Cancer Survivors’ Reported Discussions with Health Care Providers About Follow-Up Care and Receipt of Written Care Plans

76 Background: The Institute of Medicine’s (IOM; 2005) seminal report, From Cancer Patient to Cancer Survivor: Lost in Transition, recommended survivorship care plans (SCPs) as a common sense approach to improve the care of cancer survivors. The American Society of Clinical Oncology (ASCO; Mayer et al., 2014) reiterated the importance of these plans and provided strategic guidance for their implementation. The American College of Surgeons’ Commission on Cancer requires SCP delivery from accredited cancer programs as of 2015. Despite the push from these organizations, SCPs remain understudied (Mayer, Birken, Check, & Chen, 2014). The impact of SCPs on patient outcomes is poorly understood. Additionally, there is limited data on patients’ preferences for SCPs. This evaluation describes the use and assessment of SCPs at six regional cancer centers in the Midwest. Methods: Feedback was collected from 30 cancer survivors after receipt of a SCP. Responses were collected with 22-item questionnaire. Outcomes included survivors’ satisfaction with the clarity and detail of SCPs, likelihood to use SCPs in the future, intention to share SCPs with other health care providers, and perceived knowledge about treatment and follow-up care. Results: Over 75% (n = 23) of survivors agreed that SCPs were easy to understand. Ninety-three percent (n = 28) of survivors indicated that SCPs contained the right amount of information. Fifty-three percent (n = 16) of survivors are very likely to use their SCP in the future, whereas 47% (n = 14) are somewhat likely to use their SCP in the future. The majority (77%; n = 23) of survivors intend to share their SCP with another health care provider. Ninety-seven percent (n = 29) of survivors felt more knowledge about their treatment and follow-up car as a result of receiving a SCP. Conclusions: This evaluation highlights the many benefits of SCPs for cancer survivors. Results suggest that SCPs educate survivors about their treatment and follow-up care. Additionally, results indicate that many survivors intend to share SCPs, perhaps allowing for better coordination between oncology and primary care. Further research is warranted on the adoption of healthy lifestyle behaviors and receipt of routine health care after delivery of SCPs.

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Monitoring the Physical Health of Cancer Survivors: A Survivorship-Focused Medical History

Journal of Clinical Oncology ◽

10.1200/jco.2006.06.0541 ◽

2006 ◽

Vol 24 (32) ◽

pp. 5105-5111 ◽

Cited By ~ 83

Author(s):

Patricia A. Ganz

Keyword(s):

Primary Care ◽

Health Care ◽

Cancer Survivors ◽

Medical History ◽

Health Care Providers ◽

Primary Care Physicians ◽

Care Providers ◽

Follow Up Care ◽

Physical Effects

Cancer survivors frequently visit their primary-care physicians, as well as oncology specialists, for follow-up care. There is a need to monitor these survivors for the late physical effects of cancer, yet few health care providers have received training in how to do this. This article provides guidance on how to take a cancer survivor-directed medical history to facilitate the elicitation of relevant exposures, family history, and symptoms that may be related to the late effects of cancer therapy.

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Predicting and Treating the Sexual Difficulties of Gynecologic Cancer Survivors

Cancer Control ◽

10.1177/107327489600300203 ◽

1996 ◽

Vol 3 (2) ◽

pp. 113-119 ◽

Cited By ~ 6

Author(s):

Barbara L. Andersen

Keyword(s):

Health Care ◽

Cancer Survivors ◽

Health Care Providers ◽

Gynecologic Cancer ◽

Initial Therapy ◽

Care Providers ◽

Cancer Treatments ◽

Clinical Observations ◽

Behavioral Therapies

Women treated for gynecologic cancer represent approximately 45% of cancer survivors. Many report significant sexual difficulties during follow-up, and data suggest these difficulties are direct consequences of their cancer treatments. Health care providers can identify at the time of initial therapy those women who will be at greater risk for problem development. Clinical observations are provided on the development of sexual problems for these women as they attempt to resume sexual intercourse, and the psychologic and behavioral therapies that can be used for treatment are discussed.

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Changing focus: Living with advanced cancer—Development of a palliative care transition project.

Journal of Clinical Oncology ◽

10.1200/jco.2015.33.29_suppl.152 ◽

2015 ◽

Vol 33 (29_suppl) ◽

pp. 152-152

Author(s):

Paul Joseph Daeninck ◽

Simone Stenekes ◽

Tara Carpenter-Kellett ◽

Jill Talylor-Brown ◽

Mark Kristjanson ◽

...

