Breaking down barriers: A strategic initiative to collect sexual orientation and gender identity information in the oncology patient population.

2020 ◽  
Vol 38 (29_suppl) ◽  
pp. 128-128
Author(s):  
Georgina T. Rodgers ◽  
Christa Poole ◽  
MaryKay Moore ◽  
Mikayla Baer ◽  
Christina Ferraro ◽  
...  
Keyword(s):  
Sexual Orientation ◽  
Gender Identity ◽  
Health Care Providers ◽  
Comfort Level ◽  
Cancer Center ◽  
Care Providers ◽  
Target Groups ◽  
Oncology Patient ◽  
Increased Risk ◽  
The Impact

128 Background: The LGBT community is a diverse population that crosses race, ethnicity, socioeconomic status, age, and other factors. It is estimated that 8.8 million Americans are part of the community and the number is likely higher due to under reporting. The population is at increased risk for certain cancers, sexually transmitted infections, and is more likely to use alcohol, tobacco, drugs, and suffer from obesity, and behavioral health issues. LGBT patients face barriers to accessing care due to being under-insured, fear of discrimination and lack of access to culturally competent health care providers. Our cancer center embraced the need to collect sexual orientation/gender identity (SOGI) data as a means to identify and address the comprehensive needs of our patients and set a goal to provide an inclusive, patient-centered environment through education of our teams to build a trusted patient-provider relationship. Methods: We implemented a history section in the EHR to assist with data collection including, preferred name, sexual orientation, gender identity, legal sex, and sex assigned at birth. A project team was developed in 2019 to improve utilization of the existing tool and provide education to increase the comfort level of our caregivers. Our target groups consist of advance practice providers, RN care coordinators, social workers and physicians. Educational sessions occurred through multiple modes and “champions” were identified within target groups to keep the momentum going. Results: There was initial hesitation in utilization due to lack of understanding of the impact on patient care and lack of confidence in communication. Training was modified to include communication techniques and the why collection of SOGI data is important. Conclusions: A monthly report was developed to determine utilization of the SOGI fields and as of May 2020 have increased from 1.5% utilization to 17.5% utilization. A survey has been deployed to education attendees to determine pre and post education comfort levels in addressing the SOGI needs of patients and early data is showing a marked improvement in the comfort level of caregivers.

scholarly journals Encouraging patients to disclose their lesbian, gay, bisexual, or transgender (LGBT) status: oncology health care providers’ perspectives

2018 ◽  
Vol 10 (4) ◽  
pp. 918-927 ◽  
Author(s):  
Smita C Banerjee ◽  
Jessica M Staley ◽  
Koshy Alexander ◽  
Chasity B Walters ◽  
Patricia A Parker
Keyword(s):  
Health Care ◽  
Sexual Orientation ◽  
Gender Identity ◽  
Health Care Providers ◽  
Care Delivery ◽  
Comprehensive Cancer Center ◽  
Cancer Center ◽  
Care Providers ◽  
Health Care Environment ◽  
Cross Sectional Survey

Abstract A compelling touted strategy for reducing discrimination towards lesbian, gay, bisexual, and transgender (LGBT) patients is improving communicative competence of health care providers (HCPs); however, evidence base for describing communication practices between HCPs and LGBT patients is scarce. The purpose of this study was to qualitatively examine HCP experiences and perspectives as they relate to patient sexual orientation and gender identity (SOGI) disclosure, perceived communication and structural/administrative challenges in interactions with LGBT patients, and suggestions for improving care of LGBT patients. The sample consisted of 1,253 HCPs, who provided open-ended responses to an online cross-sectional survey conducted at a Comprehensive Cancer Center in the Northeastern United States. The open-ended responses were inductively and deductively coded for key themes and sub-themes. The results demonstrated an array of useful communication strategies employed by oncology HCPs to encourage LGBT patients’ SOGI disclosure (direct questions regarding sexual orientation, use of the term “partner,” and using correct pronouns), communication and structural/administrative challenges faced by HCPs in providing care (HCP own fears and biases, transgender patient care, insurance issues, and procedural challenges for LGBT patients), and suggested recommendations from oncology HCPs to improve their care delivery for LGBT patients (more provider-based training, improving awareness of LGBT-friendly resources, establishing trusting relationships, and not assuming sexuality or gender identity). These findings have implications for developing and evaluating training programs to improve LGBT sensitivity and communication among HCPs, and encourage SOGI disclosure in an open and judgment-free health care environment.

