scholarly journals Current status of integrating oncology and palliative care in Japan: A nationwide survey

2019 ◽  
Author(s):  
Yu Uneno ◽  
Kazuki Sato ◽  
Tatsuya Morita ◽  
Mayumi Nishimura ◽  
Satoko Ito ◽  
...  
Keyword(s):  
Palliative Care ◽  
Cancer Control ◽  
Nationwide Survey ◽  
Daily Practice ◽  
Current Status ◽  
Full Time ◽  
International Consensus ◽  
Cross Sectional ◽  
Symptom Screening ◽  
The Government

Abstract Background: Palliative care (PC) is increasingly recognized as essential for oncology care, and several academic societies strongly recommend integrating oncology and palliative care (IOP) in daily practice. Similarly, the Japanese government encouraged the implementation of IOP through the Cancer Control Act of 2007; however, its detailed progress remains unclear. Therefore, this cross-sectional nationwide survey was conducted to investigate the current status and hospital executive physicians’ perception of IOP. Methods: The questionnaire was developed based on IOP indicators with international consensus. It was distributed to executive physicians at all government-designated cancer hospitals (DCHs, n = 399) and matched non-DCHs (n = 478) in November 2017 and the results were compared. Results: In total, 269 (67.4%) DCHs and 259 (54.2%) non-DCHs responded. The number of PC resources in DCHs was significantly higher than those in non-DCHs (e.g., full-time PC physicians and nurses, 52.8% vs. 14.0%, p < 0.001; availability of outpatient PC service ≥3 days per week, 47.6% vs. 20.7%, p < 0.001). Routine symptom screening was more frequently performed in DCHs than in non-DCHs (65.1% vs. 34.7%, p < 0.001). Automatic trigger for PC referral availability was limited (e.g., referral using time trigger, 14.9% vs. 15.3%, p = 0.700). Education and research opportunities were seriously limited in both types of hospitals. Most executive physicians regarded IOP as beneficial for their patients (95.9% vs. 94.7%, p = 0.163) and were willing to facilitate an early referral to PC services (54.7% vs. 60.0%, p < 0.569); however, the majority faced challenges to increase the number of full-time PC staff, and <30% were planning to increase the staff members. Conclusions: This survey highlighted a considerable number of IOP indicators met, particularly in DCHs probably due to the government policy. Further investigation is warranted whether those indicators effectively work in real clinical situations.

scholarly journals Current status of integrating oncology and palliative care in Japan: A nationwide survey

2020 ◽  
Author(s):  
Yu Uneno ◽  
Kazuki Sato ◽  
Tatsuya Morita ◽  
Mayumi Nishimura ◽  
Satoko Ito ◽  
...  
Keyword(s):  
Palliative Care ◽  
Cancer Control ◽  
Nationwide Survey ◽  
Daily Practice ◽  
Current Status ◽  
Full Time ◽  
International Consensus ◽  
Cross Sectional ◽  
Symptom Screening ◽  
The Government

Abstract Background: Palliative care (PC) is increasingly recognized as essential for oncology care, and several academic societies strongly recommend integrating oncology and palliative care (IOP) in daily practice. Similarly, the Japanese government encouraged the implementation of IOP through the Cancer Control Act of 2007; however, its detailed progress remains unclear. Therefore, this cross-sectional nationwide survey was conducted to investigate the current status and hospital executive physicians’ perception of IOP. Methods: The questionnaire was developed based on IOP indicators with international consensus. It was distributed to executive physicians at all government-designated cancer hospitals (DCHs, n = 399) and matched non-DCHs (n = 478) in November 2017 and the results were compared. Results: In total, 269 (67.4%) DCHs and 259 (54.2%) non-DCHs responded. The number of PC resources in DCHs was significantly higher than those in non-DCHs (e.g., full-time PC physicians and nurses, 52.8% vs. 14.0%, p < 0.001; availability of outpatient PC service ≥3 days per week, 47.6% vs. 20.7%, p < 0.001). Routine symptom screening was more frequently performed in DCHs than in non-DCHs (65.1% vs. 34.7%, p < 0.001). Automatic trigger for PC referral availability was limited (e.g., referral using time trigger, 14.9% vs. 15.3%, p = 0.700). Education and research opportunities were seriously limited in both types of hospitals. Most executive physicians regarded IOP as beneficial for their patients (95.9% vs. 94.7%, p = 0.163) and were willing to facilitate an early referral to PC services (54.7% vs. 60.0%, p < 0.569); however, the majority faced challenges to increase the number of full-time PC staff, and <30% were planning to increase the staff members. Conclusions: This survey highlighted a considerable number of IOP indicators met, particularly in DCHs probably due to the government policy. Further efforts are needed to address the serious research/educational gaps.

