Bibliographies: 'Oncology patient' – Grafiati (2024)

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PURPOSE Patients with cancer in low- and middle-income countries face complex socioeconomic barriers within health systems that can lead to poor oncologic outcomes. Patient navigation has been shown to reduce disparities in oncologic outcomes in the United States. Belize, a middle-income country in Central America, has recently launched its first-ever public medical oncology program. Here, we report on the development of Directly Observed Care (DOC), a pilot patient navigation care model for patients with cancer in Belize, inspired from directly observed treatment for tuberculosis. METHODS DOC will be a patient-centered program, where a nurse trained in patient navigation will assume responsibility for proactively identifying barriers that Belizean patients with cancer face in access to care and working to remove them. This process will include patient education on cancer and its treatment, identification of financial barriers to care and potential funding sources, assistance with care logistics such as transportation and childcare, and referral to psychosocial support services for patients who need them. DOC will rely on an electronic patient-tracking platform, which will allow real-time tracking of all oncology patients and identify patients who miss or delay treatments. This will allow timely intervention and continuous quality monitoring of the program. In addition to patient navigation, DOC will seek to reduce delays in patient care by liaising with pathology and radiology services. RESULTS The program is in its development and pilot phase. So far, approximately 100 patients have been seen for consultation. We intend to capture epidemiologic data about cancer in Belize, as well as real-time data about the progression of patients through their treatment course. We aim to identify critical delays to patients’ care and design interventions to address them. CONCLUSION We believe that the DOC program will be particularly beneficial for the oncology patient population in Belize, because this population has a high burden of socioeconomic barriers to care and is largely unfamiliar with the complexity of oncologic care. We hypothesize that DOC can improve treatment appropriateness and timeliness and, thereby, patient outcomes in Belize.

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Abstract INTRODUCTION Developing and advancing patient-centered care within neuro-oncology is an essential element of any tertiary brain tumor center. Patient-centered care of neuro-oncology patients requires a holistic approach that integrates oncologic treatment with social and psychological support. OBJECTIVE The aim of this study is to evaluate how a Patient Family Advisory Council can be created within an existing brain tumor center and utilized to improve patient-centered care. METHODS Current patients and caregivers were recruited by brain tumor staff to participate in monthly meetings. All participants underwent screening and training by our Patient Education Research Center team. Discussions focused on current and future brain tumor center initiatives, and participants were encouraged to give feedback from the patient perspective. New ideas to improve the patient experience were solicited. RESULTS A total of 15 participants (female = 57%) were recruited, including 10 with grade 3 or higher brain tumors. Monthly meetings, in-person or virtual, were held for two years. Utilizing participant feedback, the group updated our 80-page patient handbook that contained a variety of patient-caregiver focused resources. Participants also provided feedback on other brain tumor center initiatives such as development of a magnet featuring key phone numbers, an easily accessible website URL for emergencies, and numerous updates to the external website. Additional discussions involved development of neuro-oncology care pathways as we move to a stand-alone cancer center facility and initiation of OncoSTAT and palliative services in this population. CONCLUSION Brain tumor patients require a comprehensive oncologic treatment team as well as a wide variety of support services. A Patient Family Advisory Council is an effective method of advancing patient-centered care and a step toward improving the neuro-oncology patient experience.

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236 Background: Improving the patient experience has been an increasingly important quality improvement goal for most health care institutions; however, all patients are not equal. Within the oncology community exist a host of unique needs that must be identified, measured, and addressed. Commercially available questionnaires are too general and often non-diagnostic. The goal of our study was to develop a method to better identify, quantify, and address the needs of this population. Methods: Over 60 hours of in-depth qualitative interviews were conducted with a diverse population of patients (n=68), physicians (n=28), nurses. and technologists (n=33) at UT MD Anderson Cancer Center. A customized patient-experience questionnaire was created from the qualitative data obtained. A balanced incomplete block design was used so each patient answered only 60 questions, while the questionnaire contained over 85 questions. The questionnaire was administered via email to approximately 30,000 patients over one week time period. Results: A total of 4,179 patients completed the survey with average completion time of 24 minutes. A total of 6,909 opened the email invitation, 6,007 began the survey (a 69% completed/began response rate). Non-response bias was monitored via a short survey completed by 2,094 patients. Analysis revealed little difference between respondents and non-respondents. The survey results showed the following: (1) when relevant, a patient will complete a lengthy survey (2) a patient’s perception of their experience is directly related to how they perceive themselves (a number, customer, patient, or loved family member) (3) higher satisfaction is correlated with perception of a “unique” interaction or service (e.g. a visit with a sub-specialty oncologist versus one with a parking attendant). Conclusions: Proper survey techniques are necessary to identify, measure, and address the needs of oncology patients. Contrary to popular belief, patients are willing to complete lengthy questionnaires with little survey fatigue. Positive patient experiences correlate with patient perceptions of provider empathy, caring, and treatment similar to that of a “loved family member” as well as unique, health care services.

