad

    The need for adolescents and young adults (AYA) to have suitable age-specific inpatient facilities has been recognised for many years, yet has received relatively little attention. This article reports the successful introduction of an inpatient facility for AYA, aged 17-24 years, on a general paediatric ward in a small district general hospital. From December 2010, a young person's unit (YPU) consisting of an 8-bed area was opened within a 24-bed children's ward. Nursing care was provided by the ward staff, all of whom had been trained in the care of young adults. Policies regarding admission criteria, safeguarding, patient choice, visiting and 'house rules' were drafted, implemented and modified as necessary. Discussions with the adult clinicians (for medical care) and site managers were held to ensure smooth running of the system, and to address any concerns or difficulties. Paediatric patients had priority of admission at times of bed crisis. During 2012, there were a total of 2351 inpatient admissions to the paediatric ward, of whom 379 (16%) were YPU patients aged from 17-24 years. Median length of stay was 2 days for patients aged 17-24 years as compared with 1 day for patients aged less than or equal to 16 years. Patients who chose admission to the paediatric ward tended to be younger, in transition from paediatric to adult services for chronic conditions, or with special needs. Patient surveys showed a high level of satisfaction with the facility. Young adults can be cared for safely and effectively on a paediatric ward with minimal additional costs. The essential ingredients for success include discussion with affected parties to address specific concerns, and the establishment of a clear, simple and unambiguous admission policy. PMID:24165407

  1. [Current perspectives on supportive care for lung cancer patients].

    Science.gov (United States)

    Serena, A; Zurkinden, C; Castellani, P; Eicher, M

    2015-05-20

    The fight against cancer comprises not only survival of the disease but also survival with the highest possible quality of life. Thus, supportive care in cancer aims at reducing physical and psycho-emotional symptom burden. Furthermore, supportive care in cancer includes self-management-support for patients and their families/caregivers. Due to high symptom prevalence and poor prognosis, lung cancer patients express more unmet supportive care needs than other patient populations with cancer. Interventions to meet these needs have been developed in the last decade. They involve new models of care that incorporate the role of a lung cancer nurse in comprehensive cancer centers and eHealth-systems to support lung cancer patients and their families/caregivers. PMID:26152086

  2. Drug interactions in oncology: the impact on cancer care

    OpenAIRE

    Suphat Subongkot

    2011-01-01

    Drug interactions are important in the cancer care setting, the majority of drugs being used for palliative care. Failure to recognise these interactions can lead to either overt toxicity or suboptimal treatment.

  3. Clinical nursing care for transgender patients with cancer.

    Science.gov (United States)

    Levitt, Nathan

    2015-06-01

    Transgender people often face barriers in their pursuit of receiving sensitive and informed health care, and many avoid preventive care and care for life threatening conditions because of those obstacles. This article focuses on cancer care of the transgender patient, as well as ways that nurses and other providers can help to create a transgender-sensitive healthcare environment. PMID:26000586

  4. Dietary intake and nutritional status in cancer patients: comparing adults and older adults

    Directory of Open Access Journals (Sweden)

    Henyse Gómez Valiente da Silva

    2014-04-01

    Full Text Available Objective: Evaluate the nutrient intake and nutritional status of food in cancer patients admitted to a university hospital, with comparison of adult and older adult age category Methods: Cross-sectional study. This study involved cancer patients admitted to a hospital in 2010. Dietary habits were collected using a Brazilian food frequency questionnaire. Participants were divided in two groups: adults or older adults and in 4-cancer category: hematologic, lung, gastrointestinal and others. Body Mass Index evaluated nutritional status. Results: A total of 86 patients with a mean age of 56.5 years, with 55% males and 42% older adults were evaluated. The older adult category had a higher frequency of being underweight (24.4% vs 16.3%, p < 0.01 and a lower frequency of being overweight (7% vs. 15.1%, p < 0.01 than adults. Both, adult and older adults had a high frequency of smoking, alcohol consumption and physical inactivity. The older adults had lower consumption of calories, intake of iron and folic acid. Inadequacy of vitamin intake was observed in both groups; respectively, 52%, 43%, 95%, 76% and 88% for Vitamin A, C, D, E and folic acid. The older adults had a higher folic acid and calcium inadequacy than the adults (97% vs 82%, p <0.01; 88% vs 72%, p < 0.01. There was no association of micronutrient intake with cancer, nor with nutritional status. Conclusion: The food intake, macro and micronutrients ingestion is insufficient among cancer individuals. Food intake of older adults was inferior, when compared to the adult category. There was a high prevalence of BMI excess in the adult group and a worst nutritional status in the older adult category.

  5. Children as partners with adults in their medical care

    OpenAIRE

    Alderson, P.; Sutcliffe, K; Curtis, K.

    2006-01-01

    Aims: To investigate the seldom published views of children with type 1 diabetes about their condition and ways in which they share in managing their medical and health care with adults. Methods: Semi-structured, tape recorded interviews, during 2003, with a purposive sample of 24 children aged 3–12 years who have type I diabetes and who attend two inner London hospitals and one hospital in a commuter town. Results: The children reported high levels of understanding, knowledge, and ...

  6. Access to Care Among Disabled Adults on Medicaid

    OpenAIRE

    Long, Sharon K.; Coughlin, Teresa A.; Kendall, Stephanie J.

    2002-01-01

    Although disabled individuals account for a disproportionate share of Medicaid expenditures, little is known about their health care needs and experiences. This article explores differences in access and use among key disability subgroups—adults with physical disabilities, mental illness, and mental retardation/development disabilities (MR/DD). We find that disabled Medicaid beneficiaries with mental illness and those with greater health and functional limitations face more difficulties in ob...

  7. Accessibility of mental health care for adults with cerebral palsy

    OpenAIRE

    Pihlaja, Kimmo; Päivärinta, Paula

    2014-01-01

    The purpose of this thesis is to describe the accessibility in mental health care from the point of view of an adult with cerebral palsy. The theoretical framework of this thesis is constructed from the related literature and previous studies closely linked to the topic. Research was done to clarify the concepts of disability, cerebral palsy, and mental health. The research showed cerebral palsy as a multidimensional physical disability which may include different types of accompanying im...

  8. Type 1 diabetes: addressing the transition from pediatric to adult-oriented health care

    Directory of Open Access Journals (Sweden)

    Monaghan M

    2016-04-01

    Full Text Available Maureen Monaghan,1,2 Katherine Baumann2 1Center for Translational Science, Children's National Health System, 2George Washington University School of Medicine, Washington, DC, USA Abstract: Adolescents and young adults with type 1 diabetes are at risk for poor health outcomes, including poor glycemic control, acute and chronic complications, and emergency department admissions. During this developmental period, adolescent and young adult patients also experience significant changes in living situation, education, and/or health care delivery, including transferring from pediatric to adult health care. In recent years, professional and advocacy organizations have proposed expert guidelines to improve the process of preparation for and transition to adult-oriented health care. However, challenges remain and evidence-based practices for preparing youth for adult health care are still emerging. Qualitative research suggests that adolescent and young adult patients rely on health care providers to guide them through the transition process and appreciate a gradual approach to preparing for adult-oriented health care, keeping parents in supportive roles into young adulthood. Patients also benefit from specific referrals and contact information for adult care providers. Promising models of transition care include provision of transition navigators, attendance at a young adult bridge clinic, or joint visits with pediatric and adult care providers. However, much of this research is in its early stages, and more rigorous trials need to be conducted to evaluate health outcomes during transition into adult health care. The purpose of this review is to provide an overview of the transition process, patient and health care provider perceptions of transition care, and emerging evidence of successful models of care for engagement in adult-oriented health care. Recommendations and resources for health care providers are also presented. Keywords: type 1 diabetes

  9. Bicalutamide 150 mg plus standard care vs standard care alone for early prostate cancer

    DEFF Research Database (Denmark)

    McLeod, David G; Iversen, Peter; See, William A;

    2006-01-01

    To evaluate, in the ongoing Early Prostate Cancer (EPC) trial programme, the efficacy and tolerability of bicalutamide 150 mg once daily in addition to standard care for localized or locally advanced, nonmetastatic prostate cancer....

  10. [Breast cancer: patient care, rehabilitation, psychooncology].

    Science.gov (United States)

    Kahán, Zsuzsanna; Szántó, István; Molnár, Mária; Rohánszky, Magda; Koncz, Zsuzsa; Mailáth, Mónika; Kapitány, Zsuzsanna; Dudás, Rita

    2016-09-01

    The development of a recommendation was intended for the follow-up of breast cancer patients treated with curative intent in Hungary. Follow-up includes the permanent contact with and health education of the patient, the surveillance and control of the adverse effects of oncological therapies or radiotherapy, the screening of metachron cancers, and the comprehensive (physical, psychological and social) rehabilitation of the patient. The early detection of local/regional tumor relapse is essential with careful follow-up, but there is no need for screening of distant metastases by means of imaging studies or tumor marker tests. If adjuvant endocrine therapy is needed, optimal adherence should be ensured with supportive therapy. In rare cases, special issues such as breast cancer risk/genetic mutation, pregnancy are raised, which should be thoughtfully discussed in view of recent advances in oncology. Follow-up is generally practised by the oncologist, however, in some cases the social worker, the physiotherapist, the psychooncologist, or in special cases, the lymphoedema expert is to be involved. The follow-up approach should be comprehensive and holistic. PMID:27579724

  11. Risk of thyroid cancer, brain cancer, and non-Hodgkin lymphoma after adult leukemia

    DEFF Research Database (Denmark)

    Nielsen, Sune F; Bojesen, Stig E; Birgens, Henrik S; Nordestgaard, Børge G

    2011-01-01

    Patients with childhood leukemia surviving into adulthood have elevated risk of developing thyroid cancer, brain cancer, and non-Hodgkin lymphoma (NHL); these risks cannot automatically be extrapolated to patients surviving adult leukemia. We tested whether survivors of adult leukemia are at...... increased risk of developing thyroid cancer, brain cancer, and NHL. We included the entire adult Danish population (14 years of age or older), in a 28-year follow-up period from 1980 through 2007, composed of 6 542 639 persons; during this period, 18 834 developed adult leukemia, 4561 developed thyroid...... cancer, 13 362 developed brain cancer, and 15 967 developed NHL. In nested studies using Cox regression models on individual participant data, we found that, after adult leukemia, the multivariate adjusted hazard ratios were 4.9 (95% confidence interval [CI], 2.8-8.5) for thyroid cancer, 1.9 (95% CI, 1...

  12. Assisting the Adult with a Respiratory Condition: Pharmacology. Care of the Adult.

    Science.gov (United States)

    Anoka-Hennepin Area Vocational Technical Inst., MN.

    These two units for students in a practical nursing program provide supplemental instruction, with a focus on pharmacology, in caring for adult patients with a respiratory condition. Unit titles are Antibiotics, and Drugs that Affect the Respiratory System. Each unit contains the following: objectives, an introduction, and five to nine learning…

  13. Bicalutamide 150 mg plus standard care vs standard care alone for early prostate cancer

    DEFF Research Database (Denmark)

    McLeod, David G; Iversen, Peter; See, William A;

    2006-01-01

    To evaluate, in the ongoing Early Prostate Cancer (EPC) trial programme, the efficacy and tolerability of bicalutamide 150 mg once daily in addition to standard care for localized or locally advanced, nonmetastatic prostate cancer.......To evaluate, in the ongoing Early Prostate Cancer (EPC) trial programme, the efficacy and tolerability of bicalutamide 150 mg once daily in addition to standard care for localized or locally advanced, nonmetastatic prostate cancer....

  14. Palliative care in advanced cancer patients in a tertiary care hospital in Uttarakhand

    OpenAIRE

    Manisha Bisht; Bist, S. S.; Dhasmana, D. C.; Sunil Saini

    2008-01-01

    Aim: Advanced cancer, irrespective of the site of the cancer, is characterized by a number of associated symptoms that impair the quality of life of patients. The management of these symptoms guides palliative care. The present study aims to describe the symptoms and appropriate palliation provided in patients with advanced cancer in a tertiary care hospital in Uttarakhand. Methods: This was an observational study. A total of 100 patients with advanced cancer were included in the study. T...

  15. Integration of early specialist palliative care in cancer care: Survey of oncologists, oncology nurses, and patients

    Directory of Open Access Journals (Sweden)

    Naveen Salins

    2016-01-01

    Conclusion: Oncologists, oncology nurses, and patients felt that integration of early specialist palliative care in cancer improves symptom control, end-of-life care, health-related communication, and continuity of care. The perceptions of benefit of the palliative care intervention in the components surveyed, differed among the three groups.

  16. Prevalence of Cigarette Smoking among Adult Cancer Survivors in Korea

    OpenAIRE

    Park, Jin Joo; Park, Hyun Ah

    2015-01-01

    Purpose Cigarette smoking is associated not only with increased risk of cancer incidence, but also influences prognosis, and the quality of life of the cancer survivors. Thus, smoking cessation after cancer diagnosis is necessary. However, smoking behavior among Korean cancer-survivors is yet unknown. Materials and Methods We investigated the smoking status of 23770 adults, aged 18 years or older, who participated in the Health Interview Survey of the Korea National Health and Nutrition Exami...

  17. Familism and Health Care Provision to Hispanic Older Adults.

    Science.gov (United States)

    Savage, Brittany; Foli, Karen J; Edwards, Nancy E; Abrahamson, Kathleen

    2016-01-01

    HOW TO OBTAIN CONTACT HOURS BY READING THIS ARTICLE INSTRUCTIONS 1.2 contact hours will be awarded by Villanova University College of Nursing upon successful completion of this activity. A contact hour is a unit of measurement that denotes 60 minutes of an organized learning activity. This is a learner-based activity. Villanova University College of Nursing does not require submission of your answers to the quiz. A contact hour certificate will be awarded once you register, pay the registration fee, and complete the evaluation form online at http://goo.gl/gMfXaf. To obtain contact hours you must: 1. Read the article, "Familism and Health Care Provision to Hispanic Older Adults" found on pages 21-29, carefully noting any tables and other illustrative materials that are included to enhance your knowledge and understanding of the content. Be sure to keep track of the amount of time (number of minutes) you spend reading the article and completing the quiz. 2. Read and answer each question on the quiz. After completing all of the questions, compare your answers to those provided within this issue. If you have incorrect answers, return to the article for further study. 3. Go to the Villanova website listed above to register for contact hour credit. You will be asked to provide your name; contact information; and a VISA, MasterCard, or Discover card number for payment of the $20.00 fee. Once you complete the online evaluation, a certificate will be automatically generated. This activity is valid for continuing education credit until December 31, 2018. CONTACT HOURS This activity is co-provided by Villanova University College of Nursing and SLACK Incorporated. Villanova University College of Nursing is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center's Commission on Accreditation. ACTIVITY OBJECTIVES 1. Explain familism and its potential effect on health care provision to Hispanic older adults. 2. Describe cultural

  18. Diffusion of standards of care for cancer pain.

    OpenAIRE

    Hagen, N; Young, J; Macdonald, N.

    1995-01-01

    The authors report the results of a symposium on improving the standards of care for patients with cancer pain. The symposium was sponsored by the Advisory Committee on Cancer Control of the National Cancer Institute of Canada and was held Apr. 8 to 10, 1994, in Toronto. Participants included experts on control of cancer pain and on diffusion techniques, patients with cancer and representatives of regulatory agencies. They suggested the following strategies to improve outcomes in patients wit...

  19. Managing Health Care After Cancer Treatment: A Wellness Plan

    OpenAIRE

    Moye, Jennifer; Langdon, Maura; Jones, Janice M.; Haggstrom, David; Naik, Aanand D.

    2014-01-01

    Many patients and health care providers lack awareness of both the existence of, and treatments for, lingering distress and disability after treatment. A cancer survivorship wellness plan can help ensure that any referral needs for psychosocial and other restorative care after cancer treatment are identified.

  20. Hyperprolactinemic breast cancer in radiooncologic care

    Energy Technology Data Exchange (ETDEWEB)

    Schlegel, G.; Luethgens, M.; Schoen, H.D.

    1986-02-01

    Serum prolactin has been determined in 334 patients with breast cancer within the radiooncologic care. In addition 54 healthy female blood donors were analysed as controls. Values above 600 mU/l were called hyperprolactinemic. 15% of the patients showed elevated prolactin levels, 25% of which coincided with recurrent disease. Preoperative evaluation of prolactin in combination with TPA and CEA may be an aid in selecting a special group of patients with poor prognosis. Following 31 patients under therapy it could be demonstrated that any successful treatment modality leads to a normalization of elevated prolactin levels. In refractory cases addition of bromocriptine may be effective. Furthermore, drug induced hyperprolactinemia ought to be treated.

  1. The hyperprolactinemic breast cancer in radiooncologic care

    International Nuclear Information System (INIS)

    Serum prolactin has been determined in 334 patients with breast cancer within the radiooncologic care. In addition 54 healthy female blood donors were analysed as controls. Values above 600 mU/l were called hyperprolactinemic. 15% of the patients showed elevated prolactin levels, 25% of which coincided with recurrent disease. Preoperative evaluation of prolactin in combination with TPA and CEA may be an aid in selecting a special group of patients with poor prognosis. Following 31 patients under therapy it could be demonstrated that any successful treatment modality leads to a normalization of elevated prolactin levels. In refractory cases addition of bromocriptine may be effective. Furthermore, drug induced hyperprolactinemia ought to be treated. (orig.)

  2. Occupational Therapy Use by Older Adults With Cancer

    OpenAIRE

    Pergolotti, Mackenzi; Cutchin, Malcolm P.; Weinberger,Morris; Meyer, Anne-Marie

    2014-01-01

    A retrospective cohort study of 27,131 older adults diagnosed with cancer between 2004 and 2007 found that survivors who used occupational therapy after diagnosis also had the highest levels of comorbidities.

  3. Integrated Care for Older Adults Improves Perceived Quality of Care : Results of a Randomized Controlled Trial of Embrace

    NARCIS (Netherlands)

    Uittenbroek, Ronald J; Kremer, Hubertus P H; Spoorenberg, Sophie L W; Reijneveld, Sijmen A; Wynia, Klaske

    2016-01-01

    BACKGROUND: All community-living older adults might benefit from integrated care, but evidence is lacking on the effectiveness of such services for perceived quality of care. OBJECTIVE: To examine the impact of Embrace, a community-based integrated primary care service, on perceived quality of care.

  4. Innovative fertility preservation strategies and programs for young adults with cancer

    Directory of Open Access Journals (Sweden)

    Johnson RH

    2016-01-01

    Full Text Available Rebecca H Johnson Division of Pediatric Hematology/Oncology, Department of Pediatrics, Mary Bridge Hospital, MultiCare Health System, Tacoma, WA, USA Abstract: Preservation of fertility is a key issue for young adults newly diagnosed with cancer. Up to 90% of cancer patients under the age of 45 are at risk for fertility impairment following cancer therapy. Cancer patients who are not offered fertility preservation (FP and those who become infertile following therapy may experience long-term psychosocial distress. This review summarizes the numerous effective strategies for preserving fertility, including sperm banking, electroejaculation, and testicular sperm extraction in males and cryopreservation of embryos or oocytes in females. This paper also highlights novel methods currently in development, such as gonadal tissue cryopreservation and in vitro maturation of gametes. In women, anti-Mullerian hormone is emerging as an accurate marker of ovarian reserve, and the use of gonadotropin releasing hormone analogs to protect fertility is increasingly well validated. Although national guidelines mandate FP counseling and referral prior to the start of cancer therapy for patients with reproductive potential, only a minority of young cancer patients in the USA currently take steps to preserve fertility prior to the start of therapy. Some cancer centers across the USA are developing institutional strategies to support FP, resulting in increased utilization of fertility services by newly diagnosed cancer patients. Keywords: young adult, cancer, fertility preservation, program, oocyte, sperm

  5. Ten years of specialized adult care for phenylketonuria – a single-centre experience

    OpenAIRE

    Mütze, Ulrike; Thiele, Alena Gerlinde; Baerwald, Christoph; Ceglarek, Uta; Kiess, Wieland; Beblo, Skadi

    2016-01-01

    Background Specialized adult care of phenylketonuria (PKU) patients is of increasing importance. Adult outpatient clinics for inherited errors of metabolism can help to achieve this task, but experience is limited. Ten years after establishment of a coordinated transition process and specialised adult care for inherited metabolic diseases, adult PKU care was evaluated with respect to metabolic control, therapy satisfaction, life satisfaction, sociodemographic data, economical welfare as well ...

  6. Problematising Home-based Care for Children with Cancer

    OpenAIRE

    Fletcher, Hannah Kate

    2013-01-01

    Background and Literature Review This study explores issues around home-based care for children with cancer. Current policy tends to promote home-based care for children with cancer; this project seeks to interrogate that approach further and to explore the evidence base for this policy direction. The literature review is structured around key themes and demonstrates the gap in the evidence from health care professionals‘ perspectives and UK based research Methodology I adopt a quali...

  7. [Integration of nutritional care into cancer treatment: need for improvement].

    Science.gov (United States)

    Joly, Caroline; Jacqueline-Ravel, Nathalie; Pugliesi-Rinaldi, Angela; Bigler-Perrotin, Lucienne; Chikhi, Marinette; Dietrich, Pierre-Yves; Dulguerov, Pavel; Miralbell, Raymond; Picard-Kossovsky, Michel; Seium, Yodit; Thériault, Michel; Pichard, Claude

    2011-11-16

    Progresses in cancer treatment transformed cancer into a chronic disease associated with growing nutritional problems. Poor nutritional status of cancer patients worsens morbidity, mortality, overall cost of care and decreases patients' quality of life, oncologic treatments tolerance and efficacy. These adverse effects lead to treatment modifications or interruptions, reducing the chances to control or cure cancer. Implementation of an interdisciplinary and longitudinal integration of nutritional care and nutritional information into cancer treatment (The OncoNut Program) could prevent or treat poor nutritional status and its adversely side effects. PMID:22400355

  8. Detecting cancer: Pearls for the primary care physician.

    Science.gov (United States)

    Zeichner, Simon B; Montero, Alberto J

    2016-07-01

    Five-year survival rates have improved over the past 40 years for nearly all types of cancer, partially thanks to early detection and prevention. Since patients typically present to their primary care physician with initial symptoms, it is vital for primary care physicians to accurately diagnose common cancers and to recognize unusual presentations of highly curable cancers such as Hodgkin lymphoma and testicular cancers, for which the 5-year overall survival rates are greater than 85%. This paper reviews these cancers and provides clinically relevant pearls from an oncologic perspective for physicians who are the first point of contact. PMID:27399864

  9. Scientific Evidence on the Supportive Cancer Care with Chinese Medicine

    Directory of Open Access Journals (Sweden)

    William CS CHO

    2010-03-01

    Full Text Available Complementary and alternative medicine has been increasingly utilized by cancer patients in developed countries. Among the various forms of complementary and alternative medicine, Traditional Chinese Medicine is one of the few that has a well constructed theoretical framework and established treatment approaches for diseases including cancer. Recent research has revealed growing evidence suggesting that Traditional Chinese Medicine is effective in the supportive care of cancer patients during and after major conventional cancer treatments. This paper succinctly summarizes some published clinical evidence and meta-analyses which support the usage of various Traditional Chinese Medicine treatment strategies including Chinese herbal medicine, acupuncture and Qigong in supportive cancer care.

  10. Patterns of cancer occurrence in a tertiary care centre

    Directory of Open Access Journals (Sweden)

    Atla Bhagyalakshmi

    2016-06-01

    Conclusions: The current study mainly summarizes the different patterns of cancer incidence in the tertiary care centre region. Cancer incidence is increasing gradually among the population and there is raise of cancer incidence in females compared to their counterparts. [Int J Res Med Sci 2016; 4(6.000: 2153-2163

  11. Cancer patients' use of family practice and secondary care

    DEFF Research Database (Denmark)

    Sokolowski, Ineta; Kjeldgaard, Anette Hvenegaard; Olesen, Frede;

    recently diagnosed with cancer and among previous cancer patients. Materials and methods: In a nationwide database in Denmark (population 5.5 million) all contacts to the health care system are registered. We describe the pattern of contact with all parts of the health care system for a) the total...... who have recently undergone treatment and patients in the survivorship phase of cancer use different parts of the health care system, and how much they use FP. Information about this will enable us to discuss the need for shared care, integrated care and information exchange and create a platform for......Aims: We know that in Denmark some 90% of citizens have contact with family practice (FP) during a year and around 40% has contact with secondary care.  This demands efforts to create integrated and shared care. The aim of this study is to document the pattern of contacts with FP among patients...

  12. Integrating palliative care into the trajectory of cancer care.

    Science.gov (United States)

    Hui, David; Bruera, Eduardo

    2016-03-01

    Over the past five decades, palliative care has evolved from serving patients at the end of life into a highly specialized discipline focused on delivering supportive care to patients with life-limiting illnesses throughout the disease trajectory. A growing body of evidence is now available to inform the key domains in the practice of palliative care, including symptom management, psychosocial care, communication, decision-making, and end-of-life care. Findings from multiple studies indicate that integrating palliative care early in the disease trajectory can result in improvements in quality of life, symptom control, patient and caregiver satisfaction, illness understanding, quality of end-of-life care, survival, and costs of care. In this narrative Review, we discuss various strategies to integrate oncology and palliative care by optimizing clinical infrastructures, processes, education, and research. The goal of integration is to maximize patient access to palliative care and, ultimately, to improve patient outcomes. We provide a conceptual model for the integration of supportive and/or palliative care with primary and oncological care. We also discuss how health-care systems and institutions need to tailor integration based on their resources, size, and the level of primary palliative care available. PMID:26598947

  13. Care of adolescents and young adults with diabetes - much more than transitional care: a personal view.

    Science.gov (United States)

    Winocour, Peter H

    2014-06-01

    There is increasing recognition that type 1 diabetes mellitus (T1DM) acquired in childhood and adolescence requires a sophisticated approach that facilitates better self-management through adherence to generic principles in managing chronic disease in this age group, allied to the complex clinical needs of managing T1DM and related conditions. Transitional care should be seen as a process over time supported by both paediatric and adult diabetologists within a multidisciplinary team, given the complementary skills that can be brought to bear. Undoubtedly, there is a need for more effective training of all healthcare professionals working in this service. However, the accumulation of older teenagers over time and new diagnoses in those aged 19 years or more confirms that a new paradigm is necessary for the successful care of young adults beyond transitional care. Traditional clinical models will often not work for those in employment and higher education, with evidence that ongoing engagement following transfer to adult services often ceases. The alarming evidence of progressive complications in T1DM of longer duration in patients under the age of 40 years is a wake-up call to transform the care of this most vulnerable group. PMID:24889572

  14. Intended care seeking for ovarian cancer symptoms among U.S. women.

    Science.gov (United States)

    Cooper, Crystale Purvis; Gelb, Cynthia A; Trivers, Katrina F; Stewart, Sherri L

    2016-06-01

    To investigate U.S. women's intended care seeking for symptoms associated with ovarian cancer, data from the 2012 HealthStyles Fall survey of U.S. adults were examined. Analyses were limited to women with no history of gynecologic cancer (N = 1726). Logistic regression models for intended care seeking within 2 weeks of symptom onset were developed. A minority of women recognized that unexplained pelvic or abdominal pain (29.9%), unexplained bloating (18.1%), and feeling full after eating a small amount of food (10.1%) can indicate ovarian cancer, and 31.1% mistakenly believed that the Papanicolaou (Pap) test screens for the disease. In the multivariate regression models, the most consistent, significant predictors (p educational efforts should emphasize that symptoms associated with ovarian cancer may also result from benign conditions. PMID:27419020

  15. Caring for cancer patients on non-specialist wards.

    LENUS (Irish Health Repository)

    Gill, Finola

    2012-02-01

    As cancer is the leading cause of death worldwide, every nurse will be required to care for patients with the condition at some point in his\\/her career. However, non-specialized oncology nurses are often ill-prepared to nurse patients suffering from cancer. This literature review aims to provide an overview of current trends and developments in cancer care nursing in an attempt to identify the range of previous research pertaining to caring for patients with cancer on non-specialist wards. The review finds that non-specialized cancer nurses report a lack of education and training with regard to cancer care and cancer treatments, which acts as a barrier to providing quality nursing care. Emotional and communication issues with patients and their families can also cause non-specialist nurses significant distress. International research has shown that specialist oncology nurses make a considerable difference to physical and psychosocial patient care. It is therefore paramount that non-speciality nurses\\' educational needs are met to develop clinical competence and to provide supportive holistic care for both patients and their families.

  16. Personalized prostate cancer care: from screening to treatment.

    Science.gov (United States)

    Conran, Carly A; Brendler, Charles B; Xu, Jianfeng

    2016-01-01

    Unprecedented progress has been made in genomic personalized medicine in the last several years, allowing for more individualized healthcare assessments and recommendations than ever before. However, most of this progress in prostate cancer (PCa) care has focused on developing and selecting therapies for late-stage disease. To address this issue of limited focus, we propose a model for incorporating genomic-based personalized medicine into all levels of PCa care, from prevention and screening to diagnosis, and ultimately to the treatment of both early-stage and late-stage cancers. We have termed this strategy the "Pyramid Model" of personalized cancer care. In this perspective paper, our objective is to demonstrate the potential application of the Pyramid Model to PCa care. This proactive and comprehensive personalized cancer care approach has the potential to achieve three important medical goals: reducing mortality, improving quality of life and decreasing both individual and societal healthcare costs. PMID:27184548

  17. Primary Care for the Older Adult Patient: Common Geriatric Issues and Syndromes.

    Science.gov (United States)

    Thompson, Katherine; Shi, Sandra; Kiraly, Carmela

    2016-06-01

    Older adults are the fastest growing segment of the US population and the majority of older adults are women. Primary care for the older adult patient requires a wide variety of skills, reflecting the complexity and heterogeneity of this patient population. Individualizing care through consideration of patients' goals, medical conditions, and prognosis is paramount. Quality care for the older adult patient requires familiarity with common geriatric syndromes, such as dementia, falls, and polypharmacy. In addition, developing the knowledge and communication skills necessary for complex care and end-of-life care planning is essential. PMID:27212097

  18. Transcutaneous electrical nerve stimulation for cancer pain in adults.

    OpenAIRE

    Robb, Karen; Bennett, Michael I.; Johnson, Mark I.; Simpson, Karen H; Oxberry, Stephen G.

    2008-01-01

    Background Cancer-related pain is complex and multi-dimensional but the mainstay of cancer pain management has predominately used a biomedical approach. There is a need for non-pharmacological and innovative approaches. Transcutaneous Electric Nerve Stimulation (TENS) may have a role for a significant number of patients but the effectiveness of TENS is currently unknown. Objectives The aim of this systematic review was to determine the effectiveness of TENS for cancer-related pain in adults. ...

  19. Urban family physicians and the care of cancer patients.

    OpenAIRE

    Dworkind, M.; Shvartzman, P; Adler, P. S.; Franco, E. D.

    1994-01-01

    Members in the Department of Family Medicine of a university teaching hospital were surveyed to find out their involvement in caring for cancer patients. Respondents indicated that many cancer patients were followed, but few cancer support services in the hospital and the community were used. The desire to take on new cancer patients was lacking, yet an interest in continuing medical education existed. Feedback from the department will help guide our Education Committee to develop continuing ...

  20. Objectively Measured Activity Patterns among Adults in Residential Aged Care

    Directory of Open Access Journals (Sweden)

    Natasha Reid

    2013-12-01

    Full Text Available Objectives: To determine the feasibility of using the activPAL3TM activity monitor, and, to describe the activity patterns of residential aged care residents. Design: Cross-sectional. Setting: Randomly selected aged care facilities within 100 km of the Gold Coast, Queensland, Australia. Participants: Ambulatory, older (≥60 years residential aged care adults without cognitive impairment. Measurements: Feasibility was assessed by consent rate, sleep/wear diary completion, and through interviews with staff/participants. Activity patterns (sitting/lying, standing, and stepping were measured via activPAL3TM monitors worn continuously for seven days. Times spent in each activity were described and then compared across days of the week and hours of the day using linear mixed models. Results: Consent rate was 48% (n = 41. Activity patterns are described for the 31 participants (mean age 84.2 years who provided at least one day of valid monitor data. In total, 14 (45% completed the sleep/wear diary. Participants spent a median (interquartile range of 12.4 (1.7 h sitting/lying (with 73% of this accumulated in unbroken bouts of ≥30 min, 1.9 (1.3 h standing, and 21.4 (36.7 min stepping during their monitored waking hours per day. Activity did not vary significantly by day of the week (p ≥ 0.05; stepping showed significant hourly variation (p = 0.018. Conclusions: Older adults in residential aged care were consistently highly sedentary. Feasibility considerations for objective activity monitoring identified for this population include poor diary completion and lost monitors.

  1. Biomarkers, Bundled Payments, and Colorectal Cancer Care

    OpenAIRE

    Ross, William; Lynch, Patrick; Raju, Gottumukkala; Rodriguez, Alma; Burke, Thomas; Hafemeister, Lisa; Hawk, Ernest; Wu, Xifeng; Raymond N. DuBois; MISHRA, LOPA

    2012-01-01

    Changes in the management of cancers such as colorectal cancer (CRC) are urgently needed, as such cancers continue to be one of the most commonly diagnosed cancers; CRC accounts for 21% of all cancers and is responsible for mortalities second only to lung cancer in the United States. A comprehensive science-driven approach towards markedly improved early detection/screening to efficacious targeted therapeutics with clear diagnostic and prognostic markers is essential. In addition, further cha...

  2. Integration and continuity of Care in health care network models for frail older adults

    Science.gov (United States)

    Veras, Renato Peixoto; Caldas, Célia Pereira; da Motta, Luciana Branco; de Lima, Kenio Costa; Siqueira, Ricardo Carreño; Rodrigues, Renata Teixeira da Silva Vendas; Santos, Luciana Maria Alves Martins; Guerra, Ana Carolina Lima Cavaletti

    2014-01-01

    A detailed review was conducted of the literature on models evaluating the effectiveness of integrated and coordinated care networks for the older population. The search made use of the following bibliographic databases: Pubmed, The Cochrane Library, LILACS, Web of Science, Scopus and SciELO. Twelve articles on five different models were included for discussion. Analysis of the literature showed that the services provided were based on primary care, including services within the home. Service users relied on the integration of primary and hospital care, day centers and in-home and social services. Care plans and case management were key elements in care continuity. This approach was shown to be effective in the studies, reducing the need for hospital care, which resulted in savings for the system. There was reduced prevalence of functional loss and improved satisfaction and quality of life on the part of service users and their families. The analysis reinforced the need for change in the approach to health care for older adults and the integration and coordination of services is an efficient way of initiating this change. PMID:24897058

  3. Transition from Hospital to Community Care: The Experience of Cancer Patients

    Directory of Open Access Journals (Sweden)

    Hanna Admi

    2015-12-01

    Full Text Available Purpose: This study examines care transition experiences of cancer patients and assesses barriers to effective transitions.Methods: Participants were adult Hebrew, Arabic, or Russian speaking oncology patients and health care providers from hospital and community settings. Qualitative (n=77 and quantitative (n=422 methods such as focus groups, interviews and self-administered questionnaires were used. Qualitative analysis showed that patients faced difficulties navigating a complex and fragmented healthcare system.Results: Mechanisms to overcome barriers included informal routes such as personal relationships, coordinating roles by nurse coordinators and the patients' general practitioners (GPs. The most significant variable was GPs involvement, which affected transition process quality as rated on the CTM (p<0.001. Our findings point to the important interpersonal role of oncology nurses to coordinate and facilitate the care transition process.Conclusion: Interventions targeted towards supporting the care transition process should emphasize ongoing counseling throughout a patient’s care, during and after hospitalization.-----------------------------------------Cite this article as:  Admi H, Muller E, Shadmi E. Transition from Hospital to Community Care: The Experience of Cancer Patients. Int J Cancer Ther Oncol 2015; 3(4:34011.[This abstract was presented at the BIT’s 8th Annual World Cancer Congress, which was held from May 15-17, 2015 in Beijing, China.

  4. Advanced lung cancer patients' experience with continuity of care and supportive care needs.

    Science.gov (United States)

    Husain, Amna; Barbera, Lisa; Howell, Doris; Moineddin, Rahim; Bezjak, Andrea; Sussman, Jonathan

    2013-05-01

    As cancer care becomes increasingly complex, the ability to coordinate this care is more difficult for health care providers, patients and their caregivers alike. Despite the widely recognized need for improving continuity and coordination of care, the relationship of continuity of care with patient outcomes has yet to be elucidated. Our study's main finding is that the Continuity and Coordination subscale of the widely used Picker System of Ambulatory Cancer Care Survey is able to distinguish between lung cancer patients with unmet supportive care needs and those without. Specifically, this study shows a new association between this widely implemented continuity and coordination survey and the 'psychological needs' domain, as well as the 'health system and information' domains of supportive care needs. The finding provides support for the idea that interventions to improve continuity may impact tangible indicators of patient care such as supportive care needs being met. The study focuses attention on continuity of care as an important aspect of optimizing outcomes in cancer care. PMID:23274923

  5. Who Are the Clients?: Goal Displacement in an Adult Care Center for Elders with Dementia

    Science.gov (United States)

    Abramson, Corey M.

    2009-01-01

    This ethnographic study of "goal displacement" in an adult day care center explains how and why certain goals come to surpass others in the organizational practices of elder day care settings. Adult day care is often oriented towards providing family caregivers with respite rather than attempting to directly improve the lives of the elders…

  6. Brief Report: The Medical Care of Adults with Autism Spectrum Disorders--Identifying the Needs

    Science.gov (United States)

    Bruder, Mary Beth; Kerins, Gerard; Mazzarella, Cynthia; Sims, Jessica; Stein, Neil

    2012-01-01

    There is a lack of information concerning adults with autism spectrum disorder (ASD), especially with regards to their access to health care. A paper and electronic survey was sent to 1,580 primary care physicians in Connecticut. 346 respondents returned a survey and provided care to adults with an ASD. This physician survey provides data on…

  7. Income in Adult Survivors of Childhood Cancer.

    OpenAIRE

    Wengenroth, Laura; Sommer, Grit; Schindler, Matthias, 1968-; Spycher, Ben D.; von der Weid, Nicolas X.; Stutz-Grunder, Eveline; Michel, Gisela; Kuehni, Claudia E.

    2016-01-01

    INTRODUCTION Little is known about the impact of childhood cancer on the personal income of survivors. We compared income between survivors and siblings, and determined factors associated with income. METHODS As part of the Swiss Childhood Cancer Survivor Study (SCCSS), a questionnaire was sent to survivors, aged ≥18 years, registered in the Swiss Childhood Cancer Registry (SCCR), diagnosed at age

  8. Quality indicators in breast cancer care.

    Science.gov (United States)

    Del Turco, M Rosselli; Ponti, A; Bick, U; Biganzoli, L; Cserni, G; Cutuli, B; Decker, T; Dietel, M; Gentilini, O; Kuehn, T; Mano, M P; Mantellini, P; Marotti, L; Poortmans, P; Rank, F; Roe, H; Scaffidi, E; van der Hage, J A; Viale, G; Wells, C; Welnicka-Jaskiewicz, M; Wengstöm, Y; Cataliotti, L

    2010-09-01

    To define a set of quality indicators that should be routinely measured and evaluated to confirm that the clinical outcome reaches the requested standards, Eusoma has organised a workshop during which twenty four experts from different disciplines have reviewed the international literature and selected the main process and outcome indicators available for quality assurance of breast cancer care. A review of the literature for evidence-based recommendations have been performed by the steering committee. The experts have identified the quality indicators also taking into account the usability and feasibility. For each of them it has been reported: definition, minimum and target standard, motivation for selection and level of evidence (graded according to AHRO). In overall 17 main quality indicators have been identified, respectively, 7 on diagnosis, 4 on surgery and loco-regional treatment, 2 on systemic treatment and 4 on staging, counselling, follow-up and rehabilitation. Breast Units in Europe are invited to comply with these indicators and monitor them during their periodic audit meetings. PMID:20675120

  9. Corruption in health-care systems and its effect on cancer care in Africa.

    Science.gov (United States)

    Mostert, Saskia; Njuguna, Festus; Olbara, Gilbert; Sindano, Solomon; Sitaresmi, Mei Neni; Supriyadi, Eddy; Kaspers, Gertjan

    2015-08-01

    At the government, hospital, and health-care provider level, corruption plays a major role in health-care systems in Africa. The returns on health investments of international financial institutions, health organisations, and donors might be very low when mismanagement and dysfunctional structures of health-care systems are not addressed. More funding might even aggravate corruption. We discuss corruption and its effects on cancer care within the African health-care system in a sociocultural context. The contribution of high-income countries in stimulating corruption is also described. Corrupt African governments cannot be expected to take the initiative to eradicate corruption. Therefore, international financial institutions, health organisations, and financial donors should use their power to demand policy reforms of health-care systems in Africa troubled by the issue of corruption. These modifications will ameliorate the access and quality of cancer care for patients across the continent, and ultimately improve the outcome of health care to all patients. PMID:26248847

  10. Advance Care Planning and Goals of Care Communication in Older Adults with Cardiovascular Disease and Multi-Morbidity.

