scholarly journals Toward a Population-Based Breast Cancer Risk Stratification Approach? The Needs and Concerns of Healthcare Providers

2021 ◽  
Vol 11 (6) ◽  
pp. 540
Author(s):  
Jolyane Blouin-Bougie ◽  
Nabil Amara ◽  
Jacques Simard
Keyword(s):  
Breast Cancer ◽  
Risk Stratification ◽  
Organizational Innovation ◽  
Cancer Genomics ◽  
Healthcare Providers ◽  
Population Level ◽  
Population Based ◽  
Key Factors ◽  
Structured Interviews ◽  
Prevention And Early Detection

Given the expanding knowledge base in cancer genomics, risk-based screening is among the promising avenues to improve breast cancer (BC) prevention and early detection at the population level. Semi-structured interviews were conducted to explore the perceptions of healthcare professionals (HPs) regarding the implementation of such an approach and identify tools that can support HPs. After undertaking an in-depth thematic content analysis of the responses, 11 themes were identified. These were embedded into a logical model to distinguish the potential eligible participants (who?), the main clinical activities (how?) and associated tools (what?), the key factors of acceptability (which?), and the expected effects of the strategy (why?). Overall, it was found that the respondents positively welcomed the implementation of this strategy and agreed on some of the benefits that could accrue to women from tailored risk-based screening. Some important elements, however, deserve clarification. The results also highlight three main conditions that should be met to foster the acceptability of BC risk stratification: respecting the principle of equity, paying special attention to knowledge management, and rethinking human resources to capitalize on the strengths of the current workforce. Because the functioning of BC risk-based screening is not yet well defined, important planning work is required before advancing this organizational innovation, and outstanding issues must be resolved to get HPs on board.

scholarly journals Determining the Cancer Diagnostic Interval Using Administrative Health Care Data in a Breast Cancer Cohort

2019 ◽  
pp. 1-10 ◽  
Author(s):  
Patti A. Groome ◽  
Colleen Webber ◽  
Marlo Whitehead ◽  
Rahim Moineddin ◽  
Eva Grunfeld ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Health Care ◽  
Control Charts ◽  
Population Level ◽  
Population Based ◽  
Statistical Control ◽  
Health Care Data ◽  
Cancer Diagnostic ◽  
Breast Cancer Cohort ◽  
Diagnostic Interval

PURPOSE Population-based administrative health care data could be a valuable resource with which to study the cancer diagnostic interval. The objective of the current study was to determine the first encounter in the diagnostic interval and compute that interval in a cohort of patients with breast cancer using an empirical approach. METHODS This is a retrospective cohort study of patients with breast cancer diagnosed in Ontario, Canada, between 2007 and 2015. We used cancer registry, physician claims, hospital discharge, and emergency department visit data to identify and categorize cancer-related encounters that were more common in the three months before diagnosis. We used statistical control charts to define lookback periods for each encounter category. We identified the earliest cancer-related encounter that marked the start of the diagnostic interval. The end of the interval was the cancer diagnosis date. RESULTS The final cohort included 69,717 patients with breast cancer. We identified an initial encounter in 97.8% of patients. Median diagnostic interval was 36 days (interquartile range [IQR], 19 to 71 days). Median interval decreased with increasing stage at diagnosis and varied across initial encounter categories, from 9 days (IQR, 1 to 35 days) for encounters with other cancer as the diagnosis to 231 days (IQR 77 to 311 days) for encounters with cyst aspiration or drainage as the procedure. CONCLUSION Diagnostic interval research can inform early detection guidelines and assess the success of diagnostic assessment programs. Use of administrative data for this purpose is a powerful tool for improving diagnostic processes at the population level.

scholarly journals Emerging Technologies for Identifying Atrial Fibrillation

2020 ◽  
Vol 127 (1) ◽  
pp. 128-142 ◽  
Author(s):  
Eric Y. Ding ◽  
Gregory M. Marcus ◽  
David D. McManus
Keyword(s):  
Atrial Fibrillation ◽  
Clinical Significance ◽  
Healthcare Providers ◽  
Population Level ◽  
Healthcare Systems ◽  
Population Based ◽  
Mobile Technologies ◽  
Great Promise ◽  
Community Settings ◽  
Funding Agencies

