Patient-Centered Satisfaction and Well Being Assessment in a Lay Patient Navigator Program for an Underserved Radiation Oncology Patient Population

PURPOSE: On-treatment visits (OTVs) for patients undergoing radiotherapy (RT) should occur every five fractions. Compliance with OTVs was identified as a potential issue in a safety-net patient population. This study determined if brightly colored placards given to patients improved OTV compliance. MATERIALS AND METHODS: A retrospective analysis of all patients with lung cancer receiving RT from October 1, 2015 to September 30, 2017 evaluated OTV compliance before (No Placard) and after (Placard) the placard was introduced in the clinic. Analysis of variance, χ2 tests, and Fisher’s exact tests were performed to assess differences in continuous and categorical patient and treatment variables, respectively. RESULTS: The No Placard group included 48 patients who were scheduled for 151 OTVs. The Placard group included 50 patients who were scheduled for 187 OTVs. The percentage of missed OTVs in the No Placard group was 9.3% (14/151), versus 2.1% (4/187) in the Placard group ( P = .004). Patients in the No Placard group were more likely to speak English (97.9% v 86.0%; P = .060), were less likely to have stage I-III disease (75% v 88%; P = .097), and received lower mean RT doses (48.2 Gy v 55.6 Gy; P = .007). On multivariate analysis adjusting for language, stage, and RT dose, the adjusted mean rate of missed OTVs in the No Placard group was 7.1%, versus 1.4% in the Placard group ( P = .019). CONCLUSION: A significant increase in compliance of OTVs was observed with the introduction of brightly colored placards. This represents a simple, inexpensive method to improve OTV compliance in a safety-net setting and may be applicable to other patient populations.

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Implanted Cardiac Defibrillator Care in Radiation Oncology Patient Population

International Journal of Radiation Oncology*Biology*Physics ◽

10.1016/j.ijrobp.2008.06.1903 ◽

2009 ◽

Vol 73 (5) ◽

pp. 1525-1531 ◽

Cited By ~ 46

Author(s):

Daphna Y. Gelblum ◽

Howard Amols

Keyword(s):

Radiation Oncology ◽

Patient Population ◽

Oncology Patient

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Veterans Health Administration’s Whole Health System of Care: Supporting the Health, Well-Being, and Resiliency of Employees

Global Advances in Health and Medicine ◽

10.1177/21649561211022698 ◽

2021 ◽

Vol 10 ◽

pp. 216495612110226

Author(s):

Kavitha P Reddy ◽

Tamara M Schult ◽

Alison M Whitehead ◽

Barbara G Bokhour

Keyword(s):

Health System ◽

Care Delivery ◽

Health Planning ◽

Well Being ◽

Employee Health ◽

Veterans Health ◽

Health Administration ◽

Patient Centered ◽

Foundational Work ◽

Health And Well Being

The Veterans Health Administration (VHA) is implementing a Whole Health System (WHS) of care that empowers and equips Veterans to take charge of their health and well-being and live their lives to the fullest, and increasingly leaders recognize the need and value in implementing a similar approach to support the health and well-being of employees. The purpose of this paper is to do the following: 1) provide an overview of the WHS of care in VHA and applicability in addressing employee resiliency; 2) provide a brief history of employee well-being efforts in VHA to date; 3) share new priorities from VHA leadership as they relate to Employee Whole Health strategy and implementation; and 4) provide a summary of the impacts of WHS of care delivery on employees. The WHS of care utilizes all therapeutic, evidence-based approaches to support self-care goals and personal health planning. Extending these approaches to employees builds upon 10 years of foundational work supporting employee health and well-being in VHA. In 2017, one facility in each of the 18 Veterans Integrated Service Networks (VISNs) in VHA was selected to participate in piloting the WHS of care with subsequent evaluation by VA’s Center for Evaluating Patient-Centered Care (EPCC). Early outcomes, from an employee perspective, suggest involvement in the delivery of the WHS of care and personal use of the whole health approach have a meaningful impact on the well-being of employees and how they experience the workplace. During the COVID-19 pandemic, VHA has continued to support employees through virtual resources to support well-being and resiliency. VHA's shift to this patient-centered model is supporting not only Veteran care but also employee health and well-being at a time when increased support is needed.

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Improving the Perception of Patient-Centered Wellness in a Virtual Population During the COVID-19 Pandemic

Journal of Doctoral Nursing Practice ◽

10.1891/jdnp-d-20-00078 ◽

2021 ◽

pp. JDNP-D-20-00078

Author(s):

Sybilla Myers ◽

Christopher Kennedy

Keyword(s):

