scholarly journals What Matters in Cancer Survivorship Research? A Suite of Stakeholder-Relevant Outcomes

2021 ◽  
Vol 28 (4) ◽  
pp. 3188-3200
Author(s):  
Robin Urquhart ◽  
Sarah Murnaghan ◽  
Cynthia Kendell ◽  
Jonathan Sussman ◽  
Geoffrey A. Porter ◽  
...  
Keyword(s):  
Cancer Survivorship ◽  
Health Care Providers ◽  
Primary Care Providers ◽  
Post Treatment ◽  
Future Research ◽  
Care Providers ◽  
Telephone Interviews ◽  
After Cancer ◽  
Descriptive Qualitative

The outcomes assessed in cancer survivorship research do not always match the outcomes that survivors and health system stakeholders identify as most important in the post-treatment follow-up period. This study sought to identify stakeholder-relevant outcomes pertinent to post-treatment follow-up care interventions. We conducted a descriptive qualitative study using semi-structured telephone interviews with stakeholders (survivors, family/friend caregivers, oncology providers, primary care providers, and cancer system decision-/policy-makers) across Canada. Data analysis involved coding, grouping, detailing, and comparing the data by using the techniques commonly employed in descriptive qualitative research. Forty-four participants took part in this study: 11 survivors, seven family/friend caregivers, 18 health care providers, and eight decision-makers. Thirteen stakeholder-relevant outcomes were identified across participants and categorized into five outcome domains: psychosocial, physical, economic, informational, and patterns and quality of care. In the psychosocial domain, one’s reintegration after cancer treatment was described by all stakeholder groups as one of the most important challenges faced by survivors and identified as a priority outcome to address in future research. The outcomes identified in this study provide a succinct suite of stakeholder-relevant outcomes, common across cancer types and populations, that should be used in future research on cancer survivorship care.

Comparisons of Patient and Physician Expectations for Cancer Survivorship Care

2009 ◽  
Vol 27 (15) ◽  
pp. 2489-2495 ◽  
Author(s):  
Winson Y. Cheung ◽  
Bridget A. Neville ◽  
Danielle B. Cameron ◽  
E. Francis Cook ◽  
Craig C. Earle
Keyword(s):  
Cancer Survivorship ◽  
Primary Care Providers ◽  
Preventive Health ◽  
Primary Cancer ◽  
Survivorship Care ◽  
Care Providers ◽  
Agreement Rate ◽  
Cancer Management ◽  
Survivorship Care Planning

Purpose To compare expectations for cancer survivorship care between patients and their physicians and between primary care providers (PCPs) and oncologists. Methods Survivors and their physicians were surveyed to evaluate for expectations regarding physician participation in primary cancer follow-up, screening for other cancers, general preventive health, and management of comorbidities. Results Of 992 eligible survivors and 607 physicians surveyed, 535 (54%) and 378 (62%) were assessable, respectively. Among physician respondents, 255 (67%) were PCPs and 123 (33%) were oncologists. Comparing patients with their oncologists, expectations were highly discrepant for screening for cancers other than the index one (agreement rate, 29%), with patients anticipating significantly more oncologist involvement. Between patients and their PCPs, expectations were most incongruent for primary cancer follow-up (agreement rate, 35%), with PCPs indicating they should contribute a much greater part to this aspect of care. Expectations between patients and their PCPs were generally more concordant than between patients and their oncologists. PCPs and oncologists showed high discordances in perceptions of their own roles for primary cancer follow-up, cancer screening, and general preventive health (agreement rates of 3%, 44%, and 51%, respectively). In the case of primary cancer follow-up, both PCPs and oncologists indicated they should carry substantial responsibility for this task. Conclusion Patients and physicians have discordant expectations with respect to the roles of PCPs and oncologists in cancer survivorship care. Uncertainties around physician roles and responsibilities can lead to deficiencies in care, supporting the need to make survivorship care planning a standard component in cancer management.

