scholarly journals Balancing patients’ fears of recurrence and fears of COVID-19 when considering their preference for review consultations

2021 ◽  
Author(s):  
Joanna Dimelow ◽  
Derek Lowe ◽  
Simon N. Rogers
Keyword(s):  
Virus Transmission ◽  
Cancer Recurrence ◽  
Postal Survey ◽  
Cancer Surveillance ◽  
Similar Response ◽  
Face To Face ◽  
Patient Groups ◽  
Initial Action ◽  
Fear Of Cancer

Abstract Purpose Head and neck cancer (HNC) patients may experience fears regarding cancer recurrence (FoR) and of catching COVID-19. There could be unease for attending hospital clinics for face to face (F2F) examination. F2F benefit in cancer surveillance has to be balanced against the risk of virus transmission. This study aimed to report perceptions of fear of cancer and fear of COVID-19 and to report patient preference for follow-up consultation in HNC survivors during the COVID-19 pandemic. Methods The study ran from lockdown in England on 24th March to 29th July 2020. Patients were offered preference to postpone their consultation, to have it by telephone, or F2F. A postal survey was undertaken in the 2 weeks post-consultation (actual or postponed). Results There were 103 patients. Initial action by consultant and patient resulted in 51 postponed consultations, 35 telephone consultations and 17 F2F meetings, with 10 F2F triggered by the patient. There were 58 responders to the survey and most (39) had a clear preference for one mode of follow-up consultation during the COVID-19 pandemic, with half (19) preferring F2F. A similar response was seen regarding their consultations in general to address unmet needs and concerns, with 38 having a preferred mode, 29 preferring F2F. Serious fears about recurrence and COVID-19 were at relatively low levels with a tendency to be more concerned about recurrence. Conclusion Any redesign of mode and frequency of out-patient follow-up in light of COVID-19 should be undertaken in discussion with patient groups and with individual patients.

Realtime teleconsultations versus face-to-face consultations in dermatology: immediate and six-month outcome

2003 ◽  
Vol 9 (4) ◽  
pp. 204-209 ◽  
Author(s):  
Håkan Granlund ◽  
Carl-Johan Thoden ◽  
Christer Carlson ◽  
Kari Harno
Keyword(s):  
Patient Satisfaction ◽  
General Practitioner ◽  
Analogue Scale ◽  
Controlled Study ◽  
Face To Face ◽  
Consultation Group ◽  
The Face ◽  
Patient Groups

We evaluated the outcome of both realtime teleconsultations and face-to-face consultations in dermatology. Forty-six patients were enrolled in an open controlled study. Twenty-nine patients (60%) answered the questionnaire sent to them after six months. Over the six-month follow-up, similar proportions of the two patient groups had visited a general practitioner or a specialist in the consulting hospital. At follow-up, overall patient satisfaction with the consultation, measured on a linear analogue scale (0–10), had fallen only slightly and to the same extent after both types of consultation, that is by 1.2 (SD 3.7) after realtime teleconsultations and by 1.4 (SD 4.5) after face-to-face consultations. The proportions of patients who would prefer the same mode of consultation for their next appointment had decreased from 83% to 50% in the realtime teleconsultation group and from 83% to 62% in the face-to-face consultation group. However, in neither group was the change significant. The study suggests that patient satisfaction with teleconsultation is well preserved after six months.

