Exploring Gender and Cultural, Socioecological Considerations in Psycho-Oncology (DRAFT)

Author(s):  
Kimlin Tam Ashing ◽  
Judy Huei-yu Wang ◽  
Marshalee George ◽  
Clement K. Gwede

The field of psychosocial oncology must respond to the needs of increasingly diverse cancer patient and survivor populations. Taking a health equity approach, this chapter reviews the intersectionality of the gender, culture, and socioecological contexts relevant to psychosocial oncology and survivorship. The authors propose five initiatives to (1) ensure gender consideration in the way forward so that psychosocial oncology is more patient responsive in treatment and healing, (2) increase the diversity and capacity of psychosocial oncology providers by training health care providers and professionals from underrepresented groups, (3) expand the reach of psychosocial care beyond the confines of academic research institutes and cancer centers into community hospitals and settings, (4) increase participation of advocates and survivors in peer-based supportive care, and (5) encourage collaboration among psychosocial oncology professionals and organizations, advocates, and policy-makers to promote access to and availability of psychosocial supportive care for ethnic minority and underserved communities.

2011 ◽  
Vol 16 (6) ◽  
pp. 551-558 ◽  
Author(s):  
Jane Ball ◽  
Howard Catton

Academic research and public enquiries demonstrate the link between adequate staffing levels and patients’ experiences and outcomes. Health care providers have a legal duty to ensure (and demonstrate to care regulators) that staffing levels are safe. Yet evidence of effective workforce planning, locally or nationally, is scarce. A plethora of tools exist to help employers to determine nurse staffing required. Although not perfect, the technical resource is none the less available to support planning, but are we willing to use it? In England the different systems have not been reviewed or tested and there is no consensus about the best approach to use. This paper asserts that decisions about current and future configurations of the nursing workforce are currently taken in a data vacuum. Fundamental aspects of nurse deployment – the proportion of registered nurses, the ratio of patients to nurse – are not systematically captured or recorded, either nationally or locally. We argue that a first step in planning is to establish this baseline. We need data on nursing inputs to relate to the growing body of data on patient outcomes, to enable managers and policy makers to understand the efficacy of current workforce configurations and inform future plans.


2018 ◽  
Vol 25 (1) ◽  
pp. 107327481876547 ◽  
Author(s):  
Christoph Kowalski ◽  
Stefan Post ◽  
Thomas Seufferlein ◽  
Stefan R. Benz ◽  
Julia Ferencz ◽  
...  

Improvements in health care depend on research involving health-care providers (HCPs) and health-care organizations (HCOs). Existing research suggests that involvement in research studies is still much lower than it could be. This study investigates factors that may impede or facilitate research involvement. A standardized online questionnaire was used to carry out a survey, in 3 countries, of key informants in colorectal cancer centers that hold certification in accordance with the requirements of the German Cancer Society. A total of 184 individuals responded (response rate 65%). The respondents found it difficult to identify studies suitable for their patients (40% agreement), criticized the small overall number of studies available (48%), and found that many studies are not worthwhile financially (56%). Among respondents who were not involved in studies as the principal investigators (PIs), 66% agreed they lacked the research infrastructure needed and 81% that they did not have enough staff. Among respondents who were involved as PIs, only 22% indicated that their hospital management encouraged them to initiate and conduct clinical trials. Eighty-five percent of the respondents agreed that the general population lacks information about the importance of studies. Five recommendations for health policy makers are derived from these findings for ways of increasing the involvement of HCPs and HCOs in research, and in cancer research in particular.


Author(s):  
Heidi F. A. Moossdorff-Steinhauser ◽  
Bary C. M. Berghmans ◽  
Marc E. A. Spaanderman ◽  
Esther M. J. Bols

