scholarly journals Provider perspectives on barriers and facilitators to adjuvant endocrine therapy-related symptom management.

2016 ◽  
Vol 34 (3_suppl) ◽  
pp. 155-155
Author(s):  
Cleo A. Samuel ◽  
Kea Turner ◽  
Heidi AS Donovan ◽  
G J. Van Londen
Keyword(s):  
Health Care ◽  
Endocrine Therapy ◽  
Health Care Providers ◽  
Symptom Management ◽  
Adjuvant Endocrine Therapy ◽  
Barriers And Facilitators ◽  
System Level ◽  
Care Providers ◽  
Provider Perspectives ◽  
Related Symptom

155 Background: Adjuvant endocrine therapy (AET)-related symptom management (SM) among breast cancer survivors (BCS) typically involves a multidisciplinary team of health care providers; yet few studies have examined provider perspectives on AET-related SM. The purpose of this study was to examine provider perspectives on the barriers and facilitators to AET-related SM among BCS and opportunities for improvement. Methods: We conducted 3 focus groups (FGs) with a multidisciplinary group of health care providers (n = [6] physician; n = [7] non-physician) experienced in caring for BCS undergoing AET. We utilized semi-structured discussion guides to elicit provider perspectives on AET-related SM and its barriers and facilitators as well as recommendations for improvement. All FGs were held at the University of Pittsburgh, audiotaped, and transcribed. We analyzed FG transcripts using qualitative software to identify key themes. Results: Providers described patient-, provider-, and system- level facilitators and barriers to AET-related SM. At the patient-level, facilitators included social support and provider communication about symptoms while cancer-related distress, misinformation and misinterpretation of online information were identified as barriers. Provider-level facilitators included strong relationships with other providers and ongoing communication with patients; however, lack of time, insufficient resources, and challenges distinguishing AET-related symptoms from other conditions were key provider-level barriers. Finally, at the system-level, electronic health records were described as both a facilitator and barrier to SM. Moreover, poor care coordination among different providers and lack of clear guidelines on which provider “owns” AET-related SM emerged as key system-level barriers. Conclusions: Findings suggest that efforts to improve AET-related SM should span multiple levels, in order to address patient-, provider-, and system-level barriers to SM. Recommendations include increased education for patients, greater access to clinical decision support tools for providers, and improved coordination of survivorship resources within hospitals.

Patient-provider communication and decision making regarding adjuvant endocrine therapy-related symptom management: Provider perspectives.

2016 ◽  
Vol 34 (3_suppl) ◽  
pp. 156-156
Author(s):  
Kea Turner ◽  
Cleo A. Samuel ◽  
Heidi AS Donovan ◽  
G J. Van Londen
Keyword(s):  
Decision Making ◽  
Endocrine Therapy ◽  
Health Care Providers ◽  
Symptom Management ◽  
Adjuvant Endocrine Therapy ◽  
Provider Communication ◽  
Care Providers ◽  
Provider Perspectives ◽  
Related Symptom ◽  
Patient Provider Communication

156 Background: Adjuvant endocrine therapy (AET)-related symptom management (SM) among breast cancer survivors (BCS) is greatly influenced by the quality of patient-provider communication; yet, few studies have examined provider perspectives on patient-provider communication and decision-making for AET-related SM. We assessed provider perspectives on AET-related SM to identify challenges and opportunities for improvement in patient-provider communication and decision-making. Methods: We conducted 3 focus groups (FGs) with a multidisciplinary group of health care providers (n = [6] physician; n = [7] non-physician) experienced in caring for BCS undergoing AET. We utilized semi-structured discussion guides to elicit provider perspectives on patient-provider communication and decision-making for AET-related SM as well as recommendations for improvement. All FGs were held at the University of Pittsburgh, audiotaped, and transcribed. We analyzed FG transcripts using qualitative software to identify key themes. Results: Providers described multiple challenges to patient-provider communication and decision-making for AET-related SM. Providers reported that BCS are often uncertain whether their symptoms are related to AET and unsure of whom to speak with about their symptoms. Providers also felt that patients are reluctant to bring up symptoms for fear that bringing up symptoms would detract from their care. Providers agreed that patient-provider communication influences BCS’ awareness and beliefs about SM. Providers indicated that provider communication strategies such as probing for symptoms, setting realistic treatment expectations, and assessing patient satisfaction with their SM plan enhances patient decision-making about AET-related SM. Conclusions: Although providers identified several challenges related to patient-provider communication and decision-making, many of these challenges are amenable to change through provider-level interventions. Future efforts aimed at improving AET-related SM should include strategies that address patient-provider communication and decision-making.