scholarly journals Barriers to and facilitators of implementation of the integration of oncology and palliative care in daily practice: a systematic review

2021 ◽  
Author(s):  
Yu Uneno ◽  
Yoshiki Horie ◽  
Yuki Kataoka ◽  
Masanori Mori ◽  
Mami Hirakawa ◽  
...  
Keyword(s):  
Systematic Review ◽  
Palliative Care ◽  
Care Delivery ◽  
Daily Practice ◽  
Individual Characteristics ◽  
Educational Opportunities ◽  
Eligibility Criteria ◽  
Ovid Medline ◽  
Care Delivery Model ◽  
The Government

Abstract Background: Palliative care (PC) is widely recognized as an essential part of oncology care, and multiple academic societies have developed strong recommendations regarding the implementation of the integration of oncology and PC (IOP) in daily practice. However, IOP implementation is a slow- evolving process, and its barriers and facilitators have not yet been comprehensively identified. This systematic review aimed to clarify the barriers to and facilitators of IOP in the context of treating patients with advanced cancer.Methods: We searched Ovid MEDLINE, Embase, and Cumulative Index of Nursing and Allied Health Literature until June 3, 2017. We included original articles, narrative and systematic reviews, guidelines, editorials, commentaries, and letters. After title and abstract screening by two of five independent reviewers, we analyzed the data qualitatively using inductive content analysis and a consolidated framework for implementation research. Results: We obtained 3,304 articles, of which 60 met the predefined eligibility criteria. The numbers and proportions of original and review articles, guidelines, and other article types were 21 (35%), 30 (50%), 3 (5%), and 7 (12%), respectively. Five categories emerged regarding both the barriers to and facilitators of IOP: intervention characteristics, outer settings, inner settings, individual characteristics, and process. The representative barriers were limited availability of and access to PC services, limited educational opportunities for PC providers, insufficient reimbursement and research funding toward PC services, focus on cure rather than care (patients and their caregivers), and insufficient communication between oncology and PC staff (n = 26, 16, 14, 13, and 7, respectively). The representative facilitators were improvement of the availability of and access to PC services, development of an optimal integrated care model, enrichment of educational opportunities regarding PC (healthcare professionals), and initiatives by government and academic societies (n = 24, 18, 25, and 7, respectively).Conclusions: This study clarified the multi-level barriers to and facilitators of the implementation of IOP. Educational and financial support from the government and academic societies appears essential, and further effort to develop and investigate the implementable care delivery model is warranted.Registration: PROSPERO:CRD42018069212

scholarly journals Current status of integrating oncology and palliative care in Japan: a nationwide survey

2020 ◽  
Vol 19 (1) ◽  
Author(s):  
Y. Uneno ◽  
K. Sato ◽  
T. Morita ◽  
M. Nishimura ◽  
S. Ito ◽  
...  
Keyword(s):  
Palliative Care ◽  
Nationwide Survey ◽  
Current Status

