Coaching intervention as a strategy for enhancing accrual to phase I/II clinical trials

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 6580-6580
Author(s):  
P. M. Fracasso ◽  
M. S. Walker ◽  
K. J. Mathews ◽  
H. P. Morgan ◽  
S. A. Goodner ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Clinical Trials ◽  
Health Care Providers ◽  
Healthcare Providers ◽  
Medical Mistrust ◽  
Care Providers ◽  
Coaching Intervention ◽  
Perceptions Of Racism ◽  
Prostate Cancers

6580 Background: Lack of both trust and rapport with health care providers has been identified as possible causes for under- representation of minorities within clinical trials. Our study used a “Peer Coach” (PC) to promote trust among minority patients with advanced cancer. Methods: Minority patients with advanced breast, colorectal, lung, or prostate carcinoma were randomly assigned to receive a PC or “Usual Care” (UC). Patients completed baseline and 6-month telephone interviews to assess demographics, trust in healthcare providers, attitudes toward clinical trials, and quality of life. Patients randomized to the coaching intervention were assigned a coach, trained in health communications, who made biweekly contacts for 6 months to address general issues, progress or development in cancer care, and available resources. Patients randomized to UC received no further intervention. Results: Over 21 months, we screened 268 patients and enrolled 73 African Americans and 2 Asians (56 women and 19 men) including 38, 18, 13, and 6 patients with breast, colorectal, lung and prostate cancers, respectively. Patients were randomly assigned to PC (38) and UC (37), with no baseline differences. Longitudinal data analysis was conducted on 69 patients who completed the 6-month follow-up assessment. Trial enrollment was slightly higher in the PC group but was found to be non-significant (p=0.226). Trust in doctor (p=0.053), absence of depressed mood (p=0.032) and higher quality of life (p=0.052) predicted enrollment. Adherence to care was unrelated to the assigned group and, in the PC group, to the number of coach contacts. Baseline depression was associated with missed physician appointments (p=0.039). There was no difference between the PC and UC groups on attitudes towards clinical trials, perceptions of racism, trust in doctor, medical mistrust, depression, or quality of life. Conclusions: Psychosocial elements of trust in doctor, depression and quality of life were found to predict trial enrollment, regardless of assignment to PC or UC. Future studies should include a more structured approach to clinical trial promotion, follow patients over a longer period, and consider treatment of depression given its association with trial enrollment and adherence. No significant financial relationships to disclose.

scholarly journals Psoriasis pathophysiology and impact on life

2018 ◽  
Vol 5 (9) ◽  
pp. 3663 ◽  
Author(s):  
Tariq Alharbi ◽  
Ali Alzahrani ◽  
Afaf Hakami ◽  
Adeeb Almohammadi ◽  
Abdullah Alsaadi ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Health Care Providers ◽  
Negative Impact ◽  
Healthcare Providers ◽  
Management Plan ◽  
Care Providers ◽  
Comprehensive Search ◽  
Control Disease ◽  
Chronic Skin

Psoriasis is a chronic skin disorder with various morphology, distribution, severity, and course of disease. The goal of the management is to control disease activity to a level that allows a sufficient quality of life with minimal toxicity from the treatment itself. Unfortunately, 25% of patients suffering from psoriasis experience major psychological distress. Its chronic nature with associated comorbidities has a negative impact on quality of life. We conducted this review using a comprehensive search of MEDLINE, PubMed and EMBASE from January 1996 to March 2017. The following search terms were used: psoriasis, pathogenesis of psoriasis, psoriasis management, quality of life in psoriasis patients. We tried to study the pathogenesis, and management of psoriasis, and understand its effect on the quality of life of patients. Due to the chronic nature and its obvious visibility on skin, many patients suffer from major psychological adverse effects. In majority of the time the health care providers fail to recognize or treat such comorbidities. Healthcare providers must be educated to provide patients with ways to tackle issues with multiple aspects, including psychological, in the management plan for better results.

scholarly journals Psychological risk factors that characterize the trajectories of quality of life after a physical trauma: a longitudinal study using latent class analysis

2021 ◽  
Author(s):  
Eva Visser ◽  
Brenda Leontine Den Oudsten ◽  
Taco Gosens ◽  
Paul Lodder ◽  
Jolanda De Vries
Keyword(s):  
Quality Of Life ◽  
Latent Class Analysis ◽  
Health Care Providers ◽  
Psychological Health ◽  
Latent Class ◽  
Stress Disorder ◽  
Class Analysis ◽  
Care Providers ◽  
Physical Trauma

