“Artificial But Better Than Nothing”

Objective: To investigate patient, staff, and carer responses to an environmental intervention in an oncology clinic waiting room and evaluate the acceptability of artificial plant materials. Design Postintervention: Cross-sectional survey study. Setting: Oncology outpatient clinic waiting room located in a metropolitan comprehensive cancer center in Australia. Main Outcome Measure: Observer ratings of perceived qualities and effects of lifelike (fake) plants while spending time in the waiting room. Participants: Convenience sample ( N = 143) consisted of 73 cancer patients, 13 staff, 52 carers, and 5 “others” aged between 24 and 89 years ( M = 56, SD = 14.5). Intervention: Artificial plant arrangements, hanging installations, two movable green walls, and one rock garden on wheels placed throughout the outpatients’ clinic waiting room. Results: Eighty-one percent (115/142) of respondents noticed the green features when first entering the waiting room and 67% (90/134) noticed they were artificial. Eighty-one percent (115/142) indicated “like/like a lot” when reporting their first reaction to the green features. Forty-eight percent (68/143) were positively affected and 23% (33/143) were very positively affected. Eighty-one percent (110/135) agreed/strongly agreed that “The greenery brightens the waiting room,” 62% (80/130) agreed/strongly agreed that they “prefer living plants,” and 76% (101/133) agreed/strongly agreed that “‘lifelike’ plants are better than no plants.” Comments included mostly positive appraisals and occasional adverse reactions to artificial plants. No significant differences were found between patients’, staff, and carers’ reactions. Conclusions: The environmental intervention positively impacted patients’, staff, and carers’ perceptions of the oncology waiting room environment. Patients, staff, and carers mostly accepted artificial plants as an alternative design solution to real plants.

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Assessing the impact of the COVID-19 pandemic on patients with genitourinary malignancies.

Journal of Clinical Oncology ◽

10.1200/jco.2021.39.6_suppl.38 ◽

2021 ◽

Vol 39 (6_suppl) ◽

pp. 38-38

Author(s):

Hala Borno ◽

Sylvia Zhang ◽

Scarlett Lin Gomez ◽

Celia Kaplan ◽

Christine Miaskowski ◽

...

Keyword(s):

Cancer Treatment ◽

Household Income ◽

Negative Impact ◽

Survey Study ◽

Comprehensive Cancer Center ◽

Cancer Center ◽

Cross Sectional Survey ◽

Annual Household Income ◽

Ongoing Research ◽

The Impact

38 Background: The COVID-19 pandemic has vast implications on the health system. Patients with a cancer diagnosis may face greater challenges in the context of the current COVID-19 pandemic. Methods: We sought to assess the impact of the COVID-19 pandemic among patients with genitourinary malignancies. We performed a cross-sectional survey study at a Comprehensive Cancer Center during the current pandemic. Results: A total of 86 participants were recruited to the study to date, 72.1% had prostate, 19.8% had kidney, and 12.8% had bladder cancer. A subset (n = 5) had more than one primary tumor. The mean time from diagnosis was 6.47 years (std dev 6.01, range from 0 to 27 years). Overall, 73% reported having metastatic disease and prior treatment with surgery (62%), radiation (71%), or systemic therapy (68%), with 68.6% currently receiving cancer treatment. In the study, 78.9% of patients were >65 years of age and 88.2% were White. The majority of participants had a bachelor’s degree or higher level of education (74.4%), were legally married (82.6%), were homeowners (91.9%), and reported an annual household income of >$100,000 (56.0%). Among respondents, 7% reported loss/change of health insurance and 30% reported a decrease in household income. Among patients with reduced household income, 23% reported a reduction of more than 50%. In this study, 28% of patients reported that the pandemic impacted their cancer treatment. Overall 7% reported decrease in frequency of labs, 11% reported a delay in obtaining a scan, 5% reported treatment delays, and 96% reported use of telemedicine (video or telephone) visit. Overall, 59% reported fear of hospitalization, 23% reported delays in seeking medical care, and 16% reported missing required medications. Conclusions: The negative impact of the COVID-19 pandemic on patients with genitourinary malignancies is extensive. Ongoing research is evaluating the impact across socio-demographically groups and examine clinical outcomes associated with delays in care and medication non-adherence.

