Is cancer care dependant on informal carers?

2012 ◽  
Vol 36 (3) ◽  
pp. 254 ◽  
Author(s):  
Rebecca E. Olson
Keyword(s):  
Patient Care ◽  
Cancer Patients ◽  
Cancer Care ◽  
Models Of Care ◽  
Interview Data ◽  
Coordinated Care ◽  
Central Focus ◽  
Care Coordinators ◽  
Informal Carers ◽  
At Home

Over the past half century, medical care has become less institutionalised, more autonomous, equitable and less costly. This has led to a shift from hospital-based delivery to community care. This paper examines the experiences of Canberra-based carers following this shift using interview data from a longitudinal qualitative study of 32 informal carers of a spouse with cancer. Cancer patients experienced poorly coordinated care. When carers observed the effects of errors and miscommunication on patients, they felt compelled to coordinate patient care. Interview data suggest that informal carers of cancer patients are relied upon to manage patient care at home and in hospitals, but are not supported in undertaking this responsibility. This implies that carers should be a far more central focus in cancer care reform strategies. What is known about the topic? Shifts in Australian models of care mean much of the care-work associated with cancer has moved from hospitals to home. Little is known about the implications of this shift on carers of cancer patients, a population at high risk of stress, depression and anxiety. What does this paper add? This study offers a rare qualitative approach to understanding the experiences of carers of spouses with cancer in Canberra-based hospitals. Their accounts suggest that cancer carers are relied on to coordinate care for their spouse on a long-term basis at home, in hospitals and across multiple medical modalities. What are the implications for practitioners? This high reliance on an informal caregiving population with a well-documented risk of stress, anxiety and depression suggests that strategic changes need to be made to support carers. As states and territories begin to implement cancer care coordinators as part of a cancer reform strategy, carers should be a central focus.

scholarly journals Considerations for the Management of Women with Breast Cancer during the COVID-19 Pandemic

2020 ◽  
Vol 5 (03) ◽  
pp. 260-263
Author(s):  
Monica Irukulla ◽  
Palwai Vinitha Reddy
Keyword(s):  
Breast Cancer ◽  
Resource Allocation ◽  
Patient Care ◽  
Cancer Patients ◽  
Cancer Care ◽  
Clinical Care ◽  
Current Availability ◽  
The Individual

AbstractOutcomes in cancer patients are strongly influenced by timeliness and quality of multidisciplinary interventions. The COVID-19 pandemic has led to severe disruption in cancer care in many countries. This has necessitated several changes in clinical care and workflow, including resource allocation, team segregation and deferment of many elective procedures. Several international oncological societies have proposed guidelines for the care of patients afflicted with breast cancer during the pandemic with a view to optimize resource allocation and maximize risk versus benefit for the individual and society. Clinicians may utilize these recommendations to adapt patient care, based on the current availability of resources and severity of the COVID-19 pandemic in each region. This article discusses the guidelines for care of patients afflicted with breast cancer during the pandemic.

Survey to evaluate quality of cancer patient care: A questionnaire based analysis in a tertiary hospital.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e18320-e18320
Author(s):  
Haritha Ackula ◽  
Ying Ning ◽  
Vishal Jindal ◽  
Shekhar Patil ◽  
Ahmad Daniyal Siddiqui
Keyword(s):  
Health Care ◽  
Cancer Patient ◽  
Patient Care ◽  
Cancer Patients ◽  
Cancer Care ◽  
Primary Care Providers ◽  
Inpatient Service ◽  
Care Providers ◽  
Goals Of Care ◽  
Effective Care