STS, ESTS and JACS survey on surveillance practices after surgical resection of lung cancer

2019 ◽  
Vol 29 (4) ◽  
pp. 532-538
Author(s):  
Cecilia Pompili ◽  
Melanie Edwards ◽  
Prasha Bhandari ◽  
Nuria Novoa ◽  
Seiki Hasegawa ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Response Rate ◽  
Statistical Tests ◽  
Cancer Recurrence ◽  
Cancer Surveillance ◽  
Routine Testing ◽  
The One ◽  
Strongly Agree ◽  
Contemporary Practice

Abstract OBJECTIVES A 1995 survey of Society of Thoracic Surgeons (STS) members revealed wide variation in postresection lung cancer surveillance practices and pessimism regarding any survival benefit. We sought to compare contemporary practice patterns and attitudes among members of STS, European Society of Thoracic Surgeons (ESTS) and the Japanese Association for Chest Surgery (JACS). METHODS A survey identical to the one conducted in 1995 was administered via mail or electronically. χ2 tests for associations were used to compare profiles of respondents and attitudes towards testing between groups. All the statistical tests were two-sided and P-values of 0.05 or less were considered statistically significant. RESULTS A total of 2978 STS members (response rate 7.8%, n = 234), 1450 ESTS members (response rate 8.4%, n = 122) and 272 JACS (response rate 40.8%, n = 111) members were surveyed. Rate of guideline-recommended surveillance computed tomography was reported highest among ESTS respondents for stage I patients (22% ESTS, 3% STS and 6% JACS members, P < 0.001). However, both JACS and ESTS respondents reported higher rates of use of non-guidelines-recommended tests compared to STS respondents, which persisted on adjusted analyses. Regarding attitudes towards surveillance, more JACS and ESTS members either ‘agree’ or ‘strongly agree’ that routine testing for non-small-cell lung cancer recurrence results in potentially curative treatment (ESTS: 86%, STS: 70%, JACS: 90%, P < 0.001). Similarly, JACS and ESTS respondents believe that the current literature documents definitive survival benefits from routine follow-up testing (ESTS: 57%, STS: 30%, JACS: 62%, P < 0.001). CONCLUSIONS The Japanese attitude towards surveillance is similar to that of ESTS members potentially highlighting significant differences between European and Asian surgeons compared to STS members. These differences clearly highlight the need for better prospective studies and joint recommendations to globally standardize practice.

scholarly journals P066 Telephone clinics: what are our patients saying?

Rheumatology ◽  
2021 ◽  
Vol 60 (Supplement_1) ◽  
Author(s):  
Muhammad Azhar Abdullah ◽  
Nicholas Heng ◽  
Sajjad Noor ◽  
Urooj Ahmed ◽  
Clare Lavery ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Action Plan ◽  
Phone Call ◽  
Telephone Consultation ◽  
Face To Face ◽  
Video Consultation ◽  
Patient Groups ◽  
To Receive ◽  
Good Patient Satisfaction

Abstract Background/Aims  Telemedicine has not previously been a regular part of routine rheumatology services.Our department adopted telephone clinics during the COVID-19 pandemic. We assessed patient satisfaction by conducting a feedback survey. Our aim was to obtain a patient perspective on remote consultations and on preferred future follow up options including video or face-to-face consultations. Methods  The cohort included 160 rheumatology patients who had a telephone consultation between May and mid-June 2020. All patients consented to receive a further phone call by a different member of the team. Patients had to answer a questionnaire about recent consultation and to rate this on a scale of 1-5. Other questions included whether all their queries were answered; clear action plan made; perceived benefits or disadvantages of telephone consultation; and views about future follow up and any additional comments. Results  71.9% of 160 patients were females while 28.1 % males. Mean age 58.6 yrs. More than half of the patients (60.6%) had a diagnosis of inflammatory arthritis, followed by connective tissue disease (19.3%), other diagnosis (8.1% ) & vasculitis (5.6%). 94.4 % of the patients in this study were return appointments-the remainder new. Feedback results revealed 92.5% patients were satisfied with their consultation with mean score of 4.3/5 (5=best,1= worst). More than 80% agreed that all their queries were answered and a clear action plan was formed during consultation. However ,71.2% would want a face to face consultation if given choice while 54 % happy to have further follow up over the phone. 65% of patients preferred not to have video consultation. Subgroup analysis showed that majority of patients who would accept video consultation were aged between 30-39. Most common benefits described were noted to be convenience; reduced time of work; travel time and safety during pandemic, whilst difficulty in describing symptoms; hearing problems; and severity of disease were disadvantages raised, but numbers were small in our cohort. Conclusion  Telephone clinics were the mainstay during the COVID-19 pandemic.The large majority of the rheumatology patients in our cohort were highly satisfied with this form of consultation. However, interestingly the majority (71% ) would still prefer face-to-face consultation as follow up in the future. Regular follow up in carefully selected patient groups can successfully be performed by telephone clinics with good patient satisfaction. This would help increase capacity within the clinic setting. Disclosure  M. Abdullah: None. N. Heng: None. S. Noor: None. U. Ahmed: None. C. Lavery: None. S. Bawa: None.

