The quality of CT surveillance in resected colorectal cancer survivors at Veterans Health Administration facilities.

2016 ◽  
Vol 34 (4_suppl) ◽  
pp. 525-525
Author(s):  
Amikar Sehdev ◽  
Eric A Sherer ◽  
Sui Hui ◽  
Jingwei Wu ◽  
David Andrew Haggstrom
Keyword(s):  
Colorectal Cancer ◽  
Univariate Analysis ◽  
Secondary Analysis ◽  
Organizational Characteristics ◽  
Ct Scans ◽  
Health Administration ◽  
Primary Analysis ◽  
Lower Stage ◽  
The Impact

525 Background: Annual CT scan for three years is the current standard for post-treatment surveillance of colorectal cancer (CRC) survivors following curative treatment. We conducted a retrospective study with the primary aim to assess the patient, physician & organizational characteristics associated with quality of CT surveillance at Veterans Administration (VA) facilities. Methods: The Department of Veterans Affairs Central Cancer Registry was used to identify patients with stage I-III CRC between 2001 & 2009. Patient (age, race, marital status, income, priority status, year of diagnosis, stage, comorbidity), provider (primary care, specialist, other) & facility (region & organizational survey) characteristics were measured. In the primary analysis, we analyzed the impact of the 2005 ASCO update in CRC surveillance guidelines. In the secondary analysis, we included only patients diagnosed after 2005 to avoid any bias due to change in guidelines. Overuse (OU) was defined as > 1 CT/12 months, whereas underuse (UU) was defined as < 1 CT/12 months. The Wald test was used for univariate analysis & logistic regression models, for multivariate analysis. Results: The primary analysis demonstrated no change in the receipt of CT scans before & after the 2005 guideline update, as there was an increasing trend favoring more CT scans in general.In the secondary analysis, there were a total of 2,263 patients. Overall, UU (19.44% patients) occurred more often than OU (15% patients). In univariate analyses, age, stage, insurance status, provider type & facility region were significant in both OU & UU analyses (p <.001). Comorbidity was associated with OU only (p =.02). Different organizational characteristics were significant for OU & UU cohorts. Multivariate analyses showed younger age [AOR = 2.17 (1.65 - 2.86)] & higher stage [AOR =.71 (.59 -.85)] were associated with OU at p <.001. Older age [AOR = 1.89 (1.54 - 3.10)], lower stage [AOR =.63 (.49 -.81)] at p <.001 & facility region [AOR = 1.84 (1.01 - 3.35)] at p =.04 were associated with UU. Conclusions: While present, there did not appear to be substantial rates of UU or OU among CRC survivors in the VA. Age & cancer stage were associated with the quality of CT surveillance.

scholarly journals Patient-Reported Quality of Supportive Care Among Patients With Colorectal Cancer in the Veterans Affairs Health Care System

2014 ◽  
Vol 32 (8) ◽  
pp. 809-815 ◽  
Author(s):  
Michelle van Ryn ◽  
Sean M. Phelan ◽  
Neeraj K. Arora ◽  
David A. Haggstrom ◽  
George L. Jackson ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Supportive Care ◽  
Cancer Care ◽  
Quality Measurement ◽  
Veterans Affairs ◽  
Health Administration ◽  
Patient Centered ◽  
Patient Reported ◽  
The Impact

Purpose High-quality supportive care is an essential component of comprehensive cancer care. We implemented a patient-centered quality of cancer care survey to examine and identify predictors of quality of supportive care for bowel problems, pain, fatigue, depression, and other symptoms among 1,109 patients with colorectal cancer. Patients and Methods Patients with new diagnosis of colorectal cancer at any Veterans Health Administration medical center nationwide in 2008 were ascertained through the Veterans Affairs Central Cancer Registry and sent questionnaires assessing a variety of aspects of patient-centered cancer care. We received questionnaires from 63% of eligible patients (N = 1,109). Descriptive analyses characterizing patient experiences with supportive care and binary logistic regression models were used to examine predictors of receipt of help wanted for each of the five symptom categories. Results There were significant gaps in patient-centered quality of supportive care, beginning with symptom assessment. In multivariable modeling, the impact of clinical factors and patient race on odds of receiving wanted help varied by symptom. Coordination of care quality predicted receipt of wanted help for all symptoms, independent of patient demographic or clinical characteristics. Conclusion This study revealed substantial gaps in patient-centered quality of care, difficult to characterize through quality measurement relying on medical record review alone. It established the feasibility of collecting patient-reported quality measures. Improving quality measurement of supportive care and implementing patient-reported outcomes in quality-measurement systems are high priorities for improving the processes and outcomes of care for patients with cancer.

