Identifying cancer patients’ care needs after discharge hospital using health claim data linked with Hospital-based Cancer Registry data in Japan.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e18012-e18012
Author(s):  
Ayako Okuyama ◽  
Yukie Takemura ◽  
Takahiro Higashi
Keyword(s):  
Cancer Patients ◽  
Cancer Registry ◽  
Cancer Care ◽  
Daily Living ◽  
Continuous Treatment ◽  
Care Needs ◽  
Discharge Data ◽  
Control Plan

e18012 Background: In 2018, the 3rd Cancer Control Plan developed in Japan. This plan recommends that we should create a better society for cancer patients to keep living at their homes after leaving hospital. In order to grasp the continuous health care needs, we investigated independence degree of Activities of Daily Living (ADL) at the time of discharge for cancer patients by hospital types. Methods: We analyzed the health insurance claims database linked with the hospital-based cancer registry of 230 cancer care hospitals covered the period from October 2012 to December 2014. Data were abstracted from patients who 1) were diagnosed with breast, lung, liver, colorectal, stomach, pancreas, or prostate cancer in 2013; 2) were 20 years or older at the time of the diagnosis; and 3) received the first course or continuous treatment at the hospital. Ministry of Health, Labor and Welfare designates cancer care hospitals (DCCHs) to provide a high quality of cancer care. In each prefecture, one hospital is designated as Type 1 DCCH, and it has the role of supporting other DCCHs in that prefecture. Remaining DCCHs are Type 2 DCCHs. Hospitals which are not designated as DCCHs are categorized into other hospitals. We assessed the differences of patient’ ADL status by these hospital types. Results: We extracted 37,523 patients’ discharge data (8,271 from Type 1 DCCHs, 28,200 from Type 2 DCCHs, and 1,052 from other hospitals). The mean age (SD) at the time of diagnosis was 65.6 (11.7) at Type 1 DCCHs, 69.1 (11.0) at Type 2 DCCHs, and 70.0 (12.3) at other hospitals. The percentage of clinical stage IV in other hospitals (25.3%) was slightly higher than others (22.5%). In total, 16.2% of patients need all assistance for bathing, while only 3.5% of patients need all assistance for eating. More patients at other hospitals were need assistance for ADL compared to patients at DCCHs. For example, 10.6% of patients need all assistance for bathing in type 1 DCCHs, while 25.2% of patients need it in other hospitals. Conclusions: Many patients discharged in not DCCHs need more assistance for their daily living. We should take these situation into account when we provide appropriate support for cancer patients.

scholarly journals Protective Effects of Konjac and Inulin Extracts on Type 1 and Type 2 Diabetes

2019 ◽  
Vol 2019 ◽  
pp. 1-12
Author(s):  
Tianle Gao ◽  
Yue Jiao ◽  
Yang Liu ◽  
Tao Li ◽  
Zhiguo Wang ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Blood Glucose ◽  
Dose Group ◽  
Vehicle Control ◽  
Continuous Treatment ◽  
High Risk Population ◽  
Wild Type ◽  
Group A

Objective. The present study was designed to determine whether konjac and inulin extracts or their combination, konjac-inulin (KI) composition, as diet supplementary, can exert beneficial effects against type 1 diabetes and type 2 diabetes using animal models. Methods. A total of 60 diabetic (type 1) rats induced by streptozotocin (STZ) were randomly assigned to five groups: vehicle control (STZ group), KI combination at low dose group (KI-L group), KI combination at medium dose group (KI-M group), KI combination at high dose group (KI-H group), konjac extract group (konjac group), and inulin extract group (inulin group). A sham group (without STZ) was also included. Levels of blood glucose were monitored at each week. After continuous treatment of each diet for 24 days, a glucose tolerance test was performed. After 28 days of treatment, plasma biochemical indicators including glycated serum proteins, total cholesterol, and triglycerides were measured and immunohistochemistry staining of the rat pancreas was performed, to study the insulin expressions. Type 2 diabetes was developed in db/db mice. A total of 28 db/db mice were divided into 4 groups: vehicle control (db/db group), KI composition group (KI group), konjac extract group (konjac group), and inulin extract group (inulin group). A wild-type control group (wild-type group) for db/db mice was also included. Levels of blood glucose, body weight, and blood triglycerides were monitored at each week. Results. Daily use of the KI composition significantly decreased levels of blood glucose and blood triglycerides, as well as improved the insulin production in islets or reduced development of obesity in STZ-induced diabetic rats or in db/db mice. Such effects from KI composition were better than single ingredient of konjac or inulin extract. Conclusion. The results of this study suggest that daily use of KI composition has a protective role on type 1 and 2 diabetes and provided experimental basis for further development of KI composition as a food supplement for diabetic or diabetic high-risk population.

