scholarly journals Outpatient Cancer Care Delivery in the Context of E-Oncology: A French Perspective on “Cancer outside the Hospital Walls”

Cancers ◽  
2019 ◽  
Vol 11 (2) ◽  
pp. 219 ◽  
Author(s):  
François Bertucci ◽  
Anne-Gaëlle Le Corroller-Soriano ◽  
Audrey Monneur-Miramon ◽  
Jean-François Moulin ◽  
Sylvain Fluzin ◽  
...  

In oncology, the treatment of patients outside of hospitals has become imperative due to an increasing number of patients who are older and live longer, along with issues such as medical desertification, oncologist hyperspecialization, and difficulties in financing mounting health expenditures. Treatments have become less “invasive”, with greater precision and efficiency. Patients can therefore receive most of their care outside of hospitals. The development of e-health can address these new imperatives. In this letter, we describe the different e-health tools and their potential clinical impacts in oncology, as already reported at every level of care, including education, prevention, diagnosis, treatment, and monitoring. A few randomized studies have yet demonstrated the clinical benefit. We also comment on issues and limits of “cancer outside the hospital walls” from the point of view of patients, health care professionals, health facilities, and public authorities. Care providers in hospitals and communities will have to adapt to these changes within well-coordinated networks in order to better meet patient expectations regarding increasing education and personalizing management. Ultimately, controlled studies should aim to definitively demonstrate areas of interest, benefits, and incentives, for not only patients, but also caregivers (formal and informal) and health care providers, health care facilities, and the nation.

2014 ◽  
Author(s):  
◽  
Mirna Becevic

Affordable Care Act (ACA) has allowed more patients that did not previously have health care insurance to have coverage and access to care. This increase in the number of patients seeking medical care will only add additional stress to the existing disproportion of supply and demand for health care providers. In addition, rising health care costs have major effect on how, where, and even if consumers will get needed care. This study examined three different telehealth platforms in three different medical specialties in order to evaluate the perception that they would be appropriate vehicles for increasing access to care. I also wanted to find out what the users' perceptions of these technologies are, as that can be a driving factor in adoption of new technologies. The first study examined the usability and acceptance of new mobile application in teledermatology clinic. The second study focused on usability and acceptance of ICU Robots in a medical ICU. Finally, the third study evaluated if children and youth currently using telepsychiatry as a care delivery method would have other in-person options if telehealth was not available. The results of these three studies point at the complexity and richness of telehealth. The adoption and acceptance of mHealth was very fast and streamlined. In the same fashion, children might not have other appropriate options for care if telepsychiatry was not available in rural Missouri. Interestingly, though, the provider acceptance of ICU Robots was slow, with some provider disengagements observed. This research contributes to the field of health informatics and medical informatics by evaluating adoption and usability of technologies from the provider perspective, vs. the more traditional approach of examining patient satisfaction, or even provider satisfaction without fully understanding the implications of attitudes on the adoption itself. This study has focused purposefully on different groups of providers using different types of telehealth technologies so we could try to see the bigger picture of how telehealth actually contributes to the health care organizational structure.


2019 ◽  
Vol 29 (Supp2) ◽  
pp. 359-364 ◽  
Author(s):  
Brian McGregor ◽  
Allyson Belton ◽  
Tracey L. Henry ◽  
Glenda Wrenn ◽  
Kisha B. Holden

 Racial/ethnic disparities have long persisted in the United States despite concerted health system efforts to improve access and quality of care among African Americans and Latinos. Cultural competence in the health care setting has been recognized as an important feature of high-quality health care delivery for decades and will continue to be paramount as the society in which we live becomes increasingly culturally diverse. Unfortunately, there is limited empirical evidence of patient health benefits of a culturally competent health care workforce in integrated care, its feasibility of imple­mentation, and sustainability strategies. This article reviews the status of cultural competence education in health care, the merits of continued commitment to training health care providers in integrated care settings, and policy and practice strategies to ensure emerging health care professionals and those already in the field are prepared to meet the health care needs of racially and ethnically diverse populations. Ethn Dis. 2019;29(Supp 2):359-364. doi:10.18865/ed.29.S2.359


2018 ◽  
Vol 35 (4) ◽  
pp. 247-256 ◽  
Author(s):  
Jessica L. Spruit ◽  
Cynthia J. Bell ◽  
Valerie B. Toly ◽  
Maryjo Prince-Paul

The care of pediatric patients with cancer and their families is complex and rapidly evolving. Despite significant advances in outcomes, symptoms of the disease and complications of therapy continue to cause suffering that may improve with the involvement of pediatric palliative care (PPC) services. This descriptive study responds to the observation of great variability in PPC utilization within pediatric oncology. Data collected from 156 health care professionals (nurses, advanced practice professionals, and physicians) from a statewide hematology alliance evaluates the knowledge, beliefs, and perceived barriers to PPC involvement. Data analysis reveals significant variability when comparing respondents from professional roles and practice environments. Despite progress in PPC availability, care delivery remains incongruent with current recommendations. Knowledge gained from this study emphasizes the important role for all health care providers in advocating for support of PPC programs, educating the public, and committing to intentional involvement of PPC services while caring for pediatric oncology patients.


