Evaluation and Implementation of ListeningTime: A Web-Based Preparatory Communication Tool for Elderly Patients With Cancer and Their Health Care Providers

BACKGROUND Effective patient-provider communication is an important condition to deliver optimal care and it supports patients in coping with their disease. The complex and emotionally loaded setting of oncology care challenges both health care providers (HCPs) and patients in reaching effective communication. ListeningTime is developed for elderly patients with cancer and their oncological HCPs to help them (better) prepare the clinical encounter and overcome communication barriers. ListeningTime is a Web-based preparatory communication tool including modeling videos and has an audio-facility to listen back to recorded encounters. OBJECTIVE This study aims to evaluate the usability, perceived usefulness, and actual use of ListeningTime, through the eyes of elderly patients with cancer and their oncological HCPs. If highly rated, the ultimate goal is to make ListeningTime publicly available. METHODS First, members of a panel of elderly cancer survivors and patients (age ≥65 years) were approached to evaluate ListeningTime through a Web-based questionnaire. The usability and perceived usefulness were assessed. Second, ListeningTime was evaluated in real-life practice through a pilot study in 3 Dutch hospitals. In these hospitals, elderly patients with cancer and their oncological HCPs were approached to evaluate ListeningTime through a similar Web-based questionnaire, measuring the perceived usefulness. In addition, we examined log files and user statistics to get insight into how the program was used. RESULTS A total of 30 cancer survivors or patients from the patient panel, and 17 patients and 8 HCPs from the hospitals, evaluated ListeningTime. Overall, both panel members and hospital patients were positive about the ListeningTime website, audio-facility, and video fragments. Some patients suggested improvements with respect to the actors’ performances in the video fragments and believed that ListeningTime is mainly suitable for non experienced patients. HCPs were also positive about ListeningTime; they valued the video fragments for patients and the audio-facility for patients and themselves. However, providers did not relisten their own recorded encounters. Patients did use the audio-facility to relisten their encounters. CONCLUSIONS ListeningTime was highly rated, both by patients and their oncological HCPs. As a result, the video fragments of ListeningTime are now made publicly available for elderly patients with cancer through the Dutch website “kanker.nl.”

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Identifying End-of-Life Preferences Among Chinese Patients With Cancer Using the Heart to Heart Card Game

American Journal of Hospice and Palliative Medicine® ◽

10.1177/1049909120917361 ◽

2020 ◽

Vol 38 (1) ◽

pp. 62-67

Author(s):

Tong Li ◽

Xianbo Pei ◽

Xiaoli Chen ◽

Shuqin Zhang

Keyword(s):

Health Care ◽

End Of Life ◽

Health Care Providers ◽

Chinese Americans ◽

Social Needs ◽

Chinese Patients ◽

Card Game ◽

Care Providers ◽

Communication Tool ◽

Patients With Cancer

Background: Understanding the preferences for end-of-life (EOL) care is imperative in providing quality care to patients with life-threatening illness. However, it is difficult for patients, families, and health-care providers to initiate EOL conversations in China. An easy-to-use tool that could help health-care providers initiate EOL discussions is the Heart to Heart Card Game (HHCG), originally designed for Chinese Americans. Objective: To evaluate the EOL preferences among Chinese patients with cancer using the HHCG. Methods: We conducted a descriptive study to assess EOL preferences using HHCG among patients at the oncology chemoradiotherapy department of a Chinese tertiary hospital. Results: We recruited 58 patients in total of which 40 (69%) patients completed HHCG. The most frequently selected card was “I want my family to get along,” followed by “I don’t want to be a burden to my family,” and “I want to maintain my dignity.” Among the 3 cards selected, social needs were rated as the most important (36.7%), followed by spiritual needs (35.8%), physical needs (20.0%), and financial needs (7.5%). The evaluation of the HHCG revealed that more than 70% of the participants highly valued HHCG. Conclusion: The HHCG can be used as a communication tool to encourage EOL discussions between cancer patients and health-care providers in China. Moreover, Chinese patients with cancer attach significant importance to their family and maintaining dignity at the EOL.