Atrial fibrillation (AF) is a major cause of morbidity and mortality globally, and much of this is driven by challenges in its timely diagnosis and treatment. Existing and emerging mobile technologies have been used to successfully identify AF in a variety of clinical and community settings, and while these technologies offer great promise for revolutionizing AF detection and screening, several major barriers may impede their effectiveness. The unclear clinical significance of device-detected AF, potential challenges in integrating patient-generated data into existing healthcare systems and clinical workflows, harm resulting from potential false positives, and identifying the appropriate scope of population-based screening efforts are all potential concerns that warrant further investigation. It is crucial for stakeholders such as healthcare providers, researchers, funding agencies, insurers, and engineers to actively work together in fulfilling the tremendous potential of mobile technologies to improve AF identification and management on a population level.

scholarly journals Qualitative exploration of sexual life among breast cancer survivors at reproductive age

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Maryam Maleki ◽  
Abbas Mardani ◽  
Mansour Ghafourifard ◽  
Mojtaba Vaismoradi
Keyword(s):  
Breast Cancer ◽  
Data Analysis ◽  
Cancer Survivors ◽  
Breast Cancer Survivors ◽  
Healthcare Providers ◽  
Reproductive Age ◽  
Sexual Life ◽  
Main Theme ◽  
Structured Interviews ◽  
Sexual Health Counseling

Abstract Background Our understanding of the experiences of women at reproductive age regarding sexual life and issues they may face after starting the treatment of breast cancer is limited. Therefore, this qualitative study aimed to explore sexual life and its related issues among breast cancer survivors at reproductive age in Iran. Methods A qualitative research was conducted. Participants were 21 breast cancer survivors who were under 51 years of age that were chosen using purposeful sampling. In-depth semi-structured interviews were carried out for data collection and the content analysis method was used for data analysis. Results The data analysis led to the development of main theme of ‘unfulfilled sexual life’. Also, four subthemes were: ‘undesirable sexual function’, ‘context-based beliefs’, ‘unmet information and supportive needs’, and ‘emotional crisis’. Conclusions Our research findings inform healthcare providers about the experiences of breast cancer survivors and related changes in their sexual and marriage life at reproductive age. Nurses and other healthcare providers in the multidisciplinary team should proactively identify health-related problems and design appropriate caring strategies to mitigate sexual and marriage issues among breast cancer survivors. Also, the establishment of sexual health counseling units for breast cancer survivors can help this vulnerable group of women with the improvement of their long-term sexual satisfaction.

scholarly journals “From the technology came the idea”: safe implementation and operation of a high quality teleradiology model increasing access to timely breast cancer assessment services for women in rural Australia

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Karen Johnston ◽  
Deborah Smith ◽  
Robyn Preston ◽  
Rebecca Evans ◽  
Karen Carlisle ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Service Delivery ◽  
Service Providers ◽  
Screening Program ◽  
Population Based ◽  
Technical Support ◽  
Assessment Model ◽  
Successful Implementation ◽  
Structured Interviews ◽  
Service Staff

Abstract Breast cancer is the most commonly diagnosed cancer in Australian women. Providing timely diagnostic assessment services for screen-detected abnormalities is a core quality indicator of the population-based screening program provided by BreastScreen Australia. However, a shortage of local and locum radiologists with availability and appropriate experience in breast work to attend onsite assessment clinics, limits capacity of services to offer assessment appointments to women in some regional centres. In response to identified need, local service staff developed the remote radiology assessment model for service delivery. This study investigated important factors for establishing the model, the challenges and enablers of successful implementation and operation of the model, and factors important in the provision of a model considered safe and acceptable by service providers. Methods Semi-structured interviews were conducted with service providers at four assessment services, across three jurisdictions in Australia. Service providers involved in implementation and operation of the model at the service and jurisdictional level were invited to participate. A social constructivist approach informed the analysis. Deductive analysis was initially undertaken, using the interview questions as a classifying framework. Subsequently, inductive thematic analysis was employed by the research team. Together, the coding team aggregated the codes into overarching themes. Results 55 service providers participated in interviews. Consistently reported enablers for the safe implementation and operation of a remote radiology assessment clinic included: clinical governance support; ability to adapt; strong teamwork, trust and communication; and, adequate technical support and equipment. Challenges mostly related to technology and internet (speed/bandwidth), and maintenance of relationships within the group. Conclusions Understanding the key factors for supporting innovation, and implementing new and safe models of service delivery that incorporate telemedicine, will become increasingly important as technology evolves and becomes more accessible. It is possible to take proposed telemedicine solutions initiated by frontline workers and operationalise them safely and successfully: (i) through strong collaborative relationships that are inclusive of key experts; (ii) with clear guidance from overarching bodies with some flexibility for adapting to local contexts; (iii) through establishment of robust teamwork, trust and communication; and, (iv) with appropriate equipment and technical support.