Quality Of Life ◽

Decision Making ◽

Shared Decision Making ◽

Cognitive Theory ◽

Well Being ◽

Mobile App ◽

Shared Decision ◽

Patient Centered ◽

The Social

BackgroundPerceived health-related quality of life (HRQOL) is fundamental to well-being and is a meaningful way to measure physical and mental health.Local ProblemNo standard method exists for measuring perceived HRQOL during the COVID-19 pandemic in participants as they attempt to improve their self-determined wellness goals. An implementation plan that considers the social distancing limitations imposed can be used to predict an individual’s likelihood of long-term success.MethodsDuring the four, 2-week plan-do-study-act (PDSA) cycles, the Social Cognitive Theory model informed the implementation of the four core interventions. To guide iterative changes, the data was analyzed through Excel and run charts.InterventionsThe four core interventions were the shared decision-making tool (SDMT), health mobile app tool (HMAT), wellness tracker tool (WTT), and the team engagement plan.ResultsAmong 28 participants, perceived quality of life increased by 70%, engagement in shared decision-making increased to 82%, app use and confidence increased to 85%, and goal attainment reached 81%.ConclusionsThe SDMT, health app, and wellness tracker created a methodical plan of accountability for increasing participant wellness. The contextual barrier of the COVID-19 pandemic added a negative wellness burden which was mitigated by creating a patient-centered culture of wellness.

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Metabolink: m-Health Solution Enabling Patient-Centered Care and Empowerment for Well-Being and Active Ageing

Biosystems & Biorobotics - Ambient Assisted Living ◽

10.1007/978-3-319-18374-9_33 ◽

2015 ◽

pp. 357-365

Author(s):

Graziano Pappadà ◽

Laura Scaringella ◽

Romina Bisceglie ◽

Nicola Modugno ◽

Antonio Pacilli ◽

...

Keyword(s):

Well Being ◽

Patient Centered Care ◽

Active Ageing ◽

Patient Centered ◽

Centered Care

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Implemented Interventionsat the Naef K. Basile Cancer Institute to Protect Patients and Medical Personnel From COVID Infections: Effectiveness and Patient Satisfaction

Frontiers in Oncology ◽

10.3389/fonc.2021.685107 ◽

2021 ◽

Vol 11 ◽

Author(s):

Jean El Cheikh ◽

Samantha El Warrak ◽

Nohra Ghaoui ◽

Farouk Al Chami ◽

Maya Shahbaz ◽

...

Keyword(s):

Patient Satisfaction ◽

Medical Care ◽

Medical Center ◽

Treatment Protocol ◽

Patient Centered ◽

Oncology Patients ◽

Oncology Patient ◽

Safety Measures ◽

Viral Spread ◽

First Case

BackgroundThe Coronavirus Disease 2019 (COVID-19) was declared a pandemic by WHO in March 2020. The first case of COVID-19 was identified in Lebanon on the 21st of February 2020, amid a national economic crisis. As the numbers of cases increased, ICU admissions and mortality rose, which led hospitals across Lebanon to take certain safety measures to contain the virus. The Naef K. Basile Cancer Institute (NKBCI) at the American University of Beirut Medical Center handles oncology outpatient visits and outpatient treatment protocol infusions. The aim of this study is to evaluate the efficacy of the safety measures put forth by the NKBCI early in the pandemic.MethodsOncology patients are amongst the immunosuppressed population, who are at greatest risk of contracting COVID-19 and consequently suffering its complications. In this manuscript, we evaluated the precautionary measures implemented at the NKBCI of AUBMC from March 1st to May 31st of 2020, by surveying oncology patients on the telephone who had live and virtual appointments in both the oncology outpatient clinics and infusion unit. We conducted a prospective study of 670 oncology patients who had appointments at the NKBCI during this period and used their answers to draw responses about patient satisfaction towards those safety measures.ResultsOur results involved 387 responses of oncology patients who visited the NKBCI during the period of March 1st to May 31st of 2020. 99% of our respondents gave a rating of good to excellent with these new measures. The option of online consultation was given to 35% in the hematology group compared to 19% in those with solid tumors (p=0.001). From the total, 15% of patients opted for the telemedicine experience as a new implemented strategy to provide patient-centered medical care. Of this group of patients, 22% faced problems with connectivity and 19% faced problems with online payment.ConclusionNKBCI was competent in following the WHO guidelines in protecting the oncology patient population. Feedback collected from the surveys will be taken into account by the committee of the NKBCI to develop new safety measures that can better control viral spread while providing patient-centered medical care.

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Characterizing The Utilization of The Trillium Drug Program by An Oncology Patient Population

Value in Health ◽

10.1016/j.jval.2017.08.273 ◽

2017 ◽

Vol 20 (9) ◽

pp. A446

Author(s):

SY Cheng ◽

C DeAngelis ◽

SJ Seung ◽

F Rahman ◽

K Chan ◽

...

Keyword(s):

Patient Population ◽

Oncology Patient

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Abstract 16622: Methodological Study for Validation of a Protocol for Behavioral Change in Patients on Warfarin: EmpoderACO

Circulation ◽

10.1161/circ.142.suppl_3.16622 ◽

2020 ◽

Vol 142 (Suppl_3) ◽

Author(s):

Hannah Cardoso Barbosa ◽

Adriana Silvina Pagano ◽

Marcus Fernando da Silva Praxedes ◽

Ilka Afonso Reis ◽

Josiane Moreira da Costa ◽

...

