scholarly journals “The support has been brilliant”: experiences of Aboriginal and Torres Strait Islander patients attending two high performing cancer services

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Emma V. Taylor ◽  
Marilyn Lyford ◽  
Michele Holloway ◽  
Lorraine Parsons ◽  
Toni Mason ◽  
...  
Keyword(s):  
Health Outcomes ◽  
Cancer Patients ◽  
Indigenous People ◽  
Cancer Care ◽  
Family Members ◽  
Hospital Staff ◽  
Cultural Safety ◽  
National Study ◽  
High Performing ◽  
Cancer Services

Abstract Background Improving health outcomes for Indigenous people by providing person-centred, culturally safe care is a crucial challenge for the health sector, both in Australia and internationally. Many cancer providers and support services are committed to providing high quality care, yet struggle with providing accessible, culturally safe cancer care to Indigenous Australians. Two Australian cancer services, one urban and one regional, were identified as particularly focused on providing culturally safe cancer care for Indigenous cancer patients and their families. The article explores the experiences of Indigenous cancer patients and their families within the cancer services and ascertains how their experiences of care matches with the cancer services’ strategies to improve care. Methods Services were identified as part of a national study designed to identify and assess innovative services for Indigenous cancer patients and their families. Case studies were conducted with a small number of identified services. In-depth interviews were conducted with Indigenous people affected by cancer and hospital staff. The interviews from two services, which stood out as particularly high performing, were analysed through the lens of the patient experience. Results Eight Indigenous people affected by cancer and 23 hospital staff (Indigenous and non-Indigenous) were interviewed. Three experiences were shared by the majority of Indigenous cancer patients and family members interviewed in this study: a positive experience while receiving treatment at the cancer service; a challenging time between receiving diagnosis and reaching the cancer centre; and the importance of family support, while acknowledging the burden on family and carers. Conclusions This article is significant because it demonstrates that with a culturally appropriate and person-centred approach, involving patients, family members, Indigenous and non-Indigenous staff, it is possible for Indigenous people to have positive experiences of cancer care in mainstream, tertiary health services. If we are to improve health outcomes for Indigenous people it is vital more cancer services and hospitals follow the lead of these two services and make a sustained and ongoing commitment to strengthening the cultural safety of their service.

scholarly journals Triaging and adaptations of surveillance of cancer services in the COVID pandemic

2020 ◽  
pp. 1-3
Author(s):  
Shirley Lewis ◽  
Lavanya Gurram ◽  
Umesh Velu ◽  
Krishna Sharan
Keyword(s):  
Cancer Patients ◽  
Clinical Examination ◽  
Cancer Care ◽  
Middle Income ◽  
Face To Face ◽  
Middle Income Countries ◽  
Cancer Services ◽  
Low Middle Income Countries

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.

How Families Make Their Way Into Your Heart: Exploring the Associations Between Daily Experiences Involving Family Members and Cardiovascular Health

2021 ◽  
Author(s):  
Hye Won Chai ◽  
David M Almeida
Keyword(s):  
Older Adults ◽  
Health Outcomes ◽  
Cardiovascular Health ◽  
Family Members ◽  
The United States ◽  
Cardiovascular Outcomes ◽  
National Study ◽  
Public Health Issue ◽  
Negative Experiences ◽  
Daily Experiences

Abstract Background Cardiovascular disease is a critical public health issue and a growing body of literature on relationships and health point to individuals’ interactions and involvement with family members as significant correlates of cardiovascular outcomes. However, less is known about the implications of daily encounters with family members on cardiovascular health outcomes and how the associations vary across adulthood. Purpose The aims of this study were to examine the associations of positive and negative daily experiences with family members with comprehensive measures of cardiovascular health and to further explore how age moderates these associations. Methods This study used data from the Midlife in the United States (MIDUS) II and MIDUS Refresher. The sample was composed of respondents who participated in two subprojects of MIDUS, namely the National Study of Daily Experiences (NSDE) and Biomarker Project (N = 1,312). Indices of cardiovascular health included inflammatory markers, autonomic functioning, and Life’s Simple 7 scores. Results Results showed that the associations between daily family experiences and cardiovascular outcomes differed by age. Having more daily negative experiences with family members was associated with better cardiovascular health outcomes among young adults and worse cardiovascular outcomes among older adults. Having more daily positive experiences was also associated with lower heart rate variability for older adults. Conclusions Results revealed that contrary to the general assumption that negative experiences have health-damaging effects, frequent involvement with family members in daily life, even negative ones, may be indicative of active engagement in life that could be health promoting for younger adults.

