scholarly journals Does migrant background predict to what extent colorectal cancer patients want to be informed about their life expectancy? – a cross-sectional analysis

2019 ◽  
Vol 18 (1) ◽  
Author(s):  
Marja Leonhardt ◽  
Katja Aschenbrenner ◽  
Martin E. Kreis ◽  
Johannes C. Lauscher
Keyword(s):  
Colorectal Cancer ◽  
Health Care ◽  
Multivariate Analysis ◽  
Life Expectancy ◽  
Health Care Professionals ◽  
Skills Training ◽  
Migrant Health ◽  
Migration Background ◽  
Cancer Stage ◽  
Migrant Background

Abstract Background Although migrant health is a topic of interest across Europe and although health care services in Germany consider migrant health issues, people with a migrant background often experience difficulties regarding health care provision. The prevalence of various cancers among migrants is lower relative to non-migrants although this equalizes with increasing duration of residence. There are documented differences in health behavior and disease-coping strategies between migrants and non-migrants, but data are scarce on this subject. This analysis investigates the extent of information migrant and non-migrant colorectal cancer (CRC) patients in Germany want about their life expectancy and the level of trust they have in their treating physician. Method Data from 522 CRC patients were collected through a self-reported questionnaire. Migrant background was determined by the patients’ and/or their parents’ birthplace. Bivariate analyses were applied to determine the differences between migrants and non-migrants. A multivariate analysis was used to measure the effect of migration background, demographics, and cancer stage and treatment on the preferred extent of information about life expectancy and trust in their treating physician. Results There were no significant differences regarding demographics or cancer stage and treatment between migrant and non-migrant CRC patients. Having a migrant background had no influence on the level of trust in the treating physician, but migrants preferred to be less informed about their life expectancy than non-migrants (21.4% vs. 13.4%, p = 0.04). The multivariate analysis showed that men (aOR = 2.102, CI: 1.123–3.932) and patients with a non-migrant background (aOR = 5.03, CI: 1.02–24.73) preferred receiving information about the approximate value of their life expectancy, rather than receiving no information. Conclusion The study found more similarities than discrepancies between migrant and non-migrant CRC patients regarding demographic factors and stage of disease and treatment, which may be a consequence of an increasingly homogeneous cross-cultural society. However, cultural differences between the minority and host population remain and should always be taken into account in daily clinical practice and in the communication skills training of health care professionals. The study also indicates that recording migration background into health registers would facilitate migrant-sensitive research.

Improving Communication Skills in Health Care

2013 ◽  
Vol 20 (3) ◽  
pp. 109-117
Author(s):  
Lynda Katz Wilner ◽  
Marjorie Feinstein-Whittaker
Keyword(s):  
Health Care ◽  
Patient Satisfaction ◽  
Communication Skills ◽  
Health Care Professionals ◽  
Skills Training ◽  
International Medical Graduate ◽  
Medical Graduate ◽  
Health Care Environment ◽  
Medical Interpreters ◽  
Accent Modification

Hospital reimbursements are linked to patient satisfaction surveys, which are directly related to interpersonal communication between provider and patient. In today’s health care environment, interactions are challenged by diversity — Limited English proficient (LEP) patients, medical interpreters, International Medical Graduate (IMG) physicians, nurses, and support staff. Accent modification training for health care professionals can improve patient satisfaction and reduce adverse events. Surveys were conducted with medical interpreters and trainers of medical interpreting programs to determine the existence and support for communication skills training, particularly accent modification, for interpreters and non-native English speaking medical professionals. Results of preliminary surveys suggest the need for these comprehensive services. 60.8% believed a heavy accent, poor diction, or a different dialect contributed to medical errors or miscommunication by a moderate to significant degree. Communication programs should also include cultural competency training to optimize patient care outcomes. Examples of strategies for training are included.

Breastfeeding Skills Training for Health Care Professionals: A Systematic Review

2021 ◽  
Author(s):  
Helen Mulcahy ◽  
Llyod F. Philpott ◽  
Michelle O’Driscoll ◽  
Róisín Bradley ◽  
Patricia Leahy-Warren
Keyword(s):  
Systematic Review ◽  
Health Care ◽  
Health Care Professionals ◽  
Skills Training

Depression, Fatigue, and QoL in Colorectal Cancer Patients During and After Treatment

2016 ◽  
Vol 38 (7) ◽  
pp. 893-908 ◽  
Author(s):  
Hong-Yi Tung ◽  
Tung-Bo Chao ◽  
Yu-Hua Lin ◽  
Shu-Fen Wu ◽  
Hui-Yen Lee ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Colorectal Cancer ◽  
Health Care ◽  
Cancer Patients ◽  
Health Care Professionals ◽  
Nursing Intervention ◽  
Prevalence Of Depression ◽  
Study Population ◽  
Colorectal Cancer Patients