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Spiritual Motivations to Practice Medicine: A Survey of Cancer Care Providers

American Journal of Hospice and Palliative Medicine® ◽

10.1177/10499091211049802 ◽

2021 ◽

pp. 104990912110498

Author(s):

Elizabeth Palmer Kelly ◽

Brian Myers ◽

Joseph Kelly-Brown ◽

Brittany L. Waterman ◽

Erin Stevens ◽

...

Keyword(s):

Religious Identity ◽

Cancer Care ◽

Comprehensive Cancer Center ◽

Cancer Center ◽

Intrinsic Religiosity ◽

Care Providers ◽

Provider Type ◽

Cross Sectional Survey ◽

Practice Of Medicine ◽

The Relationship

Background: There is increased interest in the role of spirituality in the cancer care context, but how it may inspire individuals to pursue a career as a healthcare provider is unknown. We sought to determine the relationship between intrinsic religiosity, religious identity, provider role, and spiritual motivations to practice medicine. Methods: A cross-sectional survey was administered to healthcare providers at a large, Midwest Comprehensive Cancer Center. The relationship between provider type, intrinsic religiosity, religious identity, and spiritual motivations to practice medicine was assessed with binary logistic regression. Results: Among 340 participants, most were female (82.1%) or Caucasian (82.6%) and identified as being religious (57.5%); median age was 35 years (IQR: 31-48). Providers included nurses (64.7%), physicians (17.9%), and “other” (17.4%). Compared with physicians, nurses were less likely to agree that they felt responsible for reducing pain and suffering in the world (OR: 0.12, p = 0.03). Similarly, “other” providers were less likely than physicians to believe that the practice of medicine was a calling (OR: 0.28, p = 0.02). Providers with a high self-reported intrinsic religiosity demonstrated a much greater likelihood to believe that the practice of medicine is a calling (OR:1.75, p = 0.001), as well as believe that personal R&S beliefs influence the practice of medicine (OR:3.57, p < 0.001). Provider religious identity was not associated with spiritual motivations to practice medicine (all p > 0.05). Conclusion: Intrinsic religiosity had the strongest relationship with spiritual motivations to practice medicine. Understanding these motivations may inform interventions to avoid symptoms of provider burnout in cancer care.

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Perceived benefits of animal-assisted therapy in the oncology waiting room

American Journal of Recreation Therapy ◽

10.5055/ajrt.2011.0025 ◽

2011 ◽

Vol 10 (4) ◽

pp. 25-34

Author(s):

Linda L. Buettner, PhD, LRT, CTRS ◽

YingChen Wang, PhD ◽

Kaitlin Stevens ◽

Hannah Jessup ◽

Gustav C. Magrinat, MD

Keyword(s):

Complementary Therapy ◽

Cognitive Stimulation ◽

Animal Assisted Therapy ◽

Cancer Center ◽

Recreational Therapy ◽

Perceived Benefits ◽

Waiting Room ◽

Convenience Sample ◽

Therapy Dog ◽

Pain Communication

This study identified perceived benefits of animal-assisted therapy (AAT) on anxiety, pain, communication, and cognition among patients waiting for treatment in a large urban cancer center. A convenience sample of 75 patients and five family members (n = 80) waiting for treatment completed a survey about AAT. After giving informed consent, participants were asked to complete questions related to attitudes about offering a complementary therapy dog program in the hospital. Findings indicated that most respondents were very accepting of AAT in the cancer center, with 78 percent indicating that they would like to take part in this complementary therapy. The perceived benefits of AAT included that it would provide a method for positive communication (93 percent), cognitive stimulation (92.3 percent), it would help to pass time more quickly (88.8 percent), it would help people to feel more comfortable at the cancer center (84.8 percent), and it would reduce participants’ pain (71.3 percent) and anxiety (68.4 percent). The association between gender and anxiety produced a statistically meaningful result in this study about predicting subjects’ participation in the program. Ultimately, offering recreational therapy facilitated AAT in cancer center waiting areas may provide benefits for patients and provide a competitive edge to hospitals.

