Oncology nurses’ experiences with the implementation and trial of video communication in the follow-up of cancer patients in primary care: a pilot study in Norway

2019 ◽  
Author(s):  
Lisbeth Østgaard Rygg ◽  
Hildfrid V. Brataas ◽  
Bente Nordtug
Keyword(s):  
Cancer Patients ◽  
Cancer Care ◽  
Cancer Survival ◽  
Oncology Nurses ◽  
Video Communication ◽  
Primary Cancer ◽  
Nursing Leaders ◽  
Number Of Patients ◽  
At Home

Abstract Background: Cancer survival has increased significantly over the last decade. An increasing number of patients require long-term health care. There is a need for new models of effective follow-up in primary cancer care.Objective: The aim was to provide knowledge about oncology nurses’ (ONs’) experiences and perceptions of the use of video communication (VC) to follow up with patients living at home.Methods: This was a descriptive, qualitative study of ONs’ experiences with implementing and trying VC. Data were gathered after a 3-month trial. Individual interviews were content analyzed.Results: Four female ONs participated. The study provides knowledge about the introduction of VC and its influences on follow-up care.Conclusions: With the provision of technical support and training during the introduction of VC and with the protection of patient safety, VC seems to be an effective addition to the traditional follow-up of cancer patients living at home. The findings indicate that VC can be used in primary cancer care. Our findings have practical consequences for nursing leaders considering VC in patient follow-up. Additional research is necessary.

scholarly journals Triaging and adaptations of surveillance of cancer services in the COVID pandemic

2020 ◽  
pp. 1-3
Author(s):  
Shirley Lewis ◽  
Lavanya Gurram ◽  
Umesh Velu ◽  
Krishna Sharan
Keyword(s):  
Cancer Patients ◽  
Clinical Examination ◽  
Cancer Care ◽  
Middle Income ◽  
Face To Face ◽  
Middle Income Countries ◽  
Cancer Services ◽  
Low Middle Income Countries

Abstract Introduction: Coronavirus disease (COVID-19) has significantly challenged the access to cancer care and follow-up for a patient with cancer. Methods: Based on published literature and our experiences, it is reasonable to presume that clinical examination and follow-up visits have been significantly curtailed worldwide in order to adhere to the new norms during the pandemic. Although telephonic and telemedicine consultations may help bridge a few gaps, completely dispensing with in-person consultation has its challenges, especially in low middle-income countries. Telephonic consultations could facilitate triaging of ambulatory cancer patients and allocation of face-to-face consultations for high priority patients. Conclusions: We propose a telephonic consultation-based triaging approach for ambulatory cancer patients in order to identify those needing in-hospital consultations.

scholarly journals Cardiovascular risk factors during cancer treatment: prevalence, incidence and prognostic relevance

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
J Caro Codon ◽  
T Lopez-Fernandez ◽  
C Alvarez-Ortega ◽  
P Zamora Aunon ◽  
I Rodriguez Rodriguez ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Cardiovascular Risk ◽  
Cancer Therapy ◽  
Cancer Patients ◽  
Individual Risk ◽  
Funding Source ◽  
Number Of Patients ◽  
All Cause Mortality

Abstract Background The actual usefulness of CV risk factor assessment in the prognostic evaluation of cancer patients treated with cardiotoxic treatment remains largely unknown. Design Prospective multicenter study in patients scheduled to receive anticancer therapy related with moderate/high cardiotoxic risk. Methods A total of 1324 patients underwent follow-up in a dedicated cardio-oncology clinic from April 2012 to October 2017. Special care was given to the identification and control of CV risk factors. Clinical data, blood samples and echocardiographic parameters were prospectively collected according to protocol, at baseline before cancer therapy and then at 3 weeks, 3 months, 6 months, 1 year, 1.5 years and 2 years after initiation of cancer therapy. Results At baseline, 893 patients (67.4%) presented at least 1 risk factor, with a significant number of patients newly diagnosed during follow-up. Individual risk factors were not related with worse prognosis during a 2-year follow-up. However, a higher Systemic Coronary Risk Estimation (SCORE) was significantly associated with higher rates of severe cardiotoxicity and all-cause mortality [HR 1.79 (95% CI 1.16–2.76) for SCORE 5–9 and HR 4.90 (95% CI 2.44–9.82) for SCORE ≥10 when compared with patients with lower SCORE (0–4)]. Conclusions This large cohort of patients treated with a potentially cardiotoxic regimen showed a significant prevalence of CV risk factors at baseline and significant incidence during follow-up. Baseline cardiovascular risk assessment using SCORE predicted severe cardiotoxicity and all-cause mortality. Therefore, its use should be recommended in the evaluation of cancer patients. Funding Acknowledgement Type of funding source: Public grant(s) – National budget only. Main funding source(s): This study was partially funded by the Fondo Investigaciones Sanitarias (Spain), Centro de Investigaciόn Biomédica en Red Cardiovascular CIBER-CV (Spain)

scholarly journals Sexual Health as Part of Gynecologic Cancer Care: What Do Patients Want?

