Current Issue : January - March Volume : 2018 Issue Number : 1 Articles : 5 Articles
Objective: To investigate whether perceived patient-centered communication\nduring oncology consultations relates to patient satisfaction and degree of emotional\ndistress following the medical encounter. Methods: 226 cancer patients\nattending an oncology outpatient clinic completed questionnaires before and\nafter a consultation including the Physician-Patient Relationship Inventory, the\nbrief Profile of Mood States, and the Information satisfaction questionnaire.\nResults: Patients who perceived the communication during the consultations to\nbe highly patient-centered were more likely to be maximally satisfied with information\nprovided by the oncologist. Additionally, adjusting for pre-consultation\ndistress, as well as sociodemographic, clinical, and consultation-related variables,\npatients who perceived the oncologist to communicate in a highly patient-\ncentered manner, experienced lower levels of emotional distress after the\nconsultation. Conclusion: Patient-centered communication may be an important\nquality in oncology as an approach to positively influence patient outcomes,\nincluding emotional distress. However, the findings in the present study\nof an effect of PCC on patient satisfaction and emotional distress are modest,\nand no firm conclusions can thus be drawn. Practice Implications: Oncology\nsettings may benefit from the positive effects of patient-centered care and physicians\nshould acknowledge the potential of their own relational competence in\norder to facilitate patient-centered communication....
Background: Gynecological pre-cancer and gynecological cancers are considerable diseases in women throughout\nthe world. The disease and treatment lead to numerous biopsychosocial issues. To improve the outcomes of\naffected women, several counseling interventions have been tested thus far in nursing research. These interventions\ntarget different endpoints and are composed of various structural and content components. The purpose of this research\nwas to systematically review the effectiveness of nurse counseling on any patient outcomes tested so far in gynecologic\noncology before, during and after treatment and to explore structure and content components.\nMethods: Experimental, quasi-experimental, and pre-experimental studies assessing the effectiveness of nurse counseling\nin women with gynecological neoplasia were searched for in PubMed�®, CINAHL�®, PsychINFO�®, Cochrane�®, and EMBASE�®.\nReference lists were hand-searched and relevant authors were contacted. Moreover, the evidence level and\nmethodological quality of the included studies were assessed. Afterwards, the effect of nurse counseling on\neach identified patient outcome was narratively analyzed. To identify the structural and content components\nof the included interventions, a structured content analysis was performed. Finally, it was determined which\ncomponents were associated with favorable outcomes within the included studies.\nResults: Seven experimental and three pre-experimental studies, reporting the effects of 11 interventions on a\ntotal of 588 participants, were eligible. No study investigated women with pre-cancer. Three studies had a high,\nfive a moderate, and two a low methodological quality. Positive effects were found on quality of life, symptoms, and\nhealthcare utilization. Eight structural components and four content components composed of various sub-components\nwere identified and linked to specific effects.\nConclusions: The current evidence base is fragmented and inconsistent. More well-designed, large-scale\nstudies including women with pre-cancer are warranted. Most convincing evidence indicates that nurse\ncounseling can improve symptom distress. Components associated with the most trustworthy effects include nurses with\nan academic education; repeated and individual consultations during and after active treatment; structured, tailored,\ninterdisciplinary orientated, and theoretically based counseling concepts; specific materials; comprehensive symptom\nmanagement; and utilization of healthcare services. Healthcare providers and researchers can use the findings of this\nreview for the systematic development of nurse counseling in gynecologic oncology....
Background. Although treatment of ductal carcinoma in situ (DCIS) is controversial, national guidelines recommend considering\nendocrine therapy for women with estrogen receptor- (ER-) positive DCIS or those undergoing breast conserving surgery (BCS)\nwithout radiation.We evaluated uptake and predictors of endocrine therapy use among older women with DCIS. Methods. In the\nSEER-Medicare database, we identified women aged 65+ years diagnosed withDCIS during 2007ââ?¬â??2011.We evaluated demographic,\ntumor, and treatment characteristics associated with endocrine therapy initiation. Results. Among 2,945 women with DCIS, 41%\ninitiated endocrine therapy (66% tamoxifen, 34% aromatase inhibitors). Initiation was more common among women with ERpositive\nthan ER-negative DCIS (48% versus 16%; HR = 3.75, 95% CI: 2.91ââ?¬â??4.83); 28% of women with unknown ER status initiated\nendocrine therapy. Initiation was less common after BCS alone compared to BCS with radiation (32% versus 50%; HR = 0.69, 95%\nCI: 0.59ââ?¬â??0.80). Conclusions. Less than half of older women with DCIS initiate endocrine therapy to prevent second breast cancers.\nOur findings suggest use was more common, but not exclusive, among women with ER-positive DCIS, but not among women who\nunderwent BCS alone. Endocrine therapy should be targeted toward patients most likely to benefit from its use....