    Science.gov (United States)

    Lum, Hillary D; Sudore, Rebecca L

    2016-05-01

    This article provides an approach to advance care planning (ACP) and goals of care communication in older adults with cardiovascular disease and multi-morbidity. The goal of ACP is to ensure that the medical care patients receive is aligned with their values and preferences. In this article, the authors outline common benefits and challenges to ACP for older adults with cardiovascular disease and multimorbidity. Recognizing that these patients experience diverse disease trajectories and receive care in multiple health care settings, the authors provide practical steps for multidisciplinary teams to integrate ACP into brief clinic encounters. PMID:27113144

  11. High rates of unsuccessful transfer to adult care among young adults with juvenile idiopathic arthritis

    Directory of Open Access Journals (Sweden)

    Duffy Ciarán M

    2010-01-01

    Full Text Available Abstract Background This study aimed to describe the proportion of patients with juvenile idiopathic arthritis (JIA who had experienced an unsuccessful transfer from a pediatric rheumatology team to an adult rheumatologist and to compare the characteristics of those who achieved successful transfer to those who did not. Methods We conducted a systematic chart review of all patients with JIA who attended their final Montreal Children's Hospital JIA clinic appointment between 1992 and 2005. We tracked these patients for the two years after transfer to an adult rheumatologist. We then compared characteristics of patients with successful and unsuccessful transfers of care. Variables pertaining to disease characteristics, disease severity and psychosocial factors were examined. Univariate analyses were performed to determine if any single factor was associated with the outcome of unsuccessful transfer of care. Results 52% of patients fulfilled our criteria for unsuccessful transfer. Of the variables tested, an active joint count (AJC of zero at last visit was associated with the outcome of unsuccessful transfer (OR = 2.67 (CI 1.16-6.16; p = 0.0199. Conclusions Despite the presence of a coordinated process of transfer from pediatric to adult health care for the majority of the patients in this study, there was a high rate of unsuccessful transfer and/or sustained follow up which is disheartening. We found that patients with less active disease at the time of transfer, as indicated by a lower AJC, were more likely to be lost to follow up. Recent literature suggests that even in the least severe categories of JIA, 50% of patients persist with active disease into adulthood. Thus educating all JIA patients about the possibility of disease flare in adulthood may improve their adherence to recommendations for sustained follow-up in the adult milieu. This may lead to improvement of longitudinal outcomes for all JIA patients.

  12. 76 FR 44573 - Child and Adult Care Food Program: National Average Payment Rates, Day Care Home Food Service...

    Science.gov (United States)

    2011-07-26

    ... Food and Nutrition Service Child and Adult Care Food Program: National Average Payment Rates, Day Care Home Food Service Payment Rates, and Administrative Reimbursement Rates for Sponsoring Organizations of Day Care Homes for the Period July 1, 2011 Through June 30, 2012 Correction In notice document...

  13. Breast cancer in adolescent and young adult women.

    Science.gov (United States)

    Gewefel, Hanan; Salhia, Bodour

    2014-12-01

    Breast cancer is one of the most frequently diagnosed malignancy among adolescent and young adult (AYA) women, accounting for approximately 14% of all AYA cancer diagnoses and 7% of all breast cancer. Breast cancer in AYA women is believed to represent a more biologically aggressive disease, but aside from commonly known hereditary predispositions, little is still known about the underlying molecular genetic causes. This review examines the current trends of breast cancer in AYA women as they relate to clinical, social, genetic, and molecular pathologic characteristics. We highlight existing trends, treatment and imaging approaches, and health burdens as they relate to breast cancer in AYA women and provide a discussion on ways to help improve the overall management of this breast cancer cohort. PMID:25034440

  14. PRIMARY PALLIATIVE CARE? - Treating terminally ill cancer patients in the primary care sector

    DEFF Research Database (Denmark)

    Neergaard, Mette Asbjørn; Jensen, Anders Bonde; Olesen, Frede;

    BACKGROUND. Palliative care for cancer patients is an important part of a GP's work. Although every GP is frequently involved in care for terminally ill cancer patients, only little is known about how these palliative efforts are perceived by the patients and their families, a knowledge that is...... vital to further improve palliative care in the primary sector.AIM. The aim of the study was to analyse the quality of palliative home care with focus on the GP's role based on evaluations by relatives of recently deceased cancer patients and professionals from both the primary and secondary health care...... sectors.METHOD. A number of focus group interviews were conducted with three types of subgroups: 1) Bereaved relatives, 2) GPs and 3) Various health-care-professionals, namely community nurses, hospital physicians and GPs. The interviews were transcribed and analysed according to a phenomenological...

  15. Hospital-based home care for children with cancer

    DEFF Research Database (Denmark)

    Hansson, Eva Helena; Kjaergaard, Hanne; Johansen, Christoffer;

    2013-01-01

    BACKGROUND: To assess the feasibility and psychosocial impact of a hospital-based home care (HBHC) program for children with cancer. PROCEDURE: A HBHC program was carried out with 51 children (0-18 years) with cancer to assess its feasibility in terms of satisfaction, care preferences, safety, and...... home-care group. No significant difference was found in the Family Impact Module. CONCLUSION: This study indicates that HBHC is a feasible alternative to hospital care for children with cancer, and is greatly preferred by parents. Specific aspects of children's HRQOL may be improved with HBHC and the...... cost. A controlled trial was conducted to assess children's health-related quality of life (HRQOL) using the parent-reported and self-reported PedsQL Generic Core Scale and PedsQL Cancer Module, and the psychosocial impact on the family by PedsQL Family Impact Module comprising a subsample of 28...

  16. Impact of Chronic Conditions on the Cost of Cancer Care...

    Data.gov (United States)

    U.S. Department of Health & Human Services — According to findings reported in Impact of Chronic Conditions on the Cost of Cancer Care for Medicaid Beneficiaries, published in Volume 2, Issue 4 of the Medicare...

  17. Assessing Patient-Centered Communication in Cancer Care: Stakeholder Perspectives

    OpenAIRE

    Mazor, Kathleen M.; Gaglio, Bridget; Nekhlyudov, Larissa; Alexander, Gwen L.; Stark, Azadeh; Hornbrook, Mark C.; Walsh, Kathleen; Boggs, Jennifer; Lemay, Celeste A.; Firneno, Cassandra; Biggins, Colleen; Blosky, Mary Ann; Arora, Neeraj K.

    2013-01-01

    Patient reports of their communication experiences during cancer care could increase understanding of the communication process, stimulate improvements, inform interventions, and provide a basis for evaluating changes in communication practices.

  18. ASCO Task Force on the Cost of Cancer Care

    OpenAIRE

    Schnipper, Lowell E.

    2009-01-01

    The United States leads the world in cancer care outcomes, but the cost is extremely high—and growing rapidly. New proposals for health reform emphasize one clear and immediate need: to control runaway cost.

  19. Radiotherapy in Palliative Cancer Care: Development and Implementation

    International Nuclear Information System (INIS)

    It is estimated that in 2008 there were over 12 million new cancer diagnoses and 7 million cancer deaths worldwide. The World Health Organisation (WHO) predicts that cancer rates will increase from 10 million to 24 million in the next 50 years. More than half of cancer cases will be diagnosed in low income nations, where 80% or more of patients will have incurable disease at diagnosis. In situations where most patients are diagnosed with incurable disease or where curative treatment is logistically unavailable, as is the case in many low income countries, the allocation of limited health care resources should reflect a greater emphasis on palliative care. Ironically, access to palliative care is greater in health care systems with well developed infrastructures and facilities for prevention, early detection, and curative treatment of cancer. To provide comprehensive cancer care, a multidisciplinary approach is needed. This maximizes the available treatments and interventions, whilst ensuring a cost effective and ethically sound approach to the treatment of patients at each stage of the disease. Barriers to palliative care may result from its low prioritization in health care policy and education. The WHO expert committee on cancer pain and palliative care report of 1990 called for the integration of efforts directed at maintaining patient quality of life through all stages of cancer treatment. As a result supportive interventions aimed at improving quality of life are needed for patients undergoing both curative and palliative cancer treatment. The International Atomic Energy Agency is currently collaborating with the Open Society Institute to develop palliative care programmes in Eastern Europe, Africa and India, as well as supporting programmes in other regions of the world, through the International Palliative Care Initiative. OSI partners with the IAEA's Programme of Action for Cancer Therapy, the World Health Organization, the International Agency for Research

  20. Peculiarities of Anxiety Score Distribution in Adult Cancer Patients.

    Science.gov (United States)

    Blank, Mikhail; Blank, Olga; Myasnikova, Ekaterina; Denisova, Daria

    2015-01-01

    The goal of the present research is to investigate and analyze possible peculiarities of the psychological state of cancer patients undergoing treatment. Scores characterizing the trait and state anxiety were acquired using the Integrative Anxiety Test from four groups: adults with no appreciable disease, pregnant women, cancer patients examined during the specific antitumor treatment, and cancer patients brought into lasting clinical remission. Statistical analysis of the testing results revealed the bimodal type of the distribution of scores. The only statistically significant exception was the distribution of the state anxiety scores in cancer patients undergoing treatment that was clearly unimodal. PMID:26176239

  1. Screening methods of ovarian cancer in adults

    Directory of Open Access Journals (Sweden)

    Milenković Vera

    2005-01-01

    Full Text Available Ovarian cancer is associated with high mortality rate which has improved a little despite therapeutic advances. It causes more deaths than combined cervical and uterine cancer. High mortality is believed to be a direct result of already advanced stage at the time of diagnosis. Survival is excellent in case of early stage disease but poor in late stage disease, regardless of histology. The goal of screening for ovarian cancer is restricted to detection of asymptomatic early stage disease, as precursor lesions of ovarian cancer have not been identified. At present, there is no reliable method of ovarian cancer screening which has been shown to reduce mortality from ovarian cancer. Therefore, routine screening of women in general population can not be currently advised. Screening should be limited to high-risk population and subjects participating in research projects as long as the results of current studies are available.

  2. Quality of Care in Women With Stage I Cervical Cancer

    OpenAIRE

    Chu, Joseph; Polissar, Lincoln; Tamimi, Hisham K.

    1982-01-01

    A study was done to assess the quality of care received by women with stage I cervical cancer. Through a population-based registry serving 13 counties of western Washington, including Seattle, we identified all women residents in whom local-stage cervical cancer developed between January 1974 and December 1978 (N=369). The cases were subdivided into stage IA (microinvasive) and stage IB (frankly invasive). Quality of care was defined as optimal or suboptimal at the outset of the study; this d...

  3. What is New in Supportive Care in Cancer?

    OpenAIRE

    Wang, Qi; Li, Wen; Wang, Yong-chuan

    2010-01-01

    The Annual Symposium of the Multinational Association of Supportive Care in Cancer (MASCC)/International Society of Oral Oncology (ISOO) was held in Vancouver, Canada, June 24-26, 2010. The symposium brought together health care professionals from many countries and many fields of expertise for an excellent forum of ideas, lectures and collegial interactions, and discussed methods to minimize cancer-induced side effects, the symptoms and complications of its treatment, and psychosocial issues...

  4. Stomach cancer screening in the adult health study population

    International Nuclear Information System (INIS)

    Examinations for parietal cell antibody (PCA) were performed on 1334 subjects of the Adult Health Study (AHS), Hiroshima, during a 1-year period. Findings revealed PCA in 112 subjects (8.4%), but no difference in frequency was noted by sex. The relationship of PCA to age showed the positive rate to be significantly higher in those age 50 or over than in those under 50. No correlation was noted between estimated A-bomb exposure dose and PCA frequency. PCA was found in 58 (11.6%) of the 502 cases presenting achlorhydria on tubeless gastric analysis, and particularly in the age 50 and over group, PCA was demonstrated in 43 (14.2%) of the 302 subjects presenting achlorhydria, which is a significant difference compared with the under 50 age group in which PCA was demonstrated in 15 (7.5%) of 200 such subjects. PCA was detected in 11 (7.2%) of 152 subjects with abnormal, or low, serum pepsinogen levels and in 20 (16.3%) of 123 subjects with high levels. The frequency of positive PCA was higher in patients diagnosed on upper gastrointestinal (GI) series as atrophic gastritis than in patients diagnosed as some other gastric disorder. PCA was negative in both of the two cases in whom a definite diagnosis of stomach cancer was established. However, in light of the finding of abnormal Diagnex Blue (DB) tests and positive PCA at a high frequency in the gastritis group and reports that gastritis provides the groundwork for stomach cancer, it is considered that care should be taken in cases with findings of abnormal DB test, abnormal serum pepsinogen levels, and positive PCA. (author)

  5. Bioética e nutrição em cuidados paliativos oncológicos em adultos Bioethics and nutrition in adult patients with cancer in palliative care

    Directory of Open Access Journals (Sweden)

    Monica de Oliveira Benarroz

    2009-09-01

    Full Text Available O câncer vem se destacando entre as doenças crônicas, sendo a segunda causa de morte em países desenvolvidos. Os cuidados paliativos se propõem a oferecer cuidados de suporte global, visando ao controle de sintomas e à melhora da qualidade de vida dos pacientes e de seus familiares. A nutrição é uma ferramenta importante nos cuidados paliativos, podendo ajudar o paciente nos aspectos físico, psicológico e social, além de promover o bem-estar e a qualidade de vida. Entretanto, a nutrição raramente poderá cumprir seu papel de recuperar e garantir o estado nutricional. Nesse momento, a intervenção do nutricionista é considerar as necessidades do indivíduo, preferências e hábitos alimentares, fundamentais tanto para o controle dos sintomas, quanto para garantir satisfação e conforto. A impossibilidade do exercício convencional das condutas já estabelecidas e o desenvolvimento de uma nova percepção do doente muitas vezes produzem dilemas para o profissional nutricionista.Cancer constitutes a major group of chronic diseases and is the second leading cause of death in the developed countries. Palliative care proposes to offer comprehensive support to control symptoms and improve quality of life for patients and their families. Nutrition is an important tool in palliative care, helping patients with their physical, psychological, and social issues and promoting comfort and quality of life. However, in the context of palliative care, nutritional support rarely achieves its role of fully recovering and assuring nutritional status. At this point, the nutritionist must consider the individual patient's needs, preferences, and eating habits, which are essential both for controlling symptoms and assuring satisfaction and comfort. The impossibility of conventionally applying established management and the development of a new perception of the patient often raise dilemmas for professional nutritionists.

  6. Linguistic Stereotyping in Older Adults' Perceptions of Health Care Aides.

    Science.gov (United States)

    Rubin, Donald; Coles, Valerie Berenice; Barnett, Joshua Trey

    2016-07-01

    The cultural and linguistic diversity of the U.S. health care provider workforce is expanding. Diversity among health care personnel such as paraprofessional health care assistants (HCAs)-many of whom are immigrants-means that intimate, high-stakes cross-cultural and cross-linguistic contact characterizes many health interactions. In particular, nonmainstream HCAs may face negative patient expectations because of patients' language stereotypes. In other contexts, reverse linguistic stereotyping has been shown to result in negative speaker evaluations and even reduced listening comprehension quite independently of the actual language performance of the speaker. The present study extends the language and attitude paradigm to older adults' perceptions of HCAs. Listeners heard the identical speaker of Standard American English as they watched interactions between an HCA and an older patient. Ethnolinguistic identities-either an Anglo native speaker of English or a Mexican nonnative speaker-were ascribed to HCAs by means of fabricated personnel files. Dependent variables included measures of perceived HCA language proficiency, personal characteristics, and professional competence, as well as listeners' comprehension of a health message delivered by the putative HCA. For most of these outcomes, moderate effect sizes were found such that the HCA with an ascribed Anglo identity-relative to the Mexican guise-was judged more proficient in English, socially superior, interpersonally more attractive, more dynamic, and a more satisfactory home health aide. No difference in listening comprehension emerged, but the Anglo guise tended to engender a more compliant listening mind set. Results of this study can inform both provider-directed and patient-directed efforts to improve health care services for members of all linguistic and cultural groups. PMID:26606170

  7. Caring for a parent with lung cancer: caregivers' perspectives on the role of communication.

    Science.gov (United States)

    Stone, Anne M; Mikucki-Enyart, Sylvia; Middleton, Ashley; Caughlin, John P; Brown, Laura E

    2012-07-01

    We investigated communication and care in the context of lung cancer through qualitative interviews with 35 adult children. Participants described two core influences on communication: situational and relational influences. Participants also suggested that the ways in which support was communicated impacted how they managed challenges and how they were able to cope with the loss of their parent. This research adds to the literature on caregiving and communicating social support by exploring the experiences of families coping with lung cancer. We suggest theoretical and practical implications for the ways family members might communicate about illness. PMID:22645222

  8. Patterns of cancer occurrence in a tertiary care centre

    OpenAIRE

    Atla Bhagyalakshmi; Anem Venkatalakshmi; Regidi Subhash; Seeram Satish kumar

    2016-01-01

    Background: This study is an attempt to know the incidence of cancer in a tertiary care centre. Statistics for all newly diagnosed cancer cases by correlation with factors like age, gender and organ systems involved with complete histopathological evaluation is presented. Emphasis is given to segregating each cancer and grouping them into their respective order for statistical analysis. Objectives of the study was to conduct a prospective statistical analysis, computing and comparing rates,...

  9. Care of Adults With Intellectual and Developmental Disabilities: Cerebral Palsy.

    Science.gov (United States)

    Jones, Kyle Bradford; Wilson, Benjamin; Weedon, Dean; Bilder, Deborah

    2015-12-01

    Cerebral palsy (CP) is a group of disorders that primarily affect motor function. This developmental disability is becoming more common in adults as life expectancy increases for individuals with CP. Many physical, medical, mental, and behavioral health conditions are associated with CP, and assistance should be provided to patients with CP to optimize function, when available. These comorbidities include intellectual disabilities, seizures, muscle contractures, abnormal gait, osteoporosis, communication disorders, malnutrition, sleep disorders, and mental health disorders, such as depression and anxiety. The physician should be familiar with screening for and assisting patients with these issues. Optimizing quality of life requires individualized care plans that may include physical therapy, muscle relaxants, surgery, and nutritional support. Other issues to be addressed include methods to facilitate employment; sexual concerns; and support through local and national organizations for patients, families, and caregivers. PMID:26669212

  10. The global state of palliative care-progress and challenges in cancer care.

    Science.gov (United States)

    Reville, Barbara; Foxwell, Anessa M

    2014-07-01

    All persons have a right to palliative care during cancer treatment and at the end-of-life. The World Health Organization (WHO) defines palliative care as a medical specialty that addresses physical, psychological, social, legal, and spiritual domains of care by an interdisciplinary team of professional and lay health care providers. Widespread adoption of this universal definition will aid policy development and educational initiatives on a national level. The need for palliative care is expanding due to the aging of the world's population and the increase in the rate of cancer in both developed and developing countries. However, in one third of the world there is no access to palliative care for persons with serious or terminal illness. Palliative care improves symptoms, most frequently pain, and improves quality of life for patients and their families, especially in the terminal disease phase. Accessibility to palliative care services, adequately trained health care professionals, availability of essential medicines, and gaps in education vary greatly throughout the world. Pain management is an integral concept in the practice of palliative care; however, opioiphobia, insufficient supply of opioids, and regulatory restrictions contribute to undue suffering for millions. Ongoing advocacy efforts call for increased awareness, palliative care integration with cancer care, and public and professional education. Enacting necessary change will require the engagement of health ministries and the recognition of the unique needs and resources of each country. The aim of this review is to examine progress in palliative care development and explore some of the barriers influencing cancer care across the globe. PMID:25841689

  11. Palliative care -- an essential component of cancer control

    OpenAIRE

    Macdonald, N.

    1998-01-01

    Unlike in other nations, in Canada palliative care has its origins in university hospitals. It has subsequently developed in a few Canadian schools as an academic discipline closely linked with oncology programs. Although this model is successful, other faculties of medicine and cancer centres have been slow to emulate it. Today, the situation is rapidly changing, and both palliative care and oncology professionals are re-examining the manifest need for collaborative efforts in patient care, ...

  12. Occupational Causes of Testicular Cancer in Adults

    Directory of Open Access Journals (Sweden)

    L Fritschi

    2010-09-01

    Full Text Available Testicular cancer is one of the commonest cancers in men of working age, and is increasing in incidence in Europe and North America. One suggested mechanism of causation is that there is impaired differentiation of germ cells in the pre- or perinatal period, followed by malignant transformation in later life, possibly by a hormonal mechanism. Endocrine disrupting chemicals (EDCs have been a major focus of interest for etiological research into testicular cancer because they interact with various hormonal pathways. Several EDCs including bisphenol A, phthalates, metals, polychlorinated biphenyls, and organochlorines have been investigated, but there are few studies and those that exist have not been able to assess exposure well. In addition, several studies, particularly those with better exposure assessment, have suggested that workers in electrical occupations have increased risks of testicular cancer. Electromagnetic radiation may have subthermal effects or may disrupt hormone release. Chronodisruption such as due to shift-work could potentially increase the risk of testicular cancer via disruption of hormonal cycles, but only one study has so far investigated this possibility. Lastly, solvent exposure, particularly to dimethylformamide, has been suggested to be associated with testicular cancer, but almost all these studies are based on job title only, with no specific assessment of solvent exposure. In conclusion, there is little evidence available on which to base definitive statements about occupational causes of testicular cancer. Future studies need to improve exposure assessment and develop ways to adjust for possible prenatal factors.

  13. Risk of thyroid cancer, brain cancer, and non-Hodgkin lymphoma after adult leukemia

    DEFF Research Database (Denmark)

    Nielsen, Sune F; Bojesen, Stig E; Birgens, Henrik S;

    2011-01-01

    Patients with childhood leukemia surviving into adulthood have elevated risk of developing thyroid cancer, brain cancer, and non-Hodgkin lymphoma (NHL); these risks cannot automatically be extrapolated to patients surviving adult leukemia. We tested whether survivors of adult leukemia are at...... increased risk of developing thyroid cancer, brain cancer, and NHL. We included the entire adult Danish population (14 years of age or older), in a 28-year follow-up period from 1980 through 2007, composed of 6 542 639 persons; during this period, 18 834 developed adult leukemia, 4561 developed thyroid.......2-3.1) for brain cancer, and 3.3 (95% CI, 2.5-4.4) for NHL. Corresponding hazard ratios after childhood leukemia were 10.4 (95% CI, 0.4-223) for thyroid cancer, 7.2 (95% CI, 2.0-26) for brain cancer, and 6.5 (95% CI, 0.4-110) for NHL. Patients with adult leukemia have excess risk of thyroid cancer, brain...

  14. Integrating Palliative Care Into the Care of Patients With Advanced Lung Cancer.

    Science.gov (United States)

    Kapo, Jennifer M; Akgün, Kathleen M

    2015-01-01

    Lung cancer is the leading cause of death due to malignancy. Although lung cancer mortality has been decreasing in recent years, it remains substantially higher than other causes of cancer death. Median survival for patients with locally advanced non-small cell lung cancer, defined as lung cancer involving regional lymph nodes, is estimated to be approximately 10 to 17 months, and median survival for patients with metastatic disease is only 6 to 9 months. In addition, patients with advanced lung cancer often experience debilitating symptoms and poor quality of life. Pain, dyspnea, and fatigue are most frequently reported and affect at least 65% of patients with advanced lung cancer. Given this burden of symptoms and high mortality, patients and their families facing a diagnosis of advanced lung cancer are in need of support. Palliative care, with its focus on addressing the emotional, physical, and spiritual sources of suffering utilizing the expertise of an interdisciplinary team, can provide this comprehensive support. This review describes the role of supportive and palliative care integrated into the treatment of patients with a diagnosis of advanced lung cancer with sections focused on the evaluation and treatment of pain and dyspnea, approaches to challenging communication tasks, and the support of caregivers who care for patients with advanced lung cancer. PMID:26389769

  15. Delivering affordable cancer care in high-income countries.

    Science.gov (United States)

    Sullivan, Richard; Peppercorn, Jeffrey; Sikora, Karol; Zalcberg, John; Meropol, Neal J; Amir, Eitan; Khayat, David; Boyle, Peter; Autier, Philippe; Tannock, Ian F; Fojo, Tito; Siderov, Jim; Williamson, Steve; Camporesi, Silvia; McVie, J Gordon; Purushotham, Arnie D; Naredi, Peter; Eggermont, Alexander; Brennan, Murray F; Steinberg, Michael L; De Ridder, Mark; McCloskey, Susan A; Verellen, Dirk; Roberts, Terence; Storme, Guy; Hicks, Rodney J; Ell, Peter J; Hirsch, Bradford R; Carbone, David P; Schulman, Kevin A; Catchpole, Paul; Taylor, David; Geissler, Jan; Brinker, Nancy G; Meltzer, David; Kerr, David; Aapro, Matti

    2011-09-01

    The burden of cancer is growing, and the disease is becoming a major economic expenditure for all developed countries. In 2008, the worldwide cost of cancer due to premature death and disability (not including direct medical costs) was estimated to be US$895 billion. This is not simply due to an increase in absolute numbers, but also the rate of increase of expenditure on cancer. What are the drivers and solutions to the so-called cancer-cost curve in developed countries? How are we going to afford to deliver high quality and equitable care? Here, expert opinion from health-care professionals, policy makers, and cancer survivors has been gathered to address the barriers and solutions to delivering affordable cancer care. Although many of the drivers and themes are specific to a particular field-eg, the huge development costs for cancer medicines-there is strong concordance running through each contribution. Several drivers of cost, such as over-use, rapid expansion, and shortening life cycles of cancer technologies (such as medicines and imaging modalities), and the lack of suitable clinical research and integrated health economic studies, have converged with more defensive medical practice, a less informed regulatory system, a lack of evidence-based sociopolitical debate, and a declining degree of fairness for all patients with cancer. Urgent solutions range from re-engineering of the macroeconomic basis of cancer costs (eg, value-based approaches to bend the cost curve and allow cost-saving technologies), greater education of policy makers, and an informed and transparent regulatory system. A radical shift in cancer policy is also required. Political toleration of unfairness in access to affordable cancer treatment is unacceptable. The cancer profession and industry should take responsibility and not accept a substandard evidence base and an ethos of very small benefit at whatever cost; rather, we need delivery of fair prices and real value from new technologies

  16. Hospital-based home care for children with cancer

    DEFF Research Database (Denmark)

    Hansson, Eva Helena; Kjaergaard, H; Schmiegelow, K;

    2012-01-01

    The study aims to describe the experiences of a hospital-based home care programme in the families of children with cancer. Fourteen parents, representing 10 families, were interviewed about their experiences of a hospital-based home care programme during a 4-month period in 2009 at a university...... decreased the strain on the family and the ill child, maintained normality and an ordinary everyday life and fulfilled the need for safety and security. According to family members of children with cancer, hospital-based home care support enhanced their quality of life during the child's cancer trajectory...... hospital in Denmark. Five children participated in all or part of the interview. The interviews were transcribed verbatim and analysed using qualitative content analysis. The findings indicate that hospital-based home care enabled the families to remain intact throughout the course of treatment, as it...

  17. Self-assessment in cancer patients referred to palliative care

    DEFF Research Database (Denmark)

    Strömgren, Annette S; Goldschmidt, Dorthe; Groenvold, Mogens;

    2002-01-01

    -based study using the European Organization for Research and Treatment of Cancer quality-of-life instrument EORTC QLQ-C30, the Edmonton Symptom Assessment System (ESAS), and the Hospital Anxiety and Depression Scale (HADS) in cancer patients who were receiving palliative care. This report describes the......-based study of symptomatology in consecutive cancer patients in palliative care, achieving rather complete data from the participants. The symptomatology in these patients was very pronounced. The questionnaires were able to detect clinically important differences between places of service.......BACKGROUND: Research in palliative care is considered difficult due to the poor health of patients. However, patient-provided data are essential for a thorough description of patient symptomatology and for the evaluation of care. METHODS: The authors examined the feasibility of a questionnaire...

  18. Video-, audio-, and computer-mediated education of patients and relatives in gynecologic cancer care

    DEFF Research Database (Denmark)

    Thygesen, Marianne Kirstine; Nicolaisen, Anne; Mogensen, Ole

    2015-01-01

    BACKGROUND:: Cancer patients can often experience emotional distress, and gynecologic cancer patients may be among the most distressed. As hospital stays become shorter, nurses are challenged to educate patients and relatives adequately. The use of computer-based technologies may alleviate the...... situation. OBJECTIVE:: This article aims to review the literature related to the use of audio-, visual-, or computer-based technologies to support healthcare professional training of adult female patients and their close relatives in gynecologic cancer care. We describe to what extent these technologies...... were found to be effective and evaluate clinical implications. METHODS:: PubMed, EMBASE and PsycINFO via Ovid, CINAHL via EBSCO, and the Cochrane Library were searched, and 4177 unique references were examined. All studies evaluating healthcare professional training of women with gynecologic cancer and...

  19. Inequalities in the care experiences of patients with cancer: analysis of data from the National Cancer Patient Experience Survey 2011–2012

    Science.gov (United States)

    Bone, Anna; Mc Grath-Lone, Louise; Day, Sophie; Ward, Helen

    2014-01-01

    Objectives To explore inequalities in the care experiences of care by patients clinical or trust-level factors for patients with cancer. Design Secondary analysis of data from the National Cancer Patient Experience Survey 2011–2012. Setting and participants Adult patients with a primary diagnosis of cancer who attended an acute or specialist National Health Service (NHS) trust in England. Outcome measure OR of a patient rating their overall care positively, adjusting for other patient, clinical and trust-level factors. Methods Using cross-sectional data from 71 793 patients with cancer who completed the National Cancer Patient Experience Survey 2011–2012, we examined associations between patient, clinical and trust-level factors and a summary measure of patient experience, namely overall rating of care. Multivariate logistic regression was used to investigate variation by sociodemographic characteristics adjusting for other patient, clinical and trust-level factors. Results Female, non-white and younger patients were less likely to rate their overall care as excellent or very good. Patients with long-standing conditions, particularly those with learning disabilities or mental health conditions, also reported poorer overall care. This variation persisted when other patient, clinical and trust-level factors were controlled for, indicating that there are real differences in experiences among patients with cancer by sociodemographic characteristics. Conclusions There is evidence of inequalities in the experiences of patients with cancer in the UK by sociodemographic characteristics such as gender, age, ethnicity and disability. Quality cancer care services must strive to meet the needs of a diverse patient population equally; this study identifies patient groups for whom it appears cancer care services are in greatest need of improvement. PMID:24531454

  20. Transition experiences and health care utilization among young adults with type 1 diabetes

    Directory of Open Access Journals (Sweden)

    Garvey KC

    2013-08-01

    Full Text Available Katharine C Garvey,1 Jonathan A Finkelstein,2,3 Lori M Laffel,1,4 Victoria Ochoa,1 Joseph I Wolfsdorf,1 Erinn T Rhodes1 1Division of Endocrinology, Boston Children's Hospital, 2Division of General Pediatrics, Boston Children's Hospital, 3Department of Population Medicine, Harvard Pilgrim Health Care Institute, 4Pediatric, Adolescent and Young Adult Section, Joslin Diabetes Center, Boston, MA, USA Background: The purpose of this study was to describe the current status of adult diabetes care in young adults with type 1 diabetes and examine associations between health care transition experiences and care utilization. Methods: We developed a survey to assess transition characteristics and current care in young adults with type 1 diabetes. We mailed the survey to the last known address of young adults who had previously received diabetes care at a tertiary pediatric center. Results: Of 291 surveys sent, 83 (29% were undeliverable and three (1% were ineligible. Of 205 surveys delivered, 65 were returned (response rate 32%. Respondents (mean age 26.6 ± 3.0 years, 54% male, 91% Caucasian transitioned to adult diabetes care at a mean age of 19.2 ± 2.8 years. Although 71% felt mostly/completely prepared for transition, only half received recommendations for a specific adult provider. Twenty-six percent reported gaps exceeding six months between pediatric and adult diabetes care. Respondents who made fewer than three diabetes visits in the year prior to transition (odds ratio [OR] 4.5, 95% confidence interval [CI] 1.2–16.5 or cited moving/relocation as the most important reason for transition (OR 6.3, 95% CI 1.3–31.5 were more likely to report gaps in care exceeding six months. Patients receiving current care from an adult endocrinologist (79% were more likely to report at least two diabetes visits in the past year (OR 6.0, 95% CI 1.5–24.0 compared with those receiving diabetes care from a general internist/adult primary care doctor (17%. Two

  1. Lung Cancer Care Before and After Medicare Eligibility.

    Science.gov (United States)

    Huesch, Marco D; Ong, Michael K

    2016-01-01

    Uninsured and underinsured near-elderly may not have timely investigation, diagnosis, or care of cancer. Prior studies suggest Medicare eligibility confers significant and substantial reductions in mortality and increases in health service utilization. We compared 2245 patients diagnosed with lung cancer at ages 64.5 to 65 years and 2512 patients aged 65 to 65.5 years, with 2492 patients aged 65.5 to 66 years (controls) in 2000 to 2005. Compared with controls, patients diagnosed with lung cancer before Medicare eligibility had no statistically significant differences in cancer stage, time to treatment, type of treatment, and survival. Study power was sufficient to exclude mortality reductions and health service utilization changes of the magnitude found in prior work, suggesting that typically, appropriate lung cancer care may be sought and delivered regardless of insurance status. PMID:27166413

  2. Separate and Cumulative Effects of Adverse Childhood Experiences in Predicting Adult Health and Health Care Utilization

    Science.gov (United States)

    Chartier, Mariette J.; Walker, John R.; Naimark, Barbara

    2010-01-01

    Objectives: Objectives of this population-based study were: (1) to examine the relative contribution of childhood abuse and other adverse childhood experiences to poor adult health and increased health care utilization and (2) to examine the cumulative effects of adverse childhood experiences on adult health and health care utilization. Methods:…

  3. Occupational Therapy for Adults With Cancer: Why It Matters.

    Science.gov (United States)

    Pergolotti, Mackenzi; Williams, Grant R; Campbell, Claudine; Munoz, Lauro A; Muss, Hyman B

    2016-03-01

    Adults with cancer may be at risk for limitations in functional status and quality of life (QOL). Occupational therapy is a supportive service with the specific mission to help people functionally engage in life as safely and independently as possible with the primary goal of improving QOL. Unfortunately, for people with cancer, occupational therapy remains underused. The overall purpose of this review is to provide an understanding of what occupational therapy is and its relevance to patients with cancer, highlight the reasons to refer, and, last, provide general advice on how to access services. PMID:26865588

  4. Critical care issues in cervical cancer management.

    Science.gov (United States)

    Mirhashemi, R; Janicek, M F; Schoell, W M

    1999-01-01

    Radical pelvic surgery in gynecologic oncology patients poses a challenge to the surgeon and the ancillary team in charge of the peri-operative care. The high frequency of medical problems observed in this patient population, in conjunction with the stresses of radical surgery, necessitates careful monitoring of patients' medical status. A comprehensive team approach in the perioperative period is critical to patient care. Early intervention and anticipation of potential problems for the patient at risk in the postoperative period minimizes morbidity and mortality. This article will review the essentials of critical care as it relates to patients undergoing radical pelvic operations. PMID:10225307

  5. Measuring quality of care for colorectal cancer care: comprehensive feedback driving quality improvement

    OpenAIRE

    Kolfschoten, Nicoline Elisabeth

    2015-01-01

    Data from clinical audits such as the Dutch Surgical Colorectal Audit, can be used for valid and meaningful feedback information, which may support improvement of quality of care. First, we showed that the continuous feedback cycle of clinical auditing has an autonomous, positive effect on the quality of surgical care. Second, we describe how data from clinical audits can be used to monitor and improve national practice and performance in colorectal cancer care, especially for high-risk patie...

  6. Caring and uncaring encounters within nursing and health care from the cancer patient's perspective.

    Science.gov (United States)

    Halldórsdóttir, S; Hamrin, E

    1997-04-01

    The aim of this phenomenological study was to explore caring and uncaring encounters with nurses and other health professionals from the perspective of the person who has been diagnosed and treated for cancer. Through thematic analysis of in-depth dialogues with five women and four men in the remission or recovery phase of cancer, three major categories regarding caring and uncaring encounters were identified. The essential structure of a caring encounter was found to be threefold: 1. the nurse/health professional perceived as caring: an indispensable companion on the cancer trajectory; 2. the resulting mutual trust and caring connection; and 3. the perceived effect of the caring encounter: a sense of solidarity, empowerment, well-being, and healing. The essential structure of an uncaring encounter is also threefold: 1. the nurse/health professional perceived as uncaring: an unfortunate hindrance to the perception of well-being and healing; 2. the resulting sense of mistrust and disconnection; and 3. the perceived effect of the uncaring encounter: a sense of uneasiness, discouragement, and a sense of being broken down. The findings emphasize the primacy of competence in professional caring, as well as that of genuine concern, openness and a willingness to connect with others. The often devastating effects of uncaring encounters on the recipient of nursing and health care raises the question whether uncaring as an ethical and a professional problem should perhaps be dealt with as malpractice in nursing and health care. PMID:9145561

  7. Perceived Medical Discrimination and Cancer Screening Behaviors of Racial and Ethnic Minority Adults

    Science.gov (United States)

    Crawley, LaVera M.; Ahn, David K.; Winkleby, Marilyn A.

    2008-01-01

    BACKGROUND Discrimination has been shown as a major causal factor in health disparities, yet little is known about the relationship between perceived medical discrimination (vs. general discrimination outside medical settings) and cancer screening behaviors. We examined whether perceived medical discrimination is associated with lower screening rates for colorectal and breast cancers among racial and ethnic minority adult Californians. METHODS Pooled cross-sectional data from 2003 and 2005 California Health Interview Surveys were examined for cancer screening trends among African-American, American-Indian/Alaskan-Native, Asian, and Latino adult respondents reporting perceived medical discrimination compared to those not reporting discrimination (n=11,245). Outcome measures were dichotomous screening variables for colorectal cancer among respondents, ages 50 -75; and breast cancer among women, ages 40 - 75. RESULTS Women perceiving medical discrimination were less likely to be screened for colorectal (OR = 0.66; CI = 0.64 - 0.69) or breast cancer (OR = 0.52; CI = 0.51 - 0.54) compared to women not perceiving discrimination. Although men who perceived medical discrimination were no less likely to be screened for colorectal cancer than those who did not (OR = 1.02; CI = 0.97 - 1.07), significantly lower screening rates were found among men who perceived discrimination and reported having a usual source of health care (OR = 0.30; CI = 0.28 - 0.32). CONCLUSIONS These findings of a significant association between perceived racial or ethnic-based medical discrimination and cancer screening behaviors have serious implications for cancer health disparities. Gender differences in patterns for screening and perceived medical discrimination warrant further investigation. PMID:18687583

  8. Evaluating the Quality of Colorectal Cancer Care in the State of Florida: Results From the Florida Initiative for Quality Cancer Care

    OpenAIRE

    Siegel, Erin M; Jacobsen, Paul B.; Malafa, Mokenge; Fulp, William; Fletcher, Michelle; Lee, Ji-Hyun; Smith, Jesusa Corazon R.; Brown, Richard; Levine, Richard; Cartwright, Thomas; Abesada-Terk, Guillermo; Kim, George; Alemany, Carlos; Faig, Douglas; Sharp, Philip

    2012-01-01

    Although the quality of care delivered within the Florida Initiative for Quality Cancer Care practices seems to be high, several components of care were identified that warrant further scrutiny on a systemic level and at individual centers.

  9. Contributors to Adult Sibling Relationships and Intention to Care of Siblings of Individuals with Down Syndrome

    Science.gov (United States)

    Cuskelly, Monica

    2016-01-01

    The contribution of childhood sibling relationships to adult sibling relationships and intention to provide care was investigated in a sample in which one member of each dyad had Down syndrome. Thirty-nine adult siblings of an adult with Down syndrome who had participated in a study of sibling relationships in childhood/adolescence provided data…

  10. Comparing Information Needs of Health Care Providers and Older Adults: Findings from a Wellness Study

    OpenAIRE

    Reeder, Blaine; Le, Thai; Thompson, Hilaire J.; Demiris, George

    2013-01-01

    Consumer health informatics technologies have the potential to enhance shared decision-making and communication between older adults, health care providers, and other stakeholders. The objective of this study was to characterize the information needs of these stakeholders to inform the design of informatics tools that support wellness in older adults. We conducted four focus groups with 31 older adults and three focus groups with 10 health care providers to explore information needs, goals, a...

  11. Cancer literacy as a mediator for cancer screening behaviour in Korean adults.

    Science.gov (United States)

    Lee, Hee Yun; Rhee, Taeho Greg; Kim, Nam Keol

    2016-09-01

    This study investigates the cancer literacy level in Korean adults and examines whether cancer literacy plays a mediating role in the relationship between population characteristics and cancer screening behaviours. We collected data from 585 community-dwelling adults in Korea using self-administered surveys and face-to-face interviews from October to December in 2009. Guided by Andersen's behavioural model, we used a structural equation model to estimate the effect of cancer literacy as a mediator and found that cancer literacy mediated cancer screening behaviour. In the individual path analysis models, cancer literacy played a significant mediating role for the use of eastern medicine, fatalism, health status and the number of chronic diseases. When controlling for other relevant covariates, we found that in the optimal path model, cancer literacy played a mediating role in the relationship between the use of eastern medicine and self-rated health status as well as cancer screening behaviour. Thus, developing community-based cancer education programmes and training clinical practitioners in eastern medicine clinics about the importance of informing their patients about regular cancer screening may be an option to boost cancer literacy and screening behaviour in Korea. PMID:25975449

  12. Creating and Maintaining a Wellness Environment in Child Care Centers Participating in the Child and Adult Care Food Program

    Science.gov (United States)

    Lofton, Kristi L.; Carr, Deborah H.

    2010-01-01

    Purpose/Objectives: This study identifies issues associated with creating and maintaining a wellness environment in child care centers (CCCs) participating in the Child and Adult Care Food Program (CACFP). Methods: Structured interviews and focus groups were conducted with CCC professionals and state agency personnel to develop a survey to assess…

  13. Communication skills training for health care professionals improves the adult orthopaedic patient's experience of quality of care

    DEFF Research Database (Denmark)

    Nørgaard, Birgitte; Kofoed, Poul-Erik; Ohm Kyvik, Kirsten;

    2012-01-01

    Scand J Caring Sci; 2012; Communication skills training for health care professionals improves the adult orthopaedic patient's experience of quality of care Rationale:  Despite the fact that communication has become a core topic in health care, patients still experience the information provided as...... insufficient or incorrect and a lack of involvement. Objective:  To investigate whether adult orthopaedic patients' evaluation of the quality of care had improved after a communication skills training course for healthcare professionals. Design and methods:  The study was designed as an intervention study...... limitation. Response rates were comparable to those of other studies. Conclusion:  Patients show increased satisfaction with the quality of health care after professionals have attended a communication skills training course, even when implemented in an entire department. Practice implications:  We recommend...