scholarly journals Parental incarceration affects children’s emotional and behavioral outcomes: A longitudinal cohort study of children aged 9 to 13 years

2021 ◽  
pp. 016502542199591
Author(s):  
Daragh Bradshaw ◽  
Ann-Marie Creaven ◽  
Orla T. Muldoon
Keyword(s):  
Cohort Study ◽  
Relationship Quality ◽  
Child Outcomes ◽  
Behavioral Outcomes ◽  
Secondary Analysis ◽  
Parental Incarceration ◽  
Child Relationship ◽  
Children And Parents ◽  
The Impact

Parental incarceration (PI) is negatively associated with emotional, educational, and psychological child outcomes. However, few studies explore potential mechanisms through which these outcomes are transmitted or the means by which prosocial outcomes might develop. This study used data from two waves of a population cohort study of children aged 9 years and followed up aged 13 years living in Ireland. Children and parents ( N = 8,568) completed measures of PI, primary caregiver (PCG) depression, PCG-child relationship quality, and child behavioral adjustment. We then conducted a secondary analysis on this national longitudinal study of children in Ireland. Using sequential mediation models, we observed a mediated indirect effect of PI on prosocial outcomes via PCG depression and PCG-child relationship quality. PI at age 9 was associated with increased difficulties and reduced prosocial behavior at age 13. Additionally, PI at age 9 affected PCG depression and the PCG-child relationship quality. Additionally, child prosocial outcomes, and emotional and behavioral difficulties were less apparent where PI had a weaker effect on PCG depression and the quality of PCG-child relationship. Supports that can mitigate the impact of PI for vulnerable caregivers and children are discussed.

scholarly journals The course of peripheral neuropathy and its association with health-related quality of life among colorectal cancer patients

2020 ◽  
Author(s):  
Cynthia S. Bonhof ◽  
Lonneke V. van de Poll-Franse ◽  
Dareczka K. Wasowicz ◽  
Laurens V. Beerepoot ◽  
Gerard Vreugdenhil ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Colorectal Cancer ◽  
Peripheral Neuropathy ◽  
Health Related Quality ◽  
Related Quality ◽  
Health Related ◽  
Eortc Qlq ◽  
The Impact

Abstract Purpose To gain more insight into the course of chemotherapy-induced peripheral neuropathy (CIPN) and its impact on health-related quality of life (HRQoL) in a population-based sample of colorectal cancer (CRC) patients up to 2 years after diagnosis. Methods All newly diagnosed CRC patients from four hospitals in the Netherlands were eligible for participation in an ongoing prospective cohort study. Patients (n = 340) completed questions on CIPN (EORTC QLQ-CIPN20) and HRQoL (EORTC QLQ-C30) before initial treatment (baseline) and 1 and 2 years after diagnosis. Results Among chemotherapy-treated patients (n = 105), a high sensory peripheral neuropathy (SPN) level was reported by 57% of patients at 1 year, and 47% at 2-year follow-up, whereas a high motor peripheral neuropathy (MPN) level was reported by 47% and 28%, at years 1 and 2, respectively. Linear mixed model analyses showed that SPN and MPN symptoms significantly increased from baseline to 1-year follow-up and did not return to baseline level after 2 years. Patients with a high SPN or MPN level reported a worse global quality of life and a worse physical, role, emotional, cognitive, and social functioning compared with those with a low SPN or MPN level. Conclusions Future studies should focus on understanding the mechanisms underlying CIPN so targeted interventions can be developed to reduce the impact of CIPN on patient’s lives. Implications for cancer survivors Patients need to be informed of both CIPN and the impact on HRQoL.

scholarly journals The impact of panitumumab treatment on survival and quality of life in patients with RAS wild-type metastatic colorectal cancer

2019 ◽  
Vol Volume 11 ◽  
pp. 5911-5924 ◽  
Author(s):  
Francesca Battaglin ◽  
Alberto Puccini ◽  
Selma Ahcene Djaballah ◽  
Heinz-Josef Lenz
Keyword(s):  
Quality Of Life ◽  
Colorectal Cancer ◽  
Metastatic Colorectal Cancer ◽  
Wild Type ◽  
The Impact

Colorectal cancer survivors’ quality of life: a qualitative study of unmet need

2020 ◽  
pp. bmjspcare-2020-002190
Author(s):  
Amanda Drury ◽  
Sheila Payne ◽  
Anne-Marie Brady
Keyword(s):  
Quality Of Life ◽  
Colorectal Cancer ◽  
Supportive Care ◽  
Cancer Survivors ◽  
Unmet Needs ◽  
Unmet Need ◽  
Safety Net ◽  
The Impact