scholarly journals The Perceived Social Support by Iranian Women with Breast Cancer: A Qualitative Study

2021 ◽  
Author(s):  
Leila Mokhtari ◽  
Abdollah Khorami Markani ◽  
Hamid Reza Khalkhali ◽  
Aram Feizi
Keyword(s):  
Breast Cancer ◽  
Social Support ◽  
Qualitative Study ◽  
Lived Experience ◽  
Qualitative Content Analysis ◽  
Healthcare Providers ◽  
Well Being ◽  
Medical Sciences ◽  
Structured Interviews ◽  
The Family

Abstract Background: Social support has an importnat role in improving health outcomes and is considered as one of the crucial aspects of the modern care in cancer patients. Therefore this article aims at discovering and describing the dimensions of social support based on the lived experience of women suffering from breast cancer.Methods: In this qualitative study, 22 women with breast cancer were selected through purposive sampling from 7 hospitals affiliated to Urmia University of Medical Sciences. The data were collected through semi-structured interviews and were analyzed by the Conventional Qualitative Content Analysis and Graneheim’s and Lundman’s (2004) approach, using MAXQDA software, version 10.Results: After completion of the analyzing process, 6 categories were appeared including “creating an empathic atmosphere by family and community”, “creating a safe communication network for the patient”, “adaption to disease”, “giving meaning to life”, “the feeling of satisfaction with the healthcare providers for fulfilling their role”, and “accepting the support and help of family and friends in fighting the disease”. Conclusion: According to the findings, good social support during the illness can result in the spiritual, mental, and physical well-being of the patients and is one of the most effective factors in fighting the disease and feeling of recovery. The findings of this study can be used to develop plans to help the patients to achieve more support from the family, healthcare providers and the community and even providing the required supportive care for this group of women.

scholarly journals Breast Cancer Diagnostics, Therapy, and Outcomes in Sub-Saharan Africa: A Population-Based Registry Study

2021 ◽  
pp. 1-11
Author(s):  
Walburga Yvonne Joko-Fru ◽  
Mirko Griesel ◽  
Nikolaus Christian Simon Mezger ◽  
Lucia Hämmerl ◽  
Tobias Paul Seraphin ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Hormone Receptor ◽  
Relative Survival ◽  
Population Level ◽  
Population Based ◽  
Hormone Receptor Status ◽  
Sub Saharan Africa ◽  
Receptor Status ◽  
Sub Saharan ◽  
The Impact

Background: Breast cancer (BC) is the most common cancer in sub-Saharan Africa (SSA). However, little is known about the actual therapy received by women with BC and their survival outcome at the population level in SSA. This study aims to describe the cancer-directed therapy received by patients with BC at the population level in SSA, compare these results with the NCCN Harmonized Guidelines for SSA (NCCN Harmonized Guidelines), and evaluate the impact on survival. Methods: Random samples of patients with BC (≥40 patients per registry), diagnosed from 2009 through 2015, were drawn from 11 urban population–based cancer registries from 10 countries (Benin, Congo, Cote d’Ivoire, Ethiopia, Kenya, Mali, Mozambique, Namibia, Uganda, and Zimbabwe). Active methods were used to update the therapy and outcome data of diagnosed patients (“traced patients”). Excess hazards of death by therapy use were modeled in a relative survival context. Results: A total of 809 patients were included. Additional information was traced for 517 patients (63.8%), and this proportion varied by registry. One in 5 traced patients met the minimum diagnostic criteria (cancer stage and hormone receptor status known) for use of the NCCN Harmonized Guidelines. The hormone receptor status was unknown for 72.5% of patients. Of the traced patients with stage I–III BC (n=320), 50.9% received inadequate or no cancer-directed therapy. Access to therapy differed by registry area. Initiation of adequate therapy and early-stage diagnosis were the most important determinants of survival. Conclusions: Downstaging BC and improving access to diagnostics and care are necessary steps to increase guideline adherence and improve survival for women in SSA. It will also be important to strengthen health systems and facilities for data management in SSA to facilitate patient follow-up and disease surveillance.

