1511 Symptom burden among patients with newly diagnosed incurable cancer

2015 ◽  
Vol 51 ◽  
pp. S208
Author(s):  
S. Alsirafy ◽  
R. Radwan ◽  
R. Fawzy ◽  
W. El-Sherief ◽  
H. Abd El-Aal ◽  
...  
Keyword(s):  
Symptom Burden ◽  
Newly Diagnosed ◽  
Incurable Cancer

scholarly journals High Symptom Burden Among Patients With Newly Diagnosed Incurable Cancer in a Developing Country

2016 ◽  
Vol 51 (5) ◽  
pp. e1-e5 ◽  
Author(s):  
Samy A. Alsirafy ◽  
Hesham H. Abd El-Aal ◽  
Dina E. Farag ◽  
Riham H. Radwan ◽  
Wessam A. El-Sherief ◽  
...  
Keyword(s):  
Developing Country ◽  
Symptom Burden ◽  
Newly Diagnosed ◽  
Incurable Cancer

Relationship between symptom burden and hospital length of stay (LOS) in patients with incurable cancer.

2016 ◽  
Vol 34 (15_suppl) ◽  
pp. 10123-10123
Author(s):  
Ryan David Nipp ◽  
Areej El-Jawahri ◽  
Samantha M.C. Moran ◽  
Sara D'Arpino ◽  
Connor Johnson ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Symptom Burden ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Incurable Cancer

Interpretation in Consultations With Immigrant Patients With Cancer: How Accurate Is It?

2011 ◽  
Vol 29 (20) ◽  
pp. 2801-2807 ◽  
Author(s):  
Phyllis N. Butow ◽  
David Goldstein ◽  
Melaine L. Bell ◽  
Ming Sze ◽  
Lynley J. Aldridge ◽  
...  
Keyword(s):  
Health Professional ◽  
Medical Oncology ◽  
Newly Diagnosed ◽  
Incurable Cancer ◽  
Face To Face ◽  
Health Team ◽  
Patients With Cancer ◽  
Medical Oncologists ◽  
Original Speech

Purpose Immigrants with cancer often have professional and/or family interpreters to overcome challenges communicating with their health team. This study explored the rate and consequences of nonequivalent interpretation in medical oncology consultations. Patients and Methods Consecutive immigrant patients with newly diagnosed with incurable cancer, who spoke Arabic, Cantonese, Mandarin, or Greek, were recruited from the practices of 10 medical oncologists in nine hospitals. Their first two consultations were audio taped, transcribed, translated into English and coded. Results Thirty-two of 78 participants had an interpreter at 49 consultations; 43% of interpreters were family, 35% professional, 18% both a professional and family, and 4% a health professional. Sixty-five percent of professional interpretations were equivalent to the original speech versus 50% for family interpreters (P= .02). Seventy percent of nonequivalent interpretations were inconsequential or positive; however, 10% could result in misunderstanding, in 5% the tone was more authoritarian than originally intended, and in 3% more certainty was conveyed. There were no significant differences in interpreter type for equivalency of interpretations. Conclusion Nonequivalent interpretation is common, and not always innocuous. Our study suggests that there may remain a role for family or telephone versus face-to-face professional interpreters. Practice implications: careful communication between oncologists and interpreters is required to ensure optimal communication with the patient.

scholarly journals Neurological symptom burden impacts survival prognosis in patients with newly diagnosed non–small cell lung cancer brain metastases

Cancer ◽  
2020 ◽  
Vol 126 (19) ◽  
pp. 4341-4352
Author(s):  
Ariane Steindl ◽  
Sarah Yadavalli ◽  
Katharina‐Anna Gruber ◽  
Maria Seiwald ◽  
Brigitte Gatterbauer ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Brain Metastases ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Neurological Symptom ◽  
Symptom Burden ◽  
Small Cell ◽  
Newly Diagnosed ◽  
Small Cell Lung ◽  
Survival Prognosis

Outpatient documentation of advance care planning (ACP).