Quality of care for breast cancer patients in Japan: An analysis of the Japanese Breast Cancer Registry

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. 6547-6547
Author(s):  
H. Mukai ◽  
T. Higashi ◽  
T. Iwase ◽  
T. Sobue
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Cancer Registry ◽  
Cancer Care ◽  
Breast Cancer Patients ◽  
Breast Cancer Care ◽  
Recommended Care ◽  
Adherence Score ◽  
Breast Cancer Registry

6547 Background: In Japan, growing concern that patients do not receive optimum care led to the enactment of the Cancer Control Act in 2006, which mandates the government to undertake initiatives in ensuring the quality of cancer care. Here, we evaluated the current status of breast cancer care in Japan using process-of-care quality indicators (QIs) for breast cancer care. Methods: Combining clinical evidence and expert opinion, we developed 45 QIs covering the continuum of breast cancer care from initial evaluation to follow-up. Each QI describes standards of a particular aspect of care, and its score is calculated as the percentage of applicable patients who received the recommended care (adherence score). Of the 45 QIs, 7 could be scored using data in the Japanese Breast Cancer Registry, which covers about 40% of all Japanese breast cancer patients and has been continuously maintained since 1975. Results: The study population included 15,227 patients registered by 224 facilities in 2005. On average, patients received 72.1% of recommended care. However, substantial variation in adherence was seen across QIs (21–98%). Adherence score was less than 85% in five of seven QIs. Variation across facilities was observed in six QIs. Conclusions: The quality of breast cancer care in Japan has room for improvement in many aspects of care. Although the amount of data in the cancer registry suitable for quality assessment is limited, it is useful in detecting quality problems. [Table: see text] No significant financial relationships to disclose.

scholarly journals CD4/CD8 Ratio of Pleural Effusion Is A Prognostic Predictor for Non-Small Cell Lung Cancer Patients Under Immune Checkpoint Inhibitor Treatments

2021 ◽  
Author(s):  
Po-Hsin Lee ◽  
Tsung-Ying Yang ◽  
Kun-Chieh Chen ◽  
Yen-Hsiang Huang ◽  
Jeng-Sen Tseng ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Pleural Effusion ◽  
Cancer Patients ◽  
Immune Checkpoint ◽  
Checkpoint Inhibitors ◽  
Lung Cancer Patients ◽  
Predicting Factor ◽  
Type 3

Abstract Pleural effusion is a rare immune-related adverse event for lung cancer patients receiving immune checkpoint inhibitors (ICIs). We enrolled 281 lung cancer patients treated with ICIs and 17 were analyzed. We categorized the formation of pleural effusion into 3 patterns: type 1, rapid and massive; type 2, slow and indolent and type 3, with disease progression. CD4/CD8 ratio of 1.93 was selected as the cutoff threshold to predict survival. Most patients of types 1 and 2 effusions possessed pleural effusion with CD4/CD8 ratios > = 1.93. The median OS time in type 1, 2, and 3 patients were not reached, 24.8, and 2.6 months. The median PFS time in type 1, 2, and 3 patients were 35.5, 30.2, and 1.4 months. The median OS for the group with pleural effusion CD4/CD8 > = 1.93 and < 1.93 were not reached and 2.6 months. The median PFS of those with pleural effusion CD4/CD8 > = 1.93 and < 1.93 were 18.4 and 1.2 months. In conclusion, patients with type 1 and 2 effusion patterns had better survival than those with type 3. Type 1 might be interpreted as pseudoprogression of malignant pleural effusion. CD4/CD8 ratio > = 1.93 in pleural effusion is a good predicting factor for PFS.

