Key workers in cancer care: patient and staff attitudes and implications for role development in cancer services

2013 ◽  
Vol 22 (5) ◽  
pp. 691-698 ◽  
Author(s):  
J. Ling ◽  
K. McCabe ◽  
S. Brent ◽  
A. Crosland
Author(s):  
Niharika Dixit ◽  
Hope Rugo ◽  
Nancy J. Burke

Notable barriers exist in the delivery of equitable care for all patients with cancers. Social determinants of health at distal, intermediate, and proximal levels impact cancer care. Patient navigation is a patient-centered intervention that functions across these overlapping determinants to increase access to cancer services throughout the cancer care continuum. There is a need to standardize patient navigation training while remaining responsive to local contexts of care and a need to implement patient navigation programs with a health equity lens to address cancer care inequities.


Author(s):  
Shirley Lewis ◽  
Lavanya Gurram ◽  
Umesh Velu ◽  
Krishna Sharan

Abstract Introduction: Coronavirus disease (COVID-19) has significantly challenged the access to cancer care and follow-up for a patient with cancer. Methods: Based on published literature and our experiences, it is reasonable to presume that clinical examination and follow-up visits have been significantly curtailed worldwide in order to adhere to the new norms during the pandemic. Although telephonic and telemedicine consultations may help bridge a few gaps, completely dispensing with in-person consultation has its challenges, especially in low middle-income countries. Telephonic consultations could facilitate triaging of ambulatory cancer patients and allocation of face-to-face consultations for high priority patients. Conclusions: We propose a telephonic consultation-based triaging approach for ambulatory cancer patients in order to identify those needing in-hospital consultations.


Author(s):  
Ernest Osei ◽  
Ruth Francis ◽  
Ayan Mohamed ◽  
Lyba Sheraz ◽  
Fariba Soltani-Mayvan

Abstract Background: Globally, cancer is the second leading cause of death, and it is estimated that over 18·1 million new cases are diagnosed annually. The COVID-19 pandemic has significantly impacted almost every aspect of the provision and management of cancer care worldwide. The time-critical nature of COVID-19 diagnosis and the large number of patients requiring hospitalisation necessitated the rerouting of already limited resources available for cancer services and programmes to the care of COVID-19 patients. Furthermore, the stringent social distancing, restricted in-hospital visits and lockdown measures instituted by various governments resulted in the disruption of the oncologic continuum including screening, diagnostic and prevention programmes, treatments and follow-up services as well as research and clinical trial programmes. Materials and Methods: We searched several databases from October 2020 to January 2021 for relevant studies published in English between 2020 and 2021 and reporting on the impact of COVID-19 on the cancer care continuum. This narrative review paper describes the impact of the COVID-19 pandemic on the cancer patient care continuum from screening and prevention to treatments and ongoing management of patients. Conclusions: The COVID-19 pandemic has profoundly impacted cancer care and the management of cancer services and patients. Nevertheless, the oncology healthcare communities worldwide have done phenomenal work with joint and collaborative efforts, utilising best available evidence-based guidelines to continue to give safe and effective treatments for cancer patients while maintaining the safety of patients, healthcare professionals and the general population. Nevertheless, several healthcare centres are now faced with significant challenges with the management of the backlog of screening, diagnosis and treatment cases. It is imperative that governments, leaders of healthcare centres and healthcare professionals take all necessary actions and policies focused on minimising further system-level delays to cancer screening, diagnosis, treatment initiation and clearing of all backlogs cases from the COVID-19 pandemic in order to mitigate the negative impact on cancer outcomes.


