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1

Access to electronic health records by care setting and provider type: perceptions of cancer care providers in Ontario, Canada  

Microsoft Academic Search

BACKGROUND: The use of electronic health records (EHRs) to support the organization and delivery of healthcare is evolving rapidly. However, little is known regarding potential variation in access to EHRs by provider type or care setting. This paper reports on observed variation in the perceptions of access to EHRs by a wide range of cancer care providers covering diverse cancer

Margo C Orchard; Mark J Dobrow; Lawrence Paszat; Hedy Jiang; Patrick Brown

2009-01-01

2

Music and healing in cancer care: A survey of supportive care providers  

Microsoft Academic Search

This paper explores the role of music activity and music therapy in health care drawing on a survey of UK cancer care providers offering music interventions and music therapy. The survey examined the extent and type of music provision and explored providers’ views about the role and contribution of music and music therapy in healing. As well as music, the

Norma Daykin; Leslie Bunt; Stuart McClean

2006-01-01

3

Do nurses provide holistic care to cancer patients?  

PubMed Central

BACKGROUND: In order to support cancer patients, nurses need to identify different physio-psycho- social needs of patients using a holistic approach. Focusing on Quality of Life (QoL) is congruent with the philosophy of a holistic approach in nursing. The main aim of this research study thus was to identify the level of agreement between cancer patients and nurses about cancer patients’ QoL. METHODS: The study was a survey which was completed in 2008. 166 cancer patients and 95 nurses were conveniently recruited from three major hospitals in Adelaide, Australia. Each patient and nurse was invited to complete the World Health Organization Quality of Life Brief (WHOQoL-BREF) questionnaire separately. This questionnaire considers QoL across four domains or dimensions: physical health, psychological health, social relationship and environment. RESULTS: The proportion of the exact agreement between the two groups was 34.9%, 34.5%, 33.8% and 36.9% for the physical, psychological, social relationship, and environmental QoL domains, respectively. CONCLUSIONS: Results may indicate that nurses do not have a holistic understanding of cancer patients’ QoL. QoL tools like the World Health Organization Quality of Life Brief (WHOQoL-BREF) might be used as guidelines for nurses to assess cancer patients’ QoL rather than relying heavily on their perceptions and intuitions. The results provide some implications for Iran. PMID:22049289

Bahrami, Masoud

2010-01-01

4

Caring for Alaska Native prostate cancer survivors in primary care: a survey of Alaska Tribal Health System providers  

PubMed Central

Background Little is known about the constraints of optimizing health care for prostate cancer survivors in Alaska primary care. Objective To describe the experiences and attitudes of primary care providers within the Alaska Tribal Health System (ATHS) regarding the care of prostate cancer survivors. Design In late October 2011, we emailed a 22-item electronic survey to 268 ATHS primary care providers regarding the frequency of Prostate Specific Antigen (PSA) monitoring for a hypothetical prostate cancer survivor; who should be responsible for the patient's life-long prostate cancer surveillance; who should support the patient's emotional and medical needs as a survivor; and providers’ level of comfort addressing recurrence monitoring, erectile dysfunction, urinary incontinence, androgen deprivation therapy, and emotional needs. We used simple logistic regression to examine the association between provider characteristics and their responses to the survivorship survey items. Results Of 221 individuals who were successfully contacted, a total of 114 responded (52% response rate). Most ATHS providers indicated they would order a PSA test every 12 months (69%) and believed that, ideally, the hypothetical patient's primary care provider should be responsible for his life-long prostate cancer surveillance (60%). Most providers reported feeling either “moderately” or “very” comfortable addressing topics such as prostate cancer recurrence (59%), erectile dysfunction (64%), urinary incontinence (63%), and emotional needs (61%) with prostate cancer survivors. These results varied somewhat by provider characteristics including female sex, years in practice, and the number of prostate cancer survivors seen in their practice. Conclusions These data suggest that most primary care providers in Alaska are poised to assume the care of prostate cancer survivors locally. However, we also found that large minorities of providers do not feel confident in their ability to manage common issues in prostate cancer survivorship, implying that continued access to specialists with more expert knowledge would be beneficial. PMID:24596707

Tilburt, Jon C.; Kelley, Stacy; DeCourtney, Christine A.; Humeniuk, Katherine M.; Latini, Jerilyn; Kim, Simon P.

2014-01-01

5

Communication about Sexuality and Intimacy in Couples Affected by Lung Cancer and their Clinical Care Providers  

PubMed Central

OBJECTIVE Little is known about the effects of lung cancer on intimate and sexual relationships. This study explores health care provider, patient, and partner perspectives on: 1) the effects of lung cancer on physical and emotional intimacy, 2) the ways in which intimacy affects the experience of living with lung cancer, and 3) communication about intimacy and sexuality in the context of lung cancer. METHODS Qualitative, in-depth interviews with 8 cancer care providers and 13 married couples (ages 43–79) affected by lung cancer were conducted and audiotaped in the clinical setting. Interviews were transcribed, iteratively analyzed, and coded according to the above domains. Coding was performed independently by members of an interdisciplinary team; inter-rater reliability was assessed using the kappa statistic; and analyses were summarized by domain. RESULTS Most cancer care providers and couples affected by lung cancer believed intimacy and sexuality issues were salient, yet few reported discussing these. Couples described negative and positive effects of cancer on intimacy. Negative effects were driven by cancer or its treatment, including physical and psychological effects. Positive effects included an increase in non-coital physical closeness and appreciation of the spouse. Age was perceived as an important factor influencing the relationship between lung cancer and intimacy. CONCLUSIONS Emotional intimacy and sexuality are important concerns for couples affected by lung cancer. The findings suggest previously unrecognized positive effects of lung cancer on emotional and physical intimacy. Couples affected by lung cancer and providers believe these issues are relevant for lung cancer care. PMID:20540168