scholarly journals Clinical profile and management of breast cancer in women in a rural based tertiary care hospital our experience

2017 ◽  
Vol 4 (2) ◽  
pp. 697
Author(s):  
Ambikavathy Mohan ◽  
Chandan Kumar
Keyword(s):  
Breast Cancer ◽  
Risk Factors ◽  
Breast Carcinoma ◽  
Health Care Providers ◽  
Diagnostic Methods ◽  
Care Hospital ◽  
Care Providers ◽  
Increased Risk ◽  
The Impact ◽  
Women In India

Background: Breast cancer is the second most common cancer among women in India and accounts for 7% of global burden of breast cancer and one-fifth of all cancers among women in India. The risk factors are related to lifestyle, early menarche, nulli parity, prolonged use of oral contraceptive pills, hormone replacement therapy, not breast‑feeding, alcohol, obesity, lack of exercise, and induced abortion. A woman who attains menopause after fifty five years of age has an increased risk of ovarian, breast, and uterine cancers. The risk is greater if a woman also began menstruating before twelve years of age. A longer exposure to estrogen increases a woman’s risk of breast cancers.Methods: This is a prospective observational study, conducted in the department of surgery, between December 2013 and June 2015(2 years). Patients diagnosed as breast carcinoma and admitted in surgical wards were included, Data pertaining to demography, clinical and pathological tumor profile, and treatment details were collected prospectively for each patient based on patient interviews and medical records. To analyse the Prevalence of breast cancer, clinical presentation, risk factors, diagnostic methods, treatment protocols, difference between pre and post‑menopausal breast cancer women regarding risk factors, assess the impact of treatment given and women’s knowledge about breast cancer.Results: A total number of 25 cases of breast carcinoma based on detailed history, clinical examination, Trucut biopsy, ultrasonography breast and axilla, ultrasound abdomen, mammogram and chest x-ray were analysed. All of them received three cycles of anterior chemotherapy consisting of 5- Fluorouracil 500 mg/m2,Adriamycin 50 mg/m2 Cyclophosphamide 80 mg/m2 (FAC regimen) administered intravenously followed by modified radical mastectomy. There were no recurrences seen on follow up till date.Conclusions: Late stage at presentation of breast cancer is a challenge to the health care providers. Cancer awareness programmes, multidisciplinary approach and evidence‑based strategies for early detection and effective management of the disease can go a long way in prevention.

scholarly journals Psychological Distress Among Health Care Workers in Health Facilities of Mettu Town During COVID-19 Outbreak, South West Ethiopia, 2020

2021 ◽  
Vol 12 ◽  
Author(s):  
Mohammedamin Hajure ◽  
Bekem Dibaba ◽  
Shuayib Shemsu ◽  
Defaru Desalegn ◽  
Mohammed Reshad ◽  
...  
Keyword(s):  
Health Care ◽  
Logistic Regression ◽  
Psychological Distress ◽  
Health Care Providers ◽  
Health Care Workers ◽  
Care Providers ◽  
Event Scale ◽  
Care Workers ◽  
Increased Risk ◽  
The Impact