2021 ◽  
pp. 1-6
Author(s):  
Giuliano Brunori ◽  
Gianpaolo Reboldi ◽  
Filippo Aucella

<b><i>Backgrounds:</i></b> The recent coronavirus disease 2019 (CO­VID-19) pandemic has placed worldwide health systems and hospitals under pressure, and so are the renal care models. This may be a unique opportunity to promote and expand alternative models of health-care delivery in patients undergoing renal replacement therapies. <b><i>Summary:</i></b> Despite the high risk of acquiring communicable diseases when undergoing in-centre treatments, only a small proportion of patients are currently being treated with home therapies. Recent data provided by the Italian Society of Nephrology (SIN), the REIN French Registry and the Wuhan Hemodialysis Quality Control Center clearly show that patients receiving hospital-based treatment have a 3- to 4-fold greater risk of infection, and a subsequent fatality proportion between 21 and 34%. On the other hand, home-based therapy can be managed remotely, there is little or no need for transport to and from the hospital, and it is less expensive. Besides, the digital revolution in health care with the development of virtual care systems can make home dialysis with telehealth a cost-effective solution for both patients and health-care providers. Such a transition would require specific training for physicians and health-care professionals and a functional re-organization of dialysis centres to improve the skills and expertise in caring for patients at home. <b><i>Conclusion:</i></b> The need for more widespread home treatment is the main lesson learnt by nephrologists by the COVID-19 pandemic.


2017 ◽  
Vol 34 (4) ◽  
pp. 261-271 ◽  
Author(s):  
Catherine M. Laing ◽  
Nancy J. Moules ◽  
Andrew Estefan ◽  
Mike Lang

The purpose of this philosophical hermeneutic study was to understand the effects on health care providers (HCPs) of watching digital stories made by (past and present) pediatric and adolescent/young adult (AYA) oncology patients. Twelve HCPs participated in a focus group where they watched digital stories made by pediatric/AYA oncology patients and participated in a discussion related to the impact the stories had on them personally and professionally. Findings from this research revealed that HCPs found digital stories to be powerful, therapeutic, and educational tools. Health care providers described uses for digital stories ranging from education of newly diagnosed families to training of new staff. Digital stories, we conclude, can be an efficient and effective way through which to understand the patient experience, implications from which can range from more efficient patient care delivery to decision making. Recommendations for incorporating digital storytelling into healthcare delivery are offered.


2017 ◽  
Vol 33 (5) ◽  
pp. 279-287 ◽  
Author(s):  
Jim Q. Ho ◽  
Christopher D. Nguyen ◽  
Richard Lopes ◽  
Stephen C. Ezeji-Okoye ◽  
Ware G. Kuschner

Spiritual care is an important component of high-quality health care, especially for critically ill patients and their families. Despite evidence of benefits from spiritual care, physicians and other health-care providers commonly fail to assess and address their patients’ spiritual care needs in the intensive care unit (ICU). In addition, it is common that spiritual care resources that can improve both patient outcomes and family member experiences are underutilized. In this review, we provide an overview of spiritual care and its role in the ICU. We review evidence demonstrating the benefits of, and persistent unmet needs for, spiritual care services, as well as the current state of spiritual care delivery in the ICU setting. Furthermore, we outline tools and strategies intensivists and other critical care medicine health-care professionals can employ to support the spiritual well-being of patients and families, with a special focus on chaplaincy services.


2000 ◽  
Vol 11 (5) ◽  
pp. 225-226 ◽  
Author(s):  
Pamela Orr

The medical literature has amply documented the transmission of influenza from patients to health care workers (HCWs) (1,2), from HCWs to patients (3) and between HCWs (4-9). The consequences of influenza transmission within the health care environment include morbidity and mortality among patients, most of who are at high risk for the complications of infection, and illness and absenteeism among health care providers. When outbreaks occur in health care facilities, absenteeism among HCWs may approach 30% to 40%, resulting in severe staff shortages, increased employment costs and the potential endangerment of health care delivery due to the scarcity of replacement workers (10-13).