Author(s):  
Umesh Jayarajah ◽  
Anuruddha M. Abeygunasekera

Abstract Background The burden of cancer in Sri Lanka is on the rise. The overall incidence of cancer in Sri Lanka has doubled over the past 25 years with a parallel rise in cancer-related mortality. Cancer has become the second commonest cause of hospital mortality in Sri Lanka. In this review, we aim to provide an overview of the current status and future direction of cancer care in Sri Lanka. Main body In Sri Lanka, cancer services are predominantly provided by the state sector free of charge to the general public. With the establishment of national cancer policy on cancer prevention and control, there has been a commendable improvement in the cancer services provided island-wide. An increasing number of breast, oropharyngeal, thyroid, oesophageal, colorectal, lung, and gastric cancers are being diagnosed and treated annually. Primary prevention measures include restrictions in tobacco and HPV vaccination. Screening programs for selected cancers such as breast, oral and cervical cancers are delivered. Medical oncology units with facilities for systemic therapy and adequately supported by surgical, pathology, and radiology departments have been established in each district general hospital island-wide. Although the current progress is commendable, future changes are necessary to overcome the current limitations and to cater the ever increasing burden of cancer. Measures are necessary to enhance the coverage of Sri Lanka Cancer Registry. Timely high-quality research and audits are essential. Community participation in planning strategies for cancer prevention and treatment is minimal. Community-based palliative care facilities and radiation and other systemic therapy should be made available in all provinces. A culture of multi-disciplinary care with proper referral pathways would help to improve the current setting. Conclusion In conclusion, Sri Lanka has a reasonably balanced and continuously expanding program for prevention, screening, and treatment of cancers. Emphasis on preventive strategies related to reducing tobacco smoking, chewing betel, and obesity, making cancers a notifiable disease, involving the community in planning cancer care and prevention strategies, conducting research to evaluate cost-effectiveness of existing treatment and increasing radiotherapy facilities would further improve the cancer services in Sri Lanka.


Cancers ◽  
2021 ◽  
Vol 13 (11) ◽  
pp. 2675
Author(s):  
Pandora Patterson ◽  
Kimberley R. Allison ◽  
Helen Bibby ◽  
Kate Thompson ◽  
Jeremy Lewin ◽  
...  

Adolescents and young adults (aged 15–25 years) diagnosed with cancer have unique medical and psychosocial experiences and care needs, distinct from those of paediatric and older adult patients. Since 2011, the Australian Youth Cancer Services have provided developmentally appropriate, multidisciplinary and comprehensive care to these young patients, facilitated by national service coordination and activity data collection and monitoring. This paper reports on how the Youth Cancer Services have conceptualised and delivered quality youth cancer care in four priority areas: clinical trial participation, oncofertility, psychosocial care and survivorship. National activity data collected by the Youth Cancer Services between 2016–17 and 2019–20 are used to illustrate how service monitoring processes have facilitated improvements in coordination and accountability across multiple indicators of quality youth cancer care, including clinical trial participation, access to fertility information and preservation, psychosocial screening and care and the transition from active treatment to survivorship. Accounts of both service delivery and monitoring and evaluation processes within the Australian Youth Cancer Services provide an exemplar of how coordinated initiatives may be employed to deliver, monitor and improve quality cancer care for adolescents and young adults.


ESMO Open ◽  
2019 ◽  
Vol 4 (3) ◽  
pp. e000467 ◽  
Author(s):  
Chi Kong Li ◽  
Rashmi Dalvi ◽  
Kan Yonemori ◽  
Hany Ariffin ◽  
Chuhl Joo Lyu ◽  
...  

BackgroundAdolescents and young adults (AYAs) with cancer require dedicated management encompassing both adult and paediatric cancer services. Following a European survey, the European Society for Medical Oncology, the European Society for Paediatric Oncology and the Asian continental branch of International Society of Paediatric Oncology undertook a similar survey to assess AYA cancer care across Asia.MethodsA link to the online survey was sent to healthcare professionals (HCPs) in Asia interested in AYA cancer care. Questions covered the demographics and training of HCPs, their understanding of AYA definition, availability and access to specialised AYA services, the support and advice offered during and after treatment, and factors of treatment non-compliance.ResultsWe received 268 responses from 22 Asian countries. There was a striking variation in the definition of AYA (median lower age 15 years, median higher age 29 years). The majority of the respondents (78%) did not have access to specialised cancer services and 73% were not aware of any research initiatives for AYA. Over two-thirds (69%) had the option to refer their patients for psychological and/or nutritional support and most advised their patients on a healthy lifestyle. Even so, 46% did not ask about smokeless tobacco habits and only half referred smokers to a smoking cessation service. Furthermore, 29% did not promote human papillomavirus vaccination for girls and 17% did not promote hepatitis B virus vaccination for high-risk individuals. In terms of funding, 69% reported governmental insurance coverage, although 65% reported that patients self-paid, at least partially. Almost half (47%) reported treatment non-compliance or abandonment as an issue, attributed to financial and family problems (72%), loss of follow-up (74%) and seeking of alternative treatments (77%).ConclusionsLack of access to and suboptimal delivery of AYA-specialised cancer care services across Asia pose major challenges and require specific interventions.