scholarly journals Measuring health care experiences that matter to Indigenous people in Australia with cancer: identifying critical gaps in existing tools

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Monica Green ◽  
Joan Cunningham ◽  
Kate Anderson ◽  
Kalinda Griffiths ◽  
Gail Garvey
Keyword(s):  
Health Care ◽  
Indigenous People ◽  
Patient Experience ◽  
Health Care Providers ◽  
Cancer Care ◽  
Cultural Safety ◽  
Service Improvement ◽  
Care Providers ◽  
Indigenous Worldview ◽  
Critical Aspects

Abstract Background Measurement of patients’ healthcare experiences is increasingly used as an indicator of quality of care, but there are concerns that existing measures omit information that is meaningful to patients and that results may not be used systematically to inform service improvement. Further, current approaches may be inadequate for some population groups, such as Indigenous people in Australia, whose healthcare experience is impacted by the context of colonisation and discordance between Indigenous understandings of health and the Western biomedical health system. This study aimed to assess the extent to which existing patient experience measures used in Australia collect information about critical aspects of cancer care, as previously identified by Indigenous people affected by cancer and their health care providers. Methods A two-stage process was used to examine the adequacy of existing patient experience measures for Indigenous people in Australia: (1) relevant tools and measures were identified and assessed, and four measures selected as suitable comparators; (2) comparators were examined in detail and mapped against topics identified in earlier research as important to Indigenous people with cancer. Gaps in topic coverage in comparators were identified. Results No comparators completely captured the critical aspects of cancer care identified by Indigenous people affected by cancer and their health care providers. The number of topics ‘partially’ captured by the four comparators ranged from 4 to 7 out of 9. While most topics were partially covered, the lack of questions around culture and cultural safety was notable. Conclusions Existing tools are likely to miss key aspects of Indigenous peoples’ experiences of cancer care in Australia. Failure to adequately assess care experiences related to cultural safety may compromise efforts to improve health outcomes. Addressing gaps requires development of experience measures that are strengths-based, reflect an Indigenous worldview and measure aspects of experience relevant to Indigenous people.

scholarly journals Transforming Community Cancer Care: The Ottawa Regional Cancer Foundation’s Cancer Coaching Practice

2017 ◽  
Vol 7 (1) ◽  
Author(s):  
Linda Eagen ◽  
Johanne Levesque
Keyword(s):  
Health Outcomes ◽  
Cancer Care ◽  
Positive Impact ◽  
Community Services ◽  
Annual Number ◽  
Community Based ◽  
Cancer Statistics ◽  
Landscape Services ◽  
Cancer Services ◽  
Per Capita

Community services are an increasingly important part of the healthcare landscape. Services that work to empower patients and their caregivers are having a positive impact on health outcomes and helping to reduce per capita costs of healthcare. According to the 2015 Canadian Cancer Statistics Report, by 2030 the annual number of new cancer cases in Canada is expected to increase by 79% [1]. Community-based cancer services, in particular, are urgently required to meet the growing demand for care as the complexity of the disease and its treatment continues to grow. RÉSUMÉ Les services communautaires jouent un rôle de plus en plus important dans les soins de santé. Les services qui veillent à habiliter les patients et leurs proches aidants ont un effet positif sur les résultats en matière de santé et aident à réduire les coûts par personne des soins de santé. D’ici 2030, le nombre annuel de nouveaux cas de cancer au Canada devrait augmenter de 79 % selon le rapport Statistiques canadiennes sur le cancer 2015 [1]. Des services communautaires pour le traitement du cancer, notamment, sont requis de toute urgence afin de répondre à la demande croissante de soins, alors que la complexité de la maladie et de son traitement ne cesse de croître. 