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Communication in oncology has always been challenging. The new era of precision medicine complicates communication even further as a result of our increasing reliance on genomic data and the varying psychological responses to genomic-based treatments and their expected outcomes. The crux of the matter hinges on understanding communication. The informed consent process may require more attention in the precision medicine era. However, many of the communication issues are actually similar to perennial long-standing communication issues in oncology, which center on providing hope when breaking bad news and ensuring that adequate informed consent to treatments is obtained. This piece presents several common patient reactions to different precision medicine scenarios in oncology practice. We highlight these new communication issues that focus on clinical and ethical questions (ie, informed consent, shared decision making, patient autonomy, and uncertainty in oncologic treatments) and provide guidance on working with each scenario. In this article, we address common reactions of patients to genomic information and provide thoughtful communication suggestions using a Shared Decision Making framework to help patients cope with the inherent distress-provoking uncertainties in oncology practice.

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Care for cancer patients is very complex with many treatments involving drugs that can be toxic outside of the therapeutic range. As such, cancer patients are a particularly vulnerable population within the healthcare system, with any error potentially being harmful to a population whose health is already compromised. Self-reported patient safety events can provide a window into healthcare, revealing areas of care that require improvement. We identified events occurring in oncology units that both caused harm and were involved cancer patients for both out-patients and in-patients. Across all events, adverse drug reactions and intravenous-related events were the most common. Other relatively frequent events included those related to poor care coordination and falling. These results illustrate the safety risks patients’ face when being treated with cytotoxic drugs and offer insight to areas in which patient care can be improved.

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Patient satisfaction is an ongoing action in which hospitals and health care providers are constantly seeking strategies to improve their satisfaction ratings. In the ambulatory oncology infusion setting, patient satisfaction is also a key metric that is being monitored, but actual patient satisfaction is unknown. Guided by Lewin's change theory and King's theory of goal attainment, the aim of this project was to use a strategy of conducting follow-up telephones calls to determine if patient satisfaction improved in an ambulatory oncology setting. A descriptive comparative approach was used to evaluate patient satisfaction before and after a telephone follow-up intervention. Participants who were starting an initial or new chemotherapy protocol were randomized into the telephone follow-up (TFU) group or the control group. A TFU script was used to guide the telephone conversation with patients about their experience with the first chemotherapy visit. All participants (N= 62) completed the OUT-PATSAT 35 questionnaire before starting their chemotherapy and 72 hours after the chemotherapy. Demographic characteristics of participants did not differ from the general cancer population. T tests were used to determine whether satisfaction differed between the two groups and revealed that participants receiving the TFU had significantly greater satisfaction in all domains post treatment, compared to those who did not (t = 2.90, df = 15, p = .01), suggesting the TFU had a positive effect on patient satisfaction. Incorporating follow-up telephone calls as a standard of practice to persons receiving an initial or new chemotherapy protocol may contribute to improved patient satisfaction scores and positive social change through an improved sense of well-being in cancer patients.

