Assessing perceptions of transition readiness in the adolescent and young adult oncology population.

2018 ◽  
Vol 36 (7_suppl) ◽  
pp. 73-73
Author(s):  
Vaibhav Agrawal ◽  
Kristina K. Blessing ◽  
Andrea Berger ◽  
Amanda Schleicher ◽  
Mike Styer ◽  
...  

73 Background: Childhood cancer patients have distinct health-related needs as they transition from patient to survivor and from pediatric to adult-based care. This study used the Transition Readiness Assessment Questionnaire (TRAQ) to assess transition readiness and compare variation in readiness perceptions between patients, parents, and physicians. Methods: The TRAQ was completed by patients between ages 12 to 26 and their parent and oncologist at Geisinger Medical Center from Sept. 2015 to Dec. 2016. Surveys were scored according to validated methods (min. 1, max. 5). Statistical analysis was completed using SAS 9.4. Results: The study enrolled 49 patients, including 6 patients (12.2%) and 43 survivors (87.8%). There were 29 males (59.2%). The patient’s mean age at the time of survey was 18.4 years. Cancer types included: acute lymphoblastic leukemia (n = 17), lymphoma (n = 12), and sarcoma (n = 7). There were no significant differences in overall TRAQ scores between parents, patients, and physicians (mean 3.2, 3.5, and 3.7, respectively). The highest interobserver agreement was seen between patients and parents; the lowest was seen between physicians and patients. The greatest competency was assessed in the activity of talking with providers, and the lowest was measured in appointment keeping. In the domain of tracking health issues, providers assigned higher scores than patients (p = 0.003) and parents (p = 0.001). In the skill of talking with providers, patients ranked themselves higher than providers (p = 0.003). There was no significant variation in scores based on disease type, length of therapy, or insurance type. Patient age at diagnosis, patient age at therapy completion, and patient age at survey were correlated with higher patient (p = 0.004, p = 0.002, p = 0.0001, respectively), parent (p = 0.017, p = 0.019, p = 0.0001, respectively), and physician (p = 0.027, p = 0.03, p = 0.0001, respectively) scores. Conclusions: This study demonstrated that the overall assessment of transition readiness in the adolescent and young adult oncology population was similar between patients, parents, and physicians. The TRAQ is a tool that can be effectively used to guide healthcare transition in this population.

2020 ◽  
pp. jim-2020-001506
Author(s):  
Avinoam Markovich ◽  
Ohad Ronen

Acute suppurative parotitis (ASP) is an acute infection of the parotid gland that necessitates hospitalization in some patients. The aim of this study was to evaluate clinical laboratory values including hydration, nutritional status, inflammatory markers and age, and to compare them with duration of hospitalization of patients with ASP. This is a retrospective chart review in a tertiary academic center. We investigated the factors affecting length of hospitalization in patients admitted to Galilee Medical Center with a diagnosis of ASP between 2010 and 2018. Of the 60 patients with ASP included in the study, 24 were male. The average age of patients was 60, ranging from 18 to 99. We found statistically significant correlations between length of hospitalization and patient age (r=0.3), C reactive protein (r=0.3), white cell count (WCC) at presentation (r=0.3), blood urea nitrogen to creatinine ratio (BUN:Cr) (r=0.2), and platelet levels at discharge (r=0.4). Examination of these factors on multivariate analysis found hospitalization duration was exclusively affected by patients’ level of dehydration as represented by BUN:Cr. Patient age, WCC levels at presentation, and platelet levels were not found to be statistically significant. Treatment and interventions should be planned accordingly.


2011 ◽  
Vol 1 (4) ◽  
pp. 160-163 ◽  
Author(s):  
Kate E. Waimey ◽  
Angela D. Krausfeldt ◽  
Robert L. Taylor ◽  
Harlan D. Wallach ◽  
Teresa K. Woodruff, on behalf of the Oncofert

2019 ◽  
Vol 66 (5) ◽  
pp. e27608 ◽  
Author(s):  
Bryan A. Sisk ◽  
Kristin Canavera ◽  
Akshay Sharma ◽  
Justin N. Baker ◽  
Liza‐Marie Johnson

2016 ◽  
Vol 7 (2) ◽  
pp. 61-69 ◽  
Author(s):  
Sidney T. Le ◽  
S. Andrew Josephson ◽  
Hans A. Puttgen ◽  
Lorrie Gibson ◽  
Elan L. Guterman ◽  
...  

Introduction: Reducing unplanned hospital readmissions has become a national focus due to the Centers for Medicare and Medicaid Services’ (CMS) penalties for hospitals with high rates. A first step in reducing unplanned readmission is to understand which patients are at high risk for readmission, which readmissions are planned, and how well planned readmissions are currently captured in comparison to patient-level chart review. Methods: We examined all 5455 inpatient neurology admissions over a 2-year period to University of California San Francisco Medical Center and Johns Hopkins Hospital via chart review. We collected information such as patient age, procedure codes, diagnosis codes, all-payer diagnosis-related group, observed length of stay (oLOS), and expected length of stay. We performed multivariate logistic modeling to determine predictors of readmission. Discharge summaries were reviewed for evidence that a subsequent readmission was planned. Results: A total of 353 (6.5%) discharges were readmitted within 30 days. Fifty-five (15.6%) of the 353 readmissions were planned, most often for a neurosurgical procedure (41.8%) or immunotherapy (23.6%). Only 8 of these readmissions would have been classified as planned using current CMS methodology. Patient age (odds ratio [OR] = 1.01 for each 10-year increase, P < .001) and estimated length of stay (OR = 1.04, P = .002) were associated with a greater likelihood of readmission, whereas index admission oLOS was not. Conclusions: Many neurologic readmissions are planned; however, these are often classified by current CMS methodology as unplanned and penalized accordingly. Modifications of the CMS lists for potentially planned neurological and neurosurgical procedures and for acute discharge neurologic diagnoses should be considered.


2019 ◽  
Vol 69 (6) ◽  
pp. 485-496 ◽  
Author(s):  
Allison G. Close ◽  
Alexandra Dreyzin ◽  
Kimberly D. Miller ◽  
Brittani K.N. Seynnaeve ◽  
Louis B. Rapkin

2017 ◽  
Vol 1 (22) ◽  
pp. 1945-1958 ◽  
Author(s):  
Justine M. Kahn ◽  
Nmazuo W. Ozuah ◽  
Kieron Dunleavy ◽  
Tara O. Henderson ◽  
Kara Kelly ◽  
...  

Abstract Lymphomas are responsible for approximately 20% to 25% of annual cancer diagnoses in the adolescent and young adult (AYA) population. In 2006, the National Cancer Institute and the Lance Armstrong Foundation developed a joint Adolescent and Young Adult Oncology Progress Review Group (AYAO-PRG) to formally address the unique cancer burden of patients age 15 to 39 years. As part of their recommendations, the AYAO-PRG identified 5 imperatives for improving outcomes of AYAs with cancer. Broadly, the recommended areas of focus included research, awareness and education, investigational infrastructure, care delivery, and advocacy. In response to the challenges highlighted by the AYAO-PRG, the Lymphoma Research Foundation held the first AYA Lymphoma Research Foundation Symposium on 2 October 2015. At this symposium, clinicians and basic scientists from both pediatric and adult disciplines gave presentations describing the state of the science and proposed a collaborative research agenda built on the imperatives proposed by the AYAO-PRG. The following review presents an in-depth discussion of lymphoma management across pediatric and adult oncologic disciplines, focusing on Hodgkin lymphoma, mature B-cell lymphomas, and anaplastic large cell lymphoma.


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