Abstract Introduction and hypothesis Urinary incontinence (UI) is a common and embarrassing complaint for pregnant women. Reported prevalence and incidence figures show a large range, due to varying case definitions, recruited population and study methodology. Precise prevalence and incidence figures on (bothersome) UI are of relevance for health care providers, policy makers and researchers. Therefore, we conducted a systematic review and meta-analysis to investigate the prevalence and incidence of UI in pregnancy in the general population for relevant subgroups and assessed experienced bother. Methods All observational studies published between January 1998 and October 2018 reporting on prevalence and/or incidence of UI during pregnancy were included. All women, regardless of weeks of gestation and type of UI presented in all settings, were of interest. A random-effects model was used. Subgroup analyses were conducted by parity, trimester and subtype of UI. Results The mean (weighted) prevalence based on 44 included studies, containing a total of 88.305 women, was 41.0% (range of 9–75%). Stress urinary incontinence (63%) is the most prevalent type of UI; 26% of the women reported daily loss, whereas 40% reported loss on a monthly basis. Bother was experienced as mild to moderate. Conclusions UI is very prevalent and rising with the weeks of gestation in pregnancy. SUI is the most common type and in most cases it was a small amount. Bother for UI is heterogeneously assessed and experienced as mild to moderate by pregnant women.


2021 ◽  
Author(s):  
Xiaotian Zhang ◽  
Yiming Zhou ◽  
Ting Deng ◽  
Xianglin Yuan ◽  
Jianping Xiong ◽  
...  

Abstract This study aimed to make a comprehensive, nationwide survey of supportive care for cancer patients in China. Two sets of questionnaires, one for medical professionals and one for patients, were distributed. Responses were received from 12,686 medical care personnel and 11,172 patients or their family representatives from 34 provinces. It was found that only about one-fourth of caregivers felt they had much knowledge about oncology supportive care, and nearly 10% admitted to having little or no knowledge. Multidisciplinary teams for supportive care were more often available in tertiary hospitals (19.9%) than in non-tertiary hospitals (15.4%) (p < 0.05). Pain was the most common patient concern; however, pain treatment was only the fifth most common therapy administered by health care providers. Patient concerns were more often subjective (pain, economic burden, appearance, and sexual dysfunction), whereas caregiver treatments were more often directed at objective concerns (nutrition and adverse reactions to treatment regimens). Patients reported that they received no guidance or guidance only when they proposed it for psychological (25%), physical exercise (15%), nutrition (40%), or spiritual (40%-65%) needs. We conclude that the concept of supportive care is widely accepted and implemented throughout China. However, gaps exist in caregiver knowledge about supportive oncology care, the use of multidisciplinary teams, especially in non-tertiary hospitals, and the interventions between what caregivers give and what patients subjectively need. Improvements in caregiver education in supportive oncology care and the delivery of care are needed.


2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Oluwaseyi Dolapo Somefun ◽  
Jane Harries ◽  
Deborah Constant

Abstract Background South Africa has a liberal abortion law, yet denial of care is not uncommon, usually due to a woman being beyond the legal gestational age limit for abortion care at that facility. For women successfully obtaining care, time from last menstrual period to confirmation of pregnancy is significantly longer among those having an abortion later in the second trimester compared to earlier gestations. This study explores women’s experiences with recognition and confirmation of unintended pregnancy, their understanding of fertile periods within the menstrual cycle as well as healthcare providers’ and policy makers’ ideas for public sector strategies to facilitate prompt confirmation of pregnancy. Methods We recruited participants from July through September 2017, at an urban non-governmental organization (NGO) sexual and reproductive health (SRH) facility and two public sector hospitals, all providing abortion care into the second trimester. We conducted in-depth interviews and group discussions with 40 women to elicit information regarding pregnancy recognition and confirmation as well as fertility awareness. In addition, 5 providers at these same facilities and 2 provincial policy makers were interviewed. Data were analysed using thematic analysis. Results Uncertainties regarding pregnancy signs and symptoms greatly impacted on recognition of pregnancy status. Women often mentioned that others, including family, friends, partners or colleagues noticed pregnancy signs and prompted them to take action. Several women were unaware of the fertility window and earliest timing for accurate pregnancy testing. Health care providers and policy makers called for strategies to raise awareness regarding risk and signs of pregnancy and for pregnancy tests to be made more readily accessible. Conclusion Early recognition of unintended pregnancy in this setting is frustrated by poor understanding and awareness of fertility and pregnancy signs and symptoms, compounded by a distrust of commercially available pregnancy tests. Improving community awareness around risk and early signs of pregnancy and having free tests readily available may help women confirm their pregnancy status promptly.