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The knowledge needs for Canadian paediatric emergency physicians in the diagnosis and management of tropical diseases: A national physician survey

Paediatrics & Child Health ◽

10.1093/pch/pxaa022 ◽

2020 ◽

Author(s):

Melissa Mengyan Wan ◽

Quynh Doan ◽

Niranjan Kissoon

Keyword(s):

Pediatric Emergency ◽

Comfort Level ◽

Survey Study ◽

Tropical Diseases ◽

Discharge Instructions ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Specific Content ◽

Paediatric Emergency ◽

Better Than

Abstract Objectives To assess the knowledge gaps and need for continuing medical education (CME) resources for Canadian paediatric emergency department (PED) physician management of common tropical diseases. Methods A cross-sectional survey study of Canadian PED was performed from May to July 2017 using the Pediatric Emergency Research Canada (PERC) database. Results The response rate was 56.4% (133/236). The mean performance on the case-based vignettes identifying clinical presentation of tropical illnesses ranged from 59.9% to 76.0%, with only 15.8% (n=21) to 31.1% (n=42) of participants scoring maximum points. Those who ‘always’ asked about fever performed better than those who only ‘sometimes’ asked (40.4% versus 23.8%). For management cases, the majority of the participants (59.4% to 89.5%) were able to interpret investigations; however, many were unsure of subsequent actions relating to initial treatment, discharge instructions, and reporting requirements. Many would consult infectious diseases (87.8% to 99.3%). Fifty-three per cent of the participants reported a low comfort level in diagnosing or managing these patients. They rated the importance of CME materials with a median of 50/100, via various modalities such as case studies (71.9%), emphasizing a need for PED-specific content. Conclusion This study identified a knowledge gap in the recognition and management of pediatric tropical diseases by Canadian PED physicians. There is a need for formal CME materials to supplement physician practice.

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1302. Antibiotic Prescribing Knowledge: A Brief Survey of Providers and Staff at an Ambulatory Cancer Center During Antibiotic Awareness Week 2017

Open Forum Infectious Diseases ◽

10.1093/ofid/ofy210.1135 ◽

2018 ◽

Vol 5 (suppl_1) ◽

pp. S398-S398

Author(s):

Erica Stohs ◽

Elizabeth M Krantz ◽

Ania Sweet ◽

Jacqlynn Zier ◽

Maria Paleologos ◽

...

Keyword(s):

Hematopoietic Cell Transplantation ◽

Antibiotic Use ◽

Cancer Center ◽

Antibiotic Prescribing ◽

Upper Respiratory Tract ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Convenience Sample ◽

Stewardship Program ◽

Tract Infections

Abstract Background Antibiotics have contributed significantly to advances in cancer therapy and hematopoietic cell transplantation, but rising antibiotic resistance threatens this progress. Little is known about knowledge and perceptions surrounding antibiotic use and resistance among staff at cancer centers. Methods We conducted a brief cross-sectional survey of healthcare professionals (HCP) at a large ambulatory cancer center to assess knowledge of antibiotic prescribing and resistance during Antibiotic Awareness Week, November 13–19, 2017. A convenience sample of providers and staff who participated in one of two 2-hour Antimicrobial Stewardship Program “open house” events was used. Questions evaluated knowledge about antibiotic use for upper respiratory tract infections (URIs). Results There were 179 respondents. The proportion of correct responses to each question by employee type is displayed in Table 1. There was a statistically significant decreasing trend in the proportion correctly answering all four questions by employee type from providers, to pharmacists, to nurses, to others (P <0.001) (Figure 1). Conclusion Providers were more likely to correctly answer questions pertaining to antibiotic use compared with other HCP. Due to the multidisciplinary nature of cancer care, patients often encounter a variety of HCP over the course of treatment. Opportunities exist to improve antibiotic stewardship education across the spectrum of HCP at our cancer center, including pharmacists, nurses, and other staff. Disclosures All authors: No reported disclosures.