scholarly journals Understanding the Perceptions of Omani Women Regarding Life After a Breast Cancer Diagnosis

2020 ◽  
Vol 20 (4) ◽  
pp. e360-367
Author(s):  
Asya Al-Riyami ◽  
Nadia N. Abdulhadi ◽  
Mohammed Al-Azri
Keyword(s):  
Breast Cancer ◽  
Coping Strategies ◽  
Cancer Diagnosis ◽  
Qualitative Content Analysis ◽  
Eastern Mediterranean ◽  
Healthcare Providers ◽  
Eastern Mediterranean Region ◽  
Breast Cancer Diagnosis ◽  
Health Concern ◽  
Structured Interviews

Objectives: There is a rising burden of breast cancer (BC) in the Eastern Mediterranean Region (EMR), and its sociopsychological impact is a quickly growing health concern in this region. Because understanding cancer patients’ perceptions of life is integral to their treatment, they are also a concern for healthcare providers. This qualitative study, therefore, explored changes in Omani women’s perceptions of life after a BC diagnosis. Methods: Semi-structured interviews were conducted individually with 21 Omani women undergoing treatment for BC at the Oncology Ward of Muscat’s Royal Hospital from March to May 2017. The collected data were subjected to qualitative content analysis. Results: After their cancer diagnosis, the women appeared to pass through three main stages in their coping processes. First, they passed through a stage of severe psychosocial distress and diminishment in personal identity. Next, they evolved strategies for coping based on cultural, religious and family resources. Finally, the women experienced acceptance and submission to the reality of the cancer as God’s will with changes in attitudes and perceptions of the meaning of life. Conclusion: A BC diagnosis impacts Omani women severely, affecting their lives dramatically. They adopt coping strategies based on cultural, religious and spiritual beliefs. Healthcare providers need to acknowledge and facilitate women’s spiritual and cultural coping strategies as an integral part of their treatment which holds potential to improve their prognosis. Such strategies should be individualised to suit each woman’s experiences, perceptions and needs. Keywords: Breast Neoplasm; Culture; Perceptions; Life; Women; Oman.  

Adherence to Physical Activity Guidelines in Breast Cancer Survivors

2010 ◽  
Vol 76 (9) ◽  
pp. 962-965 ◽  
Author(s):  
Savanna G. Smith ◽  
Anees B. Chagpar
Keyword(s):  
Breast Cancer ◽  
Physical Activity ◽  
General Population ◽  
Cancer Survivors ◽  
Breast Cancer Survivors ◽  
Healthcare Providers ◽  
Population Based ◽  
Study Data ◽  
Breast Cancer Patients ◽  
Physical Activity Guidelines

Physical activity in breast cancer survivors has been shown to improve outcomes. This study evaluated breast cancer patients’ adherence to physical activity guidelines in a population-based study. Data from the 2007 National Health Interview Survey were used to compare adherence to physical activity guidelines in patients with breast cancer with the general population. Statistical analyses were performed using SUDAAN software. In 2007, 327 breast cancer survivors and 23,030 others from the general population were surveyed. Breast cancer survivors were significantly older than the general population (mean age 64.9 vs 45.6 years, P < 0.001) and tended to be female (99.4 vs 51.2%, P < 0.001). Despite being significantly more likely to have interacted with a healthcare professional within the past year (96.7 vs 82.1%, P < 0.001), fewer breast cancer survivors reported following physical activity guidelines than nonbreast cancer survivors (4.64 vs 12.0%, P < 0.001). Controlling for age, gender, and interaction with healthcare providers, breast cancer survivors were no more likely to follow physical activity guidelines than the general population (OR: 0.73; 95% CI: 0.41-1.30, P = 0.282). Despite more interaction with healthcare providers, breast cancer survivors are no more likely to adhere to activity guidelines than the general population.

