The role of oncologic health care providers in end of life discussions for women with recurrent gynecologic or breast cancer.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e20543-e20543
Author(s):  
Ashley Stuckey ◽  
Katina Robison ◽  
Don S. Dizon ◽  
Michelle Rogers ◽  
Miles Ott ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Health Care ◽  
End Of Life ◽  
Health Care Providers ◽  
Institutional Review Boards ◽  
Care Providers ◽  
Provider Type ◽  
Health Care Proxy ◽  
Recurrent Cancer ◽  
And Gender

e20543 Background: Advance care planning (ACP) is an important topic for women with metastatic or recurrent cancer. Unfortunately, data suggest ACP is often not discussed at health care visits. Because patients with metastatic or recurrent cancer are incurable, the issue of end of life (EOL) is one faced by patients and providers. This study evaluates how often oncologic health care providers initiate EOL conversations with their patients. Methods: Eligible patients included women with metastatic or recurrent gynecologic or breast cancer of ≥3 month’s duration in an academic women’s oncology program. Interviews were conducted by research staff. Clinical characteristics and documentation of EOL decisions were obtained through chart reviews. Data were analyzed using SAS v.9.3. Multivariate logistic regression was used to model the association of EOL discussions with ACP. The study was approved by the hospital and university Institutional Review Boards. Results: 200 women were enrolled; 64% had stage III-IV cancer at diagnosis. The majority was white (91%) with a mean age of 60 (range 35-82). A total of 638 providers were identified (mean: 3.2 providers per patient; 57% female). Health care provider type and gender were not associated with EOL discussions. Only 49 women (25%) recalled an EOL conversation with at least one provider which appeared to correspond to the low proportion of people with documented ACP. Only 42 (22%) had an advanced directive (AD) and 29 (15%) a health care proxy (HCP) in the chart. Having an EOL conversation with at least one provider was not associated with a chart-documented AD (OR=1.6, 95% CI=0.7-3.6) or HCP (OR=1.8, 95% CI=0.7-4.5). The time since recurrence was shorter for those reporting EOL conversations (1.7 vs. 3.1 years, p=.0274). Conclusions: In this study, oncologic health care providers infrequently initiated EOL discussions with their patients with metastatic or recurrent cancer. More concerning, patient recollection of an EOL discussion with a provider was not associated with chart-documented ACP. Further studies evaluating the factors limiting EOL discussions as well as studies testing interventions to improve provider documentation of the ACP are warranted.

scholarly journals Teaching Health-Care Providers to Query Patients With Cancer About Sexual and Gender Minority (SGM) Status and Sexual Health

2019 ◽  
Vol 36 (6) ◽  
pp. 533-537 ◽  
Author(s):  
Elizabeth J. Cathcart-Rake ◽  
Carmen Radecki Breitkopf ◽  
Judith Kaur ◽  
Jennifer O’Connor ◽  
Jennifer L. Ridgeway ◽  
...  
Keyword(s):  
Health Care ◽  
Sexual Health ◽  
End Of Life ◽  
Health Care Providers ◽  
Position Statement ◽  
Care Providers ◽  
Related Data ◽  
Patients With Cancer ◽  
And Gender ◽  
American Society

End of life is difficult for all patients but sexual and gender minorities (SGM) are prone to isolation and loneliness, especially if their SGM status is unknown or unaccepted. In oncology clinics, where goals of care discussions about end of life are integral and frequent, querying patients about their SGM status and sexual health is of particular importance. The American Society of Clinical Oncology recently released a position statement that called for greater focus on SGM populations with the goal of reducing and eventually eliminating disparities in cancer care within this group. An important first step in addressing such disparities is learning how best to train cancer health-care providers to ask patients about their SGM status and about sexual health in general. This article summarizes the mandate for understanding cancer issues in SGM populations and the dearth of cancer-related data within this group. This article also describes an ongoing 3-part study intended to build a mini curriculum with the goal of helping cancer health-care providers to ask patients with cancer about SGM status and to ask all patients with cancer about sexual health issues. The results of this ongoing study could potentially improve end-of-life care for subgroups of patients.

Pandemic Visitation Restrictions at the End of Life

2021 ◽  
Vol 46 (11) ◽  
pp. 3-4
Author(s):  
Molly Antone ◽  
Keyword(s):  
Health Care ◽  
End Of Life ◽  
Health Care Providers ◽  
Treatment Options ◽  
Care Providers ◽  
Medical Practices ◽  
Whole Person ◽  
Catholic Health Care

Dying today looks dramatically different than it did a century ago, largely due to wider treatment options and more specialized medical practices. Often missing from these advancements is the focus on factors relative to a patient’s total circumstances. Especially in light of the recent pandemic, it is incumbent upon Catholic health care providers to treat who whole person rather than simply focus on more utilitarian philosophies of care.

On the Margins of Death: A Scoping Review on Palliative Care and Schizophrenia

2018 ◽  
Vol 34 (1) ◽  
pp. 62-69 ◽  
Author(s):  
Erin Relyea ◽  
Brooke MacDonald ◽  
Christina Cattaruzza ◽  
Denise Marshall
Keyword(s):  
Health Care ◽  
Palliative Care ◽  
Access To Care ◽  
End Of Life ◽  
Health Care Providers ◽  
Scoping Review ◽  
End Of Life Care ◽  
Psychosocial Interventions ◽  
Life Care ◽  
Care Providers