Lindau, Stacy Tessler; Surawska, Hanna; Paice, Judith; Baron, Shirley R.

2012-01-01

6

Pancreatic Cancer Center: Providing the Research Tools Necessary to Advance Pancreatic Cancer Patient Care  

E-print Network

Pancreatic Cancer Center: Providing the Research Tools Necessary to Advance Pancreatic Cancer number of NCI-designated cancer centers have a specialized pancreatic cancer program. The creation of the IUPUI Signature Center for Pancreatic Cancer Research has been the foundation for putting IUPUI, the IU

Zhou, Yaoqi

7

Effectively Communicating Colorectal Cancer Screening Information to Primary Care Providers: Application for State, Tribe or Territory Comprehensive Cancer Control Coalitions  

ERIC Educational Resources Information Center

Background: Patients are more likely to be screened for colorectal cancer if it is recommended by a health care provider. Therefore, it is imperative that providers have access to the latest screening guidelines. Purpose: This practice-based project sought to identify Kentucky primary care providers' preferred sources and methods of receiving…

Redmond, Jennifer; Vanderpool, Robin; McClung, Rebecca

2012-01-01

8

The Gynecologist Has a Unique Role in Providing Oncofertility Care to Young Cancer Patients  

PubMed Central

Facing a cancer diagnosis at any age is devastating. However, young cancer patients have the added burden that life-preserving cancer treatments, including surgery, chemotherapy, and radiotherapy, may compromise their future fertility. The possibility of reproductive dysfunction as a consequence of cancer treatment has a negative impact on the quality of life of cancer survivors. The field of oncofertility, which merges the clinical specialties of oncology and reproductive endocrinology, was developed to explore and expand fertility preservation options and to better manage the reproductive status of cancer patients. Fertility preservation for females has proved to be a particular challenge because mature female gametes are rare and difficult to acquire. The purpose of this article is to provide the gynecologist with a comprehensive overview of how cancer treatments affect the female reproductive axis, delineate the diverse fertility preservation options that are currently available or being developed for young women, and describe current measures of ovarian reserve that can be used pre- and post-cancer treatment. As a primary care provider, the gynecologist will likely interact with patients throughout the cancer care continuum. Thus, the gynecologist is in a unique position to join the oncofertility team in providing young cancer patients with up-to-date fertility preservation information and referrals to specialists. PMID:21927621

Duncan, Francesca E; Jozefik, Jennifer K; Kim, Alison M; Hirshfeld-Cytron, Jennifer; Woodruff, Teresa K

2011-01-01

9

The nursing dimension of providing palliative care to children and adolescents with cancer.  

PubMed

Palliative care for children and adolescents with cancer includes interventions that focus on the relief of suffering, optimization of function, and improvement of quality of life at any and all stages of disease. This care is most effectively provided by a multidisciplinary team. Nurses perform an integral role on that team by identifying symptoms, providing care coordination, and assuring clear communication. Several basic tenets appear essential to the provision of optimal palliative care. First, palliative care should be administered concurrently with curative therapy beginning at diagnosis and assuming a more significant role at end of life. This treatment approach, recommended by many medical societies, has been associated with numerous benefits including longer survival. Second, realistic, objective goals of care must be developed. A clear understanding of the prognosis by the patient, family, and all members of the medical team is essential to the development of these goals. The pediatric oncology nurse is pivotal in developing these goals and assuring that they are adhered to across all specialties. Third, effective therapies to prevent and relieve the symptoms of suffering must be provided. This can only be accomplished with accurate and repeated assessments. The pediatric oncology nurse is vital in providing these assessments and must possess a working knowledge of the most common symptoms associated with suffering. With a basic understanding of these palliative care principles and competency in the core skills required for this care, the pediatric oncology nurse will optimize quality of life for children and adolescents with cancer. PMID:23641169

Docherty, Sharron L; Thaxton, Cheryl; Allison, Courtney; Barfield, Raymond C; Tamburro, Robert F

2012-01-01

10

Patient and provider barriers to colorectal cancer screening in the primary care safety-net  

Microsoft Academic Search

Objectives. This study examines patient and provider barriers to screening for colorectal cancer among low-income uninsured African-Americans aged 50 years or older in an urban safety-net primary care clinic, with the goal of informing a future intervention.Methods. Four focus groups were conducted among 40 patients from, or living in the immediate neighborhood of, a primary care clinic for uninsured residents

A. S O'Malley; E Beaton; K. R Yabroff; R Abramson; J Mandelblatt

2004-01-01

11

Providing inbuilt economic resilience options : an obligation of comprehensive cancer care.  