Health Literacy and Medication Literacy in Saudi Arabia: Current Status

2019 ◽  
Vol 2 (1) ◽  
pp. 1
Author(s):  
Rasha A. Almubark ◽  
Mada Basyouni ◽  
Ashjan Alghanem ◽  
Amani S. Alqahtani ◽  
Nasser F. BinDhim
Keyword(s):  
Chronic Disease ◽  
Health Literacy ◽  
Health Information ◽  
Information Sources ◽  
Nationwide Survey ◽  
Current Status ◽  
Common Source ◽  
Web Pages ◽  
Cross Sectional ◽  
Low Health Literacy

Background: Low health literacy and medication literacy can be associated with adverse medication-related events. The objectives of this research were to characterize medication use, describe health information sources, and characterize medication literacy in the KSA population. Methods: A cross-sectional nationwide survey was conducted among Saudi residents aged 18 years or above. Results: A total of 3,557 surveys were available for analysis (men = 1,811 and women = 1,746). Respondents were concentrated in younger categories, and each region was represented by 7% to 8% of respondents by design. Twenty-three percent of respondents (n = 825) reported having at least one chronic disease. A total of 1,882 (53%) of respondents reported ever looking for health information; of those, web pages were the most popular information sources. Among those taking medication for chronic disease, only 61% agreed that they knew how their medication should be monitored, 51% agreed that they knew what to do if they missed a dose, and 50% agreed that they knew their drug's side effects. Conclusion: This study's results suggest that interventions focused on medication literacy and tailored to prevalent chronic disease groups should be explored. Because the most common source of health information is web pages, interventions to improve overall health information literacy, especially pertaining to online medication information, should be studied.

Disaster Preparedness Among University Students in Guangzhou, China: Assessment of Status and Demand for Disaster Education

2016 ◽  
Vol 11 (3) ◽  
pp. 310-317 ◽  
Author(s):  
Yibing Tan ◽  
Xiaolan Liao ◽  
Haihao Su ◽  
Chun Li ◽  
Jiagen Xiang ◽  
...  
Keyword(s):  
University Students ◽  
Disaster Preparedness ◽  
Southern China ◽  
Female Students ◽  
Current Status ◽  
Cross Sectional ◽  
Male And Female ◽  
Course Content ◽  
Disaster Education ◽  
The Government

AbstractObjectiveThis study had 2 aims. First, we evaluated the current levels of disaster preparedness among university students in southern China. Second, we assessed students’ demands for future disaster education. In addition, we examined the influence of demographic factors on current disaster preparedness status and demand.MethodsA cross-sectional design was used. The data were collected from 1893 students in 10 universities in the Guangzhou Higher Education Mega (GHEM) center. A self-administered questionnaire developed for this study was administered to assess the current status and demand for disaster education.ResultsThe results are based on 1764 valid questionnaires. Among the participants, 77.8% reported having had disaster education experiences before, 85.5% indicated their desire for a systematic disaster course, and 75.4% expressed their willingness to take such a course upon its availability. The total mean score for demand for disaster course content (5-point Likert scale) was 4.17±0.84, with items relating to rescue skills given the highest scores. These results suggested that students had high desires for disaster preparedness knowledge, especially knowledge concerning rescue skills. We observed significant differences in disaster education experiences between male and female students and across programs, school years, and home locations. Furthermore, we observed significant differences in demand for disaster course content between male and female students and across universities, student programs, years of school, and students’ majors.ConclusionA systematic disaster course focused on rescue skills is needed by all types of universities. To improve the disaster education system in universities, disaster drills should be performed on a semester basis as a refresher and to enhance disaster preparedness. The government and universities should support building a simulated disaster rescue center and recruit faculty from the emergency department, especially those who have had disaster relief experience. (Disaster Med Public Health Preparedness. 2017;11:310–317)

scholarly journals Parental Acceptability of COVID-19 Vaccination for Children Under the Age of 18 Years: Cross-Sectional Online Survey