In this study, we sought to explore the prevalence of depression and fatigue in colorectal cancer patients during and after treatment to examine how these variables affect quality of life (QoL). In total, 170 patients with colorectal cancer participated in this study. The study population was divided into two groups: one receiving treatment and another that had finished treatment. The results showed that depression and fatigue measurements were higher in patients receiving treatment. Depression was a strong and significant predictor of QoL in both groups, whereas fatigue was not, with the exception of the symptom score. These findings underscore the importance of early detection and management of depression and fatigue during the treatment and survival stages of patients with colorectal cancer. Our findings indicate that health care professionals should provide appropriate nursing intervention to decrease depression and fatigue and enhance patient QoL.

scholarly journals Developing a Self-Administered Decision Aid for Fecal Immunochemical Test�Based Colorectal Cancer Screening Tailored to Citizens With Lower Educational Attainment: Qualitative Study (Preprint)

2017 ◽  
Author(s):  
Pernille Gabel ◽  
Pia Kirkegaard ◽  
Mette Bach Larsen ◽  
Adrian Edwards ◽  
Berit Andersen
Keyword(s):  
Colorectal Cancer ◽  
Health Care ◽  
Cancer Screening ◽  
Colorectal Cancer Screening ◽  
Health Care Professionals ◽  
Decision Aid ◽  
Information Needs ◽  
Screening Participation ◽  
Beta Testing ◽  
Cancer Screening Participation

BACKGROUND Citizens with lower educational attainments (EA) take up colorectal cancer screening to a lesser degree, and more seldom read and understand conventional screening information than citizens with average EAs. The information needs of citizens with lower EA are diverse, however, with preferences ranging from wanting clear recommendations to seeking detailed information about screening. Decision aids have been developed to support citizens with lower EA in making informed decisions about colorectal cancer screening participation, but none embrace diverse information needs. OBJECTIVE The aim of this study was to develop a self-administered decision aid for participation in fecal immunochemical test–based colorectal cancer screening. The decision aid should be tailored to citizens with lower EA and should embrace diverse information needs. METHODS The Web-based decision aid was developed according to an international development framework, with specific steps for designing, alpha testing, peer reviewing, and beta testing the decision aid. In the design phase, a prototype of the decision aid was developed based on previous studies about the information needs of lower EA citizens and the International Patient Decision Aid Standards guidelines. Alpha testing was conducted using focus group interviews and email correspondence. Peer review was conducted using email correspondence. Both tests included both lower EA citizens and health care professionals. The beta testing was conducted using telephone interviews with citizens with lower EA. Data were analyzed using thematic analysis. RESULTS The developed decision aid presented information in steps, allowing citizens to read as much or as little as wanted. Values clarification questions were included after each section of information, and answers were summarized in a “choice-indicator” on the last page, guiding the citizens toward a decision about screening participation. Statistics were presented in both natural frequencies, absolute risk formats and graphically. The citizens easily and intuitively navigated around the final version of the decision aid and stated that they felt encouraged to think about the benefits and harms of colorectal cancer screening without being overloaded with information. They found the decision aid easy to understand and the text of suitable length. The health care professionals agreed with the citizens on most parts; however, concerns were raised about the length and readability of the text. CONCLUSIONS We have developed a self-administered decision aid presenting information in steps. We involved both citizens and health care professionals to target the decision aid for citizens with lower EA. This decision aid represents a new way of communicating detailed information and may be able to enhance informed choices about colorectal cancer screening participation among citizens with lower EA.

scholarly journals Health care professionals' attitudes towards deprescribing in older patients with limited life expectancy: A systematic review

2019 ◽  
Vol 85 (5) ◽  
pp. 868-892 ◽  
Author(s):  
Carina Lundby ◽  
Trine Graabæk ◽  
Jesper Ryg ◽  
Jens Søndergaard ◽  
Anton Pottegård ◽  
...  
Keyword(s):  
Systematic Review ◽  
Health Care ◽  
Life Expectancy ◽  
Health Care Professionals ◽  
Older Patients ◽  
Limited Life Expectancy ◽  
Limited Life

scholarly journals CLINICAL AND ECONOMIC JUSTIFICATION OF SOFTWARE SCREENING PERFORMANCE OF COLORECTAL CANCER AT THE REGION LEVEL

2021 ◽  
Vol 9 (6) ◽  
pp. 465-475
Author(s):  
Yu. Yu. Petukhova ◽  
E. V. Eliseeva ◽  
A. G. Petukhova
Keyword(s):  
Colorectal Cancer ◽  
Health Care ◽  
Life Expectancy ◽  
Economic Analysis ◽  
Economic Research ◽  
Malignant Neoplasms ◽  
Clinical Effects ◽  
Crc Screening ◽  
Economic Justification ◽  
The Cost

