scholarly journals Cancer Care in a Time of COVID: Lung Cancer Patient’s Experience of Telehealth and Connectedness

Author(s):  
Anne Fraser ◽  
Rob Mc Neill ◽  
Jackie Robinson

Abstract Objective: To explore lung cancer patient’s experiences of telehealth during COVID-19 restrictions.Methods: 30 patients with lung cancer were recruited. Data was collected using a qualitative exploratory design with semi-structured interviews. Transcripts were thematically coded using NVivo software.Results: Five key themes were identified. Maintaining resilience: participants acknowledged they were self-reliant prior to their diagnosis, and that the sense of their own internal capabilities was a source of comfort for them; Importance of pre-established relationships with healthcare professionals: the sense of connection established prior to the telehealth consultation supported participants to engage with healthcare professionals. The need for connectedness was amplified by a sense of isolation. Seeking help: participants sought help from services that they perceived as being “expert”; Convenience: factors such as costs and saving time were highlighted; Preferences for consultation type: majority of participants identified physical and emotional comfort being in their own space. For a small number of patients, continuing a face to face assessment was important due to expectation based on previous experience. Conclusion: The use of telehealth was supported during the management of COIVD-19. Connectedness and convenience were key to the level of comfort and confidence for patients with lung cancer using telehealth during ‘lockdown’.

Author(s):  
Ernest Osei ◽  
Ruth Francis ◽  
Ayan Mohamed ◽  
Lyba Sheraz ◽  
Fariba Soltani-Mayvan

Abstract Background: Globally, cancer is the second leading cause of death, and it is estimated that over 18·1 million new cases are diagnosed annually. The COVID-19 pandemic has significantly impacted almost every aspect of the provision and management of cancer care worldwide. The time-critical nature of COVID-19 diagnosis and the large number of patients requiring hospitalisation necessitated the rerouting of already limited resources available for cancer services and programmes to the care of COVID-19 patients. Furthermore, the stringent social distancing, restricted in-hospital visits and lockdown measures instituted by various governments resulted in the disruption of the oncologic continuum including screening, diagnostic and prevention programmes, treatments and follow-up services as well as research and clinical trial programmes. Materials and Methods: We searched several databases from October 2020 to January 2021 for relevant studies published in English between 2020 and 2021 and reporting on the impact of COVID-19 on the cancer care continuum. This narrative review paper describes the impact of the COVID-19 pandemic on the cancer patient care continuum from screening and prevention to treatments and ongoing management of patients. Conclusions: The COVID-19 pandemic has profoundly impacted cancer care and the management of cancer services and patients. Nevertheless, the oncology healthcare communities worldwide have done phenomenal work with joint and collaborative efforts, utilising best available evidence-based guidelines to continue to give safe and effective treatments for cancer patients while maintaining the safety of patients, healthcare professionals and the general population. Nevertheless, several healthcare centres are now faced with significant challenges with the management of the backlog of screening, diagnosis and treatment cases. It is imperative that governments, leaders of healthcare centres and healthcare professionals take all necessary actions and policies focused on minimising further system-level delays to cancer screening, diagnosis, treatment initiation and clearing of all backlogs cases from the COVID-19 pandemic in order to mitigate the negative impact on cancer outcomes.


2021 ◽  
Vol 12 ◽  
Author(s):  
Anouk S. Schuit ◽  
Karen Holtmaat ◽  
Valesca van Zwieten ◽  
Eline J. Aukema ◽  
Lotte Gransier ◽  
...  

BackgroundCancer patients often suffer from psychological distress during or after cancer treatment, but the use of psycho-oncological care among cancer patients is limited. One of the reasons might be that the way psycho-oncological care is organized, does not fit patients’ preferences. This study aimed to obtain detailed insight into cancer patients’ preferences regarding the organization of psycho-oncological care.Methods18 semi-structured interviews were conducted among cancer patients. Patients completed psycho-oncological treatment between 2015 and 2020 at the psychology department in a general hospital or a center specialized in psychological cancer care in the Netherlands. The interview comprised questions related to preferences regarding the institute where to receive treatment, the psychologist who provides treatment, and the type of treatment, as well as questions related to experienced barriers and facilitators to receive psycho-oncological care. Interviews were digitally recorded and transcribed verbatim. Data were analyzed individually by two coders into key issues and themes.ResultsRegarding the institute, easy accessibility and prompt availability of psychol-oncological care were considered important. Regarding the psychologist, most participants had a strong preference to be treated by a psychologist specialized in cancer or other somatic diseases. Individual face-to-face therapy was preferred above other types of treatment. Several barriers were mentioned to receive psycho-oncological treatment, among which poor accessibility to psycho-oncological care, lack of knowledge on the possibilities for psycho-oncological treatment, and stigma. Most frequently mentioned facilitators were being assertive to ask for help, having a good relationship with the healthcare professional, and the integration of psycho-oncological support within medical cancer care.ConclusionFrom the patient’s perspective, the organization of psycho-oncological care for cancer patients should focus on easy accessibility and availability, delivered by specialized psychologists, and integration in medical cancer care. Online and group therapy are acceptable, but individual face-to-face therapy is preferred. It is warranted to increase awareness on psycho-oncological care targeting both patients and healthcare providers.