2018 ◽  
Vol 28 (9) ◽  
pp. 1737-1742 ◽  
Author(s):  
Casey M. Hay ◽  
Heidi S. Donovan ◽  
Erin G. Hartnett ◽  
Jeanne Carter ◽  
Mary C. Roberge ◽  
...  
Keyword(s):  
Health Care ◽  
Sexual Health ◽  
Sexual Activity ◽  
Cancer Patients ◽  
Cancer Care ◽  
Gynecologic Cancer ◽  
Relationship Status ◽  
Cancer Type ◽  
Sexual Health Care

ObjectiveSexual health is important to quality of life; however, the sexual health of gynecologic cancer patients is infrequently and inadequately addressed. We sought to understand patient experiences and preferences for sexual health care to help inform strategies for improvement.Methods/MaterialsAn anonymous, cross-sectional survey of outpatient gynecologic cancer patients at a large academic medical center was performed as part of a larger study examining patient and caregiver needs. The survey explored patient-provider discussions about sexuality across 3 domains (experiences, preferences, barriers) and 4 phases of cancer care (diagnosis, treatment, treatment completion, follow-up). Age, relationship status, sexual activity, and cancer type were recorded.ResultsMean age was 63 years. Most patients had ovarian cancer (38%) or endometrial cancer (32%). Thirty-seven percent received treatment within the last month, 55% were in a relationship, and 35% were sexuality active. Thirty-four percent reported sexuality as somewhat or very important, whereas 27% felt that it was somewhat or very important to discuss. Importance of sexuality was associated with age, relationship status, and sexual activity but not cancer type. Fifty-seven percent reported never discussing sexuality. Age was associated with sexuality discussions, whereas relationship status, sexual activity, and cancer type were not. The most common barrier to discussion was patient discomfort. Follow-up was identified as the best time for discussion. Sexuality was most often discussed with a physician or advanced practice provider and usually brought up by the provider.ConclusionsDemographic predictors of importance of sexuality to the patient are age, relationship status, and sexual activity. Providers primarily use age as a proxy for importance of sexuality; however, relationship status and sexual activity may represent additional ways to screen for patients interested in discussing sexual health. Patient discomfort with discussing sexuality is the primary barrier to sexual health discussions, and awareness of this is key to developing effective approaches to providing sexual health care.

Comparison of real prognosis and estimated prognosis by Adjuvant! Online in breast cancer in sites of Itajaí, Brazil.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e12035-e12035
Author(s):  
Giuliano Santos Borges ◽  
Evandro De Azambuja ◽  
Rodrigo Rovere ◽  
Paulo Henrique Colchon ◽  
Marcos Cesar Staak Junior
Keyword(s):  
Breast Cancer ◽  
External Validity ◽  
Cancer Survival ◽  
Medical Literature ◽  
Breast Cancer Survival ◽  
Number Of Patients ◽  
The One ◽  
Post Hoc ◽  
Disease Free

e12035 Background: Internet-available programme Adjuvant! Online is widely regarded as one of the best tools to estimate prognosis as well as benefit of adjuvant therapy in breast cancer. Methods: It is a retrospective cohort study, with a post hoc analysis with 214 patients of three different Brazilian services in which were measured the year overall and disease free survivals in a follow up of three years, and the same endpoints were estimated on a 10 year basis by the Adjuvant! Online programme. Results: See table. Conclusions: Our study shows interesting trends in breast cancer survival, even though the number of patients accrued may not be enough to have full external validity. We conclude that the OS and DFS rates in our sample compared to the one calculated by the Adjuvant! Online programme display agreement, following the same pattern, considering different periods of follow up (much longer in the internet tool). The only group which had poor concordance was the group of younger patients (i.e., under 40), even though it was the least represented group in our sample. Nevertheless, it can be suggested that the programme underestimates the usually bad prognosis in these cases, as broadly documented in medical literature. Our study shows interesting trends in breast cancer survival, even though the number of patients accrued may not be enough to have full external validity. [Table: see text]

Using Canadian administrative data to evaluate primary and oncology care of breast cancer patients post-treatment: Subset of the CanIMPACT Study.