2019 ◽  
Vol 44 (3) ◽  
pp. 177-184
Author(s):  
Karla T Washington ◽  
Nidhi Khosla ◽  
Christi Lero

Abstract The number of individuals of South Asian origin receiving health care in the United States is rapidly growing, yet little is known about their psychosocial needs. To better inform the provision of culturally competent social work services for this patient population, researchers sought to describe U.S. health care providers’ perceptions of the psychosocial needs of seriously ill patients of South Asian origin. To do so, they conducted a multimethod qualitative descriptive study, collecting data during focus groups and individual interviews of health care providers (N = 57) and analyzing them via directed content analysis. Identified patient needs included addressing financial and legal problems, challenges completing activities of daily living, spiritual or existential concerns, psychosocial experiences of unresolved physical symptoms, and psychological distress. Providers also emphasized the importance of supporting patients’ family members to aid in their caregiving abilities and to enhance their quality of life. As social workers in U.S. health care settings encounter a growing number of patients of South Asian origin, a more comprehensive understanding of their psychosocial needs is imperative. Study findings suggest that health social workers should provide psychosocial care that encompasses culture-specific needs and psychosocial care that can be provided in a culturally responsive manner.


2020 ◽  
Vol 28 (5) ◽  
pp. 542-544
Author(s):  
Shaun L Greene ◽  
Anton Scamvougeras ◽  
Amanda Norman ◽  
Yvonne Bonomo ◽  
David J Castle

Objective: North American and other jurisdictions have seen an alarming rise in the abuse of the fentanyls, with related overdose deaths. We sought to review this group of drugs to alert Australian psychiatrists and drug and alcohol clinicians to their clinical effects and potential harms. Conclusions: The extreme potency of the fentanyls underlie their lethality. Vigilance and investment from both policy makers and health care providers are required to mitigate harm from a possible future Australian fentanyl epidemic.


2017 ◽  
pp. 1-7 ◽  
Author(s):  
Callie M. Berkowitz ◽  
Leah L. Zullig ◽  
Bridget F. Koontz ◽  
Sophia K. Smith

Introduction Although there are over 500 mobile health (mHealth) applications (apps) available for download in the field of oncology, little research has addressed their acceptability among health care providers. In addition, the providers’ perspectives regarding patient app use has been largely unexamined. We conducted a qualitative study to explore opportunities and barriers for mHealth app use for oncology care. Methods We developed a structured interview guide focusing on acceptability, appropriateness, feasibility, and sustainability of the use of apps in cancer care. We interviewed 15 oncology providers about their attitudes and preferences. De-identified audio recordings were transcribed and coded for emerging themes. Results Providers interviewed included physicians (n = 8) and advanced practice (n = 3) and supportive services (n = 4) providers who care for a wide range of cancer types; ages ranged from 32 to 68 years. Interviews lasted approximately 30 minutes. Oncology providers reported limited exposure to mHealth apps in patient care, but were generally open to recommending or prescribing apps in the future. Key themes included opportunities for mobile app use (including general health promotion, tracking symptoms, and engaging patients) and barriers to implementation (including access to technology, responsibility, workflow, and the source of the app itself). Conclusion Our results show openness among oncology providers to using mHealth technology as part of patient care, but concerns regarding implementation. Designing acceptable apps may be challenging and require involvement of key stakeholders, partnering with trustworthy institutions, and outcome-based research.


2017 ◽  
Vol 29 (1) ◽  
pp. 84-100 ◽  
Author(s):  
Carolyn L. Tobin ◽  
Pam Di Napoli ◽  
Cheryl Tatano Beck

The aim of this work is to synthesize qualitative research on refugee and immigrant women’s experiences of postpartum depression (PPD) to gain insight into the unique needs of this group of women. This population is more at risk of developing PPD due to a complexity of issues including pre- and postmigratory stressors; however, there is currently little research on this topic available to health care providers and policy makers. Thirteen articles met inclusion criteria, and five themes emerged from the meta-synthesis: (a) suffering in solitude, (b) the invisible illness, (c) cultural conceptualizations, (d) barriers to help seeking, and (e) facilitators of help seeking. Conclusions suggest immigrant women with PPD may lack understanding of their condition, are often isolated, are alone, fear stigmatization, and risk being considered an unfit mother. Raising awareness with health care providers of the meaning of PPD for immigrant women is key to the provision of effective care.


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