e18320 Background: As the burden of cancer is on the rise, there is a need to understand the logistics in caring for cancer patients. Internists and nurses are integral part of cancer care team, alongside oncologists. Our aim was to assess their knowledge, attitude and practice in order to identify areas of strength and limitation to help devise opportunities to enhance care. Methods: A close ended cross-sectional survey was conducted among internal medicine physicians, residents and nurses. We developed 36 questions broadly based on cancer-care and distributed them randomly. Additionally, subjects were asked to list factors limiting their ability to provide effective care. We semi quantitatively graded the depth of awareness amongst participants. A total of 95 health care providers were included in the final analysis. Results: Only 62% of participants were accurate in knowledge based questions. About 57% believed all cancer patients benefit from less aggressive treatment and considered chemotherapy side-effects to be the most common cause of hospitalization. Total of 94% reported effective care coordination by visiting nurses, primary care providers in outpatient settings decrease readmissions. Seventy percent thought a dedicated inpatient service run by Oncologists would be better for cancer patient care, with 96% preferring co-management. Around 80% felt they were better able to manage decompensated heart failure and fulminant liver disease than oncological emergencies like neutropenic fever. All the attendings (100%) were comfortable discussing new cancer diagnosis compared to 65% residents and 60% nurses. However 58% of them would like the health care proxy to be involved in all goals of care decisions, irrespective of patient’s capacity. Conclusions: Surprisingly, the baseline knowledge about cancer-care is suboptimal and there is a significant gap in expected versus real cancer-care delivery. Most commonly encountered factors hindering patient-care were lack of awareness of cancer illness trajectories and unclear goals of care with inter-provider disparities/gaps in understanding them. Initiatives such as targeted education, shared care plan and engaging patients at every step is crucial.

The role of the practice nurse in cancer care reviews

2021 ◽  
Vol 32 (6) ◽  
pp. 238-240
Author(s):  
Sandra Dyer
Keyword(s):  
Cancer Patients ◽  
Cancer Care ◽  
Models Of Care ◽  
Practice Nurses ◽  
Improved Outcomes ◽  
Quality And Outcomes ◽  
Quality And Outcomes Framework

Recent changes to the Quality and Outcomes Framework provide an ideal opportunity to improve the quality of cancer care reviews and cancer patients' experiences. Sandra Dyer explains the important role practice nurses can play in improving care Improved outcomes for people diagnosed with cancer have led to increasing numbers of people living with and beyond the disease, and for many, cancer has transitioned to a long-term condition. There is a greater need for models of care that best meet these patients' needs, with the role of primary care becoming increasingly important. Recent changes to the Quality and Outcomes Framework (QOF) provide an ideal opportunity to improve the quality of cancer care reviews and improve cancer patients' experiences. More education and training for general practice nurses on cancer is urgently required to allow them to lead on quality improvement in this important area of care.

The oncologist’s role in delivering palliative care

2021 ◽  
pp. 787-799
Author(s):  
Nathan I. Cherny ◽  
Stein Kaasa
Keyword(s):  
Quality Of Life ◽  
Palliative Care ◽  
Patient Care ◽  
Cancer Patients ◽  
Continuity Of Care ◽  
Cancer Care ◽  
Palliative Medicine ◽  
Collaborative Practice ◽  
Interdisciplinary Care

The division of cancer care into initial primary antitumour therapies followed by hospice or palliative care for patients who have progressive disease is anachronistic. Since the goals of medical oncology extend beyond the reduction of tumour burden and the deferral of death and incorporate a quality-of-life dimension, there is need for a continuum in patient care independent of whether the treatment intention is curative, life-prolonging, or symptomatic. Palliative care interventions should be integrated according to the clinical circumstances of the patient. This chapter outlines the oncologist’s role in the delivery of palliative care to cancer patients, emphasizing issues related to communication, interdisciplinary care, and collaborative practice with palliative medicine experts, and emphasizing principles of non-abandonment and continuity of care.

Oncology nurses’ experiences with the implementation and trial of video communication in the follow-up of cancer patients in primary care: a pilot study in Norway

2019 ◽  
Author(s):  
Lisbeth Østgaard Rygg ◽  
Hildfrid V. Brataas ◽  
Bente Nordtug
Keyword(s):  
Cancer Patients ◽  
Cancer Care ◽  
Cancer Survival ◽  
Oncology Nurses ◽  
Video Communication ◽  
Primary Cancer ◽  
Nursing Leaders ◽  
Number Of Patients ◽  
At Home

