scholarly journals French Health professionals’ attitudes about patient empowerment in the cancer care pathway

2019 ◽  
Vol 7 (4) ◽  
pp. 41
Author(s):  
Elise Verot ◽  
Véronique Régnier-Denois ◽  
Dominique Feld ◽  
Romain Rivoirard ◽  
Franck Chauvin
Keyword(s):  
Nursing Care ◽  
Health Professionals ◽  
Cancer Care ◽  
Care Pathway ◽  
Patient Empowerment ◽  
Patient Centered Care ◽  
Care Providers ◽  
Patient Centered ◽  
Centered Care ◽  
New Form

Objective: France is experiencing a shift in health policy. The purpose of this article is to describe how cancer care health professionals define patient empowerment, describe modalities of care of the cancer patient treated by intravenous means and identify avenues for reflection on the specific challenges facing patient-centered care, from the perspective of changes in practices in the cancer care pathway.Methods: 19 individual, semi-structured interviews with health professionals working in cancer care facilities were analyzed in a qualitative study, using the Theoretical Domain Framework linked to the COM-B model.Results: The organization of care is governed by three factors. First of all, the cancer care system focuses on the strictly curative aspect of this disease. All devices lead to management centered on the pathology, and not on the patient as a whole. Secondly, the fact that the patient suffers from cancer modifies the attitudes and representations of caregivers towards the patient. Cancer introduces a relational bias in each of the stakeholders. Thirdly, the current organization of nursing care maintains paternalistic and prescriptive care in the cancer care pathway. Only new nursing jobs (coordinating nurses or pivot nurses) suggest the possibility of switching to patient-centered care. The analysis from TDF linked to the COM-B model shows that the strategy of implementing a new tool to measure the level of patient engagement, in routine nursing care, must focus on the reflective opportunity and motivation of the stakeholders.Conclusions: Caregivers should be acculturated to patient empowerment. TDF linked to the COM-B model can make it possible to think about how to prepare and adapt this change in practice at several sites of cancer treatment. Training adapted to the context to familiarize current caregivers with this new form of care is currently being implemented. To succeed, acculturating current health care providers to this new form of care, while offering them a tool to objectively assess the level of patient empowerment would undoubtedly foster their involvement in supporting patient empowerment, while allowing them to evaluate the time required to integrate this type of care.

scholarly journals Patient-centered care pathways: what does it mean? An integrative conceptual framework to meet the need of an international consensus: a qualitative systematic review protocol

2021 ◽  
Author(s):  
Jean-Baptiste Gartner ◽  
Kassim Said Abasse ◽  
Ghita Ben Zagguou ◽  
Frédéric Bergeron ◽  
Paolo Landa ◽  
...  
Keyword(s):  
Systematic Review ◽  
Health Care ◽  
Care Delivery ◽  
Care Pathway ◽  
Patient Centered Care ◽  
Patient Centered ◽  
International Consensus ◽  
Patient Journey ◽  
Centered Care ◽  
Health Care Delivery Systems

Background: Faced with increased expectations regarding the quality and safety of health care delivery systems, a number of stakeholders are increasingly looking for more qualitative and efficient ways to deliver care. This study is conducted to provide a clear definition of the patient-centered care pathway and its characteristics to meet the need for an international consensus. Methods: This qualitative systematic review aims to perform a systematic synthesis of published evidence concerning (1) the definition of the patient trajectory, patient pathway or patient journey and (2) their characteristics. With a consulting librarian, a comprehensive and systematic search in three databases was conducted (PUBMED, Embase, ABI/Inform), from 1995 to 2020 without language criteria. Eligibility criteria guiding data selection will follow the PICo mnemonic criteria consisting of (1) Population : all types of patients managed by health care delivery systems for an acute or chronic condition regardless of age or condition, (2) Phenomena : studies that contribute to the definition and conceptualization of the concepts of care trajectory, care pathway and patient journey resulting in a theoretical and conceptual contribution, and (3) Context : health care providers include all providers of primary, secondary, tertiary, and quaternary care in any geographic area. Two reviewers will independently screen, select, extract data and make a critical assessment of the methodology used with the JBI Qualitative Assessment and Review Instrument (JBI QARI).Discussion: This systematic review will provide much-needed knowledge regarding patient-centered pathways. The results will benefit clinicians, decision makers, and researchers by giving them a clear and integrated definition and understanding of the patient-centered care pathways and their characteristics to finally meet the need for an international consensus.

scholarly journals Patients’ Perceptions of Portal Use Across Care Settings: Qualitative Study (Preprint)

