Internet Cancer Information Use by Newly Diagnosed Individuals and Interactions With the Health System

Background and context: In limited resource environments such as Vietnam, there is a severe lack of informational and instrumental support offered to newly diagnosed cancer patients. As a result, patients and caregivers are often left uninformed, frightened and confused about their treatment and future. Additionally, due to the stigma that surrounds cancer in many countries, patients are often discouraged from openly discussing their disease, even among family and friends. This can have a tremendous psychological impact on patients and interfere with their ability to seek and receive the medical care they need. Aim: Provide psychosocial support for newly diagnosed breast cancer patients in Vietnam. Strategy/Tactics: Adapt a well-established peer-to-peer mentoring program (Woman to Woman) to three major oncology hospitals in Vietnam. Program/Policy process: - Conduct interviews and group discussions with key stakeholders to assess feasibility and acceptability of adapting the Woman to Woman program to the Vietnam context. - Develop resource-appropriate, culturally-relevant, and context-specific materials (training modules, cancer information and resources, assessment scales and questionnaires). - Launch the adapted program, with commitment from local stakeholders. - Monitor progress and evaluate program effectiveness. - Advocate for scale-up of the program through local organizations and government entities. Outcomes: - Reduced patient distress. - Increased cancer awareness among patients and caregivers. - Reduced burden on hospital staff. - Increased skills and self-efficacy among peer mentors. What was learned: - Engagement of local stakeholders in initial assessments is key to ensure buy-in. - Program adaptation must consider the different needs of the local policy and environment contexts, not just national-level and cultural issues. - Empowering cancer survivors requires the incorporation of their diverse voices and experiences.

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Characteristics of Emergency Department Visits and Select Predictors of Hospitalization for Adults With Newly Diagnosed Cancer in a Safety-Net Health System

Journal of Oncology Practice ◽

10.1200/jop.18.00614 ◽

2019 ◽

Vol 15 (6) ◽

pp. e490-e500 ◽

Cited By ~ 2

Author(s):

Arthur S. Hong ◽

Navid Sadeghi ◽

Valorie Harvey ◽

Simon Craddock Lee ◽

Ethan A. Halm

Keyword(s):

Emergency Department ◽

Health System ◽

Safety Net ◽

Emergency Department Visits ◽

Urgent Care ◽

Newly Diagnosed ◽

Care Clinic ◽

Medication Refill ◽

Urban Safety ◽

Ed Visits

PURPOSE: There is little description of emergency department (ED) visits and subsequent hospitalizations among a safety-net cancer population. We characterized patterns of ED visits and explored nonclinical predictors of subsequent hospitalization, including time of ED arrival. PATIENTS AND METHODS: This was a retrospective cohort study of patients with cancer (excluding leukemia and nonmelanoma skin cancer) between 2012 and 2016 at a large county urban safety-net health system. We identified ED visits occurring within 180 days after a cancer diagnosis, along with subsequent hospitalizations (observation stay or inpatient admission). We used mixed-effects multivariable logistic regression to model hospitalization at ED disposition, accounting for variability across patients and emergency physicians. RESULTS: The 9,050 adults with cancer were 77.2% nonwhite and 55.0% female. Nearly one-quarter (24.7%) of patients had advanced-stage cancer at diagnosis, and 9.7% died within 180 days of diagnosis. These patients accrued 11,282 ED visits within 180 days of diagnosis. Most patients had at least one ED visit (57.7%); half (49.9%) occurred during business hours (Monday through Friday, 8:00 am to 4:59 pm), and half (50.4%) resulted in hospitalization. More than half (57.5%) of ED visits were for complaints that included: pain/headache, nausea/vomiting/dehydration, fever, swelling, shortness of breath/cough, and medication refill. Patients were most often discharged home when they arrived between 8:00 am and 11:59 am (adjusted odds ratio for hospitalization, 0.69; 95% CI, 0.56 to 0.84). CONCLUSION: ED visits are common among safety-net patients with newly diagnosed cancer, and hospitalizations may be influenced by nonclinical factors. The majority of ED visits made by adults with newly diagnosed cancer in a safety-net health system could potentially be routed to an alternate site of care, such as a cancer urgent care clinic.