2018 ◽  
Vol 32 (8) ◽  
pp. 1428-1437
Author(s):  
Lucy Walker ◽  
Karen Neoh ◽  
Hazel Gilkes ◽  
Clare Rayment

Background: Corneal transplantation can lead to sight restoration, but globally there is a donor shortage. Many palliative care patients can donate their corneas but think they are ineligible due to comorbidities. Healthcare professionals are reluctant to broach the topic, but studies have shown that relatives would be upset if they were not offered this chance. There is no existing research involving patients. Aim: To understand the views and feelings of patients in palliative care settings towards corneal donation and explore their opinions regarding the timing of its discussion. Design: This is an exploratory study based at one UK palliative care unit. A census sampling method was used. Nine participants took part in semi-structured interviews and thematic analysis was undertaken. Results: Themes found included altruistic motivation and the value of sight. Family views were important, but the influence on final decisions varied. The timing of discussion relative to the illness trajectory was important; patients want to be able to engage fully in conversations and had concerns about not being able to think clearly when closer to death. Participants also associated discussion of donation as an indication of a poor prognosis. Patients prefer face-to-face discussions with someone whom they had a close rapport. Many had misconceptions about eligibility. Conclusion: This is the first study to engage directly with palliative care patients and to establish their views on the timing of corneal donation discussions. Patients are willing to discuss donation, and further exploration of patient views in this area should be undertaken.


2019 ◽  
Vol 27 (12) ◽  
pp. 760-766
Author(s):  
Rhona Reardon ◽  
Sarah Grogan

This study explores midwives' experiences of talking to postnatal women about smoking cessation. Face-to-face, semi-structured interviews were held with seven midwives based in the UK. Thematic analysis identified themes which provided understanding as to factors determining discussion of smoking cessation. Six themes were identified, namely postnatal women factors, midwife factors, providing information, involving others, priorities, and whole family approach. Implications for midwives working with postnatal women are discussed, including the need to increase the involvement of other healthcare professionals in supporting postnatal women to stop smoking.


2020 ◽  
Vol 7 ◽  
Author(s):  
Eiji Kawamoto ◽  
Asami Ito-Masui ◽  
Ryo Esumi ◽  
Hiroshi Imai ◽  
Motomu Shimaoka

Numerous factors affecting the interactions between healthcare professionals in the workplace demand a comprehensive understanding if the quality of patient healthcare is to be improved. Our previous cross-sectional analysis showed that patient severity scores [i.e., Acute Physiology and Chronic Health Evaluation (APACHE) II] in the 24 h following admission positively correlated with the length of the face-to-face interactions among ICU healthcare professionals. The present study aims to address how the relationships between patient severity and interaction lengths can change over a period of time during both admission and treatment in the ICU. We retrospectively analyzed data prospectively collected between 19 February to 17 March 2016 from an open ICU in a University Hospital in Japan. We used wearable sensors to collect a spatiotemporal distribution dataset documenting the face-to-face interactions between ICU healthcare professionals, which involved 76 ICU staff members, each of whom worked for 160 h, on average, during the 4-week period of data collection. We studied the longitudinal relationships among these interactions, which occurred at the patient bedside, vis-à-vis the severity of the patient's condition [i.e., the Sequential Organ Failure Assessment (SOFA) score] assessed every 24 h. On Day 1, during which a total of 117 patients stayed in the ICU, we found statistically significant positive associations between the interaction lengths and their SOFA scores, as shown by the Spearman's correlation coefficient value (R) of 0.447 (p < 0.01). During the course of our observation from Day 1 to Day 10, the number of patients (N) who stayed in the ICU gradually decreased (N = 117, Day1; N = 10, Day 10), as they either were discharged or died. The statistically significant positive associations of the interaction lengths with the SOFA scores disappeared from Days 2 to 6, but re-emerged on Day 7 (R = 0.620, p < 0.05) and Day 8 (R = 0.625, p < 0.05), then disappearing again on Days 9 and 10. Whereas all 6 SOFA sub-scores correlated well with the interaction lengths on Day 1, only a few of the sub-scores (coagulation, cardiovascular, and central nervous system scores) did so; specifically, those on Days 7 and 8. The results suggest that patient severity may play an important role in affecting the interactions between ICU healthcare professionals in a time-related manner on ICU Day 1 and on Days 7/8.


2021 ◽  
Author(s):  
Adèle PERRIN ◽  
Eléonore Damiolini ◽  
Anne-Marie Schott ◽  
Jéremy Zermati ◽  
Estelle Bravant ◽  
...  