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Concerns of Patients With Cancer on Accessing Cannabis Products in a State With Restrictive Medical Marijuana Laws: A Survey Study

Journal of Oncology Practice ◽

10.1200/jop.19.00184 ◽

2019 ◽

Vol 15 (10) ◽

pp. 531-538 ◽

Cited By ~ 2

Author(s):

Vinita Singh ◽

Ali J. Zarrabi ◽

Kimberly A. Curseen ◽

Roman Sniecinski ◽

Justine W. Welsh ◽

...

Keyword(s):

Health Care ◽

Palliative Care ◽

Health Care Providers ◽

Medical Marijuana ◽

Survey Study ◽

Care Practice ◽

Care Providers ◽

Patients With Cancer ◽

Medical Marijuana Laws ◽

Source Of Information

PURPOSE: Several states, particularly in the Southeast, have restrictive medical marijuana laws that permit qualified patients to use specific cannabis products. The majority of these states, however, do not provide avenues for accessing cannabis products such as in-state dispensaries. METHODS: We conducted a survey of patients registered for medical marijuana (low tetrahydrocannabinol [THC] oil cards) in an ambulatory palliative care practice in Georgia (one of the states with restrictive medical marijuana laws). RESULTS: We had a total of 101 responses. Among our sample of patients who use cannabis as part of a state-approved low THC oil program, 56% were male and 64% were older than age 50 years. Advanced cancer was the most common reason (76%) for granting the patients access to a low THC oil card. Although patients reported cannabis products as being extremely helpful for reducing pain, they expressed considerable concerns about the legality issues (64%) and ability to obtain THC (68%). Several respondents were using unapproved formulations of cannabis products. For 48% of the patients, their physician was the source of information regarding marijuana-related products. Furthermore, they believed that their health care providers and family members were supportive of their use of cannabis (62% and 79%, respectively). CONCLUSION: Patients on Georgia’s medical marijuana program are most concerned about the legality of the product and their ability to obtain marijuana-related products. Therefore, we recommend that states with medical marijuana laws should provide safe and reliable access to cannabis products for qualifying patients.

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Use and Effects of Patient Access to Medical Records in General Practice Through a Personal Health Record in the Netherlands: Protocol for a Mixed-Methods Study

JMIR Research Protocols ◽

10.2196/10193 ◽

2018 ◽

Vol 7 (9) ◽

pp. e10193 ◽

Cited By ~ 1

Author(s):

Maria MT Vreugdenhil ◽

Rudolf B Kool ◽

Kees van Boven ◽

Willem JJ Assendelft ◽

Jan AM Kremer

Keyword(s):

Health Care ◽

General Practice ◽

Health Care Providers ◽

Personal Health Record ◽

Mixed Methods Study ◽

Personal Health ◽

Care Providers ◽

Group Discussions ◽

Web Based ◽

Staff Level

Background In the Dutch health care system, general practitioners hold a central position. They store information from all health care providers who are involved with their patients in their electronic health records. Web-based access to the summary record in general practice through a personal health record (PHR) may increase patients’ insight into their medical conditions and help them to be involved in their care. Objective We describe the protocol that we will use to investigate the utilization of patients’ digital access to the summary of their medical records in general practice through a PHR and its effects on the involvement of patients in their care. Methods We will conduct a multilevel mixed-methods study in which the PHR and Web-based access to the summary record will be offered for 6 months to a random sample of 500 polypharmacy patients, 500 parents of children aged <4 years, and 500 adults who do not belong to the former two groups. At the patient level, a controlled before-after study will be conducted using surveys, and concurrently, qualitative data will be collected from focus group discussions, think-aloud observations, and semistructured interviews. At the general practice staff (GP staff) level, focus group discussions will be conducted at baseline and Q-methodology inquiries at the end of the study period. The primary outcomes at the patient level are barriers and facilitators for using the PHR and summary records and changes in taking an active role in decision making and care management and medication adherence. Outcomes at the GP staff level are attitudes before and opinions after the implementation of the intervention. Patient characteristics and changes in outcomes related to patient involvement during the study period will be compared between the users and nonusers of the intervention using chi-square tests and t tests. A thematic content analysis of the qualitative data will be performed, and the results will be used to interpret quantitative findings. Results Enrollment was completed in May 2017 and the possibility to view GP records through the PHR was implemented in December 2017. Data analysis is currently underway and the first results are expected to be submitted for publication in autumn 2019. Conclusions We expect that the findings of this study will be useful to health care providers and health care organizations that consider introducing the use of PHR and Web-based access to records and to those who have recently started using these. Trial Registration Netherlands Trial Registry NTR6395; http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=6395 (Archived by WebCite at http://www.webcitation.org/71nc8jzwM) Registered Report Identifier RR1-10.2196/10193