PubMed

For many, a cancer death in the family is the immediately obvious part of what is actually a double devastation. Overwhelming financial damage also results for many families, from the cost of medical care and from the loss of earning power by the patient and family. For some families, the consequences may be multigenerational and can affect the health of the survivors. Although this situation is not limited to cancer, the authors argue that oncology can take a lead in attending to these consequences of cancer as an integral part of its commitment to comprehensive cancer care. They make this case for both the national and the international settings. They also articulate and illustrate the notion of inbuilt options for economic resilience (IERs), which the authors suggest the medical industry, and its cancer care sectors in particular, should be providing to all patients and their families if they are at risk for damaging financial losses. After describing key features to IER, the authors illustrate it with 1 type of approach for households of the terminally ill: hospice care with provision of supplementary training and certification to the family caregiver. Such programming could generate a low-technology, semiskilled healthcare service economy as trained family caregivers provide support to other households in need, thereby both providing a recovery option for themselves and reduced economic devastation to the households which, by receiving the services, can stay in the workforce. Finally, the authors call for invigorated research on the economic impact of cancer on families and for the modeling, demonstration, and study of options for economic resilience, including IER programs. PMID:19058152

Cross, Eva Reitschuler; Emanuel, Linda

2008-12-15

12

Predicting cancer prognosis using interactive online tools: A systematic review and implications for cancer care providers  

PubMed Central

Cancer prognosis is of keen interest for cancer patients, their caregivers and providers. Prognostic tools have been developed to guide patient-physician communication and decision-making. Given the proliferation of prognostic tools, it is timely to review existing online cancer prognostic tools and discuss implications for their use in clinical settings. Using a systematic approach, we searched the Internet, Medline, and consulted with experts to identify existing online prognostic tools. Each was reviewed for content and format. Twenty-two prognostic tools addressing 89 different cancers were identified. Tools primarily focused on prostate (n=11), colorectal (n=10), breast (n=8), and melanoma (n=6), though at least one tool was identified for most malignancies. The input variables for the tools included cancer characteristics (n=22), patient characteristics (n=18), and comorbidities (n=9). Effect of therapy on prognosis was included in 15 tools. The most common predicted outcome was cancer specific survival/mortality (n=17). Only a few tools (n=4) suggested patients as potential target users. A comprehensive repository of online prognostic tools was created to understand the state-of-the-art in prognostic tool availability and characteristics. Use of these tools may support communication and understanding about cancer prognosis. Dissemination, testing, refinement of existing, and development of new tools under different conditions are needed. PMID:23956026

Rabin, Borsika A.; Gaglio, Bridget; Sanders, Tristan; Nekhlyudov, Larissa; Dearing, James W.; Bull, Sheana; Glasgow, Russell E.; Marcus, Alfred

2013-01-01

13

Rural Primary Care Providers' Perceptions of Their Role in the Breast Cancer Care Continuum  

ERIC Educational Resources Information Center

Context: Rural women in the United States experience disparity in breast cancer diagnosis and treatment when compared to their urban counterparts. Given the 11% chance of lifetime occurrence of breast cancer for women overall, the continuum of breast cancer screening, diagnosis, treatment, and recovery are of legitimate concern to rural women and…

Rayman, Kathleen M.; Edwards, Joellen

2010-01-01

14

Anti-Smoking Communication to Preadolescents With and Without a Cancer Diagnosis: Parents and Health Care Providers as Important Communicators  

Microsoft Academic Search

A cancer diagnosis does not prevent smoking among pediatric oncology patients, and anti-smoking communications among parents and health care providers have been proposed as influencing smoking outcomes in this group. Anti-smoking communications were compared among 93 preadolescents with cancer and 402 controls. After adjusting for demographics and covariates, preadolescents with cancer were less likely than control participants to report receipt

Leslee Throckmorton-Belzer; Vida L. Tyc; Leslie A. Robinson; James L. Klosky; Shelly Lensing; Andrea K. Booth

2009-01-01

15

Implementation of Cancer Clinical Care Pathways: A Successful Model of Collaboration Between Payers and Providers  

PubMed Central

Despite rising medical costs within the US health care system, quality and outcomes are not improving. Without significant policy reform, the cost-quality imbalance will reach unsustainable proportions in the foreseeable future. The rising cost of health care in part results from an expanding aging population with an increasing number of life-threatening diseases. This is further compounded by a growing arsenal of high-cost therapies. In no medical specialty is this more apparent than in the area of oncology. Numerous attempts to reduce costs have been attempted, often with limited benefit and brief duration. Because physicians directly or indirectly control or influence the majority of medical care costs, physician behavioral changes must occur to bend the health care cost curve in a sustainable fashion. Experts within academia, health policy, and business agree that a significant paradigm change in stakeholder collaboration will be necessary to accomplish behavioral change. Such a collaboration has been pioneered by Blue Cross Blue Shield of Michigan and Physician Resource Management, a highly specialized oncology health care consulting firm with developmental and ongoing technical, analytic, and consultative support from Cardinal Health Specialty Solutions, a division of Cardinal Health. We describe a successful statewide collaboration between payers and providers to create a cancer clinical care pathways program. We show that aligned stakeholder incentives can drive high levels of provider participation and compliance in the pathways that lead to physician behavioral changes. In addition, claims-based data can be collected, analyzed, and used to create and maintain such a program. PMID:22942833

Feinberg, Bruce A.; Lang, James; Grzegorczyk, James; Stark, Donna; Rybarczyk, Thomas; Leyden, Thomas; Cooper, Joseph; Ruane, Thomas; Milligan, Scott; Stella, Philip; Scott, Jeffrey A.