Culturally Relevant Online Cancer Education Supports Tribal Primary Care Providers to Reduce Their Cancer Risk and Share Information About Cancer

2021 ◽  
pp. 152483992110278
Author(s):  
Katie Cueva ◽  
Melany Cueva ◽  
Laura Revels ◽  
Michelle Hensel ◽  
Mark Dignan
Keyword(s):  
Primary Care ◽  
Cancer Risk ◽  
Culturally Relevant ◽  
Cancer Education ◽  
Primary Care Providers ◽  
Future Research ◽  
Cancer Information ◽  
Care Providers ◽  
Share Information

Background Culturally relevant education is an opportunity to reduce health disparities, and online learning is an emerging avenue for health promotion. In 2014–2019, a team based at the Alaska Native Tribal Health Consortium developed, implemented, and evaluated culturally relevant online cancer education modules with, and for, Alaska’s tribal primary care providers. The project was guided by Indigenous Ways of Knowing and the principles of community-based participatory action research and was evaluated in alignment with empowerment theory. About 265 unique learners completed 1,898 end-of-module evaluation surveys between March 2015 and August 2019, and 13 people completed a follow-up survey up to 28 months post module completion. Key Findings Learners described the modules as culturally respectful and informative and reported feeling more knowledgeable and comfortable talking about cancer as a result of the modules. About 98% of the learners planned to reduce their cancer risk because of the modules, and all follow-up survey respondents had reduced their risk, including by quitting smoking, getting screened for cancer, eating healthier, and exercising more. About 98% of the learners planned to share information with their patients, families, friends, and community members because of the modules, with all follow-up survey respondents indicating that they had shared information about cancer from the modules. Implications for Practice and Further Research Culturally relevant online modules have the capacity for positive behavioral change and relatively high correlations between intent and behavior change. Future research could determine which aspects of the modules catalyzed reduced cancer risk and increased dissemination of cancer information.

Poison Centers: An Overview of the Past, Present, and Future

2000 ◽  
Vol 13 (1) ◽  
pp. 14-26
Author(s):  
Rose Ann Gould Soloway
Keyword(s):  
Health Care Providers ◽  
Clinical Course ◽  
Future Research ◽  
Care Providers ◽  
Need For Treatment ◽  
The Past ◽  
Poison Centers ◽  
Poison Prevention

Poison centers are the source of expert treatment advice for all types of poison exposures. For this reason, health care providers and consumers are encouraged to call poison centers immediately in case of a possible poison exposure. This allows for rapid evaluation of potential toxicity, determination of the need for treatment, follow-up to the conclusion of a patient's clinical course, and data collection which can be useful in identifying unsuspected poisons, directing future research, and identifying subjects for poison prevention efforts.

scholarly journals Stakeholder-Identified Interventions to Address Cancer Survivors’ Psychosocial Needs after Completing Treatment

2021 ◽  
Vol 28 (6) ◽  
pp. 4961-4971
Author(s):  
Sarah Murnaghan ◽  
Cynthia Kendell ◽  
Jonathan Sussman ◽  
Geoffrey A. Porter ◽  
Doris Howell ◽  
...  
Keyword(s):  
Knowledge Translation ◽  
Cancer Survivors ◽  
Health Care Providers ◽  
Primary Care Providers ◽  
Survivorship Care ◽  
Care Providers ◽  
Psychosocial Needs ◽  
Policy Makers ◽  
Knowledge Translation Interventions ◽  
Descriptive Qualitative

The interventions used in cancer-survivorship care do not always address outcomes important to survivors. This study sought to understand stakeholders’ views on the key concerns of cancer survivors after treatment and the interventions needed to meet survivors’ and families’ psychosocial needs after completing cancer treatment. We conducted a descriptive qualitative study using semi-structured interviews with stakeholders (survivors, family/friend caregivers, oncology providers, primary care providers, and cancer system decision-/policy-makers) from across Canada. For the data analysis, we used techniques commonly employed in descriptive qualitative research, such as coding, grouping, detailing, and comparing the data. There were 44 study participants: 11 survivors, seven family/friend caregivers, 18 health care providers, and eight decision-/policy-makers. Stakeholder-relevant interventions to address survivors’ psychosocial needs were categorized into five groups, as follows: information provision, peer support, navigation, knowledge translation interventions, and caregiver-specific supports. These findings, particularly interventions that deliver timely and relevant information about the post-treatment period and knowledge translation interventions that strive to integrate effective tools and programs into survivorship care, have implications for future research and practice.

