Onco-fertility care in a children's hospital: A quality improvement initiative.

2013 ◽  
Vol 31 (31_suppl) ◽  
pp. 41-41
Author(s):  
Masanori Hayashi ◽  
Catherine Michelle Albert ◽  
Alexandra Gubin ◽  
Ann Katz ◽  
Cara Kramer ◽  
...  
Keyword(s):  
Fertility Preservation ◽  
Pediatric Oncology ◽  
Baseline Survey ◽  
Quality Improvement Initiative ◽  
Team Approach ◽  
Cross Sectional ◽  
Non Invasive ◽  
Fertility Counseling ◽  
Practice Standard

41 Background: Patients who will receive gonadotoxic cancer therapy should be counseled on fertility risks and be offered appropriate fertility preservation methods. Previous studies have shown low adherence to these quality measures. At Johns Hopkins Pediatric Oncology, a baseline survey revealed that only 70% of patients or their parents recalled receiving fertility counseling at initial diagnosis, and 50% of eligible patients were referred for fertility preservation procedures. Methods: A multidisciplinary group comprising Pediatric Oncology physicians, nurses, and social workers was formed to address barriers to appropriate oncofertility care. The team identified staff education, a practice standard, and familiarity with fertility preservation resources as needs. Many active resources were available, such as a pediatric ovarian cryopreservation research protocol. Results: Comprehensive fertility counseling and preservation practices for boys and girls were established to provide guidance and resources to the treating primary oncology team. Girls are risk stratified according to the planned therapy for their disease, and offered ovarian or oocyte cryopreservation if therapy carries an intermediate to high risk of fertility loss. Non-invasive sperm banking is recommended for all post-pubertal males who will receive therapy with any degree of gonadotoxicity. An oncofertility team provides 24/7 consultation for the primary oncology team and patients and proactively identifies newly diagnosed patients who need counseling. The comprehensive protocol has been published on the online center-wide policy repository, and the consult service has been frequently utilized. A cross-sectional questionnaire study will be performed annually to monitor compliance to protocol and quality of care. Conclusions: A proactive team approach can overcome barriers to quality oncofertility practice.

Fertility preservation in children newly diagnosed with cancer: Existing standards of practice in Australia and New Zealand

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 9047-9047
Author(s):  
J. A. Heath ◽  
C. J. Stern
Keyword(s):  
New Zealand ◽  
Fertility Preservation ◽  
Pediatric Oncology ◽  
North American ◽  
Ethical Issues ◽  
Ovarian Tissue ◽  
Newly Diagnosed ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
And Storage

9047 Background: Over the past two decades, rapid advances have occurred in both the successful treatment of childhood cancers and reproductive medicine. We sought to establish the current level of clinical practice for sperm, oocyte and gonadal tissue collection and storage in children newly diagnosed with cancer in Australia and New Zealand (ANZ). Methods: A cross-sectional survey of all pediatric oncology services in ANZ was performed. Comparisons to recently published North American practices and to current recommendations for best practice were also made. Results: Of the 13 centers invited to participate, 12 (92%) completed the survey. All centers had offered sperm conservation, but only ten (83%) had offered oocyte/ovarian tissue conservation. Available methods of gamete collection and storage were not consistent. Two centers were using GnRH agonists as fertility protection in post-pubertal females. Forty-two per cent had offered fertility conservation to males and females prior to completion of sexual development. All centers were more likely to offer sperm conservation than oocyte conservation for any given disease. The most common diseases for which conservation was offered were lymphomas and sarcomas. The anticipated cumulative dose at which centers elected to offer fertility preservation varied widely, both for the alkylator cyclophosphamide (1g/m2 to 10g/m2) and for abdominal/pelvic irradiation (any to 12 Gy) and spinal irradiation (any to 18Gy). Fertility counseling was offered in a variety of settings by 82% of centers. Despite 92% of centers agreeing that fertility preservation guidelines would be helpful, only two (17%) had any in place. Overall, there was greater uptake and consistency of utilization of fertility services in ANZ when compared with published North American data. Conclusions: There are inconsistencies regarding the indications for and methods of gamete conservation in pediatric oncology centers throughout ANZ. Unresolved medical, legal and ethical issues suggest the development of guidelines and a voluntary code of practice would be helpful. No significant financial relationships to disclose.

scholarly journals Pretreatment fertility counseling and fertility preservation improve quality of life in reproductive age women with cancer

