scholarly journals Evaluation of an electronic psycho-oncological adaptive screening program (EPAS) with immediate patient feedback: findings from a German cluster intervention study

2021 ◽  
Author(s):  
Peter Esser ◽  
Leon Sautier ◽  
Susanne Sarkar ◽  
Georgia Schilling ◽  
Carsten Bokemeyer ◽  
...  
Keyword(s):  
Cancer Survivors ◽  
Screening Program ◽  
Well Being ◽  
Cancer Center ◽  
Care Needs ◽  
Novel Technologies ◽  
Psychosocial Services ◽  
Patient Feedback ◽  
Information Level ◽  
T1 And T2

Abstract Purpose Distress screening has become mandatory and essential in comprehensive cancer care. We evaluated an electronic psycho-oncological adaptive screening (EPAS) which assesses objective indicators of care needs and subjectively perceived care needs and subsequently provides patient feedback with individualized recommendations about psychosocial care services. Methods Patients were assessed within clusters, i.e., different oncological facilities of the competence network of the University Cancer Center Hamburg (UCCH). Patients in the intervention arm underwent the screening, controls received standard care. Patients were assessed at baseline (t0), 3-month (t1), and 6-month (t2) follow-up. Outcomes included information level and use of/access to nine psychosocial services at UCCH, well-being (GAD-7, PHQ-9, SF-8), and treatment satisfaction (SCCC). Conditional linear and logistic regressions were used to identify screening effects at t1 and t2. Results Of 1320 eligible patients across 11 clusters, 660 were included (50%). The average age was 60 years; 46% were female. The intervention was associated with increased information level for all psychosocial services at t1 and t2 (all p < .001), increased use in some of these services at t1 and t2, respectively (p ≤ .02), and better evaluation of access (e.g., more recommendations for services provided by physicians, p < .01). At t2, the intervention was associated with a lower level of satisfaction with disease-related information (p = .02). Conclusions EPAS may improve information about psychosocial services as well as utilization of and access to these services. The effect on information level seems not to be generalizable to other aspects of oncological care. Future studies should incorporate novel technologies and condense the procedure to its core factors. Implications for Cancer Survivors: The screening may help to enhance self-management competencies among cancer survivors. Trial registration The trial was retrospectively registered (2/2021) at ClinicalTrials.gov (number: NCT04749056).

The Bon Secours St. Francis Cancer Survivorship Program: A model for community-based multidisciplinary survivorship care.

2016 ◽  
Vol 34 (3_suppl) ◽  
pp. 45-45
Author(s):  
Kaitlin Bomar ◽  
Nicole Vickery ◽  
Meagan Duggan ◽  
Tina Redenz ◽  
Tracey Lukker ◽  
...  
Keyword(s):  
South Carolina ◽  
Cancer Survivors ◽  
Well Being ◽  
Academic Community ◽  
Care Plan ◽  
Survivorship Care Plan ◽  
Cancer Center ◽  
Team Approach ◽  
Survivorship Care ◽  
Community Based

45 Background: In 1974, Giulio D' Angio,MD, stated “Cure Is Not Enough” and the concept of Survivorship was ignited. Multidisciplinary survivorship clinics have since become a mainstay of many pediatric cancer programs; few such clinics exist in adult cancer programs, especially in community practice. We report on the development of a survivorship care plan and a community-based clinic designed to provide guideline-driven after care for cancer survivors. Methods: An overview of the vision and mission of the Bone Secours St. Francis Cancer Center Survivorship Program is provided. Descriptive analysis of the components and metrics of success are provided, in the context of accrediting organizations requirements for current and future goals for survivorship care. Results: BSSF, which is a non-academic, community-based cancer program, and receives over 1300 referrals annually from a referral population of 1.32 million in 10 counties. St. Francis , accredited by both the Commission on Cancer and National Accreditation Program for Breast Centers, has been providing cancer‐related services to the Upstate South Carolina region for a decade. The survivorship program at St. Francis is a STAR‐certified program and is a patient‐centered service provided in a comprehensive and coordinated multidisciplinary team approach, including integrated psychologic care. A custom survivorship care plan was developed and efforts, including successes and barriers, to implementation of plans for all cancer survivors in accordance with CoC and NAPBC goals are addressed. Conclusions: The BSSF Cancer Center Survivorship Program has developed a practical, yet comprehensive SCP, which is risk-adapted and guideline-driven in order to provide customized survivorship education and monitoring. The MDC provides comprehensive evaluations and recommendations in order to maximize health and well-being of patients navigating life after cancer diagnosis and treatment. Our efforts have demonstrated that survivorship clinics of this nature can be established and successful in a non-academic community setting.