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INNV-25. PATIENT CENTERED MULTI-DISCIPLINARY NEURO-ONCOLOGIC CARE AS DIRECTED BY NEW PATIENT STAKEHOLDERS

Neuro-Oncology ◽

10.1093/neuonc/noaa215.508 ◽

2020 ◽

Vol 22 (Supplement_2) ◽

pp. ii122-ii122

Author(s):

Rachel Hunt ◽

Adam Robin ◽

Lisa Scarpace ◽

Nestelynn Gay ◽

Ian Lee ◽

...

Keyword(s):

Brain Tumor ◽

Focus Group ◽

Health System ◽

Advisory Council ◽

Tumor Board ◽

Valuable Insight ◽

Newly Diagnosed ◽

Patient Centered ◽

Care Experience ◽

System Leaders

Abstract Multidisciplinary oncology care requires a team of experts which should include patient stakeholders. The Henry Ford Health System (HFHS) Hermelin Brain Tumor Center (BTC) patient and family advisory council (PFAC) recommended a focus group of patient stakeholders newly diagnosed with glioblastoma(GBM) to better understand this experience. Our PFAC, comprised primarily of long-term survivors and patient advocates, felt the perspective of newly diagnosed patients may not be adequately represented. We reviewed the BTC tumor board records, identified patients within six months from GBM diagnosis, and invited these patients and their advocates to participate in an in-person session held November 2019. The BTC Patient Resource Coordinator who is also a brain tumor survivor led the session. Predefined questions prompted discussion of their neuro-oncologic care experience. Patient perspectives and recommendations were disseminated to the BTC PFAC and health system leaders. Nine patients and ten caregivers participated. Key feedback included the need for improved communication in the peri-operative period (symptom presentation until pathology results consultation). Participants requested more information prior to surgery on what to expect after surgery and with a brain tumor diagnosis. The PFAC-developed BTC experience handbook was declared useful, but patients did not receive this book until 2-weeks after surgery. As a result, we ensured that patients received a copy of the handbook at the time of diagnosis. Additionally, the development of a brain tumor surgery “prehab” course is underway. Use of a focus group to obtain input from patients recently diagnosed with GBM provided valuable insight into their experience that can be used to align care pathways with patient needs. Feedback was used to improve the delivery of neuro-oncologic care and enhance patient communication. In the constantly evolving landscape of GBM diagnosis and treatment, it is important to remain attuned to our patients’ perspectives on the care we deliver.

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DETECTION AND CONTROL OF ARTERIAL HYPERTENSION IS AN EFFECTIVE TOOL FOR REDUCING MORTALITY FROM DISEASES OF THE CIRCULATORY SYSTEM

Social Aspects of Population Health ◽

10.21045/2071-5021-2021-67-5-9 ◽

2021 ◽

Vol 67 (5) ◽

pp. 9

Author(s):

V.A. Evdakov ◽

◽

O.O. Zakharchenko ◽

D.S. Terentyeva ◽

D.A. Khaltourina ◽

...

Keyword(s):