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Querying Patients With Cancer About Sexual Health and Sexual and Gender Minority Status: A Qualitative Study of Health-Care Providers

American Journal of Hospice and Palliative Medicine® ◽

10.1177/1049909119879129 ◽

2019 ◽

Vol 37 (6) ◽

pp. 418-423 ◽

Cited By ~ 1

Author(s):

Elizabeth Cathcart-Rake ◽

Jennifer M. O’Connor ◽

Jennifer L. Ridgeway ◽

Carmen Radecki Breitkopf ◽

Lois J. Mc Guire ◽

...

Keyword(s):

Health Care ◽

Sexual Health ◽

Health Care Providers ◽

Minority Status ◽

Care Providers ◽

Gender Minority ◽

Patients With Cancer ◽

National Organizations ◽

Sexual And Gender Minority ◽

And Gender

Background: Although national organizations advocate that health-care providers ask patients about sexual health and sexual and gender minority status—to learn, for example, about side effects of treatment and to understand patients’ social support—these conversations often do not occur. This study explored health-care providers’ reasons for having/not having these conversations. Methods: This single-institution study recruited health-care providers from medical oncology, hematology, radiation oncology, and gynecology. Face-to-face interviews were recorded, transcribed, and analyzed qualitatively. Results: Three main themes emerged: (1) patient-centric reasons for discussing/not discussing sexual health and sexual and gender minority status (“So I think just the holistic viewpoint is important”); (2) health-care provider–centric reasons for discussing/not discussing these issues (“That’s going to take more time to talk about and to deal with…” or “I was raised orthodox, so this is not something we talk about…”; and (3) reasons that appeared to straddle both of the above themes (eg, acknowledgment of the sometimes taboo nature of these topics). Conclusion: Although many health-care providers favor talking with patients with cancer about sexual health and sexual and gender minority status, limited time, personal reluctance, and the taboo nature of these topics appear at times to hamper the initiation of these conversations.

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Chemotherapy Acute Infusion Reactions: A Qualitative Report of the Perspectives of Patients With Cancer

American Journal of Hospice and Palliative Medicine® ◽

10.1177/1049909118773995 ◽

2018 ◽

Vol 35 (11) ◽

pp. 1384-1389

Author(s):

David J. Bartlett ◽

Daniel S. Childs ◽

Carmen Radecki Breitkopf ◽

Megan E. Grudem ◽

Jessica L. Mitchell ◽

...

Keyword(s):

Health Care ◽

Health Care Providers ◽

Antineoplastic Agents ◽

Qualitative Methodology ◽

Infusion Reaction ◽

Care Providers ◽

Patients With Cancer ◽

Life Threatening ◽

Infusion Reactions

Objective: A growing number of cancer antineoplastic agents can cause life-threatening acute infusion reactions. Because previous studies have not studied these reactions from the perspective of patients, this study was undertaken with that objective in mind. Methods: Patients who had an acute infusion reaction were interviewed based on the Leventhal model. Once saturation of content was achieved, interviews were transcribed and analyzed with qualitative methodology. Results: Twenty-one patients were enrolled. Most were women (n = 15); the median age was 58 years, and paclitaxel was the most common inciting agent. Three themes emerged. First, these reactions are frightening; patients made remarks such as “I was just thinking oh my God, I am dying.” Second, prior education about these reactions seemed to mitigate this fear, “Basically everything the nurses told me potentially could happen, like happened. So, I was prepared.” Third, when health-care providers were prompt and attentive during the reaction, patients described less fear with future chemotherapy, “So no, I’m really not fearful about going in tomorrow because I know they’ll be there and they’ll be watching me.” Conclusion: These reactions evoke fear which can be mitigated with education prior to and with prompt responsiveness during the acute infusion reaction.