scholarly journals The Hardest Weeks of My Life: A Qualitative Study of Experiences, Practice Changes, and Emotional Burden of New York City Oncology Physicians During the COVID-19 Surge in 2020

2021 ◽  
Author(s):  
Kathleen A. Lynch ◽  
Angela Green ◽  
Leonard Saltz ◽  
Andrew S. Epstein ◽  
Danielle R. Romano ◽  
...  
Keyword(s):  
New York ◽  
New York City ◽  
York City ◽  
Well Being ◽  
Cancer Center ◽  
Care Needs ◽  
Goals Of Care ◽  
Medical Oncologists ◽  
Practitioner Training ◽  
Oncology Care

PURPOSE: The COVID-19 pandemic surge in New York City in Spring 2020 resulted in an unprecedented constraint on health care resources. This study aimed to explore the experiences of doctors providing care to oncology patients during this time. METHODS: Hospitalists and medical oncologists from two large inpatient services at a dedicated cancer center participated in virtual in-depth interviews exploring how the pandemic affected their practice and to what extent it may have affected decisions for urgent evaluation or hospital admission, interventions, or goals-of-care discussions. Interviews also explored how the pandemic affected each individual physician's psychologic well-being. Transcripts were analyzed by three independent coders in Atlas.ti v. 7.5, using a thematic analysis approach. RESULTS: Eighteen physicians were interviewed (n = 6 GI medical oncologists, n = 6 gynecologic medical oncologists, and n = 6 hospitalists). Analysis identified five major themes related to fear and distress: (1) perceived patient fears of the hospital during COVID-19, leading to avoidance and delay of acute care needs before admission, (2) physicians' fear and distress delivering oncology care during COVID-19, (3) physician distress resulting from ambiguity in decision making, (4) distress and anxiety balancing the need for patient contact with the need to minimize infection risk, and (5) distress regarding impact of uncertainty and acuity of COVID-19 on goals-of-care discussions. CONCLUSION: Insight into the experiences of physicians providing cancer care during a COVID-19 surge underscores the need for strategies mitigate short-term distress and long-term psychologic impacts. Findings can also inform practitioner training and preparedness for future pandemics in the oncology setting.

scholarly journals Evaluation of a Technology-Based Survivor Care Plan for Breast Cancer Survivors: Pre-Post Pilot Study (Preprint)

2018 ◽  
Author(s):  
Talya Laufer ◽  
Bryan Lerner ◽  
Anett Petrich ◽  
Anna M Quinn ◽  
Leah Ernst ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Pilot Study ◽  
Cancer Survivors ◽  
Breast Cancer Survivors ◽  
Care Plan ◽  
Community Center ◽  
Cancer Center ◽  
Care Needs ◽  
Academic Center ◽  
Survivor Care Plan

BACKGROUND As of 2016, almost 16 million individuals were cancer survivors, including over 3.5 million survivors of breast cancer. Because cancer survivors are living longer and have unique health care needs, the Institute of Medicine proposed a survivor care plan as a way to alleviate the many medical, emotional, and care coordination problems of survivors. OBJECTIVE This pilot study for breast cancer survivors was undertaken to: (1) examine self-reported changes in knowledge, confidence, and activation from before receipt to after receipt of a survivor care plan; and (2) describe survivor preferences for, and satisfaction with, a technology-based survivor care plan. METHODS A single group pretest-posttest design was used to study breast cancer survivors in an academic cancer center and a community cancer center during their medical visit after they completed chemotherapy. The intervention was a technology-based survivor care plan. Measures were taken before, immediately after, and 1 month after receipt of the survivor care plan. RESULTS A total of 38 breast cancer survivors agreed to participate in the study. Compared to baseline levels before receipt of the survivor care plan, participants reported increased knowledge both immediately after its receipt at the academic center (<italic>P</italic>&lt;.001) and the community center (<italic>P</italic>&lt;.001) as well as one month later at the academic center (<italic>P</italic>=.002) and the community center (<italic>P</italic>&lt;.001). Participants also reported increased confidence immediately following receipt of the survivor care plan at the academic center (<italic>P</italic>=.63) and the community center (<italic>P</italic>=.003) and one month later at both the academic center (<italic>P</italic>=.63) and the community center (<italic>P</italic>&lt;.001). Activation was increased from baseline to post-survivor care plan at both the academic center (<italic>P</italic>=.05) and community center (<italic>P</italic>&lt;.001) as well as from baseline to 1-month follow-up at the academic center (<italic>P</italic>=.56) and the community center (<italic>P</italic>&lt;.001). Overall, community center participants had lower knowledge, confidence, and activation at baseline compared with academic center participants. Overall, 22/38 (58%) participants chose the fully functional electronic survivor care plan. However, 12/23 (52%) in the community center group chose the paper version compared to 4/15 (27%) in the academic center group. Satisfaction with the format (38/38 participants) and the content (37/38 participants) of the survivor care plan was high for both groups. CONCLUSIONS This study provides evidence that knowledge, confidence, and activation of survivors were associated with implementation of the survivor care plan. This research agrees with previous research showing that cancer survivors found the technology-based survivor care plan to be acceptable. More research is needed to determine the optimal approach to survivor care planning to ensure that all cancer survivors can benefit from it.