scholarly journals Experience of Cancer Patients on their Visit to Cancer Outpatient Department: A Qualitative Study from a Regional Hospital in Mauritius

2020 ◽  
Author(s):  
Abhishek Kashyap ◽  
Indrajit Banerjee ◽  
Akash Thakur ◽  
Vaishali Notwani ◽  
Mitanshi Raghuvanshi
Keyword(s):  
Qualitative Study ◽  
Cancer Treatment ◽  
Cancer Patients ◽  
Cancer Care ◽  
Treatment Compliance ◽  
Sampling Technique ◽  
Emotional Reactions ◽  
Care Needs ◽  
Female Ratio ◽  
State Of Mind

Introduction: Cancer care studies suggest that being diagnosed with cancer, the patients and their families face various hardships such as financial crisis, increased mental stress, difficulty in managing their relationships and routine lifestyle activities. Moreover, psycho-oncological studies also describe the intense distress and disbelief experienced by patients on their initial diagnosis. The role of cancer care needs to be understood as well as implemented in cancer treatment, thus further enriching the insights of the treating oncologist about their patient’s state of mind. This ultimately allows for the betterment of treatment compliance. Aim: To study the experience of cancer patients on their visit to the cancer clinic and the emotional turmoil after diagnosis and throughout treatment. Materials and Methods: A descriptive phenomenological qualitative study was designed and conducted from August to September 2019 at the Oncology Department of Victoria Hospital, Mauritius. Participation in the study was voluntary, and written consent was taken from each of the study participants. The data was collected on an in-depth one on one interview basis and was recorded, and the purposive sampling technique was used for collecting the data. Results: Out of 12 patients, the male/female ratio equated to 5:7, these patients were from the ages of 23 to 70 years and the mean age of the participants was 48.2 years. A total of 25 different codes were generated in the study, seven main themes were established there from (Motivational factors, Psychological factors, Society, Message for others, Awareness about the disease, Economic factors and Perception towards the healthcare environment). Conclusion: The main implication that emerged from this study is the notion of the lateral views of informal caregivers, family members and medical professionals, towards the patient’s feelings and emotional reactions in respect to their experience of cancer. It has been noted that the positivity of the caregiver corresponds directly to positive outcomes in the cancer treatment whilst simultaneously decreasing the psychological ramifications of the process.

scholarly journals 13 Caregiving Burden and Unmet Support Needs in Chinese Caregivers and Cancer Patients

2021 ◽  
Vol 50 (Supplement_1) ◽  
pp. i1-i6
Author(s):  
D Y P Leung
Keyword(s):  
Cancer Patients ◽  
Daily Living ◽  
Information Needs ◽  
Protective Factor ◽  
Complete Information ◽  
Support Needs ◽  
Care Needs ◽  
Convenience Sample ◽  
Caregiving Burden ◽  
Roles And Responsibilities