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Personalised medicine for cancer treatment promises benefits for patient survival and effective use of medical resources. This goal requires the development of predictive models for the identification and implementation of biomarkers for the prediction of patient survival given treatment options. This thesis addresses research questions in this area. The systematic review detailed in Chapter 2 investigates the literature concerning the prediction of resistance to chemotherapy for ovarian cancer patients using statistical methods and gene expression measurements. The range of models used by studies in the systematic review highlights the popularity of traditional models, such as Cox proportional hazards, with few more complex models being utilised. In Chapters 3 and 4, new methods are presented for modelling right-censored survival data. Due to the nature of biomedical data, the methods used need to be flexible and adequately account for high dimensional, noisy data. Gaussian processes fulfil these requirements and were hence used for the development of three Gaussian process models for right-censored survival data. Chapter 3 details these models, and they are applied to synthetic and cancer data in Chapter 4. In all cases the Gaussian processes for survival were found to equal or outperform all comparison models, as measured by concordance index. Given the application to molecular cancer data, it was expected that the data would be high dimensional. Two feature selection methods are investigated in Chapter 5 for use with Gaussian processes to address this. In Chapter 6 a program is developed for the analysis of the data produced by a test for cancer mutations using qPCR. The automated program was designed to isolate the analysis from the user and produce results and reports for clinical use. It is observed that this approach of automated analysis would be suitable for application to any form of clinical test or complex predictive model without the requirement of user guidance.

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Cancer diagnoses affect millions of people in the United States each year. Today, cancer patients face many challenges when trying to navigate the complex healthcare system. Patient navigation programs were developed to address and overcome barriers patients may face as they make their way through the healthcare system. The purpose of this project was to provide an analysis and discussion of the current published literature to provide evidence for improving care coordination and patient satisfaction in the oncology clinical setting with a patient navigator program. The practice-focused question for this project asked if a patient navigator program for adult cancer patients improved patient outcomes. The systematic review, guided by Watson's theory of caring, included 11 studies published between 2010 and 2017 identified through Cochrane Library, CINAHL, ProQuest, PubMed, and Joanna Briggs Institute. Initially a total of 679 articles were identified; however the number reduced by removing duplicates and after review of titles and abstracts. The remaining articles were then evaluated by the level of evidence based on the Manly and Fineout-Overholt's guide on hierarchy of evidence. The results identified in this systematic review showed patient navigation can improve care coordination and patient satisfaction. This review offers findings on the impact of cancer care coordination and patient satisfaction, which may be used by healthcare leaders when determining how to improve cancer care and as a result may provide positive social change. If the organization implements a patient navigator program, it is expected that this change would benefit patients, families, healthcare providers and the organization.

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Exercise benefits patients with cancer during and after treatments. A formalized educational program is lacking at the project's site for oncology nurses on the benefits of exercise for their patients during and after treatment. The purpose of the project was to address the identified gap in practice at the project's site by providing education to oncology nurses on the benefits of exercise for their patients during and after treatment. The ARCS model of motivational design was used as a theoretical foundation to develop and guide the educational program presented to the oncology nurses. The question addressed in the project was: Will oncology nurses show an improvement in their knowledge on the benefits of exercise for patients during and after cancer treatments when comparatively measured pre-education and immediately post-education? The nature of this project was quality improvement with a pre-posttest approach. A total of 14 female registered nurses routinely employed in the oncology department (M age = 36.7 years, SD = 12.0) took part in the project. Their knowledge level was tested before and after the intervention using an assessment tool developed for the project. Data analysis from the paired sample t test using the IBM SPSS version 24 showed a significant improvement in the nurses' knowledge at posttest (M = 6.86, SD = 1.027) compared to pretest (M = 8.36, SD = 1.447); t (13) = 4.0070, p = .001. The findings suggest the intervention was effective in improving nursing knowledge regarding the benefits of exercise in patients undergoing cancer treatment. The implication for positive social change is that incorporation of staff education regarding exercise in oncology patients can improve nursing knowledge that can then promote positive patient outcomes.

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El presente trabajo se orienta a determinar con exactitud la presencia del duelo anticipatorio no en los pacientes con cáncer sino en sus familiares, puesto que aunque muy comúnmente llevan un papel silencioso en toda esta lucha contra el cáncer, nadie puede negar el fuerte impacto que dicho mal genera en ellos; antes, durante y después de toda esta pelea; salud vs. enfermedad.The present work is aimed at accurately determining the presence of anticipatory grief not in patients with cancer but in their relatives, since although they most commonly play a silent role in this fight against cancer, no one can deny the strong impact that said bad generates in them; before, during and after all this fight; health vs. disease.