Strategies to embed palliative care into a culture of cancer care.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e21678-e21678
Author(s):  
Angela Marie Taber ◽  
Susan F. Korber ◽  
Edward Martin ◽  
Anthony E. Mega
Keyword(s):  
Palliative Care ◽  
Health System ◽  
Cancer Patients ◽  
Cancer Care ◽  
Medical Oncology ◽  
National Study ◽  
Claims Analysis ◽  
Patient Centered ◽  
Medicare Claims ◽  
Multi Level

e21678 Background: In 2012, the 3 hospital Lifespan Health System launched a palliative care initiative. The hospitals and medical oncologists knew this was critical for patient centered and value-based cancer care, but recognized many barriers: physician practice patterns, lack of dedicated resources and systems, patient and family education gaps, and limited return on investment in the current environment. A multi-level inpatient and outpatient strategy was implemented and tracked over four years. Methods: External benchmarking data from a Medicare claims analysis of Vizient (academic health system consortium) member organizations and from ASCO QOPI data were used in the analysis. Internal data analysis included a study on symptom management for lung cancer patients, hospital reports on palliative care service utilization, ED visits and hospital admission trends for cancer patients. Multi-level interventions were employed: hospital investment in staff and systems, partnership with a community-based hospice and palliative care provider, a medical oncology physician champion with Board certification in palliative care, a palliative care inpatient consult service and daily ICU rounds, an oncology medical home, medical oncologist Saturday hours, electronic prompts for consults, and a cancer call triage center. Results: A Medicare claims analysis for 2012 to 2014 on cancer decedents with ICU stays in the last 30 days in the Vizient national study of health systems showed that Lifespan was at the 11th percentile, making them the 4th lowest (days in ICU) in performance (pre/post data requested). QOPI data on appropriate referrals to hospice or palliative care prior to death improved from 58% in 2010, which was below the QOPI benchmark of 61%, to 94% in 2016 which is above the QOPI benchmark of 74%. Other QOPI and hospital data will be included in the presentation. Conclusions: Palliative care, a crucial tool for the delivery of future cancer care, is challenging to implement effectively. This study shows that a hospital/medical oncology partnership can drive change to embed palliative care into the culture of cancer care and these strategies offer a roadmap for others to follow as they strive to offer patient centered and value-based cancer care.

scholarly journals Action Research: Benevolence and Barriers of Reciprocal Career Plan for Cancer Community

2018 ◽  
Vol 4 (Supplement 2) ◽  
pp. 105s-105s
Author(s):  
K.Y. Cheng ◽  
C.L. Chi ◽  
Y. Chen ◽  
Y.W. Wang ◽  
L.Y. Tseng ◽  
...  
Keyword(s):  
Action Research ◽  
Cancer Patients ◽  
Cancer Care ◽  
Family Members ◽  
Reciprocal Relationship ◽  
Full Time ◽  
Mutual Help ◽  
Career Plan ◽  
Working Space ◽  
Service To Others

Background: There are 106 cancer communities organized by cancer patients and their family members as volunteers. Mutual help between patients and family members, according to practical experiences and researches, is more important and irreplaceable than professional help. Hence all service projects set off by Hope Foundation for Cancer Care aims at helping to bridge mutual help and coping skills among patients. In recent years, cancer patients are getting younger and younger, and their financial status for medical and daily expenses become heavy weight. In addition, cancer is proven to be a chronic disease. It is inevitable for cancer patients to return to workforce. Therefore, supporting cancer patients for employment is one of the major ways we can help patients to maintain their quality of life. Namely, being used acts bifacade to family financial sources and self-identifications. Aim: In response to their need for financial support and identity empowerment, Hope Foundation for Cancer Care offers reciprocal career plan for cancer community through action researches to support cancer patients build up active plans for participation in working fields. Hope Foundation also encourages patients to take part in the decision making process, so that the foundation can offer its service in accordance to patients' needs. Methods: Action research was carried out for one year. 3 patient-workers and 3 full-time workers were included in this plan. Results: Staff members' workload reduced since the patients joined the team. Together they went through nine meetings to improve the space and the procedure of the service they are offering. These meetings and discussions not only facilitated management of the organization, but also allow the patients to express their ideas and creativity as well as enhance their own authority at work. However, due to bureaucracy of the organization, ideas proposed by the patients often took a long period of time to receive response, which potentially caused them to hold back. Therefore, they were at best partly empowered at work. On the other hand, they who'd gone through cancer themselves, helped the staff to optimize the service to others by bridging their own experiences and participating in discussions with staffs of the organization. Such reciprocal relationship between the patients and the organization embodies the very aim of this project. Conclusion: Two among the three patient-workers were officially recruited as employees in 2018. From patients to paid staffs, they transformed from receiving help to giving help. After the project ran for a year, all the staffs agreed that these patient-workers made a big contribution to the foundation. Not only did they help build the working space more friendly because of their physical conditions, but challenge the foundation to adapt more flexible management tactics, which reflects our core value - to serve for the rights of the patients.

