Kidney cancer survivorship survey of urologists and survivors: The gap in perceptions of care, but agreement on needs

Introduction: There is lack of evidence-based literature addressing comprehensive long-term care for kidney cancer (KC) survivors. Additionally, it is unclear if the concerns of KC patients/caregivers are being adequately addressed. Therefore, Kidney Cancer Canada (KCC), a patient-led support organization for Canadians diagnosed with KC, commissioned this first recorded survivorship survey specific to patients/caregivers diagnosed with localized KC. Methods: A cross-sectional on-line survey for Canadian patients/caregivers with non-metastatic KC at diagnosis, and a separate parallel survey of Canadian urologists were performed. The primary objective was to assess patient/caregivers’ and urologists’ perceptions of information provided, as well as the physical/psychological/emotional impact of KC treatment. Results: Urologists recalled providing information about surgical complications (90%) and their management (63%), while patients/caregiver recall was much less (33% and 35% respectively). Ninety-three percent of urologists recalled providing information on cancer recurrence, but only 42% of patients/caregivers remembered receiving this information. The concerns identified by patients/caregivers and urologists were similar: fear of recurrence, concerns about cancer, fatigue, and anxiety. Importantly, all agreed that survivorship information was important. Education of both patients/caregivers and physicians and the development of guidelines were factors identified to ensure optimal KC survivorship. Discussion/Conclusions: There was some discordance between urologists’ and patients/caregivers’ rates of recall of information provided. Patients/caregivers would have desired more information about their cancer, long-term follow-up, and potential complications. Provision of a survivorship care plan tailored to KC may be an effective measure to address these needs. The impact of such an intervention on the survivor outcomes should be rigorously assessed.

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A Cross-Sectional Study on the Impacts of Perceived Job Value, Job Maintenance, and Social Support on Burnout among Long-Term Care Staff in Hawaii

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18020476 ◽

2021 ◽

Vol 18 (2) ◽

pp. 476

Author(s):

Bum Jung Kim ◽

Sun-young Lee

Keyword(s):

Social Support ◽

Long Term Care ◽

Cross Sectional Study ◽

Care Staff ◽

Hierarchical Regression ◽

Sectional Study ◽

Cross Sectional ◽

Term Care ◽

The Impact

Extensive research has demonstrated the factors that influence burnout among social service employees, yet few studies have explored burnout among long-term care staff in Hawaii. This study aimed to examine the impact of job value, job maintenance, and social support on burnout of staff in long-term care settings in Hawaii, USA. This cross-sectional study included 170 long-term care staff, aged 20 to 75 years, in Hawaii. Hierarchical regression was employed to explore the relationships between the key independent variables and burnout. The results indicate that staff with a higher level of perceived job value, those who expressed a willingness to continue working in the same job, and those with strong social support from supervisors or peers are less likely to experience burnout. Interventions aimed at decreasing the level of burnout among long-term care staff in Hawaii may be more effective through culturally tailored programs aimed to increase the levels of job value, job maintenance, and social support.

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Linking Incidents in Long-Term Care Facilities to Worker Activities

Workplace Health & Safety ◽

10.1177/2165079916680366 ◽

2017 ◽

Vol 65 (10) ◽

pp. 457-466

Author(s):

Rose McCloskey ◽

Cindy Donovan ◽

Alicia Donovan

Keyword(s):

Health Care Providers ◽

Long Term Care ◽

Occupational Injury ◽

Worker Safety ◽

Care Providers ◽

Cross Sectional ◽

Term Care ◽

Care Facilities ◽

The Impact

This article reports on a study examining staff activities being performed when incidents were reported to have occurred. The risk for injury among health care providers who engage in patient handling activities is widely acknowledged. For those working in long-term care, the risk of occupational injury is particularly high. Although injuries and injury prevention have been widely studied, the work has generally focused on incident rates and the impact of specific assistive devices on worker safety. The purpose of this study was to examine reported staff incidents in relation to staff activities. A multicenter cross-sectional exploratory study used retrospective data from reported staff incidents (2010, 2011, and 2012) and prospective data from 360 hours of staff observations in five long-term care facilities during 2013. Descriptive statistics were used to analyze data. A total of 898 staff incidents were reviewed from the facilities. Incidents were most likely to occur in resident rooms. Resident aides were more likely to be engaged in high-risk activities than other care providers. Times when staff incidents were reported to have occurred were not associated with periods of high staff-to-resident contact. Safe handling during low and moderate risk activities should be promoted. Education on what constitutes a reportable incident and strategies to ensure compliance with reporting policies and procedures may be needed to ensure accuracy and completeness of incident data.