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Treatment decision making (TDM) in oncology is complex. Understanding treatment information is essential for shared TDM. Research suggests many patients have low numeracy. This mixed methods study explored numeracy and experience with numbers in a sample of individuals diagnosed with follicular lymphoma. Participants completed questionnaires (N = 32) and interviews (N = 20) assessing numeracy, decisional conflict and regret, and number preference. Results suggest that mean objective numeracy was relatively high, and most reported high confidence in numerical ability. Most participants preferred to receive numbers during the TDM process. There was no relationship between numeracy and decision outcomes. Future research should investigate the use of numeracy measures in practice and the impact of patient preferences and beliefs on shared TDM.

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Most cases of lung cancer have a commonly-understood behavioral etiology. Thus, individuals with lung cancer are often blamed for their illness by others and may therefore seek to avoid this blame by concealing their diagnosis from others. This study sought to determine the prevalence of diagnosis concealment, examine potential predictors of concealment, and test parts of a cognitive-affective-behavioral model of the effects of concealing a concealable stigma among individuals receiving treatment for lung cancer. With regard to predictors of concealment, it was hypothesized that concealment would be positively associated with male gender, introversion, and trait social anxiety and would be negatively associated with social support and the use of seeking guidance and support as a coping strategy. Hypothesized correlates of concealment included poorer self-esteem as well as greater anxiety, cancer-specific distress, and social avoidance. A sample of 117 participants receiving chemotherapy or radiation for stage I-IV non-small cell lung cancer and limited to extensive stage small cell lung cancer was recruited during routine outpatient visits. A medical chart review was conducted to assess clinical factors and participants completed a standard demographic questionnaire as well as measures of coping strategies, introversion, trait social anxiety, social avoidance, social support, anxiety, depression, cancer-specific distress, self-esteem, perceived stigma, public self-consciousness, and private self-consciousness. Results indicated that 31% of participants concealed their diagnosis from others since their diagnosis and 26% concealed their diagnosis in the month preceding their participation in the study. Hypotheses regarding predictors and correlates of concealment were not supported. However, exploratory analyses identified use of alcohol, recency of a recurrence of lung cancer, use of positive reappraisal as a coping strategy, and social support as predictors of concealment as well as internalized shame as a correlate of concealment. These findings serve to extend existing literature on concealing a concealable stigma and support parts of an existing model on the effects of concealment. Future research should aim to test the impacts of concealment in the context of certain social situations to examine longitudinal relationships between predictors and consequences of concealment.

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Patient routing is a key tool for ensuring the availability and quality of cancer care, ensuring early detection of pathology and timely treatment. Mathematical and simulation modeling methods allow to predict the bottlenecks of patient flows and plan the optimal distribution of healthcare resources. Goal to optimize patients’ pathways for oncology care using the simulation modelling methods. Materials and methods Patient routing was presented in the logic of discrete events, the average resource utilization, the patient’s stay time were described, the bottlenecks of the system were determined. Simulation modeling methods were used to build the optimal organization of oncology care services in the region. Results The average waiting time at the pre-hospital stage was 10 days, the average hospitalization time for X-ray therapy was 24 bed days, the throughput of the X-ray therapy room was 6 patients per week, the average duration of the X-ray therapy session per patient was 10 minutes. With the help of simulation modeling methods, a multimodal system of oncodermatology care was created and put into practice, which allowed to reduce the patient’s waiting time for treatment to 0.7 days, increasing the throughput of the entire system.