Abstract Background: Cancer survival has increased significantly over the last decade. An increasing number of patients require long-term health care. There is a need for new models of effective follow-up in primary cancer care.Objective: The aim was to provide knowledge about oncology nurses’ (ONs’) experiences and perceptions of the use of video communication (VC) to follow up with patients living at home.Methods: This was a descriptive, qualitative study of ONs’ experiences with implementing and trying VC. Data were gathered after a 3-month trial. Individual interviews were content analyzed.Results: Four female ONs participated. The study provides knowledge about the introduction of VC and its influences on follow-up care.Conclusions: With the provision of technical support and training during the introduction of VC and with the protection of patient safety, VC seems to be an effective addition to the traditional follow-up of cancer patients living at home. The findings indicate that VC can be used in primary cancer care. Our findings have practical consequences for nursing leaders considering VC in patient follow-up. Additional research is necessary.

scholarly journals Challenges and insights in implementing coordinated care between oncology and primary care providers: a Canadian perspective

2017 ◽  
Vol 24 (2) ◽  
pp. 120 ◽  
Author(s):  
J.R. Tomasone ◽  
M. Vukmirovic ◽  
M.C. Brouwers ◽  
E. Grunfeld ◽  
R. Urquhart ◽  
...  
Keyword(s):  
Primary Care ◽  
Care Coordination ◽  
Cancer Care ◽  
Program Planning ◽  
Primary Care Providers ◽  
Models Of Care ◽  
Future Research ◽  
Care Providers ◽  
Coordinated Care ◽  
Program Support

We report here on the current state of cancer care coordination in Canada and discuss challenges and insights with respect to the implementation of collaborative models of care. We also make recommendations for future research. This work is based on the findings of the Canadian Team to Improve Community-Based Cancer Care Along the Continuum (canimpact) casebook project. The casebook project identified models of collaborative cancer care by systematically documenting and analyzing Canadian initiatives that aim to improve or enhance care coordination between primary care providers and oncology specialists. The casebook profiles 24 initiatives, most of which focus on breast or colorectal cancer and target survivorship or follow-up care.Current key challenges in cancer care coordination are associated with establishing program support, engaging primary care providers in the provision of care, clearly defining provider roles and responsibilities, and establishing effective project or program planning and evaluation. Researchers studying coordinated models of cancer care should focus on designing knowledge translation strategies with updated and refined governance and on establishing appropriate protocols for both implementation and evaluation.

Understanding cancer care coordination: Opening the black box.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e18310-e18310
Author(s):  
Maureen Canavan ◽  
Tannaz Sedghi ◽  
Cary Philip Gross ◽  
Stacey Lane ◽  
Jeanette Bogdan ◽  
...  
Keyword(s):  
Patient Care ◽  
Care Coordination ◽  
Cancer Care ◽  
Direct Patient Care ◽  
Activity Time ◽  
Cancer Support ◽  
Significant Difference ◽  
Care Coordinators ◽  
Oncology Care ◽  
Day Of The Week

e18310 Background: Cancer care is complex, requiring multidisciplinary care over time and settings. Our implementation strategy for participation in CMS’ Oncology Care Model included the development of a new care management program to provide elderly patients with cancer support and continuity between inpatient and outpatient care with the goal of reducing acute care utilization. With no published models of care coordination in cancer, we launched this program using nurses experience to risk stratify and manage the needs of nearly 2500 patients. To optimize their work, we sought to understand the activity breakdown of their working time and to identify areas that can be managed more efficiently. Methods: Care coordinators are nurses responsible for completing the Institute of Medicine (IOM) care plan, stratifying patients by risk and comorbidity and administering weekly symptom assessment scales to those at high risk for disease and treatment complications. We created, pilot tested and refined a data collection tool that care coordinators could self-report the time they spent in activities of direct and indirect patient care. We performed a desk audit to measure the amount of time that oncology care coordinators spend on various activities and to explore differences in academic center versus care center care coordinators. A total of seven care coordinators self-reported activity specific time for 5 working days. Data were analyzed to assess variation in the proportion of activity time by care coordinator, site of care and day of the week using anova and t-test for the difference in mean activity time. Results: Care coordinators spent the majority of their time in indirect patient care (58%) with the highest percentage of their time specifically on charting/documentation (28%) while only 42% of their time included activities that were direct patient care. We observed no significant difference in the proportion of time spent in direct versus indirect patient care across care coordinators (p = 0.47, day of the week (p = 0.35) or by location of care (p = 0.68). Conclusions: A minority of care coordinators time is spent on providing direct patient care and substantial time is spent on indirect activities including charting and documentation. The efficiency of the care coordination model may be improved by transferring tasks that do not require the clinical expertise of these nurses.