Abstract Introduction Cancer burden continues to rise globally and locally. Due to the shift of the cancer care from the hospital to the community, many cancer patients requiring needs in palliative care from their informal caregivers. Many caregivers often taking up the important roles and responsibilities but their own needs are largely neglected, and hence may induce caregiving burden. This study aims to explore the relationships of caregiving burden with unmet support needs in both cancer patients and their caregivers. Method A convenience sample of 280 patient-caregiver dyads was recruited from the oncology outpatient clinic of two hospitals in Hong Kong between April and June 2018. Among them, 258 (92.1%) patient-caregiver dyads provided complete information on unmet supportive care needs (Patient: the 34-item SCNS-SF34-C, Caregivers: the 26-item SPUNS-SF), and caregiving burden (Caregiver Strain Index). Results Among the patients, their mean age was 60.8 (SD = 13.6) and 66% were female. Among the caregivers, their mean age was 49.3 (SD = 14.6), 67.2% were female, and 38.2% were children of the patient. Mean level caregiving burden in caregivers was 4.87 (SD = 3.75) out of a range 0–13. Regression analysis showed that higher caregiving burden was associated significantly with higher caregiver’s unmet support in personal and emotional needs (βstd = 0.348) and future concerns (βstd = 0.204), and patient’s unmet support in physical and daily living needs (βstd = 0.201), but lower caregiver’s unmet support in information needs (βstd = −0.233) after controlling for age, gender, and education level of both patients and caregivers. Conclusions The findings shed lights in designing interventions aim at reducing caregiving burden by targeting caregiver’s unmet support in personal and emotional need and those caregivers are taking care of cancer patients with unmet support in physical and daily living needs. However, the finding on caregiver’s unmet support in information needs was a protective factor of caregiving burden warrants further exploration.

Identification of supportive care needs in a sample of Puerto Rican cancer patients with the Supportive Care Needs Survey-34 (SCNS-34)

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. e20697-e20697
Author(s):  
V. Gonzalez ◽  
M. Velez ◽  
E. Pedro ◽  
C. Cruz ◽  
M. Cotto ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Supportive Care ◽  
Health System ◽  
Puerto Rican ◽  
Cancer Patients ◽  
Clinical Data ◽  
Daily Living ◽  
Supportive Care Needs ◽  
Care Needs ◽  
Perceived Needs

e20697 Background: The assessment of supportive care needs is important in the management of cancer patients. The Supportive Care Needs Survey (SCNS-34) was administered to a population of Puerto Rican cancer patients to assess their perceived needs in five domains (psychological, health system and information, physical and daily living, patient care and support, and sexuality.) Methods: Patients attending the surgical, radiation and medical oncology clinics at the Puerto Rico Medical Center participated in the study. After informed consent, patients completed the Spanish- Puerto Rican translation of the SCNS-34. A second instrument to measure the quality of the SCNS-34 was administered. Demographic and clinical data was obtained from medical records. Descriptive, univariate and multivariate analysis was performed to assess correlation between reported needs and demographic and clinical data. To assess the validity and consistency of the Spanish Puerto Rican translation of the SCNS-34, the Cronbach's alpha test was used. Results: A total of 103 patients participated in the study (female n=66; male n=37). Median age was 54 years. The most common malignancies were breast cancer (29 patients), gynecologic cancers (22 patients), prostate cancer (17 patients) and gastrointestinal cancers (14 patients). The overall internal consistency of the instrument was 0.882. Patients perceived needs were highest in the domains of sexuality (67%), physical and daily living (55.3%), and psychological (38.8%). Logistic regression analysis demonstrated that younger age was an independent predictor of perceived needs in the psychologic domain (p=0.010). Also, a diagnosis of breast cancer was a significant predictor of perceived needs in the health system and information domain (p=0.020). Being a female was correlated with reporting needs in the domain of physical and daily living (p=0.009). Educated patients were more prone to perceive needs in the domains of sexuality (p=0.045). Conclusions: The Spanish- Puerto Rican translation of the Supportive Care Needs Survey (SCNS-34) showed satisfactory internal consistency and validity. The supportive care needs of Puerto Ricans cancer patients seem to be affected by age, gender, and cancer site. No significant financial relationships to disclose.

scholarly journals Pattern and Predictors of Unmet Supportive Care Needs in Cancer Patients

2018 ◽  
Vol 4 (Supplement 2) ◽  
pp. 117s-117s
Author(s):  
P. Okediji ◽  
O. Salako ◽  
O. Fatiregun
Keyword(s):  
Quality Of Life ◽  
Supportive Care ◽  
Cancer Patients ◽  
Cancer Care ◽  
Unmet Needs ◽  
Supportive Care Needs ◽  
Emotional Instability ◽  
Care Needs ◽  
Wide Range

