From common sense to evidence-based: An evaluation of survivorship planning.

2017 ◽  
Vol 35 (5_suppl) ◽  
pp. 76-76
Author(s):  
Sam Gaster
Keyword(s):  
Health Care ◽  
Cancer Survivors ◽  
Health Care Providers ◽  
Common Sense ◽  
Care Providers ◽  
Care Plans ◽  
Follow Up Care ◽  
The Future ◽  
The Impact

76 Background: The Institute of Medicine’s (IOM; 2005) seminal report, From Cancer Patient to Cancer Survivor: Lost in Transition, recommended survivorship care plans (SCPs) as a common sense approach to improve the care of cancer survivors. The American Society of Clinical Oncology (ASCO; Mayer et al., 2014) reiterated the importance of these plans and provided strategic guidance for their implementation. The American College of Surgeons’ Commission on Cancer requires SCP delivery from accredited cancer programs as of 2015. Despite the push from these organizations, SCPs remain understudied (Mayer, Birken, Check, & Chen, 2014). The impact of SCPs on patient outcomes is poorly understood. Additionally, there is limited data on patients’ preferences for SCPs. This evaluation describes the use and assessment of SCPs at six regional cancer centers in the Midwest. Methods: Feedback was collected from 30 cancer survivors after receipt of a SCP. Responses were collected with 22-item questionnaire. Outcomes included survivors’ satisfaction with the clarity and detail of SCPs, likelihood to use SCPs in the future, intention to share SCPs with other health care providers, and perceived knowledge about treatment and follow-up care. Results: Over 75% (n = 23) of survivors agreed that SCPs were easy to understand. Ninety-three percent (n = 28) of survivors indicated that SCPs contained the right amount of information. Fifty-three percent (n = 16) of survivors are very likely to use their SCP in the future, whereas 47% (n = 14) are somewhat likely to use their SCP in the future. The majority (77%; n = 23) of survivors intend to share their SCP with another health care provider. Ninety-seven percent (n = 29) of survivors felt more knowledge about their treatment and follow-up car as a result of receiving a SCP. Conclusions: This evaluation highlights the many benefits of SCPs for cancer survivors. Results suggest that SCPs educate survivors about their treatment and follow-up care. Additionally, results indicate that many survivors intend to share SCPs, perhaps allowing for better coordination between oncology and primary care. Further research is warranted on the adoption of healthy lifestyle behaviors and receipt of routine health care after delivery of SCPs.

Cancer Survivors’ Reported Discussions with Health Care Providers About Follow-Up Care and Receipt of Written Care Plans

2017 ◽  
Vol 33 (6) ◽  
pp. 1181-1188 ◽  
Author(s):  
Sarah C. Reed ◽  
Rod Walker ◽  
Rebecca Ziebell ◽  
Borsika Rabin ◽  
Stephanie Nutt ◽  
...  
Keyword(s):  
Health Care ◽  
Cancer Survivors ◽  
Health Care Providers ◽  
Care Providers ◽  
Care Plans ◽  
Follow Up Care

Monitoring the Physical Health of Cancer Survivors: A Survivorship-Focused Medical History

2006 ◽  
Vol 24 (32) ◽  
pp. 5105-5111 ◽  
Author(s):  
Patricia A. Ganz
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Cancer Survivors ◽  
Medical History ◽  
Health Care Providers ◽  
Primary Care Physicians ◽  
Care Providers ◽  
Follow Up Care ◽  
Physical Effects

Cancer survivors frequently visit their primary-care physicians, as well as oncology specialists, for follow-up care. There is a need to monitor these survivors for the late physical effects of cancer, yet few health care providers have received training in how to do this. This article provides guidance on how to take a cancer survivor-directed medical history to facilitate the elicitation of relevant exposures, family history, and symptoms that may be related to the late effects of cancer therapy.

Predicting and Treating the Sexual Difficulties of Gynecologic Cancer Survivors

1996 ◽  
Vol 3 (2) ◽  
pp. 113-119 ◽  
Author(s):  
Barbara L. Andersen
Keyword(s):  
Health Care ◽  
Cancer Survivors ◽  
Health Care Providers ◽  
Gynecologic Cancer ◽  
Initial Therapy ◽  
Care Providers ◽  
Cancer Treatments ◽  
Clinical Observations ◽  
Behavioral Therapies

Women treated for gynecologic cancer represent approximately 45% of cancer survivors. Many report significant sexual difficulties during follow-up, and data suggest these difficulties are direct consequences of their cancer treatments. Health care providers can identify at the time of initial therapy those women who will be at greater risk for problem development. Clinical observations are provided on the development of sexual problems for these women as they attempt to resume sexual intercourse, and the psychologic and behavioral therapies that can be used for treatment are discussed.

Changing focus: Living with advanced cancer—Development of a palliative care transition project.