This study aimed to explore an evidence-based nursing practice model of CRF management\nin hospitalized adult patients using the PARIHS evidence-implementation framework\nas the theoretical structure to provide guidance for similar nursing practices. The implementation\nof guideline evidence into clinical practice was conducted on the oncology and radiotherapy\nwards of a university-affiliated hospital. The process of integrating the guideline into\nthe symptom management system of cancer patients was described. The impact of the evidence\nimplementation was evaluated from three aspects: organizational innovations and\noutcome measures associated with nurses and with patients pre- and post-evidence implementation.\nDuring the implementation of evidence into practice on the wards, a nursing process,\nhealth education, a quality control sheet and CRF training courses were established.\nThrough this implementation, compliance with evidence related to CRF increased significantly\non the two wards, with that of ward B being higher than that of ward A. Regarding\nnursing outcomes, nursing knowledge, attitude and behavior scores with respect to CRF\nnursing care increased substantially after its application on the two wards, and the ward B\nnurses� scoring was higher than that of the ward A nurses. Qualitative analysis concerning\nthe nurses suggested that leadership, patient concern about CRF management, and the\nneed for professional development were the main motivators of the application, whereas the\nshortage and mobility of nursing human resources and insufficient communication between\ndoctors and nurses were the main barriers. Additionally, most nurses felt more professional\nand confident about their work. Regarding patient outcomes, patient knowledge, attitude\nand behavior scores regarding CRF self-management increased significantly. Patients�\npost-implementation CRF was alleviated compared with the pre-implementation treatment\ncycle. The PARIHS framework may provide instructive guidance for the incorporation of evidence\ninto practice, and the process-oriented framework might provide greater operational\nutility of the application....
Background: Knowing incidence for, breast cancer, co-morbidities, diagnosis and treatment methods given a strategic approach for community awareness and rapid management. Methods: Retrospective cross-sectional descriptive design was utilized. Total of 183 confirmed breast cancer female patients from 2007-2014 were included but the available reviewed cases were 120. Females with any other type of cancer and any breast cancer (BC) case before 2007 were excluded. IRB approvals have been obtained. Results: Overall result showed that age of Breast cancer female patients ranged from 40-60 with mean (51.9 �± 14.4). The overall mean of Body Mass Index was (31.1 �± 07.6). The most common comorbidities associated with Breast Cancer females were diabetes, hypertension and heart disease (49.1%; 48.2% and 18.9%). Most Breast Cancer cases were diagnosed with infiltrating ductal carcinoma (79.3%). 48% of the discovered tumor was dominating in the left side of the breast (48.3%). 54.1% of BC females were diagnosed with a tumor size of 2-5cm (T2). 39.4% of BC cases were diagnosed as grade III. Most of the cases (80%) in 2007 were positive human epidermal growth factor receptor 2 (HER2) but it decreased to 27.3% positive cases in 2014. The disease manifestations were a mass in the breast -lump (98.2%), pain (98.2%) and lymph node involvement (66.4%).The first line of treatment used for those patients included mastectomy (79.6%), chemotherapy (67.9%), radiation (34.0%) and hormonal (15.0%). Conclusion: Current study support and validate the scientific body of knowledge about BC in Saudi Arabia. Each year, the incidence rates increase specially for age above 50. According to Body Mass Index values, there were indications that the cases were obese. Diabetes, hypertension, and heart disease were the common co-morbidities among females with Breast Cancer. Cases of BC were managed by more than one approach such as surgery, chemotherapy, radiation, and hormonal treatment....
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