Background: During any of the infectious disease outbreak, health care workers were at increased risk of being infected, and psychological distress was a common phenomenon. Therefore, the study aimed to assess the psychological distress related to COVID-19 among healthcare workers in Mettu town.Methods: A cross sectional study was conducted from May 1–15, 2020 using convenient sampling techniques among 127 health care providers during COVID-19 pandemic in the Mettu town. Self-administered questionnaire was used to collect information. Depression and anxiety were evaluated as subscales from the Depression Anxiety Stress Scale (DASS-21). Psychological distress related to COVID-19 was measured using the Impact of Event Scale Revised (IES-R). Data analysis were done using SPSS version 24. Chi-square test was used to find the association between the outcome and demographic variables. Multivariable logistic regression analyses were used to evaluate the significance of the association at P-value < 0.05.Result: Using IES-R scale, 40.2% of the participants reported to have the symptoms of psychological distress. The majority of the participants reported mild psychological distress (37%) followed by moderate psychological distress (29%). The multivariate logistic regression analysis revealed that the odds of psychological distress were found to be higher among health care providers who reported to have depressive symptoms, and those who used alcohol, khat and tobacco in the past 3 months shows a significant association with psychological distress.Conclusion: Our findings revealed that the COVID-19 pandemic had exerted major psychological distress on health care providers. So the findings, seek attention for early psychological intervention needed to manage psychological distress in health care providers regarding identified factors.

scholarly journals Patients’ Perspectives and Advice on How to Discuss Sexual Orientation, Gender Identity, and Sexual Health in Oncology Clinics

2020 ◽  
Vol 37 (12) ◽  
pp. 1053-1061
Author(s):  
Elizabeth Cathcart-Rake ◽  
Jennifer O’Connor ◽  
Jennifer L. Ridgeway ◽  
Carmen Radecki Breitkopf ◽  
Judith S. Kaur ◽  
...  
Keyword(s):  
Health Care ◽  
Sexual Orientation ◽  
Gender Identity ◽  
Sexual Health ◽  
Health Care Provider ◽  
Health Care Providers ◽  
Care Provider ◽  
Care Providers ◽  
Female Doctor ◽  
Transition Clinic

Objective: This study sought to understand the patients’ perspective of what contributes to an absence of discussions of sexual orientation (SO), gender identity (GI), and sexual health in cancer care. Methods: Patients were recruited from oncology, gynecology, and a gender transition clinic to participate in semistructured interviews, which were analyzed with qualitative methods. Results: A total of 25 patients were interviewed, shedding light on 2 themes. The first was that these conversations are important but infrequent. One patient explained, “…. we know people who have had sex changes…[they] would have appreciated that question.” In response to whether sexual health was ever brought up, one patient responded, “No doctor ever has.” Patients described unaddressed issues: “There have been times, you know, we’ve wondered if it was okay to make love.” The second theme consisted of 4 pragmatic, patient-provided points to facilitate discussions: (1) implementation of a scale of 1 to 10 (with 10 being comfortable) to first gauge patients’ comfort in talking about SO, GI, and sexual health; (2) having the health-care provider explore the topic again over-time; (3) making sure the health-care provider is comfortable, as such comfort appears to enhance the patient’s comfort (“I have a doctor here, a female doctor, who just matter of fact will ask if I get erections and so on because of the medication she’s giving me);” and (4) eliminating euphemisms (one patient stated, “I don’t know what you mean by ‘sexual health’.”). Conclusion: Oncology health-care providers have a unique opportunity and responsibility to address SO, GI, and sexual health.

scholarly journals Breast Cancer Patients’ Experience and Wishes Regarding Communication on Sexual Health - The BEROSE Study

2021 ◽  
Author(s):  
Marion Aupomerol ◽  
Dan Chaltiel ◽  
Patricia Pautier ◽  
Delphine Wehrer ◽  
Lucie Veron ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Sexual Health ◽  
Health Care Providers ◽  
Cancer Center ◽  
Care Providers ◽  
Breast Cancer Patients ◽  
Cross Sectional ◽  
Lack Of Information ◽  
Treatment Administration ◽  
The Impact