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Prognosticating futures and the human experience of hope

Palliative & Supportive Care ◽

10.1017/s1478951507000399 ◽

2007 ◽

Vol 5 (3) ◽

pp. 227-239 ◽

Cited By ~ 28

Author(s):

Sally Thorne ◽

Valerie Oglov ◽

Elizabeth-Anne Armstrong ◽

T. Gregory Hislop

Keyword(s):

Health Care ◽

Chronic Illness ◽

Health Care Providers ◽

Health Care Professionals ◽

Secondary Analysis ◽

Human Experience ◽

Clinical Encounter ◽

Care Providers ◽

Health Care Communication ◽

Patients With Cancer

Objectives: Communication between health care providers and patients with cancer and other chronic diseases typically references probabilities that certain future events will or will not occur. Beyond the context of diagnostic encounters and the transmission of “bad news,” such “prognostic” communications take place in various forms throughout the illness trajectory. It is well known that such information transmitted badly can have devastating psychosocial consequences for patients and their families and, conversely, that difficult information exchanged with sensitivity can lend tremendous support. This study aimed to extend our understanding of how such communications are received and interpreted by patients, so that we might optimally apply what we know about general principles of effective communication within the particularly challenging context of predicting futures.Methods: We conducted a combined secondary analysis of two prior qualitative studies into patient perceptions of helpful and unhelpful health care communication with 200 cancer patients and 30 persons with chronic illness. These data sets offered a rich resource for comparing perceptions across a range of contextual variables, and secondary analysis focused on future-oriented interactions, including both prognostication and prediction.Results: The accounts of patients with cancer and chronic illness reveal various ways in which health care communications involving future projections interact with their human experience of hope, powerfully shaping their capacity to make sense of and live with serious illness. They include a synthesis of what patients recommend health care professionals know and understand about this challenging dynamic.Significance of results: The findings of this study offer a distinct angle of vision onto the various communications that involve future predictions, illuminating a patient perspective with the potential to inform health care communication approaches that are both informative and therapeutic. As such, the study supports a dynamic understanding of the tenuous balance between hope and honesty in the clinical encounter.

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Brazilian guidelines for endovascular treatment of patients with acute ischemic stroke

Arquivos de Neuro-Psiquiatria ◽

10.1590/0004-282x20160174 ◽

2017 ◽

Vol 75 (1) ◽

pp. 50-56 ◽

Cited By ~ 8

Author(s):

Octávio Marques Pontes-Neto ◽

Pedro Cougo ◽

Sheila Cristina Ouriques Martins ◽

Daniel G. Abud ◽

Raul G. Nogueira ◽

...

Keyword(s):

Health Care ◽

Ischemic Stroke ◽

Acute Ischemic Stroke ◽

Health Care Providers ◽

Cerebrovascular Diseases ◽

Discussion Forums ◽

Care Providers ◽

Web Based ◽

Health Authorities ◽

Public Health Authorities

ABSTRACT These guidelines are the result of a joint effort from writing groups of the Brazilian Stroke Society, the Scientific Department of Cerebrovascular Diseases of the Brazilian Academy of Neurology, the Brazilian Stroke Network and the Brazilian Society of Diagnostic and Therapeutic Neuroradiology. Members from these groups participated in web-based discussion forums with predefined themes, followed by videoconference meetings in which controversies and position statements were discussed, leading to a consensus. This guidelines focuses on the implications of the recent clinical trials on endovascular therapy for acute ischemic stroke due to proximal arterial occlusions, and the final text aims to guide health care providers, health care managers and public health authorities in managing patients with this condition in Brazil.

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