scholarly journals ENT Telephone Clinics During the Coronavirus Pandemic: An Analysis of 400 Telephone Consultations at a District General Hospital

2021 ◽  
pp. 014556132110280
Author(s):  
Narek Sargsyan ◽  
Dilhara Karunaratne ◽  
Alisha Masani ◽  
Lauren Howell ◽  
Madi Yousif
Keyword(s):  
Health Care ◽  
Patient Flow ◽  
District General Hospital ◽  
Face To Face ◽  
Throat Symptom ◽  
Specialist Health Care ◽  
Patient Groups ◽  
Improve Patient ◽  
Nose And Throat

Background: The COVID-19 pandemic led to the introduction of telephone consultations in order to provide specialist health care remotely. This study analyses the outcomes of ear, nose, and throat (ENT) telephone consultations. Methods: Retrospective analysis was undertaken of 400 ENT telephone consultations. Results: All 2-week-wait neck or face lump patients underwent imaging and 78% were successfully discharged. 80% of vertigo patients and 100% of 2-week-wait throat symptom patients were offered face-to-face consultations. All primary hyperparathyroidism patients were managed remotely, being discharged, or with telephone follow-up. The majority of routine referrals were managed without the need for face-to-face consultation. Conclusion: Vertigo patients and 2-week-wait throat symptom patients should be offered a face-to-face consultation in the first instance. For patients with neck or face lumps, initial referral for imaging may improve patient flow and facilitate safe discharge. It is appropriate to continue with telephone consultations for all other patient groups.

scholarly journals Remote Psychological Interventions for Fear of Cancer Recurrence: Scoping Review (Preprint)

2021 ◽  
Author(s):  
Clizia Cincidda ◽  
Silvia Francesca Maria Pizzoli ◽  
Gabriella Pravettoni
Keyword(s):  
Cancer Recurrence ◽  
Fear Of Cancer Recurrence ◽  
Current Evidence ◽  
Psychological Interventions ◽  
Face To Face ◽  
Patients With Cancer ◽  
Acceptance And Commitment ◽  
Evidence Based Treatments ◽  
Behavioral Therapies ◽  
Fear Of Cancer

BACKGROUND Patients with cancer and survivors may experience the fear of cancer recurrence (FCR), a preoccupation with the progression or recurrence of cancer. During the spread of COVID-19 in 2019, patients and survivors experienced increased levels of FCR. Hence, there is a greater need to identify effective evidence-based treatments to help people cope with FCR. Remotely delivered interventions might provide a valuable means to address FCR in patients with cancer. OBJECTIVE The aim of this study is to first discuss the available psychological interventions for FCR based on traditional cognitive behavioral therapies (CBTs) or contemporary CBTs, in particular, mindfulness and acceptance and commitment therapy, and then propose a possible approach based on the retrieved literature. METHODS We searched key electronic databases to identify studies that evaluated the effect of psychological interventions such as CBT on FCR among patients with cancer and survivors. RESULTS Current evidence suggests that face-to-face psychological interventions for FCR are feasible, acceptable, and efficacious for managing FCR. However, there are no specific data on the interventions that are most effective when delivered remotely. CONCLUSIONS CBT interventions can be efficacious in managing FCR, especially at posttreatment, regardless of whether it is delivered face to face, on the web, or using a blended approach. To date, no study has simultaneously compared the effectiveness of face-to-face, web-based, and blended interventions. On the basis of the retrieved evidence, we propose the hypothetical program of an intervention for FCR based on both traditional CBT and contemporary CBT, named Change Of Recurrence, which aims to improve the management of FCR in patients with cancer and survivors.