scholarly journals Measuring Health Care Experiences that Matter to Indigenous People in Australia with Cancer: Identifying Critical Gaps in Existing Tools

2020 ◽  
Author(s):  
Monica Green ◽  
Joan Cunningham ◽  
Kate Anderson ◽  
Kalinda Griffiths ◽  
Gail Garvey
Keyword(s):  
Health Care ◽  
Indigenous People ◽  
Patient Experience ◽  
Health Care Providers ◽  
Cancer Care ◽  
World View ◽  
Cultural Safety ◽  
Care Providers ◽  
Care Experience ◽  
Critical Aspects

Abstract Background: The measurement of patients’ experiences of healthcare is increasingly used as an indicator of the quality of care. There are concerns that many mechanisms used to collect patient experience data produce large amounts of superficial data, while missing deeper, more nuanced information that is meaningful to the patient, and that insufficient attention is paid to whether the information is used to make a difference to health care. This is particularly so for Indigenous people in Australia, whose health care experience is impacted by the context of colonisation and discordance between Indigenous understandings of health and the biomedical health system. The aim of this study was to assess the extent to which existing patient experience measures currently in use in Australia collect information about the most critical aspects of cancer care, as identified by Indigenous people affected by cancer and their health care providers in previous research. Methods: A two-stage process was used to examine the adequacy of existing patient experience measures for Indigenous people in Australia: (1) relevant tools and measures were identified and assessed, and four measures were selected as suitable comparators; (2) the comparators were examined in detail and mapped against the topics identified in our earlier research as important to Indigenous people affected by cancer. Gaps in topic coverage in the comparators were identified. Results: No comparators completely captured the critical aspects of cancer care identified by Indigenous people with cancer and their health care providers. The number of topics ‘partially’ captured by the four comparators ranged from 4 to 7 out of 9. While most topics were at least partially covered, the lack of questions around culture and cultural safety was notable. Conclusions: Existing patient experience measurement tools are likely to miss some key aspects of Indigenous peoples’ experiences of cancer care in Australia. Failure to adequately assess experiences of care related to cultural safety may compromise efforts to improve health outcomes. Addressing the gaps requires the development of experience measures that are strengths-based, reflect an Indigenous world view and measure aspects of experience that are relevant to Indigenous people.

Identifying Potential Indicators of the Quality of End-of-Life Cancer Care From Administrative Data

2003 ◽  
Vol 21 (6) ◽  
pp. 1133-1138 ◽  
Author(s):  
Craig C. Earle ◽  
Elyse R. Park ◽  
Bonnie Lai ◽  
Jane C. Weeks ◽  
John Z. Ayanian ◽  
...  
Keyword(s):  
End Of Life ◽  
Cancer Patients ◽  
Quality Indicators ◽  
Administrative Data ◽  
Cancer Care ◽  
Symptom Control ◽  
Family Members ◽  
Data Systems ◽  
Delphi Approach