  14. Functional prognosis of dizziness in older adults in primary care: a prospective cohort study.

    OpenAIRE

    Dros, J.; Maarsingh, O.R.; Beem, L.; van der Horst, H.E.; Riet, G. ter; Schellevis, F G; van Weert, H.C.P.M.

    2012-01-01

    Objectives: To investigate the 6-month functional prognosis of dizziness in older adults in primary care, to identify important predictors of dizziness-related impairment, and to construct a score to assist risk prediction. Design: Prospective cohort study with 6-month follow-up. Setting: Twenty-four primary care practices in the Netherlands. Participants: Four hundred seventeen older adults (mean age 78.5, range 65–95, 74% female) presenting consecutively to primary care with dizziness. Meas...

  15. The provision of staff development programs in Virginia adult day care centers

    OpenAIRE

    Hensley, A. Dawn

    1994-01-01

    This study examined a neglected area in long term care and adult day care research: staff development. The specific purposes of this study were to describe the provision of a comprehensive staff development program in adult day care centers in Virginia in order to (a) differentiate those centers providing only the minimum required inservice training from those centers providing more comprehensive staff development programs and (b) define what meaning is placed upon sta...

  16. Assessment of depression and anxiety in adult cancer outpatients: a cross-sectional study

    Directory of Open Access Journals (Sweden)

    Shahzad Mohammad A

    2010-10-01

    Full Text Available Abstract Background The prevalence of anxiety and depressive disorders in cancer patients and its associated factors in Pakistan is not known. There is a need to develop an evidence base to help introduce interventions as untreated depression and anxiety can lead to significant morbidity. We assessed the prevalence of depression and anxiety among adult outpatients with and without cancer as well as the effect of various demographic, clinical and behavioral factors on levels of depression and anxiety in cancer patients. Methods This cross-sectional study was carried out in outpatient departments of Multan Institute of Nuclear Medicine and Radiotherapy and Nishtar Medical College Hospital, Multan. Aga Khan University Anxiety and Depression Scale (AKUADS was used to define the presence of depression and anxiety in study participants. The sample consisted of 150 diagnosed cancer patients and 268 participants without cancer (control group. Results The mean age of cancer patients was 40.85 years (SD = 16.46 and median illness duration was 5.5 months, while the mean age of the control group was 39.58 years (SD = 11.74. Overall, 66.0% of the cancer patients were found to have depression and anxiety using a cutoff score of 20 on AKUADS. Among the control group, 109 subjects (40.7% had depression and anxiety. Cancer patients were significantly more likely to suffer from distress compared to the control group (OR = 2.83, 95% CI = 1.89-4.25, P = 0.0001. Performing logistic regression analysis showed that age up to 40 years significantly influenced the prevalence of depression and anxiety in cancer patients. There was no statistically significant difference between gender, marital status, locality, education, income, occupation, physical activity, smoking, cancer site, illness duration and mode of treatment, surgery related to cancer and presence of depression and anxiety. Cancers highly associated with depression and anxiety were gastrointestinal

  17. Assessment of depression and anxiety in adult cancer outpatients: a cross-sectional study

    International Nuclear Information System (INIS)

    The prevalence of anxiety and depressive disorders in cancer patients and its associated factors in Pakistan is not known. There is a need to develop an evidence base to help introduce interventions as untreated depression and anxiety can lead to significant morbidity. We assessed the prevalence of depression and anxiety among adult outpatients with and without cancer as well as the effect of various demographic, clinical and behavioral factors on levels of depression and anxiety in cancer patients. This cross-sectional study was carried out in outpatient departments of Multan Institute of Nuclear Medicine and Radiotherapy and Nishtar Medical College Hospital, Multan. Aga Khan University Anxiety and Depression Scale (AKUADS) was used to define the presence of depression and anxiety in study participants. The sample consisted of 150 diagnosed cancer patients and 268 participants without cancer (control group). The mean age of cancer patients was 40.85 years (SD = 16.46) and median illness duration was 5.5 months, while the mean age of the control group was 39.58 years (SD = 11.74). Overall, 66.0% of the cancer patients were found to have depression and anxiety using a cutoff score of 20 on AKUADS. Among the control group, 109 subjects (40.7%) had depression and anxiety. Cancer patients were significantly more likely to suffer from distress compared to the control group (OR = 2.83, 95% CI = 1.89-4.25, P = 0.0001). Performing logistic regression analysis showed that age up to 40 years significantly influenced the prevalence of depression and anxiety in cancer patients. There was no statistically significant difference between gender, marital status, locality, education, income, occupation, physical activity, smoking, cancer site, illness duration and mode of treatment, surgery related to cancer and presence of depression and anxiety. Cancers highly associated with depression and anxiety were gastrointestinal malignancies, chest tumors and breast cancer. This study

  18. Symptom Interpretation and Health Care Seeking in Ovarian Cancer

    DEFF Research Database (Denmark)

    Seibæk, L.; Petersen, L. K.; Blaakaer, J.;

    2011-01-01

    BACKGROUND: Ovarian cancer is the leading cause of death among women suffering from gynaecological malignancies in the Western world. Worldwide, approximately 200,000 women are diagnosed with the disease each year. This article deals with the health care seeking and symptom interpretation process...... ovarian cancer. These results were combined with findings from semi-structured qualitative research interviews on women's bodily experiences with symptom development. RESULTS: A number of 663 Danish women with ovarian cancer attended 27 different kinds of primary health care providers in a total of 14...... among Danish women, who have a very high mortality rate. METHODS: The health seeking and symptom interpretation process was analysed via combining study methods. The material consisted of registry data dealing with the use of public health care and hospital services of Danish women, newly diagnosed with...

  19. Symptom interpretation and health care seeking in ovarian cancer

    DEFF Research Database (Denmark)

    Seibaek, Lene; Petersen, Lone K; Blaakær, Jan;

    2011-01-01

    BACKGROUND: Ovarian cancer is the leading cause of death among women suffering from gynaecological malignancies in the Western world. Worldwide, approximately 200,000 women are diagnosed with the disease each year. This article deals with the health care seeking and symptom interpretation process...... ovarian cancer. These results were combined with findings from semi-structured qualitative research interviews on women's bodily experiences with symptom development. RESULTS: A number of 663 Danish women with ovarian cancer attended 27 different kinds of primary health care providers in a total of 14...... among Danish women, who have a very high mortality rate. METHODS: The health seeking and symptom interpretation process was analysed via combining study methods. The material consisted of registry data dealing with the use of public health care and hospital services of Danish women, newly diagnosed with...

  20. Transitions to Adult Care for Rhode Island Youth with Special Healthcare Needs.

    Science.gov (United States)

    McLaughlin, Suzanne; Terry, Christopher; Neukirch, Jodie; Garneau, Deborah; Golding, Deb; Brown, Joanna

    2016-01-01

    The transitioning of youth from pediatric to adult care systems is often fraught with discontinuity, miscommunication and gaps in care. This is most significant for youth with special health care needs. A panel discussion on transitioning youth to adult care systems that was part of a learning collaborative held by The RI Care Transformation Collaborative (CTC) is presented here, illustrated by a pertinent case of a youth with type 1 diabetes. [Full article available at http://rimed.org/rimedicaljournal-2016-08.asp, free with no login]. PMID:27472770

  1. Improving cancer care in India: prospects and challenges.

    Science.gov (United States)

    Pal, Sanjoy Kumar; Mittal, Balraj

    2004-01-01

    The World Cancer Report, a 351 - page global report issued by International Agency for Research on Cancer (IARC) tells us that cancer rates are set to increase at an alarming rate globally (Stewart and Kleiues 2003). Cancer rates could increase by 50 % to 15 million new cases in the year 2020. This will be mainly due to steadily aging populations in both developed and developing countries and also to current trends in smoking prevalence and the growing adoption of unhealthy lifestyles. The report also reveals that cancer has emerged as a major public health problem in developing countries, matching its effect in industrialized nations. Healthy lifestyles and public health action by governments and health practitioners could stem this trend, and prevent as many as one third of cancers worldwide. In a developing country such as India there has been a steady increase in the Crude Incidence Rate (CIR) of all cancers affecting both men and women over the last 15 years. The increase reported by the cancer registries is nearly 12 per cent from 1985 to 2001, representing a 57 per cent rise in India's cancer burden. The total number of new cases, which stood at 5.3 lakhs Care lakh is 100,000 in 1985 has risen to over 8.3 lakhs today. The pattern of cancers has changed over the years, with a disturbing increase in cases that are linked to the use of tobacco. In 2003, there were 3.85 lakhs of cases coming under this category in comparison with 1.94 lakhs cases two decades ago. Lung cancer is now the second most common cancer among men. Earlier, it was in fifth place. Among women in urban areas, cancer of the uterine cervix had the highest incidence 15 years ago, but it has now been overtaken by breast cancer. In rural areas, cervical cancer remains the most common form of the disease (The Hindu 2004). PMID:15244530

  2. Income in Adult Survivors of Childhood Cancer

    Science.gov (United States)

    Wengenroth, Laura; Sommer, Grit; Schindler, Matthias; Spycher, Ben D.; von der Weid, Nicolas X.; Stutz-Grunder, Eveline; Michel, Gisela; Kuehni, Claudia E.

    2016-01-01

    Introduction Little is known about the impact of childhood cancer on the personal income of survivors. We compared income between survivors and siblings, and determined factors associated with income. Methods As part of the Swiss Childhood Cancer Survivor Study (SCCSS), a questionnaire was sent to survivors, aged ≥18 years, registered in the Swiss Childhood Cancer Registry (SCCR), diagnosed at age 4’500 CHF), even after we adjusted for socio-demographic and educational factors (OR = 0.46, p<0.001). Older age, male sex, personal and parental education, and number of working hours were associated with high income. Survivors of leukemia (OR = 0.40, p<0.001), lymphoma (OR = 0.63, p = 0.040), CNS tumors (OR = 0.22, p<0.001), bone tumors (OR = 0.24, p = 0.003) had a lower income than siblings. Survivors who had cranial irradiation, had a lower income than survivors who had no cranial irradiation (OR = 0.48, p = 0.006). Discussion Even after adjusting for socio-demographic characteristics, education and working hours, survivors of various diagnostic groups have lower incomes than siblings. Further research needs to identify the underlying causes. PMID:27213682

  3. Physician Perspectives on Providing Primary Medical Care to Adults with Autism Spectrum Disorders (ASD)

    Science.gov (United States)

    Warfield, Marji Erickson; Crossman, Morgan K.; Delahaye, Jennifer; Der Weerd, Emma; Kuhlthau, Karen A.

    2015-01-01

    We conducted in-depth case studies of 10 health care professionals who actively provide primary medical care to adults with autism spectrum disorders. The study sought to understand their experiences in providing this care, the training they had received, the training they lack and their suggestions for encouraging more physicians to provide this…

  4. Smarter palliative care for cancer: Use of smartphone applications

    Directory of Open Access Journals (Sweden)

    Nisha Rani Jamwal

    2016-01-01

    Full Text Available Smartphones are technologically advanced mobile phone devices which use software similar to computer-based devices as a user-friendly interface. This review article is aimed to inform the palliative care professionals, cancer patients and their caregivers about the role of smartphone applications (apps in the delivery of palliative care services, through a brief review of existing literature on the development, feasibility, analysis, and effectiveness of such apps. There is a dearth need for sincere palliative care clinicians to work together with software professionals to develop the suitable smartphone apps in accordance with the family/caregivers' necessities and patients' biopsychosocial characteristics that influence the technology driven evidence informed palliative cancer care.

  5. Implementing the chronic care model for frail older adults in the Netherlands: study protocol of ACT (frail older adults: care in transition

    Directory of Open Access Journals (Sweden)

    Muntinga Maaike E

    2012-04-01

    Full Text Available Abstract Background Care for older adults is facing a number of challenges: health problems are not consistently identified at a timely stage, older adults report a lack of autonomy in their care process, and care systems are often confronted with the need for better coordination between health care professionals. We aim to address these challenges by introducing the geriatric care model, based on the chronic care model, and to evaluate its effects on the quality of life of community-dwelling frail older adults. Methods/design In a 2-year stepped-wedge cluster randomised clinical trial with 6-monthly measurements, the chronic care model will be compared with usual care. The trial will be carried out among 35 primary care practices in two regions in the Netherlands. Per region, practices will be randomly allocated to four allocation arms designating the starting point of the intervention. Participants: 1200 community-dwelling older adults aged 65 or over and their primary informal caregivers. Primary care physicians will identify frail individuals based on a composite definition of frailty and a polypharmacy criterion. Final inclusion criterion: scoring 3 or more on a disability case-finding tool. Intervention: Every 6 months patients will receive a geriatric in-home assessment by a practice nurse, followed by a tailored care plan. Expert teams will manage and train practice nurses. Patients with complex care needs will be reviewed in interdisciplinary consultations. Evaluation: We will perform an effect evaluation, an economic evaluation, and a process evaluation. Primary outcome is quality of life as measured with the Short Form-12 questionnaire. Effect analyses will be based on the “intention-to-treat” principle, using multilevel regression analysis. Cost measurements will be administered continually during the study period. A cost-effectiveness analysis and cost-utility analysis will be conducted comparing mean total costs to functional

  6. Pharmacopuncture for cancer care: a systematic review.

    Science.gov (United States)

    Cheon, Soyeon; Zhang, Xiuyu; Lee, In-Seon; Cho, Seung-Hun; Chae, Younbyoung; Lee, Hyangsook

    2014-01-01

    Background. Pharmacopuncture, injection to acupoints with pharmacological medication or herbal medicine, is a new acupuncture therapy widely available in Korea and China for cancer-related symptoms. However, the evidence is yet to be clear. Objective. To determine pharmacopuncture's effectiveness on cancer-related symptoms. Methods. Eleven databases were searched for randomized controlled trials of pharmacopuncture in cancer patients. The Cochrane risk of bias (ROB) assessment tool was used for quality assessment. Results. Twenty-two studies involving 2,459 patients were included. Five trials of chemotherapy-induced nausea and vomiting (CINV) underwent meta-analysis. Pharmacopuncture significantly relieved severity of CINV compared with control group (3 trials, risk ratio (RR) 1.28, 95% confidence interval (CI) = 1.14-1.44). The frequency of CINV was also significantly reduced with pharmacopuncture (2 trials, RR 2.47, 95% CI = 2.12-2.89). Seventeen trials studied various symptoms, and in most studies, pharmacopuncture significantly relieved pain, ileus, hiccup, fever, and gastrointestinal symptoms and improved quality of life in various cancer patients. ROB was generally high. Conclusion. It may be suggested with caution that pharmacopuncture may help various symptom relief in cancer patients, but it is hard to draw a firm conclusion due to clinical heterogeneity and high ROB of the included studies, hence warranting further investigation. PMID:24899911

  7. Genetic Assessment of Breast Cancer Risk in Primary Care Practice

    OpenAIRE

    Burke, Wylie; Culver, Julie; Pinsky, Linda; Hall, Sarah; Reynolds, Susan E; Yasui, Yutaka; Press, Nancy

    2009-01-01

    Family history is increasingly important in primary care as a means to detect candidates for genetic testing or tailored prevention programs. We evaluated primary care physicians’ skills in assessing family history for breast cancer risk, using unannounced standardized patient visits to 86 general internists and family medicine practitioners in King County, WA. Transcripts of clinical encounters were coded to determine ascertainment of family history, risk assessment, and clinical follow-up. ...

  8. Cardiovascular Disease in Survivors of Adolescent and Young Adult Cancer

    DEFF Research Database (Denmark)

    Rugbjerg, Kathrine; Mellemkjaer, Lene; Boice, John D;

    2014-01-01

    BACKGROUND: Cardiovascular disease has emerged as a serious late effect in survivors of adolescent and young adult cancer, but risk has not been quantified comprehensively in a population-based setting. METHODS: In the Danish Cancer Registry, we identified 43153 1-year survivors of cancer diagnosed...... at ages 15 to 39 years (1943-2009) and alive in 1977; from the Danish Civil Registration System, we randomly selected a comparison cohort of the same age and sex. Subjects were linked to the Danish Patient Register, and observed numbers of first hospitalizations for cardiovascular disease (International...... Classification of Diseases, Tenth Revision codes I10-I79) were compared with the expected numbers derived from the comparison cohort. We calculated the absolute excess risks attributable to status as a survivor of cancer and standardized hospitalization rate ratios (RRs). All statistical tests were two...

  9. Translating basic research in cancer patient care

    Directory of Open Access Journals (Sweden)

    Marcello Maugeri-Saccà

    2011-01-01

    Full Text Available With the advent of molecular targeted therapies and the development of high-throughput biotechnologies, it has become evident that progress in cancer research is largely due to the creation of multidisciplinary teams able to plan clinical trials supported by appropriate molecular hypotheses. These efforts have culminated in the identification and validation of biomarkers predictive of response, as well as in the generation of more accurate prognostic tools. The identification of cancer stem cells has provided further insights into mechanisms of cancer, and many studies have tried to translate this biological notion into prognostic and predictive information. In this regard, new agents targeting key stemness-related pathways have entered the clinical development, and preliminary data suggested an encouraging antitumor activity.

  10. Symptom monitoring, alleviation, and self-care among Mexican Americans during cancer treatment.

    Science.gov (United States)

    Williams, Phoebe D; Lantican, Leticia S; Bader, Julia O; Lerma, Daniela

    2014-10-01

    Monitoring the occurrence and severity of symptoms among Mexican American adults undergoing cancer treatments, along with their self-care to alleviate symptoms, are understudied; the current study aimed to fill this gap in the literature. A total of 67 Mexican Americans receiving outpatient oncology treatments in the southwestern United States participated. Instruments included a patient-report checklist, the Therapy-Related Symptom Checklist (TRSC), the Symptom Alleviation: Self-Care Methods tool, and a demographic and health information form. At least 40% of participants reported the occurrence of 12 symptoms: hair loss, feeling sluggish, nausea, taste change, loss of appetite, depression, difficulty sleeping, weight loss, difficulty concentrating, constipation, skin changes, and numb fingers and toes. More than a third also reported pain, vomiting, decreased interest in sexual activity, cough, and sore throat. The helpful self-care strategies reported included diet and nutrition changes; lifestyle changes; and mind, body control, and spiritual activities. Patient report of symptoms during cancer treatments was facilitated by the use of the TRSC. Patients use symptom alleviation strategies to help relieve symptoms during their cancer treatment. The ability to perform appropriate, effective self-care methods to alleviate the symptoms may influence adherence to the treatment regimen. PMID:25253108

  11. Cancer, a disease of aging (part 2) - risk factors for older adult cancer mortality in Switzerland 1991-2008

    OpenAIRE

    Schmidlin, Kurt; Spoerri, Adrian; Egger, Matthias; Zwahlen, Marcel; Stuck, Andreas; Clough-Gorr, Kerri M; Swiss National Cohort

    2012-01-01

    Cancer is disease of aging that disproportionately affects older adults and often results in considerable public health consequences. This study evaluated gender-age-specific cancer mortality risk factors in older adults in Switzerland with attention to the most common types of cancer.

  12. Experiences of Community-Living Older Adults Receiving Integrated Care Based on the Chronic Care Model: A Qualitative Study

    Science.gov (United States)

    Spoorenberg, Sophie L. W.; Wynia, Klaske; Fokkens, Andrea S.; Slotman, Karin; Kremer, Hubertus P. H.; Reijneveld, Sijmen A.

    2015-01-01

    Background Integrated care models aim to solve the problem of fragmented and poorly coordinated care in current healthcare systems. These models aim to be patient-centered by providing continuous and coordinated care and by considering the needs and preferences of patients. The objective of this study was to evaluate the opinions and experiences of community-living older adults with regard to integrated care and support, along with the extent to which it meets their health and social needs. Methods Semi-structured interviews were conducted with 23 older adults receiving integrated care and support through “Embrace,” an integrated care model for community-living older adults that is based on the Chronic Care Model and a population health management model. Embrace is currently fully operational in the northern region of the Netherlands. Data analysis was based on the grounded theory approach. Results Responses of participants concerned two focus areas: 1) Experiences with aging, with the themes “Struggling with health,” “Increasing dependency,” “Decreasing social interaction,” “Loss of control,” and “Fears;” and 2) Experiences with Embrace, with the themes “Relationship with the case manager,” “Interactions,” and “Feeling in control, safe, and secure”. The prospect of becoming dependent and losing control was a key concept in the lives of the older adults interviewed. Embrace reinforced the participants’ ability to stay in control, even if they were dependent on others. Furthermore, participants felt safe and secure, in contrast to the fears of increasing dependency within the standard care system. Conclusion The results indicate that integrated care and support provided through Embrace met the health and social needs of older adults, who were coping with the consequences of aging. PMID:26489096

  13. Experiences of Community-Living Older Adults Receiving Integrated Care Based on the Chronic Care Model: A Qualitative Study.

    Directory of Open Access Journals (Sweden)

    Sophie L W Spoorenberg

    Full Text Available Integrated care models aim to solve the problem of fragmented and poorly coordinated care in current healthcare systems. These models aim to be patient-centered by providing continuous and coordinated care and by considering the needs and preferences of patients. The objective of this study was to evaluate the opinions and experiences of community-living older adults with regard to integrated care and support, along with the extent to which it meets their health and social needs.Semi-structured interviews were conducted with 23 older adults receiving integrated care and support through "Embrace," an integrated care model for community-living older adults that is based on the Chronic Care Model and a population health management model. Embrace is currently fully operational in the northern region of the Netherlands. Data analysis was based on the grounded theory approach.Responses of participants concerned two focus areas: 1 Experiences with aging, with the themes "Struggling with health," "Increasing dependency," "Decreasing social interaction," "Loss of control," and "Fears;" and 2 Experiences with Embrace, with the themes "Relationship with the case manager," "Interactions," and "Feeling in control, safe, and secure". The prospect of becoming dependent and losing control was a key concept in the lives of the older adults interviewed. Embrace reinforced the participants' ability to stay in control, even if they were dependent on others. Furthermore, participants felt safe and secure, in contrast to the fears of increasing dependency within the standard care system.The results indicate that integrated care and support provided through Embrace met the health and social needs of older adults, who were coping with the consequences of aging.

  14. Current lifestyle of young adults treated for cancer in childhood.

    OpenAIRE

    Evans, S E; Radford, M

    1995-01-01

    The aim of this study was to look at the current lifestyle of young adult survivors of childhood cancer between the ages of 16 and 30 years to document their achievements and expose any psychosocial problems. Sixty six young adult survivors were contacted and asked if they and their siblings (16-30 years) would take part in a lifestyle study; 48 patients and 38 sibling controls were interviewed. This took the form of a structured lifestyle questionnaire, a self esteem questionnaire (Oxford Ps...

  15. Cancer - the delivery of nursing care

    International Nuclear Information System (INIS)

    This and the preceding article (Nursing Mirror, Sept. 1, 1978) form a slightly shortened version of Chap. 5 from Vol. 2 of the book 'Oncology for Nurses and Health Care Professionals', ed. R. Tiffany, (Allen and Unwin, Oct. 1978). Teletherapy was dealt with in part 1. Part 2 is concerned with radiotherapy using radioisotope implants and applicators and unsealed sources, and with surgery and chemotherapy, including side effects of anti-tumour drugs. The physical and psychological effects on the patient of these forms of treatment are discussed, and nursing care and radiological safety precautions for both patients and nursing staff are described. (author)

  16. Estimating cancer risks to adults undergoing body CT examinations

    International Nuclear Information System (INIS)

    The purpose of the study is to estimate cancer risks from the amount of radiation used to perform body computed tomography (CT) examination. The ImPACT CT Patient Dosimetry Calculator was used to compute values of organ doses for adult body CT examinations. The radiation used to perform each examination was quantified by the dose-length product (DLP). Patient organ doses were converted into corresponding age and sex dependent cancer risks using data from BEIR VII. Results are presented for cancer risks per unit DLP and unit effective dose for 11 sensitive organs, as well as estimates of the contribution from 'other organs'. For patients who differ from a standard sized adult, correction factors based on the patient weight and antero-posterior dimension are provided to adjust organ doses and the corresponding risks. At constant incident radiation intensity, for CT examinations that include the chest, risks for females are markedly higher than those for males, whereas for examinations that include the pelvis, risks in males were slightly higher than those in females. In abdominal CT scans, risks for males and female patients are very similar. For abdominal CT scans, increasing the patient age from 20 to 80 resulted in a reduction in patient risks of nearly a factor of 5. The average cancer risk for chest/abdomen/pelvis CT examinations was ∼26 % higher than the cancer risk caused by 'sensitive organs'. Doses and radiation risks in 80 kg adults were ∼10 % lower than those in 70 kg patients. Cancer risks in body CT can be estimated from the examination DLP by accounting for sex, age, as well as patient physical characteristics. (authors)

  17. Core communication components along the cancer care process: the perspective of breast cancer patients

    OpenAIRE

    Prades, Joan; Ferro, Tàrsila; Gil, Francisco; Borràs Andrés, Josep Maria

    2014-01-01

    This study sought to assess the impact of health care professional (HCP) communication on breast cancer patients across the acute care process as perceived by patients. Methodological approach was based on eight focus groups conducted with a sample of patients (n ¼ 37) drawn from 15 Spanish Regions; thematic analysis was undertaken using the National Cancer Institute (NCI) framework of HCP communication as the theoretical basis. Relevant results of this study were the identification of four m...

  18. Treatment of adolescents and young adults (AYA) with cancer in a multidisciplinary setting: on the way to a highly specialized AYA unit.

    Science.gov (United States)

    Bernig, T; Jahn, F; Witkowsky, S; Huehn, R; Hentschel, A; Kegel, T; Schmoll, H-J; Körholz, D

    2013-11-01

    Further survival improvements of adolescents and young adults (AYA) with cancer are clearly affected by biological characteristics of the malignancies and age-specific needs. Multidisciplinary teams drawing expertice from both pediatric and adult cancer teams as well as clinical trials are required to meet the age specific needs of AYA patients with cancer. In 2011, the first AYA unit was established at the University Hospital Halle (Saale), where patients with newly-diagnosed cancer aged 15-25 are treated interdisciplinary by pediatric and adult oncologists. The enrollment into pediatric or adult clinical trials is controlled by age 18. Over the last 2 years, 19 AYA with cancer have been treated at the unit; and, in turn patients and their relatives reflected a high satisfaction with the offered novel health care approach. In the scope of the future Comprehensive Cancer Center at the University Hospital Halle (Saale), a complete ward is planned for all admitted AYA up to 25 years with cancer. The patients will be treated by a tumor-specialized multidisciplinary team of adult or pediatric oncologists and oncological surgeons. Therefore, we intend to establish a special teaching curriculum for physicians, nurses and psychosocial health care staff. Rather than age, cancer biology of a malignancy, surveillance data of late side effects as well as the age-specific needs of AYA patients will be crucial for best treatment options. PMID:24166088

  19. Promoting physical exercise in breast cancer care

    OpenAIRE

    Kirshbaum, M.

    2004-01-01

    This article is intended to promote awareness of physical exercise as a safe, advantageous and feasible intervention for the individual who has or has had breast cancer. It will specify the numerous and varied benefits of exercise and focus on the implications for nursing practice in light of current research evidence.

  20. Nasopharyngeal cancer; Cancers du cavum de l'adulte

    Energy Technology Data Exchange (ETDEWEB)

    Fleury, B.; Biston, M.C.; Montbarbon, X.; Pommier, P. [Departement de radiotherapie, Centre de lutte contre le cancer Leon-Berard, 69 - Lyon (France)

    2010-07-01

    The main objective of this work was to propose recommendations concerning the delineation of the target volume of the nasopharyngeal cancers, the planning of the treatment, and describe the expected results about the efficiency and the toxicities. Theses recommendations are based upon anatomy, natural history of theses tumors, and upon published experiences from different teams working with IMRT. (authors)

  1. Meaning and Practice of Palliative Care for Hospitalized Older Adults with Life Limiting Illnesses

    OpenAIRE

    Bethel Ann Powers; Norton, Sally A.; Schmitt, Madeline H.; Quill, Timothy E.; Maureen Metzger

    2011-01-01

    Objective. To illustrate distinctions and intersections of palliative care (PC) and end-of-life (EOL) services through examples from case-centered data of older adults cared for during a four-year ethnographic study of an acute care hospital palliative care consultation service. Methods. Qualitative narrative and thematic analysis. Results. Description of four practice paradigms (EOL transitions, prognostic uncertainty, discharge planning, and patient/family values and preferences) and identi...

  2. Cancer in adolescents and young adults in countries with limited resources.

    Science.gov (United States)

    Magrath, Ian; Epelman, Sidnei

    2013-08-01

    Cancer in adolescents and young adults (AYA) represents a higher fraction of all cancer in countries that are still undergoing a demographic transition. Such countries tend to have much younger populations, and therefore unless they have a particularly low incidence of cancer in this age group, will have a higher burden of cancer (absolute number of cases with cancer) in AYA. Cancers in AYA are comprised of the tail end of the incidence curve of cancers that have their peak incidence, or occur almost exclusively in childhood, the beginning of the incidence curve of cancers that primarily affect the elderly, and a third set of cancers that have their peak incidence (or are at least common) in the AYA age group (e.g., testicular cancer, sarcomas, melanoma, thyroid cancer). Many, but not all, of these cancers require radiation or cancer surgery, but the poorest countries do not have a sufficient number of radiation therapy units and surgical oncologists, or indeed medical and pediatric oncologists, to deal with the burden of cancer they face. The AYA age group is particularly important, both with regard to their contribution to the economy now and in the future (the majority are in the "working" age-group defined as 15-64 years), as well as their important role in caring for their families. Moreover, some of these cancers are eminently curable with chemotherapy alone, and more could be cured by simply improving the efficiency of existing health services and providing education and training to both the public as well as oncologists and other specialists required for the care of AYA (although such individuals will not necessarily be exclusively concerned with this age group). Of particular importance is the detection and diagnosis of cancer patients at the earliest possible time in the course of their disease. Avoiding delays in initiating therapy, which are partly due to the poverty and lack of education of the public as well as to a failure on the part of primary

  3. Recruiting young adult cancer survivors for behavioral research.

    Science.gov (United States)

    Rabin, Carolyn; Horowitz, Santina; Marcus, Bess

    2013-03-01

    Young adults have been dramatically underrepresented in cancer survivorship research. One contributing factor is the difficulty recruiting this population. To identify effective recruitment strategies, the current study assessed the yield of strategies used to recruit young survivors for an exercise intervention including: clinic-based recruitment, recruitment at cancer-related events, mailings, telephone-based recruitment, advertising on the internet, radio, television and social networking media, distributing brochures and word-of-mouth referrals. When taking into account the strategies for which we could track the number of survivors approached, recruitment at an oncology clinic was the most productive: 38 % of those approached were screened and 8 % enrolled. When evaluating which strategy yielded the greatest percentage of the sample, however, mailings were the most productive. Given widespread use of the internet and social networking by young adults, investigators should also consider these low-cost recruitment strategies. PMID:22810954

  4. Terminal Cancer and Suicide: The Health Care Professional's Dilemma.

    Science.gov (United States)

    Hansen, Leslie C.; McAleer, Charles A.

    1984-01-01

    Examined factors influencing the evaluation of a patient contemplating suicide, in a study of 138 health care professionals. Results showed subjects' evaluations, acceptance, and behavior were affected by their belief that the patient had cancer and/or was dying, and by their own degree of death anxiety. (JAC)

  5. Early stage cervical cancer : quality of cancer care and quality of life

    NARCIS (Netherlands)

    Pieterse, Quirine Dionne

    2007-01-01

    To improve quality of cancer care treatment-related information is needed. This could be acquired by registries. Since January 1984, the Leiden University Medical Center (LUMC) collects prospectively more than 200 relevant clinical and pathological parameters of women with cervical cancer treated in

  6. Cancer screening: Should cancer screening be essential component of primary health care in developing countries?

    Directory of Open Access Journals (Sweden)

    Saurabh Bobdey

    2015-01-01

    Conclusions: Our study highlights the availability and success of visual screening tools in early detection and mortality reduction of major neoplasia in resource-poor health care settings and recommends implementation of oral and cervical cancer screening as part of assured primary health care package in developing countries.

  7. Process of diffusing cancer survivorship care into oncology practice.

    Science.gov (United States)

    Tessaro, Irene; Campbell, Marci K; Golden, Shannon; Gellin, Mindy; McCabe, Mary; Syrjala, Karen; Ganz, Patricia A; Jacobs, Linda; Baker, Scott; Miller, Kenneth D; Rosenstein, Donald L

    2013-06-01

    The LIVESTRONG Centers of Excellence were funded to increase the effectiveness of survivorship care in oncology practice. This study describes the ongoing process of adopting and implementing survivorship care using the framework of the diffusion of innovation theory of change. Primary data collection included telephone interviews with 39 members from the eight centers and site visits. Organizational characteristics, overall progress, and challenges for implementation were collected from proposals and annual reports. Creating an awareness of cancer survivorship care was a major accomplishment (relative advantage). Adoption depended on the fit within the cancer center (compatibility), and changed over time based on trial and error (trialability). Implementing survivorship care within the existing culture of oncology and breaking down resistance to change was a lengthy process (complexity). Survivorship care became sustainable as it became reimbursed, and more new patients were seen (observability). Innovators and early adopters were crucial to success. Diffusion of innovation theory can provide a strategy to evaluate adoption and implementation of cancer survivorship programs into clinical practice. PMID:24073165

  8. Integrative Cancer Care in a US Academic Cancer Centre: The Memorial Sloan–Kettering Experience

    OpenAIRE

    Deng, G

    2008-01-01

    Various surveys show that interest in complementary and alternative medicine (cam) is high among cancer patients. Patients want to explore all options that may help their treatment. Many cam modalities offer patients an active role in their self-care, and the resulting sense of empowerment is very appealing. On the other hand, many unscrupulous marketeers promote alternative cancer “cures,” targeting cancer patients who are particularly vulnerable. Some alternative therapies can hurt patients...

  9. Awareness, Interest, and Preferences of Primary Care Providers in Using Point-of-Care Cancer Screening Technology

    OpenAIRE

    Kim, Chloe S.; Vanture, Sarah; Cho, Margaret; Klapperich, Catherine M.; Wang, Catharine; Huang, Franklin W.

    2016-01-01

    Well-developed point-of-care (POC) cancer screening tools have the potential to provide better cancer care to patients in both developed and developing countries. However, new medical technology will not be adopted by medical providers unless it addresses a population’s existing needs and end-users’ preferences. The goals of our study were to assess primary care providers’ level of awareness, interest, and preferences in using POC cancer screening technology in their practice and to provide g...

  10. Psychological, social, and behavioral issues for young adults with cancer.

    Science.gov (United States)

    Zebrack, Brad J

    2011-05-15

    Theories of human development suggest that, although all cancer patients experience a common set of life disruptions, they experience them differently, focus on different issues, and attach different levels of importance to different aspects of the experience depending on the time in life at which they were diagnosed. During the critical developmental transition from childhood to adulthood, older adolescents and young adults in particular have typical concerns with establishing identity, developing a positive body image and sexual identity, separating from parents, increasing involvement with peers and dating, and beginning to make decisions about careers or employment, higher education, and/or family. Accordingly, cancer-related issues such as premature confrontation with mortality, changes in physical appearance, increased dependence on parents, disruptions in social life and school/employment because of treatment, loss of reproductive capacity, and health-related concerns about the future may be particularly distressing for adolescents and young adults. Psychosocial and behavioral interventions for young adult cancer patients and survivors often involve assisting these individuals in retaining or returning to function in significant social roles, such as spouse, parent, student, worker, or friend. Successful interventions will enable these young people to overcome the detrimental impact of a health crisis and strengthen the internal and external coping resources available to them. PMID:21523748

  11. The interaction between informal cancer caregivers and health care professionals

    DEFF Research Database (Denmark)

    Lund, Line; Ross, Lone; Petersen, Morten Aagaard;

    2015-01-01

    PURPOSE: In order to meet the caregiving challenges, informal caregivers often need a substantial level of interaction with health care professionals (HCPs). This study investigated to which extent the cancer caregivers' needs regarding the interaction with HCPs are met and the associations between...... dissatisfaction with the interaction and socio-demographic and disease-related variables. METHODS: In a cross-sectional questionnaire study, cancer patients with various diagnoses and disease stages were invited to pass on the 'cancer caregiving tasks, consequences and needs questionnaire' (CaTCoN) to up to three...... optimal involvement of the caregivers in the patients' disease, treatment and/or care (30 % were dissatisfied), attention to the caregivers' wellbeing (e.g., 51 % of the caregivers reported that HCPs only sometimes or rarely/never had shown interest in how the caregivers had been feeling), and provision...

  12. Assessing cognitive function and capacity in older adults with cancer.

    Science.gov (United States)

    McKoy, June M; Burhenn, Peggy S; Browner, Ilene S; Loeser, Kari L; Tulas, Katrina M; Oden, Megan R; Rupper, Randall W

    2014-01-01

    The number of older individuals with cancer is increasing exponentially, mandating that oncologists contemplate more comprehensive and multidisciplinary approaches to treatment of this cohort. Recruitment of assessment instruments validated in older patients can be invaluable for guiding treatment and decision-making by both patients and providers, and can arguably contribute to improving outcomes and health-related quality of life. The Comprehensive Geriatric Assessment is one such validated instrument that can be used by oncologists to assess patient readiness and appropriateness for prescribed cancer therapy. As a multidisciplinary diagnostic and treatment process, it comprises functional status, cognitive status, social support, and advance care preferences, and is an ideal instrument for evaluating complex older individuals. It is well established that many older individuals with cancer travel with multiple comorbid illnesses, including cognitive impairment, and when presented with a cancer diagnosis struggle to choose from multiple treatment options. In addition to the complete medical history, the ability of patients to decide on a course of therapy in concert with their oncologist is critically important. Alternatively, many oncologists are conflicted as to whether true informed consent for treatment can be obtained from many older patients. Having a roadmap to decision-making capacity is therefore an inescapable imperative in geriatric oncology, because careful attention must be directed at identifying older patients with cancer who might benefit from these assessments and the individualized treatment plans that emerge. PMID:24453297

  13. The Edinburgh Malawi Cancer Partnership: helping to establish multidisciplinary cancer care in Blantyre, Malawi.

    Science.gov (United States)

    Brown, E; Gorman, D; Knowles, G; Taylor, F; Jere, Y; Bates, J; Masamba, L

    2016-12-01

    In response to the growing incidence of cancer in Malawi, a new oncology unit was established at the Queen Elizabeth Central Hospital, Blantyre. The unit opened in 2010, the first in the country, and is led by a single consultant oncologist. In 2012, a healthcare partnership was formed between the oncology and palliative care unit at Queen Elizabeth Central Hospital and the Edinburgh Cancer Centre, UK. The principal objective of the partnership is to help develop high quality multidisciplinary cancer care in Malawi. Methods A needs assessment identified three priority areas for further improvement of cancer services: nurse-led treatment delivery; management of clinical data; and multidisciplinary working. The partnership received grant funding from the Scottish Government Malawi Development Programme in 2013 and a three year project plan was implemented. This has been conducted through a series of reciprocal training visits. Results Key achievements have been completion of a programme of oncology nursing education attended by 32 oncology nurses and other healthcare professionals, which has resulted in increased experience in cancer practice and standardisation of chemotherapy delivery procedures; development of a clinical database that enables prospective collection of data of all new patients with cancer and which links to the Malawi Cancer Registry; development of weekly multidisciplinary meetings involving oncology, gynaecology and surgery that has enabled a cross-specialty approach to patient care. Conclusion The Edinburgh Malawi Cancer Partnership is supporting nursing education, data use and cross-specialty collaboration that we are confident will improve cancer care in Malawi. Future work will focus on the further development of multidisciplinary breast cancer care and the development of a radiotherapy service for patients in Malawi. PMID:27092363

  14. Contributors to Adult Sibling Relationships and Intention to Care of Siblings of Individuals With Down Syndrome.

    Science.gov (United States)

    Cuskelly, Monica

    2016-05-01

    The contribution of childhood sibling relationships to adult sibling relationships and intention to provide care was investigated in a sample in which one member of each dyad had Down syndrome. Thirty-nine adult siblings of an adult with Down syndrome who had participated in a study of sibling relationships in childhood/adolescence provided data about the quality of current relationships and of their intention to provide care for their brother/sister with Down syndrome in the future. Only behavior problems in the child with Down syndrome predicted warmth of the current adult relationship. Although adult sibling relationships were reported to be warm, the quality of neither the current nor the past relationship was associated with the reported intention to provide care. PMID:27119212

  15. Palliative care in advanced cancer patients in a tertiary care hospital in Uttarakhand

    Directory of Open Access Journals (Sweden)

    Manisha Bisht

    2008-01-01

    Full Text Available Aim: Advanced cancer, irrespective of the site of the cancer, is characterized by a number of associated symptoms that impair the quality of life of patients. The management of these symptoms guides palliative care. The present study aims to describe the symptoms and appropriate palliation provided in patients with advanced cancer in a tertiary care hospital in Uttarakhand. Methods: This was an observational study. A total of 100 patients with advanced cancer were included in the study. The data obtained from the patients included symptoms reported by the patients, currently prescribed treatments and the site of cancer. Results: The average number of symptoms reported per patient was 5.33 ± 0.67 (mean ± SE. The most common symptoms were pain, weakness/fatigue, anorexia, insomnia, nausea/vomiting, dyspnea, constipation and cough. Polypharmacy was frequent. Patients consumed approximately 8.7 ± 0.38 (mean ± SE drugs on average during the 2-month period of follow-up. Conclusion: The result gives insight into the varied symptomatology of patients with advanced cancer. Polypharmacy was quite common in patients with advanced cancer, predisposing them to complicated drug interactions and adverse drug reactions.