2015 ◽  
Vol 33 (29_suppl) ◽  
pp. 152-152
Author(s):  
Paul Joseph Daeninck ◽  
Simone Stenekes ◽  
Tara Carpenter-Kellett ◽  
Jill Talylor-Brown ◽  
Mark Kristjanson ◽  
...  
Keyword(s):  
Health Care ◽  
Palliative Care ◽  
Advanced Cancer ◽  
Health Care Providers ◽  
Care Providers ◽  
Cancer Centre ◽  
Palliative Approach ◽  
Follow Up Care ◽  
Treatment Summary

152 Background: The improvement in cancer screening, detection and treatment is changing the illness trajectory and experience for patients. Many cancer patients are living longer with advanced disease as treatment options have expanded. Thus, accurate prognostication is becoming challenging and referral to palliative care programs is often delayed until close to death. This has made the transition to a predominantly palliative approach to care complex to navigate for the health care team, patient and family. Methods: CancerCare Manitoba has undertaken an innovative project “Changing Focus: Living with Advanced Cancer” to enhance communication with primary health care providers (HCPs) and assist patients and caregivers in the transition to a palliative approach to care. The project includes development of an individualized patient treatment summary that provides details of the patient’s cancer treatment and symptoms, identifies the role of the HCPs involved with the patient and family, as well as the expectations for follow up care at the cancer centre and in the community. The transition appointment includes discussion around the treatment summary, standardized follow up care plan, and written information about palliative care, decision making, symptom management, unique issues for caregivers and details about local supports and resources is provided. Results: This presentation will focus on the development and implementation of this project within the cancer centre and throughout the province. Evaluation of this approach is ongoing. Family members and patients will provide feedback using a standardized questionnaire, and ongoing improvement will be built into the evolution of this program. HCPs will also be engaged in evaluation from their perspective. Conclusions: We expect this intervention will allow patients and families better quality of life and possibly improve the interval between the termination of chemotherapy and death.

scholarly journals Conservative Management of Acute Appendicitis In The Era Of COVID 19: A Multicenter prospective observational study at The United Arab Emirates

2020 ◽  
Author(s):  
Fatima Y. AL Hashmi ◽  
Abeer Al Zuabi ◽  
Ibrahim Y. Hachim ◽  
Guido H.H. Mannaerts ◽  
Omar Bekdache
Keyword(s):  
Health Care ◽  
Acute Appendicitis ◽  
United Arab Emirates ◽  
Health Care Providers ◽  
Conservative Management ◽  
Length Of Hospital Stay ◽  
Operative Management ◽  
Care Providers ◽  
The Impact

Background Since its emergence in December 2019, the Novel Coronavirus (COVID-19) pandemic resulted in a profound impact on the health care system worldwide. We propose herein to evaluate the impact of implementing conservative management as an alternative approach to surgical appendectomy in the treatment of proven acute appendicitis during COVID19 pandemic. Methods Our study is a prospective multicenter study that includes a cohort of 160 patients admitted to the surgical departments in both Tawam Hospital and Sheikh Shakhbout Medical City, Abu Dhabi, UAE, for the period from February 2020 till July 2020. Results Our results showed that 56 of our patients (35%) were treated conservatively, while the other 104 (65%) underwent operative management. There was a significant decrease in length of hospital stay (LOS) (2.32 days) among the first group compared to the second (2.8 days). Also, short term follow-up showed that 90% of those patients did not require further operative intervention or developed any serious complications. Out of the 110 patients that were swapped for COVID19, nine (8.18%) were confirmed to be positive. Our protocol was to avoid surgical management for COVID19 positive patients unless indicated. This resulted in (8/9) of COVID19 positive patients to be treated conservatively. Follow up was achieved by using telemedicine-based follow-up with the aim of empowering social distancing and reducing risk of viral exposure to patients as well as the health care providers. In conclusion, our results showed that the implementation of conservative management in treating patients with acute appendicitis who were COVID19 positive is a safe and feasible approach that maybe essential in reducing viral transmission risks as well as avoiding operative risks on COVID19 positive patients.

(De)Racializing Refugee Medicine

2020 ◽  
Vol 45 (5) ◽  
pp. 829-847
Author(s):  
Michelle Munyikwa
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Cultural Difference ◽  
Refugee Health ◽  
Care Providers ◽  
Structural Racism ◽  
Care Plans ◽  
Economic Injustice ◽  
Based Medicine ◽  
The Impact