Cancer ◽  
2011 ◽  
Vol 118 (6) ◽  
pp. 1710-1717 ◽  
Author(s):  
Joseph M. Letourneau ◽  
Erin E. Ebbel ◽  
Patricia P. Katz ◽  
Audra Katz ◽  
Wei Z. Ai ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Fertility Preservation ◽  
Reproductive Age ◽  
Improve Quality ◽  
Reproductive Age Women ◽  
Fertility Counseling

scholarly journals EUPRON: nurses’ practice in interprofessional pharmaceutical care in Europe. A cross-sectional survey in 17 countries

BMJ Open ◽  
2020 ◽  
Vol 10 (6) ◽  
pp. e036269 ◽  
Author(s):  
Elyne De Baetselier ◽  
Bart Van Rompaey ◽  
Luis M Batalha ◽  
Monica Bergqvist ◽  
Bozena Czarkowska-Paczek ◽  
...  
Keyword(s):  
Pharmaceutical Care ◽  
Interprofessional Collaboration ◽  
Active Role ◽  
European Countries ◽  
Team Approach ◽  
Therapeutic Effects ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Nurses And Physicians

ObjectivesSafe pharmaceutical care (PC) requires an interprofessional team approach, involving physicians, nurses and pharmacists. Nurses’ roles however, are not always explicit and clear, complicating interprofessional collaboration. The aim of this study is to describe nurses’ practice and interprofessional collaboration in PC, from the viewpoint of nurses, physicians and pharmacists.DesignA cross-sectional survey.SettingThe study was conducted in 17 European countries, each with their own health systems.ParticipantsPharmacists, physicians and nurses with an active role in PC were surveyed.Main outcome measuresNurses’ involvement in PC, experiences of interprofessional collaboration and communication and views on nurses’ competences.ResultsA total of 4888 nurses, 974 physicians and 857 pharmacists from 17 European countries responded. Providing patient education and information (PEI), monitoring medicines adherence (MMA), monitoring adverse/therapeutic effects (ME) and prescribing medicines were considered integral to nursing practice by 78%, 73%, 69% and 15% of nurses, respectively. Most respondents were convinced that quality of PC would be improved by increasing nurses’ involvement in ME (95%), MMA (95%), PEI (91%) and prescribing (53%). Mean scores for the reported quality of collaboration between nurses and physicians, collaboration between nurses and pharmacists and interprofessional communication were respectively <7/10, ≤4/10, <6/10 for all four aspects of PC.ConclusionsME, MMA, PEI and prescribing are part of nurses’ activities, and most healthcare professionals felt their involvement should be extended. Collaboration between nurses and physicians on PC is limited and between nurses and pharmacists even more.

Contraception and fertility counseling in patients receiving chemotherapy.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e23055-e23055
Author(s):  
Alexa Calfee ◽  
Taylor Hasley ◽  
Laura Becca Daily ◽  
Todd D. Tillmanns ◽  
Adam ElNaggar
Keyword(s):  
Demographic Data ◽  
Cross Sectional Study ◽  
Reproductive History ◽  
Newly Diagnosed ◽  
Chi Square ◽  
Cross Sectional ◽  
Contraception Use ◽  
Fertility Counseling ◽  
Contraception Counseling

e23055 Background: Cancer care advances allow more patients to pursue fertility. Unfortunately, treatments may have detrimental effects both on fertility and risks to fetus should pregnancy occur. This study examines patient perceptions of fertility and contraception counseling, as well as physician documentation thereof. Methods: After IRB approval, a cross-sectional study was performed identifying men and women, ages 18-50, seen between May 2017 and 2018 with newly diagnosed malignancy. Patients with previous sterilization procedures, a secondary or synchronous cancer, or prior lines of chemotherapy, were excluded. Consented patients received a survey regarding their perception receipt and quality of counseling. Demographic data, including contraception use, reproductive history, and physician documentation were obtained. Differences in receipt of counseling and perception of received counseling were evaluated using chi-square tests. Results: Of 179 patients identified, 53 ultimately participated. Majority were women (75 v 25%). Counseling documentation for contraception and fertility occurred in 5% and 32% of charts, respectively. Though 42% and 49% perceived receipt, respectively. Of those receiving counseling, it was perceived as sufficient by 64% regarding contraception and 72% regarding fertility. Race, gender, and reproductive history were not found to be associated to whether patients perceived counseling on contraception (p > 0.1). Men were more likely than women to be perceive counseling regarding fertility (85 v 43%, p = 0.010). However, both felt fertility counseling to be sufficient with similar rates of documentation. Caucasians were more likely to perceive receipt of fertility counseling and to perceive it to be sufficient, then African Americans (68 v 29% and 70 v 40%, respectively) at same rate of documentation (35%). Conclusions: Significant discrepancies in perception of contraception and fertility counseling were seen, though documentation rates were similar across all groups examined. Despite equal rates of physician documentation, gender and race were important factors for the perception of fertility counseling, while race was a factor to quality of perceived counseling.