  16. Epidemiology of Adolescents and Young Adults with Cancer in Europe.

    Science.gov (United States)

    Desandes, Emmanuel; Stark, Daniel P

    2016-01-01

    To design the services for adolescents and young adults (AYAs) with cancer, we need to understand the patterns of disease and the other clinical and managerial challenges of the patient group. Cancer occurring between the ages of 15 and 39 years is 4 times less rare than cancer occurring during the first 15 years of life and consists of 2% of all invasive cancer in Europe, about 66,000 patients in Europe each year. AYAs have a unique distribution of cancer types, including the peak in incidence of Hodgkin lymphoma (HL) or germ cell tumors. The relative improvement in the survival rate in AYAs has not kept pace with that achieved in younger children, especially for acute leukemia, non-HLs, Ewing tumors and rhabdomyosarcoma. Etiological factors are under-researched and remain largely hypothetical. In this unique group of illnesses, improving AYA cancer management involves bridging interfaces. Since this has begun, outcomes have also begun to improve. The local nature of these interfaces determines the age group considered as AYA. Specific skills are necessary in the clinical, biological and psychosocial domains. Services need support from policy, clinical and administrative professionals. National policy and supranational groups such as SIOPE and ESMO are in constructive collaboration to develop this further. PMID:27595352

  17. Experiences of health care transition voiced by young adults with type 1 diabetes: a qualitative study

    Directory of Open Access Journals (Sweden)

    Garvey KC

    2014-10-01

    Full Text Available Katharine C Garvey,1,5 Margaret G Beste,2 Donna Luff,3,5 Astrid Atakov-Castillo,2 Howard A Wolpert,2,5 Marilyn D Ritholz4–61Division of Endocrinology, Boston Children’s Hospital, Boston, MA, USA; 2Adult Section, Joslin Diabetes Center, Boston, MA, USA; 3Institute for Professionalism and Ethical Practice, Boston Children's Hospital, Boston, MA, USA; 4Behavioral and Mental Health Unit, Joslin Diabetes Center, Boston, MA, USA; 5Harvard Medical School, Boston, MA, USA; 6Department of Psychiatry, Boston Children's Hospital, Boston, MA, USAObjective: This qualitative study aimed to explore the experience of transition from pediatric to adult diabetes care reported by posttransition emerging adults with type 1 diabetes (T1D, with a focus on preparation for the actual transfer in care.Methods: Twenty-six T1D emerging adults (mean age 26.2±2.5 years receiving adult diabetes care at a single center participated in five focus groups stratified by two levels of current glycemic control. A multidisciplinary team coded transcripts and conducted thematic analysis.Results: Four key themes on the process of transfer to adult care emerged from a thematic analysis: 1 nonpurposeful transition (patients reported a lack of transition preparation by pediatric providers for the transfer to adult diabetes care; 2 vulnerability in the college years (patients conveyed periods of loss to follow-up during college and described health risks and diabetes management challenges specific to the college years that were inadequately addressed by pediatric or adult providers; 3 unexpected differences between pediatric and adult health care systems (patients were surprised by the different feel of adult diabetes care, especially with regards to an increased focus on diabetes complications; and 4 patients’ wish list for improving the transition process (patients recommended enhanced pediatric transition counseling, implementation of adult clinic orientation programs, and peer

  18. Vitamin D supplementation for prevention of cancer in adults

    DEFF Research Database (Denmark)

    Bjelakovic, Goran; Gluud, Lise Lotte; Nikolova, Dimitrinka;

    2014-01-01

    predominantly elderly community-dwelling women. Vitamin D₃ supplementation decreased cancer mortality and vitamin D supplementation decreased all-cause mortality, but these estimates are at risk of type I errors due to the fact that too few participants were examined, and to risks of attrition bias originating......BACKGROUND: The evidence on whether vitamin D supplementation is effective in decreasing cancers is contradictory. OBJECTIVES: To assess the beneficial and harmful effects of vitamin D supplementation for prevention of cancer in adults. SEARCH METHODS: We searched the Cochrane Central Register of...... provided data for the analyses. All trials came from high-income countries. Most of the trials had a high risk of bias, mainly for-profit bias. Most trials included elderly community-dwelling women (aged 47 to 97 years). Vitamin D was administered for a weighted mean of six years. Fourteen trials tested...

  19. American Society of Clinical Oncology policy statement: opportunities in the patient protection and affordable care act to reduce cancer care disparities.

    Science.gov (United States)

    Moy, Beverly; Polite, Blase N; Halpern, Michael T; Stranne, Steven K; Winer, Eric P; Wollins, Dana S; Newman, Lisa A

    2011-10-01

    Patients in specific vulnerable population groups suffer disproportionately from cancer. The elimination of cancer disparities is critically important for lessening the burden of cancer. The Patient Protection and Affordable Care Act provides both opportunities and challenges for addressing cancer care disparities and access to care. The American Society of Clinical Oncology (ASCO) advocates for policies that ensure access to cancer care for the underserved. Such policies include insurance reform and the reduction of economic barriers to quality health care. Building on ASCO's prior statement on disparities in cancer care (2009), this article summarizes elements of the health care law that are relevant to cancer disparities and provides recommendations for addressing major provisions in the law. It outlines specific strategies to address insurance reform, access to care, quality of care, prevention and wellness, research on health care disparities, and diversity in the health care workforce. ASCO is committed to leading efforts toward the improvement of cancer care among the most vulnerable patients. PMID:21810680

  20. Assessing general practitioners' care of adult patients with learning disability: case-control study.

    OpenAIRE

    Whitfield, M.; Langan, J; Russell, O

    1996-01-01

    OBJECTIVE--To compare general practitioners' care of adult patients with learning disability with that of control patients in the same practice. DESIGN--Case-control study of patients and controls by a structured interview study of general practitioners. SETTING--Avon. PATIENTS--78 adult patients with learning disability and 78 age and sex matched controls--cared for by 62 general practitioners. MAIN MEASURES--Number and content of consultations and opinions of the general practitioners. RESU...

  1. In Sickness and in Health: Health Care Experiences of Korean Immigrant Older Adults

    OpenAIRE

    Juhn, Erica

    2012-01-01

    The purpose of this study was to document the health care experiences of Korean immigrant older adults, 65 years of age or older, living in Los Angeles County, who have health care access through Medicare and/or Medi-Cal, access to a large Korean ethnic enclave, and a diverse social support network. Twelve Korean immigrant older adults were recruited through word-of-mouth via community contacts. Semi-structured qualitative interviews were conducted with individual seniors, with the help of ...

  2. Is older adult care mediated by caregivers’ cultural stereotypes? The role of competence and warmth attribution

    Science.gov (United States)

    Fernández-Ballesteros, Rocío; Bustillos, Antonio; Santacreu, Marta; Schettini, Rocio; Díaz-Veiga, Pura; Huici, Carmen

    2016-01-01

    Purpose The purpose of this study is to examine, from the stereotype content model (SCM) perspective, the role of the competence and warmth stereotypes of older adults held by professional caregivers. Methods A quasi-experimental design, ex post facto with observational analyses, was used in this study. The cultural view on competence and warmth was assessed in 100 caregivers working in a set of six residential geriatric care units (three of them organized following a person-centered care approach and the other three providing standard geriatric care). In order to assess caregivers’ cultural stereotypical views, the SCM questionnaire was administered. To evaluate the role of caregivers’ cultural stereotypes in their professional performance as well as in older adult functioning, two observational scales from the Sistema de Evaluación de Residencias de Ancianos (assessment system for older adults residences)-RS (staff functioning and residents’ functioning) were applied. Results Caregivers’ cultural views of older adults (compared to young people) are characterized by low competence and high warmth, replicating the data obtained elsewhere from the SCM. Most importantly, the person-centered units predict better staff performance and better resident functioning than standard units. Moreover, cultural stereotyping of older adult competence moderates the effects of staff performance on resident functioning, in line with the findings of previous research. Conclusion Our results underline the influence of caregivers’ cultural stereotypes on the type of care, as well as on their professional behaviors and on older adult functioning. Caregivers’ cultural stereotypes could be considered as a central issue in older adult care since they mediate the triangle of care: caregivers/older adults/type of care; therefore, much more attention should be paid to this psychosocial care component. PMID:27217736

  3. Free-standing cancer centers: rationale for improving cancer care delivery.

    Science.gov (United States)

    Lokich, J J; Silvers, S; Brereton, H; Byfield, J; Bick, R

    1989-10-01

    Free-standing cancer centers (FSCC) represent a growing trend in cancer care delivery within community practice. The critical components to FSCC are multidisciplinary cancer care, a complete menu of direct care and support services, a commitment to clinical trials and clinical investigation, and a comprehensive program for quality assurance. The advantages of FSCC to the community, to hospital programs, to the practicing surgical, medical, and radiation oncologists, and to the third-party carriers, including health maintenance organizations, are detailed. The development of an FSCC depends on the resolution of issues of (a) competition (between hospitals, hospitals and physicians, therapeutic disciplines, regional comprehensive cancer centers and FSCCs) and (b) concerns about conflict of interest. The ideal model of FSCC may well be represented by the joint venture of community hospital(s) and the community oncologists. PMID:2801600

  4. Use of and interest in alternative therapies among adult primary care clinicians and adult members in a large health maintenance organization.

    Science.gov (United States)

    Gordon, N P; Sobel, D S; Tarazona, E Z

    1998-09-01

    During spring 1996, random samples of adult primary care physicians, obstetrics-gynecology physicians and nurse practitioners, and adult members of a large northern California group practice model health maintenance organization (HMO) were surveyed by mail to assess the use of alternative therapies and the extent of interest in having them incorporated into HMO-delivered care. Sixty-one percent (n = 624) of adult primary care physicians, 70% (n = 157) of obstetrics-gynecology clinicians, and 50% (2 surveys, n = 1,507 and n = 17,735) of adult HMO members responded. During the previous 12 months, 25% of adults reported using and nearly 90% of adult primary care physicians and obstetrics-gynecology clinicians reported recommending at least 1 alternative therapy, primarily for pain management. Chiropractic, acupuncture, massage, and behavioral medicine techniques such as meditation and relaxation training were most often cited. Obstetrics-gynecology clinicians used herbal and homeopathic medicines more often than adult primary care physicians, primarily for menopause and premenstrual syndrome. Two thirds of adult primary care physicians and three fourths of obstetrics-gynecology clinicians were at least moderately interested in using alternative therapies with patients, and nearly 70% of young and middle-aged adult and half of senior adult members were interested in having alternative therapies incorporated into their health care. Adult primary care physicians and members were more interested in having the HMO cover manipulative and behavioral medicine therapies than homeopathic or herbal medicines. PMID:9771154

  5. The Perceived Needs and Availability of Eye Care Services for Older Adults in Long-term Care Facilities

    Science.gov (United States)

    Kergoat, Hélène; Boisjoly, Hélène; Freeman, Ellen E.; Monette, Johanne; Roy, Sylvie; Kergoat, Marie-Jeanne

    2014-01-01

    Background The objective was to evaluate the eye care services offered to older residents living in long-term care facilities (LTCFs). Methods A questionnaire targeting residents aged ≥65 years was sent to all LTCFs in Quebec. Questions related to the institution’s characteristics, demographic data related to residents, oculovisual health of residents and barriers to eye care, eye care services offered within and outside the institution, and degree of satisfaction regarding the eye care services offered to residents. Results 196/428 (45.8%) LTCFs completed the questionnaire. Participating LTCFs had an average of 97.0 ± 5.1 residents with a mean age of 82.8 ± 3.0 yrs and 69% women. Eye care services were mostly offered outside the institution, on a “per request” basis. The main barriers to eye care were the perception that residents could not cooperate and the lack of eye care professionals. Most LTCFs were satisfied with the eye care services offered to residents. Conclusions The fact that the LTCFs were satisfied with the eye care services offered to their residents, although it was neither provided on a regular basis nor to all residents, suggests that eye care professionals should take a proactive educational role for improving services to older institutionalized adults. PMID:25232370

  6. Challenges faced by palliative care physicians when caring for doctors with advanced cancer

    NARCIS (Netherlands)

    Noble, S. I. R.; Nelson, A.; Finlay, I. G.

    2008-01-01

    Background: It is possible that patients with advanced cancer, who are from the medical profession, have different or additional care needs than other patients. Previous training, professional experiences and access to information and services may influence their needs and subsequent illness behavio

  7. Mental disorders in cancer patients: observations at a tertiary care centre in Pakistan

    International Nuclear Information System (INIS)

    To study the frequencies of metal disorders among adult cancer patients in relation to their age, gender, marital status and type of malignancy. Socio-demographic characteristics and cancer diagnoses were recorded on a data capture form. diagnoses of metal disorders were made on the basis of diagnostic and statistical manual (DSM-IV) fourth edition. Shuakat Khanum Memorial Hospital and Research Centre. Two hundred and twenty newly diagnosed cancer patients were interviewed by a clinical psychologist before commencing any cancer treatment. Diagnosis of any metal disorder was transcribed using DSM-IV criteria and data thus collected were analyzed using SPSS for Windows. Observed frequencies of various metal disorders were compared with respect to patient's age, gender, martial status and type of cancer. Sixty five percent patients presented with various mental disorder. Adjusting disorders and mood disorders accounted for 34% each, while anxiety disorder was seen in 30% and remaining had delirium and somatoform disorders. Mental disorders were more common in males, and in younger age group. The oncologist and physicians treating cancer patients should carefully evaluate their patients for symptom of associated mental disorder and provide the required clinical support. (author)

  8. What Should You Ask Your Health Care Team About Pancreatic Cancer?

    Science.gov (United States)

    ... should you ask your health care team about pancreatic cancer? It’s important to have honest, open discussions with ... these questions: When you’re told you have pancreatic cancer What kind of pancreatic cancer do I have? ...

  9. Making Work Fit Care: Reconciliation Strategies Used by Working Mothers of Adults with Intellectual Disabilities

    Science.gov (United States)

    Chou, Yueh-Ching; Fu, Li-yeh; Chang, Heng-Hao

    2013-01-01

    Background: This study explored the experiences of working mothers with an adult child with intellectual disabilities to understand how they reconcile paid work and care responsibilities. Methods: Fifteen working mothers in Taiwan with an adult child with intellectual disabilities were interviewed, and an interpretative phenomenological approach…

  10. Health professional's perspectives of the barriers and enablers to cancer care for Indigenous Australians.

    Science.gov (United States)

    Meiklejohn, J A; Adams, J; Valery, P C; Walpole, E T; Martin, J H; Williams, H M; Garvey, G

    2016-03-01

    To investigate health professionals' perspectives about factors that impede or facilitate cancer care for Indigenous people. Semi-structured interviews with 22 health professionals involved in Indigenous cancer care. Data were interpreted using an inductive thematic analysis approach. Participants presented their perspectives on a number of barriers and enablers to Indigenous cancer care. Barriers were related to challenges with communication, the health system and coordination of care, issues around individual and community priorities and views of cancer treatment and health professional judgement. Enablers to cancer care were related to the importance of trust and rapport as well as health care system and support factors. The findings highlighted the need for recording of Indigenous status in medical records and a coordinated approach to the provision of evidence-based and culturally appropriate cancer care. This could go some way to improving Indigenous patient's engagement with tertiary cancer care services. PMID:26918690

  11. Challenges in multidisciplinary cancer care among general surgeons in Canada

    Directory of Open Access Journals (Sweden)

    McLeod Robin S

    2008-12-01

    Full Text Available Abstract Background While many factors can influence the way that cancer care is delivered, including the way that evidence is packaged and disseminated, little research has evaluated how health care professionals who manage cancer patients seek and use this information to identify whether and how this could be supported. Through interviews we identified that general surgeons experience challenges in coordinating care for complex cancer patients whose management is not easily addressed by guidelines, and conducted a population-based survey of general surgeon information needs and information seeking practices to extend these findings. Methods General surgeons with privileges at acute care hospitals in Ontario, Canada were mailed a questionnaire to solicit information needs (task, importance, information seeking (source, frequency of and reasons for use, key challenges and suggested solutions. Non-responders received up to three reminder packages. Significant differences among sub-groups (age, setting were examined statistically (Kruskal Wallis, Mann Whitney, Chi Square. Standard qualitative methods were used to thematically analyze open-ended responses. Results The response rate was 44.2% (170/385 representing all 14 health regions. System resource constraints (60.4%, comorbidities (56.4% and physiologic factors (51.8% were top-ranked issues creating information needs. Local surgical colleagues (84.6%, other local colleagues (82.2% and the Internet (81.1% were top-ranked sources of information, primarily due to familiarity and speed of access. No resources were considered to be highly applicable to patient care. Challenges were related to limitations in diagnostics and staging, operative resources, and systems to support multidisciplinary care, together accounting for 76.0% of all reported issues. Findings did not differ significantly by surgeon age or setting of care. Conclusion General surgeons appear to use a wide range of information

  12. Evaluation of the impact of interdisciplinarity in cancer care

    Directory of Open Access Journals (Sweden)

    Touati Nassera

    2011-06-01

    Full Text Available Abstract Background Teamwork is a key component of the health care renewal strategy emphasized in Quebec, elsewhere in Canada and in other countries to enhance the quality of oncology services. While this innovation would appear beneficial in theory, empirical evidences of its impact are limited. Current efforts in Quebec to encourage the development of local interdisciplinary teams in all hospitals offer a unique opportunity to assess the anticipated benefits. These teams working in hospital outpatient clinics are responsible for treatment, follow-up and patient support. The study objective is to assess the impact of interdisciplinarity on cancer patients and health professionals. Methods/Design This is a quasi-experimental study with three comparison groups distinguished by intensity of interdisciplinarity: strong, moderate and weak. The study will use a random sample of 12 local teams in Quebec, stratified by intensity of interdisciplinarity. The instrument to measure the intensity of the interdisciplinarity, developed in collaboration with experts, encompasses five dimensions referring to aspects of team structure and process. Self-administered questionnaires will be used to measure the impact of interdisciplinarity on patients (health care utilization, continuity of care and cancer services responsiveness and on professionals (professional well-being, assessment of teamwork and perception of teamwork climate. Approximately 100 health professionals working on the selected teams and 2000 patients will be recruited. Statistical analyses will include descriptive statistics and comparative analysis of the impact observed according to the strata of interdisciplinarity. Fixed and random multivariate statistical models (multilevel analyses will also be used. Discussion This study will pinpoint to what extent interdisciplinarity is linked to quality of care and meets the complex and varied needs of cancer patients. It will ascertain to what extent

  13. New Analysis Reexamines The Value Of Cancer Care In The United States Compared To Western Europe

    OpenAIRE

    Soneji, Samir; Yang, Jaewon

    2015-01-01

    Despite sharp increases in spending on cancer treatment since 1970 in the United States compared to Western Europe, US cancer mortality rates have decreased only modestly. This has raised questions about the additional value of US cancer care derived from this additional spending. We calculated the number of US cancer deaths averted, compared to the situation in Western Europe, between 1982 and 2010 for twelve cancer types. We also assessed the value of US cancer care, compared to that in Wes...

  14. Identifying Care Coordination Interventions Provided to Community-Dwelling Older Adults Using Electronic Health Records.

    Science.gov (United States)

    Kim, Tae Youn; Marek, Karen D; Coenen, Amy

    2016-07-01

    Although care coordination is a popular intervention, there is no standard method of delivery. Also little is known about who benefits most, or characteristics that predict the amount of care coordination needed, especially with chronically ill older adults. The purpose of this study was to identify types and amount of nurse care coordination interventions provided to 231 chronically ill older adults who participated in a 12-month home care medication management program in the Midwest. For each participant, the nurse care coordinator spent an average of 134 min/mo providing in-person home care, 48 min/mo of travel, and 18 min/mo of indirect care occurring outside the home visit. This accounted for 67.2%, 23.8%, and 9.0% of nursing time, respectively, for home visits, travel, and indirect care. Four of 11 nursing interventions focused on medication management were provided to all participants. Seven of the 11 main interventions were individualized according to each person's special needs. Wide variations were observed in time provided with in-person home care and communications with multiple stakeholders. Study findings indicate the importance of individualizing interventions and the variability in the amount of nursing time needed to provide care coordination to chronically ill older adults. PMID:26985762

  15. Telemedicine: an enhanced emergency care program for older adults

    Directory of Open Access Journals (Sweden)

    Takahashi PY

    2014-07-01

    Full Text Available Paul Y Takahashi,1 Anupam Chandra,1 Frederick North,1 Jennifer L Pecina,2 Benjavan Upatising,3 Gregory J Hanson11Mayo Clinic Division of Primary Care Internal Medicine, 2Mayo Clinic Department of Family Medicine, Rochester, MN, USA; 3Regenstrief Center for Healthcare Engineering, Purdue University, West Lafayette, IN, USAAbstract: Recent changes and consolidations in health care systems have resulted in an increase in new health care delivery models. Telemedicine holds great promise as one of these models. There is a great potential for new patient evaluation and treatment models in emergency care (EC, especially when patients are miles away from a medical team. Evaluations can be performed in a patient's home, a nursing care facility, and in hospitals that focus on advanced subspecialty care. Due to rapid developments in this area, current care models are constantly being evaluated and modified. This review article outlines current telemedicine models for EC and summarizes their potential benefits to patients and the health care system. The review examines the role that the telephone, a fundamental tool of telemedicine, plays in these new models. The review also examines evidence of improved health care outcomes by highlighting the role of telemedicine in reducing hospitalizations. The patient is the primary focus; as a result, this review also examined patient experiences and satisfaction levels regarding telemedicine health care teams. The authors support these technological advances and their potential for information transfer. Health care providers need to continue developing these models by making use of increasing amounts of information. One of the main implementation barriers of these new models in the US and other countries is the issue of payment and reimbursement. Despite this, advancements in EC telemedicine continue.Keywords: telemedicine, emergency care, geriatric, patient evaluation models

  16. Older Parents Providing Child Care for Adult Children: Does It Pay Off?

    Science.gov (United States)

    Geurts, Teun; Poortman, Anne-Rigt; van Tilburg, Theo G.

    2012-01-01

    This study examined whether past grandparental child care is related to present support from adult children. On the basis of social exchange theory, the authors expected that grandparental child care creates a debt that is repaid in the form of receiving support later in life. Using data from the Longitudinal Aging Study Amsterdam (N = 349…

  17. Supportive Care.

    Science.gov (United States)

    Olsen, Pia Riis; Lorenzo, Rosalía

    2016-01-01

    This chapter takes its point of departure in psychosocial aspects of supportive care in adolescent and young adult cancer care. The purpose is to describe some of the challenges that these young people face following a cancer diagnosis and guide healthcare professionals in how to provide care that improves the quality of life. In most hospitals and healthcare systems, adolescents and young adults are cared for and treated in settings for children or adults. Accordingly, healthcare professionals may lack attention to and knowledge about what characterize young peoples' life situation, their special needs and how to meet them. The topics we include in the chapter are the following: the youth friendly environment, social support and social network, parents, information during a psychosocial crisis event, the use of HEADSS, peer support, fertility, body image and self-esteem, after treatment and future challenges and palliative and end of life care. PMID:27595353

  18. The Influence of Adult Attachment on Patient Self-Management in Primary Care - The Need for a Personalized Approach and Patient-Centred Care

    OpenAIRE

    Katja Brenk-Franz; Bernhard Strauss; Fabian Tiesler; Christian Fleischhauer; Paul Ciechanowski; Nico Schneider; Jochen Gensichen

    2015-01-01

    Objective Self-management strategies are essential elements of evidence-based treatment in patients with chronic conditions in primary care. Our objective was to analyse different self-management skills and behaviours and their association to adult attachment in primary care patients with multiple chronic conditions. Methods In the apricare study (Adult Attachment in Primary Care) we used a prospective longitudinal design to examine the association between adult attachment and self-management...

  19. Recent advances in the surgical care of breast cancer patients

    Directory of Open Access Journals (Sweden)

    Vitelli Carlo E

    2010-01-01

    Full Text Available Abstract A tremendous improvement in every aspect of breast cancer management has occurred in the last two decades. Surgeons, once solely interested in the extipartion of the primary tumor, are now faced with the need to incorporate a great deal of information, and to manage increasingly complex tasks. As a comprehensive assessment of all aspects of breast cancer care is beyond the scope of the present paper, the current review will point out some of these innovations, evidence some controversies, and stress the need for the surgeon to specialize in the various aspects of treatment and to be integrated into the multisciplinary breast unit team.

  20. Current lifestyle of young adults treated for cancer in childhood.

    Science.gov (United States)

    Evans, S E; Radford, M

    1995-05-01

    The aim of this study was to look at the current lifestyle of young adult survivors of childhood cancer between the ages of 16 and 30 years to document their achievements and expose any psychosocial problems. Sixty six young adult survivors were contacted and asked if they and their siblings (16-30 years) would take part in a lifestyle study; 48 patients and 38 sibling controls were interviewed. This took the form of a structured lifestyle questionnaire, a self esteem questionnaire (Oxford Psychologists Press), and an unstructured interview. Fifty five per cent of patients achieved five or more A-C grades at 'O' level/GCSE compared with 62% of siblings and a national average of 30%. Despite that these patients were significantly less likely to go on to higher education than their siblings. The two groups were equally employable and earning similar salaries. There were three cases of known employer prejudice. A slightly higher percentage of patients than siblings had their driving licence. Seventeen patients felt their appearance had changed and eight felt that they had a residual physical mobility problem. Both groups were socially active and equally likely to partake in competitive sports. There was no overall difference in the self esteem of the two groups. In general the survivors of childhood cancer were coping well in their young adult life and achieving the same lifestyle goals as their siblings. However, significant problems have been identified. PMID:7618909

  1. Palliative care among heart failure patients in primary care: a comparison to cancer patients using English family practice data.

    Directory of Open Access Journals (Sweden)

    Amy Gadoud

    Full Text Available INTRODUCTION: Patients with heart failure have a significant symptom burden and other palliative care needs often over a longer period than patients with cancer. It is acknowledged that this need may be unmet but by how much has not been quantified in primary care data at the population level. METHODS: This was the first use of Clinical Practice Research Datalink, the world's largest primary care database to explore recognition of the need for palliative care. Heart failure and cancer patients who had died in 2009 aged 18 or over and had at least one year of primary care records were identified. A palliative approach to care among patients with heart failure was compared to that among patients with cancer using entry onto a palliative care register as a marker for a palliative approach to care. RESULTS: Among patients with heart failure, 7% (234/3 122 were entered on the palliative care register compared to 48% (3 669/7 608 of cancer patients. Of heart failure patients on the palliative care register, 29% (69/234 were entered onto the register within a week of their death. CONCLUSIONS: This confirms that the stark inequity in recognition of palliative care needs for people with heart failure in a large primary care dataset. We recommend a move away from prognosis based criteria for palliative care towards a patient centred approach, with assessment of and attention to palliative needs including advance care planning throughout the disease trajectory.

  2. Improving Cancer Care Through Nursing Research.

    Science.gov (United States)

    Mayer, Deborah K

    2015-09-01

    Nursing research and nurse researchers have been an integral and significant part of the Oncology Nursing Society's (ONS's) history, as evidenced by the development of the Nursing Research Committee within a few years of ONS's establishment. Ruth McCorkle, PhD, RN, FAAN, was the committee's first chairperson in 1979. This was followed by the creation of the Advanced Nursing Research Special Interest Group in 1989 under the leadership of Jean Brown, PhD, RN, FAAN. ONS also began to recognize nurse researchers in 1994 by creating the annual ONS Distinguished Researcher Award to recognize the contributions of a member who has conducted or promoted research that has enhanced the science and practice of oncology nursing. The list of recipients and of their work is impressive and reflects the wide range of our practice areas (see http://bit.ly/1MTC5cp for the recipient list). In addition, the ONS Foundation began funding research in 1981 and has distributed more than $24 million in research grants, research fellowships, and other scholarships, lectures, public education projects, and career development awards (ONS Foundation, 2015). And, in 2006, the Putting Evidence Into Practice resource was unveiled, which provides evidence-based intervention reviews for the 20 most common problems experienced by patients with cancer and their caregivers (www.ons
.org/practice-resources/pep)
. PMID:26302272

  3. An audit of the quality of inpatient care for adults with learning disability in the UK

    OpenAIRE

    Sheehan, Rory; Gandesha, Aarti; Hassiotis, Angela; Gallagher, Pamela; Burnell, Matthew; Jones, Glyn; Kerr, Michael; Hall, Ian; Chaplin, Robert; Crawford, Michael J.

    2016-01-01

    Objectives To audit patient hospital records to evaluate the performance of acute general and mental health services in delivering inpatient care to people with learning disability and explore the influence of organisational factors on the quality of care they deliver. Setting Nine acute general hospital Trusts and six mental health services. Participants Adults with learning disability who received inpatient hospital care between May 2013 and April 2014. Primary and secondary outcome measure...

  4. Incidence of diabetes mellitus type 2 complications among Saudi adult patients at primary health care center

    OpenAIRE

    Alsenany, Samira; Al Saif, Amer

    2015-01-01

    [Purpose] This study analyzed type 2 diabetes and its role in complications among adult Saudi patients. [Subjects] Patients attending four primary health care centers in Jeddah were enrolled. [Methods] A cross-sectional design study among Saudi patients attending Ministry of Health primary health care centers in Jeddah was selected for use by the Primary Health Care administration. Patients were interviewed with structured questionnaires to determine the presence of diabetes and risk factors ...

  5. Overview of outcome measurement for adults using social care services and support

    OpenAIRE

    Netten, Ann

    2011-01-01

    What is meant by outcome inevitably varies depending on the context and scope of what is under consideration. This review discusses the measurement of outcome for individuals and their carers for research purposes, particularly the type of research which evaluates the effectiveness and cost effectiveness of social care for adults and which has implications for social care practice. The review discusses what is meant by outcome in social care, presenting a model that describes different ‘types...

  6. Psychiatric Nursing Care for Adult Survivors of Child

    NARCIS (Netherlands)

    Zalm, Yvonne van der; Nugteren, Willem; Hafsteinsdóttir, Thóra van der; Venne, Cokky van der; Kool, Nienke; Meijel, Berno van

    2014-01-01

    PURPOSE: To determine what is known from the literature about nursing care of psychiatric patients with a history of child maltreatment. CONCLUSIONS: Psychiatric nurses underline the importance of a routine inquiry of child abuse on admission of patients to psychiatric care, but are reluctant to as

  7. Geriatric simulation: practicing management and leadership in care of the older adult.

    Science.gov (United States)

    Miller, Sally; Overstreet, Maria

    2015-06-01

    According to the Centers for Disease Control and Prevention, patients age 65 and older account for 43% of hospital days. The complexity of caring for older adults affords nursing students opportunities to assess, prioritize, intervene, advocate, and experience being a member of an interdisciplinary health care team. However, these multifaceted hospital experiences are not consistently available for all students. Nursing clinical simulation (NCS) can augment or replace specific clinical hours and provide clinically relevant experiences to practice management and leadership skills while caring for older adults. This article describes a geriatric management and leadership NCS. PMID:25999076

  8. Holistic care of the patient with cervical cancer.

    Science.gov (United States)

    McMullin, M

    1992-12-01

    Participation by women in screening programs for cervical cancer is far from optimal, and many lives are lost because of this. Cervical cancer is common, and is easily detected and treated. It has a good prognosis for cure if detected early in its course. Effective screening has been shown to have a major role in decreasing the morbidity and mortality associated with cervical cancer. Therefore, there is a need for increased public health education and availability of screening programs for women. It is particularly important that public health efforts reach women in the lower socioeconomic groups who are less apt to exhibit health promotive behaviors. Women of Latin American heritage are at particularly high risk because of cultural barriers to the discussion of sexual practices. Until public health interventions are more successful, cervical cancer will continue to pose a major threat to women who are either too embarrassed or too misinformed to understand that prevention is an integral part of women's health care. Nurses view patients in a holistic way. It is this philosophy of care that offers women who are diagnosed with cervical cancer a means to adapt successfully to the psychologic and physiologic stresses associated with the diagnosis. Nurses need to recognize this strength and to offer holistic approaches to women in crisis. No two patients deal with a diagnosis of cancer in the same manner. A major challenge to nurses across a hospital community continuum is to provide comprehensive psychologic and physiologic assessment of a women's response to a diagnosis of cervical cancer and to provide effective and holistic intervention when necessary. PMID:1448360

  9. Magnitude and Leading Sites of Cancer in A Tertiary Cancer Care Hospital of Western Maharashtra

    Directory of Open Access Journals (Sweden)

    Kapil H Agrawal, S.S. Rajderkar

    2011-01-01

    Full Text Available Context: It is observed that cancers are increasingly seen in both genders and all the age groups due to a complex interaction of various risk factors. To implement the Public health intervention measures it is essential to have the baseline data regarding frequency, distribution of cancers in the population. Aims: To study the magnitude of cancers by obtaining a baseline data regarding the frequency, distribution, leading cancer sites among the patients in a tertiary cancer care hospital of Western Maharashtra. Study settings: Shri Siddhivinayak Ganapati Cancer Hospital, Miraj Study Design: Hospital based, Cross sectional study involving retrospective information of patients from 1st March 2005 to 28th February 2006. Methods and Material: Retrospective, questionnaire study of patients from 1st March 2005 to 28th February 2006. Out of the total 2168 new patients registered, 1891 patients were detected to be malignant and included in the study. Results: 63.5 % Males and 67% Females in the age group 35-64 years had cancer. The sex ratio percent was 1.01%. Top five Cancer in males in our study were Oral Cavity, Oesophagus, Lung, Larynx and NHL. Top five Cancer in females in our study were Cervix, Breast, Ovary, Oral Cavity and Oesophagus. 27% were TRCs (Tobacco Related Cancers in males while 9.6% were TRCs in females. 34% cancers were in easily accessible parts of body. Conclusions: The Tobacco Related Cancers represent the most preventable form of cancer in our society. It was 27% in males and 9.6% in females in our study. Additionally 34% cancers were in easily accessible parts of body. It highlights the possibility of easy and early detection of cancers in the population thus decreasing the cancer burden in the community.

  10. Bi-parental care contributes to sexually dimorphic neural cell genesis in the adult mammalian brain.

    Directory of Open Access Journals (Sweden)

    Gloria K Mak

    Full Text Available Early life events can modulate brain development to produce persistent physiological and behavioural phenotypes that are transmissible across generations. However, whether neural precursor cells are altered by early life events, to produce persistent and transmissible behavioural changes, is unknown. Here, we show that bi-parental care, in early life, increases neural cell genesis in the adult rodent brain in a sexually dimorphic manner. Bi-parentally raised male mice display enhanced adult dentate gyrus neurogenesis, which improves hippocampal neurogenesis-dependent learning and memory. Female mice display enhanced adult white matter oligodendrocyte production, which increases proficiency in bilateral motor coordination and preference for social investigation. Surprisingly, single parent-raised male and female offspring, whose fathers and mothers received bi-parental care, respectively, display a similar enhancement in adult neural cell genesis and phenotypic behaviour. Therefore, neural plasticity and behavioural effects due to bi-parental care persist throughout life and are transmitted to the next generation.

  11. Cervical cancer screening in primary health care setting in Sudan

    DEFF Research Database (Denmark)

    Ibrahim, Ahmed; Aro, Arja R.; Rasch, Vibeke;

    2012-01-01

    of this study showed that VIA has higher sensitivity and lower specificity compared to Pap smear, but a combination of both tests has greater sensitivity and specificity than each test independently. It indicates that VIA is useful for screening of cervical cancer in the primary health care setting in Sudan......OBJECTIVE: To determine the feasibility of visual inspection with the use of acetic acid (VIA) as a screening method for cervical cancer, an alternative to the Pap smear used in primary health care setting in Sudan, and to compare sensitivity, specificity, positive and negative predictive values......, and histological diagnosis of positive cases of both tests. METHODS: A cross-sectional study of 934 asymptomatic women living in Khartoum, Sudan, was conducted during 2009-2010. A semi-structured questionnaire containing socio-economic and reproductive variables was used to collect data from each participant...

  12. Integrating cannabis into clinical cancer care.

    Science.gov (United States)

    Abrams, D I

    2016-03-01

    Cannabis species have been used as medicine for thousands of years; only since the 1940s has the plant not been widely available for medical use. However, an increasing number of jurisdictions are making it possible for patients to obtain the botanical for medicinal use. For the cancer patient, cannabis has a number of potential benefits, especially in the management of symptoms. Cannabis is useful in combatting anorexia, chemotherapy-induced nausea and vomiting, pain, insomnia, and depression. Cannabis might be less potent than other available antiemetics, but for some patients, it is the only agent that works, and it is the only antiemetic that also increases appetite. Inhaled cannabis is more effective than placebo in ameliorating peripheral neuropathy in a number of conditions, and it could prove useful in chemotherapy-induced neuropathy. A pharmacokinetic interaction study of vaporized cannabis in patients with chronic pain on stable doses of sustained-release opioids demonstrated no clinically significant change in plasma opiates, while suggesting the possibility of synergistic analgesia. Aside from symptom management, an increasing body of in vitro and animal-model studies supports a possible direct anticancer effect of cannabinoids by way of a number of different mechanisms involving apoptosis, angiogenesis, and inhibition of metastasis. Despite an absence of clinical trials, abundant anecdotal reports that describe patients having remarkable responses to cannabis as an anticancer agent, especially when taken as a high-potency orally ingested concentrate, are circulating. Human studies should be conducted to address critical questions related to the foregoing effects. PMID:27022315

  13. Integrating cannabis into clinical cancer care

    Science.gov (United States)

    Abrams, D.I.

    2016-01-01

    Cannabis species have been used as medicine for thousands of years; only since the 1940s has the plant not been widely available for medical use. However, an increasing number of jurisdictions are making it possible for patients to obtain the botanical for medicinal use. For the cancer patient, cannabis has a number of potential benefits, especially in the management of symptoms. Cannabis is useful in combatting anorexia, chemotherapy-induced nausea and vomiting, pain, insomnia, and depression. Cannabis might be less potent than other available antiemetics, but for some patients, it is the only agent that works, and it is the only antiemetic that also increases appetite. Inhaled cannabis is more effective than placebo in ameliorating peripheral neuropathy in a number of conditions, and it could prove useful in chemotherapy-induced neuropathy. A pharmacokinetic interaction study of vaporized cannabis in patients with chronic pain on stable doses of sustained-release opioids demonstrated no clinically significant change in plasma opiates, while suggesting the possibility of synergistic analgesia. Aside from symptom management, an increasing body of in vitro and animal-model studies supports a possible direct anticancer effect of cannabinoids by way of a number of different mechanisms involving apoptosis, angiogenesis, and inhibition of metastasis. Despite an absence of clinical trials, abundant anecdotal reports that describe patients having remarkable responses to cannabis as an anticancer agent, especially when taken as a high-potency orally ingested concentrate, are circulating. Human studies should be conducted to address critical questions related to the foregoing effects. PMID:27022315

  14. The Effect of Free Adult Preventive Care Services on Subsequent Utilization of Inpatient Services in Taiwan.

    Science.gov (United States)

    Tian, Wei-Hua

    2016-07-01

    The objective of this article is to investigate the relationship between the utilization of free adult preventive care services and subsequent utilization of inpatient services among elderly people under the National Health Insurance program in Taiwan. The study used secondary data from the 2005 Taiwan National Health Interview Survey and claim data from the 2006 Taiwan National Health Insurance Research Database for the elderly aged 65 or over. A bivariate probit model was used to avoid the possible endogeneity in individuals' utilization of free adult preventive care and inpatient services. This study finds that, when individuals had utilized the preventive care services in 2005, the probability that they utilized inpatient services in 2006 was significantly reduced by 13.89%. The findings of this study may provide a good reference for policy makers to guide the efficient allocation of medical resources through the continuous promotion of free adult preventive care services under the National Health Insurance program. PMID:27287671

  15. Core communication components along the cancer care process: the perspective of breast cancer patients.

    Science.gov (United States)

    Prades, Joan; Ferro, Tàrsila; Gil, Francisco; Borras, Josep M

    2014-10-01

    This study sought to assess the impact of health care professional (HCP) communication on breast cancer patients across the acute care process as perceived by patients. Methodological approach was based on eight focus groups conducted with a sample of patients (n = 37) drawn from 15 Spanish Regions; thematic analysis was undertaken using the National Cancer Institute (NCI) framework of HCP communication as the theoretical basis. Relevant results of this study were the identification of four main communication components: (1) reassurance in coping with uncertainty after symptom detection and prompt access until confirmed diagnosis; (2) fostering involvement before delivering treatments, by anticipating information on practical and emotional illness-related issues; (3) guidance on the different therapeutic options, through use of clinical scenarios; and, (4) eliciting the feeling of emotional exhaustion after ending treatments and addressing the management of potential treatment-related effects. These communication-related components highlighted the need for a comprehensive approach in this area of cancer care. PMID:24980292

  16. Outpatient treatment costs and their potential impact on cancer care

    International Nuclear Information System (INIS)

    Cancer creates a tremendous financial burden. Cancer-related costs are categorized into direct, indirect, and psychosocial costs. Although there have been many reports on medical care costs, which are direct, those on other costs are extremely scarce. We estimated travel time and costs required for cancer patients to receive outpatient treatment. We studied 521 cancer patients receiving anti-cancer treatment between February 2009 and December 2012 at the Outpatient Chemotherapy Center of Teikyo University Chiba Medical Center. Address data were extracted from Data Warehouse electronic medical records, and travel distance and time required for outpatient treatment were calculated via MapInfo and ACT Distance Calculator Package. Transportation costs were estimated on the basis of ¥274 (=$3.00) per kilometer. The study design was approved by an ethics review board of Teikyo University (12-851). Average round-trip travel distance, time, and cost for all patients were 26.7 km, 72.5 min, and ¥7,303 ($79.99), respectively. Cancer patients incurred a travel cost of ¥4000–¥9000 ($40.00 to $100.00) for each outpatient treatment. With population aging, seniors living alone and senior households are increasing, and outpatient visits are becoming a common burden

  17. Outpatient treatment costs and their potential impact on cancer care.

    Science.gov (United States)

    Isshiki, Takahiro

    2014-12-01

    Cancer creates a tremendous financial burden. Cancer-related costs are categorized into direct, indirect, and psychosocial costs. Although there have been many reports on medical care costs, which are direct, those on other costs are extremely scarce. We estimated travel time and costs required for cancer patients to receive outpatient treatment. We studied 521 cancer patients receiving anti-cancer treatment between February 2009 and December 2012 at the Outpatient Chemotherapy Center of Teikyo University Chiba Medical Center. Address data were extracted from Data Warehouse electronic medical records, and travel distance and time required for outpatient treatment were calculated via MapInfo and ACT Distance Calculator Package. Transportation costs were estimated on the basis of ¥274 (=$3.00) per kilometer. The study design was approved by an ethics review board of Teikyo University (12-851). Average round-trip travel distance, time, and cost for all patients were 26.7 km, 72.5 min, and ¥7,303 ($79.99), respectively. Cancer patients incurred a travel cost of ¥4000-¥9000 ($40.00 to $100.00) for each outpatient treatment. With population aging, seniors living alone and senior households are increasing, and outpatient visits are becoming a common burden. PMID:25060622

  18. Measuring improvement in populations: implementing and evaluating successful change in lung cancer care

    OpenAIRE

    Yu, Xinhua; Klesges, Lisa M; Smeltzer, Mathew P.; Osarogiagbon, Raymond U.