2016 ◽  
Vol 34 (3_suppl) ◽  
pp. 5-5 ◽  
Author(s):  
Mary L McBride ◽  
Patti Groome ◽  
Donna Turner ◽  
Margaret Jorgensen ◽  
Cynthia Kendell ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Primary Care ◽  
Cancer Patients ◽  
Administrative Data ◽  
Cancer Care ◽  
Data Access ◽  
Post Treatment ◽  
Breast Cancer Patients ◽  
Oncology Care

5 Background: CanIMPACT is a multi-provincial Canadian research team funded to identify and address key issues faced by cancer patients and providers at the intersection of primary and specialist oncology care. Canada has national healthcare standards, but provincial/territorial healthcare delivery systems. One facet will use administrative data from the population-based, publicly-funded healthcare system to evaluate issues during pre-diagnosis, treatment, and post-treatment survivorship for breast cancer patients. For the survivorship phase, we aim to conduct the following analyses and compare across provinces: 1) Utilization of physician services overall and by specialty, including oncologists, non-oncology specialists, and primary care; 2) Assessment of adherence to ASCO and Canadian follow-up guideline for breast cancer care, use of surveillance breast imaging, and metastatic investigations; 3) Assessment of adherence to recommended care of chronic illness and preventive care; 4) Quantification of the cost of follow-up overall and by specialty; 5) Comparison of inter- and intra-provincial variation for all outcomes by health administrative region and for vulnerable groups (age ≥ 75 at diagnosis, northern/rural/remote, low income, immigrants), and examine the effect of continuity of primary care and chronic disease on post-treatment care. Methods: Patients will be identified from provincial cancer registries and linked to data extracted from: outpatient physician service claims, hospital inpatient and outpatient data, and cancer facility medical records. Results: Participating provinces have finalized the core questions and detailed protocols, and assessed data comparability. They are in the process of obtaining the required ethics and data access approvals, and data acquisition for processing and analysis. Conclusions: Results will address existing information gaps that can be used to improve transition and care across the cancer care trajectory. Importantly, results will be combined with those of a CanIMPACT qualitative study to inform design of a pragmatic randomized trial focused on improving coordination and quality of care.

scholarly journals Acupuncture as a complementary therapy for cancer care: acceptability and preferences of patients and informal caregivers

2020 ◽  
Author(s):  
Tessa Lefebvre ◽  
Laura Tack ◽  
Virginie Blieck ◽  
Lieselot Cool ◽  
Hans Pottel ◽  
...  
Keyword(s):  
Side Effects ◽  
Cancer Patients ◽  
Cancer Care ◽  
Informal Caregivers ◽  
Participation Rate ◽  
Complementary Therapy ◽  
Care Clinic ◽  
Supportive Cancer Care ◽  
Number Of Patients ◽  
To Receive

Abstract Background: Acupuncture provides a possible complementary therapy which can be used alongside or following cancer treatment to relieve side-effects for cancer patients and survivors, such as pain and depression. Equally, it can provide relief from symptoms such as anxiety and sleep disturbance, which are recognised as significant issues among caregivers of those with cancer. The aim of this study was to explore the acceptability and preferences of cancer patients, disease survivors and their informal caregivers in relation to acupuncture.Methods: A questionnaire was developed to explore acceptability and preferences of cancer patients, disease survivors and their caregivers in relation to acupuncture, including motivations to use acupuncture, preferred symptoms to be addressed, and practical issues (location; cost).Results: A participation rate of 94.5% was obtained, with 116 participating patients and survivors, and 54 caregivers. Acceptability of acupuncture was around 1/3 for patients (34.5%; 40/116) and almost half for informal caregivers (48.0%; 26/54). In terms of preferences, the day care clinic was the favoured location for patients (52.5%; 21/40) to undergo acupuncture, while there was no specific preference on location observed for caregivers. A large number of patients indicated they would be willing to pay to receive the complementary therapy (60%; 24/40). Symptoms of fatigue, feeling listless, and pain were most often identified as complaints patients and survivors would use acupuncture for (60.0%, 57.5%, and 47.5% respectively). For informal caregivers, 48.0% (26/54) expressed an interest in using acupuncture for their pain, stress and sleeping difficulties.Conclusions: This study indicates that many cancer patients, disease survivors and informal caregivers would accept acupuncture as a complementary therapy. They could further identify many symptoms they felt this therapy could relieve. This openness to acupuncture, and expressed preferences provide the foundations for this complementary therapy to be incorporated into holistic and supportive cancer care, both for patients and those supporting them.

Cancer patients use of nonproven therapy: a 5-year follow-up study.