2013 ◽  
Vol 31 (31_suppl) ◽  
pp. 169-169
Author(s):  
Jennifer Carrie Obel ◽  
Bruce Brockstein ◽  
Tiffany Benfield ◽  
Chad Konchak ◽  
Ari Robicsek ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Time Frame ◽  
Baseline Period ◽  
Cost Of Care ◽  
Future Research ◽  
Newly Diagnosed ◽  
Incurable Cancer ◽  
Code Status ◽  
Period 2 ◽  
Pilot Implementation

169 Background: To increase and systematize outpatient ACP, our quality improvement team developed enhancements in 2 oncologists’ cohorts of newly diagnosed, incurable cancer patients (pts). At 1st consultation, an ACP form is given to pts; a nurse assesses knowledge about medical POAs and goals of care. Pts return for chemotherapy teaching and ACP education session conducted by a nurse utilizing an ACP workbook describing end-of-life (EOL) scenarios. After reviewing the workbook, the nurse or social worker fills out an Advance Directive Note (ADN). At next visit, the oncologist reviews the plan, cosigns the ADN and inputs code status orders (CSOs). Alternatively, oncologists may choose to create the ADN. Methods: An EOL quality database of 9 metrics was created via the Electronic Health Record to measure quality of EOL care for cancer patients. Before pilot implementation, baseline assessment of ACP documentation in deceased cancer pts was obtained utilizing the EOL database for a 3 month time frame (12/12-2/13) for 2 oncologists (GI and thoracic oncology). These rates are compared to ACP documentation for newly diagnosed incurable cancer patients in the outpatient clinic during the 3 month pilot occurring from 3/13-5/13. Results: During the pilot, 5/13 (38%) new thoracic oncology patients and 13/17 (76%) GI patients had outpatient ADNs. The average days to ADN placement from 1st visit, was 14 and 10 in thoracic and GI, respectively. GI oncology placed 6/13 ADNs on the 1st visit; 12/13 GI pts had ADNs placed less than 10 days from 1st visit. GI oncology also placed 10/17 outpatient CSOs of which 8/10 were less than 10 days from 1st visit. In the same thoracic oncologist’s deceased patients during the baseline period, 2/20 (10%) had outpatient ADNs compared to 7/20 who had inpatient ADNs; 2/20 thoracic patients had outpatient CSOs compared to 15/20 with inpatient CSOs. In two comparable practices which did not participate in the pilot from 3/13-5/13, 0/26 and 1/26 new patients had outpatient ADNs and CSOs, respectively. Conclusions: Outpatient ACP is feasible early in the care of cancer patients through systematic improvement in work flow and motivated providers. Future research will focus on whether ACP soon after a cancer diagnosis affects downstream metrics of quality and cost of care during EOL.

Patient knowledge and expectations of anti-cancer treatments in the advanced disease setting.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e24187-e24187
Author(s):  
Darren Cowzer ◽  
Maeve Hennessy ◽  
Anna Linehan ◽  
zac coyne ◽  
Daniel Creegan ◽  
...  
Keyword(s):  
Advanced Disease ◽  
Symptom Burden ◽  
School Level ◽  
Cancer Treatments ◽  
Incurable Cancer ◽  
Incurable Disease ◽  
Improve Symptom ◽  
Systemic Treatments ◽  
International Data ◽  
University Level

e24187 Background: Systemic treatments can improve symptom burden and prolong life in patients with advanced cancer. However, these therapies come with associated toxicities and in some cases can result in reduced quality of life for patients with no possibility of cure. International data has suggested that this cohort of patients have a poor understanding surrounding the goals of treatment in the advanced disease setting. We aimed to evaluate the expectations for cure and palliation from systemic therapies among patients with advanced, incurable cancer in our institution. Methods: Patients on active treatment attending the Oncology Day Ward completed anonymous questionnaires over a four week period. Personal demographics, decision making for treatment and expectation of benefit and toxicity was assessed. Analysis was carried out on patients assessed to have advanced metastatic disease. Results: 254 patients completed the questionnaire. 217 patients were assessed to have metastatic/incurable disease based on responses. 57% were male, 56% were age 30-64 and 35% had completed university level education. 42% of patients stated that treatment was very likely or somewhat likely to cure their cancer. Among patients who reported that a cure was very likely, there were more men (62%) compared to women (38%), more patients were aged less than 65 (62%) compared to over 65 (38%) and more patients had only completed elementary school level education (71%) compared to university level education (29%). Most patients (84%) felt treatment was either very likely or somewhat likely to help them live longer. 68% of patients felt treatment would help them with problems related to their cancer and 33% of patients felt that treatment was very likely to have side effects or complications. 22% of patients stated that doctors made decisions without their input. Conclusions: Many patients receiving treatment for incurable cancers do not understand that it is unlikely to be curative. Male gender, younger age and a lower level of education appears to be associated with unrealistic expectations. This could compromise their ability to make informed treatment decisions. More effective communication around goals of treatment and end of life care may help to improve patients understanding and expectations around the outcomes of chemotherapy.

