Stage 1: Patient Assessment and Quality of Life Treatment Planning

2013 ◽  
2019 ◽  
Vol 37 (27_suppl) ◽  
pp. 224-224
Author(s):  
Ellen Miller-Sonet ◽  
Gabrielle Betty Rocque

224 Background: The National Academies of Medicine prioritizes patient’s needs, values, and preferences when patient’s and care teams make treatment decisions. However, the collection of this patient information is not part of the formal clinical intake process, nor are pertinent questions included in EHR templates. Methods: Surveys were conducted of cancer patients and cancer physicians to understand perceptions on whether patients’ quality of life priorities (e.g work, hobbies, key events, household responsibilities) are discussed, documented and reflected in treatment plans. Physicians were recruited via a market research panel. Patients were recruited from the Cancer Care data base via an email request to complete an online survey. Results: From February to October, 2018, 310 cancer patients and 109 cancer physicians completed surveys. Cancer patients were mostly female, 91% had been diagnosed in the last year, 61% had breast cancer, and 55% were stage 1 or 2. Among physicians, 88% self-identified as trained in oncology, 33% practice at academic centers, 51% in community practices, 34% from the Northeast, 21% the Southeast, and 25% the Midwest. Most patients (62%) said it was very/extremely important their doctor know their priorities. Most physicians (66%) report they most of the time/always know patients’ personal quality of life priorities before finalizing treatment plans, and 62% say this information has a large/major impact on recommendations. However, only 40% of patients report having this conversation before treatment started. Although 76% of doctors said they discussed what is important to patients most of the time or always, only 60% report it is documented, usually in the social history or notes fields. Only 36% of patients are sure this information is entered into their medical record. Conclusions: Cancer patients want their doctors to know what is important to them, and physicians agree. However, documentation is often relegated to narrative notes fields in the EHR. Considering the key role patients’ priorities should play in treatment planning, there need to be standardized collection tools so this information can be timely collected and shared.


2016 ◽  
Vol 3 (2) ◽  
Author(s):  
Ms. Alvita de Souza ◽  
Dr. Shanmukh V. Kamble

The present study was designed to: (a) determine whether there is empirical support for a relationship between Gratitude and Spirituality in Quality of Life, (b) provide an estimate of the strength of this relationship, and (c) examine whether Spirituality and Gratitude is a predictor of quality of life. Stage 1 and Stage 2 Cancer patients were employed for this study. The sample for the study consisted of 397 Cancer patients aged between 36 to 67 years. The Spirituality Scale, Gratitude Scale and the Quality of Life for Adult Cancer Survivors were administered on the participants. Results supported previous research that Spirituality and Gratitude were positively correlated to Quality of life. It was also was a significant predictor in Quality of Life in Cancer Patients. The implication of this study is that Spirituality and Gratitude as a paradigm can be used to improve the Quality of life particularly for those who report very poor health while suffering from Cancer or are at the end of their life with disease.


2020 ◽  
pp. bmjspcare-2020-002249
Author(s):  
Manuel Cobo Dols ◽  
Carmen Beato Zambrano ◽  
Luis Cabezón Gutiérrez ◽  
Rodolfo Chicas Sett ◽  
María Isabel Blancas López-Barajas ◽  
...  

ObjectivesOpioid-induced constipation (OIC) can affect up to 63% of all patients with cancer. The objectives of this study were to assess quality of life as well as efficacy and safety of naloxegol, in patients with cancer with OIC.MethodsAn observational study was made of a cohort of patients with cancer and with OIC exhibiting an inadequate response to laxatives and treated with naloxegol. The sample consisted of adult outpatients with a Karnofsky performance status score ≥50. The Patient Assessment of Constipation Quality of Life Questionnaire (PAC-QOL) and the Patient Assessment of Constipation Symptoms (PAC-SYM) were applied for 3 months.ResultsA total of 126 patients (58.2% males) with a mean age of 61.3 years (range 34–89) were included. Clinically relevant improvements (>0.5 points) were recorded in the PAC-QOL and PAC-SYM questionnaires (p<0.0001) from 15 days of treatment. The number of days a week with complete spontaneous bowel movements increased significantly (p<0.0001) from 2.4 to 4.6 on day 15, 4.7 after 1 month and 5 after 3 months. Pain control significantly improved (p<0.0001) during follow-up. A total of 13.5% of the patients (17/126) presented some gastrointestinal adverse reaction, mostly of mild (62.5%) or moderate intensity (25%).ConclusionsClinically relevant improvements in OIC-related quality of life, number of bowel movements and constipation-related symptoms were recorded as early as after 15 days of treatment with naloxegol in patients with cancer and OIC, with a good safety profile.


2011 ◽  
Vol 140 (5) ◽  
pp. S-204
Author(s):  
Lin Zheng ◽  
Zhao Zhenzhen ◽  
Lin Lin ◽  
Wang Meifeng ◽  
Zhang Hongjie ◽  
...  

2016 ◽  
Vol 20 (3) ◽  
pp. 172-177 ◽  
Author(s):  
Georgi Iliev

Summary Nowadays in the aesthetic dentistry concepts, techniques, and materials which aim is to establish new smiles with minimally invasive approaches and maximum natural effect on the restorations and in the same time to restore the mastication and phonetics for a better quality of life are used. However, the patient’s demands and the level of information has driven the profession to a certain questioning respecting the treatment customization especially those related to treatment planning according to the individual psychological characteristics of each patient, that if ignored, may lead to esthetically dissatisfaction, even though all the esthetic rules which tend to establish standards were incorporated.The purpose of this article is to show that besides the esthetic rules established throughout the time, the emotional expression of the treatment, represented by the shapes and lines constituent of a smile, should also be taken into consideration during the treatment planning. Softwares for personalized smile design could be powerful tool for planning such new smile designs.


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