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Introduction: The Evidence Based Medicine in oncological sciences is founded on many factors. Pathetic state of patient retrieval system and follow up are some of the inherent problems faced in developing countries. The absence of follow up seems to affect the patient survival, intervention in case of predictive recurrence, and it also fails to fortifies authenticity of research and survival data. Paper outlines histrionics, evolved/recommended methodologies, nationwide survey with regards to authenticity of Evidence Based Practices in Oncological research. It opens the facts sheet of awareness, practice of follow-up and obstacles faced in India institutions. Relevant for obstetricians adopting Gynec Oncology. Aims and Objective: (1) To Evaluate the Evidence based practice of Gynec Oncology, (2) To evaluate the effectiveness of follow up methodologies, (3) Compliance of institutions and oncologist with regards to follow-up of Gynec cancer patients. Materials and Methods: The follow up methodology propagated; 1–6 address system (IARC 3 Address System), 2-Postcarding, 3-SMS/Telephony, 4-Door to door patient retrieval, 5-Family Physician referrals/feedback, 6-Software Alert on follow up defaulters in the Hospital Based Cancer Registry. etc. A stock taking was started 10 years back with repeated circulars on dates of “The National Cancer Calendar” (one date every months) that were sent to some 10,000 E-mail address of personnel/institutions connected with oncological sciences. Over five years 150 postgraduate examinees and 50 faculty in various institutions were interviewed on their 1 - Practicing Evidence Based Gynec Oncology and 2 - Understanding of Follow up/patient retrieval system practices in Gynec cancers. As an inspector of a major medical accreditation institution 50 institutions were inspected and existence of their follow up methodologies were evaluated. 100 post graduate dissertations reviewed, were studied with regards to status of follow up in the study carried out or the existence of follow-up system in the institution. Undergraduate students and their text books were searched if they are educated about follow up and necessity of patient retrieval system and its significance in Medical sciences. Faculty/Specialist of Obs and Gyn departments were interviewed for the same. Observations and Results: Response to circulars on follow up in cancer patients was cold shouldered, 95 percent of examinee PG students did not know how to follow up the cancer patients, out which as many as 90 percent of their institutions did not have any follow up system in order. 99 percent of dissertation did not show any effort from the side of candidate for patient retrieval system in order to fortify the research data. Only 20 percent institutions had infrastructure and significant effort (including door to door retrieval) on following up the patients that are treated there. Non of the undergraduate text books had guidelines or teaching in follow up so were total blankness of concept of follow up with undergraduate students. The awareness of Evidence based practice of Gynec oncology in most of the faculty of Obs and Gyne Departments was abysmal and “Not Necessary or Not possible” issue. Conclusion: Death and prolongation of survival both in curable and not so curable gynec cancers is directly related to Patient retrieval through follow up that generates evidence on Indian patients. In order to improve the survival and timely therapeutic intervention, follow up has to be strengthen at under graduate and post graduate medical teaching. This also applies for the authenticity of oncological research data that is produced in large numbers in developing countries. This is especially significant in the large poor socio economic gynec cancer patient population with poor literacy levels and far off homes from cancer treatment centres.

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Despite significant advances in the understanding of the principal mechanisms leading to various cancer types, less progress has been made toward developing patient-specific treatments. Advanced mathematical and computational models could play a significant role in examining the most effective patient-specific therapies. The purpose of ISMCO is to provide a common interdisciplinary forum for mathematicians, scientists, engineers and clinical oncologists throughout the world to present and discuss their latest research findings, ideas, developments and applications in mathematical and computational oncology. In particular, ISMCO aspires to enable the forging of stronger relationships among mathematics and physical sciences, computer science, data science, engineering and oncology with the goal of developing new insights into the pathogenesis and treatment of malignancies.

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Nutritional therapy helps patients with cancer to maintain their weight within normal limits, maintain tissue integrity and reduce the side effects of cancer therapies. Nutritional oncology deals with both prevention and patient support during treatment, in convalescence and in palliative situations. Cancer patients need full support from the team of health professionals (oncologists, nurses and dietitians). The following basic elements should not be missing from the cancer patient's diet: water, protein intake, animal and vegetable fats, as well as vitamins and minerals. The diet of cancer patients should be closely monitored, as body weight should be kept within normal limits, ie a body mass index (BMI) between 19 and 24 (the calculation is made by dividing the weight by the square of the height). The oncologist should therefore be aware of the adverse effects of malnutrition on patient outcomes and view nutritional support as an essential component of the clinical management, chemotherapy, radiation therapy, antiemetic treatment, and treatment for pain.