Based on ethnographic research within refugee-serving institutions in Philadelphia, Pennsylvania (USA), this paper examines the relationship between physicians and the knowledge they produce and consume about caring for refugees from around the world. I explore the “seething presence” of race in refugee medicine, a domain of medical practice whose entanglement with racial ideology and practice has been underexamined. I consider how knowledge about refugees from different groups—whether racially laden designations like “Asian” or “African” or national markers like Congolese or Burmese—circulates in clinical spaces as health-care teams diagnose and treat refugees using standards of “evidence-based” medicine. Assessing the primary literatures that refugee health-care providers use to justify varying care plans, I argue that race, while often unmentioned, structures the practice of refugee medicine. Additionally, the implicit use of race as an analytic, not racism or economic injustice, often disguises the impact of structural racism and inequality in refugee health disparities. I end with some reflections on how we might conduct a more just practice of refugee health care—and by extension, health care more generally—by shifting our gaze from the particularities of seemingly obvious cultural difference to social structure.

scholarly journals Sexual assault survivors’ perspectives on clinical follow-up in the Eden District, South Africa: A qualitative study

2018 ◽  
Vol 10 (1) ◽  
Author(s):  
Gail Holton ◽  
Kate Joyner ◽  
Robert Mash
Keyword(s):  
Health Care ◽  
Sexual Assault ◽  
Health Care Providers ◽  
Care Providers ◽  
Sexual Assault Survivors ◽  
Care Services ◽  
Follow Up Care ◽  
Negative Perceptions ◽  
Assault Survivors

Background: Although effective follow-up of sexual assault survivors is linked to optimal recovery, attendance at follow-up consultations is poor. It is therefore essential that health care providers maximise the benefit of follow-up care for every sexual assault survivor.Aim: This study explored the personal experiences of sexual assault survivors to better understand the enablers of, and barriers to, attendance at follow-up consultations.Methods: This phenomenological qualitative study was conducted at the three hospitals which manage most sexual assault survivors within the Eden District. Using purposive sampling, 10 participants were selected. Consenting participants shared their experiencesduring semi-structured interviews with the researcher.Results: Authoritative, client-held documentation was a powerful enabler to accessing follow-up care. Individualised, patient-centred care further enhanced participants’ access to, and utilisation of, health care services. The failure of health care providers to integrate follow-up care for sexual assault survivors into established chronic care services was a missedopportunity in the continuum of care. Negative perceptions, based on others’ or personal prior experience of police, judicial and health care systems, were further barriers to follow-up care.Conclusion: This study highlights the need of survivors of sexual assault for integrated,patient-centred care, encompassing principles of good communication. Committed actions of all stakeholders are necessary to tackle negative perceptions that create barriers to follow-upcare. A simple practical strategy, the provision of a scheduled appointment on official stationery, is easy to effect at facility level. As a powerful enabler to follow-up care, this should be implemented as a priority intervention.

Using implementation science to initiate survivorship care plan practice change.

2018 ◽  
Vol 36 (34_suppl) ◽  
pp. 175-175
Author(s):  
Betty Goracke Olguin ◽  
Lindsay L. Benes
Keyword(s):  
Health Care ◽  
Side Effects ◽  
Implementation Science ◽  
Health Care Providers ◽  
Care Coordination ◽  
Survivorship Care ◽  
Care Providers ◽  
Follow Up Care ◽  
Strongly Agree

175 Background: Failure to address coordination of cancer survivorship care can result in physical disability, emotional distress, and increased health care costs. The Institute of Medicine (IOM) recommended Survivorship Care Plans (SCPs) to improve care coordination among cancer survivors. Despite evidence supporting SCPs there remains limited implementation of SCPs. The use of implementation science, frameworks, and strategies that address contextual and process factors, could improve use of SCPs in oncology clinics (Selove et al., 2016). Methods: This innovation used the Quality Implementation Framework (QIF) (Meyers, Durlak, & Wandersman, 2012) to guide implementation. The QIF outlines steps and strategies for four phases of implementation; initial considerations regarding the host setting, creating a structure for implementation, ongoing structure once implementation begins, and improving future application. Results: During the project period (January 29, 2018 through April 23, 2018), 17 SCP visits were conducted; all 17 patients completed study surveys. In response to, “My health care providers work together as a team to ensure that my needs are met,” 65% reported strongly agree, 29% reported agree, 5% reported disagree, and 0% reported strongly disagree. When asked “My health care providers have informed me of what my follow-up care should be” 65% reported strongly agree and 35% reported agree. Of the 17 PCP surveys mailed, four were returned. In response to “For this patient the SCP helps me coordinate follow-up care,” three PCPs responded “agree.” When asked “For this patient, the SCP helps me provide better care,” three responded “strongly agree.” One PCP reported neutral feelings toward both statements. All PCPs reported SCP helped them better understand cancer treatment given and side effects. Conclusions: Successful SCP implementation, replicating outcomes of trials supporting SCPs, is attributable to the use of implementation science. Results from this project demonstrated SCPs achieved care coordination and patient satisfaction. SCPs enhanced PCPs’ understanding of cancer treatment and side effects which could increase likelihood PCPs discuss survivorship issues, as demonstrated in literature.

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