Keyword(s):

Health Care ◽

Palliative Care ◽

Advanced Cancer ◽

Health Care Providers ◽

Care Providers ◽

Cancer Centre ◽

Palliative Approach ◽

Follow Up Care ◽

Treatment Summary

152 Background: The improvement in cancer screening, detection and treatment is changing the illness trajectory and experience for patients. Many cancer patients are living longer with advanced disease as treatment options have expanded. Thus, accurate prognostication is becoming challenging and referral to palliative care programs is often delayed until close to death. This has made the transition to a predominantly palliative approach to care complex to navigate for the health care team, patient and family. Methods: CancerCare Manitoba has undertaken an innovative project “Changing Focus: Living with Advanced Cancer” to enhance communication with primary health care providers (HCPs) and assist patients and caregivers in the transition to a palliative approach to care. The project includes development of an individualized patient treatment summary that provides details of the patient’s cancer treatment and symptoms, identifies the role of the HCPs involved with the patient and family, as well as the expectations for follow up care at the cancer centre and in the community. The transition appointment includes discussion around the treatment summary, standardized follow up care plan, and written information about palliative care, decision making, symptom management, unique issues for caregivers and details about local supports and resources is provided. Results: This presentation will focus on the development and implementation of this project within the cancer centre and throughout the province. Evaluation of this approach is ongoing. Family members and patients will provide feedback using a standardized questionnaire, and ongoing improvement will be built into the evolution of this program. HCPs will also be engaged in evaluation from their perspective. Conclusions: We expect this intervention will allow patients and families better quality of life and possibly improve the interval between the termination of chemotherapy and death.

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Sexual assault survivors’ perspectives on clinical follow-up in the Eden District, South Africa: A qualitative study

African Journal of Primary Health Care & Family Medicine ◽

10.4102/phcfm.v10i1.1631 ◽

2018 ◽

Vol 10 (1) ◽

Author(s):

Gail Holton ◽

Kate Joyner ◽

Robert Mash

Keyword(s):

Health Care ◽

Sexual Assault ◽

Health Care Providers ◽

Care Providers ◽

Sexual Assault Survivors ◽

Care Services ◽

Follow Up Care ◽

Negative Perceptions ◽

Assault Survivors

Background: Although effective follow-up of sexual assault survivors is linked to optimal recovery, attendance at follow-up consultations is poor. It is therefore essential that health care providers maximise the benefit of follow-up care for every sexual assault survivor.Aim: This study explored the personal experiences of sexual assault survivors to better understand the enablers of, and barriers to, attendance at follow-up consultations.Methods: This phenomenological qualitative study was conducted at the three hospitals which manage most sexual assault survivors within the Eden District. Using purposive sampling, 10 participants were selected. Consenting participants shared their experiencesduring semi-structured interviews with the researcher.Results: Authoritative, client-held documentation was a powerful enabler to accessing follow-up care. Individualised, patient-centred care further enhanced participants’ access to, and utilisation of, health care services. The failure of health care providers to integrate follow-up care for sexual assault survivors into established chronic care services was a missedopportunity in the continuum of care. Negative perceptions, based on others’ or personal prior experience of police, judicial and health care systems, were further barriers to follow-up care.Conclusion: This study highlights the need of survivors of sexual assault for integrated,patient-centred care, encompassing principles of good communication. Committed actions of all stakeholders are necessary to tackle negative perceptions that create barriers to follow-upcare. A simple practical strategy, the provision of a scheduled appointment on official stationery, is easy to effect at facility level. As a powerful enabler to follow-up care, this should be implemented as a priority intervention.

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Using implementation science to initiate survivorship care plan practice change.

Journal of Clinical Oncology ◽

10.1200/jco.2018.36.34_suppl.175 ◽

2018 ◽

Vol 36 (34_suppl) ◽

pp. 175-175

Author(s):

Betty Goracke Olguin ◽

Lindsay L. Benes

Keyword(s):