scholarly journals Effect of Psychological Intervention on Fear of Cancer Recurrence: A Systematic Review and Meta-Analysis

2019 ◽  
Vol 37 (31) ◽  
pp. 2899-2915 ◽  
Author(s):  
Nina M. Tauber ◽  
Mia S. O’Toole ◽  
Andreas Dinkel ◽  
Jacqueline Galica ◽  
Gerry Humphris ◽  
...  
Keyword(s):  
Systematic Review ◽  
Psychological Intervention ◽  
Meta Analysis ◽  
Cancer Recurrence ◽  
Fear Of Cancer Recurrence ◽  
Psychological Interventions ◽  
Controlled Trials ◽  
Number Of Patients ◽  
Fear Of Cancer

PURPOSE Fear of cancer recurrence (FCR) is a significantly distressing problem that affects a substantial number of patients with and survivors of cancer; however, the overall efficacy of available psychological interventions on FCR remains unknown. We therefore evaluated this in the present systematic review and meta-analysis. METHODS We searched key electronic databases to identify trials that evaluated the effect of psychological interventions on FCR among patients with and survivors of cancer. Controlled trials were subjected to meta-analysis, and the moderating influence of study characteristics on the effect were examined. Overall quality of evidence was evaluated using the GRADE system. Open trials were narratively reviewed to explore ongoing developments in the field (PROSPERO registration no.: CRD42017076514). RESULTS A total of 23 controlled trials (21 randomized controlled trials) and nine open trials were included. Small effects (Hedges’s g) were found both at postintervention ( g = 0.33; 95% CI, 0.20 to 0.46; P < .001) and at follow-up ( g = 0.28; 95% CI, 0.17 to 0.40; P < .001). Effects at postintervention of contemporary cognitive behavioral therapies (CBTs; g = 0.42) were larger than those of traditional CBTs ( g = 0.24; β = .22; 95% CI, .04 to .41; P = .018). At follow-up, larger effects were associated with shorter time to follow-up (β = −.01; 95% CI, −.01 to −.00; P = .027) and group-based formats (β = .18; 95% CI, .01 to .36; P = .041). A GRADE evaluation indicated evidence of moderate strength for effects of psychological intervention for FCR. CONCLUSION Psychological interventions for FCR revealed a small but robust effect at postintervention, which was largely maintained at follow-up. Larger postintervention effects were found for contemporary CBTs that were focused on processes of cognition—for example, worry, rumination, and attentional bias—rather than the content, and aimed to change the way in which the individual relates to his or her inner experiences. Future trials could investigate how to further optimize and tailor interventions to individual patients’ FCR presentation.

Randomized Trial of ConquerFear: A Novel, Theoretically Based Psychosocial Intervention for Fear of Cancer Recurrence

2017 ◽  
Vol 35 (36) ◽  
pp. 4066-4077 ◽  
Author(s):  
Phyllis N. Butow ◽  
Jane Turner ◽  
Jemma Gilchrist ◽  
Louise Sharpe ◽  
Allan Ben Smith ◽  
...  
Keyword(s):  
Psychological Distress ◽  
Randomized Trial ◽  
Cancer Recurrence ◽  
Attention Control ◽  
Fear Of Cancer Recurrence ◽  
General Anxiety ◽  
Face To Face ◽  
Fear Of Cancer ◽  
The Impact ◽  
Post Therapy