scholarly journals The association of preoperative blood markers with postoperative readmissions following arthroplasty

2021 ◽  
Vol 2 (6) ◽  
pp. 388-396
Author(s):  
Amir Khoshbin ◽  
Graeme Hoit ◽  
Lauren Leone Nowak ◽  
Anser Daud ◽  
Martine Steiner ◽  
...  
Keyword(s):  
At Risk ◽  
Cohort Analysis ◽  
Healthcare Providers ◽  
Population Level ◽  
Population Based ◽  
National Quality ◽  
Blood Marker ◽  
Risk Patients ◽  
Improvement Programme ◽  
The Mean

Aims While preoperative bloodwork is routinely ordered, its value in determining which patients are at risk of postoperative readmission following total knee arthroplasty (TKA) and total hip arthroplasty (THA) is unclear. The objective of this study was to determine which routinely ordered preoperative blood markers have the strongest association with acute hospital readmission for patients undergoing elective TKA and THA. Methods Two population-based retrospective cohorts were assembled for all adult primary elective TKA (n = 137,969) and THA (n = 78,532) patients between 2011 to 2018 across 678 North American hospitals using the American College of Surgeons National Quality Improvement Programme (ACS-NSQIP) registry. Six routinely ordered preoperative blood markers - albumin, haematocrit, platelet count, white blood cell count (WBC), estimated glomerular filtration rate (eGFR), and sodium level - were queried. The association between preoperative blood marker values and all-cause readmission within 30 days of surgery was compared using univariable analysis and multivariable logistic regression adjusted for relevant patient and treatment factors. Results The mean TKA age was 66.6 years (SD 9.6) with 62% being females (n = 85,163/137,969), while in the THA cohort the mean age was 64.7 years (SD 11.4) with 54% being female (n = 42,637/78,532). In both cohorts, preoperative hypoalbuminemia (< 35 g/l) was associated with a 1.5- and 1.8-times increased odds of 30-day readmission following TKA and THA, respectively. In TKA patients, decreased eGFR demonstrated the strongest association with acute readmission with a standardized odds ratio of 0.75 per two standard deviations increase (p < 0.0001). Conclusion In this population level cohort analysis of arthroplasty patients, low albumin demonstrated the strongest association with acute readmission in comparison to five other commonly ordered preoperative blood markers. Identification and optimization of preoperative hypoalbuminemia could help healthcare providers recognize and address at-risk patients undergoing TKA and THA. This is the most comprehensive and rigorous examination of the association between preoperative blood markers and readmission for TKA and THA patients to date. Cite this article: Bone Jt Open 2021;2(6):388–396.

scholarly journals Meanings of Breast Cancer Survivorship Among Members of Ethnically-Identified Support Groups

2017 ◽  
Vol 9 ◽  
pp. 62-80
Author(s):  
K. E. Dyer ◽  
J. Coreil
Keyword(s):  
Breast Cancer ◽  
Support Groups ◽  
Cancer Survivorship ◽  
Healthcare Providers ◽  
Religious Faith ◽  
Individual Responsibility ◽  
Structured Interviews ◽  
Central Florida ◽  
Cancer Support ◽  
Cancer Support Groups

Research on both cancer survivorship and support needs has been limited in its attention to survivors from culturally-diverse communities.  This study examined the perspectives of members and leaders of ethnically-identified breast cancer support groups regarding the meanings and expectations attached to survivorship.  Semi-structured interviews were conducted with 38 African American and Latina survivors in Central Florida.  Participant narratives invoked themes of spiritual renewal and deepening religious faith, and deemphasized individual responsibility for personal change.  Participants emphasized the importance of shared cultural identity in shaping the survivor experience, and some Latina women drew parallels between survivorship and the challenges of migration to a new country.  An unwavering display of optimism was held to be paramount.  These themes are interpreted within the framework of the interplay between dominant societal discourses of survivorship and locally-constructed meanings.  Findings underscore the importance for healthcare providers to be cognizant and respectful of diverse perspectives on illness.

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