Abstract Purpose: Although sexual health (SH) is a major concern for many patients with breast cancer (BC), only few of them receive adequate information on this topic throughout their care. BEROSE is a single-center pilot cross-sectional observational study, which aimed at evaluating communication on SH between women with BC and their health-care providers.Methods: From June 12th to July 31th, 2020, a survey was distributed to patients consulting at Breast Cancer Unit of Gustave Roussy Cancer Center. The primary endpoint was the rate of women reporting to have received information on SH from health professionals throughout active treatment administration or BC follow-up.Results: Of 348 surveys collected, 318 were completely filled and included in the analysis. Sixty-one percent of women were older than 50 years and 65% had a localized BC. The majority (63%) was receiving hormone-therapy (37%) or chemotherapy (26%). Overall, 65% reported that they had not received any information about SH throughout their care, while 69% felt it would have been important to discuss sexual issues. Most of women expected professionals to bring up the topic, preferably oncologists or gynecologists, during face-to-face consultations. Concerning satisfaction on SH, 83% reported of being satisfied or very satisfied before BC diagnosis, and only 30% at the time of our survey. Conclusion: Most of women treated or followed-up for BC feel that they lack of information regarding SH-related issues. The impact of BC diagnosis and treatment on SH should be discussed with all women from the first visit and then regularly readdressed.

Recognizing the impact of COVID-19 on depression and its mitigation (Preprint)

2020 ◽  
Author(s):  
Harshil Bhatt ◽  
Sandeep Singh ◽  
Sijo Sunny
Keyword(s):  
Mental Health ◽  
Health Care Providers ◽  
Large Scale ◽  
Negative Impact ◽  
Healthcare Access ◽  
Care Providers ◽  
Treatment And Prevention ◽  
Increased Risk ◽  
New Guidelines ◽  
The Impact

UNSTRUCTURED Abstract Introduction: COVID-19 pandemic is a rapidly evolving threat to all of humanity and overall global stability. It is evident from history that events like pandemics or large-scale disasters lead to an increased risk of adverse mental health effects. The ongoing pandemic of COVID-19 is presenting unprecedented challenges to all walks of life and is also likely to spark a widespread negative impact on mental health all around the world. Objective: The primary purpose of this article is to review the effect of COVID- 19 pandemic on depression and discussion of possible methods to its recognition and mitigation. Discussion: The onset of the COVID-19 pandemic introduced a widespread panic into individuals from all parts of society. In many respects, it has had a negative domino effect on mental health. The pervasive stay-at-home orders targeted to contain the spread of the infection have led to isolation, which has further reduced outlet avenues for individuals from the difficult aspects of their lives and has planted the seeds for psychological issues. In some cases, preventative measures even have led to the surfacing of pre-existing mental health challenges. The economic hardship and the limitations of healthcare access during the pandemic have further escalated the situation. Cognizance, detection, treatment, and prevention methodologies are needed to combat the impact of COVID-19 pandemic on depression in the population. More research into this field would allow mental health care providers to formulate new guidelines and recommendations to limit the impact of this pandemic on behavioral health.

scholarly journals Breast Cancer Patients’ Experience and Wishes Regarding Communication on Sexual Health - The BEROSE Study

2021 ◽  
Author(s):  
Marion Aupomerol ◽  
Dan Chaltiel ◽  
Patricia Pautier ◽  
Delphine Wehrer ◽  
Lucie Véron ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Sexual Health ◽  
Health Care Providers ◽  
Care Pathway ◽  
Cancer Center ◽  
Care Providers ◽  
Breast Cancer Patients ◽  
Adequate Information ◽  
The Impact

Abstract Purpose: Although sexual health (SH) is a major concern for many patients with breast cancer (BC), only few of them receive adequate information on this topic throughout their whole care pathway. BEROSE is a single-center pilot cross-sectional observational study, which aimed at evaluating communication on SH between women with BC and their health-care providers.Methods: From June 12th to July 31st, 2020, a survey was distributed to patients consulting at Breast Cancer Unit of Gustave Roussy Cancer Center. The primary endpoint was the rate of women reporting to have received information on SH from health professionals throughout active treatment administration or BC follow-up.Results: Of 348 surveys collected, 318 were fully completed and included in the analysis. Sixty-one percent of women were older than 50 years and 65% had a localized BC. The majority (63%) was receiving hormone-therapy (37%) or chemotherapy (26%). Overall, 65% reported that they had not received any information about SH throughout their care, while 69% felt it would have been important to discuss sexual issues. For 31% of women, professionals, preferably oncologists or gynecologists, should have initiated the discussion on SH, during an in-person consultation. Concerning satisfaction on SH, 83% reported being satisfied or very satisfied before BC diagnosis, and only 30% at the time they completed the survey.Conclusion: Most of women undergoing treatment or follow-up for BC feel that they lack of adequate information regarding sexual issues associated to BC. The impact of BC diagnosis and treatment on SH should be discussed with all women from the first visit and then regularly readdressed.