    2015-01-01

    Improving quality of care in lung cancer, the leading cause of cancer death worldwide and in the United States, is a major public health challenge. Such improvement requires accurate and meaningful measurement of quality of care. Preliminary indicators have been derived from clinical practice guidelines and expert opinions, but there are few standard sets of quality of care measures for lung cancer in the United States or elsewhere. Research to develop validated evidence-based quality of care...

  19. Fighting Global Disparities in Cancer Care: A Surgical Oncology View.

    Science.gov (United States)

    Hoekstra, Harald J; Wobbes, Theo; Heineman, Erik; Haryono, Samuel; Aryandono, Teguh; Balch, Charles M

    2016-07-01

    Cancer is the second leading cause of death globally after cardiovascular disease. Long-term cancer survival has improved in the Western world due to early detection and the use of effective combined treatment modalities, as well as the development of effective immunotherapy and drug-targeted therapy. Surgery is still the mainstay for most solid tumors; however, low- and middle-income countries are facing an increasing lack of primary surgical care for easily treatable conditions, including breast, colon, and head and neck cancers. In this paper, a surgical oncology view is presented to elaborate how the Western surgical oncologist can take part in the 'surgical fight' against global disparities in cancer care, and a plea is made to strive for structural solutions, such as a partnership in surgical oncology training. The pros and cons of the use of eHealth and mHealth technologies and education programs for schools and the community are discussed as these create an opportunity to reach a large portion of the population in these countries, at low cost and with high impact. PMID:27038459

  20. Socioeconomic status and patterns of care in lung cancer

    International Nuclear Information System (INIS)

    This retrospective study aims to explore any associations between socioeconomic factors and lung cancer management and outcome in the Australian setting. The study population consisted of patients newly diagnosed with lung cancer in 1996 who were living in the Northern Sydney Area Health Service (NSAHS) or South Western Sydney Area Health Service (SWSAHS). These two Area Health Services differ in socioeconomic profiles based on socioeconomic indexes for areas (SEIFA), median income, education level and unemployment rate. Data on patient demographics, tumour characteristics, management details, recurrence and survival were collected, and the patterns of care were analysed. Socioeconomic status indicators of the two Area Health Services were imputed from the Australian Bureau of Statistics data. There were 270 and 256 new cases of lung cancer identified in NSAHS and SWSAHS respectively. Patients in NSAHS were slightly older (median age 73 versus 68 years) and there was less male predominance. The stage distributions and performance status of the two cohorts were similar. There were no significant differences in the utilisation rates of different treatment modalities between the two areas: radiotherapy (54% in NSAHS and 55% in SWSAHS), chemotherapy (34% and 25%), surgery (26% and 21%) and no treatment (22% and 25%). The 5-year overall survival was slightly in favour of NSAHS (10.5% and 7.4%), but did not reach statistical significance. Despite differences in socioeconomic profiles between the two area health services, patients with lung cancer had similar patterns of care and survival

  1. Caring and curing: paediatric cancer services since 1960.

    Science.gov (United States)

    Barnes, E

    2005-09-01

    This paper traces the history of the specialist meanings of 'cure' in paediatric oncology in the UK, how they have changed with increasing organization of the discipline, ever-rising survival rates for all childhood cancers, and with feedback from patients and families. It examines the differing ways in which those involved in researching, treating, and raising funds for work on childhood cancers have understood and used the language of cure, and speculates as to why talking about the 'cure' of survivors of childhood cancers is so problematic. The paper discusses the particular importance of holistic care in the development of paediatric oncology. Psychosocial support is delivered alongside surgery, radiotherapy and chemotherapy. The focus for support is the patient's whole family, building a tenet of palliative care into curative treatment. The concept of the 'truly cured child' is argued to have been crucial in the discipline's decision in the 1970s and 1980s to make the psychosocial needs of patients and their families central in the programme of curing children with cancer. PMID:16098123

  2. Cancer registries can provide evidence-based data to improve quality of care and prevent cancer deaths

    OpenAIRE

    Bouchardy Magnin, Christine; Rapiti Aylward, Elisabetta; Benhamou, Simone

    2014-01-01

    Today, many countries are increasing their efforts to ensure that all cancer patients receive the best possible care. Population-based cancer registries have adapted their registration to collect additional clinical variables to provide clinicians with unbiased population data on cancer treatment and survival. Taking several examples of epidemiological cancer research performed at the Geneva Cancer Registry, we aim to illustrate how cancer registries oversee the treatment and outcomes of canc...

  3. Psychiatric Nursing Care for Adult Survivors of Child

    OpenAIRE

    Zalm, Yvonne van der; Nugteren, Willem; Hafsteinsdóttir, Thóra van der; Venne, Cokky van der; Kool, Nienke; van Meijel, Berno

    2014-01-01

    PURPOSE: To determine what is known from the literature about nursing care of psychiatric patients with a history of child maltreatment. CONCLUSIONS: Psychiatric nurses underline the importance of a routine inquiry of child abuse on admission of patients to psychiatric care, but are reluctant to ask about child abuse. They often feel insufficiently competent to respond effectively to patients with a history of child maltreatment. PRACTICE IMPLICATIONS: Psychiatric nurses need training in how ...

  4. Health care restructuring and family physician care for those who died of cancer

    Directory of Open Access Journals (Sweden)

    Johnston Grace

    2005-01-01

    Full Text Available Abstract Background During the 1990s, health care restructuring in Nova Scotia resulted in downsized hospitals, reduced inpatient length of stay, capped physician incomes and restricted practice locations. Concurrently, the provincial homecare program was redeveloped and out-of-hospital cancer deaths increased from 20% (1992 to 30% (1998. These factors all pointed to a transfer of end-of-life inpatient hospital care to more community-based care. The purpose of this study was to describe the trends in the provision of Family Physician (FP visits to advanced cancer patients in Nova Scotia (NS during the years of health care restructuring. Methods Design Secondary multivariate analysis of linked population-based datafiles including the Queen Elizabeth II Health Sciences Centre Oncology Patient Information System (NS Cancer Registry, Vital Statistics, the NS Hospital Admissions/Separations file and the Medical Services Insurance Physician Services database. Setting Nova Scotia, an eastern Canadian province (population: 950,000. Subjects: All patients who died of lung, colorectal, breast or prostate cancer between April 1992 and March 1998 (N = 7,212. Outcome Measures Inpatient and ambulatory FP visits, ambulatory visits by location (office, home, long-term care facility, emergency department, time of day (regular hours, after hours, total length of inpatient hospital stay and number of hospital admissions during the last six months of life. Results In total, 139,641 visits were provided by family physicians: 15% of visits in the office, 10% in the home, 5% in the emergency department (ED, 5% in a long-term-care centre and 64% to hospital inpatients. There was no change in the rate of FP visits received for office, home and long-term care despite the fact that there were 13% fewer hospital admissions, and length of hospital stay declined by 21%. Age-sex adjusted estimates using negative binomial regression indicate a decline in hospital inpatient FP

  5. Mixed care networks of community-dwelling older adults with physical health impairments in the Netherlands.

    Science.gov (United States)

    Broese van Groenou, Marjolein; Jacobs, Marianne; Zwart-Olde, Ilse; Deeg, Dorly J H

    2016-01-01

    As part of long-term care reforms, home-care organisations in the Netherlands are required to strengthen the linkage between formal and informal caregivers of home-dwelling older adults. Information on the variety in mixed care networks may help home-care organisations to develop network type-dependent strategies to connect with informal caregivers. This study first explores how structural (size, composition) and functional features (contact and task overlap between formal and informal caregivers) contribute to different types of mixed care networks. Second, it examines to what degree these network types are associated with the care recipients' characteristics. Through home-care organisations in Amsterdam, the Netherlands, we selected 74 frail home-dwelling clients who were receiving care in 2011-2012 from both informal and formal caregivers. The care networks of these older adults were identified by listing all persons providing help with five different types of tasks. This resulted in care networks comprising an average of 9.7 caregivers, of whom 67% were formal caregivers. On average, there was contact between caregivers within 34% of the formal-informal dyads, and both caregivers carried out at least one similar type of task in 29% of these dyads. A principal component analysis of size, composition, contact and task overlap showed two distinct network dimensions from which four network types were constructed: a small mixed care network, a small formal network, a large mixed network and a large formal network. Bivariate analyses showed that the care recipients' activities of daily living level, memory problems, social network, perceived control of care and level of mastery differed significantly between these four types. The results imply that different network types require different actions from formal home-care organisations, such as mobilising the social network in small formal networks, decreasing task differentiation in large formal networks and assigning

  6. Symptom interpretation and health care seeking in ovarian cancer

    Directory of Open Access Journals (Sweden)

    Blaakaer Jan

    2011-06-01

    Full Text Available Abstract Background Ovarian cancer is the leading cause of death among women suffering from gynaecological malignancies in the Western world. Worldwide, approximately 200,000 women are diagnosed with the disease each year. This article deals with the health care seeking and symptom interpretation process among Danish women, who have a very high mortality rate. Methods The health seeking and symptom interpretation process was analysed via combining study methods. The material consisted of registry data dealing with the use of public health care and hospital services of Danish women, newly diagnosed with ovarian cancer. These results were combined with findings from semi-structured qualitative research interviews on women's bodily experiences with symptom development. Results A number of 663 Danish women with ovarian cancer attended 27 different kinds of primary health care providers in a total of 14,009 visits during 2007. The women also had 6,214 contacts with various hospitals, and obtained 562 different diagnoses. From the main theme "Women's experiences with the onset of symptoms" three sub-themes were identified: "Bodily sensations", "From bodily sensation to symptom", and "Health seeking and treatment start". In all cases the General Practitioner represented the first contact to public health care, acting as gate-keeper to specialist and hospital referral. The women were major users of public health care throughout the diagnostic process and subsequent treatment. All women held personal knowledge concerning the onset of their symptoms. The early symptoms of ovarian cancer might be uncharacteristic and non-disease-specific when interpreted as personal experiences, but they had similarities when analysed together. Conclusions Diagnostic delay in ovarian cancer seems far from being exclusively a medical problem, as the delay proved to be influenced by organisational, cultural, and social factors, too. Initiatives facilitating the diagnostic

  7. Integrative cancer care in a US academic cancer centre: The Memorial Sloan-Kettering Experience.

    Science.gov (United States)

    Deng, G

    2008-08-01

    Various surveys show that interest in complementary and alternative medicine (CAM) is high among cancer patients. Patients want to explore all options that may help their treatment. Many CAM modalities offer patients an active role in their self-care, and the resulting sense of empowerment is very appealing. On the other hand, many unscrupulous marketeers promote alternative cancer "cures," targeting cancer patients who are particularly vulnerable. Some alternative therapies can hurt patients by delaying effective treatment or by causing adverse effects or detrimental interactions with other medications. It is not in the best interest of cancer patients if they cannot get appropriate guidance on the use of CAM from the health care professionals who are part of their cancer care team. The Integrative Medicine Service at Memorial Sloan-Kettering Cancer Center in New York was established in 1999 to address patient interest in cam, to incorporate helpful complementary therapies into each patient's overall treatment management, to guide patients in avoiding harmful alternative therapies, and to develop prospective research to evaluate the efficacy of CAM modalities. PMID:18769574

  8. Integrative Cancer Care in a US Academic Cancer Centre: The Memorial Sloan–Kettering Experience

    Science.gov (United States)

    Deng, G.

    2008-01-01

    Various surveys show that interest in complementary and alternative medicine (cam) is high among cancer patients. Patients want to explore all options that may help their treatment. Many cam modalities offer patients an active role in their self-care, and the resulting sense of empowerment is very appealing. On the other hand, many unscrupulous marketeers promote alternative cancer “cures,” targeting cancer patients who are particularly vulnerable. Some alternative therapies can hurt patients by delaying effective treatment or by causing adverse effects or detrimental interactions with other medications. It is not in the best interest of cancer patients if they cannot get appropriate guidance on the use of cam from the health care professionals who are part of their cancer care team. The Integrative Medicine Service at Memorial Sloan–Kettering Cancer Center in New York was established in 1999 to address patient interest in cam, to incorporate helpful complementary therapies into each patient’s overall treatment management, to guide patients in avoiding harmful alternative therapies, and to develop prospective research to evaluate the efficacy of cam modalities. PMID:18769574

  9. Cancer patient-centered home care: a new model for health care in oncology

    Directory of Open Access Journals (Sweden)

    Tralongo P

    2011-09-01

    Full Text Available Paolo Tralongo1, Francesco Ferraù2, Nicolò Borsellino3, Francesco Verderame4, Michele Caruso5, Dario Giuffrida6, Alfredo Butera7, Vittorio Gebbia81Medical Oncology Unit, Azienda Sanitaria Provinciale, Siracusa; 2Medical Oncology Unit, Ospedale San Vincenzo, Taormina; 3Medical Oncology Unit, Ospedale Buccheri La Ferla, Palermo; 4Medical Oncology Unit, Ospedale Giovanni Paolo II, Sciacca; 5Medical Oncology Unit, Istituto Humanitas, Catania; 6Medical Oncology Unit, Istituto Oncologico del Mediterraneo, Catania; 7Medical Oncology Unit, Ospedale San Giovanni di Dio, Agrigento; 8Medical Oncology Unit, Dipartimento Oncologico, La Maddalena, Università degli Studi, Palermo, ItalyAbstract: Patient-centered home care is a new model of assistance, which may be integrated with more traditional hospital-centered care especially in selected groups of informed and trained patients. Patient-centered care is based on patients' needs rather than on prognosis, and takes into account the emotional and psychosocial aspects of the disease. This model may be applied to elderly patients, who present comorbid diseases, but it also fits with the needs of younger fit patients. A specialized multidisciplinary team coordinated by experienced medical oncologists and including pharmacists, psychologists, nurses, and social assistance providers should carry out home care. Other professional figures may be required depending on patients' needs. Every effort should be made to achieve optimal coordination between the health professionals and the reference hospital and to employ shared evidence-based guidelines, which in turn guarantee safety and efficacy. Comprehensive care has to be easily accessible and requires a high level of education and knowledge of the disease for both the patients and their caregivers. Patient-centered home care represents an important tool to improve quality of life and help cancer patients while also being cost effective.Keywords: cancer, home care

  10. Perceptions of lung cancer and potential impacts on funding and patient care: a qualitative study.

    Science.gov (United States)

    Tran, Kim; Delicaet, Kendra; Tang, Theresa; Ashley, Leslie Beard; Morra, Dante; Abrams, Howard

    2015-03-01

    The objective of this study was to explore health-care professionals', health administrators', and not-for-profit cancer organization representatives' perceptions of lung cancer-related stigma and nihilism and the perceived impacts on funding and patient care. This is a qualitative descriptive study using semi-structured interviews, which was conducted in Ontario, Canada. Seventy-four individuals from medical oncology, radiation oncology, thoracic surgery, respirology, pathology, radiology, primary care, palliative care, nursing, pharmacy, social work, genetics, health administration, and not-for-profit cancer organizations participated in this study. Participants described lung cancer-related stigma and nihilism and its negative impact on patients' psychological health, lung cancer funding, and patient care. The feeling of guilt and shame experienced by lung cancer patients as a result of the stigma associated with the disease was described. In terms of lung cancer funding, stigma was described as a reason lung cancer receives significantly less research funding compared to other cancers. In terms of patient care, lung cancer-related nihilism was credited with negatively impacting physician referral patterns with the belief that lung cancer patients were less likely to receive referrals for medical treatment. Health-care professionals, health administrators, and not-for-profit cancer organization representatives described lung cancer-related stigma and nihilism with far-reaching consequences. Further work is needed to increase education and awareness about lung cancer to reduce the stigma and nihilism associated with the disease. PMID:24882441

  11. Dealing with chemotherapy-related symptoms at home: a qualitative study in adult patients with cancer.

    Science.gov (United States)

    Coolbrandt, A; Dierckx de Casterlé, B; Wildiers, H; Aertgeerts, B; Van der Elst, E; van Achterberg, T; Milisen, K

    2016-01-01

    Given that chemotherapy treatments are done mostly in an outpatient setting, patients with cancer must deal with treatment-related symptoms mainly at home. Evidence suggests that they often feel left alone or unprepared to do so. This qualitative study explores how patients deal with chemotherapy-related symptoms in their home, which factors and ideas influence their self-management and what role professional caregivers play. One-off, semi-structured interviews were held with 28 adult patients with cancer being treated with chemotherapy. Using a Grounded Theory approach, we cyclically collected and analysed data to come to a thorough understanding of the major conceptual themes and their interconnections. Dealing with chemotherapy-related symptoms involves a process of experiencing and learning how side effects unfold over time and how to deal with them. Patients express very personal symptom experiences and symptom-management styles, which are shaped by personal factors (e.g. coping with cancer and cancer treatment, perceived level of control) and environmental factors (e.g. professionals' attitude, information resources). Improving symptom self-management support requires active exploration of the personal symptom experience and symptom-management style. Professional care should be tailored to the patient's perspective and should address personal and environmental determinants of their behaviour. PMID:25752741

  12. Meaning and practice of palliative care for hospitalized older adults with life limiting illnesses.

    Science.gov (United States)

    Powers, Bethel Ann; Norton, Sally A; Schmitt, Madeline H; Quill, Timothy E; Metzger, Maureen

    2011-01-01

    Objective. To illustrate distinctions and intersections of palliative care (PC) and end-of-life (EOL) services through examples from case-centered data of older adults cared for during a four-year ethnographic study of an acute care hospital palliative care consultation service. Methods. Qualitative narrative and thematic analysis. Results. Description of four practice paradigms (EOL transitions, prognostic uncertainty, discharge planning, and patient/family values and preferences) and identification of the underlying structure and communication patterns of PC consultation services common to them. Conclusions. Consistent with reports by other researchers, study data support the need to move beyond equating PC with hospice or EOL care and the notion that EOL is a well-demarcated period of time before death. If professional health care providers assume that PC services are limited to assisting with and helping patients and families prepare for dying, they miss opportunities to provide care considered important to older individuals confronting life-limiting illnesses. PMID:21584232

  13. Fetal Programming of Adult Disease: Implications for Prenatal Care

    Science.gov (United States)

    The obesity epidemic, including a marked increase in the prevalence of obesity among pregnant women, represents a critical public health problem in the United States and throughout the world. Over the past two decades, it has been increasingly recognized that the risk of adult ...

  14. 75 FR 9913 - Request for Measures of Patient Experiences of Cancer Care

    Science.gov (United States)

    2010-03-04

    ... tool being developed to measure Patient Centered Communication (PCC) in cancer care. While both... of the communication between patients and clinicians throughout the spectrum of cancer care (i.e...) as cited in Epstein & Street (Epstein RM, Street RL Jr. Patient Centered Communication in Cancer...

  15. Cancer patient-centered home care: a new model for health care in oncology

    Science.gov (United States)

    Tralongo, Paolo; Ferraù, Francesco; Borsellino, Nicolò; Verderame, Francesco; Caruso, Michele; Giuffrida, Dario; Butera, Alfredo; Gebbia, Vittorio

    2011-01-01

    Patient-centered home care is a new model of assistance, which may be integrated with more traditional hospital-centered care especially in selected groups of informed and trained patients. Patient-centered care is based on patients’ needs rather than on prognosis, and takes into account the emotional and psychosocial aspects of the disease. This model may be applied to elderly patients, who present comorbid diseases, but it also fits with the needs of younger fit patients. A specialized multidisciplinary team coordinated by experienced medical oncologists and including pharmacists, psychologists, nurses, and social assistance providers should carry out home care. Other professional figures may be required depending on patients’ needs. Every effort should be made to achieve optimal coordination between the health professionals and the reference hospital and to employ shared evidence-based guidelines, which in turn guarantee safety and efficacy. Comprehensive care has to be easily accessible and requires a high level of education and knowledge of the disease for both the patients and their caregivers. Patient-centered home care represents an important tool to improve quality of life and help cancer patients while also being cost effective. PMID:21941445

  16. Will patients benefit from regionalization of gynecologic cancer care?

    Directory of Open Access Journals (Sweden)

    Kathleen F Brookfield

    Full Text Available OBJECTIVE: Patient chances for cure and palliation for a variety of malignancies may be greatly affected by the care provided by a treating hospital. We sought to determine the effect of volume and teaching status on patient outcomes for five gynecologic malignancies: endometrial, cervical, ovarian and vulvar carcinoma and uterine sarcoma. METHODS: The Florida Cancer Data System dataset was queried for all patients undergoing treatment for gynecologic cancers from 1990-2000. RESULTS: Overall, 48,981 patients with gynecologic malignancies were identified. Endometrial tumors were the most common, representing 43.2% of the entire cohort, followed by ovarian cancer (30.9%, cervical cancer (20.8%, vulvar cancer (4.6%, and uterine sarcoma (0.5%. By univariate analysis, although patients treated at high volume centers (HVC were significantly younger, they benefited from an improved short-term (30-day and/or 90-day survival for cervical, ovarian and endometrial cancers. Multivariate analysis (MVA, however, failed to demonstrate significant survival benefit for gynecologic cancer patients treated at teaching facilities (TF or HVC. Significant prognostic factors at presentation by MVA were age over 65 (HR = 2.6, p<0.01, African-American race (HR = 1.36, p<0.01, and advanced stage (regional HR = 2.08, p<0.01; advanced HR = 3.82, p<0.01, respectively. Surgery and use of chemotherapy were each significantly associated with improved survival. CONCLUSION: No difference in patient survival was observed for any gynecologic malignancy based upon treating hospital teaching or volume status. Although instances of improved outcomes may occur, overall further regionalization would not appear to significantly improve patient survival.

  17. Falls, Depression, and Other Hospitalization Risk Factors for Adults in Residential Care Facilities.

    Science.gov (United States)

    Gimm, Gilbert W; Kitsantas, Panagiota

    2016-06-01

    Prior research has shown a relationship between falls, hospitalizations, and depression among older adults in nursing home settings, but few studies have explored these relationships for younger and older adults in residential care facilities. This study examined risk factors for hospitalizations among assisted living residents. Using the 2010 National Survey of Residential Care Facilities, the study found that 24% of residents had a hospital stay in the past year. Residents with falls were more than twice as likely to have a hospitalization. For younger residents, depression was a key risk factor (OR = 1.74, p depression and severe mental illness, who are at greater risk of hospitalization. Reducing avoidable hospitalizations can improve well-being for older and younger adults in residential care facilities. PMID:27147680

  18. Using function-focused care to increase physical activity among older adults.

    Science.gov (United States)

    Resnick, Barbara; Galik, Elizabeth

    2013-01-01

    Despite the known benefits of physical activity for older adults, adherence to regular physical activity recommendations is poor. Less than half of adults in this country meet physical activity recommendations with reasons for lack of adherence including such things as access, motivation, pain, fear, comorbidities, among others. To overcome these challenges, function-focused care was developed. Function-focused care is a philosophy of care that focuses on evaluating the older adult's underlying capability with regard to function and physical activity and helping him or her optimize and maintain physical function and ability and continually increase time spent in physical activity. Examples of function-focused care include such things as using verbal cues during bathing, so the older individual performs the tasks rather than the caregiver bathing the individual; walking a resident or patient to the bathroom rather than using a urinal, or taking a resident to an exercise class. There are now over 20 studies supporting the benefits of function-focused care approaches across all settings and different types of patient groups (i.e, those with mild versus moderate-to-severe cognitive impairment). The approaches for implementation of function-focused care have also been well supported and have moved beyond establishing effectiveness to considering dissemination and implementation of this approach into real world clinical settings. The process of dissemination and implementation has likewise been articulated and supported, and ongoing work needs to continue in this venue across all care settings. PMID:24894140

  19. Caring for older adults: practice guided by Watson's caring-healing model.

    Science.gov (United States)

    Bernick, Laurie

    2004-04-01

    Caring for older people and listening attentively to what they say about themselves and their varied health situations, especially in relation to quality of life and peace of mind, body, and soul, are important matters to nurses aligned with Watson's caring-healing theory. Assumptions and key concepts of Watson's framework are described with examples that illustrate how a nursing framework has shaped the author's advanced nursing practice. Some of the key concepts discussed include intersubjectivity, transpersonal caring, spirituality, and caring moments. Watson's framework of caring-healing is shown to inform practice, education, and research. PMID:15090087

  20. Personality Assessment Screener, Childhood Abuse, and Adult Partner Violence in African American Women Using Primary Care.

    Science.gov (United States)

    Porcerelli, John H; Hurrell, Kristen; Cogan, Rosemary; Jeffries, Keturah; Markova, Tsveti

    2015-12-01

    This study assessed the relationship between psychopathology with the Personality Assessment Screener (PAS) and childhood physical and sexual abuse and adult physical and sexual partner violence in a primary care sample of 98 urban-dwelling African American women. Patients completed the PAS, the Childhood Trauma Questionnaire, and the Conflict Tactics Scale. The PAS total score significantly correlated with all measures of childhood and adult abuse. Stepwise regression analyses revealed that PAS element scores of Suicidal Thinking and Hostile Control significantly predicted a history of childhood physical abuse; Suicidal Thinking, Hostile Control, and Acting Out significantly predicted a history of childhood sexual abuse; Suicidal Thinking, Negative Affect, and Alienation significantly predicted current adult partner physical violence; and Psychotic Features, Alcohol Problems, and Anger Control significantly predicted current adult sexual partner violence. The PAS appears to be a useful measure for fast-paced primary care settings for identifying patients who need a more thorough assessment for abuse. PMID:26374084

  1. Palliative care for cancer patients in a primary health care setting:Bereaved relatives' experience, a qualitative group interview study

    DEFF Research Database (Denmark)

    Neergaard, Mette Asbjørn; Olesen, Frede; Jensen, Anders Bonde;

    2008-01-01

    Background: Knowledge about the quality and organisation of care to terminally ill cancer patients with a relatives' view in a primary health care setting is limited. The aim of the study is to analyse experiences and preferences of bereaved relatives to terminally ill cancer patients in a primary...... care setting to explore barriers and facilitators for delivery of good palliative home care. Methods: Three focus group interviews with fourteen bereaved relatives in Aarhus County, Denmark. Results: Three main categories of experience were identified: 1) The health professionals' management, where a...... need to optimize was found. 2) Shared care, which was lacking. 3) The relatives' role, which needs an extra focus. Conclusion: Relatives experience insufficient palliative care mainly due to organizational and cultural problems among professionals. Palliative care in primary care in general needs...

  2. Factors influencing dental care access in Jordanian adults

    OpenAIRE

    Obeidat, Suhair Ref’at; Alsa’di, Amani Ghassan; Taani, Dafi Sultan

    2014-01-01

    Background The aims of this study are to assess the influences of demographic and personal factors on Jordanian adults’ abilities to use dental services and the barriers to regular attendance. Methods A self-administered questionnaire was distributed to a sample of 650 Jordanian adults attending King Abdullah University Hospital (KAUH) (n = 200), Jordan University of Science and Technology–Dental Health Teaching Center (JUST–DHTC) (n = 150), Yarmouk University Health Clinics (YUHC) (n = 150),...

  3. Delay in seeking specialized care for oral cancers: Experience from a tertiary cancer center

    Directory of Open Access Journals (Sweden)

    P Joshi

    2014-01-01

    Full Text Available Objective: Advanced oral cancers are a challenge for treatment, as they require complex procedures for excision and reconstruction. Despite being occurring at a visible site and can be detected easily, many patients present in advanced stages with large tumors. Timely intervention is important in improving survival and quality of life in these patients. The aim of the present study was to find out the causes of delay in seeking specialist care in advanced oral cancer patients. Materials and Methods: A prospective questionnaire based study was done on 201 consecutive advanced oral squamous cancer patients who underwent surgery at our hospital. All patients had either cancer of gingivobuccal complex (GBC or tongue and had tumors of size more than 4 cm (T3/T4 and were treatment naοve at presentation. RESULTS: Even though most patients observed abnormal lesions in their mouth, majority delayed the decision to visit a physician early. A significant percentage of patients (50% also reported a delayed diagnosis by the primary care physician before being referred to a tertiary care center for definitive treatment. The average total duration from symptoms to treatment was 7 months. Conclusion: The main reasons of this delay in receiving treatment were due to patients themselves (primary delay or due to time taken by the primary physician to diagnose the condition (secondary delay. Oral self-examination can be helpful in detecting oral cancers early.

  4. Health of adults caring for orphaned children in an HIV endemic community in South Africa

    OpenAIRE

    Kuo, Caroline; Operario, Don

    2011-01-01

    In South Africa, an estimated 2.5 million children have been orphaned by AIDS and other causes of adult mortality. Although there is a growing body of research on the well-being of South African orphaned children, few research studies have examined the health of adult individuals caring for children in HIV endemic communities. The cross-sectional survey assessed prevalence of general health and functioning (based on Short-Form 36 version 2 scale), depression (based on Center for Epidemiologic...

  5. Self-Reported Sleep Difficulties and Self-Care Strategies Among Rural Older Adults

    OpenAIRE

    Sandberg, Joanne C.; Suerken, Cynthia K.; Quandt, Sara A.; Altizer, Kathryn P.; Bell, Ronny A.; Lang, Wei; Nguyen, Ha T.; Grzywacz, Joseph G.; Arcury, Thomas A.

    2013-01-01

    This study examined the use of self-care strategies to address difficulty sleeping among community-dwelling older adults. Data were collected from a series of 18 questionnaires administered to 195 rural African American and white older adults in North Carolina. Participants reported whether they had experienced difficulty sleeping and strategies used to respond to the symptom. The most widely used strategies included ignoring the symptom, staying in bed or resting, and praying. Herb and suppl...

  6. From pediatric to adult care: strategic evaluation of a transition program for patients with osteogenesis imperfecta

    OpenAIRE

    Dogba, Maman Joyce; Rauch, Frank; Wong, Trudy; Ruck, Joanne; Glorieux, Francis H; Bedos, Christophe

    2014-01-01

    Background Achieving a successful transition from pediatric to adult care for young adults with special needs, especially rare genetic diseases such as osteogenesis imperfecta (OI), is a prominent issue in healthcare research. This transition represents a challenge for patients with OI, their families, clinicians and healthcare managers because of the complex nature of the process and the lack of evaluation of existing transition programs. We evaluated a transition program for adolescents and...

  7. Preventive care delivered within Public Dental Service after caries risk assessment of young adults

    DEFF Research Database (Denmark)

    Hänsel Petersson, G; Ericson, E; Twetman, S

    2016-01-01

    OBJECTIVES: To study preventive care provided to young adults in relation to their estimated risk category over a 3-year period. METHODS: The amount and type of preventive treatment during 3 years was extracted from the digital dental records of 982 patients attending eight public dental clinics...... adults attending public dental service. Further research is needed how to reach those with the greatest need of primary and secondary prevention....

  8. Cognitive Performance Associated With Self-care Activities in Mexican Adults With Type 2 Diabetes

    OpenAIRE

    Compeán Ortiz, Lidia Guadalupe; Gallegos Cabriales, Esther C; Gonzalez Gonzalez, Jose G; GÓMEZ MEZA, MARCO VINICIO; Therrien, Barbara; Salazar Gonzalez, Bertha C

    2010-01-01

    PURPOSE: The purpose of this study was to determine the effect of memory-learning on self-care activities in adults with type 2 diabetes moderated by previous education/understanding in diabetes and to explore the explicative capacity of age, gender, schooling, diabetes duration, and glycemic control in memory-learning. METHODS: A descriptive correlational study was conducted in a randomized sample of 105 Mexican adult patients with type 2 diabetes at a community-based outpatient clinic. Eval...

  9. Epoetin and Darbepoetin Treatment for Adults with Cancer

    Science.gov (United States)

    ... Health Disparities and Cancer For Patient Advocates Public Policy Advocacy Cancer Awareness Dates Survivorship Blog About Us You ... Health Disparities and Cancer For Patient Advocates Public Policy Advocacy Cancer Awareness Dates Cancer.Net provides timely, comprehensive, ...

  10. Perceived barriers to mental health care and goal setting among depressed, community-dwelling older adults

    Directory of Open Access Journals (Sweden)

    Mark I Weinberger

    2009-05-01

    Full Text Available Mark I Weinberger1, Camila Mateo2, Jo Anne Sirey11Department of Psychiatry, Weill Cornell Medical College, White Plains, NY, USA; 2College of Public Health and Health Professions, University of Florida, Gainesville, FL, USAObjective: Older adults are particularly vulnerable to the deleterious effects of depression and tend to underutilize mental health services. The current study aims to characterize the perceived barriers to care and goal setting in a sample of depressed, community-dwelling older adults. Methods: We report on the association among perceived barriers to care, goal setting and accepting a mental health referral using a subset of data from a larger study. The Patient Health Questionnaire (PHQ-9 was used to assess depressive symptoms. Results: Forty-seven participants completed the study (Mean age = 82, SD = 7.8, 85% female. Accessing and paying for mental health treatment were the barriers most frequently cited by participants. Clinical improvement and improved socialization were most cited goals. In bivariate associations, participants who set goals (χ2 = 5.41, p = 0.02 and reported a logistic barrier (χ2 = 5.30, p = 0.02 were more likely to accept a mental health referral.Conclusion: Perceived barriers to care and goal setting appear to be central to accepting a mental health referral among community dwelling older, depressed adults. Developing interventions that can be used to increase mental health service utilization of older adults is necessary. Keywords: depression, older adults, community, perceived barriers to care

  11. Relationship between continuity of care and adverse outcomes varies by number of chronic conditions among older adults with diabetes

    OpenAIRE

    DuGoff, Eva H.; Bandeen-Roche, Karen; Anderson, Gerard F.

    2016-01-01

    Background: Continuity of care is a basic tenant of primary care practice. However, the evidence on the importance of continuity of care for older adults with complex conditions is mixed. Objective: To assess the relationship between measurement of continuity of care, number of chronic conditions, and health outcomes. Design: We analyzed data from a cohort of 1,600 US older adults with diabetes and ≥1 other chronic condition in a private Medicare health plan from July 2010 to December 2011. M...

  12. Predictors of Adult Quality of Life for Foster Care Alumni with Physical and/or Psychiatric Disabilities

    Science.gov (United States)

    Anctil, Tina M.; McCubbin, Laurie D.; O'Brien, Kirk; Pecora, Peter; Anderson-Harumi, Cheryl A.

    2007-01-01

    Introduction: This study used quality of life and resilience as theoretical frameworks for evaluating predictors of outcomes for adults who received foster care services alumni of foster care and were diagnosed with a physical or psychiatric disability while in foster care. Method: First, outcomes for foster care alumni with and without physical…

  13. [Depression in older adults: the National Mental Care Project for People with Physical Illness].

    Science.gov (United States)

    Ito, Hiroto; Fukuda, Koji; Hattori, Hideyuki

    2013-01-01

    Political attention is being increasingly directed to mental health in Japan. Mental disorders are now the fifth priority disease after cancer, stroke, acute myocardial infarction and diabetes for national medical services since April 2013. Each prefecture has to implement strategic mental healthcare plans at the regional level. With the increase in co-morbid mental and physical illnesses, patient information should be shared between psychiatric and non-psychiatric healthcare providers, and coordination is required in the healthcare systems. A better understanding of mental health between patients and medical staffs could contribute to improved access to psychiatric services in the integrated mental health care system. Collaborative care programs focusing on depression screening and management in the Mental Health Care Project for Patients with Physical Illness have been launched among six national specialized care and research centers (cancer, cardiovascular disease, diabetes, child care, geriatric care and neurology and psychiatry) since 2012. These efforts to integrate mental health care into the general health care system would help to improve psychiatric care for elderly patients with physical illnesses. PMID:24622214

  14. Is older adult care mediated by caregivers’ cultural stereotypes? The role of competence and warmth attribution

    OpenAIRE

    Fernández-Ballesteros, Rocío; Bustillos, Antonio; Santacreu, Marta; Schettini, Rocio; Díaz-Veiga, Pura; Huici, Carmen

    2016-01-01

    Purpose The purpose of this study is to examine, from the stereotype content model (SCM) perspective, the role of the competence and warmth stereotypes of older adults held by professional caregivers. Methods A quasi-experimental design, ex post facto with observational analyses, was used in this study. The cultural view on competence and warmth was assessed in 100 caregivers working in a set of six residential geriatric care units (three of them organized following a person-centered care app...

  15. Imported falciparum malaria among adults requiring intensive care: analysis of the literature.

    OpenAIRE

    Marks, M; Armstrong, M.; Walker, D.; Doherty, T.

    2014-01-01

    BACKGROUND Malaria is the most important imported tropical disease. Infection with Plasmodium falciparum is responsible for most of the morbidity and mortality. There are differences in both the epidemiology of imported malaria and in the facilities available to treat travellers with severe malaria between different parts of the world. There are limited data to guide clinicians caring for adults with imported malaria in an intensive care unit (ICU). Available data from the English-speaking li...

  16. Seroprevalence of hepatitis B and C virus in two institutions caring for mentally handicapped adults.

    OpenAIRE

    Cramp, M.E.; Grundy, H C; Perinpanayagam, R M; Barnado, D. E.

    1996-01-01

    Hepatitis B virus infection is common in institutions caring for the mentally handicapped. Hepatitis B virus and hepatitis C virus share routes of transmission but the prevalence of hepatitis C virus infection in this population is unknown. We have tested 101 patients from two institutions in South-East England caring for adults with mental handicap for the presence of hepatitis C antibody, hepatitis B core antibody, and if necessary hepatitis B surface antigen. None tested positive for hepat...

  17. The Child and Adult Care Food Program and the Nutrition of Preschoolers

    OpenAIRE

    Korenman, Sanders; Abner, Kristin S.; Kaestner, Robert; Gordon, Rachel A.

    2013-01-01

    Children spend a considerable amount of time in preschools and child care centers. As a result, these settings may have an influence on their diet, weight, and food security, and are potentially important contexts for interventions to address nutritional health. The Child and Adult Care Food Program (CACFP) is one such intervention. No national study has compared nutrition-related outcomes of children in CACFP-participating centers to those of similar children in non-participating centers. We...

  18. Prevalence of Mental and Social Disorders in Adults Attending Primary Care Centers in Bosnia and Herzegovina

    OpenAIRE

    Broers, Teresa; Hodgetts, Geoffrey; Batić-Mujanović, Olivera; Petrović, Verica; Hasanagić, Melida; Godwin, Marshall

    2006-01-01

    Aim: To determine the prevalence of mental and social disorders in adults who attend primary care health centers in Bosnia and Herzegovina. Methods: Sixty-nine family physicians from the Primary Care Research Network in Bosnia and Herzegovina each invited 20 randomly selected patients from their practices to complete the Patient Health Questionnaire (PHQ), which consists of 26-58 questions about symptoms and signs of depression, anxiety, somatization disorder, eating disorders, and alcohol...

  19. Care of Older Adults: Role of Primary Care Physicians in the Treatment of Cataracts and Macular Degeneration.

    Science.gov (United States)

    Marra, Kyle V; Wagley, Sushant; Kuperwaser, Mark C; Campo, Rafael; Arroyo, Jorge G

    2016-02-01

    This article aims to facilitate optimal management of cataracts and age-related macular degeneration (AMD) by providing information on indications, risk factors, referral guidelines, and treatments and to describe techniques to maximize quality of life (QOL) for people with irreversible vision loss. A review of PubMed and other online databases was performed for peer-reviewed English-language articles from 1980 through August 2012 on visual impairment in elderly adults. Search terms included vision loss, visual impairment, blind, low vision, QOL combined with age-related, elderly, and aging. Articles were selected that discussed vision loss in elderly adults, effects of vision impairment on QOL, and care strategies to manage vision loss in older adults. The ability of primary care physicians (PCPs) to identify early signs of cataracts and AMD in individuals at risk of vision loss is critical to early diagnosis and management of these common age-related eye diseases. PCPs can help preserve vision by issuing aptly timed referrals and encouraging behavioral modifications that reduce risk factors. With knowledge of referral guidelines for soliciting low-vision rehabilitation services, visual aids, and community support resources, PCPs can considerably increase the QOL of individuals with uncorrectable vision loss. By offering appropriately timed referrals, promoting behavioral modifications, and allocating low-vision care resources, PCPs may play a critical role in preserving visual health and enhancing the QOL for the elderly population. PMID:26825587

  20. Building A Health Care Data Warehouse for Cancer Diseases

    Directory of Open Access Journals (Sweden)

    Osama E.Sheta

    2012-11-01

    Full Text Available This paper presents architecture for health care data warehouse specific to cancer diseases which could be used by executive managers, doctors, physicians and other health professionals to support the healthcare process. The data today existing in multi sources with different formats makes it necessary to have some techniques for data integration. Executive managers need access to Information so that decision makers can react in real time to changing needs. Information is one of the most factors to an organization success that executive managers or physicians would need to base their decisions on, during decisionmaking. A health care data warehouse is therefore necessary to integrate the different data sources into a central data repository and analysis this data.

  1. IMRT QA at the Illawarra cancer care centre

    International Nuclear Information System (INIS)

    Full text: Intensity Modulated Radiation Therapy (IMRT) has the potential to conform dose to complex target structures as well as sparing normal tissue. The complexity of the technique requires additional verification steps to ensure that the treatments are planned, transferred and delivered correctly. IMRT was introduced at the Illawarra Cancer Care Centre (ICCC) in 2002. Since that time over 70 head-and-neck cases have been treated. An overview of the current IMRT QA program at the ICCC and a summary of QA results for the last 5 years will be presented.