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Current studies have demonstrated the significant contributions that spirituality offers to the mental health of people in oncological treatment. This study, promoted by the Núcleo de PesquisaMultidisciplinar em Cultura, Fé e Razão (NUCFER) of the Pastoral Universitária dos Institutos Superiores de Ensino do CENSA –ISECENSA in partnership with the Psychology course of ISECENSA, has the purpose of identifying, analyzing and understanding the conceptions of oncologic patients, family members and health professionals about the meaning and influence between spirituality and mental health in Oncology. Thus, the general objective of this study is to understand the meaning of spirituality for oncologic patients during their treatment and how it can contribute to the patient, family and health professionals. The research will be qualitative, and at first a Literature Review will be carried out to expand the researchers' knowledge with updates on the proposed theme. For this, scientific articles published in the last 10 (ten) years on the subject will be surveyed, with the following descriptors: psychology, spirituality, health, cancer. Afterwards, a field research will be carried out, using a questionnaire with semi-structured questions. It is intended to apply the questionnaire to 15 (fifteen) people, 5 (five) with relatives of patients undergoing cancer treatment or who have undergone treatment; 5 (five) with health professionals and 5 (five) with people who are undergoing cancer treatment or who have undergone treatment. It is expected to promote quality of life for oncologic patients through psychology and spirituality and, at the end of the research, publish a scientific article in the Revista Perspectivas Online

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Abstract Introduction Acute adverse drug reactions (ADRs) in day care chemotherapy are not uncommon and easily manageable many a time. However, sometimes they may lead to untoward events. It is of paramount importance to document and analyze such events in contemporary medical oncology practice for the best utilization and planning of available personnel and resources. Objectives This study was aimed to analyze the acute ADRs occurring in day care cancer chemotherapy setting. Materials and Methods All acute ADRs reported in day care cancer chemotherapy setting, during the administration of chemotherapy, at Basavatarakam Indo American Cancer Hospital, Hyderabad, Telangana, India, were included in the study from June 15, 2020 to September 30, 2020. The ADRs were classified in to anaphylactic, allergic, and gastrointestinal (nausea/vomiting/heart burns/chest tightness). All ADRs were graded according to CTCAE version 5.0. Suspected drugs, time to reaction, and corrective measures were analyzed. Results During the study period, a total of 8,600 sessions of day care chemotherapy were administered. ADRs were noticed in 83 cases (~1%). Among the reported ADRs, anaphylactic reactions were noted in 20 patients (24%); allergic reactions of grades 1 and 2 were noted in 41 patients (49%). Gastrointestinal ADRs were noted in 30 patients (36%). Adverse reactions are mostly seen in oxaliplatin (22.8%), rituximab (14.4%), pacl*taxel (15.6%), carboplatin (13.2%), and docetaxel (7.2%). In grade-I (10%) and grade-II (63%) resections, supportive treatment was provided and chemotherapy was continued. Grade-III ADRs were noted in 21 patients (25%) out of whom, 3 patients required short-term intensive care, chemotherapy was withheld until the next cycle in one patient, and chemotherapy regimen was changed in 3 patients. No patient died of ADR. Conclusion Serious ADRs are rare in contemporary medical oncology practice during day care chemotherapy administration. Most acute ADRs were easily managed.

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Review question / Objective: FL is the most common indolent B cell lymphoma worldwide and patients with FL always have long term survival. However, advanced FL remains incurable and there is no universal agreement on optimal regimen to manage relapsed FL. Condition being studied: The efficacy of chemo-free regimens, including CD20 antibodies and targeted agents, in relapsed and/or refractory Follicular lymphoma. Information sources: We used the MEDLINE, Embase, and Cochrane Library databases to search the RCTs met our selection criteria. We also searched clinicalTrials.gov and the international clinical trial registry platform for completed and ongoing trials. In addition, we searched abstracts that published on American Society of Hematology (ASH), The European Hematology Association (EHA) or American Society of Clinical Oncology (ASCO) meetings.

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This paper documents the effects of an intervention on knowledge sharing, in which information embedded in efficient private organizations is used to improve bureaucratic procedures of public agencies. In particular, it analyzes the impact of the Knowledge for Results (K4R) program on the efficiency of public agencies in Colombia. The findings of the study indicate that K4R is associated with a statistically significant improvement in operational efficiency. The paper presents two examples of K4R. In the first example, K4R reduced the time that local ombudsman offices need to deal with incoming petitions from citizens. In the second example, K4R reduced the time that oncology patients spend in an emergency clinic until they are discharged from the hospital. These time reductions are quantitatively relevant and imply efficiency gains of between 25 and 40 percent relative to pre-program levels.