ObjectiveCancer survivors’ perceptions of healthcare have been identified as a predictor of quality of life (QoL) outcomes. This study aims to explore colorectal cancer (CRC) survivors’ perceptions of how cancer-related healthcare affects their QoL.MethodsSemistructured interviews were conducted with 22 CRC survivors receiving follow-up care between 1 and 5 years post diagnosis. Interviews were recorded, transcribed and analysed thematically.ResultsFive themes described the impact of healthcare experiences on CRC survivors’ QoL. While cancer survivors spoke positively of their relationships with healthcare professionals, many experienced a range of unmet information and supportive care needs. Participants described a range of positive and negative experiences, as power dynamics and navigation of healthcare systems had implications for their QoL. Where negative healthcare events aligned, survivors’ autonomy, dignity and confidence were undermined, and survivorship issues could be inadequately addressed. To address persistent unmet needs, survivors developed a safety net(work) of supports to bridge the gap of unmet needs in healthcare with varying outcomes.ConclusionsCancer survivors’ experience of follow-up and healthcare can positively or negatively affect their QoL. Preparation for cancer survivorship must be incorporated into the acute phase of diagnosis and treatment and interlinked with clear pathways of survivorship care and accessible supportive care, which support survivors to be equal partners in their healthcare. Understanding cancer survivors’ knowledge, expertise and mastery of their condition is essential to ensure delivery of person-centred supportive care that adequately addresses the survivor’s unmet needs.

The impact of telehealth care on health-related quality of life of patients with heart failure: Results from the Danish TeleCare North heart failure trial

2019 ◽  
Vol 26 (7-8) ◽  
pp. 452-461 ◽  
Author(s):  
Simon L Cichosz ◽  
Flemming W Udsen ◽  
Ole Hejlesen
Keyword(s):  
Quality Of Life ◽  
Heart Failure ◽  
Health Related Quality ◽  
Primary Analysis ◽  
Sf 36 ◽  
Patients With Heart Failure ◽  
Related Quality ◽  
Health Related ◽  
The Impact

Aim The aim of this study was to assess the impact on health-related quality of life (HRQoL) of a telehealth care solution compared with usual practice of patients with heart failure (HF). Methods A randomized controlled trial with a telehealth care solution (Telekit) as the intervention (with a focus on self-empowerment achieved by engaging patients in their own illness through self-monitoring) combined with usual care and usual care as the control. The primary outcome was a change in HRQoL as measured by the Short Form-36 (SF-36) questionnaire Physical Component Summary (PCS) score. Secondary outcomes were changes in HRQoL as measured by the SF-36 questionnaire Mental Component Summary (MSC) score and the HF disease-specific questionnaire Kansas City Cardiomyopathy Questionnaire 12 (KCCQ12) score, all of which were assessed from baseline to approximately 12 months’ follow-up between the two groups. Outcomes were assessed via unadjusted and adjusted analyses. Results At baseline, 299 (145 interventions, 154 controls) patients were enrolled. In the primary analysis ( n = 299), the adjusted intervention effects were PCS –0.81 (95% CI −2.7–1.1), MCS 4.66 (95% CI 1.8–7.5) and KCCQ12 3.67 (95% CI −0.7–8.1). Only the change in MCS was statistically significant. An unadjusted analysis replicated the primary analysis. Complete case analyses ( n = 193) generally resulted in a lower intervention effect on the PCS score, but the difference remained statistically insignificant. Conclusions Only the MCS score was significantly higher in the telehealth care group compared to the control group. ClinicalTrials.gov (NCT02860013), July 28, 2016

Impact of Depressive Symptoms on the Work-life Quality of Financial Workers in China

2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1 ◽  
Author(s):  
X.-L. Wang
Keyword(s):  
Depressive Symptoms ◽  
Interpersonal Relationships ◽  
Turnover Intention ◽  
Large Scale ◽  
Univariate Analysis ◽  
Life Quality ◽  
Well Being ◽  
Work Life ◽  
The Impact

Depression cases have been reported among workers in the financial industries. Occupations in this industry are considered among the most stressful ones. This study aimed to examine the impact of depressive symptoms of financial workers in China on their productivity and well-being. A survey was conducted using a convenient sample of 1024 financial workers recruited from three large-scale financial organizations located in the north and south of China. The result of Hierarchical Regression Analyses shows that depressive symptoms of workers significantly impaired their work-life quality. Severity of depressive symptoms had significant positive relationships with three behavioral manifestations at works. These are, in order of decreasing effect size, turnover intention, presenteeism, and absenteeism. Specifically, depressive symptoms had a larger effect on presenteeism compared to absenteeism, which implies the unawareness or insufficient recognition of Chinese workers towards depression as an illness in comparison with other physical illnesses. Moreover, a Univariate Analysis was conducted to study the moderating effect of emotional labor on the relationship between the severity of depressive symptoms and presenteeism. An aggravating effect was found, displaying a greater damage of depressive symptoms to psychosocial functions of workers. Besides, depressive symptoms of workers also impaired their quality of life in aspects such as interpersonal relationships, life situation, and so on. This study provides evidence of impairments of depression in the workplace, urging the management to pay more attention to its employees' mental health no matter whether it is for the sake of the company's benefit or the employees' well-being.