2012-01-01

16

Implementation of cancer clinical care pathways: a successful model of collaboration between payers and providers.  

PubMed

Despite rising medical costs within the US health care system, quality and outcomes are not improving. Without significant policy reform, the cost-quality imbalance will reach unsustainable proportions in the foreseeable future. The rising cost of health care in part results from an expanding aging population with an increasing number of life-threatening diseases. This is further compounded by a growing arsenal of high-cost therapies. In no medical specialty is this more apparent than in the area of oncology. Numerous attempts to reduce costs have been attempted, often with limited benefit and brief duration. Because physicians directly or indirectly control or influence the majority of medical care costs, physician behavioral changes must occur to bend the health care cost curve in a sustainable fashion. Experts within academia, health policy, and business agree that a significant paradigm change in stakeholder collaboration will be necessary to accomplish behavioral change. Such a collaboration has been pioneered by Blue Cross Blue Shield of Michigan and Physician Resource Management, a highly specialized oncology health care consulting firm with developmental and ongoing technical, analytic, and consultative support from Cardinal Health Specialty Solutions, a division of Cardinal Health. We describe a successful statewide collaboration between payers and providers to create a cancer clinical care pathways program. We show that aligned stakeholder incentives can drive high levels of provider participation and compliance in the pathways that lead to physician behavioral changes. In addition, claims-based data can be collected, analyzed, and used to create and maintain such a program. PMID:22942833

Feinberg, Bruce A; Lang, James; Grzegorczyk, James; Stark, Donna; Rybarczyk, Thomas; Leyden, Thomas; Cooper, Joseph; Ruane, Thomas; Milligan, Scott; Stella, Philip; Scott, Jeffrey A

2012-05-01

17

Predictors of Colorectal Cancer Screening Variation Among Primary Care Providers and Clinics  

PubMed Central

Objectives Colorectal cancer (CRC) screening is underutilized. To effect change, we must understand reasons for underuse at multiple levels of the healthcare system. We evaluated patient, provider, and clinic factors that predict variation in CRC screening among primary care clinics and primary care providers (PCPs). Methods We analyzed electronic medical record (EMR) data for 34,319 adults eligible for CRC screening, 19 clinics, and 97 PCPs in a large, academic physician group. Detailed data on potential patient, provider, and clinic predictors of CRC screening were obtained from the EMR. PCP perceptions of CRC screening barriers were measured via survey. The outcome was completion of CRC screening at the patient level. Multivariate logistic regression with clustering on clinics obtained adjusted odds ratios and 95% confidence intervals for potential predictors of CRC screening at each level. Results Seventy-one percent of patients completed CRC screening. Variation in screening rates was seen among clinics (51–80%) and among PCPs (51–82%). Significant predictors of completing CRC screening were identified at all levels: patient (older age, white race, being married, primarily English-speaking, having commercial insurance plans versus Medicare or Medicaid, and higher healthcare resource utilization), provider (larger panel size of patients eligible for CRC screening), and clinic (hospital-owned, shorter distance to nearest optical colonoscopy center). Conclusions Variation in CRC screening exists among primary care clinics and providers within a single clinic. Predictors of variation can be identified at patient, provider, and clinic levels. Quality improvement interventions addressing CRC screening need to be directed at multiple levels of the healthcare system. PMID:23670114

Weiss, Jennifer M.; Smith, Maureen A.; Pickhardt, Perry J.; Kraft, Sally A.; Flood, Grace E.; Kim, David H.; Strutz, Elizabeth; Pfau, Patrick R.

2013-01-01

18

For Health Care Providers  

Cancer.gov

For Health Care Providers Training Categories Palliative Care Clinical Trials Translational Research Palliative Care Education in Palliative and End-of-Life Care For Oncology (EPEC™-O )Format: Web-based self-study, 3 plenary sessions and 15 content

19

Choosing Your Prenatal Care Provider  

MedlinePLUS

... Prenatal care > Choosing your prenatal care provider Prenatal care Prenatal care is the care you get while ... been added to your dashboard . Choosing your prenatal care provider Prenatal care is medical care you get ...