10.2196/24827 ◽  
2020 ◽  
Vol 3 (2) ◽  
pp. e24827
Author(s):  
Ke Chun Zhang ◽  
Yuan Fang ◽  
He Cao ◽  
Hongbiao Chen ◽  
Tian Hu ◽  
...  
Keyword(s):  
Social Media ◽  
Online Survey ◽  
Vaccine Development ◽  
Perceived Behavioral Control ◽  
Full Time ◽  
Background Characteristics ◽  
Factory Workers ◽  
Cross Sectional ◽  
The Government ◽  
Parental Acceptability

Background It is expected that COVID-19 vaccines will become available in China by the end of 2020. Vaccinating children against COVID-19 would contribute to the control of the pandemic and the recovery of the global economy. For children under the age of 18 years, parents are usually the decision makers regarding their children’s vaccination. Objective The goal of this study was to investigate parental acceptability of free COVID-19 vaccination for children under the age of 18 years in China. Methods This is a secondary analysis of a cross-sectional, closed online survey among 2053 factory workers in Shenzhen, China, implemented from September 1 to 7, 2020. Participants of the online survey were full-time employees aged 18 years or over who had resumed work in factories in Shenzhen. Factory workers in Shenzhen are required to receive physical examinations once a year. Eligible workers attending six designated physical examination sites were invited to complete an online survey. This study was based on a subsample of those who had at least one child under the age of 18 years (N=1052). After being briefed that COVID-19 vaccines developed by China are likely to be available by the end of 2020, participants were asked about their likelihood of having their children under the age of 18 years take up free COVID-19 vaccination provided by the government, if it existed. Multivariate logistic regression models were fitted to examine the associations of perceptions related to COVID-19 vaccination based on the theory of planned behavior (TPB) and exposure to information related to COVID-19 through social media with parental acceptability, after controlling for significant background characteristics. Results The prevalence of parents’ acceptability of COVID-19 vaccination for their children was 72.6% (764/1052). After adjusting for significant background characteristics, positive attitudes toward COVID-19 vaccination (adjusted odds ratio [AOR] 1.70, 95% CI 1.50-1.91), the perception that a family member would support them in having their children take up COVID-19 vaccination (ie, perceived subjective norm) (AOR 4.18, 95% CI 3.21-5.43), and perceived behavioral control to have the children take up COVID-19 vaccination (AOR 1.84, 95% CI 1.49-2.26) were associated with higher parental acceptability of COVID-19 vaccination. Regarding social media influence, higher exposure to positive information related to COVID-19 vaccination was associated with higher parental acceptability of COVID-19 vaccination (AOR 1.35, 95% CI 1.17-1.56). Higher exposure to negative information related to COVID-19 vaccination was negatively associated with the dependent variable (AOR 0.85, 95% CI 0.74-0.99). Conclusions Parents’ acceptability of COVID-19 vaccination for their children under 18 years of age was high in China. The TPB is a useful framework to guide the development of future campaigns promoting COVID-19 vaccination targeting parents. Transparency in communicating about the vaccine development process and vaccine safety testing is important. Public health authorities should also address misinformation in a timely manner.

scholarly journals CURA—An Ethics Support Instrument for Nurses in Palliative Care. Feasibility and First Perceived Outcomes

HEC Forum ◽  
2021 ◽  
Author(s):  
Malene Vera van Schaik ◽  
H. Roeline Pasman ◽  
Guy Widdershoven ◽  
Bert Molewijk ◽  
Suzanne Metselaar
Keyword(s):  
Palliative Care ◽  
Moral Distress ◽  
Daily Practice ◽  
Evaluation Study ◽  
Cross Sectional ◽  
Ethics Support ◽  
Organizational Barriers ◽  
Moral Competences ◽  
Perceived Outcomes ◽  
Moral Resilience