Upping my game as a parent: Attributed gains in participating in a cancer parenting program for child-rearing parents with advanced cancer

2020 ◽  
Vol 18 (3) ◽  
pp. 339-345
Author(s):  
Ellen H. Zahlis ◽  
Mary Ellen Shands ◽  
Frances Marcus Lewis
Keyword(s):  
Symptom Burden ◽  
Parenting Program ◽  
Child Rearing ◽  
Communication Intervention ◽  
Incurable Cancer ◽  
Educational Counseling ◽  
Study Results ◽  
Cutoff Scores ◽  
Cancer Experience ◽  
Core Construct

AbstractObjectivesThe objective of this study was to describe in the words of child-rearing parents with incurable cancer, what they had gained or thought about as a result of participating in a five-session, scripted, telephone-delivered psycho-educational parenting intervention, the Enhancing Connections Program in Palliative Care.MethodsA total of 26 parents completed the program. Parents’ responses were audio-recorded and transcribed verbatim and verified for accuracy. The analysis proceeded through four steps: unitizing, coding into categories, defining categories, and formation of a core construct that explained parents’ attributed gains. Trustworthiness of study results was protected by coding to consensus, formal peer debriefing, and maintaining an audit trail.ResultsAlthough 50% reached or exceeded clinical cutoff scores on anxiety and 42% reached or exceeded clinical cutoff scores on depressed mood, parents extensively elaborated what they gained. Results revealed six categories of competencies they attributed to their participation in the program: (1) being ready for a conversation about my cancer, (2) bringing things out in the open, (3) listening better to my child, (4) getting my child to open up, (5) not getting in my child's way, and (6) changing my parenting.ConclusionsDespite an extensive symptom burden, parents with incurable cancer attributed major gains from a brief, fully scripted, cancer parenting communication intervention. A manualized telephone-delivered educational counseling program for symptomatic parents with incurable cancer has the potential to augment competencies for parents as they assist their children manage the cancer experience.

Symptom burden to predict health care utilization in hospitalized patients with incurable cancer.

2016 ◽  
Vol 34 (26_suppl) ◽  
pp. 98-98
Author(s):  
Ryan David Nipp ◽  
Areej El-Jawahri ◽  
Samantha M.C. Moran ◽  
Sara D'Arpino ◽  
Connor Johnson ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Utilization ◽  
Hospital Admissions ◽  
Symptom Burden ◽  
Well Being ◽  
Hospitalized Patients ◽  
Care Utilization ◽  
Cancer Type ◽  
Incurable Cancer ◽  
Mood Symptoms

98 Background: Patients with incurable cancer are often hospitalized and have frequent readmissions after discharge. Considering the high physical and psychological symptom burden in this population, we sought to investigate symptoms as predictors of hospital length of stay (LOS) and time to first unplanned readmission. Methods: We consecutively enrolled incurable cancer patients with unplanned hospital admissions from 9/2014-4/2016. Within the first 5 days of admission, we assessed physical (Edmonton Symptom Assessment System [ESAS]; scored 0-10) and mood symptoms (Patient Health Questionnaire 4 [PHQ-4]; scored categorically). We created summated ESAS total and physical symptom variables. To identify predictors of LOS we used linear regression and for time to readmission we used Cox regression, with all models adjusted for age, sex, marital status, comorbidity, education, cancer type and time since incurable diagnosis. Results: We enrolled 1,000 of 1,227 (81%) eligible patients (mean age = 63.4; 50% female; 66% married). Gastrointestinal (33%) and lung (18%) cancers were the most common. Mean hospital LOS was 6.2 days and 30-day readmission rate was 25%. Over half of patients reported moderate/severe fatigue, drowsiness, lack of appetite, pain and poor well-being. Over one-fourth screened positive for PHQ depression and anxiety. All physical and mood symptoms individually predicted for longer LOS. Pain, nausea, poor well-being, ESAS total, ESAS physical and PHQ anxiety predicted for shorter time to readmission. Conclusions: Hospitalized patients with incurable cancer experience a high symptom burden, which correlates with their health care utilization. Both physical and psychological symptoms predict for longer hospital LOS and shorter time to readmission. These findings can inform interventions targeting patients’ symptoms during hospital admissions in an effort to improve health care delivery and utilization. [Table: see text]

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