Author(s):  
Fay J. Hlubocky ◽  
Anthony L. Back ◽  
Tait D. Shanafelt

Despite their benevolent care of others, today, more than ever, the cancer care professional who experiences overwhelming feelings of exhaustion, cynicism, and inefficacy is in grave jeopardy of developing burnout. Clinicians are repeatedly physically and emotionally exposed to exceedingly long hours in direct care with seriously ill patients/families, limited autonomy over daily responsibilities, endless electronic documentation, and a shifting medical landscape. The physical and emotional well-being of the cancer care clinician is critical to the impact on quality care, patient satisfaction, and overall success of their organizations. The prevention of burnout as well as targeting established burnout need to be proactively addressed at the individual level and organizational level. In fact, confronting burnout and promoting wellness are the shared responsibility of both oncology clinicians and their organizations. From an individual perspective, oncology clinicians must be empowered to play a crucial role in enhancing their own wellness by identification of burnout symptoms in both themselves and their colleagues, learning resilience strategies (e.g., mindful self-compassion), and cultivating positive relationships with fellow clinician colleagues. At the organizational level, leadership must recognize the importance of oncology clinician well-being; engage leaders and physicians in collaborative action planning, improve overall practice environment, and provide institutional wellness resources to physicians. These effective individual and organizational interventions are crucial for the prevention and improvement of overall clinician wellness and must be widely and systematically integrated into oncology care.


BMC Cancer ◽  
2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Mario Jorge Sobreira da Silva ◽  
Gisele O’Dwyer ◽  
Claudia Garcia Serpa Osorio-de-Castro

Abstract Background The organisation and systematisation of health actions and services are essential to ensure patient safety and the effectiveness and efficiency of cancer care. The objective of this study was to analyse the structure of cancer care envisaged in Brazilian norms, describe the types of accreditations of cancer services and their geographic distribution, and determine the planning and evaluation parameters used to qualify the health units that provide cancer care in Brazil. Methods This observational study identified the current organisation of cancer care and other health services that are accredited by Brazil’s national health system (SUS) for cancer treatment as of February 2017. The following information was collected from the current norms and the National Registry of Health Establishments: geographic location, type of accreditation, type of care, and hospital classification according to annual data of the number of cancer surgeries. The adequacy of the number of licensed units relative to population size was assessed. The analysis considered the facilitative or restrictive nature of policies based on the available rules and resources. Results The analysis of the norms indicated that these documents serve as structuring rules and resources for developing and implementing cancer care policies in Brazil. A total of 299 high-complexity oncology services were identified in facilities located in 173 (3.1%) municipalities. In some states, there were no authorised services in radiotherapy, paediatric oncology and/or haematology-oncology. There was a significant deficit in accredited oncology services. Conclusions The parameters that have been used to assess the need for accredited cancer services in Brazil are widely questioned because the best basis of calculation is the incidence of cancer or disease burden rather than population size. The results indicate that the availability of cancer services is insufficient and the organisation of the cancer care network needs to be improved in Brazil.


2020 ◽  
Vol 4 (2) ◽  
pp. 77-85
Author(s):  
Olayide S. Agodirin ◽  
Ganiyu A. Rahman ◽  
Samuel A. Olatoke ◽  
Isiaka Aremu ◽  
Asimiyu A. Shittu ◽  
...  

Background: The coronavirus disease 2019 (COVID-19) pandemic has disrupted cancer care, among others and increased the suffering of breast cancer (BC) patient owing to the imposed lockdown. This is study investigated the impact of COVID-19 lockdown on the volume of BC patients accessing care in a poor resource setting . Methods: We surveyed general surgery units (GSU) in North central and Southwestern Nigeria during the first lockdown in April/May 2020. Using an electronically mailed questionnaire, we requested data on patients accessing clinics, chemotherapy and definitive surgery before and during lockdown. The data were analyzed and presented in descriptive statistics using SPSS v 20 and Microsoft Excel software. Results: Among the 22 GSUs, only 5(23%) prepared for maintaining oncology or breast cancer services during the lockdown. Compared to the volume before the lockdown, 15(60%) GSUs received <30% of the usual volume of new cases, 16 (73%) received <30% of the usual of patients chemotherapy patients and no patient accessed definitive surgery in 15 (68%) GSUs. Conclusion: There was a marked reduction in the volume of BC patients accessing outpatient clinics, chemotherapy facilities, and definitive surgery during the COVID-19 lockdown


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