Abstract Background The course and corresponding characteristics of quality of life (QOL) domains in trauma population are unclear. Our aim was to identify longitudinal QOL trajectories and determine and predict the sociodemographic, clinical, and psychological characteristics of trajectory membership in physical trauma patients using a biopsychosocial approach. Methods Patients completed a questionnaire set after inclusion, and at 3, 6, 9, and 12 months follow-up. Trajectories were identified using repeated-measures latent class analysis. The trajectory characteristics were ranked using Cohen’s d effect size or phi coefficient. Results Altogether, 267 patients were included. The mean age was 54.1 (SD = 16.1), 62% were male, and the median injury severity score was 5.0 [2.0—9.0]. Four latent trajectories were found for psychological health and environment, five for physical health and social relationships, and seven trajectories were found for overall QOL and general health. The trajectories seemed to remain stable over time. For each QOL domain, the identified trajectories differed significantly in terms of anxiety, depressive symptoms, acute stress disorder, post-traumatic stress disorder, Neuroticism, trait anxiety, Extraversion, and Conscientiousness. Discussion Psychological factors characterized the trajectories during 12 months after trauma. Health care providers can use these findings to identify patients at risk for impaired QOL and offer patient-centered care to improve QOL.

scholarly journals Patient Suffering in Chronic Digestive Diseases: Will Primary Care-Specialist Collaboration With Effective Interactive Communication and Integrative Medicine in the Plan of Care Improve Quality of Life?

2020 ◽  
Vol 7 (6) ◽  
pp. 989-993
Author(s):  
Andrew Thomas ◽  
Annie Thomas
Keyword(s):  
Quality Of Life ◽  
Primary Care ◽  
Health Care ◽  
Health Care Providers ◽  
The United States ◽  
Care Providers ◽  
Physician Visits ◽  
Digestive Diseases ◽  
Care Specialist

Acute and chronic digestive diseases are causing increased burden to patients and are increasing the United States health care spending. The purpose of this case report was to present how nonconfirmatory and conflicting diagnoses led to increased burden and suffering for a patient thus affecting quality of life. There were many physician visits and multiple tests performed on the patient. However, the primary care physician and specialists could not reach a confirmatory diagnosis. The treatment plans did not offer relief of symptoms, and the patient continues to experience digestive symptoms, enduring this burden for over 2 years. The central theme of this paper is to inform health care providers the importance of utilizing evidence-based primary care specialist collaboration models for better digestive disease outcomes. Consistent with patient’s experience, the authors propose to pilot/adopt the integrative health care approaches that are proven effective for treating digestive diseases.

How Are You Feeling? Who Wants To Know? Patients’ and Oncologists’ Preferences for Discussing Health-Related Quality-of-Life Issues

2000 ◽  
Vol 18 (18) ◽  
pp. 3295-3301 ◽  
Author(s):  
S.B. Detmar ◽  
N.K. Aaronson ◽  
L.D. V. Wever ◽  
M. Muller ◽  
J.H. Schornagel
Keyword(s):  
Quality Of Life ◽  
Health Care Providers ◽  
Physical Symptoms ◽  
Psychosocial Issues ◽  
Care Providers ◽  
Health Related Quality ◽  
Wide Range ◽  
Related Quality ◽  
Health Related

PURPOSE: This study investigated (1) the attitudes of cancer patients toward discussing health-related quality-of-life (HRQL) issues; (2) the association between such attitudes and patients’ characteristics; and (3) oncologists’ attitudes and self-reported behavior regarding these same issues. PATIENTS AND METHODS: Two hundred seventy-three patients receiving palliative chemotherapy and ten physicians were asked to complete a series of questionnaires. RESULTS: Almost all patients wanted to discuss their physical symptoms and physical functioning and were also willing to address their emotional functioning and daily activities. However, 25% of the patients were only willing to discuss these latter two issues at the initiative of their physician. Patients varied most in their willingness to discuss their family and social life, with 20% reporting no interest in discussing these issues at all. Female patients were more reluctant to discuss various HRQL issues than male patients. Older and less well-educated patients were more likely to prefer that their physician initiate discussion of HRQL issues. All physicians considered it to be primarily their task to discuss the physical aspects of their patients’ health, whereas four physicians indicated that discussion of psychosocial issues was a task to be shared with other health care providers. All physicians indicated that they generally defer to their patients in initiating discussion of psychosocial issues. CONCLUSION: Although both patients and oncologists seem willing to discuss a wide range of HRQL issues, communication regarding psychosocial issues may be hampered by competing expectations as to who should take the lead in initiating such discussions.