Keyword(s):

Drug Therapy ◽

Behavior Change ◽

Content Validity ◽

Self Care ◽

Well Being ◽

Methodological Study ◽

Patient Centered ◽

Middle Income ◽

Centered Care ◽

Ethical Approval

Introduction: To achieve stable control in warfarin therapy is challenging in clinical practice. Patients′ active participation is essential to promote self-care and medication adherence. We sought to build a conceptual map to substantiate the validation of EmpoderACO, in Brazilian Portuguese, a protocol for behavior change for patients on warfarin. Methods: This methodological study involved the development of a conceptual map focused on identifying self-care domains in warfarin users. Its content guided the development and validation of a behavior change protocol which comprised the following steps: definition of instrument objectives; construction and selection of items; construction and measurement of response scales; iv) structuring and assessment of content validity. The content validity was assessed by a committee of judges (CJ) and calculated by content validity coefficient (CVC). We used the software CmapTools (version 6.04, 2020) to build the conceptual map. Ethical approval 65928316.3.0000.5149. Results: Self-care domains in the conceptual map were divided into three categories: understanding and satisfaction with drug therapy; reduction of adverse events; promotion of well-being and healthy habits. The use of the conceptual map allowed the development of the final version of EmpoderACO with 27 items. A total of 34 specialists composed the multiprofessional CJ that analyzed the validity content. The overall average of CVC was ≥0.91, including relevance (0.92), adequacy (0.92) and clarity (0.91). Conclusions: The protocol EmpoderACO may contribute to a global approach of patients on warfarin to improve patient′s understanding of drug therapy, self-care behaviors and design of patient-centered care. The application of empowerment principles may be of particular utility in vulnerable populations living in low- and middle-income countries where warfarin is still widely prescribed for oral anticoagulation. Fig. 1 Conceptual map

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Medical Education

Human-Computer Interaction ◽

10.4018/978-1-4666-8789-9.ch101 ◽

2015 ◽

pp. 2021-2034

Author(s):

Joachim Sturmberg

Keyword(s):

Medical Education ◽

Health Professional ◽

Complex Adaptive Systems ◽

Adaptive Systems ◽

Medical Condition ◽

Well Being ◽

Tertiary Hospital ◽

Patient Centered ◽

Semiotic Model ◽

Complex Adaptive

The notion that the medical professions are grounded in sound social and philosophical commitments to human well-being and advancement is the very foundation of medicine since time in memoriam. Caring is the essential work of all health professionals, since most patients have no medical condition explainable by the mechanistic biomedical model. Health, illness, and disease, and biomedically defined disease distributions in the community follow a Pareto distribution (aka the 80/20 split) (i.e. only a minor percentage require tertiary hospital interventions). This chapter unravels important failures inherent in current medical education approaches – the misconceptions about science, the limitations inherent in the prevailing worldviews, the shaping of attitudes and behaviors resulting from social interactions in health professional institutions, and the impact of the lack of flexibility within health professional institutions. Positing that health is a personal dynamic balanced state, represented through a somato-psycho-socio-semiotic model, is the basis on which principles for a patient-centered educational approach are developed. Such a new curriculum would embrace the complex adaptive systems principle – focusing on the interdependencies between teachers and learners, allowing the curriculum to emerge over the course based on learners' clinical exposures and experiences, fostering a critical engagement with the multifaceted knowledge base of the disciplines, and most importantly, building the necessary resilience for handling, individually and collectively, the emotional demands of caring.

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Treatment Goals for Patients with Schizophrenia — A Narrative Review of Physician and Patient Perspectives

Pharmacopsychiatry ◽

10.1055/a-1298-4546 ◽

2020 ◽

Author(s):

Gerhard Gründer ◽

Philipp Bauknecht ◽

Stefan Klingberg ◽

Karolina Leopold ◽

Michael Paulzen ◽

...

Keyword(s):

Quality Of Life ◽

Well Being ◽

Narrative Review ◽

Patient Perspectives ◽

Treatment Goals ◽

Patient Centered ◽

Symptom Resolution ◽

Patient Subgroups ◽

Physician’S Perspective

Abstract Introduction There are many possible treatment goals for patients with schizophrenia. Two major perspectives on treatment goals are the patient’s and the physician’s perspective. Patient-centered treatment mandates that an individual patient’s treatment goals are taken into account when treatment is planned. In this narrative review, we address the commonalities and differences of the patient’s and physician’s perspectives. Methods We searched for literature on treatment goals for patients with schizophrenia from the last 10 years. Results Fifty-two relevant records were identified, 4 of which directly compare patient’s and physician’s perspectives. Two further articles used the same set of goals to ask patients or physicians for their assessment. Discussion Agreement between patients and physicians regarding valuation of treatment goals was high. However, physicians tended to put more emphasis on the classical “textbook” goals of symptom resolution and functioning, while patients stressed well-being and quality of life more. Results on treatment goals from patients are difficult to generalize, since recruiting representative patient samples is challenging and patient subgroups may have differing priorities.

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