scholarly journals Provider perspectives on barriers and facilitators to adjuvant endocrine therapy-related symptom management

2017 ◽  
Vol 25 (12) ◽  
pp. 3723-3731 ◽  
Author(s):  
Cleo A. Samuel ◽  
Kea Turner ◽  
Heidi A. S. Donovan ◽  
Ellen Beckjord ◽  
Alexandra Cardy ◽  
...  
Keyword(s):  
Endocrine Therapy ◽  
Symptom Management ◽  
Adjuvant Endocrine Therapy ◽  
Barriers And Facilitators ◽  
Provider Perspectives ◽  
Related Symptom

scholarly journals Patient and Health Care Provider Perspectives on Long Acting Injectable Antipsychotics in Schizophrenia and the Introduction of Olanzapine Long-Acting Injection

2011 ◽  
Vol 3 ◽  
pp. JCNSD.S4091 ◽  
Author(s):  
Heidi J. Wehring ◽  
Sheryl Thedford ◽  
Maju Koola ◽  
Deanna L. Kelly
Keyword(s):  
Health Care ◽  
Health Care Provider ◽  
Health Care Providers ◽  
Care Provider ◽  
Treatment Options ◽  
Care Providers ◽  
Provider Attitudes ◽  
Provider Perspectives ◽  
Long Acting ◽  
Acting Agent

Olanzapine long acting injection has joined risperidone and paliperidone as the second generation long acting antipsychotic injection options for treatment of patients with schizophrenia. Long acting injections are important alternatives to oral medications for patients who have difficulty adhering to daily or multiple daily medication administrations, yet may be underutilized or not well understood. Patient perceptions, adherence, and preferences are important issues for health care providers to address when discussing treatment options with their patients. Reviewed here are overall patient and health care provider attitudes and perceptions regarding long acting injections and the details of olanzapine long acting injectable, the newest agent, and how it will fit in the marketplace. In addition, efficacy, safety, dosing and use data regarding this newest long acting agent are reviewed and compared to other available long acting agents.

scholarly journals A FRAMEWORK FOR CARE TRANSITIONS FOR OLDER ADULTS WITH COMPLEX HEALTH CONDITIONS

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S687-S687
Author(s):  
Paul Stolee ◽  
Jacobi B Elliott ◽  
Kerry Byrne ◽  
Joanie Sims-Gould ◽  
Catherine Tong ◽  
...  
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Health Care Providers ◽  
Service Use ◽  
Care Transitions ◽  
Ethnographic Study ◽  
System Level ◽  
Health Conditions ◽  
Care Providers ◽  
Framework Analysis

Abstract For older adults with complex health conditions, transitions between care settings are common and a major risk to quality of care and patient safety. Care transition interventions have shown positive impacts on continuity of care and health service use, however, most require additional human resources (e.g., transition coach), focus on one transition or “handoff”, and provide support for individual patients without addressing underlying challenges of health system integration. We sought to develop a framework for system-level enhancements to care transitions for older adults. We report a secondary framework analysis of an ethnographic investigation (the “InfoRehab” project) of care transitions for older persons who had experienced a hip fracture. The ethnographic study involved interviews, observations, and document reviews for 23 patients, 19 family caregivers, and 92 health care providers. Data were collected at each transition point (1-4/patient) along the care continuum, at three Canadian sites (large urban, mid-size urban, rural). Our framework analysis followed the approach described by Gale et al. (2013), using as cases 12 peer-reviewed papers which had reported InfoRehab results. Two researchers coded findings from each paper, then developed an analytical framework of eight themes by consensus; these include: patient involvement and choice, family caregiver involvement, patient complexity, health care provider coordination, information sharing, documentation, system constraints, and relationships. NVivo 11 was used to index findings into these themes and to generate a matrix. We are working with system stakeholders, including patients and caregivers, to apply this framework in the development of improved systems for care transitions.