Purpose: To explore potential indicators of the quality of end-of-life services for cancer patients that could be monitored using existing administrative data. Methods: Quality indicators were identified and assessed by literature review for proposed indicators, focus groups with cancer patients and family members to assess candidate indicators and generate new ideas, and an expert panel ranking the meaningfulness and importance of each potential indicator using a modified Delphi approach. Results: There were three major concepts of poor quality of end-of-life cancer care that could be examined using currently-available administrative data (such as Medicare claims): institution of new anticancer therapies or continuation of ongoing treatments very near death; a high number of emergency room visits, inpatient hospital admissions, or intensive care unit days near the end of life; and a high proportion of patients never enrolled in hospice, only admitted in the last few days of life, or dying in an acute-care setting. Concepts such as access to psychosocial and other multidisciplinary services and pain and symptom control are important and may eventually be feasible, but they cannot currently be applied in most data systems. Indicators based on limiting the use of treatments with low probability of benefit or indicators based on economic efficiency were not acceptable to patients, family members, or physicians. Conclusion: Several promising claims-based quality indicators were identified that, if found to be valid and reliable within data systems, could be useful in identifying health-care systems in need of improving end-of-life services.

scholarly journals Equity-Oriented Healthcare: What It Is and Why We Need It in Oncology

2022 ◽  
Vol 29 (1) ◽  
pp. 186-192
Author(s):  
Tara C. Horrill ◽  
Annette J. Browne ◽  
Kelli I. Stajduhar
Keyword(s):  
Health Outcomes ◽  
Access To Care ◽  
Health Equity ◽  
Cancer Care ◽  
Socially Disadvantaged ◽  
Cancer Services ◽  
Social Inequities ◽  
Cancer Trajectory ◽  
Taking Action ◽  
Related Mortality

Alarming differences exist in cancer outcomes for people most impacted by persistent and widening health and social inequities. People who are socially disadvantaged often have higher cancer-related mortality and are diagnosed with advanced cancers more often than other people. Such outcomes are linked to the compounding effects of stigma, discrimination, and other barriers, which create persistent inequities in access to care at all points in the cancer trajectory, preventing timely diagnosis and treatment, and further widening the health equity gap. In this commentary, we discuss how growing evidence suggests that people who are considered marginalized are not well-served by the cancer care sector and how the design and structure of services can often impose profound barriers to populations considered socially disadvantaged. We highlight equity-oriented healthcare as one strategy that can begin to address inequities in health outcomes and access to care by taking action to transform organizational cultures and approaches to the design and delivery of cancer services.

scholarly journals Mental Health of Sexual and Gender Minority Oncology Patients: Synthesis of Recommendations for Advancing Health Equity

2021 ◽  
Vol 2 (4) ◽  
pp. 279-298
Author(s):  
Kaitlin J. Huelsman ◽  
Brittany J. Wright ◽  
Jessica R. Vanderlan ◽  
David H. Morris ◽  
Amaris R. Tippey
Keyword(s):  
Mental Health ◽  
Health Outcomes ◽  
Cancer Patients ◽  
Cancer Care ◽  
Mental Health Outcomes ◽  
Health Concerns ◽  
Gender Minority ◽  
Increased Risk ◽  
Sexual And Gender Minority ◽  
And Gender

Sexual and gender minority (SGM) individuals are at increased risk for several health concerns, including those related to mental health. This increased risk, combined with the unique psychosocial challenges faced by SGM cancer patients, leads to disparities in mental health outcomes across the cancer care continuum. Despite these disparities, little to no resources (e.g. SGM groups, SGM cancer-related literature) exist within most cancer institutes to target SGM populations for appropriate cancer care, such as cancer prevention, accessible treatment, end-of-life, and survivorship concerns, which all may impact psychological wellbeing. This paper synthesizes existing recommendations, both general and cancer-specific, pertaining to the mental health concerns of SGM individuals with hope to provide a valuable resource for cancer institutes and providers on how to better address the unique mental health outcomes of SGM cancer patients. Additional input was obtained from stakeholders from a large, Midwestern, NCI-designated cancer center in an effort to expand our understanding of SGM cancer patients' needs. Through review of relevant guidelines and recommendations and feedback from stakeholder meetings, five broad areas of recommendation for improving SGM cancer care were identified: welcoming environment, patient education and support, community connections, standard approach to care, and research. Rooted in pertinent psychological constructs, each recommendation provides suggestions for increasing attention to SGM patients' psychosocial oncological needs. These recommendations seek to establish culturally inclusive and responsive climates where all SGM cancer patients feel valued and respected.

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