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Characteristics of patients with cancer in European long-term care facilities

Aging Clinical and Experimental Research ◽

10.1007/s40520-021-01972-2 ◽

2021 ◽

Author(s):

Emanuele Rocco Villani ◽

Domenico Fusco ◽

Laura Franza ◽

Graziano Onder ◽

Roberto Bernabei ◽

...

Keyword(s):

Cancer Patients ◽

Long Term Care ◽

Cross Sectional Study ◽

Do Not Resuscitate ◽

Cross Sectional ◽

Term Care ◽

Patients With Cancer ◽

Care Approach ◽

The Impact

Abstract Purpose Up to 26% of residents in nursing homes (NHs) are affected by cancer. Their care represents a challenge, because NHs are not usually considered a setting focused on oncologic management and care. The aim of this paper is to describe socio-demographic and clinical features of patients with cancer residing in European NHs. Methods Cross-sectional study based on data from the Services and Health for Elderly in Long TERm care (SHELTER) study. Participants were assessed through the interRAI-LTCF, which includes cancer assessment. Results Among 4140 participants (mean age 83.4 years; female 73%), 442 (10.7%) had cancer. Patients with cancer had a higher prevalence of do-not-resuscitate directives compared to those without cancer (21.1% vs 16.5%, p = 0.019). Variables directly associated with cancer were male sex (adj OR 1.67, 95% CI 1.36–2.05), pain (adj OR 1.43, 95% CI 1.16–1.77), fatigue (adj OR 1.25, 95% CI 1.01–1.55), polypharmacy (adj OR 1.59, 95% CI 1.21–2.08) and falls (adj OR. 1.30, 95% CI 1.01–1.67). Dementia was inversely associated with cancer (adj OR 0.74, 95% CI 0.58–0.94). Symptomatic drugs such as opioids (23.5% vs 12.2, p < .001), NSAIDS (7.2% vs 3.9%, p = 0.001), antidepressants (39.1% vs 33.8%, p = 0.026) and benzodiazepines (40.3% vs 34.3, p = 0.012) were all prescribed more in participants with cancer compared to those without cancer. Conclusions Cancer patients are prevalent in European NHs and they show peculiar characteristics. Studies are needed to evaluate the impact of a supportive care approach on the management of NHs residents with cancer throughout all its phases, until the end-of-life care

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Provider-survivor communication: Identifying and addressing unmet needs.

Journal of Clinical Oncology ◽

10.1200/jco.2016.34.3_suppl.81 ◽

2016 ◽

Vol 34 (3_suppl) ◽

pp. 81-81

Author(s):

Angela K. Patterson ◽

Cam Escoffery ◽

James Hotz ◽

Nancy M. Paris ◽

Donna L. Meyer ◽

...

Keyword(s):