scholarly journals TPH Gene Polymorphisms Are Associated With Disease Perception and Quality of Life in Women With Irritable Bowel Syndrome

2012 ◽  
Vol 16 (1) ◽  
pp. 95-104 ◽  
Author(s):  
Sang-Eun Jun ◽  
Ruth Kohen ◽  
Kevin C. Cain ◽  
Monica E. Jarrett ◽  
Margaret M. Heitkemper
Keyword(s):  
Quality Of Life ◽  
Irritable Bowel Syndrome ◽  
Gene Polymorphisms ◽  
Tryptophan Hydroxylase ◽  
Univariate Analysis ◽  
Gastrointestinal Symptoms ◽  
Tph2 Gene ◽  
Irritable Bowel ◽  
The Impact

The aims of this exploratory study were to examine whether tryptophan hydroxylase ( TPH) gene polymorphisms are associated with psychosocial factors in women with irritable bowel syndrome (IBS). TPH is the rate-limiting enzyme in the biosynthesis of serotonin and has two isoforms, TPH1 and TPH2. Four single nucleotide polymorphisms (SNPs) in the TPH1 gene and one SNP in the TPH2 gene were selected based on previous studies investigating associations between these SNPs and psychiatric or behavioral disorders. One hundred ninety-nine Caucasian women with IBS were included. Results of univariate analysis showed no association between TPH1and TPH2 gene SNPs and current level of psychological distress or psychiatric illness. However, TPH1 gene SNPs were associated with IBS-related cognitions (rs4537731 and rs21105) and quality of life (rs684302 and rs1800532), in particular the mental health and energy subscales. These associations were independent of the subjects’ levels of gastrointestinal symptoms. These results suggest that patients’ perception of their illness, and of the impact it has on their lives, may be subject to genetic influences, in this case sequence variants in TPH1. However, caution should be used in interpreting these results given the large number of hypothesis tests performed in this exploratory hypothesis-generating study, and the results should be considered tentative until confirmed in an independent sample.

Sarcoligo: Impact of local ablative treatment of oligometastatic sarcomas on overall survival.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 10042-10042
Author(s):  
Juliette Thariat ◽  
Laurence Moureau-Zabotto ◽  
Nicolas Penel ◽  
Antoine Italiano ◽  
Jacques-Olivier Bay ◽  
...  
Keyword(s):  
Overall Survival ◽  
Lung Metastases ◽  
Univariate Analysis ◽  
Survival Rates ◽  
Locoregional Treatment ◽  
Metastatic Sites ◽  
The Impact

10042 Background: 40-50% of sarcomas become metastatic. Median survival of metastatic patients has improved over time. The probably multifactorial reasons for such improvement are not fully clear. Noteworthy, for patients with a controlled primary and a limited number of lung metastases, complete resection of their metastases yields survival rates of up to 40% at three years. Advances in surgery, radiotherapy and radiofrequency have fostered the use of local treatments for various metastatic sites (lung, liver, spine...). Methods: A multicentric retrospective study of the Groupe Sarcome Francais (GSF-GETO); approved by the nationally-review board and ethical committee, was conducted to assess the impact of local ablative treatment on overall survival. Patients who had had oligometastases (any site, 1-5 synchronous metastases) at diagnostic or during the course of disease between 2000 and 2010 were included. Results: Median age of the 243 oligometastatic sarcoma patients was 53 years-old (11-86). Patients had grade I, II and III in 7.5%, 29.6% and 63.3% of cases, respectively with various histologies. 69% of patients underwent local ablative treatment of metastases. Median follow-up was 59 months (4-212) for living patients. Median overall survival was 51 months (1-348). On univariate analysis, grade, histology, absence of chemotherapy, local ablative treatment (surgery, irradiation, radiofrequency or chemoembolisation) correlated with survival but not age or site of oligometastasis. On multivariate analyses, grade (hazard ratio HR 0.12 [CI95 0.3-0.6]) and local ablative treatment (HR 3.8 [CI95 2.1-7.1]) remained significant. Conclusions: Local ablative treatment of metastases is associated with better survival in sarcoma patients with oligometastatic disease. The role of the locoregional treatment of metastases and its impact on quality of life should be assessed prospectively.

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