Determinants of Health-Related Quality of Life Among Elderly: Evidence From Chi Linh Town, Vietnam

2017 ◽  
Vol 29 (5_suppl) ◽  
pp. 84S-93S ◽  
Author(s):  
Nguyen Thanh Huong ◽  
Le Thi Hai Ha ◽  
Truong Quang Tien
Keyword(s):  
Quality Of Life ◽  
The Elderly ◽  
Cross Sectional Study ◽  
Vulnerable Groups ◽  
Baseline Survey ◽  
Health Related Quality ◽  
Cross Sectional ◽  
Related Quality ◽  
Health Related

As Vietnam confronts with the challenge of an aging population, the importance of quality of life for elderly people becomes apparent. This article aims to assess health-related quality of life (HRQoL) and its correlates for the elderly, using a cross-sectional study design. A total of 1599 adults, aged 60 years and older, were drawn from the 2016 baseline survey of Chi Linh Health and Demographic Surveillance System (CHILILAB HDSS), which incorporated the EQ-5D, to measure HRQoL. Data were analyzed using multivariate linear regression analyses. The EQ-5D index of the elderly was found to be 0.871 (95% confidence interval = 0.862-0.880). After controlling for covariates, there were statistically significant associations between lower HRQoL and older age (≥80 years), lower education, no pension, chronic disease(s), and health insurance schemes targeting poor/near poor/priority groups. Current and future policies for improving HRQoL in old age should be extended to cover the most vulnerable groups.

Development of a Home Chemotherapy Program for Pediatric Oncology Patients

1995 ◽  
Vol 8 (6) ◽  
pp. 297-302 ◽  
Author(s):  
Mark T. Holdsworth ◽  
Cathy M. Chavez
Keyword(s):  
Pediatric Oncology ◽  
Professional Growth ◽  
Third Party ◽  
Team Approach ◽  
Oncology Patients ◽  
Successful Communication ◽  
The Family ◽  
Monetary Savings

Provision of home chemotherapy to pediatric oncology patients offers substantial advantages to children and their families, including improved scheduling and continuity of care and decreased disruption of the family unit. These advantages may positively impact upon both parental anxiety and quality of life for these children and their families. Establishing and maintaining a successful home chemotherapy program is a complex task, requiring a detailed orientation program along with an interdisciplinary team approach, a successful communication network, and close patient follow-up. Home chemotherapy delivery offers a unique practice setting with many professional growth opportunities for clinicians. A home chemotherapy program may also result in substantial monetary savings to patients and third-party payors, especially for protocols that require several days of inpatient admission to deliver.

scholarly journals Attitudes toward fertility and fertility preservation in women with glioma

2018 ◽  
Vol 6 (3) ◽  
pp. 218-225 ◽  
Author(s):  
Rachel K Stiner ◽  
Jennifer L Clarke ◽  
Nikita Sinha ◽  
Jessica Chan ◽  
Joseph M Letourneau ◽  
...  
Keyword(s):  
Fertility Preservation ◽  
San Francisco ◽  
Survey Analysis ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Fertility Counseling ◽  
Survey Results ◽  
Chemotherapy Initiation ◽  
After Cancer ◽  
The University

Abstract Background No studies have examined the fertility priorities of women undergoing treatment for their glioma. Glioma patients frequently undergo chemotherapy as part of their treatment; however, it is unknown whether patients truly are aware of its possible effects on their fertility. Our objective was to assess the fertility priorities of glioma patients and ascertain whether female glioma patients are being effectively counseled on the effects of chemotherapy on their fertility prior to beginning treatment. Methods The sample was composed of female patients from the Neuro-oncology clinic of the University of California, San Francisco. Participants completed a cross-sectional survey between October 2010 and December 2013 exploring their attitudes toward fertility and their experience with fertility counseling prior to chemotherapy initiation. Results Seventy-two women completed the survey. Analysis of the survey results showed that 30% of women receiving chemotherapy reported having a discussion regarding fertility preservation prior to beginning treatment. Of those who reported having this discussion, 80% were aware that chemotherapy could negatively affect their fertility. Many women reported that while fertility preservation was not important to them at the time of diagnosis, it was a priority for them at the time of survey completion. Although interest in having children tended to decrease after cancer treatment, the majority of respondents reported wanting a child after treatment. Conclusions The data obtained in this study suggest a lack of understanding of reproductive priorities, which may be addressed with a more comprehensive fertility discussion prior to beginning treatment.