Barriers and Facilitators to Testing in Primary Care Among Health Care Providers

2011 ◽  
Vol 103 (5) ◽  
pp. 432-438 ◽  
Author(s):  
Emma M. Simmons ◽  
Monique J. Brown ◽  
Kay Slye ◽  
Mindy Ma ◽  
Madeline Y. Sutton ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Health Care Providers ◽  
Barriers And Facilitators ◽  
Care Providers

scholarly journals Provider perspectives on patient-provider communication for adjuvant endocrine therapy symptom management

2016 ◽  
Vol 25 (4) ◽  
pp. 1055-1061 ◽  
Author(s):  
Kea Turner ◽  
Cleo A Samuel ◽  
Heidi AS Donovan ◽  
Ellen Beckjord ◽  
Alexandra Cardy ◽  
...  
Keyword(s):  
Endocrine Therapy ◽  
Symptom Management ◽  
Adjuvant Endocrine Therapy ◽  
Provider Communication ◽  
Provider Perspectives ◽  
Patient Provider Communication

scholarly journals Addressing Physical Activity Behavior in Multiple Sclerosis Management

2019 ◽  
Vol 22 (4) ◽  
pp. 178-186
Author(s):  
Sarah J. Donkers ◽  
Sarah Oosman ◽  
Stephan Milosavljevic ◽  
Kristin E. Musselman
Keyword(s):  
Physical Activity ◽  
Multiple Sclerosis ◽  
Health Care ◽  
Clinical Practice ◽  
Behavior Change ◽  
Health Care Providers ◽  
Behavioral Interventions ◽  
System Level ◽  
Change Strategies ◽  
Care Providers

Abstract Background: Although physical activity (PA) is considered the most important nonpharmaceutical intervention for persons with multiple sclerosis (MS), less than 20% of people with MS are engaging in sufficient amounts to accrue benefits. Promotion of PA is most effective when combined with additional behavior change strategies, but this is not routinely done in clinical practice. This study aimed to increase our understanding of current practice and perspectives of health care providers (HCPs) in Canada regarding their use of interventions to address PA behavior in MS management. Investigating HCPs’ perspectives on implementing PA behavior change with persons with MS will provide insight into this knowledge-to-practice gap. Methods: Semistructured focus groups were conducted with 31 HCPs working with persons with MS in Saskatchewan, Canada. Based on interpretive description, data were coded individually by three researchers, who then collaboratively developed themes. Analysis was inductive and iterative; triangulation and member reflections were used. Results: Five themes were established: 1) prescribing, promoting, and impacting wellness with PA; 2) coordinating communication and continuity in practice; 3) timely access to relevant care: being proactive rather than reactive; 4) enhancing programming and community-based resources; and 5) reconciling the value of PA with clinical practice. Conclusions: The HCPs value PA and want more support with application of behavior change strategies to deliver PA behavioral interventions, but due to the acute and reactive nature of health care systems they feel this cannot be prioritized in practice. Individual- and system-level changes are needed to support consistent and effective use of PA behavioral interventions in MS.

Caring for adolescents in Guatemala: provider perspectives

2017 ◽  
Vol 0 (0) ◽  
Author(s):  
Areej Hassan ◽  
Juan Carlos Reyes Maza ◽  
Hayley G. Teich ◽  
Erwin H. Calgua Guerra
Keyword(s):  
Health Care ◽  
Adolescent Health ◽  
Health Care Providers ◽  
Strong Support ◽  
Comfort Level ◽  
Care Providers ◽  
Framework Analysis ◽  
Provider Perspectives ◽  
Healthcare Needs ◽  
Medical Education And Training

AbstractPurposeToday’s generation of adolescents is the largest in history, creating a major challenge for low and middle income countries faced with the necessity of addressing their growing healthcare needs. Our objective was to assess the extent to which health care providers in Guatemala are trained, knowledgeable and feel comfortable providing services to adolescents.MethodsA sample of 20 medical providers were recruited from the School of Medicine at San Carlos University and its affiliated hospitals. Providers were interviewed face-to-face for 30–40 min using a semi-structured guide exploring their training, knowledge, skills and experience in adolescent health care. Recruitment continued until thematic saturation was reached. Interviews were recorded and transcribed verbatim, and then analyzed for emergent themes using principles of framework analysis.ResultsThe provider’s mean age was 33.7 years [standard deviation (SD) = 10.2]. Most were female (65%) and practiced medicine in a metropolitan location. Results revealed the presence of five major themes: (1) Need for dedicated adolescent health services; (2) Presence of a multitude of barriers to providing adolescent health care; (3) Perceived comfort level in communicating with adolescents; (4) Limited knowledge of current adolescent specific services, programs, and guidelines; and (5) Gaps in medical education and training.ConclusionProviders recognize the need for increased and dedicated adolescent health care services. There is strong support for the creation of a credentialed national adolescent health training program.

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