The aim of the study is to assess the clinical and economic effectiveness of the practical implementation results of programmed screening for colorectal cancer (CRC) in the Primorsky Territory using clinical and economic research methods.Materials and methods. In the study, the following kinds of data were used: the statistical data from the regional clinic’s cancer registry on the structure of the morbidity and average life expectancy of CRC patients in the Primorsky Territory; the data on the cost of screening studies and the stages of anticancer therapy in accordance with the “Territorial Tariff Agreement on Payment for Medical Care (Medical Services) in the System of Compulsory Health Insurance in the Territory of Primorsky Krai”, 2021. Two methods of clinical and economic analysis with the corresponding calculation formulas have been applied. The cost of medical interventions were estimated in accordance with the screening standards and clinical guidelines for the treatment of malignant neoplasms of the colon and rectum, approved by the Scientific and Practical Council of the Ministry of Health of the Russian Federation, 2020.Results. The evidence-based substantiation of screening clinical effects has been obtained: the structure redistribution of colorectal cancer incidence towards the prevalence of early forms by 16.81%; the average increase in the life expectancy of patients with the studied disease is 12.8 months. A natural consequence of these events is the predicted decrease in the mortality rate from CRC in the territory of the subject in the subsequent years. The economic justification of CRC screening software which guarantees a significant saving in health care resources amounting to 23% compared to an alternative strategy, has been demonstrated. It can influence the management decisions on the further strategy of the mass introduction of this medical technology.Conclusion. Currently, CRC screening is the most effective way to reduce morbidity and mortality from this disease. The predominance of the early diagnosis of the disease is extrapolated to significant savings in public health care. A promising direction for further research in the field of CRC screening is the study of its long-term effects, in particular, a detailed clinical and economic analysis of the diagnostics effectiveness and the elimination of premalignant neoplasms.

scholarly journals Az igazságosság és a besorolás etikai problémái az egészségügyben, különös tekintettel a COVID–19-járvány olaszországi tapasztalataira

2020 ◽  
Vol 161 (45) ◽  
pp. 1899-1907
Author(s):  
Orsolya Márta Péter
Keyword(s):  
Health Care ◽  
Intensive Care ◽  
Life Expectancy ◽  
Health Care Professionals ◽  
Scarce Resources ◽  
Probability Of Survival ◽  
Sensitive Issue ◽  
Life Saving ◽  
Heated Debate ◽  
Utilitarian Approach

Összefoglaló. A 2020. év elején kirobbant COVID–19-világjárvány többek között ráirányította a figyelmet az életmentő-életfenntartó kezelések igazságos elosztásának érzékeny kérdésére is. Európán belül elsőként Olaszországot sújtotta a katasztrófa, a válsághelyzetben pedig az érzéstelenítés, fájdalomcsillapítás, újraélesztés és intenzív ellátás területén tevékenykedő szakemberek olasz társasága, a SIAARTI 2020. március 6-án közzétett egy 15 pontos ajánlást. E szerint utilitarista megközelítéssel a rendelkezésre álló szűkös erőforrásokat azon betegek kezelésére kellene fordítani, akik túlélési esélye nagyobb, valamint több életévre számíthatnak a jövőben, mert ez biztosíthatja a lehető legtöbb ember számára a lehető legnagyobb hasznot. A javaslat komoly szakmai vitát robbantott ki, amely egyértelművé tette, hogy az orvosi eszközök igazságos elosztására vonatkozó diskurzust feltétlenül folytatni kell, nemcsak Olaszországon belül, hanem a pandémiától sújtott többi államban is. Orv Hetil. 2020; 161(45): 1899–1907. Summary. Among other queries, the explosion of the COVID-19 pandemic at the beginning of 2020 has firmly put in focus the sensitive issue of how to allocate scarcely available life-saving treatments in a fair and just manner. The first European country to face an emergency caused by the pandemic was Italy. In a rapidly escalating crisis, on 6th March 2020, the Italian Society of Anaesthesia, Analgesia, Resuscitation, and Intensive Care (SIAARTI) issued a series of 15 recommendations, suggesting that a utilitarian approach should be adopted in Italian health care and the extremely scarce resources should be reserved for patients with a greater probability of survival and life expectancy, in order to maximize the benefits for the largest possible number of people. The recommendations generated a heated debate among health care professionals, thereby evidencing that similar discussions must be initiated and pursued in all countries affected by the pandemic. Orv Hetil. 2020; 161(45): 1899–1907.

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