scholarly journals Evaluation of a Technology-Based Survivor Care Plan for Breast Cancer Survivors: Pre-Post Pilot Study

JMIR Cancer ◽  
10.2196/12090 ◽  
2019 ◽  
Vol 5 (2) ◽  
pp. e12090
Author(s):  
Talya Laufer ◽  
Bryan Lerner ◽  
Anett Petrich ◽  
Anna M Quinn ◽  
Leah Ernst ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Pilot Study ◽  
Cancer Survivors ◽  
Breast Cancer Survivors ◽  
Care Plan ◽  
Community Center ◽  
Cancer Center ◽  
Care Needs ◽  
Academic Center ◽  
Survivor Care Plan

Background As of 2016, almost 16 million individuals were cancer survivors, including over 3.5 million survivors of breast cancer. Because cancer survivors are living longer and have unique health care needs, the Institute of Medicine proposed a survivor care plan as a way to alleviate the many medical, emotional, and care coordination problems of survivors. Objective This pilot study for breast cancer survivors was undertaken to: (1) examine self-reported changes in knowledge, confidence, and activation from before receipt to after receipt of a survivor care plan; and (2) describe survivor preferences for, and satisfaction with, a technology-based survivor care plan. Methods A single group pretest-posttest design was used to study breast cancer survivors in an academic cancer center and a community cancer center during their medical visit after they completed chemotherapy. The intervention was a technology-based survivor care plan. Measures were taken before, immediately after, and 1 month after receipt of the survivor care plan. Results A total of 38 breast cancer survivors agreed to participate in the study. Compared to baseline levels before receipt of the survivor care plan, participants reported increased knowledge both immediately after its receipt at the academic center (P<.001) and the community center (P<.001) as well as one month later at the academic center (P=.002) and the community center (P<.001). Participants also reported increased confidence immediately following receipt of the survivor care plan at the academic center (P=.63) and the community center (P=.003) and one month later at both the academic center (P=.63) and the community center (P<.001). Activation was increased from baseline to post-survivor care plan at both the academic center (P=.05) and community center (P<.001) as well as from baseline to 1-month follow-up at the academic center (P=.56) and the community center (P<.001). Overall, community center participants had lower knowledge, confidence, and activation at baseline compared with academic center participants. Overall, 22/38 (58%) participants chose the fully functional electronic survivor care plan. However, 12/23 (52%) in the community center group chose the paper version compared to 4/15 (27%) in the academic center group. Satisfaction with the format (38/38 participants) and the content (37/38 participants) of the survivor care plan was high for both groups. Conclusions This study provides evidence that knowledge, confidence, and activation of survivors were associated with implementation of the survivor care plan. This research agrees with previous research showing that cancer survivors found the technology-based survivor care plan to be acceptable. More research is needed to determine the optimal approach to survivor care planning to ensure that all cancer survivors can benefit from it.

scholarly journals The “little big things”: A qualitative study of ovarian cancer survivors and their experiences with the health care system.