20

Guideline for referral of patients with suspected lung cancer by family physicians and other primary care providers  

PubMed Central

Abstract Objective The aim of this guideline is to assist FPs and other primary care providers with recognizing features that should raise their suspicions about the presence of lung cancer in their patients. Composition of the committee Committee members were selected from among the regional primary care leads from the Cancer Care Ontario Provincial Primary Care and Cancer Network and from among the members of the Cancer Care Ontario Lung Cancer Disease Site Group. Methods This guideline was developed through systematic review of the evidence base, synthesis of the evidence, and formal external review involving Canadian stakeholders to validate the relevance of recommendations. Report Evidence-based guidelines were developed to improve the management of patients presenting with clinical features of lung cancer within the Canadian context. Conclusion Earlier identification and referral of patients with lung cancer might ultimately help improve lung cancer morbidity and mortality. These guidelines might also be of value for informing the development of lung cancer diagnostic programs and for helping policy makers to ensure appropriate resources are in place. PMID:25122814

Del Giudice, M. Elisabeth; Young, Sheila-Mae; Vella, Emily T.; Ash, Marla; Bansal, Praveen; Robinson, Andrew; Skrastins, Roland; Ung, Yee; Zeldin, Robert; Levitt, Cheryl

2014-01-01

21

Implementation of cancer clinical care pathways: s successful model of collaboration between payers and providers.  

PubMed

Despite rising medical costs within the US healthcare system, quality and outcomes are not improving. Without significant policy reform, the cost-quality imbalance will reach unsustainable proportions in the foreseeable future. The rising cost of healthcare in part results from an expanding aging population with an increasing number of life-threatening diseases. This is further compounded by a growing arsenal of high-cost therapies. In no medical specialty is this more apparent than in the area of oncology. Numerous attempts to reduce costs have been attempted, often with limited benefit and brief duration. Because physicians directly or indirectly control or influence the majority of medical care costs, physician behavioral changes must occur to bend the healthcare cost curve in a sustainable fashion. Experts within academia, health policy, and business agree that a significant paradigm change in stakeholder collaboration will be necessary to accomplish behavioral change. Such a collaboration has been pioneered by Blue Cross Blue Shield of Michigan and Physician Resource Management, a highly specialized oncology healthcare consulting firm with developmental and ongoing technical, analytic, and consultative support from Cardinal Health Specialty Solutions, a division of Cardinal Health. We describe a successful statewide collaboration between payers and providers to create a cancer clinical care pathways program. We show that aligned stakeholder incentives can drive high levels of provider participation and compliance in the pathways that lead to physician behavioral changes. In addition, claims-based data can be collected, analyzed, and used to create and maintain such a program. PMID:22694114

Feinberg, Bruce A; Lang, James; Grzegorczyk, James; Stark, Donna; Rybarczyk, Thomas; Leyden, Thomas; Cooper, Joseph; Ruane, Thomas; Milligan, Scott; Stella, Phillip; Scott, Jeffrey A

2012-05-01

22

Guideline for referral of patients with suspected prostate cancer by family physicians and other primary care providers  

PubMed Central

Abstract Objective The aim of this guideline is to assist FPs and other primary care providers with recognizing features that should raise their suspicion about the presence of prostate cancer in their patients. Composition of the committee Committee members were selected from among the regional primary care leads from the Cancer Care Ontario Provincial Primary Care and Cancer Network and from among the members of the Cancer Care Ontario Genitourinary Cancer Disease Site Group. Methods This guideline was developed through systematic review of the evidence base, synthesis of the evidence, and formal external review involving Canadian stakeholders to validate the relevance of recommendations. Report Evidence-based guidelines were developed to improve the management of patients presenting with clinical features of prostate cancer within the Canadian context. Conclusion These guidelines might lead to more timely and appropriate referrals and might also be of value for informing the development of prostate cancer diagnostic programs and for helping policy makers to ensure appropriate resources are in place.

Young, Sheila-Mae; Bansal, Praveen; Vella, Emily T.; Finelli, Antonio; Levitt, Cheryl; Loblaw, Andrew

2015-01-01

23

Is Distance to Provider a Barrier to Care for Medicaid Patients with Breast, Colorectal, or Lung Cancer?  

ERIC Educational Resources Information Center

Purpose: Distance to provider might be an important barrier to timely diagnosis and treatment for cancer patients who qualify for Medicaid coverage. Whether driving time or driving distance is a better indicator of travel burden is also of interest. Methods: Driving distances and times from patient residence to primary care provider were…

Scoggins, John F.; Fedorenko, Catherine R.; Donahue, Sara M. A.; Buchwald, Dedra; Blough, David K.; Ramsey, Scott D.

2012-01-01

24

Compassion FatigueA Review of the Research to Date and Relevance to Cancer-care Providers  

Microsoft Academic Search

Fifty-seven studies were reviewed to identify the prevalence of compassion fatigue among cancer-care providers, instruments used to detect it and means of prevention and treatment. Conclusions were limited by an ambiguous definition of compassion fatigue that fails to adequately differentiate it from related constructs (e.g. burnout, secondary traumatic stress) and the modest number of cancer-related studies found. However, evidence suggests

Nadine Najjar; Louanne W. Davis; Kathleen Beck-Coon; Caroline Carney Doebbeling

2009-01-01

25

Enhancing Oncology Health Care Provider’s Sensitivity to Cultural Communication to Reduce Cancer Disparities: A Pilot Study  