AbstractEvaluating the feasibility and first perceived outcomes of a newly developed clinical ethics support instrument called CURA. This instrument is tailored to the needs of nurses that provide palliative care and is intended to foster both moral competences and moral resilience. This study is a descriptive cross-sectional evaluation study. Respondents consisted of nurses and nurse assistants (n = 97) following a continuing education program (course participants) and colleagues of these course participants (n = 124). Two questionnaires with five-point Likert scales were used. The feasibility questionnaire was given to all respondents, the perceived outcomes questionnaire only to the course participants. Data collection took place over a period of six months. Respondents were predominantly positive on most items of the feasibility questionnaire. The steps of CURA are clearly described (84% of course participants agreed or strongly agreed, 94% of colleagues) and easy to apply (78–87%). The perceived outcomes showed that CURA helped respondents to reflect on moral challenges (71% (strongly) agreed), in perspective taking (67%), with being aware of moral challenges (63%) and in dealing with moral distress (54%). Respondents did experience organizational barriers: only half of the respondents (strongly) agreed that they could easily find time for using CURA. CURA is a feasible instrument for nurses and nurse assistants providing palliative care. However, reported difficulties in organizing and making time for reflections with CURA indicate organizational preconditions ought to be met in order to implement CURA in daily practice. Furthermore, these results indicate that CURA helps to build moral competences and fosters moral resilience.

scholarly journals Current Status of Distress Screening in Designated Cancer Hospitals: A Cross-Sectional Nationwide Survey in Japan

2016 ◽  
Vol 14 (9) ◽  
pp. 1098-1104 ◽  
Author(s):  
Toru Okuyama ◽  
Yoshiyuki Kizawa ◽  
Tatsuya Morita ◽  
Hiroya Kinoshita ◽  
Megumi Uchida ◽  
...  
Keyword(s):  
Nationwide Survey ◽  
Current Status ◽  
Distress Screening ◽  
Cross Sectional

Abstract P328: Current Status Of HIV-infected Men Who Have Sex With Men: A Real-world Cross-sectional Study In Underdeveloped Southwest China

Circulation ◽  
2020 ◽  
Vol 141 (Suppl_1) ◽  
Author(s):  
Liyu Ran ◽  
Yi Huang ◽  
Xiaoqing He ◽  
Wei Huang
Keyword(s):  
Sexual Behaviors ◽  
Real World ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Cross Sectional Study ◽  
Current Status ◽  
Health Examination ◽  
Cross Sectional ◽  
The Government ◽  
Sex With Men

Background: The prevalence of human immunodeficiency virus (HIV) among men who have sex with men (MSM) remains high and has shown an upward trend in China. However, the status of HIV-infected MSM in the underdeveloped southwest of China is unknown. The study aimed to evaluate the real-world status of HIV-infected MSM and to compare the characteristics between HIV-infected ‘men who have sex with men only’ (MSMO) and ‘men who have sex with men and women’ (MSMW). Method: The study was conducted with HIV-infected MSM patients in Chongqing in 2017. A questionnaire addressing socio-demographic characteristics, sexual behaviors, condom use, clinical signs and symptoms, and HIV detection and transmission routes was used. Results: A total of 865 HIV-infected MSM were enrolled. More than 70% of MSM had experienced their first sexual intercourse before 20 years old. More than 55.8% of the patients had a high income. Compared with MSMW, more MSMO went to college (60.2% vs. 48.7%), and more often (20.9% vs. 8.7%) use condom during anal sex. Weight loss was the most common sign (15.1%). The numbers of male partners and high-risk sexual behaviors among HIV-infected MSM remained high (30.6%), and few patients (4.6%) agreed to voluntary counseling and testing (VCT). Routine health examination was the most frequently (72.7%) used detection method . Homosexual behavior may be the most frequent transmission route (87.9%) among HIV-infected MSMO and MSMW. Conclusion: The findings indicate that the government should promote more prevention strategies against HIV transmission and detection among MSM.

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