1998 ◽  
Vol 16 (1) ◽  
pp. 6-12 ◽  
Author(s):  
T Risberg ◽  
E Lund ◽  
E Wist ◽  
S Kaasa ◽  
T Wilsgaard
Keyword(s):  
Survival Rate ◽  
Cancer Patients ◽  
Cumulative Risk ◽  
Faith Healing ◽  
High Educational Level ◽  
Cross Sectional ◽  
Follow Up Study ◽  
Number Of Patients ◽  
Oncologic Patients

PURPOSE To investigate the prospective pattern of use of alternative medicine, here called nonproven therapy (NPT), among oncologic patients during a 5-year period, and the relationship between this use and survival, a questionnaire-based follow-up study was performed at the Department of Oncology, University of Tromsø, from 1990 to 1996. PATIENTS AND METHODS Two-hundred fifty-two patients answered the first questionnaire during the period July 1990 to July 1991. Eligible patients were mailed follow-up questionnaires after 4, 12, 24 and 60 months. A telephone interview performed after the last follow-up questionnaire showed little disagreement with the prospective collected information as regards the number of patients reported as users of NPT (kappa, 0.92). RESULTS The number of patients who reported ever using NPT in each cross-sectional part of the study varied between 17.4% and 27.3%. However, the estimated cumulative risk of being a user of NPT during the follow-up period was 45%. Seventy-four percent of NPT users in this north Norwegian study population used faith healing or healing by hand (spiritual NPT) alone or in combination with other forms of NPT. The proportion of patients who used spiritual versus nonspiritual forms of NPT was consistent throughout the follow-up period. Women were more often users than men (50% v 31%, P = .002). Patients older than 75 years of age seldomly used NPT. The 5-year observed survival rate was not influenced by the use of NPT. Adjusted for sex, age, and diagnosis, patients with a high educational level had a borderline higher 5-year survival rate than patients with less education (P = .06). CONCLUSION Our results demonstrate that cross-sectionally designed studies will underestimate the number of ever-users of NPT in a cancer patient population. The use of NPT does not influence observed survival among cancer patients seen in north Norway.

Circulating tumor cells (CTCs) in peripheral blood of primary breast cancer patients

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 10595-10595 ◽  
Author(s):  
B. K. Rack ◽  
C. Schindlbeck ◽  
S. Hofmann ◽  
A. Schneeweiss ◽  
M. Rezai ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Peripheral Blood ◽  
Primary Breast Cancer ◽  
Systemic Treatment ◽  
Blood Sampling ◽  
Breast Cancer Patients ◽  
Cytostatic Treatment ◽  
Number Of Patients

10595 Background: Detection of CTCs has been shown to predict decreased PFS and OAS in metastatic breast cancer, whereas only limited data has been published in the adjuvant setting. We evaluate the role of CTCs in peripheral blood at primary diagnosis and during adjuvant chemotherapy, endocrine and bisphophonate treatment within the SUCCESS-Trial (n=3,658 pts). Methods: We analyzed 23ml of peripheral blood from 1767 N+ and high risk N- primary breast cancer pts before systemic treatment. 852 of these pts have undergone follow-up blood sampling after completion of chemotherapy. The presence of CTCs was assessed with the CellSearchSystem (Veridex, Warren, USA). Briefly, after immunomagnetic enrichment with an anti-Epcam-antibody, cells were labelled with anti-cytokeratin (8,18,19) and anti-CD45 antibodies to distinguish epithelial cells and leukocytes. Results: 10% of pts with a blood sampling before systemic treatment (n=170) showed >1CTC before the start of systemic treatment (mean 13, range 2–827). While we found 2 CTCs in 5% of pts, 3% had 3–5 CTCs and 1% 6–10 and >10 CTCs each. The presence of CTCs did not correlate with tumor size (p=.07), grading (p=.30), hormonal status (p=.54) or Her2-Status of the primary tumor (p=.26). However, we observed a significant correlation with the presence of lymph node metastases (p=.015). None of 24 healthy individuals showed more than 1 CTC. Among those 852 pts with follow-up blood sampling after the completion of cytostatic treatment, 11% were CTC positive before starting systemic treatment (mean 7, range 2–166), while 7% of patients presented with >1CTC after completion of chemotherapy (mean 6, range 2–84). Of those, initially CTC positive, 10% remained positive (n=9) and 90% had a negative CTC test after chemotherapy (n=82). Of those initially CTC negative, 93% remained negative (n=711), whereas 7% returned with a positive CTC test (n=50) (p=.24). Conclusions: Our data show good feasibility of this highly standardized and easily applicable approach for the detection of CTCs in a large number of primary breast cancer patients. In a considerable number of patients, persistent CTCs can be detected after completion of cytostatic treatment. Whether this finding is prognostically relevant will have to been shown with longer follow-up of the SUCCESS-trial. No significant financial relationships to disclose.

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