PubMed Central

Under the auspices of a partnership grant to reduce cancer health disparities, Moffitt Cancer Center (MCC) partnered with the Ponce School of Medicine to identify the perceived cultural communication needs of MCC healthcare providers regarding Hispanic patients with limited or no English skills. Oncologists (N=72) at MCC were surveyed to identify the specific areas of cultural communication techniques for which they desired to receive additional training. The majority of participants (66%) endorsed an interest in obtaining training to communicate difficult issues (terminal illness, controversial diagnosis) in a manner respectful to Hispanic culture. A workshop was conducted with providers (N=55) to improve cultural communication between Hispanic patients and families focusing on culture, terminal illness, and communication strategies. Findings from a pre–post test indicate an overall positive response to the workshop. Results from this study can help inform future efforts to enhance cultural competency among health providers. PMID:21479572

Jimenez, Julio; Meade, Cathy; Muñoz-Antonia, Teresita; Gwede, Clement; Castro, Eida; Vadaparampil, Susan; Simmons, Vani; McIntyre, Jessica; Crocker, Theresa; Brandon, Thomas

2013-01-01

26

Adherence to Survivorship Care Guidelines in Health Care Providers for Non-Small Cell Lung Cancer and Colorectal Cancer Survivor Care  

ClinicalTrials.gov

Adenocarcinoma of the Lung; Mucinous Adenocarcinoma of the Colon; Mucinous Adenocarcinoma of the Rectum; Signet Ring Adenocarcinoma of the Colon; Signet Ring Adenocarcinoma of the Rectum; Squamous Cell Lung Cancer; Stage I Colon Cancer; Stage I Rectal Cancer; Stage IA Non-small Cell Lung Cancer; Stage IB Non-small Cell Lung Cancer; Stage IIA Colon Cancer; Stage IIA Non-small Cell Lung Cancer; Stage IIA Rectal Cancer; Stage IIB Colon Cancer; Stage IIB Non-small Cell Lung Cancer; Stage IIB Rectal Cancer; Stage IIC Colon Cancer; Stage IIC Rectal Cancer; Stage IIIA Colon Cancer; Stage IIIA Non-small Cell Lung Cancer; Stage IIIA Rectal Cancer; Stage IIIB Colon Cancer; Stage IIIB Non-small Cell Lung Cancer; Stage IIIB Rectal Cancer; Stage IIIC Colon Cancer; Stage IIIC Rectal Cancer

2014-01-31

27

The work left undone. Understanding the challenge of providing holistic lung cancer nursing care in the UK.  

PubMed

In England best practice guidance in cancer recommends that all patients have access to a specialist nurse such as the tumour specific clinical nurse specialist. The role has become pivotal providing aspects of care e.g. meeting information needs, holistic nurse led follow up including symptom control, managing care and providing psychological and social interventions including referral to others in the role of keyworker. There are approximately 295 lung cancer nurse specialists in England and recent study to model optimum caseload used an on line survey to look at workload of lung cancer specialist nurses. A survey of 100 lung cancer nurses from across the UK (RR78%) examined the perception of the work left undone against best practice guidance, caseload size, workload and other factors. 67 of 78 respondents perceived they left work such as proactive management (52) undertaking holistic needs assessments (46) providing appropriate psychological care (26) and meeting information needs (16). The majority (70) worked unpaid overtime (mean 3.8 h range 1-10 h) per week. Although proactive management is thought to result in better outcomes for lung cancer patients in terms of survival, quality of life and decisions of end of life a substantial number of the specialist nurses felt that factors such as caseload and organisational factors inhibited this. PMID:24246444

Leary, Alison; White, John; Yarnell, Laura

2014-02-01

28

Is Distance to Provider a Barrier to Care for Medicaid Patients With Breast, Colorectal, or Lung Cancer?  

PubMed Central

Purpose Distance to provider might be an important barrier to timely diagnosis and treatment for cancer patients who qualify for Medicaid coverage. Whether driving time or driving distance is a better indicator of travel burden is also of interest. Methods Driving distances and times from patient residence to primary care provider were calculated for 3,917 breast, colorectal (CRC) and lung cancer Medicaid patients in Washington State from 1997 to 2003 using MapQuest.com. We fitted regression models of stage at diagnosis and time-to-treatment (number of days between diagnosis and surgery) to test the hypothesis that travel burden is associated with timely diagnosis and treatment of cancer. Findings Later stage at diagnosis for breast cancer Medicaid patients is associated with travel burden (OR = 1.488 per 100 driving miles, P = .037 and OR = 1.270 per driving hour, P = .016). Time-to-treatment after diagnosis of CRC is also associated with travel burden (14.57 days per 100 driving miles, P = .002 and 5.86 days per driving hour, P = .018). Conclusions Although travel burden is associated with timely diagnosis and treatment for some types of cancer, we did not find evidence that driving time was, in general, better at predicting timeliness of cancer diagnosis and treatment than driving distance. More intensive efforts at early detection of breast cancer and early treatment of CRC for Medicaid patients who live in remote areas may be needed. PMID:22236315

Scoggins, John F.; Fedorenko, Catherine R.; Donahue, Sara M. A.; Buchwald, Dedra; Blough, David K.; Ramsey, Scott D.