Background: The incidence of cancers is increasing, and this is associated with an increase in the burden of the disease. Patients with cancer have to deal with reduced physical functioning, emotional instability, difficulty in concentrating, and an overall diminished feeling of well-being. This creates deficits that have not been well catered for by traditional cancer care, leading to an overall dissatisfaction with care, and a reduced quality of life. Aim: This review aims at assessing the pattern of unmet needs in cancer patients and to provide information as to the factors that influence the perception of unmet needs. Methods: Studies directly focused on unmet needs in cancer patients were retrieved from MEDLINE, PubMed, PsychINFO, Embase, and Google Scholar; from the earliest records until 2016. Unmet needs in cancer patients have been measured with a wide variety of tools, with the Supportive Care Needs Survey (SCNS) being the most commonly used as a result of its strong psychometric properties, ease of use, responsiveness, and its coverage of all the domains of unmet needs. Results: The most common unmet needs were in the domains of health system and information, psychological, and physical and daily living. These needs were influenced by sociodemographic factors such as age, sex, marital status, income level; and clinical factors such as location of cancer, stage of disease, and tumor size. Conclusion: It is clear that cancer patients experience a wide range of unmet supportive needs, for which efforts need to be desperately made to improve the supportive care services for these patients and their quality of life. While it may not be possible to meet all the needs of every cancer patient, routine and regular monitoring of unmet needs using the appropriate tools is crucial so that cancer care and other health professionals can develop, implement, and streamline specific aspects of cancer care to strategically meet the specific needs of their patients.

scholarly journals The Unmet Supportive Care Needs of Nigerian Patients With Cancer

2018 ◽  
Vol 4 (Supplement 2) ◽  
pp. 118s-118s
Author(s):  
O. Fatiregun ◽  
P. Okediji ◽  
O. Awofeso ◽  
A. Sowunmi ◽  
M. Habeebu ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Supportive Care ◽  
Cancer Patients ◽  
Psychological Health ◽  
Daily Living ◽  
Unmet Needs ◽  
Care Needs ◽  
Care And Support ◽  
The Mean

Background: Cancer is an important cause of morbidity and mortality globally, and its incidence has been on the increase in Nigeria, and the rest of the world. The diagnosis and treatment of cancer is associated with significant psychological distress and patients face a broad range of challenges which create a huge vacuum of “unmet needs” that patients feel as a loss of personal control and frustration. This impacts negatively on their quality of life and other care outcomes. Aim: This study was aimed at determining the magnitude, distribution, and predictors of unmet needs in Nigerian cancer patients. Methods: Using a descriptive cross-sectional approach, 205 cancer patients attending oncology outpatient clinics at Lagos University Teaching Hospital (LUTH), Idi-Araba, were assessed for unmet needs. Eligible patients were given the self-administered Supportive Care Needs Survey - Short Form (SCNS-SF34) questionnaire with focus on five domains of need - psychological, health system and information, physical and daily living, patient care and support, and sexuality. Data analysis was carried out with SPSS version 20, and the level of significance was set at < 0.05. Results: The mean age of the 205 cancer patients was 47.4 ± 12.3 years, who are predominantly females (96.6%). The most common diagnosis was breast cancer (92.2%), and the mean duration since diagnosis was 20.9 ± 21.9 months for all the patients. The mean SCNS score was 83.9 ± 24.8, and at least 46% of the participants indicated unmet needs in 15 items of the SCNS. The most frequent unmet needs were related to the health information (53.4%), physical and daily living (49.4%), and psychological (48.5%) need domains. The most frequently met needs were in the sexuality, and patient care and support need domains. None of the factors considered (age, gender, marital status, family type, educational attainment, employment status, economic status, presence of financial support, social support, and cancer type) were significantly predictive of unmet needs in these patients ( P > 0.05). Conclusion: Nigerian cancer patients experience high levels of unmet needs, particularly in the areas of health information, physical and daily living, and psychological health. Hence, there is an urgent need to provide sustainable and long-term interventions and support for these patients to help them achieve increased care satisfaction, improved treatment outcomes, and a better quality of life.

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