Abstract Background: Implementing practices adapted to patient health literacy (HL) is a promising avenue for improving their outcomes in the context of cardiovascular diseases (CVD). The health communication skills of healthcare professionals (HCPs) and the quality of information provided are essential for low-HL patients. We aimed to explore HCPs knowledge about HL, patients and HCPs views on current practices regarding low-HL patients, and facilitators and barriers to adapting communication to patients’ HL level, in order to prepare the implementation of a complex intervention dedicated to improve CVD management for low-HL patients.Methods: We conducted face-to-face semi-structured interviews with HCPs practicing in cardiology units and patients hospitalized for CVD. Study design and analysis were based on the Theory of Planned Behavior for HCPs and the framework of Health Literacy and Health Action for patients. Deductive and inductive thematic analysis were used. Barriers and facilitators were structured into an Ishikawa fishbone diagram and implementation strategies were selected to address resulting themes from the Expert Recommendations for Implementing Change (ERIC).Results: Fifteen patients and 14 HCPs were interviewed. HCPs had partial knowledge of HL dimensions. Perceptions of HCPs and patients were not congruent regarding HCP-patient interactions and information provided by hospital and community HCPs. HCPs perceived they lacked validated tools and skills, and declared they adapted spontaneously their communication when interacting with low-HL patients. Patients expressed unmet needs regarding communication during hospital discharge and at return to home. Conclusion: To implement HL-tailored practices in this setting, our results suggest that several implementation strategies will be valuable at individual (engaging patients and their family), interactional (educating and training of HCPs about HL) and organizational levels (creating a multidisciplinary HCPs interest group dedicated to HL). Trial registration: The study was registered on Clinical Trials: NCT03949309.


2019 ◽  
Vol 5 ◽  
pp. 205520761984554
Author(s):  
Angus Watt ◽  
Katherine Swainston ◽  
Gemma Wilson

Objective Wearable technologies for health monitoring are becoming increasingly mainstream. However, there is currently limited evidence exploring use from the perspective of healthcare professionals. This study aimed to explore health professionals’ attitudes toward their patients’ use of wearable technologies. Methods A convenience sample of health professionals was recruited to participate in this study. Qualitative semi-structured interviews were carried out either face-to-face, via Skype or telephone. Interviews were recorded using a Dictaphone, transcribed verbatim and analysed using thematic analysis. Results Four themes emerged from the qualitative findings: ‘opportunities for wearable technology’, ‘usability and understanding’, ‘privacy and surveillance’ and ‘cost’. Conclusions The findings portray health professionals’ ambivalence to the use of wearable technology, and it was apparent that whilst the participants considered the technology as being beneficial to patients, they still had concerns for its use.


2018 ◽  
Vol 22 (2) ◽  
pp. 238-250 ◽  
Author(s):  
Amy C Stewart ◽  
Kenneth N Gannon ◽  
Fran Beresford ◽  
Louise Fleming

This study explored the experiences of adolescents and their caregivers regarding adherence to inhaled corticosteroids which are assessed through an electronic monitoring device (EMD). These devices are increasingly being used for assessing medication adherence, yet there is little information about patient’s experience of these tools. Semi-structured interviews were conducted with eight adolescents with severe asthma, aged 11–15 years, who were electronically monitored as part of their care, along with their caregivers. Interviews were analysed using thematic analysis. Three themes were identified: ‘they were trying to help me get better’, ‘checking up and catching out’ and ‘who is responsible?’ The themes highlighted differences in priorities between participant groups, the impact of monitoring on the healthcare relationship and the dilemma of transferring responsibility for asthma management to adolescents. The findings suggest it is important for healthcare professionals to engage with patient’s preferences and priorities when introducing EMDs.


2018 ◽  
Vol 2 (1) ◽  
pp. 35
Author(s):  
Jacquie Kidd

These three poems re-present the findings from a research project that took place in 2013 (Kidd et al. 2018, Kidd et al. 2014). The research explored what health literacy meant for Māori patients and whānau when they accessed palliative care. Through face-to-face interviews and focus groups we engaged with 81 people including patients, whānau, bereaved loved ones, support workers and health professionals. The poems are composite, written to bring some of our themes to life. The first poem is titled Aue. This is a Māori lament that aligns to English words such as ‘oh no’, or ‘arrgh’, or ‘awww’. Each stanza of the poem re-presents some of the stories we heard throughout the research. The second poem is called Tikanga. This is a Māori concept that encompasses customs, traditions and protocols. There are tikanga rituals and processes that guide all aspects of life, death, and relationships. This poem was inspired by an elderly man who explained that he would avoid seeking help from a hospice because ‘they leave tikanga at the door at those places’. His choice was to bear his pain bravely, with pride, within his cultural identity. The third poem is called ‘People Like Me’. This is an autoethnographical reflection of what I experienced as a researcher which draws on the work of scholars such as bell hooks (1984), Laurel Richardson (1997) and Ruth Behar (1996). These and many other authors encourage researchers to use frustration and anger to inform our writing; to use our tears to fuel our need to publish our research.


Sign in / Sign up

Export Citation Format

Share Document