ALS caregiver quality of life and psychological implications

2018 ◽  
Author(s):  
Peggy Z. Shipley
Keyword(s):  
Quality Of Life ◽  
Family Caregivers ◽  
Health Care Providers ◽  
Care Providers ◽  
Physical And Mental Health ◽  
Emotional Challenges ◽  
Disease Trajectory ◽  
Caregiver Quality ◽  
High Distress

Amyotrophic lateral sclerosis (ALS) impacts greatly not only those who have the disease, but also family caregivers who provide the majority of care for their loved ones throughout the ALS disease trajectory. In the provision of this care, these family caregivers frequently experience significant threats to their own physical and mental health, and thus to their quality of life. The burden of caregiving can be high, distress is not uncommon, and support is needed to best address these issues. Despite the physical and emotional challenges faced by family caregivers, limited research has been directed at this caregiving phenomenon. The more health care providers understand the key elements of the ALS caregiving experience, the better equipped they will be to recognize the caregivers as not only co-providers of care, but as potential recipients of care to meet the unique physical and mental challenges of this caregiving population.

scholarly journals A Canadian perspective on the subcutaneous administration of rituximab in non-Hodgkin lymphoma

2017 ◽  
Vol 24 (1) ◽  
pp. 33 ◽  
Author(s):  
D. MacDonald ◽  
T. Crosbie ◽  
A. Christofides ◽  
W. Assaily ◽  
J. Wiernikowski
Keyword(s):  
Quality Of Life ◽  
Health Care ◽  
Hodgkin Lymphoma ◽  
Health Care Providers ◽  
Subcutaneous Administration ◽  
Fixed Dose ◽  
Care Providers ◽  
Health Care Resources ◽  
Non Hodgkin Lymphoma

Rituximab is widely used for the treatment of non-Hodgkin lymphoma, being a key component in most therapeutic regimens. Administration of the intravenous (IV) formulation is lengthy and places a significant burden on health care resources and patient quality of life. A subcutaneous (sc) formulation that provides a fixed dose of rituximab is being examined in a number of studies. Results indicate that the pharmacokinetics are noninferior and response rates are comparable to those obtained with the IV formulation. Moreover, the sc formulation is preferred by patients and health care providers and reduces administration and chair time. Additional advantages include a lesser potential for dosing errors, shorter preparation time, reduced drug wastage, and fewer infusion-related reactions. Despite the success of the sc formulation, correct administration is needed to reduce administration-related reactions. By using a careful procedure, the sc formulation can be given safely and effectively, potentially reducing the burden on health care resources and improving quality of life for patients.

scholarly journals Complementary and Alternative Medicine Use and Its Association with Quality of Life among Cancer Patients Receiving Chemotherapy in Ethiopia: A Cross-Sectional Study

2016 ◽  
Vol 2016 ◽  
pp. 1-8 ◽  
Author(s):  
Daniel Asfaw Erku
Keyword(s):  
Quality Of Life ◽  
Health Care ◽  
Cancer Patients ◽  
Health Care Providers ◽  
Cross Sectional Study ◽  
Care Providers ◽  
Sectional Study ◽  
Cross Sectional ◽  
Cam Use

Background.Today, complementary and alternative medicine (CAM) use is being routinely practiced by cancer patients worldwide. This study aimed at examining the prevalence of CAM use in patients with cancer and comparing the quality of life (QoL) in CAM users and nonusers.Methods.A cross-sectional study was employed on 195 cancer patients receiving chemotherapy at Gondar University Referral Hospital (GURH) chemotherapy center. Interviewer-administered questionnaires were used and the collected data were analyzed by the Statistical Package for the Social Sciences (SPSS) software version 21.0 for Windows.Results.154 (79%) patients were found to be users of CAM. Educational status, average monthly income, disease stage, and comorbidity were strong predictors of use of CAM. The most commonly utilized types of CAM were traditional herbal based medicine (72.1%) and only 20.8% of patients discuss with their doctors CAM use. No significant difference was found in QoL between CAM users and nonusers except in financial difficulties (p=0.020).Conclusions.This study revealed a high rate of CAM use with very low disclosure rate to their health care providers. Health care providers should be open to discuss the use of CAM with their patients as it will lead to better health outcome.

HIV Symptoms

2007 ◽  
Vol 25 (1) ◽  
pp. 259-291 ◽  
Author(s):  
Carmen J. Portillo ◽  
William L. Holzemer ◽  
Fang-Yu Chou
Keyword(s):  
Quality Of Life ◽  
Health Care Providers ◽  
Highly Active Antiretroviral Therapy ◽  
Medical Attention ◽  
Future Research ◽  
Care Providers ◽  
Highly Active ◽  
Hiv Symptoms ◽  
Hiv Aids

People with HIV/AIDS are a vulnerable group whose symptoms can seriously affect their quality of life. HIV/AIDS symptoms can result from the disease itself, from secondary complications of the disease, or from side-effects of highly active antiretroviral therapy (HAART) and other medications related to comorbidities. HIV symptoms are the single most important indicators for patients and practitioners. Symptoms prompt patients to seek medical attention and provide health care providers with essential clues about changes in health status and quality of life. Despite increased recognition of the importance of addressing symptoms among people with HIV/AIDS, few studies have examined the management of HIV symptoms. This chapter introduces HIV symptoms, reports on the methods of review, provides an overview of contextual issues including the literature on symptoms, issues related to symptom measures, theoretical foundations on symptom management, HIV-specific measures, non-HIV-specific measures, translation of findings into practice, and implications for future research and policy.

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