2018 ◽  
Author(s):  
Ann Scheck McAlearney ◽  
Cynthia J Sieck ◽  
Alice Gaughan ◽  
Naleef Fareed ◽  
Jaclyn Volney ◽  
...  
Keyword(s):  
Health Care Providers ◽  
Medical Center ◽  
Academic Medical Center ◽  
Patient Centered Care ◽  
Theory Approach ◽  
Access To Information ◽  
Engagement In Care ◽  
Care Providers ◽  
Patient Centered ◽  
Centered Care

BACKGROUND Patient portals are a promising instrument to improve patient-centered care, as they provide patients information and tools that can help them better manage their health. The implementation of portals in both the inpatient and outpatient setting gives health care providers an opportunity to support patients both during hospitalization and after discharge. Thus, there is a need to better understand how inpatient and outpatient portals are used across care contexts. OBJECTIVE This study aimed to examine patients’ perceptions of using inpatient and outpatient portals across the care settings, including how they used the portals and the benefits and concerns associated with portal use. METHODS This study was conducted in a large Midwestern academic medical center consisting of seven hospitals. We interviewed 120 patients who had used an inpatient portal during their hospitalization, at 15 days and 6 months postdischarge, to determine their perspectives of portal use in both hospital and outpatient settings. Interview transcripts were analyzed inductively and deductively by using team coding processes consistent with a grounded theory approach. RESULTS Interviews focused on three main areas of portal use: experience with the portal features, perceived benefits, and concerns. Responses at 15 days (n=60) and 6 months (n=60) postdischarge were consistent with respect to perceptions about portal use. Patients identified viewing their health information, managing their schedule, and communicating with providers as notable activities. Convenience, access to information, and better engagement in care were indicated as benefits. Concerns were related to technology issues and privacy/security risks. CONCLUSIONS Implementation of inpatient portals as a complement to outpatient portals is increasing and can enable patients to better manage aspects of their care. Although care processes vary substantively across settings, the benefits of convenience, improved access to information, and better engagement in care provide opportunities for portal use across care settings to support patient-centered care.

scholarly journals Care Pathways in Persistent Orofacial Pain

2016 ◽  
Vol 2 (1) ◽  
pp. 48-57 ◽  
Author(s):  
M. Breckons ◽  
S.M. Bissett ◽  
C. Exley ◽  
V. Araujo-Soares ◽  
J. Durham
Keyword(s):  
Health Care Providers ◽  
Orofacial Pain ◽  
Care Pathway ◽  
Comparative Method ◽  
Qualitative Interviews ◽  
Care Pathways ◽  
Care Providers ◽  
Patient Centered ◽  
Centered Care ◽  
The Impact

Persistent orofacial pain is relatively common and known to have an adverse effect on quality of life. Previous studies suggest that the current care pathway may be problematic, but it is not well understood which health services patients access and what their experience is. The aim of this study was to explore care pathways and their impact from the perspective of patients. Qualitative interviews were conducted with a maximum variation sample of patients recruited from primary (community based) and secondary (specialist hospital based) care in the United Kingdom. Questions focused on the stages in their pathway and the impact of the care that they had received. Interviews were digitally recorded and transcribed verbatim, and analysis followed principles of the constant comparative method. NVivo 10 was used to help organize and analyze data. Twenty-two patients were interviewed at baseline, and 18 took part in a second interview at 12 mo. Three main themes emerged from the data: the “fluidity of the care pathway,” in which patients described moving among health care providers in attempts to have their pain diagnosed and managed, occurring alongside a “failure to progress,” where despite multiple appointments, patients described frustration at delays in obtaining a diagnosis and effective treatment for their pain. Throughout their care pathways, patients described the “effects of unmanaged pain,” where the longer the pain went unmanaged, the greater its potential to negatively affect their lives. Findings of this study suggest that the current care pathway is inefficient and fails to meet patient needs. Future work needs to focus on working with stakeholder groups to redesign patient-centered care pathways. Knowledge Transfer Statement: Data from qualitative interviews conducted with patients with persistent orofacial pain suggest significant problems with the existing care pathway, consisting of delays to diagnosis, treatment, and referral. Patients describing their struggle to progress through the current care pathway highlighted the difficulties occurring while living with orofacial pain. This study suggests a need for a revised care pathway, which better meets the needs of people with persistent orofacial pain.