scholarly journals First, Do No Harm: Understanding Primary Care Providers’ Perception of Risks Associated With Discussing Weight With Pediatric Patients

2021 ◽  
Vol 8 ◽  
pp. 2333794X2110409
Author(s):  
Katie A. Loth ◽  
Jocelyn Lebow ◽  
Marc James Abrigo Uy ◽  
Samantha M. Ngaw ◽  
Dianne Neumark-Sztainer ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Care Providers ◽  
Pediatric Patients ◽  
Primary Care Providers ◽  
Unintended Consequences ◽  
Future Research ◽  
Care Providers ◽  
Perceived Risks ◽  
Negative Impacts ◽  
Pediatric Weight Management

Many health care providers struggle with if- and how-to discuss weight with their pediatric patients. This study used one-on-one interviews with primary care providers (n = 20) to better understand their: (1) perception of risks associated with talking about weight with pediatric patients, (2) commitment to adhering to best practices of pediatric weight management, and (3) approaches to mitigate perceived risks. Providers felt concerned that discussing weight with children during clinic visits may have unintended negative impacts. Despite perceived risks, providers continued regular BMI screening and weight-focused conversations, but took care with regard to language and approach with the goal of mitigating perceived risks. Findings suggest that pediatric primary care providers perceive that engaging in weight-related discussions with their patients has the potential to lead to negative, unintended consequences. Future research is needed to understand if weight-focused conversations should be avoided altogether or if there are approaches that can effectively mitigate risks.

Moving forward after cancer: Implementation of transition appointments and follow-up care plans in Manitoba.

2016 ◽  
Vol 34 (3_suppl) ◽  
pp. 50-50
Author(s):  
Tara Carpenter-Kellett ◽  
Jeffrey James Sisler
Keyword(s):  
Primary Care ◽  
Health Care Providers ◽  
Gynecologic Cancer ◽  
Survivorship Care ◽  
Care Providers ◽  
Care Plans ◽  
Medical Responsibility ◽  
After Cancer

50 Background: Patient experience and local and international clinical research have focused attention on transitions in cancer care from treatment to follow-up. Deficiencies in the quality of survivorship care, including necessary testing, have been demonstrated. The Canadian Partnership Against Cancer has funded projects designed to enhance the implementation of survivorship care plans (SCPs) and to improve cancer system-primary care coordination. CancerCare Manitoba, a provincial agency, is a leader in this work. Methods: The Moving Forward After Cancer initiative combines the generation of standardized written SCPs from the EMR with enhanced patient assessment at the end of curative systemic / radiation therapy. A transition appointment (TA) is provided by the patient’s usual oncology providers and includes screening for distress, appropriate referrals, and provision of a personalized treatment summary and SCP to the patient, with copies to the primary care physician and surgeon. The TA often marks the transfer of medical responsibility to the primary care provider (PCP). Results: Transition appointments have been implemented for colorectal (2012), breast (2014), and lymphoma and gynecologic cancer patients (2015). A total of 364 TAs were done in Manitoba in 2014, of which 140 were with colorectal (stage II and III) and 224 with breast (stage I – III) patients, about 59% and 35% respectively of eligible patients. This is an increase of 385% from the 75 TAs done in 2013. Other patient outcomes being collected include perceptions of continuity of care, confidence in survivorship information, evaluation of the care plan documents and also PCP and oncology team perceptions. In order to support practice change, a workflow solution led by a designated team that is adaptable by all sites across the province has been developed. Conclusions: The provision of TAs and SCPs is being well adopted in Manitoba. We expect that this intervention willimprove the experience of both patients and health care providers and the quality of care at the time of transition to survivorship. Implementation is underway with other disease site groups with the goal of all patients receiving a TA as they transition into survivorship.