2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Jalana Lazar ◽  
Laura Boned-Rico ◽  
Ellinor K. Olander ◽  
Christine McCourt

Abstract Background Group antenatal care is a rapidly expanding alternative antenatal care delivery model. Research has shown it to be a safe and effective care model for women, but less is known about the perspectives of the providers leading this care. This systematic review examined published literature that considered health care professionals’ experiences of facilitating group antenatal care. Methods Systematic searches were conducted in seven databases (Cinahl, Medline, Psychinfo, Embase, Ovid Emcare, Global Health and MIDRS) in April 2020. Qualitative or mixed methods studies with a significant qualitative component were eligible for inclusion if they included a focus on the experiences of health care providers who had facilitated group antenatal care. Prisma screening guidelines were followed and study quality was critically appraised by three independent reviewers. The findings were synthesised thematically. Results Nineteen papers from nine countries were included. Three main themes emerged within provider experiences of group antenatal care. The first theme, ‘Giving women the care providers feel they want and need’, addresses richer use of time, more personal care, more support, and continuity of care. The second theme, ‘Building skills and relationships’, highlights autonomy, role development and hierarchy dissolution. The final theme, ‘Value proposition of group antenatal care’, discusses provider investment and workload. Conclusions Health care providers’ experience of delivering group antenatal care was positive overall. Opportunities to deliver high-quality care that benefits women and allows providers to develop their professional role were appreciated. Questions about the providers’ perspectives on workload, task shifting, and the structural changes needed to support the sustainability of group antenatal care warrant further exploration.


2021 ◽  
pp. 205336912110600
Author(s):  
Nargis Asad ◽  
Rozina Somani ◽  
Nausheen Peerwani ◽  
Shahina Pirani ◽  
Nadeem Zuberi ◽  
...  

Objective The study aims to explore the perceptions and experiences of menopausal women living in Karachi, Pakistan. Study design Using qualitative exploratory design, in-depth interviews were conducted with eleven women, aged 35–55 years. The data was collected through face-to-face interviews using semi structured interview guide. Creswell frame work for content analysis was used to analyze the data. Main outcome measures Perceptions and experiences of menopause women living in Karachi, Pakistan. Results Women described positive and negative experiences of menopause, though predominantly negative intensified by mental distress, lack of support from intimate partner, and misperceptions about menopause. A majority of the women emphasized the need for educating their husbands regarding menopausal changes. In clinical practices, health care professionals should screen the women for menopause challenges when they visit health care facilities and offer education regarding self-care and management to achieve better quality of life and positive coping. Conclusions We conducted a preliminary study on women’s perceptions and experiences of menopause in the context of Pakistan. Our study offers significant findings from an Asian cultural perspective, in which norms are predominantly patriarchal and male dominated. The study provides useful guidelines for health care providers to better address health care needs of menopausal women.


Author(s):  
Agnete E. Kristoffersen ◽  
Ann Ragnhild Broderstad ◽  
Frauke Musial ◽  
Trine Stub

Abstract Background Patient-centered culturally sensitive health care (PC-CSHC) has emerged as a primary approach to health care. This care focuses on the cultural diversity of the patients rather than the views of the health care professionals. PC-CSHC enables the patient to feel comfortable, respected, and trusted in the health care delivery process. As users of traditional and complementary medicine (T&CM) rarely inform their conventional health care providers of such use, the providers need to identify the users of T&CM themselves to avoid negative interaction with conventional medicine and to be able to provide them with PC-CSHC. Since the patterns of traditional medicine (TM) use are different to those of complementary medicine (CM), the aim of this study was to investigate the prevalence, and the health- and sociodemographic associations for visits to TM- and CM providers in an urban population. Method The data were collected through two self-administrated questionnaires from the seventh survey of the Tromsø Study, a population-based cohort study conducted in 2015–2016. All inhabitants of Tromsø aged 40 or above were invited (n = 32,591) and n = 21,083 accepted the invitation (response rate 65%). Pearson chi-square tests and one-way ANOVA tests were used to describe differences between the groups whereas binary logistic regressions were used for adjusted values. Results The results revealed that 2.5% of the participants had seen a TM provider, 8.5% had seen a CM provider whereas 1% had visited both a TM and a CM provider during a 12-month period. TM users tended to be older, claim that religion was more important to them, have poorer economy and health, and have lower education compared to CM users. We found that more than 90% of the participants visiting T&CM providers also used conventional medicine. Conclusion A considerable number of the participants in this study employed parallel health care modalities including visits to conventional, traditional, and complementary medicine providers. To offer patient-centered culturally sensitive health care that is tailored to the patients’ treatment philosophy and spiritual needs, conventional health care providers need knowledge about, and respect for their patients’ use of parallel health care systems.


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