Oncology team perception and patient experience discordances in triple-negative breast cancer (TNBC) care.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e19176-e19176
Author(s):  
Sara A. Hurvitz ◽  
Rebecca R Crawford ◽  
Tamar Sapir ◽  
Jeffrey D. Carter
Keyword(s):  
Treatment Options ◽  
Primary Care Providers ◽  
Patient Centered Care ◽  
Influential Factors ◽  
Patient Treatment ◽  
Care Providers ◽  
Patient Centered ◽  
Actual Patient ◽  
Patient Reported ◽  
Centered Care

e19176 Background: In TNBC, ensuring patients understand their treatment options and engaging them in shared decision-making (SDM) is vital to patient centered care; however, system-, team-, and individual-level barriers may challenge optimal SDM. As part of a quality improvement, accredited initiative, we identified areas of discordance between oncology healthcare professionals (HCP) perception and actual patient reported experiences. Methods: From 02/2019 – 10/2019, we administered surveys to assess challenges, barriers, attitudes, and experiences of HCP who care for patients with TNBC (N = 77) and their patients with TNBC (N = 65) at 6 community oncology practices. Results: Despite indications of high levels of SDM – 86% of patients indicated that they are always or mostly involved with treatment decisions – survey responses highlight discordances. For example, when asked to identify the most influential factors to patient treatment choice, HCP most commonly indicated side effects (94%), while patients most commonly indicated quality of life (48%). Additionally, when asked to identify the side effect of greatest concern to patients, 61% of patients indicated alopecia, while 45% of HCP indicated gastrointestinal (GI) distress. While both HCP and their patients indicate that the oncology team is the most useful source of patient education, HCP underestimated the extent to which patients rely on their primary care providers (PCPs). Patients and HCP each identified limited time as a barrier to SDM, but patients indicated not knowing what to ask, while HCP indicated that low health literacy was the top barrier to SDM. 31% of patients and their care team identified that improvements in discussions about realistic prognosis were vital to improved care. Conclusions: These survey findings reveal discordances between oncology HCP’s perceptions and patient reported experiences when receiving treatment for TNBC. These findings may highlight areas for improvement in co-productive patient-centered care. [Table: see text]

scholarly journals Multimorbidity: An Issue of Growing Importance for Oncologists

2011 ◽  
Vol 7 (6) ◽  
pp. 371-374 ◽  
Author(s):  
Christine S. Ritchie ◽  
Elizabeth Kvale ◽  
Michael J. Fisch
Keyword(s):  
Cancer Care ◽  
Patient Centered Care ◽  
Care Plan ◽  
Patient Centered ◽  
Centered Care ◽  
The Impact

Recognition of the impact of multiple co-occurring conditions on a patient's cancer care plan and development of strategies to address the challenges associated with multimorbidity will enable oncologists to provide higher quality, patient-centered care.

One-day diagnosis for hepatobiliary and pancreatic lesions: An innovative patient-centered care pathway organization

2018 ◽  
Vol 155 (6) ◽  
pp. 439-443 ◽  
Author(s):  
P. Pessaux ◽  
V. Faucher ◽  
R. Cuny ◽  
M. Stephan ◽  
F. Klein ◽  
...  
Keyword(s):  
Care Pathway ◽  
Patient Centered Care ◽  
Patient Centered ◽  
Centered Care

Psychometric Evaluation of the Korean Version of Patient-Centered Care Scale for Hospital Nurses

2018 ◽  
Vol 42 (3) ◽  
pp. 344-365 ◽  
Author(s):  
Yun Mi Lee ◽  
Ju-Eun Song ◽  
Chanhee Park ◽  
Youn-Jung Son
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Goodness Of Fit ◽  
Discriminant Validity ◽  
Patient Centered Care ◽  
Care Providers ◽  
University Hospitals ◽  
Patient Centered ◽  
Korean Version ◽  
Centered Care

Patient-centered care (PCC) encourages active collaboration and effective communication among patients, their family caregivers, and health-care providers to achieve high-quality care. Despite its importance, there is no validated and reliable Korean instrument for assessing PCC among health-care providers yet. This study aimed to establish a Korean version of the PCC (K-PCC) Scale using international translation guidelines and systematically evaluating its psychometric properties. The participants in this study were 424 nurses with a mean age of 28.07 years (±4.56) from two university hospitals in South Korea. Confirmatory factor analysis identified that the revised model, which included three factors (holistic, collaborative, and responsive care), had a satisfactory goodness of fit. The testing of item convergent and item-discriminant validity revealed a 100% scaling success. Criterion validity showed that nurses who had positive perceptions of K-PCC were more likely to practice PCC ( r = .692, p < .001). The internal consistency for 23 items as a whole was good, at .935. From these results, K-PCC is considered a valid and reliable instrument for measuring health-care providers’ perceptions of PCC among Korean populations. Scale brevity and simplicity, together with rigorous testing, indicate that validation of the PCC Scale may be helpful for ensuring quality improvement in hospital settings.

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