Associations Among Cancer Survivorship Discussions, Patient and Physician Expectations, and Receipt of Follow-Up Care

2010 ◽  
Vol 28 (15) ◽  
pp. 2577-2583 ◽  
Author(s):  
Winson Y. Cheung ◽  
Bridget A. Neville ◽  
Craig C. Earle
Keyword(s):  
Cancer Survivors ◽  
Cancer Survivorship ◽  
Primary Care Providers ◽  
Survivorship Care ◽  
Care Providers ◽  
Follow Up Care ◽  
Physical Examinations ◽  
Survivorship Care Planning ◽  
Influenza Vaccinations

Purpose To explore the associations among cancer survivorship discussions, patient-physician expectations, and receipt of follow-up care in cancer survivors. Patients and Methods We surveyed cancer survivors about various aspects of their care, including expectations of their providers' roles, whether discussions with a physician had occurred, and self-reported patterns of follow-up. Primary care providers (PCPs) and oncologists were also surveyed for their own perceived roles. We developed a scoring system to evaluate the level of agreement in expectations between patients and physicians and between PCPs and oncologists (where 0 = most discordant and 4 = most concordant). Regression and stratified analyses were conducted to examine the relationships among expectations, discussions, and follow-up. Results In total, 535 patients (54%) and 378 physicians (62%) responded. Survivorship care expectations were most discrepant between PCPs and oncologists (mean score, 1.78), moderate between patients and oncologists (mean score, 1.97), and most similar between patients and PCPs (mean score, 2.82). Having a conversation specifically about cancer follow-up was associated with better concordance between patients and oncologists, but not for patients and their PCPs or between physicians. Better concordance in patient-oncologist expectations also correlated with greater odds of receiving certain aspects of follow-up care, such as influenza vaccinations and physical examinations, but only if a discussion about cancer follow-up had occurred. Conclusion A discussion about cancer follow-up may affect survivorship care through its primary influence on patient-oncologist expectations. Further work is required to clarify the aspects of survivorship discussions that are important for optimal cancer survivorship care planning.

scholarly journals Exclusive breast-feeding promotion among HIV-infected women in South Africa: an Information–Motivation–Behavioural Skills model-based pilot intervention

2017 ◽  
Vol 20 (8) ◽  
pp. 1481-1490 ◽  
Author(s):  
Emily L Tuthill ◽  
Lisa M Butler ◽  
Jennifer A Pellowski ◽  
Jacqueline M McGrath ◽  
Regina M Cusson ◽  
...  
Keyword(s):  
South Africa ◽  
Breast Feeding ◽  
Health Care Providers ◽  
Self Efficacy ◽  
Feeding Behaviour ◽  
Future Research ◽  
Care Providers ◽  
Exclusive Breast Feeding ◽  
Pilot Intervention

AbstractObjectiveExclusive breast-feeding (EBF) provides optimal nutrition for infants and mothers. The practice of EBF while adhering to antiretroviral medication decreases the risk of mother-to-child transmission of HIV from approximately 25 % to less than 5 %. Thus the WHO recommends EBF for the first 6 months among HIV-infected women living in resource-limited settings; however, EBF rates remain low. In the present study our aim was to design and implement a pilot intervention promoting EBF among HIV-infected women.DesignThe Information–Motivation–Behavioural Skills (IMB) model was applied in a brief motivational interviewing counselling session that was tested in a small randomized controlled trial.SettingPietermaritzburg, South Africa, at two comparable rural public health service clinics.SubjectsSixty-eight HIV-infected women in their third trimester were enrolled and completed baseline interviews between June and August 2014. Those randomized to the intervention arm received the IMB-based pilot intervention directly following baseline interviews. Follow-up interviews occurred at 6 weeks postpartum.ResultsWhile not significantly different between trial arms, high rates of intention and practice of EBF at 6-week follow-up were reported. Findings showed high levels of self-efficacy being significantly predictive of breast-feeding initiation and duration regardless of intervention arm.ConclusionsFuture research must account for breast-feeding self-efficacy on sustaining breast-feeding behaviour and leverage strategies to enhance self-efficacy in supportive interventions. Supporting breast-feeding behaviour through programmes that include both individual-level and multi-systems components targeting the role of health-care providers, family and community may create environments that value and support EBF behaviour.

The Pink Ribbon Survivors Network: An Internet resource for breast cancer survivorship education for patients and the health care providers that care for them.