scholarly journals Delivery of Cancer Care at Home during the First COVID-19 Pandemic in Italy: A Case Series Study (DomOnCOVID Project)

2021 ◽  
pp. 1-6
Author(s):  
Rodolfo Passalacqua ◽  
Rodolfo Passalacqua ◽  
Margherita Ratti ◽  
Maria Bonomi ◽  
Giulia Grizzi ◽  
...  
Keyword(s):  
Home Care ◽  
Cancer Patients ◽  
Cancer Care ◽  
Vital Signs ◽  
Case Series ◽  
Health Care Facilities ◽  
Home Based ◽  
Case Series Study ◽  
Care At Home ◽  
At Home

Background: Cancer represents a major risk factor for COVID-19 poor outcomes. During the crucial phase of the pandemic, we launched a home care project, called DomOnCOVID, aiming to provide care to patients in their own homes, enabling to keep immunocompromised individuals away from health care facilities, decrease hospital use, and strengthen hospital capacity for subjects with COVID-19 and other conditions. This paper describes this intervention in terms of feasibility and clinical outcomes. Methods: This is a descriptive study of cancer patients with confirmed or suspected COVID-19 infection assisted at home in the Italian Province of Cremona during the pandemic’s first peak. We devised an organizational home care system which included a medical and nursing team equipped with a car for home visits, and a nurse manager who screened patient calls requesting inclusion in the project. The team administered oral drugs at home (chemotherapy, TKis, etc.) and was equipped with all necessary tools to conduct examinations, check vital signs, take blood samples, and nasopharyngeal swabs for COVID-19 testing. Results: From March 23rd to May 15th 2020, 71 cancer patients were assisted at home (181 visits, mean 2.5, SD 1.6 range 1-7). All had symptoms that could be traced back to COVID infection, but only 26/71 (37%) were found to be COVID+; 19/26 (73%) had mild symptoms, while 7 with severe symptoms were hospitalized and 2 died for COVID-19. The remaining patients recovered. 43/71 (60%) received at home oral or subcutaneous drugs and no particular problems or toxicity were observed. 16/28 (57%) of individuals living with COVID+ patients were found to be COVID+, while none of the non-cohabiting were COVID+. Conclusion: Delivery of cancer care at home is feasible and may be particularly useful not only during health crises but also after the epidemic in order to reduce hospital access, patient and care-giver travel and improve their quality of life. Further implementation studies on home-based care in oncology are warranted.

scholarly journals Horizon Scanning in Cancer Genomics: How Advances in Genomic Medicine Will Change Cancer Care Over the Next Decade

2021 ◽  
Author(s):  
Lydia M. Seed
Keyword(s):  
Patient Care ◽  
Cancer Patients ◽  
Cancer Care ◽  
Cancer Genomics ◽  
Care Pathway ◽  
Genomic Medicine ◽  
Survival Rates ◽  
Precision Oncology ◽  
Clinical Environment ◽  
Horizon Scanning

Abstract Purpose of Review Advances in genomic medicine have the potential to revolutionise cancer patient care by driving forwards the clinical practice of precision oncology. This review aims to outline how genomic medicine advances may alter the care of cancer patients and their families over the next 10 years. Recent Findings The translation of oncogenomic advances into the clinical environment will likely be facilitated by the increasing availability of next-generation sequencing technologies and the increasing genomic literacy of healthcare professionals. The implementation of the centralised, nationwide NHS Genomic Medicine Service promises to improve equity of cancer care and to facilitate personalisation of almost every stage of the care pathway, from informing population screening and how we diagnose cancer to delivering prognoses and surveillance. Advances in cancer pharmacogenomics, and other “omics” technologies, have a tremendous potential to optimise patient care. Genomic medicine advances will also enhance the care offered to cancer patients’ families. Summary Genomic medicine advances are likely to transform almost every aspect of a cancer patient’s care pathway. Cancer care will profoundly improve over the next decade, increasing UK cancer survival rates and improving patient outcomes.

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