2011-01-01

29

Longitudinal Changes and Predictors of Caregiving Burden While Providing End-of-Life Care for Terminally Ill Cancer Patients  

PubMed Central

Abstract Background The effect of caring for a dying cancer patient on caregiving burden has been explored primarily in Western-based studies with small samples or in studies that did not follow up until the patient's death, but has not yet been investigated in Taiwan. Objective The study's goals were (1) to identify the trajectory of caregiving burden for family caregivers (FCs) of terminally ill cancer patients in Taiwan, and (2) to investigate the determinants of caregiving burden in a large sample and with longitudinal follow-ups, until the patient's death. Method A prospective, longitudinal study was conducted among 193 FCs. The trajectory and determinants of caregiving burden were identified by a generalized estimation equation approach. Results Caregiving burden did not change as the patient's death approached. FCs experienced heavy caregiving burden when their relative suffered from greater symptom distress or if they were spousal caregivers; provided high intensity of assistance to the patient while spending fewer hours providing care; reported financial insufficiency; or had lower social support, fewer psychological resources, or less confidence in caregiving. Conclusions Taiwanese family caregivers' carrry moderate caregiving burden which did not change significantly as the patients' death approached. The effects of caregiving burden while providing EOL care to terminally ill cancer patients may be tempered substantially by enhancing family caregivers caregiving confidence, social support, and psychological resources. PMID:23556989

Lee, Kwo C.; Chang, Wen-Cheng; Chou, Wen-Chi; Su, Po-Jung; Hsieh, Chia-hsun; Chen, Jen-Shi

2013-01-01

30

Quality of Cancer Care  

Cancer.gov

Work is underway to make cancer a working model for quality of care research and the translation of this research into practice. This requires addressing how data collection about cancer care can be standardized and made most useful to a variety of audiences including providers, patients and their families, purchasers, payers, researchers, and policymakers. The Applied Research Program has spearheaded several key activities to carry out this initiative.

31

Is detection of oral and oropharyngeal squamous cancer by a dental health care provider associated with a lower stage at diagnosis?  

Microsoft Academic Search

Purpose: Stage at diagnosis is the most important prognostic indictor for oral and oropharyngeal squamous cell cancers (SCCs). Unfortunately, approximately 50% of these cancers are identified late (stage III or IV). We set out to examinationine the detection patterns of oral and oropharyngeal SCCs and to determine whether detection of these cancers by various health care providers was associated with

Jon D. Holmes; Eric J. Dierks; Louis D. Homer; Bryce E. Potter

2003-01-01

32

Making It Work: Health Care Provider Perspectives on Strategies to Increase Colorectal Cancer Screening in Federally Qualified Health Centers  

PubMed Central

Objective Colorectal cancer screening (CRCS) rates are low among men and women who seek health care at federally qualified health centers (FQHCs). This study explores health care providers' perspectives about their patient's motivators and impediments to CRCS and receptivity to preparatory education. Methods A mixed methods design consisting of in-depth interviews, focus groups, and a short survey. Setting: FQHCs in the Tampa Bay area. Participants: Seventeen health care providers practicing in FQHCs. Results Test-specific patient impediments and motivations were identified including fear of abnormal findings; importance of offering less invasive fecal occult blood tests; and need for patient-centered test-specific educational materials in clinics. Opportunities to improve provider practices were identified including providers' reliance on patients' report of symptoms as a cue to recommend CRCS and overemphasis of clinic-based guaiac stool tests. Conclusions This study adds to the literature on CRCS test-specific motivators and impediments. Providers offered unique approaches for motivating patients to follow through with recommended CRCS and were receptive to in-clinic patient education and. Findings are readily inform the design of educational materials and interventions to increase CRCS in FQHCs. PMID:23943277

Gwede, Clement K.; Davis, Stacy N.; Quinn, Gwendolyn P.; Koskan, Alexis M.; Ealey, Jamila; Abdulla, Rania; Vadaparampil, Susan T.; Elliott, Gloria; Lopez, Diana; Shibata, David; Roetzheim, Richard G.; Meade, Cathy D.

2013-01-01

33

Making it work: health care provider perspectives on strategies to increase colorectal cancer screening in federally qualified health centers.  

PubMed

Colorectal cancer screening (CRCS) rates are low among men and women who seek health care at federally qualified health centers (FQHCs). This study explores health care providers' perspectives about their patient's motivators and impediments to CRCS and receptivity to preparatory education. A mixed methods design consisting of in-depth interviews, focus groups, and a short survey is used in this study. The participants of this study are 17 health care providers practicing in FQHCs in the Tampa Bay area. Test-specific patient impediments and motivations were identified including fear of abnormal findings, importance of offering less invasive fecal occult blood tests, and need for patient-centered test-specific educational materials in clinics. Opportunities to improve provider practices were identified including providers' reliance on patients' report of symptoms as a cue to recommend CRCS and overemphasis of clinic-based guaiac stool tests. This study adds to the literature on CRCS test-specific motivators and impediments. Providers offered unique approaches for motivating patients to follow through with recommended CRCS and were receptive to in-clinic patient education. Findings readily inform the design of educational materials and interventions to increase CRCS in FQHCs. PMID:23943277

Gwede, Clement K; Davis, Stacy N; Quinn, Gwendolyn P; Koskan, Alexis M; Ealey, Jamila; Abdulla, Rania; Vadaparampil, Susan T; Elliott, Gloria; Lopez, Diana; Shibata, David; Roetzheim, Richard G; Meade, Cathy D

2013-12-01

34

Types of health care providers  

MedlinePLUS

... serve as a primary care provider in family medicine (FNP), pediatrics (PNP), adult care (ANP), or geriatrics (GNP). Others are trained to address women's health care (common concerns and ... of Medicine (MD) or a Doctor of Osteopathic Medicine (DO). ...