Unmet Needs ◽

Cancer Control ◽

Adult Survivors ◽

Fear Of Recurrence ◽

Care Plan ◽

Survivorship Care Plan ◽

Spiritual Needs ◽

Emotional Needs ◽

Cross Sectional ◽

Print Materials

81 Background: The Georgia Cancer Control Consortium’s Survivorship Working Group conducted a needs assessment to understand physical, psychological, practical, and spiritual needs of adult survivors. Results were used to assess survivors’ level of distress and how effectively their needs were being met. Methods: Cross-sectional online and paper-based surveys developed using NCCN and Commission on Cancer (CoC) guidelines. Surveys were distributed through survivorship programs of CoC hospitals (n = 40) and cancer organizations via email, social media and mail. 740 responses received September-December 2014. Results: Respondents were primarily female (78%) married (65%), college-educated (55%) and insured (97%). 83% were White,16% were African American and 3% were Hispanic. 36% of respondents were within 1 year of treatment; 45% were 1 - 5 years post treatment. Survivors reported positive experiences with provider communication. Responses of ‘often’ or ‘very often’ were: provider gave them a chance to ask questions (90.6%); provider involved them in healthcare decisions (84.7%), provider spent enough time with them (78.5%) and provider helped with feelings of uncertainty about health issues or treatment (75.7%). Physical and emotional needs were not as effectively met as spiritual or practical needs. A higher proportion of survivors reported moderate to extreme levels of emotional distress with: depression (32.7%), anxiety (32.1%), stress (30.2%), fear of recurrence (28.2%) and defining a “new normal” (25.9%). 81% of survivors found information and assistance online (56%), in print materials (41%) and from providers/cancer centers (41%). 37% received a survivorship care plan (SCP); 98% reported the SCP was helpful. Conclusions: Results demonstrate the need for providers in Georgia to be educated about and responsive to survivors’ unmet needs and levels of distress. Survivors report positive communication with providers but lower levels of having physical and emotional needs addressed. Survivors actively seek resources and benefit from SCPs. Providers can contribute to addressing needs and reducing distress by maintaining strong communication, guiding survivors to evidence-based resources and implementing SCPs.

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Function-Focused Person–Environment Fit for Long-Term Care Residents With Dementia: Impact on Apathy

The Gerontologist ◽

10.1093/geront/gnaa111 ◽

2020 ◽

Cited By ~ 1

Author(s):

Ying-Ling Jao ◽

Wen Liu ◽

Habib Chaudhury ◽

Jyotsana Parajuli ◽

Sarah Holmes ◽

...

Keyword(s):

Physical Function ◽

Long Term Care ◽

Future Research ◽

Common Symptom ◽

Cross Sectional ◽

Term Care ◽

Housing Enabler ◽

The Impact ◽

The Relationship

Abstract Background and Objectives Apathy is a common symptom in dementia and is associated with rapid cognitive decline, poor quality of life, and higher mortality. Lawton’s Competence and Environmental Press model suggests that an individual’s behavior and affect are influenced by the fit of their functional abilities with the environmental demands. Yet, empirical evidence on the association between person–environment (P–E) fit and apathy is lacking. Thus, this study examined the relationship between P–E fit and apathy in dementia. Specifically, this study focused on the extent the physical environment fits individual functional limitations. Research Design and Methods This is a cross-sectional study using the baseline data from long-term care residents with dementia. The sample included 199 residents with moderate-to-severe cognitive impairment from 4 assisted living and 4 nursing homes. Function-focused P–E fit was measured using the Housing Enabler scale. Apathy was measured using the Apathy Evaluation Scale. Multilevel linear models were used to analyze the relationship between P–E fit and apathy. Results Findings revealed that greater P–E fit, specifically indoor environment, was significantly associated with lower apathy after controlling for age, gender, and years living in the facility. Yet, the association became not significant after controlling for individual physical function. Discussion and Implications Findings support the association between function-focused P–E fit and apathy, but the association is no longer significant after physical function is adjusted. Future research may explore other aspects of P–E fit and the impact of social and organizational environment on apathy in dementia.

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Impact of lymphoma survivorship clinic visit on patient-centered outcomes.

Journal of Clinical Oncology ◽

10.1200/jco.2016.34.3_suppl.64 ◽

2016 ◽

Vol 34 (3_suppl) ◽

pp. 64-64 ◽

Cited By ~ 1

Author(s):

Carrie A. Thompson ◽

Jessica N Towns ◽

Laurie Dripps ◽

Sarah Jenkins ◽

Kandace Lackore ◽

...