Purpose Fear of cancer recurrence (FCR) is prevalent, distressing, and long lasting. This study evaluated the impact of a theoretically/empirically based intervention (ConquerFear) on FCR. Methods Eligible survivors had curable breast or colorectal cancer or melanoma, had completed treatment (not including endocrine therapy) 2 months to 5 years previously, were age > 18 years, and had scores above the clinical cutoff on the FCR Inventory (FCRI) severity subscale at screening. Participants were randomly assigned at a one-to-one ratio to either five face-to-face sessions of ConquerFear (attention training, metacognitions, acceptance/mindfulness, screening behavior, and values-based goal setting) or an attention control (Taking-it-Easy relaxation therapy). Participants completed questionnaires at baseline (T0), immediately post-therapy (T1), and 3 (T2) and 6 months (T3) later. The primary outcome was FCRI total score. Results Of 704 potentially eligible survivors from 17 sites and two online databases, 533 were contactable, of whom 222 (42%) consented; 121 were randomly assigned to intervention and 101 to control. Study arms were equivalent at baseline on all measured characteristics. ConquerFear participants had clinically and statistically greater improvements than control participants from T0 to T1 on FCRI total ( P < .001) and severity subscale scores ( P = .001), which were maintained at T2 ( P = .017 and P = .023, respectively) and, for FCRI total only, at T3 ( P = .018), and from T0 to T1 on three FCRI subscales (coping, psychological distress, and triggers) as well as in general anxiety, cancer-specific distress (total), and mental quality of life and metacognitions (total). Differences in FCRI psychological distress and cancer-specific distress (total) remained significantly different at T3. Conclusion This randomized trial demonstrated efficacy of ConquerFear compared with attention control (Taking-it-Easy) in reduction of FCRI total scores immediately post-therapy and 3 and 6 months later and in many secondary outcomes immediately post-therapy. Cancer-specific distress (total) remained more improved at 3- and 6-month follow-up.

scholarly journals Remote Psychological Interventions for Fear of Cancer Recurrence: Scoping Review

JMIR Cancer ◽  
10.2196/29745 ◽  
2022 ◽  
Vol 8 (1) ◽  
pp. e29745
Author(s):  
Clizia Cincidda ◽  
Silvia Francesca Maria Pizzoli ◽  
Gabriella Pravettoni
Keyword(s):  
Cancer Recurrence ◽  
Fear Of Cancer Recurrence ◽  
Current Evidence ◽  
Psychological Interventions ◽  
Face To Face ◽  
Patients With Cancer ◽  
Acceptance And Commitment ◽  
Evidence Based Treatments ◽  
Behavioral Therapies ◽  
Fear Of Cancer

Background Patients with cancer and survivors may experience the fear of cancer recurrence (FCR), a preoccupation with the progression or recurrence of cancer. During the spread of COVID-19 in 2019, patients and survivors experienced increased levels of FCR. Hence, there is a greater need to identify effective evidence-based treatments to help people cope with FCR. Remotely delivered interventions might provide a valuable means to address FCR in patients with cancer. Objective The aim of this study is to first discuss the available psychological interventions for FCR based on traditional cognitive behavioral therapies (CBTs) or contemporary CBTs, in particular, mindfulness and acceptance and commitment therapy, and then propose a possible approach based on the retrieved literature. Methods We searched key electronic databases to identify studies that evaluated the effect of psychological interventions such as CBT on FCR among patients with cancer and survivors. Results Current evidence suggests that face-to-face psychological interventions for FCR are feasible, acceptable, and efficacious for managing FCR. However, there are no specific data on the interventions that are most effective when delivered remotely. Conclusions CBT interventions can be efficacious in managing FCR, especially at posttreatment, regardless of whether it is delivered face to face, on the web, or using a blended approach. To date, no study has simultaneously compared the effectiveness of face-to-face, web-based, and blended interventions. On the basis of the retrieved evidence, we propose the hypothetical program of an intervention for FCR based on both traditional CBT and contemporary CBT, named Change Of Recurrence, which aims to improve the management of FCR in patients with cancer and survivors.

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