Blood Pressure ◽

Arterial Hypertension ◽

Health System ◽

Adult Population ◽

Circulatory System ◽

Total Mortality ◽

Medical Examination ◽

Newly Diagnosed ◽

And Control

Significance. Over the last two decades, Russia has been regestering the increased prevalence of high blood pressure among adults. The relationship between blood pressure and mortality from diseases of the circulatory system has been proved. Reducing morbidity and mortality from diseases of the circulatory system calles for improved efficiency of the state health system to detect and control blood pressure at the population level. Purpose. To improve organization of measures aimed at detecting high blood pressure and enhancing control of arterial hypertension in order to reduce adult mortality from diseases of the circulatory system in Russia. Material and methods. The authors have conducted a content analysis of regulatory and legal documents regulating activities of individual structures of the public health system on medical examination and follow-up of patients with chronic non-communicable diseases, registration and reporting forms of the federal statistical surveillance (FSN No. 12) and industry statistical surveillance (No.131/o), including information on the number of adults with arterial hypertension residing within the catchment area of the healthcare facility in dynamics from 2010 to 2019, as well as information on the number of newly diagnosed cases of arterial hypertension during medical examination of certain groups of the Russian adult population in 2015-2019; and the number of patients taken under medical follow-up with the detected (including newly diagnosed) arterial hypertension. Results. During the period from 2010 to 2019, the number of registered patients with arterial hypertension in Russia increased by 5.4 million (46%), from 11.7 in 2010 to 17.1 million in 2019. The rate of growth in the detection of new cases of arterial hypertension actively increased with initiation of the state program on medical examination of certain groups of the adult population (state checkup for non-communicable diseases). Coverage with follow-up of patients with arterial hypertension increased from 905.7 thous. in 2015 (69.5%) to 1321.4 thous. (77.0%) in 2019, including among newly detected cases during medical examination from 74.9 to 83.4%. Decrease in mortality from arterial hypertension, diseases of the circulatory system and total mortality over the period under study (2010-2019) in Russia is primarily associated with the improved detection of arterial hypertension, increased effectiveness of drug treatment and control of arterial hypertension. Conclusion. Improved detection, drug treatment and control of arterial hypertension have contributed to the decrease in mortality from arterial hypertension, diseases of the circulatory system and total mortality in the Russian adults.

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Level and contributing factors of health data quality and information use in two districts in Northwest Ethiopia: social-ecological perspective

BMC Medical Informatics and Decision Making ◽

10.1186/s12911-021-01741-1 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Binyam Tilahun ◽

Lemma Derseh ◽

Asmamaw Atinafu ◽

Adane Mamuye ◽

Tesfahun H. Mariam ◽

...

Keyword(s):

Health System ◽

Ecological Model ◽

Information Use ◽

Health Data ◽

Social Ecological Model ◽

Supportive Supervision ◽

Social Ecological ◽

The Social ◽

Quality Health

Abstract Background The health management information system has been implemented at all levels of healthcare delivery to ensure quality data production and information use in Ethiopia. Including the capacity-building activities and provision of infrastructure, various efforts have been made to improve the production and use of quality health data though the result is still unsatisfactory. This study aimed to examine the quality of health data and use in Wogera and Tach-Armacheho districts and understand its barriers and facilitators. Methods The study utilized a mixed-method; for the quantitative approach, institution-based cross-sectional study was conducted to determine the quality of health data and use by 95 departments in the two districts. The qualitative approach involved 16 in-depth interviewees from Wogera district. A descriptive Phenomenological design was used to explore factors influencing the quality and use of health data. The quantitative data were expressed descriptively with tables, graphs, and percent whereas the qualitative data were analyzed with content analysis guided by the social-ecological model framework. Result The average levels of information use for Wogera and Tach-Armacheho districts were estimated at 29 and 35.9, respectively. The overall average level of accuracy of reports for six different health services in the HCs of Wogera and Tach Armacheho districts were 0.95 and 0.86, respectively. The qualitatively identified factors that influence the production and use of quality health data include valuing data, getting staff training, being a patriotic staff, and getting supportive supervision, were identified from individual-level characteristics; similarly, coaching, supportive supervision, and peer-to-peer learning from relational/interpersonal level characteristics, and organizational culture, incentive, infrastructure establishing accountability, and staff turnover, were identified from organizational level characteristics. Conclusion The quality of data and routine information utilization was low and were influenced by a number of actors presented in and around the health system including individual, interpersonal, and organizational characteristics. Incentive affects data quality and information use directly or indirectly after modifying factors at all levels of the social-ecological model. Therefore, interventions should gear towards addressing multiple social-ecological factors of the health system concomitantly or intervene on incentive which has a multifaceted effect on the outcome.

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