2012 ◽  
Vol 30 (34_suppl) ◽  
pp. 329-329
Author(s):  
Robert E. Fisher ◽  
Kelly Ann Adams
Keyword(s):  
Breast Cancer ◽  
Health Care ◽  
Cancer Survivors ◽  
Cancer Survivorship ◽  
Health Care Providers ◽  
Breast Cancer Survivors ◽  
Primary Care Providers ◽  
Internet Resource ◽  
Care Providers ◽  
Breast Cancer Survivorship

329 Background: The authors identified a need to provide three online tools for the benefit of breast cancer survivors and health care providers: 1) An online collection of relevant publications from all cancer specialties regarding breast cancer survivorship housed in one virtual library. 2) An online collection of guidelines and relevant publications as a resource for primary care providers to access clinical information on medical care and psychosocial issues regarding breast cancer survivorship. 3) An online collection of resources, organizations, and supportive programs and selected readings for breast cancer survivors. These readings would be organized in a "Curriculum for Recovery" Library. We were motivated by the belief that, "all breast cancer survivors are underserved, if their healthcare providers are undereducated." Methods: Using the Joomla software system, a free, online website has been developed. This site houses the three virtual libraries, on separate landing pages, described above. Additional resources for breast cancer survivors are also housed on the website. Results: The Pink Ribbon Survivors Network now provides a resource of over 500 separate listings designed to educate and support breast cancer survivors, and health care professionals. The online professional libraries were created from abstracts available from medical journals and similar mainstream oncology publications. The libraries are continuously updated with new publications. These collective libraries will serve as unique breast cancer survivorship tools for women and their health care providers, for new publications, and for resources. Conclusions: This abstract establishes that a system using internet technology can provide virtual resources for breast cancer survivors, cancer specialists, and primary health care providers. This is now a functional online system for the 2.5 million breast cancer survivors and nearly 500,000 health care providers involved in the care of these survivors. The organization’s website is www.PinkRibbonSurvivorsNetwork.org.

Patterns of follow-up in oncologic care across Canada.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e20589-e20589
Author(s):  
Allison Y. Ye ◽  
Winson Y. Cheung ◽  
Karen Goddard ◽  
Robert Anton Olson
Keyword(s):  
Health Care Providers ◽  
Primary Care Providers ◽  
Care Providers ◽  
Practice Nurses ◽  
Resource Limitations ◽  
Radiation Oncologists ◽  
Canadian Association ◽  
Improved Outcomes ◽  
Clinical Scenarios

e20589 Background: With continual advancements in cancer care, improved outcomes and increasing survivor populations, cancer survivorship has become an important area of research. Methods: A 35-question electronic survey was sent to physician members of the Canadian Association of Radiation Oncologists. Based on their scope of practice, respondents were presented with brief clinical scenarios pertaining to various survivor populations. A subsequent series of questions were posed to determine routine follow-up practices. Results: In total, 111 radiation oncologists (RO) responded (44% response rate); 29% were female, 43% were in practice less than 10 years, and most regions of Canada were well represented. Most worked in centers staffed by more than 10 oncologists (69%), and saw more than 200 new patient consults per year (78%). 10% would not follow patients routinely, mainly in cases involving breast or prostate survivors. 73% of such patients (73%) would be followed by their primary care providers (PCP) whereas ROs would follow their CNS, GI, HN and GYNE patients. Lack of resources (55%) and a belief that follow-up by PCPs is equally effective (55%) were the top two reasons for not following patients. Treatment toxicity (92%) and the possibility of salvage or palliative treatment (86%) were the two most common reasons for routine follow-up. The majority (55%) of ROs follow patients for < 5 years, with 36% following for 5-10 years, and a minority (9%) following for longer than 10 years. 54% would not change the frequency of their follow-up, but 39% would decrease and only 7% would make no change. Workload and lack of resources were major barriers to follow-up, but in addition, many felt that follow-up by FPs or Advanced Practice Nurses could be equally effective. Some felt this would require additional training and more guidelines to make this effective. Conclusions: The majority of ROs follow their patients, especially when salvage treatment is possible. A significant portion would decrease their follow-up in frequency because of workload burden, resource limitations and a belief that there can or should be increased involvement from FPs and other allied health care providers.

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