  2. Supportive care for head and neck cancer patients receiving radiotherapy

    International Nuclear Information System (INIS)

    Recently (chemo-)radiotherapy has been widely used in head and neck cancer with definite evidence. As long survivor has increased, social problems associated with late toxicity have become more. Late toxicities induced by radiotherapy for head and neck lesion are often severe. Xerostomia is one of the severe late toxicities conventionally and dysphagia after chemoradiotherapy is a new topic. Some industrial development (ex. Intensity Modulated Radiotherapy: IMRT) play a great role in toxicity management. Multidisciplinary approach (cooperation between not only physicians but also nurses and dentists) is necessary to control toxicities. The research of supportive care will be needed same as definitive treatment in the future. (author)

  3. Interpersonal complaints regarding cancer care through a gender lens.

    Science.gov (United States)

    Olsson, Erik Masao

    2016-07-11

    Purpose - The purpose of this paper is to investigate healthcare customer complaints concerning interpersonal matters in cancer care. Design/methodology/approach - Complaints from cancer patients and their relatives (n=116) that dealt with interpersonal matters registered between 2009 and 2011 at four local Patients' Advisory Committees in Western Sweden were sampled and analyzed using qualitative content analysis. Findings - Complaints concerned lack of information and consideration from healthcare providers. Lack of empathy and civility also caused dissatisfaction, the latter particularly for women. Relatives complained that they did not feel included in the care process or were not offered proper support. Most complaints by relatives were filed by a female relative and concerned a male patient. Research limitations/implications - Information about patient demographics other than gender could not be investigated due to database limitations. Hence, factors such as age, country of birth, and geographical residence were not included for analysis. In addition, neither the type nor stage of cancer among the sampled patients was able to be addressed. Practical implications - Patient complaints should not only be viewed as a post-consumption judgment, but also as a service interaction activity. This may require healthcare providers to enhance their interpersonal skills, allowing patients and relatives to provide feedback during service interaction to satisfactorily address dissatisfaction. Visualizing gender disparities may help healthcare providers prevent stereotypical encounters. In addition, the provider should be invited to participate in the customer's value creating network, which may also include knowledge and skills from other sources, such as relatives. Originality/value - Value co-creation offers a different view on patient complaints. Incorporating social construction into value co-creation may reveal socially constructed disparities. The paper provides

  4. Advance care planning: A systematic review of randomised controlled trials conducted with older adults.

    Science.gov (United States)

    Weathers, Elizabeth; O'Caoimh, Rónán; Cornally, Nicola; Fitzgerald, Carol; Kearns, Tara; Coffey, Alice; Daly, Edel; O'Sullivan, Ronan; McGlade, Ciara; Molloy, D William

    2016-09-01

    Advance care planning (ACP), involving discussions between patients, families and healthcare professionals on future healthcare decisions, in advance of anticipated impairment in decision-making capacity, improves satisfaction and end-of-life care while respecting patient autonomy. It usually results in the creation of a written advanced care directive (ACD). This systematic review examines the impact of ACP on several outcomes (including symptom management, quality of care and healthcare utilisation) in older adults (>65years) across all healthcare settings. Nine randomised controlled trials (RCTs) were identified by searches of the CINAHL, PubMed and Cochrane databases. A total of 3646 older adults were included (range 72-88 years). Seven studies were conducted with community dwellers and the other two RCTs were conducted in nursing homes. Most studies did not implement a standardised ACD, or measure the impact on quality of end-of-life care or on the death and dying experience. All studies had some risk of bias, with most scoring poorly on the Oxford Quality Scale. While ACP interventions are well received by older adults and generally have positive effects on outcomes, this review highlights the need for well-designed RCTs that examine the economic impact of ACP and its effect on quality of care in nursing homes and other sectors. PMID:27451328

  5. Risk Factors, Preventive Practices, and Health Care Among Breast Cancer Survivors, United States, 2010

    OpenAIRE

    Homan, Sherri G.; Kayani, Noaman; Yun, Shumei

    2016-01-01

    Introduction We compared behavioral risk factors and preventive measures among female breast cancer survivors, female survivors of other types of cancers, and women without a history of cancer. Survivorship health care indicators for the 2 groups of cancer survivors were compared. Methods Using data from the 2010 Behavioral Risk Factor Surveillance System, we calculated the proportion of women with risk factors and their engagement in preventive practices, stratified by cancer status (cancer ...

  6. Nurses’ Knowledge and Education about Oral Care of Cancer Patients Undergoing Chemotherapy and Radiation Therapy

    OpenAIRE

    Pai, Radhika R; Ravikiran Ongole

    2015-01-01

    Context: Oral health awareness and oral care are crucial aspects of oncology nursing practice. However very few studies concentrate on the oral care of cancer patients undergoing cancer treatment and nursing practice in the Indian subcontinent. Most of the published studies have been conducted in the Western and European countries. Aim: This study aimed to determine the nurses′ knowledge and education about oral care in cancer patient undergoing chemotherapy and radiation therapy. Sett...

  7. Register studies of cancer in the Southern Health Care Region in Sweden

    OpenAIRE

    Attner, Bo

    2012-01-01

    The overall aim was to study different aspect of health care use and health care costs on a population based level for persons with cancer and their partners, and from an individual level to explore the impact of comorbidities in incidence and survival. In the beginning of the study all persons in the Southern Health Care Region in Sweden diagnosed with colon, rectal, breast, prostate and lung cancer during the period 2000 to 2005 were identified via the Swedish Cancer Register. Lately, inclu...

  8. From state care to self-care: cancer screening behaviours among Russian-speaking Australian women.

    Science.gov (United States)

    Team, Victoria; Manderson, Lenore H; Markovic, Milica

    2013-01-01

    In this article, we report on a small qualitative scale study with immigrant Russian-speaking Australian women, carers of dependent family members. Drawing on in-depth interviews, we explore women's health-related behaviours, in particular their participation in breast and cervical cancer screening. Differences in preventive health care policies in country of origin and Australia explain their poor participation in cancer screening. Our participants had grown up in the former Soviet Union, where health checks were compulsory but where advice about frequency and timing was the responsibility of doctors. Following migration, women continued to believe that the responsibility for checks was their doctor's, and they maintained that, compared with their experience of preventive medicine in the former Soviet Union, Australian practice was poor. Women argued that if reproductive health screening were important in cancer prevention, then health care providers would take a lead role to ensure that all women participated. Data suggest how women's participation in screening may be improved. PMID:22951044

  9. Clinical care of adult Turner syndrome--new aspects

    DEFF Research Database (Denmark)

    Trolle, Christian; Mortensen, Kristian Havmand; Hjerrild, Britta E;

    2012-01-01

    TS female enters adulthood it is less clear who should be the primary care giver. Morbidity and mortality is increased, especially due to the risk of dissection of the aorta and other cardiovascular diseases, as well as the risk of type 2 diabetes, hypertension, osteoporosis, thyroid disease and...... treatment for increasing height, are becoming well founded. Osteoporosis, diabetes, both type 1 and 2, hypothyroidism, obesity and a host of other endocrine diseases and conditions are seen more frequently in TS. Prevention, intervention and proper treatment is only just being recognized. Hypertension is...

  10. Mental Health Screening of Older Adults in Primary Care

    OpenAIRE

    Davis, Mary J.; Moye, Jennifer; Karel, Michele J.

    2002-01-01

    In an effort to document mental health outreach in our primary care clinic, 316 veterans (mean age 72) not currently in psychiatric treatment were screened for multiple mental health symptoms. Depressed mood was reported by 18% of the sample, insomnia by 26%, and morbid/suicidal ideation by 6.9% for at least several days during the past 2 weeks. Of those who experienced a loss over the past year (43%), 36% remained affected by the loss. Also reported were anxiety symptoms (29%) and PTSD sympt...

  11. Integrating regional and community lung cancer services to improve patient care

    OpenAIRE

    Dahele, M.; Ung, Y.; Meharchand, J.; Shulman, H.; Zeldin, R.; Behzadi, A.; Simone, C; Cheng, S.; Weigensberg, C.; Sivjee, K.

    2007-01-01

    Lung cancer is the leading cause of cancer death in Canada. The organization of health care services is central to the delivery of accessible, high-quality medical care and may be one factor that influences patient outcome. An exciting opportunity arose for clinicians to initiate the redesign of lung cancer services provided by three institutions in the Greater Toronto Area. This qualitative report describes the integrated lung cancer network that they developed, the innovation it has facilit...

  12. Validation of the Prognosis in Palliative Care Study Predictor Models in Terminal Cancer Patients

    OpenAIRE

    Kim, Eun-Shin; Lee, Jung-Kwon; Kim, Mi-Hyun; Noh, Hye-Mi; Jin, Yeong-Hyeon

    2014-01-01

    Background Prognosis in Palliative Care Study (PiPS) predictor models were developed in 2011 to estimate the survival of terminal cancer patients in the United Kingdom. The aim of this study was to validate the PiPS model for terminal cancer patients in Korea, and evaluate its value in clinical practice. Methods This study included 202 advanced cancer patients who were admitted to the cancer hospital's palliative care ward from November 2011 to February 2013. On admission, physicians recorded...

  13. Knowledge, attitudes, and preventive practices about colorectal cancer among adults in an area of Southern Italy

    Directory of Open Access Journals (Sweden)

    Marinelli Paolo

    2008-06-01

    Full Text Available Abstract Background Colorectal cancer (CRC is the second most commonly diagnosed cancer for both sexes in developed countries. This study assessed the knowledge, attitudes, and preventive practices regarding CRC of adults in Italy. Methods A random sample of 1165 adults received a self-administered questionnaire on socio-demographic characteristics; knowledge regarding definition, risk factors, and screening; attitudes regarding perceived risk of contracting CRC and utility of screening tests; health-related behaviors and health care use; source of information. Results Only 18.5% knew the two main modifiable risk factors (low physical activity, high caloric intake from fat and this knowledge was significantly associated with higher educational level, performing physical activity, modification of dietary habits and physical activity for fear of contracting CRC, and lower risk perception of contracting CRC. Half of respondents identified fecal occult blood testing (FOBT as main test for CRC prevention and were more knowledgeable those unmarried, more educated, who knew the main risk factors of CRC, and have received advice by physician of performing FOBT. Personal opinion that screening is useful for CRC prevention was high with a mean score of 8.3 and it was predicted by respondents' lower education, beliefs that CRC can be prevented, higher personal perceived risk of contracting CRC, and information received by physician about CRC. An appropriate behavior of performing FOBT if eligible or not performing if not eligible was significantly higher in female, younger, more educated, in those who have been recommended by physician for undergo or not undergo FOBT, and who have not personal history of precancerous lesions and familial history of precancerous lesions or CRC. Conclusion Linkages between health care and educational systems are needed to improve the levels of knowledge and to raise CRC screening adherence.

  14. Acute nursing care of the older adult with fragility hip fracture: An international perspective (Part 2)

    LENUS (Irish Health Repository)

    Maher, Ann Butler

    2012-10-23

    The second part of this paper provides those who care for orthopaedic patients with evidence-supported international perspectives about acute nursing care of the older adult with fragility hip fracture. Developed by an international group of nurse experts and guided by a range of information from research and clinical practice, it focuses on nurse sensitive quality indicators during the acute hospitalisation for fragility hip fracture. Optimal care for the patient who has experienced such a fracture is the focus. This includes (in the first, earlier, part):\\r\

  15. The View of Nurses toward Prioritizing the Caring Behaviors in Cancer Patients

    OpenAIRE

    Valizadeh, Leila; Zamanzadeh, Vahid; Azimzadeh, Roghaieh; Rahmani, Azad

    2012-01-01

    Introduction: There are many opportunities for nurses to assist improving patient’s ex-perience of cancer. In fact, in every stage of cancer process, nurses can provide the re-quired and necessary cares and supports by representing substantial caring behaviors. Thus, by identifying and understanding the importance of caring behaviors which led to nurse-patient effective interactions, nurses would be able to care better for patients and so to enhance patients’ satisfaction towar...

  16. The quality of preventive health care delivered to adults: results from a cross-sectional study in Southern Italy

    Directory of Open Access Journals (Sweden)

    Nobile Carmelo GA

    2010-06-01

    Full Text Available Abstract Background It is assumed that providing clinical preventive services to patients can identify or detect early important causes of adult mortality. The aim of this study was to quantify access to preventive services in Southern Italy and to assess whether and how the provision of preventive care was influenced by any specific characteristics of patients. Methods In a cross-sectional study adults aged 18 years and over attending primary care physician (PCP offices located in Southern Italy were interviewed from June through December 2007. Quality indicators of preventive health care developed from RAND's Quality Assessment Tools and Behavioral Risk Factor Surveillance System (BRFSS were used. Multivariate analysis was performed to identify and to assess the role of patients' characteristics on delivery of clinical preventive services. Results A total of 1467 subjects participated in the study. Excepting blood pressure preventive check (delivered to 64.4% of eligible subjects and influenza vaccination (recommended to 90.2% of elderly, the rates of delivery of clinical preventive services were low across all measures, particularly for screening and counseling on health habits. Rates for providing cancer screening tests at recommended times were 21.3% for colonoscopy, 51.5% for mammography and 52.4% for Pap smear. Statistical analysis showed clear disparities in the provision of clinical preventive services associated with age, gender, education level, perceived health status, current health conditions and primary care access measures. Conclusions There is overwhelming need to develop and implement effective interventions to improve delivery of routine clinical preventive services.

  17. Prospective study of falls and risk factors for falls in adults with advanced cancer.

    LENUS (Irish Health Repository)

    Stone, Carol A

    2012-06-10

    Retrospective studies of inpatients with cancer suggest that a cancer diagnosis confers a high risk of falls. In adults with advanced cancer, we aimed to prospectively document the incidence of falls, identify the risk factors, and determine if falls in this population occur predominantly in older patients.

  18. Food and Nutrition Practices and Education Needs in Florida's Adult Family Care Homes

    Science.gov (United States)

    Dahl, Wendy J.; Ford, Amanda L.; Gal, Nancy J.

    2014-01-01

    A statewide survey was carried out to determine food and nutrition practices and education needs of Florida's adult family care homes (AFCHs). The 30-item survey included questions on food and nutrition education, supplement use, and menu planning. Infrequent use of menus and nutrition supplements was reported. A strong need was indicated for…

  19. Care of the Older Adult in the Emergency Department: Nurses Views of the Pressing Issues

    Science.gov (United States)

    Boltz, Marie; Parke, Belinda; Shuluk, Joseph; Capezuti, Elizabeth; Galvin, James E.

    2013-01-01

    Purpose: The purpose of the study was to describe nurses' views of the issues to be addressed to improve care of the older adult in the emergency department (ED). Design and Methods: An exploratory content analysis examined the qualitative responses of 527 registered nurses from 49U.S. hospitals who completed the Geriatric Institutional Profile.…

  20. Health and Social Care Interventions Which Promote Social Participation for Adults with Learning Disabilities: A Review

    Science.gov (United States)

    Howarth, Sharon; Morris, David; Newlin, Meredith; Webber, Martin

    2016-01-01

    People with learning disabilities are among the most socially excluded in society. There is a significant gap in research evidence showing how health and social care workers can intervene to improve the social participation of adults with learning disabilities. A systematic review and modified narrative synthesis was used to appraise the quality…

  1. 76 FR 34541 - Child and Adult Care Food Program Improving Management and Program Integrity

    Science.gov (United States)

    2011-06-13

    ... improve Program management and integrity in the Child and Adult Care Food Program (CACFP), at 67 FR 43447 (June 27, 2002) and at 69 FR 53501 (September 1, 2004). Section 243 of Public Law 106-224, the... rule was issued in proposed form on September 12, 2000 (65 FR 55101). In response to State and...

  2. Needing smart home technologies: the perspectives of older adults in continuing care retirement communities

    Directory of Open Access Journals (Sweden)

    Karen Courtney

    2008-11-01

    Conclusions Factors influencing self-perception of need for smart home technology, including the influence of primary care providers, are presented. Further exploration of the factors influencing older adults' perceptions of smart home technology need and the development of appropriate interventions is necessary.

  3. Personalisation of Adult Social Care: Self-Directed Support and the Choice and Control Agenda

    Science.gov (United States)

    Kendall, Sophie; Cameron, Ailsa

    2014-01-01

    In 2007, "self-directed support" was introduced in adult social care in England to establish choice and control--in the assessment process itself and over service provision--for "all" service users. The personalisation agenda is underpinned by a range of ideologies, particularly a civil rights empowerment approach and…

  4. Hazards of Immobility: Bedsores. Adult Residential Care Home, Lesson Plan No. 5.

    Science.gov (United States)

    Lin, Kathleen

    Developed as part of a 104-hour course on adult residential care homes (ARCHs), this 50-minute lesson is designed to enable a student to: (1) define a bedsore; (2) list and describe three major causes of bedsores; (3) identify potential bedsore sites in the back-lying, side-lying, and sitting positions; and (4) calculate the risk for developing…

  5. Health, Quality of Care and Quality of Life: A Case of Frail Older Adults

    Science.gov (United States)

    Hsieh, Chang-Ming

    2009-01-01

    This study explores the relationship between health, quality of care of geriatric case management and quality of life for the purpose of furthering the understanding of the relationship between quality of life and geriatric case management. Using survey data from a group of frail older adults, this study assesses the relative merit of two…

  6. Functional prognosis of dizziness in older adults in primary care: a prospective cohort study.

    NARCIS (Netherlands)

    Dros, J.; Maarsingh, O.R.; Beem, L.; Horst, H.E. van der; Riet, G. ter; Schellevis, F.G.; Weert, H.C.P.M. van

    2012-01-01

    Objectives: To investigate the 6-month functional prognosis of dizziness in older adults in primary care, to identify important predictors of dizziness-related impairment, and to construct a score to assist risk prediction. Design: Prospective cohort study with 6-month follow-up. Setting: Twenty-fou

  7. Improving outcomes in lung cancer: the value of the multidisciplinary health care team

    Directory of Open Access Journals (Sweden)

    Denton E

    2016-03-01

    Full Text Available Eve Denton,1 Matthew Conron2 1Allergy, Immunology and Respiratory Department, Alfred Hospital, 2Department of Respiratory and Sleep Medicine, St Vincent's Hospital, Melbourne, VIC, Australia Abstract: Lung cancer is a major worldwide health burden, with high disease-related morbidity and mortality. Unlike other major cancers, there has been little improvement in lung cancer outcomes over the past few decades, and survival remains disturbingly low. Multidisciplinary care is the cornerstone of lung cancer treatment in the developed world, despite a relative lack of evidence that this model of care improves outcomes. In this article, the available literature concerning the impact of multidisciplinary care on key measures of lung cancer outcomes is reviewed. This includes the limited observational data supporting improved survival with multidisciplinary care. The impact of multidisciplinary care on other benchmark measures of quality lung cancer treatment is also examined, including staging accuracy, access to diagnostic investigations, improvements in clinical decision making, better utilization of radiotherapy and palliative care services, and improved quality of life for patients. Health service research suggests that multidisciplinary care improves care coordination, leading to a better patient experience, and reduces variation in care, a problem in lung cancer management that has been identified worldwide. Furthermore, evidence suggests that the multidisciplinary model of care overcomes barriers to treatment, promotes standardized treatment through adherence to guidelines, and allows audit of clinical services and for these reasons is more likely to provide quality care for lung cancer patients. While there is strengthening evidence suggesting that the multidisciplinary model of care contributes to improvements in lung cancer outcomes, more quality studies are needed. Keywords: lung cancer, multidisciplinary care, mortality, tumor board

  8. Explaining variation in cancer survival between 11 jurisdictions in the International Cancer Benchmarking Partnership: a primary care vignette survey

    OpenAIRE

    Rose, Peter W; Rubin, Greg; Perera-Salazar, Rafael; Almberg, Sigrun Saur; Barisic, Andriana; Dawes, Martin; Grunfeld, Eva; Hart, Nigel; Neal, Richard D.; Pirotta, Marie; Sisler, Jeffrey; Konrad, Gerald; Toftegaard, Berit Skjødeberg; Thulesius, Hans; Vedsted, Peter

    2015-01-01

    OBJECTIVES: The International Cancer Benchmarking Partnership (ICBP) is a collaboration between 6 countries and 12 jurisdictions with similar primary care-led health services. This study investigates primary care physician (PCP) behaviour and systems that may contribute to the timeliness of investigating for cancer and subsequently, international survival differences.DESIGN: A validated survey administered to PCPs via the internet set out in two parts: direct questions on primary care structu...

  9. Alliance Against Cancer, the network of Italian cancer centers bridging research and care.

    Science.gov (United States)

    De Paoli, Paolo; Ciliberto, Gennaro; Ferrarini, Manlio; Pelicci, PierGiuseppe; Dellabona, Paolo; De Lorenzo, Francesco; Mantovani, Alberto; Musto, Pellegrino; Opocher, Giuseppe; Picci, Piero; Ricciardi, Walter; De Maria, Ruggero

    2015-01-01

    Alliance Against Cancer (ACC) was established in Rome in 2002 as a consortium of six Italian comprehensive cancer centers (Founders). The aims of ACC were to promote a network among Italian oncologic institutions in order to develop specific, advanced projects in clinical and translational research. During the following years, many additional full and associate members joined ACC, that presently includes the National Institute of Health, 17 research-oriented hospitals, scientific and patient organizations. Furthermore, in the last three years ACC underwent a reorganization process that redesigned the structure, governance and major activities. The present goal of ACC is to achieve high standards of care across Italy, to implement and harmonize principles of modern personalized and precision medicine, by developing cost effective processes and to provide tailored information to cancer patients. We herein summarize some of the major initiatives that ACC is currently developing to reach its goal, including tumor genetic screening programs, establishment of clinical trial programs for cancer patients treated in Italian cancer centers, facilitate their access to innovative drugs under development, improve quality through an European accreditation process (European Organization of Cancer Institutes), and develop international partnerships. In conclusion, ACC is a growing organization, trying to respond to the need of networking in Italy and may contribute significantly to improve the way we face cancer in Europe. PMID:26578263

  10. Consensus statement on the management of the GH-treated adolescent in the transition to adult care

    DEFF Research Database (Denmark)

    Clayton, P E; Cuneo, R C; Juul, A; Monson, J P; Shalet, S M; Tauber, M

    2005-01-01

    The European Society for Paediatric Endocrinology held a consensus workshop in Manchester, UK in December 2003 to discuss issues relating to the care of GH-treated patients in the transition from paediatric to adult life. Clinicians experienced in the care of paediatric and adult patients on GH t...

  11. Provision of Transition Education and Referral Patterns from Pediatric Cardiology to Adult Cardiac Care.

    Science.gov (United States)

    Harbison, Anna L; Grady, Stafford; Chi, Kevin; Fernandes, Susan M

    2016-02-01

    ACC/AHA guidelines recommend a structured preparation for and transfer to adult-oriented cardiac care for adult survivors of pediatric onset heart disease (POHD). Given this, we sought to describe the transition and transfer practices for a cohort of young adults with POHD and to determine factors associated with successful transfer to adult-oriented cardiac care. We performed a single-center, retrospective chart review on patients ≥18 years of age, with POHD likely to require lifelong cardiac care, who were seen in outpatient pediatric cardiology (PC) between 2008 and 2011. Successful transfer was defined as the subsequent attendance at adult cardiology (AC) within 2 years of PC visit. We identified 118 patients who met study criteria. Mean age 22.4 ± 2.0 years, 59 % male, 64 % white and 40 % Hispanic. Mean transition education topics noted was 3.3 ± 1.8 out of 20 and covered the underlying cardiac disease (89 %), follow-up and current medications (56 %) and exercise limitations (34 %). Recommendations for follow-up were AC (57 %) and PC (33 %). Of those told to transfer to AC, 79 % successfully transferred. Characteristics of successful transfer included: prior cardiac surgery (p = 0.008), cardiac medication use (p = 0.006) and frequency of follow-up ≤1 year (p = 0.037). One-quarter of all subjects did not follow-up within at least 2 years. Despite published guidelines, transition education appears lacking and the approach to transfer to adult cardiac care is not consistent. Given the increased risk of morbidity and mortality in this patient population, standardization of transition education and transfer processes appear warranted. PMID:26385471

  12. Intensive care for the adult population in Ireland: a multicentre study of intensive care population demographics

    OpenAIRE

    ,

    2008-01-01

    Introduction This prospective observational study was conducted to describe the nature of the intensive care population across Ireland, identify adherence to international benchmarks of practice, and describe patient outcomes in critically ill patients. Methods A prospective observational multicentre study of demographics and organ failure incidence was carried out over a 10-week period in 2006 across the intensive care units (ICUs) of 14 hospitals in both the Republic and Northern Ireland. R...

  13. Perceptions of the appropriateness of care in California adult intensive care units

    OpenAIRE

    Anstey, Matthew H; Adams, John L.; McGlynn, Elizabeth A

    2015-01-01

    Introduction Increased demand for expensive intensive care unit (ICU) services may contribute to rising health-care costs. A focus on appropriate use may offer a clinically meaningful way of finding the balance. We aimed to determine the extent and characteristics of perceived inappropriate treatment among ICU doctors and nurses, defined as an imbalance between the amount or intensity of treatments being provided and the patient’s expected prognosis or wishes. Methods This was a cross-section...

  14. Assessing and optimizing health-related quality of life during and after cancer treatment in adolescents and young adults

    Directory of Open Access Journals (Sweden)

    Szalda D

    2014-12-01

    Full Text Available Dava Szalda,1 Esther Kim,2 Jill P Ginsberg1,2 1Division of Oncology, The Children's Hospital of Philadelphia, 2Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA Abstract: Adolescent and young adults (AYAs with cancer have needs unique from their pediatric or adult counterparts at diagnosis, during treatment, and throughout survivorship care. Healthcare teams may find it difficult to assess and manage the complex psychosocial needs of AYA patients, however, attention to the multi-faceted care of the AYA oncology patient may directly affect health outcomes and quality of life. Comprehensive AYA care therefore must be maximized during treatment and in transition to survivorship care by including assessments of general health, sexual health, mental health, health behaviors, and conversations concerning transition to survivorship and adulthood with AYA patients. Identifying and treating issues that arise in the AYA population may help promote adherence to treatment, engagement in follow-up care, and ultimately quality of life for this unique group of patients. Keywords: quality of life, sexual health, health behaviors, mental health, transition, survivorship

  15. "Fighting the system": Families caring for ventilator-dependent children and adults with complex health care needs at home

    Directory of Open Access Journals (Sweden)

    Nielsen Erik W

    2011-07-01

    Full Text Available Abstract Background An increasing number of individuals with complex health care needs now receive life-long and life-prolonging ventilatory support at home. Family members often take on the role of primary caregivers. The aim of this study was to explore the experiences of families giving advanced care to family members dependent on home mechanical ventilation. Methods Using qualitative research methods, a Grounded Theory influenced approach was used to explore the families' experiences. A total of 15 family members with 11 ventilator-dependent individuals (three children and eight adults were recruited for 10 in-depth interviews. Results The core category, "fighting the system," became the central theme as family members were asked to describe their experiences. In addition, we identified three subcategories, "lack of competence and continuity", "being indispensable" and "worth fighting for". This study revealed no major differences in the families' experiences that were dependent on whether the ventilator-dependent individual was a child or an adult. Conclusions These findings show that there is a large gap between family members' expectations and what the community health care services are able to provide, even when almost unlimited resources are available. A number of measures are needed to reduce the burden on these family members and to make hospital care at home possible. In the future, the gap between what the health care can potentially provide and what they can provide in real life will rapidly increase. New proposals to limit the extremely costly provision of home mechanical ventilation in Norway will trigger new ethical dilemmas that should be studied further.

  16. Estimates of complications of medical care in the adult US population

    Directory of Open Access Journals (Sweden)

    Anderson Jeremy N

    2001-03-01

    Full Text Available Abstract Background Total US population estimates of complications of medical care have relied on extrapolations of state-specific estimates. Generalizability is suspect because findings are limited by geographical location or time. We describe the relationship between the annual prevalence of complications of medical care (CM and socio-demographic characteristics in the adult US population. Methods We used data from the National Health Interview Surveys, annual nationwide surveys of the resident, civilian, noninstitutionalized population of the United States. The main outcome of interest was self-reported conditions from CMs (ICD-9 996-999 and activity limitations that arise from such events. Univariate estimates and multivariably adjusted models accounting for selected socio-demographic characteristics and health status were derived. Results A total of 618,167 reports of conditions from 313,438 subjects 18 years and older from 1987 to 1994 were examined. In 1987, 830,386 adults reported complications of medical care, increasing by about 40% to 1,174,089 adults in 1994. Based on an extrapolation to the US adult population, rates increased by 25% from 558 to 678 per 100,000 during the same period. One-third reported onset a year prior to the interview; two-thirds visited a doctor six months prior; half experienced limitation in major activities; a quarter reported limitation in personal care activities. In the two weeks preceding the interview, complications of medical care caused an average of 1.72 days of restricted activity, 0.79 days spent in bed, and 0.58 days of work lost. Race modified the age-specific risk of these complications. Conclusions Complications of medical care impose heavier morbidity than previously considered with some indication that socio-demographic variables modify the risk for injuries.

  17. Primary care physicians’ perceived barriers and facilitators to conservative care for older adults with chronic kidney disease: design of a mixed methods study

    OpenAIRE

    Tam-Tham, Helen; Hemmelgarn, Brenda; Campbell, David; Thomas, Chandra; Quinn, Robert; Fruetel, Karen; King-Shier, Kathryn

    2016-01-01

    Background Guideline committees have identified the need for research to inform the provision of conservative care for older adults with stage 5 chronic kidney disease (CKD) who have a high burden of comorbidity or functional impairment. We will use both qualitative and quantitative methodologies to provide a comprehensive understanding of barriers and facilitators to care for these patients in primary care. Objectives Our objectives are to (1) interview primary care physicians to determine t...

  18. Prevalence of oral pain and barriers to use of emergency oral care facilities among adult Tanzanians

    Directory of Open Access Journals (Sweden)

    Kahabuka Febronia

    2008-09-01

    Full Text Available Abstract Background Oral pain has been the major cause of the attendances in the dental clinics in Tanzania. Some patients postpone seeing the dentist for as long as two to five days. This study determines the prevalence of oral pain and barriers to use of emergency oral care in Tanzania. Methods Questionnaire data were collected from 1,759 adult respondents aged 18 years and above. The study area covered six urban and eight rural study clusters, which had been selected using the WHO Pathfinder methodology. Chi-square tests and logistic regression analyses were performed to identify associations. Results Forty two percent of the respondents had utilized the oral health care facilities sometimes in their lifetime. About 59% of the respondents revealed that they had suffered from oral pain and/or discomfort within the twelve months that preceded the study, but only 26.5% of these had sought treatment from oral health care facilities. The reasons for not seeking emergency care were: lack of money to pay for treatment (27.9%; self medication (17.6%; respondents thinking that pain would disappear with time (15.7%; and lack of money to pay for transport to the dental clinic (15.0%. Older adults were more likely to report that they had experienced oral pain during the last 12 months than the younger adults (OR = 1.57, CI 1.07–1.57, P dental clinics far from home (OR = 5.31, CI = 2.09–13.54, P and being treated by traditional healer (OR = 5.31, CI = 2.25–12.49, P as reasons for not seeking emergency care from the oral health care facilities than their counterparts from urban areas. Conclusion Oral pain and discomfort were prevalent among adult Tanzanians. Only a quarter of those who experienced oral pain or discomfort sought emergency oral care from oral health care facilities. Self medication was used as an alternative to using oral care facilities mainly by rural residents. Establishing oral care facilities in rural areas is recommended.

  19. Challenges in the Delivery of Quality Breast Cancer Care: Initiation of Adjuvant Hormone Therapy at an Urban Safety Net Hospital

    OpenAIRE

    Crowley, Meaghan M.; McCoy, Molly E.; Bak, Sharon M.; Caron, Sarah E.; Ko, Naomi Y.; Kachnic, Lisa A.; Alvis, Faber; Battaglia, Tracy A.

    2013-01-01

    Urgently needed interventions to reduce disparities in breast cancer treatment should take into account obstacles inherent among immigrant and indigent populations and complexities of multidisciplinary cancer care.

  20. Validation of an information–motivation–behavioral skills model of self-care among Chinese adults with type 2 diabetes

    OpenAIRE

    Gao, Junling; Wang, Jingli; Zhu, Yaocheng; Yu, Jinming

    2013-01-01

    Background Self-care is a crucial component of diabetes management. But comprehensive behavior change frameworks are needed to provide guidance for the design, implementation, and evaluation of diabetes self-care programs in diverse populations. We tested the Information–Motivation–Behavioral Skills (IMB) model in a sample of Chinese adults with Type 2 diabetes. Methods A cross-sectional study of 222 Chinese adults with type 2 diabetes was conducted in a primary care center. We collected info...

  1. Campaign awareness and oral cancer knowledge in UK resident adult Bangladeshi: a cross-sectional study

    OpenAIRE

    Croucher, R; Islam, S. S.; Nunn, H

    2011-01-01

    Background: This study reports awareness of the ‘Open up to Mouth Cancer' campaign materials and oral cancer knowledge among two UK adult Bangladeshi communities, both at high risk for oral cancer. Methods: Differences in the outcomes of campaign awareness and knowledge of oral cancer risk factors and early signs were compared between campaign and comparison areas. Home-based interviews were conducted with representative samples from both areas by bilingual interviewers. Data collected includ...

  2. Serum carotenoid levels and risk of lung cancer death in US adults

    OpenAIRE

    Min, Kyoung-Bok; Min, Jin-Young

    2014-01-01

    Lung cancer is one of the most common cancers worldwide and is the leading cause of cancer-induced death in the USA. Although much attention has been focused on the anti-carcinogenic effect of consuming carotenoid-containing food or supplements, the results have been inconsistent. We investigated whether serum carotenoid levels were associated with the mortality risk of lung cancer in US adults using data from a nationally representative sample. The data were obtained from the Third Nutrition...

  3. Distress and adjustment among adolescents and young adults with cancer: an empirical and conceptual review

    OpenAIRE

    Sansom-Daly, Ursula M.; Wakefield, Claire E.

    2013-01-01

    Adolescents and young adults (AYAs) with cancer must simultaneously navigate the challenges associated with their cancer experience, whilst striving to achieve a number of important developmental milestones at the cusp of adulthood. The disruption caused by their cancer experience at this critical life-stage is assumed to be responsible for significant distress among AYAs living with cancer. The quality and severity of psychological outcomes among AYAs remain poorly documented, however. This ...

  4. Activating Older Adults With Serious Mental Illness for Collaborative Primary Care Visits

    Science.gov (United States)

    Bartels, Stephen J.; Aschbrenner, Kelly A.; Rolin, Stephanie A.; Hendrick, Delia Cimpean; Naslund, John A.; Faber, Marjan J.

    2016-01-01

    Objective Persons with serious mental illness frequently receive inadequate medical care and are more likely to experience difficulty navigating the health care system compared with the general population. To address this gap in quality, we developed a program of peer co-led collaborative activation training for primary care (CAT-PC) designed to improve “patient activation” and person-centered care in primary care visits for middle-aged and older adults with serious mental illness and cardiovascular risk. This report presents pilot study feasibility and participant outcomes for CAT-PC. Method A pre-post pilot evaluation of CAT-PC included N = 17 adults (age ≥ 50) with serious mental illness and cardiovascular health risk conditions, and N = 6 primary care providers. CAT-PC consists of 9 weekly peer co-led patient education and skills training sessions and a 45-min video-based training for primary care providers. Pre-post measures included the Patient Activation Measure (PAM), Perceived Efficacy in Patient-Physician Interactions (PEPPI), Autonomy Preference Index (API) for preferred role in primary care encounters, and Social Skills Performance Assessment (SSPA) role-play test for medical visits. Results All 17 participants attended 5 or more sessions. Post-intervention improvement was found for patient activation and simulated performance of medical visit communication skills. Trends were observed for improved self-efficacy in provider interactions and greater preference for a more collaborative role in decision-making. Conclusions and Implications CAT-PC is a brief, peer co-led education and skills training intervention potentially improving patient activation in primary care encounters and providing an important missing component in emerging models of “patient-centered behavioral health homes” for this high-risk group. PMID:24219769

  5. [Choice of Expiration for Cancer Patients under Home Medical Care - Palliative Care Unit or Home].

    Science.gov (United States)

    Okino, Takashi; Okagaki, Tetsuya; Nakamura, Hiromi; Okino, Akie

    2015-12-01

    Kohka Public Hospital(KPH)was rebuilt at a new place in April 2013. The Palliative Care Unit(PCU)was newly constructed during renovation. We examined the will and outcome of cancer patients, especially on expiration. A 123 patients died in 2014: 27 died at the PCU, and the remaining 7 at home. Of 27 patients, 20 were willing to die at the PCU, and one patient visited the hospital after judgment by the Visiting Nurse Center. Other 6 patients were admitted finally after their families experienced fatigue. Six of seven patients who died at home, showed a strong will to stay at home. We think that patients' will drives the clinical course, especially in their end-stage. In this context, the majority of the patients decided their terminal place based on their will. On the contrary, there were several cases whose requests were not fulfilled. To overcome the problem, we should discuss cancer patients' will to make a choice regarding death at the end-stage of their lives and the place of expiration in advance. We including the staff of social care and regional medical resources, should co-operate and share information on these patients to solve the problems. PMID:26809413

  6. Terminal Versus Advanced Cancer: Do the General Population and Health Care Professionals Share a Common Language?

    OpenAIRE

    Kim, Sang Hyuck; Shin, Dong Wook; Kim, So Young; Yang, Hyung Kook; Nam, Eunjoo; Jho, Hyun Jung; Ahn, Eunmi; Cho, Be Long; Park, Keeho; Park, Jong-Hyock

    2015-01-01

    Purpose Many end-of-life care studies are based on the assumption that there is a shared definition of language concerning the stage of cancer. However, studies suggest that patients and their families often misperceive patients’ cancer stages and prognoses. Discrimination between advanced cancer and terminal cancer is important because the treatment goals are different. In this study, we evaluated the understanding of the definition of advanced versus terminal cancer of the general populatio...

  7. Fatigue in Family Caregivers of Adult Intensive Care Unit Survivors

    Science.gov (United States)

    Choi, JiYeon; Tate, Judith A.; Hoffman, Leslie A.; Schulz, Richard; Ren, Dianxu; Donahoe, Michael P.; Given, Barbara A.; Sherwood, Paula R.

    2014-01-01

    Context Family caregivers are a vital resource in the recovery of intensive care unit (ICU) survivors. Of concern, the stress associated with this role can negatively affect caregiver health. Fatigue, an important health indicator, has been identified as a predictor of various illnesses, greater use of health services, and early mortality. Examining the impact of fatigue on caregivers’ physical health can assist in identifying critical time points and potential targets for intervention. Objectives To describe self-reported fatigue in caregivers of ICU survivors from patients’ ICU admission to ≤ two weeks, two- and four-months post-ICU discharge. Methods Patient-caregiver pairs were enrolled from a medical ICU. Caregiver fatigue was measured using the Short-Form-36 Health Survey Vitality subscale (SF-36 Vitality). Caregiver psychobehavioral stress responses included depressive symptoms, burden, health risk behaviors, and sleep quality. Patient data included self-reported physical symptoms and disposition (home vs. institution). Results Forty seven patient-caregiver pairs were initially enrolled. Clinically significant fatigue (SF-36 Vitality ≤ 45) was reported by 43% to 53% of caregivers across the time points and these caregivers reported worse scores in measures of depressive symptoms, burden, health risk behaviors and sleep quality, and patients’ symptom burden. In 26 caregivers with data for all time points (55% of the total sample), SF-36 Vitality scores showed trends of improvement when the patient returned home and greater impairment when institutionalization continued. Conclusion In caregivers of ICU survivors, fatigue is common and potentially linked with poor psychobehavioral responses. Worsening fatigue was associated with greater symptom distress and long-term patient institutionalization. PMID:24439845

  8. Delivering Flexible Education and Training to Health Professionals: Caring for Older Adults in Disasters.

    Science.gov (United States)

    Altman, Brian A; Gulley, Kelly H; Rossi, Carlo; Strauss-Riggs, Kandra; Schor, Kenneth

    2016-08-01

    The National Center for Disaster Medicine and Public Health (NCDMPH), in collaboration with over 20 subject matter experts, created a competency-based curriculum titled Caring for Older Adults in Disasters: A Curriculum for Health Professionals. Educators and trainers of health professionals are the target audience for this curriculum. The curriculum was designed to provide breadth of content yet flexibility for trainers to tailor lessons, or select particular lessons, for the needs of their learners and organizations. The curriculum covers conditions present in the older adult population that may affect their disaster preparedness, response, and recovery; issues related to specific types of disasters; considerations for the care of older adults throughout the disaster cycle; topics related to specific settings in which older adults receive care; and ethical and legal considerations. An excerpt of the final capstone lesson is included. These capstone activities can be used in conjunction with the curriculum or as part of stand-alone preparedness training. This article describes the development process, elements of each lesson, the content covered, and options for use of the curriculum in education and training for health professionals. The curriculum is freely available online at the NCDMPH website at http://ncdmph.usuhs.edu (Disaster Med Public Health Preparedness. 2016;10:633-637). PMID:27109606

  9. The need for hospital care of patients with clinically localized prostate cancer managed by noncurative intent

    DEFF Research Database (Denmark)

    Brasso, K; Friis, S; Juel, K;

    2000-01-01

    We studied the need for hospital care of patients 74 years old or younger with clinically localized prostate cancer managed by deferred endocrine therapy.......We studied the need for hospital care of patients 74 years old or younger with clinically localized prostate cancer managed by deferred endocrine therapy....

  10. Quality palliative care for cancer and dementia in five European countries: some common challenges

    NARCIS (Netherlands)

    Davies, N.; Maio, L.; Riet Paap, J.C. van; Mariani, E.; Jaspers, B.; Sommerbakk, R.; Grammatico, D.; Manthorpe, J.; Ahmedzai, S.; Vernooij-Dassen, M.J.F.J.; Iliffe, S.