Health Care ◽

Side Effects ◽

Implementation Science ◽

Health Care Providers ◽

Care Coordination ◽

Survivorship Care ◽

Care Providers ◽

Follow Up Care ◽

Strongly Agree

175 Background: Failure to address coordination of cancer survivorship care can result in physical disability, emotional distress, and increased health care costs. The Institute of Medicine (IOM) recommended Survivorship Care Plans (SCPs) to improve care coordination among cancer survivors. Despite evidence supporting SCPs there remains limited implementation of SCPs. The use of implementation science, frameworks, and strategies that address contextual and process factors, could improve use of SCPs in oncology clinics (Selove et al., 2016). Methods: This innovation used the Quality Implementation Framework (QIF) (Meyers, Durlak, & Wandersman, 2012) to guide implementation. The QIF outlines steps and strategies for four phases of implementation; initial considerations regarding the host setting, creating a structure for implementation, ongoing structure once implementation begins, and improving future application. Results: During the project period (January 29, 2018 through April 23, 2018), 17 SCP visits were conducted; all 17 patients completed study surveys. In response to, “My health care providers work together as a team to ensure that my needs are met,” 65% reported strongly agree, 29% reported agree, 5% reported disagree, and 0% reported strongly disagree. When asked “My health care providers have informed me of what my follow-up care should be” 65% reported strongly agree and 35% reported agree. Of the 17 PCP surveys mailed, four were returned. In response to “For this patient the SCP helps me coordinate follow-up care,” three PCPs responded “agree.” When asked “For this patient, the SCP helps me provide better care,” three responded “strongly agree.” One PCP reported neutral feelings toward both statements. All PCPs reported SCP helped them better understand cancer treatment given and side effects. Conclusions: Successful SCP implementation, replicating outcomes of trials supporting SCPs, is attributable to the use of implementation science. Results from this project demonstrated SCPs achieved care coordination and patient satisfaction. SCPs enhanced PCPs’ understanding of cancer treatment and side effects which could increase likelihood PCPs discuss survivorship issues, as demonstrated in literature.

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Factors Associated with Meeting the Psychosocial Needs of Cancer Survivors in Nova Scotia, Canada

Current Oncology ◽

10.3390/curroncol28010004 ◽

2020 ◽

Vol 28 (1) ◽

pp. 13-25

Author(s):

Soleil Chahine ◽

Gordon Walsh ◽

Robin Urquhart

Keyword(s):

Primary Care ◽

Nova Scotia ◽

Cancer Survivors ◽

Sociodemographic Factors ◽

Patient Navigator ◽

Care Providers ◽

Psychosocial Needs ◽

Factors Associated ◽

Follow Up Care

Purpose: The purpose of this study is to describe the psychosocial needs of cancer survivors and examine whether sociodemographic factors and health care providers accessed are associated with needs being met. Methods: All Nova Scotia survivors meeting specific inclusion and exclusion criteria are identified from the Nova Scotia Cancer Registry and sent an 83-item survey to assess psychosocial concerns and whether and how their needs were met. Descriptive statistics (frequencies, percentages) and Chi-square analyses are used to examine associations between sociodemographic and provider factors and outcomes. Results: Anxiety and fear of recurrence, depression, and changes in sexual intimacy are major areas of concern for survivors. Various sociodemographic factors, such as immigration status, education, employment, and internet use, are associated with reported psychosocial health and having one’s needs met. Having both a specialist and primary care provider in charge of follow-up care is associated with a significantly (p < 0.05) higher degree of psychosocial and informational needs met compared to only one physician or no follow-up physician in charge. Accessing a patient navigator also is significantly associated with a higher degree of needs met. Conclusions: Our study identifies the most prevalent psychosocial needs of cancer survivors and the factors associated with having a higher degree of needs met, including certain sociodemographic factors, follow-up care by both a primary care practitioner and specialist, and accessing a patient navigator.

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TELE-MONITORING SYSTEM OF RISK IN RESPIRATORY PATIENTS

Biomedical Engineering Applications Basis and Communications ◽

10.4015/s1016237221500411 ◽

2021 ◽

pp. 2150041

Author(s):

Awad Al-Zaben ◽

Lina M.K. Al-Ebbini ◽

Badr Qatashah

Keyword(s):

Health Care ◽

Signal Processing ◽

Health Care Providers ◽

Mobile Phones ◽

Model Parameters ◽

Care Providers ◽

Server Side ◽

Respiration Signal ◽

At Home

In many situations, health care professionals need to evaluate the respiration rate (RR) for home patients. Moreover, when cases are more than health care providers’ capacity, it is important to follow up cases at home. In this paper, we present a complete system that enables healthcare providers to follow up with patients with respiratory-related diseases at home. The aim is to evaluate the use of a mobile phone’s accelerometer to capture respiration waveform from different patients using mobile phones. Whereas measurements are performed by patients themselves from home, and not by professional health care personnel, the signals captured by mobile phones are subjected to many unknowns. Therefore, the validity of the signals has to be evaluated first and before any processing. Proper signal processing algorithms can be used to prepare the captured waveform for RR computations. A validity check is considered at different stages using statistical measures and pathophysiological limitations. In this paper, a mobile application is developed to capture the accelerometer signals and send the data to a server at the health care facility. The server has a database of each patient’s signals considering patient privacy and security of information. All the validations and signal processing are performed on the server side. The patient’s condition can be followed up over a few days and an alarm system may be implemented at the server-side in case of respiration deterioration or when there is a risk of a patient’s need for hospitalization. The risk is determined based on respiration signal features extracted from the received respiration signal including RR, and Autoregressive (AR) moving average (ARMA) model parameters of the signal. Results showed that the presented method can be used at a larger scale enabling health care providers to monitor a large number of patients.

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