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Evaluating transgender youth and parent interest and preferences regarding support groups

Global Pediatric Health ◽

10.1177/2333794x20954680 ◽

2020 ◽

Vol 7 ◽

pp. 2333794X2095468

Author(s):

Shauna Marie Lawlis ◽

Patrick Butler ◽

Amy Middleman

Keyword(s):

Support Groups ◽

Support Group ◽

Group Structure ◽

Survey Study ◽

Sex And Gender ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Convenience Sample ◽

Interest Level ◽

Additional Support

The purpose of this cross-sectional survey study is to explore transgender teens’ and their parents’ interest in and preferences regarding support groups in an effort to optimally serve the entire family’s needs. The aims of the study were to: (1) describe transgender teens interest level and preferences regarding support groups; (2) describe parents of transgender teens interest level and preferences regarding support groups; and (3) compare responses based on demographics including teens versus parent, natal sex, and gender identity. De-identified surveys were collected from a convenience sample of transgender patients (N = 26), ages 13-18 years, and their parents (N = 20). Overall level of interest in support groups was 7.20/10 for youth and 7.95/10 for parents where 0 is not interested and 10 is very interested. Both groups endorsed benefits of a support group, including help with managing school issues, learning about local resources for transgender teens, and providing peer support. Both groups indicated “no time” as the most common potential barrier to attendance. Both groups expressed moderate interest in support groups, with minor differences between youths and parents noted in preferred support group structure. Further examination is warranted to determine optimal support group characteristics aimed specifically at parents and, separately, for youth. Additional support services might complement groups for a more comprehensive approach to support resources for this community.

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Cancer patients’ attitudes toward future research uses of their donated tissue: Preliminary results of a mail survey study

Journal of Clinical Oncology ◽

10.1200/jco.2006.24.18_suppl.6009 ◽

2006 ◽

Vol 24 (18_suppl) ◽

pp. 6009-6009

Author(s):

P. R. Helft ◽

R. E. Eckles ◽

J. Kempf ◽

C. S. Johnson-Calley ◽

J. Brooks ◽

...

Keyword(s):

Cancer Patients ◽

Tissue Bank ◽

Mail Survey ◽

The United States ◽

Survey Study ◽

Cancer Center ◽

Future Research ◽

Presumed Consent ◽

Convenience Sample ◽

Tissue Samples

6009 Background: Millions of tissue samples are stored in the United States, but little is known about the attitudes of tissue donors. Understanding the attitudes of those who donate tissue for use in future research would inform the design of studies using stored tissues (ST). Methods: Eligible subjects included cancer patients who donated remaining tissue after biopsy or surgery to the Indiana University Cancer Center Tissue Bank. All subjects signed informed consent to donate tissue. A convenience sample were approached for participation. A survey instrument was developed from literature review and expert input, and refined by focus groups. Results: 243 surveys were mailed, and 196 completed surveys were returned (response rate 80.7%). Respondents were 70% married, 93% white, 54% female. 57% had completed at least some college. Average age was 60. Average time since diagnosis was 13.8 months. 81% of respondents remembered donating tissue. 61% were not at all or a little concerned about the privacy of their ST. >80% of subjects agreed that their ST could be used in future research on their type of cancer, other cancers, and other diseases,. Non-whites were less likely than whites to allow tissue to be used in research (p = 0.0128). Around 40% of respondents agreed that researchers should have to recontact them before using their ST. Non-whites and less educated subjects were more likely to want to be recontacted for each research use of their ST. 90% of subjects would allow their ST to be used by university researchers, but only 60% agreed that ST could be used by pharmaceutical companies. 39% objected to the use of STs to develop a treatment for profit. No differences were found in willingness of ST to be used in future research whether samples were identified, de-identified, or linked. 60% of respondents wanted to be notified of research results that would impact their, or their children’s, health whether treatments were available or not, and whether results had been validated or not. Conclusions: This cohort of cancer patients was very willing to allow their ST to be used in future research on all conditions, but a significant minority desired to be recontacted each time ST were used. These findings do not support policies based on a simple presumed consent model. No significant financial relationships to disclose.