    2014-01-01

    Objectives: There is a growing consensus worldwide that palliative care needs to be both more inclusive of conditions other than cancer and to improve. This paper explores some common challenges currently faced by professionals providing palliative care for patients with either cancer or dementia ac

  11. [The Home Care Doctor Today is "STRIKE" - Considering Care of Terminal Stage Patients with Cancer through a Case Report].

    Science.gov (United States)

    Ogihara, Miyoko; Yamaoka, Keita; Fujimaki, Yoko; Watanabe, Mutsuko; Hirohara, Masayoshi; Kushida, Kazuki

    2015-12-01

    Although many patients wish to remain in their familiar home environment while undergoing cancer treatment, many obstacles prevent a patient from receiving cancer care at home. With early-stage cancer, the patients may better accept the diagnosis and have a greater will to fight the illness. However as time proceeds, progression or recurrence of cancer may occur, and eventually, proactive treatments will not be available. This progression results in great physical and mental strain on the patients and their family. At all stages of such progression, opportunities exist for a care provider to assist with overcoming potential obstacles by openly communicating with the patients, talking through the patients' experiences, and understanding their feelings. However, on diagnosis, cancer patients must often face the reality that they have very little time left to live. When transiting medical care from their long-trusted hospital to a home care base, a new physician must be selected and other decisions related to their care must be quickly made. Transferring responsibility to a good home care provider can greatly influence a patient's emotional state. This paper reports one such case in which the patients died in their homes with the best comfort and possible outcome. PMID:26809394

  12. Healing environments in cancer treatment and care. Relations of space and practice in hematological cancer treatment

    DEFF Research Database (Denmark)

    Høybye, Mette Terp

    2013-01-01

    of who were followed closely over an extended time period. Results. Through thematic analysis fi ve key concepts emerged about the social dynamics of hospital environments: practices of self; creating personal space; social recognition; negotiating space; and ambiguity of space and care. Through...... these concepts, the study demonstrates how the hospital environment is a fl ow of relations between space and practice that changes and challenges a structural idea of design and healing. Patients ’ sense of healing changes with the experience of progression in treatment and the capacity of the hospital...... space to incite an experience of homeliness and care. Furthermore, cancer patients continuously challenge the use and limits of space by individual objects and practices of privacy and home. Discussion. Healing environments are complex relations between practices, space and care, where recognition of...

  13. An analysis of paediatric cancer patient volume and pathway of care from French hospital claim databases

    OpenAIRE

    Filipovic-Pierucci, Antoine

    2015-01-01

    Hospital activity in paediatric cancerology was described on treatment type and hospital category, by care territories. Pathways of care were also studied, especially for ALL and CNS tumours.Hospital stays linked to cancer care from french hospital claim databases were studied in individuals below 25 on number of stays, breakdown by care territory, hospital category and treatment type. Pathways of care were studied during the first year after diagnosis.In 2012, 142208 stays were extracted for...

  14. Medication transitions and polypharmacy in older adults following acute care

    Directory of Open Access Journals (Sweden)

    Gamble JM

    2014-03-01

    Full Text Available John-Michael Gamble,1,* Jill J Hall,2,* Thomas J Marrie,3 Cheryl A Sadowski,2 Sumit R Majumdar,4 Dean T Eurich5 1School of Pharmacy, Memorial University of Newfoundland, St John's, NL, 2Faculty of Pharmacy and Pharmaceutical Sciences, University of Alberta, Edmonton, AB, 3Faculty of Medicine, Dalhousie University, Halifax, NS, 4Faculty of Medicine and Dentistry, 5School of Public Health, University of Alberta, Edmonton, AB, Canada *These authors contributed equally to this work Background/objective: Medication changes at transitions of care and polypharmacy are growing concerns that adversely impact optimal drug use. We aimed to describe transitions and patterns of medication use before and 1 year after older patients were hospitalized for community-acquired pneumonia, the second-most common reason for admission in North America. Materials and methods: This was an analysis of a population-based clinical registry of patients treated in any of the six hospitals or seven emergency departments in Edmonton, Alberta, Canada, comprising 2,105 patients 65 years and older with community-acquired pneumonia who had survived at least 1 year. The prevalence of polypharmacy (five or more unique prescription drugs, as well as new use and persistence of common drug classes were assessed. Results: The mean age was 78 years (standard deviation 8 years, 50% were female, 62% were hospitalized, and 58% had severe pneumonia. Among the 2,105 patients, 949 (45% were using five or more medications prior to hospitalization, increasing to 1,559 (74% within 90 days postdischarge and remaining over 70% at 1 year. Overall, 1,690 (80% patients newly started and 1,553 (74% patients stopped at least one medication in the first 90 days of follow-up. The prevalence of the most common drug classes (ie, cardiovascular, alimentary/metabolism remained stable, with the exception of anti-infective agents, whereby 25% of patients were dispensed an anti-infective agent 3 months to 1 year

  15. Evaluating components of dental care utilization among adults with diabetes and matched controls via hurdle models

    Directory of Open Access Journals (Sweden)

    Chaudhari Monica

    2012-07-01

    Full Text Available Abstract Background About one-third of adults with diabetes have severe oral complications. However, limited previous research has investigated dental care utilization associated with diabetes. This project had two purposes: to develop a methodology to estimate dental care utilization using claims data and to use this methodology to compare utilization of dental care between adults with and without diabetes. Methods Data included secondary enrollment and demographic data from Washington Dental Service (WDS and Group Health Cooperative (GH, clinical data from GH, and dental-utilization data from WDS claims during 2002–2006. Dental and medical records from WDS and GH were linked for enrolees continuously and dually insured during the study. We employed hurdle models in a quasi-experimental setting to assess differences between adults with and without diabetes in 5-year cumulative utilization of dental services. Propensity score matching adjusted for differences in baseline covariates between the two groups. Results We found that adults with diabetes had lower odds of visiting a dentist (OR = 0.74, p  0.001. Among those with a dental visit, diabetes patients had lower odds of receiving prophylaxes (OR = 0.77, fillings (OR = 0.80 and crowns (OR = 0.84 (p 0.005 for all and higher odds of receiving periodontal maintenance (OR = 1.24, non-surgical periodontal procedures (OR = 1.30, extractions (OR = 1.38 and removable prosthetics (OR = 1.36 (p  Conclusions Patients with diabetes are less likely to use dental services. Those who do are less likely to use preventive care and more likely to receive periodontal care and tooth-extractions. Future research should address the possible effectiveness of additional prevention in reducing subsequent severe oral disease in patients with diabetes.

  16. No place like home? Potential pathways to loneliness in older adults under the care of a live-in foreign home care worker.

    Science.gov (United States)

    Ayalon, Liat; Shiovitz-Ezra, Sharon; Palgi, Yuval

    2012-01-01

    The arrangement in which frail older adults from the developed world are cared for in their homes by individuals from the developing world has become increasingly prevalent worldwide. In Israel, this arrangement is termed foreign home care. In this article, the authors first describe the global phenomenon of foreign home care of frail older adults as well as the more local characteristics of this arrangement in Israel. The authors then describe the concept of loneliness. Based on empirical and theoretical knowledge in the field of loneliness, the authors argue that older adults under live-in foreign home care may be particularly prone to feelings of loneliness for several reasons: some that are general to older adults with cognitive or physical disability and others that are specific to this particular caregiving arrangement. The authors conclude by providing ideas for future practice and research on this highly vulnerable group that, to date, has received only minimal research attention. PMID:22303620

  17. Developing Navigation Competencies to Care for Older Rural Adults with Advanced Illness.

    Science.gov (United States)

    Duggleby, Wendy; Robinson, Carole A; Kaasalainen, Sharon; Pesut, Barbara; Nekolaichuk, Cheryl; MacLeod, Roderick; Keating, Norah C; Santos Salas, Anna; Hallstrom, Lars K; Fraser, Kimberly D; Williams, Allison; Struthers-Montford, Kelly; Swindle, Jennifer

    2016-06-01

    Navigators help rural older adults with advanced illness and their families connect to needed resources, information, and people to improve their quality of life. This article describes the process used to engage experts - in rural aging, rural palliative care, and navigation - as well as rural community stakeholders to develop a conceptual definition of navigation and delineate navigation competencies for the care of this population. A discussion paper on the important considerations for navigation in this population was developed followed by a four-phased Delphi process with 30 expert panel members. Study results culminated in five general navigation competencies for health care providers caring for older rural persons and their families at end of life: provide patient/family screening; advocate for the patient/family; facilitate community connections; coordinate access to services and resources; and promote active engagement. Specific competencies were also developed. These competencies provide the foundation for research and curriculum development in navigation. PMID:27093177

  18. The art of professional development and caring in cancer nursing.

    Science.gov (United States)

    Wengström, Yvonne; Ekedahl, Marieanne

    2006-03-01

    The impetus for this qualitative study was the premise expressed by lay people that nursing terminally ill cancer patients must be depressing and difficult to cope with. Its focus was nurses' stress and coping strategies, both secular and religious. Data was collected using a narrative life-story approach, and then Lazaruz and Folkman's coping theory and Pargament's theory on the psychology of religion were used during the analysis of the data. Several factors were identified, related to the individual and group levels, that influence a nurse's identity and professional development. A person's life orientation was suggested as a first concept for developing a professional paradigm that includes caritas as a main orienting factor. Directed by the nurse's secular and religious orientation, competence develops, making it possible to understand, analyze, manage, and appreciate the significance of the professional work of caring. PMID:16451425

  19. Animal-Assisted Therapy and Application to Older Adults in Long Term Care

    OpenAIRE

    Kimberly Ann Mercer

    2015-01-01

    In the past thirty years animal-assisted therapy (AAT) has moved beyond anecdotal status to a scientific evidence-based intervention. AAT comes in many shapes and sizes. There are a variety of animals which can be used such as dogs, cats, rabbits, horses, guinea pigs, goats, dolphins, and even fish aquariums. Loneliness is a common theme among older adults in long term care (LTC). Many older adults living in LTC facilities feel isolated. Some have little contact with family members or friends...

  20. Evaluation of health care services provided for older adults in primary health care centers and its internal environment. A step towards age-friendly health centers

    OpenAIRE

    Alhamdan , A.A.; Alshammari , S.A.; Al-Amoud, M.M.; Hameed , T.A.; Al-Muammar , M.N.; Bindawas , S.M.; Al-Orf , S.M.; Mohamed , A.G.; Al-Ghamdi , E.A.; P.C. Calder

    2015-01-01

    Objectives: to evaluate the health care services provided for older adults by primary health care centers (PHCCs) in Riyadh, Kingdom of Saudi Arabia (KSA), and the ease of use of these centers by older adults. Methods: between October 2013 and January 2014, we conducted a descriptive cross-sectional study of 15 randomly selected PHCCs in Riyadh City, KSA. The evaluation focused on basic indicators of clinical services offered and factors indicative of the ease of use of the centers by o...

  1. Informal Care Provided by Family Caregivers: Experiences of Older Adults With Multimorbidity.

    Science.gov (United States)

    Lindvall, Agneta; Kristensson, Jimmie; Willman, Ania; Holst, Göran

    2016-08-01

    HOW TO OBTAIN CONTACT HOURS BY READING THIS ARTICLE INSTRUCTIONS 1.3 contact hours will be awarded by Villanova University College of Nursing upon successful completion of this activity. A contact hour is a unit of measurement that denotes 60 minutes of an organized learning activity. This is a learner-based activity. Villanova University College of Nursing does not require submission of your answers to the quiz. A contact hour certificate will be awarded once you register, pay the registration fee, and complete the evaluation form online at http://goo.gl/gMfXaf. To obtain contact hours you must: 1. Read the article, "Informal Care Provided by Family Caregivers: Experiences of Older Adults With Multimorbidity" found on pages 24-31, carefully noting any tables and other illustrative materials that are included to enhance your knowledge and understanding of the content. Be sure to keep track of the amount of time (number of minutes) you spend reading the article and completing the quiz. 2. Read and answer each question on the quiz. After completing all of the questions, compare your answers to those provided within this issue. If you have incorrect answers, return to the article for further study. 3. Go to the Villanova website listed above to register for contact hour credit. You will be asked to provide your name; contact information; and a VISA, MasterCard, or Discover card number for payment of the $20.00 fee. Once you complete the online evaluation, a certificate will be automatically generated. This activity is valid for continuing education credit until July 31, 2019. CONTACT HOURS This activity is co-provided by Villanova University College of Nursing and SLACK Incorporated. Villanova University College of Nursing is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center's Commission on Accreditation. ACTIVITY OBJECTIVES 1. Describe how older adults with multimorbidity experience care provided from informal

  2. Challenges Caring for Adults With Congenital Heart Disease in Pediatric Settings: How Nurses Can Aid in the Transition.

    Science.gov (United States)

    Anton, Kristin

    2016-08-01

    As surgery for complex congenital heart disease is becoming more advanced, an increasing number of patients are surviving into adulthood, yet many of these adult patients remain in the pediatric hospital system. Caring for adult patients is often a challenge for pediatric nurses, because the nurses have less experience and comfort with adult care, medications, comorbid conditions, and rehabilitation techniques. As these patients age, the increased risk of complications and comorbid conditions from their heart disease may complicate their care further. Although these patients are admitted on a pediatric unit, nurses can aid in promoting their independence and help prepare them to transition into the adult medical system. Nurses, the comprehensive medical teams, and patients' families can all effectively influence the process of preparing these patients for transition to adult care. PMID:27481810

  3. Variation in quality of preventive care for well adults in Indigenous community health centres in Australia

    Directory of Open Access Journals (Sweden)

    Hains Jenny

    2011-06-01

    Full Text Available Abstract Background Early onset and high prevalence of chronic disease among Indigenous Australians call for action on prevention. However, there is deficiency of information on the extent to which preventive services are delivered in Indigenous communities. This study examined the variation in quality of preventive care for well adults attending Indigenous community health centres in Australia. Methods During 2005-2009, clinical audits were conducted on a random sample (stratified by age and sex of records of adults with no known chronic disease in 62 Indigenous community health centres in four Australian States/Territories (sample size 1839. Main outcome measures: i adherence to delivery of guideline-scheduled services within the previous 24 months, including basic measurements, laboratory investigations, oral health checks, and brief intervention on lifestyle modification; and ii follow-up of abnormal findings. Results Overall delivery of guideline-scheduled preventive services varied widely between health centres (range 5-74%. Documentation of abnormal blood pressure reading ([greater than or equal to]140/90 mmHg, proteinuria and abnormal blood glucose ([greater than or equal to]5.5 mmol/L was found to range between 0 and > 90% at the health centre level. A similarly wide range was found between health centres for documented follow up check/test or management plan for people documented to have an abnormal clinical finding. Health centre level characteristics explained 13-47% of variation in documented preventive care, and the remaining variation was explained by client level characteristics. Conclusions There is substantial room to improve preventive care for well adults in Indigenous primary care settings. Understanding of health centre and client level factors affecting variation in the care should assist clinicians, managers and policy makers to develop strategies to improve quality of preventive care in Indigenous communities.

  4. The Experiences of Korean Young Adult Survivors of Childhood Cancer: A Photovoice Study.

    Science.gov (United States)

    Yi, Jaehee; Kim, Min Ah; An, Sangmin

    2016-07-01

    Photovoice was used to understand the impact of childhood cancer on Korean young adult survivors. Seven survivors of childhood cancer (currently aged 20-27 years), diagnosed before the age of 19 and with cancer treatment completed, participated in five sessions. The participants took photographs that captured their group's weekly topics and participated in discussions about their feelings and experiences. Fifty-six photo images with narratives on the survivors' experiences were produced on these four participant-selected themes: Relationships With Others, Stigma, Overcoming Difficulties, and The Future This study on Korean childhood cancer survivors sheds light on their perspectives about the impact of cancer. Using an innovative methodology that takes the participants' point of view, this study contributes to the literature on young adult cancer survivors' quality of life and their psychosocial adjustment. The results can inform educational programs and increase public awareness by providing survivors' schoolteachers and peers with knowledge about childhood cancer. PMID:26265716

  5. Determinants for Aggressive End-of-Life Care for Oral Cancer Patients

    OpenAIRE

    Chang, Ting-Shou; Su, Yu-Chieh; Lee, Ching-Chih

    2015-01-01

    Abstract Few studies have addressed the association between oral cancer and end-of-life (EOL) aggressive care using population data. We investigated the relationship between patient demographics, primary physician's specialty, and hospital characteristics of patients who died from oral cancer in Taiwan from 2009 to 2011 and the aggressiveness of their EOL care. This nationwide population-based, retrospective cohort study identified 5386 patients who died from oral cancer identified from Taiwa...

  6. Barriers and challenges in integration of anthroposophic medicine in supportive breast cancer care

    OpenAIRE

    Ben-Arye, Eran; Schiff, Elad; Levy, Moti; Raz, Orit Gressel; Barak, Yael; Bar-Sela, Gil

    2013-01-01

    In the last decade, more and more oncology centers are challenged with complementary medicine (CM) integration within supportive breast cancer care. Quality of life (QOL) improvement and attenuation of oncology treatment side effects are the core objectives of integrative CM programs in cancer care. Yet, limited research is available on the use of specific CM modalities in an integrative setting and on cancer patients’ compliance with CM consultation. Studies are especially warranted to view ...

  7. Patient-centered care in lung cancer: exploring the next milestones

    OpenAIRE

    Ben-Arye, Eran; Samuels, Noah

    2015-01-01

    In this editorial, the authors comment on a recently published review paper by Molassiotis et al. on the developments made over the past 40 years in supportive care for patients with lung cancer. During this period, a paradigm shift promoting patient-centered care (PCC) has led to an important change in the approach of supportive cancer care, from a purely disease-centered approach, measuring survival-related outcomes, to recognizing the importance of quality of life outcomes as well. This ch...

  8. Examining the trajectories of children providing care for adults in rural Kenya

    DEFF Research Database (Denmark)

    Skovdal, Morten

    2011-01-01

    Research on caregiving children tends to be limited to children's caregiving experiences of parents with a specific disease or disability. This has led to a common perception that children's caregiving is a single, uniform and often long-term experience. Whilst this is most certainly the case for...... family and community members for varying periods of time and intensities. Although their living arrangements and life circumstances often gave them little choice but to care, a social recognition of children's capacity to provide care for fragile adults, helped the children construct an identity, which...

  9. Childhood cancer in developing society: A roadmap of health care

    Directory of Open Access Journals (Sweden)

    P M Ramesh

    2011-01-01

    Full Text Available Background: We assessed referral patterns of children with hematological malignancies (HM in North India. Materials and Methods: The parents/guardians were interviewed at presentation, in the period between October 2001 and November 2002. Patient delay (symptom-contact, health system delay (contact-diagnosis, total delay (symptom-diagnosis, and number of contacts were compared between high- and standard-risk disease group. Results: Of the 79 children (55 boys; 69.6% with HM, 47 (59.5% had Acute Lymphoblastic Leukemia (ALL. Forty-four children had high-risk disease. The patient, system and total delay were a median of 2 days (with Interquartile range IQR of 1−6, 37 days (IQR 13−55, and 38 days (IQR 15−60 respectively. Majority of patients (64/79; 81% went to private sector (non governmental health care providers for health care. Number of contacts, which was the most significant, correlate with system delay. Conclusions: Sensitizing the private sector practitioners about cancer in symptomatic children (pallor, bleeding, fever may be effective.

  10. Considerations for Implementation of Cancer Molecular Diagnostics Into Clinical Care.

    Science.gov (United States)

    Hayes, Daniel F

    2016-01-01

    Physicians have provided personalized care with as much precision as possible for several centuries. However, increasingly sophisticated understanding of the human genome and of cancer biology has permitted identification of genetic and phenotypic distinctions that might permit development of new tumor biomarker tests for risk categorization, screening, differential diagnosis, prognosis, prediction, and monitoring. Both commercial and academic laboratories are offering tests for single analytes, panels of tests of single analytes, multiparameter assays coalesced into a signature, and total genomic, transcriptomic, or proteomic analyses. However, the absence of a consistent regulatory environment has led to marketing of assays without proven analytic validity or clinical utility. U.S. Food and Drug Administration (FDA) approval or clearance does not necessarily imply that use of the test will improve patient outcomes, and FDA discretion to permit laboratory-developed tests results in unknown benefit, or harm, of others. In this regard, a "bad tumor marker is as bad as a bad drug." Caveat emptor is not a satisfactory approach to delivering high-quality care. Rather, adoption of tumor biomarker tests should be based on high levels of evidence generated in scientifically rigorous studies that demonstrate both analytical validity and clinical utility. Doing so will ensure that clinicians and patients are confident that a tumor biomarker test is likely to improve their outcomes. PMID:27249708

  11. Long-term follow-up study and long-term care of childhood cancer survivors

    Directory of Open Access Journals (Sweden)

    Hyeon Jin Park

    2010-04-01

    Full Text Available The number of long-term survivors is increasing in the western countries due to remarkable improvements in the treatment of childhood cancer. The long-term complications of childhood cancer survivors in these countries were brought to light by the childhood cancer survivor studies. In Korea, the 5-year survival rate of childhood cancer patients is approaching 70%; therefore, it is extremely important to undertake similar long-term follow-up studies and comprehensive long-term care for our population. On the basis of the experiences of childhood cancer survivorship care of the western countries and the current Korean status of childhood cancer survivors, long-term follow-up study and long-term care systems need to be established in Korea in the near future. This system might contribute to the improvement of the quality of life of childhood cancer survivors through effective intervention strategies.

  12. Challenges in Prevention and Care Delivery for Women with Cervical Cancer in Sub-Saharan Africa

    Science.gov (United States)

    Randall, Thomas C.; Ghebre, Rahel

    2016-01-01

    Virtually all cases of invasive cervical cancer are associated with infection by high-risk strains of human papilloma virus. Effective primary and secondary prevention programs, as well as effective treatment for early-stage invasive cancer have dramatically reduced the burden of cervical cancer in high-income countries; 85% of the mortality from cervical cancer now occurs in low- and middle-income countries. This article provides an overview of challenges to cervical cancer care in sub-Saharan Africa (SSA) and identifies areas for programmatic development to meet the global development goal to reduce cancer-related mortality. Advanced stage at presentation and gaps in prevention, screening, diagnostic, and treatment capacities contribute to reduced cervical cancer survival. Cost-effective cervical cancer screening strategies implemented in low resource settings can reduce cervical cancer mortality. Patient- and system-based barriers need to be addressed as part of any cervical cancer control program. Limited human capacity and infrastructure in SSA are major barriers to comprehensive cervical cancer care. Management of early-stage, locally advanced or metastatic cervical cancer involves multispecialty care, including gynecology oncology, medical oncology, radiology, pathology, radiation oncology, and palliative care. Investment in cervical cancer care programs in low- and middle-income countries will need to include effective recruitment programs to engage women in the community to access cancer screening and diagnosis services. Though cervical cancer is a preventable and treatable cancer, the challenges to cervical control in SSA are great and will require a broadly integrated and sustained effort by multiple stakeholders before meaningful progress can be achieved. PMID:27446806

  13. Challenges in Prevention and Care Delivery for Women with Cervical Cancer in Sub-Saharan Africa.

    Science.gov (United States)

    Randall, Thomas C; Ghebre, Rahel

    2016-01-01

    Virtually all cases of invasive cervical cancer are associated with infection by high-risk strains of human papilloma virus. Effective primary and secondary prevention programs, as well as effective treatment for early-stage invasive cancer have dramatically reduced the burden of cervical cancer in high-income countries; 85% of the mortality from cervical cancer now occurs in low- and middle-income countries. This article provides an overview of challenges to cervical cancer care in sub-Saharan Africa (SSA) and identifies areas for programmatic development to meet the global development goal to reduce cancer-related mortality. Advanced stage at presentation and gaps in prevention, screening, diagnostic, and treatment capacities contribute to reduced cervical cancer survival. Cost-effective cervical cancer screening strategies implemented in low resource settings can reduce cervical cancer mortality. Patient- and system-based barriers need to be addressed as part of any cervical cancer control program. Limited human capacity and infrastructure in SSA are major barriers to comprehensive cervical cancer care. Management of early-stage, locally advanced or metastatic cervical cancer involves multispecialty care, including gynecology oncology, medical oncology, radiology, pathology, radiation oncology, and palliative care. Investment in cervical cancer care programs in low- and middle-income countries will need to include effective recruitment programs to engage women in the community to access cancer screening and diagnosis services. Though cervical cancer is a preventable and treatable cancer, the challenges to cervical control in SSA are great and will require a broadly integrated and sustained effort by multiple stakeholders before meaningful progress can be achieved. PMID:27446806

  14. Pediatric Cancers and Brain Tumors in Adolescents and Young Adults.

    Science.gov (United States)

    McCabe, Martin G; Valteau-Couanet, Dominique

    2016-01-01

    Embryonal tumors classically occur in young children, some principally within the first year of life. Prospective national and international clinical trials during recent decades have brought about progressive improvements in survival, and associated biological studies have advanced our understanding of tumor biology, in some cases allowing biological tumor characteristics to be harnessed for therapeutic benefit. Embryonal tumors continue to occur, albeit less commonly, during childhood, adolescence and throughout adulthood. These tumors are less well understood, usually not managed according to standardized protocols and rarely included in clinical trials. Survival outcomes are generally poorer than their childhood equivalents. We present here a summary of the published literature on embryonal tumors that present ectopically during adolescence and adulthood. We show that for some tumors protocol-driven treatment, supported by accurate and complete diagnostics and staging, can result in equivalent outcomes to those seen during childhood. We make the case that clinical trial eligibility criteria should be disease-based rather than age-based, and support improvements in dialogue between children's and adults' cancer clinicians to improve outcomes for these rare tumors. PMID:27595358

  15. Colorectal cancer screening practices of primary care providers: results of a national survey in Malaysia.

    Science.gov (United States)

    Norwati, Daud; Harmy, Mohamed Yusoff; Norhayati, Mohd Noor; Amry, Abdul Rahim

    2014-01-01

    The incidence of colorectal cancer has been increasing in many Asian countries including Malaysia during the past few decades. A physician recommendation has been shown to be a major factor that motivates patients to undergo screening. The present study objectives were to describe the practice of colorectal cancer screening by primary care providers in Malaysia and to determine the barriers for not following recommendations. In this cross sectional study involving 132 primary care providers from 44 Primary Care clinics in West Malaysia, self-administered questionnaires which consisted of demographic data, qualification, background on the primary care clinic, practices on colorectal cancer screening and barriers to colorectal cancer screening were distributed. A total of 116 primary care providers responded making a response rate of 87.9%. About 21% recommended faecal occult blood test (FOBT) in more than 50% of their patients who were eligible. The most common barrier was "unavailability of the test". The two most common patient factors are "patient in a hurry" and "poor patient awareness". This study indicates that colorectal cancer preventive activities among primary care providers are still poor in Malaysia. This may be related to the low availability of the test in the primary care setting and poor awareness and understanding of the importance of colorectal cancer screening among patients. More awareness programmes are required for the public. In addition, primary care providers should be kept abreast with the latest recommendations and policy makers need to improve colorectal cancer screening services in health clinics. PMID:24761922

  16. Internet-Based Physical Activity Intervention Targeting Young Adult Cancer Survivors

    OpenAIRE

    Rabin, Carolyn; Dunsiger, Shira; Ness, Kirsten K.; Marcus, Bess H

    2011-01-01

    Purpose: Young adults who have been treated for cancer face several health and psychosocial risks. To minimize these risks, is it imperative that they address any modifiable risk factors, such as sedentary lifestyle. Unfortunately, more than half of young adult cancer survivors remain sedentary. To facilitate the adoption of physical activity (PA) in this population—potentially reducing health and psychosocial risks—we developed and pilot tested an internet-based PA intervention for young sur...

  17. Screening for alcohol and drug use disorders among adults in primary care: a review

    Directory of Open Access Journals (Sweden)

    Pilowsky DJ

    2012-04-01

    Full Text Available Daniel J Pilowsky1, Li-Tzy Wu21Departments of Epidemiology and Psychiatry, Columbia University, and the New York State Psychiatric Institute, New York City, NY, 2Department of Psychiatry and Behavioral Sciences, School of Medicine, Duke University Medical Center, Durham, NC, USABackground: The Patient Protection and Affordable Care Act of 2010 supports integration of substance abuse interventions and treatments into the mainstream health care system. Thus, effective screening and intervention for substance use disorders in health care settings is a priority.Objective: This paper reviews the prevalence of alcohol and drug use disorders (abuse or dependence in primary care settings and emergency departments, as well as current screening tools and brief interventions.Methods: MEDLINE was searched using the following keywords: alcohol use, alcohol use disorder, drug use, drug use disorder, screening, primary care, and emergency departments. Using the related-articles link, additional articles were screened for inclusion. This review focuses on alcohol and drug use and related disorders among adults in primary care settings.Conclusion: Screening, brief intervention, and referral for treatment are feasible and effective in primary care settings, provided that funding for screening is available, along with brief interventions and treatment facilities to which patients can be referred and treated promptly.Keywords: brief intervention, emergency departments

  18. The psychosocial oncology learning assessment: a province-wide survey of cancer care providers' learning needs.

    Science.gov (United States)

    Rennie, Heather; Mackenzie, Gina

    2010-06-01

    A psychosocial oncology learning needs assessment was developed and offered online to cancer care providers in a variety of settings across all health regions in British Columbia. The purpose was to better understand the psychosocial learning needs of cancer care providers and to use this knowledge to shape continuing education priorities. Respondents' preferred learning formats, access to technology and barriers to accessing psychosocial learning opportunities were also assessed. Cancer care providers including radiation therapists, social workers, dieticians, pharmacists, physicians and nurses in both community and agency settings were surveyed. Two hundred and sixty-seven people completed the survey. Key learning needs identified included cultural aspects of care, symptom management, treating the anxious patient, self-care for the professional, care of elderly patients, basic cancer-related medical issues surrounding care and ethics. Community respondents indicated more needs than agency respondents. On-site training was the most preferred learning format, and time constraints were the biggest barrier to accessing learning opportunities. Participants had access to technology. Next steps include conducting key informant and focus group interviews to determine if interest in a learning need is the same as a relevant knowledge and practice gap. This research suggests that cancer care providers are interested in learning more about the psychosocial issues related to cancer care. PMID:20361284

  19. Early mobilization in the critical care unit: A review of adult and pediatric literature.

    Science.gov (United States)

    Cameron, Saoirse; Ball, Ian; Cepinskas, Gediminas; Choong, Karen; Doherty, Timothy J; Ellis, Christopher G; Martin, Claudio M; Mele, Tina S; Sharpe, Michael; Shoemaker, J Kevin; Fraser, Douglas D

    2015-08-01

    Early mobilization of critically ill patients is beneficial, suggesting that it should be incorporated into daily clinical practice. Early passive, active, and combined progressive mobilizations can be safely initiated in intensive care units (ICUs). Adult patients receiving early mobilization have fewer ventilator-dependent days, shorter ICU and hospital stays, and better functional outcomes. Pediatric ICU data are limited, but recent studies also suggest that early mobilization is achievable without increasing patient risk. In this review, we provide a current and comprehensive appraisal of ICU mobilization techniques in both adult and pediatric critically ill patients. Contraindications and perceived barriers to early mobilization, including cost and health care provider views, are identified. Methods of overcoming barriers to early mobilization and enhancing sustainability of mobilization programs are discussed. Optimization of patient outcomes will require further studies on mobilization timing and intensity, particularly within specific ICU populations. PMID:25987293

  20. Up against the System: A Case Study of Young Adult Perspectives Transitioning from Pediatric Palliative Care

    Directory of Open Access Journals (Sweden)

    Karen Cook

    2013-01-01

    Full Text Available Advances in pediatric care have not provided the interdisciplinary support services required by those young adults with pediatric life-threatening conditions (pedLTCs who live beyond childhood but have limited expectations to live past early adulthood. These young adults, the first generation to live into adulthood, face multiple challenges transitioning from a plethora of pediatric palliative services to scant adult health services. In a case study, using an innovative bulletin board focus group, we describe the complex interplay of the health, education, and social service sectors in this transition. Our descriptions include system deficits and strengths and the young adults’ resilience and coping strategies to overcome those deficits and move forward with their lives. Young adults with pedLTC need knowledgeable providers, coordinated and accessible services, being respected and valued, and services and supports that promote independence. We recommend implementation of multidisciplinary solutions that are focused on young adult priorities to ensure seamless access to resources to support these young adults’ health, educational, vocational, and social goals. The input and voice of young adults in the development of these services are imperative to ensure that multisystem services support their needs and life goals.

  1. UTILIZATION OF HEALTH CARE SERVICES AMONG ADULTS ATTENDING A HEALTH FAIR IN SOUTH LOS ANGELES COUNTY

    OpenAIRE

    Macias, Eduardo P.; Morales, Leo S.

    2000-01-01

    A bilingual survey was developed to collect information regarding socio-demographics, access to medical and dental care, health insurance coverage, perceived health status, and use of folk medicine providers from 70 adults presenting to a health fair in South Los Angeles County. Ninety-seven percent of respondents were foreign-born. Seventy-nine percent reported having no health insurance during the year prior to survey. Of the uninsured, 61 percent lacked a doctor visit and 76 percent lacked...

  2. Adult safeguarding policy and law:a thematic chronology relevant to care homes and hospitals

    OpenAIRE

    Manthorpe, Jill; Stevens, Martin

    2014-01-01

    Elder abuse is a ‘social problem’, as illustrated by the production of policy documents and legislation that define and revise the scope and nature of the problem. This article synthesises and discusses the policy documents and legal changes that have taken place in England since 2000, when the first policy guidance to address adult safeguarding as a whole was produced. The focus of this article is on particular locations, namely care home and hospital settings, and the applicable policy and ...

  3. The Role of the Primary Care Physician in Helping Adolescent and Adult Patients Improve Asthma Control

    OpenAIRE

    Yawn, Barbara P.

    2011-01-01

    Many adolescents and adults with asthma continue to have poorly controlled disease, often attributable to poor adherence to asthma therapy. Failure to adhere to recommended treatment may result from a desire to avoid regular reliance on medications, inappropriate high tolerance of asthma symptoms, failure to perceive the chronic nature of asthma, and poor inhaler technique. Primary care physicians need to find opportunities and methods to address these and other issues related to poor asthma ...

  4. Temporal Artery versus Bladder Thermometry during Adult Medical-Surgical Intensive Care Monitoring: An Observational Study

    OpenAIRE

    Stelfox Henry T; Straus Sharon E; Ghali William A; Conly John; Laupland Kevin; Lewin Adriane

    2010-01-01

    Abstract Background We sought to evaluate agreement between a new and widely implemented method of temperature measurement in critical care, temporal artery thermometry and an established method of core temperature measurement, bladder thermometry as performed in clinical practice. Methods Temperatures were simultaneously recorded hourly (n = 736 observations) using both devices as part of routine clinical monitoring in 14 critically ill adult patients with temperatures ranging ≥1°C prior to ...

  5. Abandonment Fears in Persons with Alzheimer's at Adult Day Care Centers

    OpenAIRE

    Judkins, Wayne A

    1999-01-01

    In my research, I examined abandonment fears in persons with Alzheimerâ s disease at the Salem Veterans Affairs adult day care center. I observed fifty hours at the center, and conducted open-ended interviews with two of the participants and their respective caregivers. These two participants (Ellen and Opel) at the center expressed abandonment fears much more frequently than any of the other participants. I found that most of the time, these two women would express their abandonment f...

  6. Drug incompatibilities in the adult intensive care unit of a university hospital

    OpenAIRE

    Marsilio, Naiane Roveda; da Silva, Daiandy; Bueno, Denise

    2016-01-01

    Objectives This study sought to identify the physical and chemical incompatibilities among the drugs administered intravenously to patients admitted to an adult intensive care unit. We also aimed to establish pharmaceutical guidelines for administering incompatible drugs. Methods This cross-sectional, prospective, and quantitative study was conducted from July to September 2015. Drug incompatibilities were identified based on an analysis of the patient prescriptions available in the hospital ...

  7. Perceived Need for Mental Health Care Among Community-Dwelling Older Adults

    OpenAIRE

    Garrido, Melissa M; Kane, Robert L; Kaas, Merrie; Kane, Rosalie A.

    2009-01-01

    Only half of older adults with a mental disorder use mental health services, and little is known about the causes of perceived need for mental health care (MHC). We used logistic regression to examine relationships among depression, anxiety, chronic physical illness, alcohol abuse and/or dependence, sociodemographics, and perceived need among a national sample of community-dwelling individuals 65 years of age and older (the Collaborative Psychiatric Epidemiology Surveys data set). Less than h...

  8. Regulatory focus and adherence to self-care behaviors among adults with type 2 diabetes.

    Science.gov (United States)

    Avraham, Rinat; Van Dijk, Dina; Simon-Tuval, Tzahit

    2016-09-01

    The aims of this study were, first, to test the association between regulatory focus of adults with type 2 diabetes and their adherence to two types of self-care behaviors - lifestyle change (e.g. physical activity and diet) and medical care regimens (blood-glucose monitoring, foot care and medication usage). Second, to explore whether a fit between the message framing and patients' regulatory focus would improve their intentions to adhere specifically when the type of behavior fits the patients' regulatory focus as well. A cross-sectional study was conducted among 130 adults with type 2 diabetes who were hospitalized in an academic medical center. The patients completed a set of questionnaires that included their diabetes self-care activities, regulatory focus, self-esteem and demographic, socioeconomic and clinical data. In addition, participants were exposed to either a gain-framed or a loss-framed message, and were then asked to indicate their intention to improve adherence to self-care behaviors. A multivariable linear regression model revealed that promoters reported higher adherence to lifestyle change behaviors than preventers did (B = .60, p = .028). However, no effect of regulatory focus on adherence to medical care regimens was found (B = .46, p = .114). In addition, preventers reported higher intentions to adhere to medical care behaviors when the message framing was congruent with prevention focus (B = 1.16, p = .023). However, promoters did not report higher intentions to adhere to lifestyle behaviors when the message framing was congruent with promotion focus (B = -.16, p = .765). These findings justify the need to develop tailor-made interventions that are adjusted to both patients' regulatory focus and type of health behavior. PMID:26576471

  9. Comprehension of a Colon Cancer Pamphlet among American Adults at Least 50 Years of Age

    Science.gov (United States)

    Liu, Chiung-ju

    2010-01-01

    Objective: The purpose of this study was to identify determinants of comprehension of an educational pamphlet on colon cancer, by adults at least 50 years of age living in the United States. Design: Data were analysed from the "2003 National Assessment of Adult Literacy" survey. The survey was designed to assess functional English literacy, which…

  10. Adult Patients’ Satisfaction with Inpatient Nursing Care and Associated Factors in an Ethiopian Referral Hospital, Northeast, Ethiopia

    OpenAIRE

    Haile Eyasu, Kokeb; Adane, Akilew Awoke; Amdie, Fisseha Zewdu; Getahun, Tesfaye Bisenebit; Biwota, Mulunesh Abuhay

    2016-01-01

    Introduction. Patient satisfaction with nursing care is considered as an important factor in explaining patients’ perceptions of service quality. Care assessed to be high quality according to clinical, economic, or other provider-defined criteria is far from ideal if as a result of that care the patient is unhappy or dissatisfied. Objective. The aim of this study was to assess adult patients’ satisfaction with inpatient nursing care and associated factors in Dessie Referral Hospital, Northeas...

  11. Adults ages 50-64 and the Affordable Care Act of 2010.

    Science.gov (United States)

    Collins, Sara R; Doty, Michelle M; Garber, Tracy

    2010-12-01

    The Patient Protection and Affordable Care Act, which will provide health insurance to nearly all U.S. citizens and improve the quality of health insurance, will particularly benefit adults ages 50 to 64, a group suffering from extended unemployment and a loss of employer health benefits. Several early provisions that go into effect in 2010, including preexisting condition insurance plans, will provide transitional assistance for adults who have struggled to gain health insurance. The biggest improvements will come in 2014 through a significant expansion in eligibility for Medicaid and the creation of health insurance exchanges with subsidized private insurance for people with low and moderate incomes. Of the 8.6 million adults ages 50 to 64 who were uninsured in 2009, up to 6.8 million may gain subsidized insurance through Medicaid and the exchanges and 1.4 million with higher incomes will have access to comprehensive health plans with new consumer protections. PMID:21155372

  12. What is supportive when an adult next-of-kin is in critical care?

    Science.gov (United States)

    Johansson, Ingrid; Fridlund, Bengt; Hildingh, Cathrine

    2005-01-01

    There is little documented knowledge about what is supportive from the perspective of relatives with a critically ill next-of-kin in the intensive care unit (ICU). The aim of the present study was to generate a theoretical understanding of what relatives experience as supportive when faced with the situation of having an adult next-of-kin admitted to critical care. The study was designed using a grounded theory methodology. Interviews were conducted with 29 adult relatives of adult ICU patients in southwest Sweden. Relatives described the need to be empowered and that support was needed to enable them to use both internal and external resources to cope with having a next-of-kin in critical care. To achieve empowerment, the relatives described the need to trust in oneself, to encounter charity and to encounter professionalism. The findings can contribute understanding and sensitivity to the situation of the relatives as well as indicating what form social support should take. It is essential that healthcare professionals understand how important it is for relatives to have control over their vulnerable situation and that they also reflect upon how they would like to be treated themselves in a similar situation. Recommendations for future practice are presented. PMID:16255336

  13. Patient navigator programs, cancer disparities, and the patient protection and affordable care act.

    Science.gov (United States)

    Moy, Beverly; Chabner, Bruce A

    2011-01-01

    Patients in vulnerable population groups suffer disproportionately from cancer. The elimination of cancer disparities is critically important for lessening the burden of cancer. Patient navigator programs have been shown to improve clinical outcomes. Among its provisions relevant to disparities in cancer care, The Patient Protection and Affordability Care Act authorizes continued funding of patient navigator programs. However, given the current economic and political environment, this funding is in jeopardy. This article describes patient navigator programs and summarizes the elements of the health care law that are relevant to these programs. It is vital that the entire oncology community remain committed to leading efforts toward the improvement of cancer care among our most vulnerable patients. PMID:21804070

  14. Factors that limit access to dental care for adults with spinal cord injury.

    Science.gov (United States)

    Yuen, Hon K; Wolf, Bethany J; Bandyopadhyay, Dipankar; Magruder, Kathryn M; Selassie, Anbesaw W; Salinas, Carlos F

    2010-01-01

    This study investigated dental care service utilization among adults with spinal cord injury (SCI) and identified barriers and other factors affecting utilization among this population. There were 192 subjects with SCI who participated in the oral health survey assessing dental care service utilization and they were compared with subjects from the 2004 Behavioral Risk Factors Surveillance System (BRFSS). There was no significant difference in the proportion of subjects with SCI who visited the dentist for any reason in the past year compared to the general population (65.5% vs. 68.8%, p= .350). However, subjects with SCI were less likely to go to the dentist for a dental cleaning in the past year compared to the general population (54.6% vs. 69.4%, p dental care were cost (40.1%), physical barriers (22.9%), and dental fear (15.1%). Multivariate modeling showed that physical barriers and fear of dental visits were the two significant factors deterring subjects from dental visits in the past year. Physical barriers preventing access to dental facilities and dental fear are prevalent and significantly impede the delivery of dental health care to adults with SCI. Dentists should undertake necessary physical remodeling of their facilities to accommodate wheelchair users and implement appropriate strategies for the management of dental fear among patients with SCI. PMID:20618781

  15. Body mass index in childhood and adult risk of primary liver cancer

    DEFF Research Database (Denmark)

    Berentzen, Tina Landsvig; Gamborg, Michael; Holst, Claus;

    2014-01-01

    BACKGROUND & AIMS: Childhood overweight increases the risk of early development of non-alcoholic fatty liver disease, which may predispose to carcinogenesis. We investigated if childhood body size during school ages was associated with the risk of primary liver cancer in adults. METHODS: A cohort......-specific reference. Information on liver cancer was obtained from the National Cancer Registry. Hazard ratios and 95% confidence intervals (95% CI) of liver cancer were estimated by Cox regression. RESULTS: During 6,963,105 person-years of follow-up, 438 cases of primary liver cancer were recorded. The hazard ratio...... (95% CI) of adult liver cancer was 1.20 (1.07-1.33) and 1.30 (1.16-1.46) per 1-unit BMI z-score at 7 years and 13 years of age, respectively. Similar associations were found in boys and girls, for hepatocellular carcinoma only, across years of birth, and after accounting for diagnoses of viral...