2016 ◽  
Vol 34 (3_suppl) ◽  
pp. 252-252
Author(s):  
Ana Isabel Tergas ◽  
Ana Angarita ◽  
Angelica Cristello ◽  
Melissa Lippitt ◽  
Amanda Nickles Fader ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Health Care ◽  
Cancer Survivors ◽  
Health Care System ◽  
Well Being ◽  
Care Team ◽  
Cancer Center ◽  
Team Approach ◽  
Efficient Delivery ◽  
Care System

252 Background: Navigating a complex and ever-changing health care system can be stressful and detrimental to psychosocial well-being for patients with serious illness. This study explored women’s experiences navigating the health care system during treatment of ovarian cancer. Methods: Focus groups moderated by trained investigators were conducted with ovarian cancer survivors at an academic cancer center. Personal experiences with cancer treatment, provider relationships, barriers to care, and the health care system were explored. Sessions were audiotaped, transcribed, and coded using grounded theory. Subsequent one-on-one interviews were conducted to further evaluate common themes. Results: Sixteen ovarian cancer survivors with a median age of 59 years participated in the focus group study.Provider consistency, personal touch, and patient advocacy positively impacted care experience.Treatment with a known provider, who was well acquainted with the individual’s medical history, was deemed an invaluable aspect of care. Negative experiences that burdened patients, referred to as the “Little Big Things”, included systems-based challenges: scheduling, wait times, pharmacy, transportation, parking, financial, insurance and discharge. Consistency, a “care-team” approach, effective communication, and efficient connection to resources were suggested as ways to improve patients’ experiences. Conclusions: Systems-based challenges were perceived as burdens to ovarian cancer survivors. The role of a consistent, accessible care team and efficient delivery of resources in the care of women with ovarian cancer should be explored further.

scholarly journals Using Shared Medical Appointments for Delivering Patient-Centered Care to Cancer Survivors: A Feist-Weiller Cancer Center Pilot Study

2022 ◽  
Vol 9 ◽  
pp. 237437352110698
Author(s):  
Udhayvir S Grewal ◽  
Tyiesha Brown ◽  
Ghanshyam R Mudigonda ◽  
Cesar Davila-Chapa ◽  
Sahith R Thotamgari ◽  
...  
Keyword(s):  
Cancer Survivors ◽  
Well Being ◽  
Cancer Center ◽  
Subjective Well Being ◽  
Cross Sectional Survey ◽  
Patient Centered ◽  
Cross Sectional ◽  
Lifestyle Medicine ◽  
Shared Medical Appointments ◽  
The Impact

Background: Shared medical appointments (SMAs) have shown promise in the care of patients with conditions such as diabetes; however, the impact of lifestyle medicine-based SMAs on the overall health status of cancer survivors remains poorly understood. Materials and Methods: This cross-sectional survey of patients was conducted to study the impact of a unique lifestyle medicine-based survivorship program on cancer survivors. Results: A total of 64 patients were telephonically contacted for the survey, out of which 39 (60.9%) patients responded. All patients (39 of 39, 100%) found the program to be helpful in some way; 26 patients (66.7%) found SMAs to be significantly helpful, while 13 patients (33.3%) found SMAs as only somewhat helpful. The majority noted feeling a great sense of support (35 of 39, 89.7%), followed by improvement in appetite (21 of 39, 54%) and improvement in pain (14 of 39, 35.9%). All patients reported at least some improvement in subjective well-being (SWB); patients who attended >3 appointments reported significant/very significant improvement in SWB ( P = .03). Conclusion: SMAs offer promise in the effective delivery of lifestyle medicine-focused care to cancer survivors. Further prospective studies are needed to validate these findings.

Feasibility, delivery, and acceptance of a multidisciplinary survivorship care model based in an Asian national ambulatory cancer center: A six-month review.

2020 ◽  
Vol 38 (29_suppl) ◽  
pp. 34-34
Author(s):  
Yu Ke ◽  
Patricia Soek Hui Neo ◽  
Kiley Loh ◽  
Grace Meijuan Yang ◽  
Shirlynn Ho ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Gynecological Cancer ◽  
Cancer Center ◽  
Survivorship Care ◽  
Care Model ◽  
Care Needs ◽  
Psychosocial Services ◽  
Cancer Centre ◽  
Acceptance Rates