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Encouraging patients to disclose their lesbian, gay, bisexual, or transgender (LGBT) status: oncology health care providers’ perspectives

Translational Behavioral Medicine ◽

10.1093/tbm/iby105 ◽

2018 ◽

Vol 10 (4) ◽

pp. 918-927 ◽

Cited By ~ 1

Author(s):

Smita C Banerjee ◽

Jessica M Staley ◽

Koshy Alexander ◽

Chasity B Walters ◽

Patricia A Parker

Keyword(s):

Health Care ◽

Sexual Orientation ◽

Gender Identity ◽

Health Care Providers ◽

Care Delivery ◽

Comprehensive Cancer Center ◽

Cancer Center ◽

Care Providers ◽

Health Care Environment ◽

Cross Sectional Survey

Abstract A compelling touted strategy for reducing discrimination towards lesbian, gay, bisexual, and transgender (LGBT) patients is improving communicative competence of health care providers (HCPs); however, evidence base for describing communication practices between HCPs and LGBT patients is scarce. The purpose of this study was to qualitatively examine HCP experiences and perspectives as they relate to patient sexual orientation and gender identity (SOGI) disclosure, perceived communication and structural/administrative challenges in interactions with LGBT patients, and suggestions for improving care of LGBT patients. The sample consisted of 1,253 HCPs, who provided open-ended responses to an online cross-sectional survey conducted at a Comprehensive Cancer Center in the Northeastern United States. The open-ended responses were inductively and deductively coded for key themes and sub-themes. The results demonstrated an array of useful communication strategies employed by oncology HCPs to encourage LGBT patients’ SOGI disclosure (direct questions regarding sexual orientation, use of the term “partner,” and using correct pronouns), communication and structural/administrative challenges faced by HCPs in providing care (HCP own fears and biases, transgender patient care, insurance issues, and procedural challenges for LGBT patients), and suggested recommendations from oncology HCPs to improve their care delivery for LGBT patients (more provider-based training, improving awareness of LGBT-friendly resources, establishing trusting relationships, and not assuming sexuality or gender identity). These findings have implications for developing and evaluating training programs to improve LGBT sensitivity and communication among HCPs, and encourage SOGI disclosure in an open and judgment-free health care environment.

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Humanizing the intensive care unit experience in a comprehensive cancer center: A patient- and family-centered improvement study

Palliative & Supportive Care ◽

10.1017/s1478951521001838 ◽

2021 ◽

pp. 1-7

Author(s):

John A. Cuenca ◽

Nirmala Manjappachar ◽

Joel Nates ◽

Tiffany Mundie ◽

Lisa Beil ◽

...

Keyword(s):

Intensive Care Unit ◽

Decision Making ◽

Intensive Care ◽

Family Members ◽

Comprehensive Cancer Center ◽

Cancer Center ◽

Decision Making Process ◽

Post Intervention ◽

Waiting Room ◽

Family Centered

Abstract Objectives Improving family-centered outcomes is a priority in oncologic critical care. As part of the Intensive Care Unit (ICU) Patient-Centered Outcomes Research Collaborative, we implemented patient- and family-centered initiatives in a comprehensive cancer center. Methods A multidisciplinary team was created to implement the initiatives. We instituted an open visitation policy (OVP) that revamped the use of the two-way communication boards and enhanced the waiting room experience by hosting ICU family-centered events. To assess the initiatives’ effects, we carried out pre-intervention (PRE) and post-intervention (POST) family/caregiver and ICU practitioner surveys. Results A total of 159 (PRE = 79, POST = 80) family members and 147 (PRE = 95, POST = 52) ICU practitioners participated. Regarding the decision-making process, family members felt more included (40.5% vs. 68.8%, p < 0.001) and more supported (29.1% vs. 48.8%, p = 0.011) after the implementation of the initiatives. The caregivers also felt more control over the decision-making process in the POST survey (34.2% vs. 56.3%, p = 0.005). Although 33% of the ICU staff considered OVP was beneficial for the ICU, 41% disagreed and 26% were neutral. Only half of them responded that OVP was beneficial for patients and 63% agreed that OVP was beneficial for families. Half of the practitioners agreed that OVP resulted in additional work for staff. Significance of results Our project effectively promoted patient- and family-centered care. The families expressed satisfaction with the communication of information and the decision-making process. However, the ICU staff felt that the initiatives increased their work load. Further research is needed to understand whether making this project universal or introducing additional novel practices would significantly benefit patients admitted to the ICU and their family.

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