Perceived Overprotection and Its Association With Quality of Life in Dementia

GeroPsych ◽  
2019 ◽  
Vol 32 (3) ◽  
pp. 125-134
Author(s):  
Mechthild Niemann-Mirmehdi ◽  
Andreas Häusler ◽  
Paul Gellert ◽  
Johanna Nordheim
Keyword(s):  
Quality Of Life ◽  
Patient Autonomy ◽  
Positive Association ◽  
Well Being ◽  
Negative Association ◽  
Significant Positive Association ◽  
Cross Sectional ◽  
People With Dementia ◽  
Mental Well Being

Abstract. To date, few studies have focused on perceived overprotection from the perspective of people with dementia (PwD). In the present examination, the association of perceived overprotection in PwD is examined as an autonomy-restricting factor and thus negative for their mental well-being. Cross-sectional data from the prospective DYADEM study of 82 patient/partner dyads (mean age = 74.26) were used to investigate the association between overprotection, perceived stress, depression, and quality of life (QoL). The analyses show that an overprotective contact style with PwD has a significant positive association with stress and depression, and has a negative association with QoL. The results emphasize the importance of avoiding an overprotective care style and supporting patient autonomy.

HUBUNGAN KUALITAS KEHIDUPAN KERJA TERHADAP KINERJA PERAWAT PELAKSANA

2019 ◽  
Vol 9 (4) ◽  
pp. 413-420
Author(s):  
Amella Gusty ◽  
Dachriyanus Dachriyanus ◽  
Leni Merdawati
Keyword(s):  
District Hospital ◽  
Simple Random Sampling ◽  
Work Life ◽  
Quality Of Work Life ◽  
P Value ◽  
Work Context ◽  
Cross Sectional ◽  
Quality Of Work ◽  
The Relationship

Kinerja perawat merupakan hasil yang dicapai dalam melaksanakan asuhan keperawatan di rumah sakit. Terciptanya asuhan keperawatan yang optimal sangat diperlukan dukungan dari pihak rumah sakit salah satunya adalah menciptakan kualitas kehidupan kerja baik bagi perawat. Penelitian ini bertujuan untuk mengetahui hubungan antara kualitas kehidupan kerja terhadap kinerja perawat pelaksana di RSUD Teluk Kuantan. Jenis penelitian kuantitatif dengan pendekatan cross sectional. Jumlah sampel 120 responden yang diperoleh melalui proportionate simple random sampling. Hasil penelitian menunjukkan kualitas kehidupan kerja perawat RSUD Teluk Kuantan berada pada kategori sedang, kinerja perawat berada pada kategori kurang baik. Berdasarkan analisis kedua variabel teridentifikasi bahwa tidak ada hubungan antara kualitas kehidupan kerja dengan kinerja perawat pelaksana dengan  p value 0,817. Dimensi work context merupakan komponen yang memiliki hubungan dengan kinerja perawat pelaksana dengan p value 0,008, dimensi work life  tidak berhubungan secara signifikan dengan kinerja perawat. Kesimpulan penelitian diketahui tidak ada hubungan antara kualitas kehidupan kerja dengan kinerja perawat pelaksana. Ada hubungan dimensi work context dengan kinerja perawat pelaksana. Tidak ada hubungan dimensi work life dengan kinerja perawat.   Kata kunci: kualitas kehidupan kerja, kinerja, perawat pelaksana   THE RELATIONSHIP BETWEEN THE QUALITY OF WORK LIFE AND THE PERFORMANCE OF IMPLEMENTERS NURSES   ABSTRACT Nurse performance is the result achieved in implementing nursing care in a hospital. The creation of optimal nursing care is very much needed support from the hospital, one of which is to create a good quality of work life for nurses. This study aims to determine the relationship between the quality of work life and the performance of nurses at the Kuantan District Hospital. This type of quantitative research with cross sectional approach. The number of samples of 120 respondents obtained through proportionate simple random sampling. The results showed that the quality of work life of nurses at the Kuantan District Hospital was in the medium category, the nurses' performance was in the unfavorable category. Based on the analysis of the two variables, it was identified that there was no relationship between the quality of work life with the performance of implementing nurses with a p value of 0.817. The work context dimension is a component that has a relationship with the performance of nurses implementing with p value 0.008, the dimension of work life does not significantly correlate with nurse performance. The conclusion of the research is that there is no relationship between the quality of work life and the performance of the implementing nurses. There is a relationship between the dimensions of the work context and the performance of the nurses. There is no relationship between the dimensions of work life and nurse performance.   Keywords: quality of work life, performance, implementers nurse

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