34 Background: Accessible Cancer Care to Enable Support for Cancer Survivors (ACCESS) is a multidisciplinary survivorship care model launched at the National Cancer Centre Singapore, the largest ambulatory cancer centre serving 70% of adult cancer patients in the public sector. ACCESS employs routine distress screening to triage patients with varying care needs and complexities. This study aims to examine the feasibility, delivery, and acceptance of ACCESS in providing appropriate service referrals to cancer patients in clinical settings. Methods: As part of an ongoing evaluation, we evaluated ACCESS for a 6-month implementation period between September 2019 and February 2020. Feasibility was assessed by proportions of (1) eligible breast and gynecological cancer patients who completed the locally adapted Distress Thermometer (DT) screening tool, (2) highly distressed patients, and (3) highly distressed patients requiring multidisciplinary meetings (MDM). Delivery was characterized by the mode and number of supportive care team (SCT) reviews required. Acceptance rates of SCT reviews by distressed patients and the uptake rate of service referrals recommended by the SCT were tabulated. Results: ACCESS screened 1074/1471 (73.0%) of all eligible patients within the 6-month period and identified 239/1074 (22.3%) as highly distressed for follow-up with the SCT. Eventually, 84.5% agreed to SCT review, with approximately one-fourth (26.7%) requiring MDM reviews. The majority (62.4%) of all distressed patients were identified at their first DT completion, whereas 19.8% and 7.4% were identified at their second and third completions respectively. The most common modes of follow-up were phone reviews (49.9%) and face-to-face in clinic waiting areas (48.6%). The SCT recommended 80 referrals to distressed patients for the following services: psychosocial (27.2%), cancer rehabilitation (5.9%), and home hospice (5.0%). The acceptance rates of the referrals for psychosocial, rehabilitation, and hospice services were 43.6%, 75.0%, and 80.0% respectively. Conclusions: ACCESS is a feasible model for triaging Asian cancer patients based on distress levels, and identifying complex patients requiring care personalization through MDM. The poorer acceptance rate of psychosocial services highlights patients’ preference for interventions targeting physical than psychosocial issues. Future studies should explore whether the uptake of psychosocial services is higher in the post-COVID era.

scholarly journals Partners and close family members of long-term cancer survivors: health status, psychosocial well-being and unmet supportive care needs

2011 ◽  
Vol 22 (1) ◽  
pp. 12-19 ◽  
Author(s):  
Daniel Turner ◽  
Eike Adams ◽  
Mary Boulton ◽  
Sian Harrison ◽  
Nada Khan ◽  
...  
Keyword(s):  
Health Status ◽  
Supportive Care ◽  
Cancer Survivors ◽  
Family Members ◽  
Well Being ◽  
Supportive Care Needs ◽  
Care Needs ◽  
Close Family

scholarly journals “Little Big Things”: A Qualitative Study of Ovarian Cancer Survivors and Their Experiences With the Health Care System

2016 ◽  
Vol 12 (12) ◽  
pp. e974-e980 ◽  
Author(s):  
Kara Long Roche ◽  
Ana M. Angarita ◽  
Angelica Cristello ◽  
Melissa Lippitt ◽  
Adil H. Haider ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Health Care ◽  
Cancer Survivors ◽  
Health Care System ◽  
Well Being ◽  
Care Team ◽  
Cancer Center ◽  
Team Approach ◽  
Focus Group Study ◽  
Care System

Purpose: Navigation of a complex and ever-changing health care system can be stressful and detrimental to psychosocial well-being for patients with serious illness. This study explored women’s experiences with navigating the health care system during treatment for ovarian cancer. Methods: Focus groups moderated by trained investigators were conducted with ovarian cancer survivors at an academic cancer center. Personal experiences with cancer treatment, provider relationships, barriers to care, and the health care system were explored. Sessions were audiotaped, transcribed, and coded by using grounded theory. Subsequently, one-on-one interviews were conducted to further evaluate common themes. Results: Sixteen ovarian cancer survivors with a median age of 59 years participated in the focus group study. Provider consistency, personal touch, and patient advocacy positively affected the care experience. Treatment with a known provider who was well acquainted with the individual’s medical history was deemed an invaluable aspect of care. Negative experiences that burdened patients, referred to as the “little big things,” included systems-based challenges, which were scheduling, wait times, pharmacy, transportation, parking, financial, insurance, and discharge. Consistency, a care team approach, effective communication, and efficient connection to resources were suggested as ways to improve patients’ experiences. Conclusion: Systems-based challenges were perceived as burdens to ovarian cancer survivors at our institution. The role of a consistent, accessible care team and efficient delivery of resources in the care of women with ovarian cancer should be explored further.

Sign in / Sign up

Export Citation Format

Share Document