Schizophrenia is a serious chronic mental illness that results in marginalization and stigma for sufferers. It is the seventh leading cause for disability worldwide. The symptoms of the illness, including hallucinations, delusions, and extremely disordered thinking and behavior, may also introduce barriers to accessing treatment, education, housing, and employment. Little is known about end-of-life care for individuals with schizophrenia. To address this gap, a scoping review was conducted to enhance understanding of hospice and palliative care for patients with schizophrenia. From this scoping review, 342 unique titles and abstracts were identified through a search of 20 databases, including 11 social science databases, 6 medical databases, and 3 gray literature databases. A total of 32 articles met the inclusion criteria and the following 4 themes were identified: Stigma affecting quality of care and access to care; Issues related to consent and capacity for the patient’s end-of-life care decisions and to appoint substitute decision makers; Best practices for psychosocial interventions, pharmacology, family and health-care collaborations, goals of care, setting, and smoking; and Barriers to care, including setting, communication, provider education, and access to care. The review suggests the importance of mandatory interdisciplinary training practices and policy standards outlining cooperative communication across health-care providers. It highlights gaps in evidence-based research on psychosocial interventions and collaborative frameworks to enable the provision of quality end-of-life care for individuals with schizophrenia.

scholarly journals FAKTOR YANG BERHUBUNGAN DENGAN PERILAKU IBU RUMAH TANGGA MELAKUKAN PEMERIKSAAN PAYUDARA SENDIRI (SADARI)

2018 ◽  
Vol 12 (2) ◽  
pp. 143
Author(s):  
Alvita Brilliana R. Arafah ◽  
Hari Basuki Notobroto
Keyword(s):  
Breast Cancer ◽  
Health Care ◽  
Health Care Providers ◽  
Early Stage ◽  
Health Providers ◽  
Care Providers ◽  
Cross Sectional ◽  
Information Accessibility ◽  
Breast Examination ◽  
Access Information

Breast cancer is cancer with the number of new cases and deaths highest in Indonesia. According to the Data Center and Information Ministry of a health Indonesia in the year 2013, the number of new cases of breast cancer of 819 and the number of deaths amounted to 217. In general, breast cancer known after stepping on an advanced stage. So the methods of early detection of breast cancer are focused on the detection of early stage tumors that are usually small with self-breast examination (SADARI). The purpose of this research is to predict the factors related to the behavior of self-breast examination (SADARI) the housewives aged 40–50 years. This research is an observational study with cross sectional approach. Sample research totaling 100 people  housewife in Kelurahan Sidotopo Wetan Kenjeran Subdistrict Surabaya. The measurement was done by providing a questionnaire to obtain information about the research variables. Variable independent research is k nowledge, attitudes, information accessibility, support health providers and descent with breast cancer. The results of this research showed the variables that are associated with the  SADARI behavior of the housewifes is attitude (p = 0.000), accessibility of information (p = 0.000), and health care providers support (p = 0.010). The majority of housewives in Kelurahan Sidotopo Wetan Kenjeran Sub-district Surabaya showed a good attitude and support toward SADARI. In the area surrounding the residence h ousewife get access information easily. There are no support for doing SADARI from health care providers.

4255 POSTER Breastfeeding After Breast Cancer – Are Health Care Providers Ready to Answer?

2011 ◽  
Vol 47 ◽  
pp. S323-S324
Author(s):  
V. Brunelli ◽  
A. Milani ◽  
F. Peccatori ◽  
S. Manera ◽  
L. Libutti ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Health Care ◽  
Health Care Providers ◽  
Care Providers

Perceived helpfulness and impact of social support provided by family, friends, and health care providers to women newly diagnosed with breast cancer

2007 ◽  
Vol 16 (5) ◽  
pp. 474-486 ◽  
Author(s):  
Neeraj K. Arora ◽  
Lila J. Finney Rutten ◽  
David H. Gustafson ◽  
Richard Moser ◽  
Robert P. Hawkins
Keyword(s):  
Breast Cancer ◽  
Social Support ◽  
Health Care ◽  
Health Care Providers ◽  
Newly Diagnosed ◽  
Care Providers ◽  
Perceived Helpfulness

scholarly journals Querying Patients With Cancer About Sexual Health and Sexual and Gender Minority Status: A Qualitative Study of Health-Care Providers

2019 ◽  
Vol 37 (6) ◽  
pp. 418-423 ◽  
Author(s):  
Elizabeth Cathcart-Rake ◽  
Jennifer M. O’Connor ◽  
Jennifer L. Ridgeway ◽  
Carmen Radecki Breitkopf ◽  
Lois J. Mc Guire ◽  
...  
Keyword(s):  
Health Care ◽  
Sexual Health ◽  
Health Care Providers ◽  
Minority Status ◽  
Care Providers ◽  
Gender Minority ◽  
Patients With Cancer ◽  
National Organizations ◽  
Sexual And Gender Minority ◽  
And Gender

Background: Although national organizations advocate that health-care providers ask patients about sexual health and sexual and gender minority status—to learn, for example, about side effects of treatment and to understand patients’ social support—these conversations often do not occur. This study explored health-care providers’ reasons for having/not having these conversations. Methods: This single-institution study recruited health-care providers from medical oncology, hematology, radiation oncology, and gynecology. Face-to-face interviews were recorded, transcribed, and analyzed qualitatively. Results: Three main themes emerged: (1) patient-centric reasons for discussing/not discussing sexual health and sexual and gender minority status (“So I think just the holistic viewpoint is important”); (2) health-care provider–centric reasons for discussing/not discussing these issues (“That’s going to take more time to talk about and to deal with…” or “I was raised orthodox, so this is not something we talk about…”; and (3) reasons that appeared to straddle both of the above themes (eg, acknowledgment of the sometimes taboo nature of these topics). Conclusion: Although many health-care providers favor talking with patients with cancer about sexual health and sexual and gender minority status, limited time, personal reluctance, and the taboo nature of these topics appear at times to hamper the initiation of these conversations.

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