scholarly journals Virtual Cancer Care During the COVID-19 Pandemic and Beyond: A Call for Evaluation (Preprint)

2020 ◽  
Author(s):  
Oren Hannun Levine ◽  
Michael McGillion ◽  
Mark Levine
Keyword(s):  
Health Care Providers ◽  
Cancer Care ◽  
Initial Period ◽  
Lessons Learned ◽  
Cancer Center ◽  
Care Providers ◽  
Virtual Care ◽  
Care Intervention ◽  
Increased Risk ◽  
National Quality

UNSTRUCTURED The interplay of virtual care and cancer care in the context of the COVID-19 pandemic is unique and unprecedented. Patients with cancer are at increased risk of SARS-CoV-2 infection and have worse outcomes than patients with COVID-19 who do not have cancer. Virtual care has been introduced quickly and extemporaneously in cancer treatment centers worldwide to maintain COVID-19–free zones. The outbreak of COVID-19 in a cancer center could have devastating consequences. The virtual care intervention that was first used in our cancer center, as well as many others, was a landline telephone in an office or clinic that connected a clinician with a patient. There is a lack of virtual care evaluation from the perspectives of patients and oncology health care providers. A number of factors for assessing oncology care delivered through a virtual care intervention have been described, including patient rapport, frailty, delicate conversations, team-based care, resident education, patient safety, technical effectiveness, privacy, operational effectiveness, and resource utilization. These factors are organized according to the National Quality Forum framework for the assessment of telehealth in oncology. This includes the following 4 domains of assessing outcomes: experience, access to care, effectiveness, and financial impact or cost. In terms of virtual care and oncology, the pandemic has opened the door to change. The lessons learned during the initial period of the pandemic have given rise to opportunities for the evolution of long-term virtual care. The opportunity to evaluate and improve virtual care should be seized upon.

scholarly journals Teaching Medical Students Skills for Effective Communication With Patients Who Have Communication Disorders

2019 ◽  
Vol 28 (1) ◽  
pp. 155-164 ◽  
Author(s):  
Carolyn Baylor ◽  
Michael Burns ◽  
Karen McDonough ◽  
Helen Mach ◽  
Kathryn Yorkston
Keyword(s):  
Health Care ◽  
Medical Students ◽  
Health Care Providers ◽  
Self Efficacy ◽  
Standardized Patients ◽  
Communication Disorders ◽  
Care Providers ◽  
Increased Risk ◽  
Before And After ◽  
The Impact

Purpose Patients with communication impairments including speech, language, cognition, or hearing disorders face many barriers to communication in health care settings. These patients report loss of autonomy in health care decision making, are at increased risk for medical errors, and are less satisfied with health care than patients without communication disorders. Although medical students receive training in effective patient–provider communication, most of this training assumes patients have intact communication abilities. Medical students and other health care providers are often unprepared to meet the communication needs of patients with communication disorders in health care encounters. The purpose of this study was to assess the impact of a curriculum for training medical students to communicate effectively with patients who have a range of communication disorders. Method Twenty-six 2nd-year medical students volunteered for assessments before and after a required workshop in a class. This workshop included instruction about different types of communication disorders and communication strategies, followed by practice with standardized patients portraying different communication disorders. Outcome measures included a knowledge test, ratings of self-efficacy, and evaluation of students' skills when interviewing standardized patients portraying aphasia and dysarthria. Results Medical students demonstrated significant improvements in knowledge, self-efficacy, and use of recommended communication techniques. Conclusions The curriculum appeared effective in changing medical students' knowledge and skills for working with patients with communication disorders. Equipping medical students to meet the needs of patients with communication disorders is 1 key element for improving the quality of health care for this patient population.

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