  16. Clinicopathological Characteristics of Colon Cancer Diagnosed at Primary Health Care Institutions

    OpenAIRE

    Park, Sang Hyun; Song, Chi Wook; Kim, Yun Bae; Kim, Young Sun; Chun, Hwang Rae; Lee, Jung Hyun; Seol, Won Jong; Yoon, Hyung Sun; Lee, Myung Kwon; Lee, Jong Hyup; Bhang, Choon Sang; Park, Jae Hyung; Park, Ji Young; Do, Byung Hun; Park, Young Dae

    2014-01-01

    Background/Aims The purpose of this study was to evaluate the clinicopathologic characteristics of colon cancers detected at the SOK Sokpeynhan Internal Medical Network, a nationwide system of primary health care institutions. Methods We analyzed 579 colon cancer patients diagnosed using colonoscopy at the SOK network from January 2011 through December 2012. Cancers from the rectum to the splenic flexure were classified as left colon cancer. Patients over 65 were classified as senior. Results...

  17. Linking Tumor Registry and Medicaid Claims to Evaluate Cancer Care Delivery

    OpenAIRE

    Schrag, Deborah; Virnig, Beth A.; Warren, Joan L.

    2009-01-01

    The utility of Medicaid claims for studying cancer care is not known. Our objective was to evaluate how well Medicaid claims capture diagnostic and treatment information recorded by the California Cancer Registry (CCR). We compared cancer treatment from Medicaid claims with CCR data, using 1988-2000 cases matched with 1997-1998 Medicaid enrollment data. Medicaid claims corroborated diagnoses for 73 percent of breast and 68 percent of colorectal cancers in CCR. Medicaid claims confirmed surger...

  18. Adaptation of a Psycho-Oncology Intervention for Black Breast Cancer Survivors: Project CARE

    OpenAIRE

    Lechner, Suzanne C.; Ennis-Whitehead, Nicole; Robertson, Belinda Ryan; Annane, Debra W.; Vargas, Sara; Carver, Charles S.; Antoni, Michael H.

    2012-01-01

    Black women are traditionally underserved in all aspects of cancer care. This disparity is particularly evident in the area of psychosocial interventions where there are few programs designed to specifically meet the needs of Black breast cancer survivors. Cognitive-behavioral stress management intervention (CBSM) has been shown to facilitate adjustment to cancer. Recently, this intervention model has been adapted for Black women who have recently completed treatment for breast cancer. We out...

  19. Residential Racial Composition, Spatial Access to Care, and Breast Cancer Mortality among Women in Georgia

    OpenAIRE

    Russell, Emily; Kramer, Michael R.; Cooper, Hannah L.F.; Thompson, Winifred Wilkins; Arriola, Kimberly R. Jacob

    2011-01-01

    We explored the association between neighborhood residential racial composition and breast cancer mortality among Black and White breast cancer patients in Georgia and whether spatial access to cancer care mediates this association. Participants included 15,256 women living in 15 metropolitan statistical areas in Georgia who were diagnosed with breast cancer between 1999 and 2003. Residential racial composition was operationalized as the percent of Black residents in the census tract. We used...

  20. Patient-centered care in lung cancer: exploring the next milestones.

    Science.gov (United States)

    Ben-Arye, Eran; Samuels, Noah

    2015-10-01

    In this editorial, the authors comment on a recently published review paper by Molassiotis et al. on the developments made over the past 40 years in supportive care for patients with lung cancer. During this period, a paradigm shift promoting patient-centered care (PCC) has led to an important change in the approach of supportive cancer care, from a purely disease-centered approach, measuring survival-related outcomes, to recognizing the importance of quality of life outcomes as well. This change of understanding in supportive and palliative care for patients with lung cancer can be further advanced through the understanding that there is a need to address bio-psycho-spiritual concerns and health belief models, within the context of the family socio-cultural environment, for both patients and their caregivers. There is also a need to address the psycho-spiritual effects of cancer on those health care professionals treating patients with lung cancer, in order to reduce compassion fatigue and increase resilience. Future directions for supportive care for patients with lung cancer may include the development of a patient-tailored treatment approach, assisted by the integration of a multidisciplinary team of health care providers and evidence-based complementary medicine practices, within conventional supportive care practice. PMID:26629435

  1. Adjuvant therapy for pancreas cancer in an era of value based cancer care

    Science.gov (United States)

    Ahn, Daniel H.; Williams, Terence M.; Goldstein, Daniel A.; El-Rayes, Bassel; Bekaii-Saab, Tanios

    2016-01-01

    In resected pancreas cancer, adjuvant therapy improves outcomes and is considered the standard of care for patients who recover sufficiently post operatively. Chemotherapy or combined chemotherapy and radiation therapy (chemoradiation; CRT) are strategies used in the adjuvant setting. However, there is a lack of evidence to suggest whether the addition of RT to chemotherapy translates to an improvement in clinical outcomes. This is true even when accounting for the subset of patients with a higher risk for recurrence, such as those with R1 and lymph node positive disease. When considering the direct and indirect costs, impact on quality of life and questionable added clinical benefit, the true “net health benefit” from added RT to chemotherapy becomes more uncertain. Future directions, including the utilization of modern RT, integration of novel therapies, and intensifying chemotherapy regimens may improve outcomes in resected pancreas cancer. PMID:26620819

  2. Acute nursing care of the older adult with fragility hip fracture

    DEFF Research Database (Denmark)

    Maher, A.B.; Meehan, A.J.; Hertz, K.;

    2013-01-01

    The second part of this paper provides those who care for orthopaedic patients with evidence-supported international perspectives about acute nursing care of the older adult with fragility hip fracture. Developed by an international group of nurse experts and guided by a range of information from...... research and clinical practice, it focuses on nurse sensitive quality indicators during the acute hospitalisation for fragility hip fracture. Optimal care for the patient who has experienced such a fracture is the focus. This includes (in the first, earlier, part):. Pain. Delirium. and in this part....... Pressure Ulcers. Fluid Balance/Nutrition. Constipation/Catheter Associated Urinary Tract Infection. Vigilant nursing assessment and prompt intervention may prevent the development of the complications we discuss. If they do occur and are identified early on, they may resolve with appropriate and timely...

  3. Adult attachment and the perceived cost of housework and child care

    DEFF Research Database (Denmark)

    Trillingsgaard, Tea; Sommer, Dion; Mathias, Lasgaard;

    2014-01-01

    Objective: This study examined the link between new mothers’ attachment orientation and the perceived cost of sole responsibility in housework and child care. Background: The transition to motherhood can be very stressful, and according to the Vulnerability Stress Adaptation Model (VSA model......), the way it affects the couple relationship is likely to depend on interacting factors from different domains of risk (e.g. individual and couple level). We expected interactions to appear between domains of attachment and labour division. The hypothesis was that sole responsibility in child care...... and housework would predict lower relationship satisfaction, particularly among mothers who were high on attachment insecurity. Methods: Data from self-report measures of adult attachment, child care, housework and relationship satisfaction were collected from 255 first-time mothers at six months postpartum...

  4. Implementation of Patient-Centered Medical Homes in Adult Primary Care Practices.

    Science.gov (United States)

    Alexander, Jeffrey A; Markovitz, Amanda R; Paustian, Michael L; Wise, Christopher G; El Reda, Darline K; Green, Lee A; Fetters, Michael D

    2015-08-01

    There has been relatively little empirical evidence about the effects of patient-centered medical home (PCMH) implementation on patient-related outcomes and costs. Using a longitudinal design and a large study group of 2,218 Michigan adult primary care practices, our study examined the following research questions: Is the level of, and change in, implementation of PCMH associated with medical surgical cost, preventive services utilization, and quality of care in the following year? Results indicated that both level and amount of change in practice implementation of PCMH are independently and positively associated with measures of quality of care and use of preventive services, after controlling for a variety of practice, patient cohort, and practice environmental characteristics. Results also indicate that lower overall medical and surgical costs are associated with higher levels of PCMH implementation, although change in PCMH implementation did not achieve statistical significance. PMID:25861803

  5. Cancer Risk Assessment for the Primary Care Physician

    OpenAIRE

    Korde, Larissa A; Gadalla, Shahinaz M.

    2009-01-01

    Cancer is the second leading cause of death in the United States. Cancer risk assessment can be divided into two major categories: assessment of familial or genetic risk and assessment of environmental factors that may be causally related to cancer. Identification of individuals with a suspected heritable cancer syndrome can lead to additional evaluation and to interventions that can substantially decrease cancer risk. Special attention should also be paid to potentially modifiable cancer ris...

  6. How do integrated health care systems address racial and ethnic disparities in colon cancer?

    OpenAIRE

    Rhoads, KF; Patel, MI; Ma, Y.; Schmidt, LA

    2015-01-01

    © 2015 by American Society of Clinical Oncology. Purpose: Colorectal cancer (CRC) disparities have persisted over the last two decades. CRC is a complex disease requiring multidisciplinary care from specialists who may be geographically separated. Few studies have assessed the association between integrated health care system (IHS) CRC care quality, survival, and disparities. The purpose of this study was to determine if exposure to an IHS positively affects quality of care, risk of mortality...

  7. [Quality of life and supportive care in head and neck cancers].

    Science.gov (United States)

    Babin, Emmanuel; Heutte, Natacha; Grandazzi, Guillaume; Prévost, Virginie; Robard, Laetitia

    2014-05-01

    The quality of life of patients treated for head and neck cancers and their carers is part of the current concerns of health care teams. Assessment tools were created and helped to highlight the severe physical effects (pain, mucositis…) and chronic (mutilation, post-radiation complications…) related to the disease or to different treatments but also to consider the psychosocial impact of this disease. Improving the quality of life through a thoughtful and comprehensive support that must be associated with somatic care, mental health care, rehabilitation and inclusion of social difficulties and suffering relatives. Supportive care shall ensure a good quality of life for patients treated and their families but also reduce the physical effects associated with the disease and treatment. They rely on coordination of care including the cancer networks established in the cancer plan to ensure comprehensive and continuous care for these patients. PMID:24886902

  8. Predictors of the Availability and Variety of Social Care Services for Older Adults: Comparison of Central European Countries

    Czech Academy of Sciences Publication Activity Database

    Lehmann, Štěpánka; Havlíková, Jana

    2015-01-01

    Roč. 41, č. 1 (2015), s. 113-132. ISSN 0148-8376 Institutional support: RVO:68378025 Keywords : Older adults * social care services * availability Subject RIV: AO - Sociology, Demography Impact factor: 0.311, year: 2014

  9. Association Between Diagnosed Diabetes and Self-Reported Cancer Among U.S. Adults

    OpenAIRE

    Li, Chaoyang; Balluz, Lina S; Ford, Earl S.; Okoro, Catherine A; Tsai, James; Zhao, Guixiang

    2011-01-01

    OBJECTIVE To assess the association between diagnosed diabetes and self-reported cancer among U.S. adults. RESEARCH DESIGN AND METHODS We analyzed data for 397,783 adults who participated in the 2009 Behavioral Risk Factor Surveillance System and had valid data on diabetes and cancer. RESULTS After adjustment for potential confounders, diabetic men had higher adjusted prevalence ratios for cancers of the prostate (1.1 [95% CI 1.0–1.3]), colon (1.3 [1.0–1.7]), pancreas (4.6 [1.8–11.7]), rectum...

  10. The relatives' perspective on advanced cancer care in Denmark. A cross-sectional survey

    DEFF Research Database (Denmark)

    Johnsen, Anna T; Ross, Lone; Petersen, Morten A;

    2012-01-01

    In order to improve advanced cancer care, evaluations are necessary. An important element of such evaluations is the perspective of the patient's relatives who have the role of being caregivers as well as co-users of the health care system. The aims were to investigate the scale structure of the...... FAMCARE scale, to investigate satisfaction with advanced cancer care from the perspective of the relatives of a representative sample of advanced cancer patients, and to investigate whether some sub-groups of relatives were more dissatisfied than others....

  11. An Individualized Approach to Cancer Screening Decisions in Older Adults: A Multilevel Framework.

    Science.gov (United States)

    Breslau, Erica S; Gorin, Sherri Sheinfeld; Edwards, Heather M; Schonberg, Mara A; Saiontz, Nicole; Walter, Louise C

    2016-05-01

    Guidelines for optimal cancer screening in older adults remain unclear, particularly for adults over the age of 75. While cancer screening in older adults may benefit some in good health, it may cause unnecessary burdens in others with limited life expectancy. Thus, a systematic approach to enable individualized cancer screening decisions in older adults is needed. We suggest a framework that guides such decisions through evidence-based approaches from multiple interactions, and that involves the patient, clinician, and healthcare system. An individualized approach considers differences in disease risk rather than the chronological age of the patient. This paper presents a comprehensive framework that depicts the independent and converging levels of influences on individualized cancer screening decisions in older adults. This Individualized Decisions for Screening (IDS) framework recognizes the reality of these interrelationships, including the tensions that arise when behaviors and outcomes are valued differently at the patient, clinician, and healthcare organization levels. Person-centered approaches are essential to advancing multilevel research of individualized cancer screening decisions among older adults. PMID:26941042

  12. Childhood body mass index and the risk of prostate cancer in adult men

    DEFF Research Database (Denmark)

    Aarestrup, J; Gamborg, M; Cook, M B; Sørensen, T I A; Baker, J L

    2014-01-01

    BACKGROUND: Prostate cancer aetiology is poorly understood. It may have origins early in life; previously we found a positive association with childhood height. The effects of early life body mass index (BMI; kg m(-2)) on prostate cancer remain equivocal. We investigated if childhood BMI, indepen......BACKGROUND: Prostate cancer aetiology is poorly understood. It may have origins early in life; previously we found a positive association with childhood height. The effects of early life body mass index (BMI; kg m(-2)) on prostate cancer remain equivocal. We investigated if childhood BMI...... Danish Cancer Registry. Cox proportional hazards regressions were performed. RESULTS: Overall, 3355 men were diagnosed with prostate cancer. Body mass index during childhood was positively associated with adult prostate cancer. The hazard ratio of prostate cancer was 1.06 (95% confidence interval (CI): 1...

  13. Formal home care utilisation by older adults in Ireland: Evidence from the Irish longitudinal study on ageing

    OpenAIRE

    Murphy, Catriona; B. Whelan; Normand, C.

    2014-01-01

    The aim of this study is to provide a population based estimate of the utilisation of publicly financed formal home care by older adults in Ireland and to identify the principal characteristics of those utilising formal home care. Data were collected through computer-aided personal interviews from a representative sample of community living older adults in Ireland. The interviews were conducted between 2009 and 2011 as part of the first wave of the Irish Longitudinal Study on Ageing (TILDA). ...

  14. Retention in care, resource utilization, and costs for adults receiving antiretroviral therapy in Zambia: a retrospective cohort study

    OpenAIRE

    Scott, Callie A.; Iyer, Hari S.; McCoy, Kelly; Moyo, Crispin; Long, Lawrence; Bruce A. Larson; Rosen, Sydney

    2014-01-01

    Background Of the estimated 800,000 adults living with HIV in Zambia in 2011, roughly half were receiving antiretroviral therapy (ART). As treatment scale up continues, information on the care provided to patients after initiating ART can help guide decision-making. We estimated retention in care, the quantity of resources utilized, and costs for a retrospective cohort of adults initiating ART under routine clinical conditions in Zambia. Methods Data on resource utilization (antiretroviral [A...

  15. Early palliative care and metastatic non-small cell lung cancer: potential mechanisms of prolonged survival.

    Science.gov (United States)

    Irwin, Kelly E; Greer, Joseph A; Khatib, Jude; Temel, Jennifer S; Pirl, William F

    2013-02-01

    Patients with advanced cancer experience a significant burden of physical symptoms and psychological distress at the end of life, and many elect to receive aggressive cancer-directed therapy. The goal of palliative care is to relieve suffering and promote quality of life (QOL) for patients and families. Traditionally, both the public and medical community have conceptualized the need for patients to make a choice between pursuing curative therapy or receiving palliative care. However, practice guidelines from the World Health Organization and leadership from the oncology and palliative care communities advocate a different model of palliative care that is introduced from the point of diagnosis of life-threatening illness. Early palliative care has been shown to provide benefits in QOL, mood, and health care utilization. Additionally, preliminary research has suggested that in contrast to fears about palliative care hastening death, referral to palliative care earlier in the course of illness may have the potential to lengthen survival, particularly in patients with advanced nonsmall-cell lung cancer. This review summarizes the literature on potential survival benefits of palliative care and presents a model of how early integrated palliative care could potentially influence survival in patients with advanced cancer. PMID:23355404

  16. Role of Physical Therapists in Reducing Hospital Readmissions: Optimizing Outcomes for Older Adults During Care Transitions From Hospital to Community.

    Science.gov (United States)

    Falvey, Jason R; Burke, Robert E; Malone, Daniel; Ridgeway, Kyle J; McManus, Beth M; Stevens-Lapsley, Jennifer E

    2016-08-01

    Hospital readmissions in older adult populations are an emerging quality indicator for acute care hospitals. Recent evidence has linked functional decline during and after hospitalization with an elevated risk of hospital readmission. However, models of care that have been developed to reduce hospital readmission rates do not adequately address functional deficits. Physical therapists, as experts in optimizing physical function, have a strong opportunity to contribute meaningfully to care transition models and demonstrate the value of physical therapy interventions in reducing readmissions. Thus, the purposes of this perspective article are: (1) to describe the need for physical therapist input during care transitions for older adults and (2) to outline strategies for expanding physical therapy participation in care transitions for older adults, with an overall goal of reducing avoidable 30-day hospital readmissions. PMID:26939601

  17. Expressions of Generativity and Posttraumatic Growth in Adult Cancer Survivors

    Science.gov (United States)

    Bellizzi, Keith M.

    2004-01-01

    Much of the psycho-oncology research that has been conducted to date has focused on understanding the negative psychological and psychosocial sequelae of cancer. However, a growing body of evidence suggests that many cancer survivors report psychological growth following a diagnosis of cancer. Further, there are few studies that examine the…

  18. Mothers’ Experiences of Participating in the Medical Care of their Child with Cancer

    DEFF Research Database (Denmark)

    Korning Lund, Line; Bregnballe, Vibeke

    . Findings/results: Six themes were found: "Distraction, control and security", "Difficulty dealing with the child's psychological reaction", "Fluctuating surplus of mental resources calls for match of expectation", "Preparing systems for the medical care on their own", "Complying with the medical care......Background: Only a few research studies have addressed parents’ experiences of participating in the medical care and treatment of their child diagnosed with cancer. Objective: To explore how mothers of children diagnosed with cancer experienced participating in the medical care of their child both...

  19. Oncology nurses′ recognition of long-term cancer survivorship care in Japan

    Directory of Open Access Journals (Sweden)

    Asako Miura

    2015-01-01

    Full Text Available Objective: This study aims to assess the knowledge of definition of cancer survivors among Japanese oncology nurses and their roles in long-term cancer survivorship care. Methods: A structured self-administered and self-report questionnaire created by the study investigators was given to members of the Japanese Society of Cancer Nursing. The subjects were 81 female oncology nurses. Results: Forty-nine nurses had 11 or more years of nursing experience, while 27 nurses had cancer-related nursing certifications such as, certification in oncology nursing specialist. This study population had rather rich experience in oncology nursing. Sixty-two nurses defined a cancer survivor from the time of diagnosis, while the nurses′ recognition of long-term survivorship care was poor, compared with nursing care at the time of diagnosis, during treatment, and end of life. Conclusions: The nurses were aware of the needs to recognize and address issues faced by long-term cancer survivors and for nursing study, but very few put the effective patient education and interventions into practice. It is because oncology nurses have few chances to see cancer survivors who go out of the hands of healthcare professionals. In increasing the number of long-term survivors, long-term survivorship care is needed in addition to incorporating such education into undergraduate and graduate programs. Further study on the knowledge of long-term cancer survivorship care and nursing practices are required.

  20. Caring for caregivers and patients: Research and clinical priorities for informal cancer caregiving.

    Science.gov (United States)

    Kent, Erin E; Rowland, Julia H; Northouse, Laurel; Litzelman, Kristin; Chou, Wen-Ying Sylvia; Shelburne, Nonniekaye; Timura, Catherine; O'Mara, Ann; Huss, Karen

    2016-07-01

    Informal/family caregivers are a fundamental source of care for cancer patients in the United States, yet the population of caregivers and their tasks, psychosocial needs, and health outcomes are not well understood. Changes in the nature of cancer care and its delivery, along with the growing population of survivors and their caregivers, warrant increased attention to the roles and demands of caregiving. This article reviews current evidence presented at a 2-day meeting examining the state of the science of informal cancer caregiving that was convened by the National Cancer Institute and the National Institute of Nursing Research. The meeting sought to define who is an informal cancer caregiver, summarize the state of the science in informal cancer caregiving, and describe both the kinds of interventions developed to address caregiving challenges and the various outcomes used to evaluate their impact. This article offers recommendations for moving science forward in 4 areas: 1) improving the estimation of the prevalence and burden of informal cancer caregiving; 2) advancing the development of interventions designed to improve outcomes for cancer patients, caregivers, and patient-caregiver dyads; 3) generating and testing strategies for integrating caregivers into formal health care settings; and 4) promoting the use of technology to support informal cancer caregivers. Cancer 2016;122:1987-95. © 2016 American Cancer Society. PMID:26991807

  1. Cancer of Unknown Primary in Adolescents and Young Adults: Clinicopathological Features, Prognostic Factors and Survival Outcomes.

    Directory of Open Access Journals (Sweden)

    Kanwal Raghav

    Full Text Available Cancer in adolescents and young adults (AYAs (15-39 years is increasingly recognized as a distinct clinical and biological entity. Cancer of unknown primary (CUP, a disease traditionally presenting in older adults with a median age of 65 years, poses several challenges when diagnosed in AYA patients. This study describes clinicopathological features, outcomes and challenges in caring for AYA-CUP patients.A retrospective review of 47 AYAs diagnosed with CUP at MD Anderson Cancer Center (6/2006-6/2013 was performed. Patients with favorable CUP subsets treated as per site-specific recommendations were excluded. Demographics, imaging, pathology and treatment data was collected using a prospectively maintained CUP database. Kaplan-Meier product limit method and log-rank test were used to estimate and compare overall survival. The cox-proportional model was used for multivariate analyses.Median age was 35 years (range 19-39. All patients underwent comprehensive workup. Adenocarcinoma was the predominant histology (70%. A median of 9 immunostains (range 2-29 were performed. The most common putative primary was biliary tract based on clinicopathological parameters as well as gene profiling. Patients presented with a median of 2 metastatic sites [lymph node (60%, lung (47%, liver (38% and bone (34%]. Most commonly used systemic chemotherapies included gemcitabine, fluorouracil, taxanes and platinum agents. Median overall survival for the entire cohort was 10.0 (95% confidence interval (CI: 6.7-15.4 months. On multivariate analyses, elevated lactate dehydrogenase (Hazard ratio (HR 3.66; 95%CI 1.52-8.82; P = 0.004, ≥3 metastatic sites (HR 5.34; 95%CI 1.19-23.9; P = 0.029, and tissue of origin not tested (HR 3.4; 95%CI 1.44-8.06; P = 0.005 were associated with poor overall survival. Culine's CUP prognostic model (lactate dehydrogenase, performance status, liver metastases was validated in this cohort (median overall survival: good-risk 25.2 months vs

  2. Training unemployed women for adult day care in Izmir, Turkey: a program evaluation.

    Science.gov (United States)

    Hussein, Shereen; Oğlak, Sema

    2014-01-01

    The proportion of older people in Turkey is increasing steadily with a subsequent growth of long-term care (LTC) needs. There is a scarcity of formal care provisions for residential and particularly nonresidential settings. Thus, formal caregiving is not meeting LTC needs nor attracting workers as a labor option. The authors examine the hypothesis that LTC may offer work opportunities for women unfamiliar with caregiving as an occupation, and also examine the need and acceptance of different types of LTC beyond residential care. The authors evaluate an innovative project introducing these two elements to 76 women in İzmir, Turkey, using an analysis framework that incorporates factors related to applications and progression; management assessment; trainees' self-assessment reflecting on their views on aging; and older people's perception of the experience and its impact on their well-being. Trainees reported a major positive shift in their attitudes toward working in LTC and toward the aging process. Users reported discovering a new dimension to care, which directly affected their quality of life. Overall, this community-based initiative appeared effective in enhancing the awareness of the concept of adult day centers providing a social model of care, and appears promising in addressing the growing need for formal LTC in Turkey. PMID:23701487

  3. Head and neck cancer in geriatric patients: Analysis of the pattern of care given at a tertiary cancer care center

    Directory of Open Access Journals (Sweden)

    S Thiagarajan

    2015-01-01

    Full Text Available Background And Aim: The percentage of elderly people with head and neck cancers (HNC is on the rise. This makes HNC in this group of patients an important issue for healthcare providers. The present study was planned to analyze the patterns of care given to the geriatric patients and to identify the factors influencing the decision making process. Materials And Methods: Data of all the elderly patients (≥65 years registered in the year 2012, with histologically proven HNC (all sites, stages, histopathological types, except lymphoma, sarcoma and cervical metastasis of unknown origin receiving treatment (definitive/palliative were collected. Results: A total of 270 patients were included in this study. The median age was 72 years (range: 65–101, with predominant male population (70%, n = 190. Oral cavity squamous cell carcinoma (SCC was the most common cancer (57%, n = 154. Eastern Co-Operative Oncology Group performance status (PS of 0–2 was seen in 91% of the patients. Co-morbidities were present in 139 (51.5% patients. 50% (n = 134 of the patients received palliative intent treatment, 45% (n = 123 definitive treatment, whereas in 5% (n = 13 the intent was not mentioned. Age, a clinical stage and PS significantly influenced the decision making on the intent of treatment. 208 (77% patients completed their treatment irrespective of the intent. Age was the only factor influencing treatment completion irrespective of the intent. Conclusion: Geriatric HNC patients frequently present with advanced disease, having multiple co-morbidities. Hence, a multidisciplinary team management of these patients is essential, also taking into account of the social and financial support available to these patients.

  4. Colon cancer care and survival: income and insurance are more predictive in the USA, community primary care physician supply more so in Canada

    OpenAIRE

    GOREY, KEVIN M.; Kanjeekal, Sindu M; Wright, Frances C; Hamm, Caroline; Luginaah, Isaac N.; Bartfay, Emma; Zou, Guangyong; Holowaty, Eric J.; Richter, Nancy L.

    2015-01-01

    Background Our research group advanced a health insurance theory to explain Canada’s cancer care advantages over America. The late Barbara Starfield theorized that Canada’s greater primary care-orientation also plays a critically protective role. We tested the resultant Starfield-Gorey theory by examining the effects of poverty, health insurance and physician supplies, primary care and specialists, on colon cancer care in Ontario and California. Methods We analyzed registry data for people wi...

  5. Blueprint for Implementing New Processes in Acute Care: Rescuing Adult Patients With Intraosseous Access.

    Science.gov (United States)

    Chreiman, Kristen M; Kim, Patrick K; Garbovsky, Lyudmila A; Schweickert, William D

    2015-01-01

    The intraosseous (IO) access initiative at an urban university adult level 1 trauma center began from the need for a more expeditious vascular access route to rescue patients in extremis. The goal of this project was a multidisciplinary approach to problem solving to increase access of IO catheters to rescue patients in all care areas. The initiative became a collaborative effort between nursing, physicians, and pharmacy to embark on an acute care endeavor to standardize IO access. This is a descriptive analysis of processes to effectively develop collaborative strategies to navigate hospital systems and successfully implement multilayered initiatives. Administration should empower nurse to advance their practice to include IO for patient rescue. Intraosseous access may expedite resuscitative efforts in patients in extremis who lack venous access or where additional venous access is required for life-saving therapies. Limiting IO dwell time may facilitate timely definitive venous access. Continued education and training by offering IO skill laboratory refreshers and annual e-learning didactic is optimal for maintaining proficiency and knowledge. More research opportunities exist to determine medication safety and efficacy in adult patients in the acute care setting. PMID:26352658

  6. A Health Services Research Agenda for Cellular, Molecular and Genomic Technologies in Cancer Care

    Science.gov (United States)

    Wideroff, Louise; Phillips, Kathryn A.; Randhawa, Gurvaneet; Ambs, Anita; Armstrong, Katrina; Bennett, Charles L.; Brown, Martin L.; Donaldson, Molla S.; Follen, Michele; Goldie, Sue J.; Hiatt, Robert A.; Khoury, Muin J.; Lewis, Graham; McLeod, Howard L.; Piper, Margaret; Powell, Isaac; Schrag, Deborah; Schulman, Kevin A.; Scott, Joan

    2009-01-01

    Background In recent decades, extensive resources have been invested to develop cellular, molecular and genomic technologies with clinical applications that span the continuum of cancer care. Methods In December 2006, the National Cancer Institute sponsored the first workshop to uniquely examine the state of health services research on cancer-related cellular, molecular and genomic technologies and identify challenges and priorities for expanding the evidence base on their effectiveness in routine care. Results This article summarizes the workshop outcomes, which included development of a comprehensive research agenda that incorporates health and safety endpoints, utilization patterns, patient and provider preferences, quality of care and access, disparities, economics and decision modeling, trends in cancer outcomes, and health-related quality of life among target populations. Conclusions Ultimately, the successful adoption of useful technologies will depend on understanding and influencing the patient, provider, health care system and societal factors that contribute to their uptake and effectiveness in ‘real-world’ settings. PMID:19367091

  7. Validity, reliability and responsiveness to change of the Italian palliative care outcome scale:A multicenter study of advanced cancer patients Cancer palliative care

    OpenAIRE

    COSTANTINI, MASSIMO; Rabitti, Elisa; Beccaro, Monica; Fusco, Flavio; Peruselli, Carlo; La Ciura, Pietro; Valle, Alessandro; Suriani, Cinzia; Berardi, Maria Alejandra; Valenti, Danila; Mosso, Felicita; Morino, Piero; Zaninetta, Giovanni; Tubere, Giorgio; Piazza, Massimo

    2016-01-01

    Background There is an increasing requirement to assess outcomes, but few measures have been tested for advanced medical illness. We aimed to test the validity, reliability and responsiveness of the Palliative care Outcome Scale (POS), and to analyse predictors of change after the transition to palliative care. Methods Phase 1: multicentre, mixed method study comprising cognitive and qualitative interviews with patients and staff, cultural refinement and adaption. Phase 2: consecutive cancer ...

  8. Multidisciplinary Approach to Breast Cancer: A New Outlook on Nursing Care

    Institute of Scientific and Technical Information of China (English)

    Ilana Kadmon; Frida Barak

    2009-01-01

    The treatment and general care for women diagnosed with breast cancer has made a tremendous change and advance in the last decades. Better methods for early detection and screening of the disease, higher compliance of women to go for screening, an open social and political discourse of women and the health care team and others, are just a few that both enabled and are a result of this change. Nurses have been highly involved in these changes, which resulted in the specialization of nursing in the field of breast cancer. This article will focus on the main four points that influence the nursing specialist care, that is, the tailoring of treatment and the ability to offer women treatment which is more specific to their own cancer; the importance of the multidisciplinary team as providing a State of the Art care; the involvement of women in the decision-making regarding their treatment and the specific developing role of the specialist breast care nurse.

  9. Living in the face of death: Studies on palliative care in upper GI cancer patients

    OpenAIRE

    Uitdehaag, Madeleen

    2012-01-01

    textabstractThis thesis explores palliative care provided to patients with advanced upper gastrointestinal (GI) cancer. The 5-year survival rates for these cancer sites range between 4 and 17%, which implies that many of these patients require palliative care. Considering the fact that there is no uniform management policy aiming at improvement of quality of life (QoL) of these patients and their families, we decided to study different interventions with effect on this primary aim. The introd...

  10. Stepped Skills: A team approach towards communication about sexuality and intimacy in cancer and palliative care

    OpenAIRE

    Hilde de Vocht; Amanda Hordern; Joy Notter; Harry van de Wiel

    2011-01-01

    BackgroundCancer often has a profound and enduring impact on sexuality, affecting both patients and their partners. Most healthcare professionals in cancer and palliative care are struggling to address intimate issues with the patients in their care.MethodsStudy 1: An Australian study using semi-structured interviews and documentary data analysis.Study 2: Building on this Australian study, using a hermeneutic phenomenological approach, data were collected in the Netherlands through interviewi...

  11. Care-seeking behavior of Japanese gynecological cancer survivors suffering from adverse effects

    OpenAIRE

    Oshima Sumiko; Kisa Kengo; Terashita Takayoshi; Kawabata Hidenobu; Maezawa Masaji

    2013-01-01

    Abstract Background Post-treatment follow-up visits for gynecological cancer survivors should provide opportunities for management of adverse physical/psychological effects of therapy and early recurrence detection. However, the adequacy of such visits in Japan is poorly documented. We qualitatively explored care-seeking experiences of Japanese gynecological cancer survivors and deduced factors influencing care-seeking behaviors and treatment access. Methods We conducted 4 semi-structured foc...

  12. Differences in Breast Cancer Survival between Public and Private Care in New Zealand: Which Factors Contribute?

    OpenAIRE

    Tin Tin, Sandar; Elwood, J. Mark; Lawrenson, Ross; Campbell, Ian; Harvey, Vernon; Seneviratne, Sanjeewa

    2016-01-01

    Background Patients who received private health care appear to have better survival from breast cancer compared to those who received public care. This study investigated if this applied to New Zealand women and identified factors that could explain such disparities. Methods This study involved all women who were diagnosed with primary breast cancer in two health regions in New Zealand, covering about 40% of the national population, between June 2000 and May 2013. Patients who received public...

  13. Existing data sources for clinical epidemiology: Danish Cancer in Primary Care cohort

    OpenAIRE

    Jensen H.; Tørring ML; Larsen MB; Vedsted P

    2014-01-01

    Henry Jensen,1,2 Marie Louise Tørring,1 Mette Bach Larsen,3 Peter Vedsted11Research Unit for General Practice, Research Centre for Cancer Diagnosis in Primary Care, 2Section for General Medical Practice, Department of Public Health, Aarhus University, Aarhus C, 3Department of Public Health Programs, Randers Regional Hospital, Randers NOE, Denmark Background: In this paper, we describe the settings, content, and possibilities of the Danish Cancer in Primary Care (CaP) cohort as wel...

  14. Diabetes Management and Self-Care Education for Hospitalized Patients With Cancer

    OpenAIRE

    Leak, Ashley; Davis, Ellen D.; Houchin, Laura B.; Mabrey, Melanie

    2009-01-01

    Managing diabetes can be a daunting task for patients with cancer. Empowerment-based diabetes education and motivational interviewing are complementary approaches. Oncology nurses may feel unprepared to teach patients and their families about self-care for diabetes, but they provide individualized information on symptom management of cancer throughout hospitalization and at discharge. The essential self-care issues include food, exercise, medication, blood glucose monitoring, prevention, reco...

  15. Nutritional support among cancer patients enrolled in palliative home care services

    OpenAIRE

    Orrevall, Ylva

    2008-01-01

    Nutritional problems are common in palliative cancer care. Little is known about nutritional problems and nutritional support in home care. AIMS: The primary aim of this thesis was to investigate experiences of nutritional problems and home nutritional support, with a special focus on home parenteral nutrition (HPN), from the perspectives of cancer patients and their family members. Further aims were to investigate the prevalence of nutritional risk and use of nutritional su...

  16. Acupuncture and Related Therapies for Symptom Management in Palliative Cancer Care

    OpenAIRE

    Lau, Charlotte H. Y.; Wu, Xinyin; Vincent C. H. Chung; Liu, Xin; Hui, Edwin P.; Cramer, Holger; Lauche, Romy; Wong, Samuel Y. S.; Lau, Alexander Y.L.; Sit, Regina S. T.; Eric T. C. Ziea; Ng, Bacon F. L.; Wu, Justin C. Y.

    2016-01-01

    Abstract Available systematic reviews showed uncertainty on the effectiveness of using acupuncture and related therapies for palliative cancer care. The aim of this systematic review and meta-analysis was to summarize current best evidence on acupuncture and related therapies for palliative cancer care. Five international and 3 Chinese databases were searched. Randomized controlled trials (RCTs) comparing acupuncture and related therapies with conventional or sham treatments were considered. ...

  17. EXPERIENCE OF CARE TO PEOPLE WITH CANCER, A STUDENT'S PERSPECTIVE OF TRAINING IN NURSING

    OpenAIRE

    Fonseca, Ana; Lopes, M. J.

    2011-01-01

    Objective: to analyze the experience of nursing students in caring for the person with cancer. Methodology: this is about a descriptive, exploratory study from qualitative approach, analyzing the speech produced by subjects from the question: What is the experience of nursing students in caring for people with cancer? Data collection was done through narratives compiled by students with prior signing of terms of free and informed consent, conducted in September 2007. Twelve students were part...

  18. Exploring the social care needs of cancer patients and their carers in a rural setting

    OpenAIRE

    Nelson, David; Kane, Ros; Davies, Helen; Mansfield, Paul

    2016-01-01

    People affected by cancer (PABC) have social care needs as well as health needs and existing research has highlighted that these needs go unmet. Despite this, we lack an in-depth understanding regarding of specific needs in a rural setting. The aim of this paper is to explore the social care needs of a sample of cancer patients and carers in the rural English county of Lincolnshire.

  19. Clowning in Health Care Settings: The Point of View of Adults

    Science.gov (United States)

    Dionigi, Alberto; Canestrari, Carla

    2016-01-01

    Within the past decade, there has been a surge of interest in investigating the effects of clown intervention in a large variety of clinical settings. Many studies have focused on the effects of clown intervention on children. However, few studies have investigated clowning effects on adults. This paper presents an overview of the concept of medical clowning followed by a literature review conducted on the empirical studies drawn from three data bases (PubMed, PsycINFO, and Google Scholar), with the aim of mapping and discussing the evidence of clowning effects on non-children, namely adults. The following areas were investigated: Adult and elderly patients (mainly those with dementia), observers of clowning, namely non-hospitalized adults who are at the hospital as relatives of patients or health-care staff, and finally clowns themselves. The main results are that 1) clown intervention induces positive emotions, thereby enhancing the patient’s well-being, reduces psychological symptoms and emotional reactivity, and prompts a decrease in negative emotions, such as anxiety and stress; 2) clown doctors are also well-perceived by relatives and healthcare staff and their presence appears to be useful in creating a lighter atmosphere in the health setting; 3) few pilot studies have been conducted on clown doctors and this lacuna represents a subject for future research. PMID:27547261

  20. Clowning in Health Care Settings: The Point of View of Adults.

    Science.gov (United States)

    Dionigi, Alberto; Canestrari, Carla

    2016-08-01

    Within the past decade, there has been a surge of interest in investigating the effects of clown intervention in a large variety of clinical settings. Many studies have focused on the effects of clown intervention on children. However, few studies have investigated clowning effects on adults. This paper presents an overview of the concept of medical clowning followed by a literature review conducted on the empirical studies drawn from three data bases (PubMed, PsycINFO, and Google Scholar), with the aim of mapping and discussing the evidence of clowning effects on non-children, namely adults. The following areas were investigated: Adult and elderly patients (mainly those with dementia), observers of clowning, namely non-hospitalized adults who are at the hospital as relatives of patients or health-care staff, and finally clowns themselves. The main results are that 1) clown intervention induces positive emotions, thereby enhancing the patient's well-being, reduces psychological symptoms and emotional reactivity, and prompts a decrease in negative emotions, such as anxiety and stress; 2) clown doctors are also well-perceived by relatives and healthcare staff and their presence appears to be useful in creating a lighter atmosphere in the health setting; 3) few pilot studies have been conducted on clown doctors and this lacuna represents a subject for future research. PMID:27547261