Keyword(s):

Response Rate ◽

Social Issues ◽

Familial Cancer ◽

Clinic Visit ◽

Care Plan ◽

Survivorship Care Plan ◽

Patient Centered ◽

The Impact

64 Background: The goals of our Lymphoma Survivorship Clinic (SC) are to coordinate care, educate patients, and create a survivorship care plan (SCP). The aim of this study was to determine if patient-centered outcomes are improved after a SC visit. Methods: From 11/13-5/15, surveys were mailed to recently-treated lymphoma patients who were within 4 weeks of their last visit and in remission. Quality of life (QOL) was measured with PROMIS and distress was measured with the Impact of Events scale. Responses between those who attended SC and those who were eligible but did not attend were analyzed. Results: There were 96 surveys sent to the SC group; 59 were returned (61% response rate). Of the non-SC group, 140 surveys were sent and 84 were returned (60% response rate). Mean age was 57 years (range 23-77) in the SC group and 59 years (23-88) in the non-SC group. There were more females in the SC group (52% vs 30%) but no differences in race, marital status, education, or health literacy. Those who attended the SC were more likely to recall receiving a summary of cancer treatment and recommendations for follow-up care (90% SC vs. 75% non-SC, p = 0.03). Furthermore, SC attendees were more likely to “definitely” recall discussion on improving health or preventing illness (89% vs. 53%), getting help in making changes in habits/lifestyle (76% vs. 50%), diet (80% vs. 31%), and exercise (82% vs. 51%), all p < 0.001. There were no differences in discussions regarding smoking, follow-up testing, and symptom monitoring. The SC group was less likely to need more information regarding sexuality (6% vs 20%, p = 0.045). There were no differences in need for information regarding anxiety, fitness, familial cancer risk, fertility, complementary therapies, and social issues. The SC group was slightly more confident that they could get information or advice related to cancer (completely confident 76% vs. 61%, p = 0.07). There were no differences in QOL or distress. Conclusions: A Lymphoma SC visit increased receipt of SCP and provided more information on survivorship issues, particularly health behaviors, but did not improve QOL or distress. Further study is needed to determine if this leads to long-term health benefits.

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Assessment of pharmacotherapeutic safety of medical prescriptions for elderly residents in a long-term care facility

Brazilian Journal of Pharmaceutical Sciences ◽

10.1590/s1984-82502012000300015 ◽

2012 ◽

Vol 48 (3) ◽

pp. 477-485 ◽

Cited By ~ 6

Author(s):

Fabiana Rossi Varallo ◽

Ingrid Stephanie Stein Ambiel ◽

Luana Orlandelli Nanci ◽

José Carlos Fernandes Galduróz ◽

Patricia de Carvalho Mastroianni

Keyword(s):

Long Term Care ◽

Care Facility ◽

World Health ◽

Potentially Inappropriate Medications ◽

Cross Sectional ◽

Term Care ◽

Term Care Facility ◽

Long Term Care Facility ◽

The Impact

The present study aimed to estimate the prevalence of elderly using potentially inappropriate medications (PIM) and with occurrence of potentially hazardous drug interactions (PHDI); to identify the risk factors for the prescription of PIM and to evaluate the impact of pharmaceutical intervention (PI) for the prescription of safer therapeutic alternatives. Therefore, a cross-sectional study was performed in a long-term care facility in São Paulo State, between December/2010 and January/2011. The medical records of the patients >60 years old who took any drugs were consulted to assess the pharmacotherapeutic safety of the medical prescriptions, in order to identify PIM and PHDI, according to the Beers (2003) and World Health Organization criteria, respectively. PI consisted of a guidance letter to the physician responsible for the institution, with the suggestions of safer equivalent therapeutics. Approximately 88% of the elderly took at least one drug, and for 30% of them the PIM had been prescribed. Most of the PIM identified (53.4%) act on the central nervous system. Among the 13 different DI detected, 6 are considered PHDI. Polypharmacy was detected as a risk factor for PIM prescription. After the PI there was no change in medical prescriptions of patients who had been prescribed PIM or PHDI. The data suggests that PI performed by letter, as the only interventional, method was ineffective. To contribute it a wide dissemination of PIM and PHDI among prescriber professionals is necessary for the selection of safer treatment for elderly. Additionally, a pharmacist should be part of the health care team in order to help promote rational use of medicines.

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