35

Family Day Care Provider Handbook  

ERIC Educational Resources Information Center

Family day care providers are responsible for creating a high-quality program where children have opportunities to grow, learn and thrive. Part of providing high-quality child care includes complying with the family day care regulations from the New York State Office of Children and Family Services (OCFS). This Handbook will help day care

New York State Office of Children and Family Services, 2006

2006-01-01

36

Choosing a primary care provider  

MedlinePLUS

Family doctor - how to choose one; Primary care provider - how to choose one; Doctor - how to choose a family doctor ... A PCP is your main health care provider in non-emergency ... and teach healthy lifestyle choices Identify and treat common ...

37

Impact of computer-assisted data collection, evaluation and management on the cancer genetic counselor's time providing patient care.  

PubMed

Cancer genetic counseling sessions traditionally encompass collecting medical and family history information, evaluating that information for the likelihood of a genetic predisposition for a hereditary cancer syndrome, conveying that information to the patient, offering genetic testing when appropriate, obtaining consent and subsequently documenting the encounter with a clinic note and pedigree. Software programs exist to collect family and medical history information electronically, intending to improve efficiency and simplicity of collecting, managing and storing this data. This study compares the genetic counselor's time spent in cancer genetic counseling tasks in a traditional model and one using computer-assisted data collection, which is then used to generate a pedigree, risk assessment and consult note. Genetic counselor time spent collecting family and medical history and providing face-to-face counseling for a new patient session decreased from an average of 85-69 min when using the computer-assisted data collection. However, there was no statistically significant change in overall genetic counselor time on all aspects of the genetic counseling process, due to an increased amount of time spent generating an electronic pedigree and consult note. Improvements in the computer program's technical design would potentially minimize data manipulation. Certain aspects of this program, such as electronic collection of family history and risk assessment, appear effective in improving cancer genetic counseling efficiency while others, such as generating an electronic pedigree and consult note, do not. PMID:21240560

Cohen, Stephanie A; McIlvried, Dawn E

2011-06-01

38

Palliative Care in Cancer  

Cancer.gov

A fact sheet that describes the role of palliative care, which is comfort care given to a patient who has a serious or life-threatening disease, such as cancer, from the time of diagnosis and throughout the course of illness.

39

Who Will Provide Your Care? (Long-Term Care)  

MedlinePLUS

... may need. Share page: Who Will Provide Your Care? Long-term care services and support typically come ... you live at home. About 80 percent of care at home is provided by unpaid caregivers and ...

40

Improving Modern Cancer Care Through Information Technology  

PubMed Central

The cancer care system is increasingly complex, marked by multiple hand-offs between primary care and specialty providers, inadequate communication among providers, and lack of clarity about a “medical home” (the ideal accountable care provider) for cancer patients. Patients and families often cite such difficulties as information deficits, uncoordinated care, and insufficient psychosocial support. This article presents a review of the challenges of delivering well coordinated, patient-centered cancer care in a complex modern healthcare system. An examination is made of the potential role of information technology (IT) advances to help both providers and patients. Using the published literature as background, a review is provided of selected work that is underway to improve communication, coordination, and quality of care. Also discussed are additional challenges and opportunities to advancing understanding of how patient data, provider and patient involvement, and informatics innovations can support high-quality cancer care. PMID:21521595

Clauser, Steven B.; Wagner, Edward H.; Bowles, Erin J. Aiello; Tuzzio, Leah; Greene, Sarah M.

2011-01-01

41

Follow-up Care After Cancer Treatment  

MedlinePLUS

... Association of Cancer Online Resources, a cancer information system that offers access to electronic mailing lists and websites, provides a list of long-term follow-up care clinics on its Ped-Onc Resource Center ...

42

Cancer Care, Inc.  

NSDL National Science Digital Library

This site, by Cancer Care, Inc., contains easy-to-understand medical information about cancer for patients, survivors, and their families. In addition, it offers advice and resources for coping with the diagnosis and the side-effects of treatment. A Special Programs Section includes information on the causes, treatment, and prevention of cancer; suggestions for coping with and relieving cancer pain; and tips on how to advocate for health policy reform and better medical care. Visitors can listen to RealAudio educational programs through teleconference and participate in online or telephone support groups. The site has information on insurance, directories of support organizations, and links to other Websites and news media resources. Professionals visiting the site can find information on how to better assist and support cancer patients and their families.

43

Homeopathy in cancer care.  

PubMed

Homeopathy is a controversial system of care that is practiced extensively in Europe, Asia, and South America primarily for functional and minor ailments. In this review, published studies on homeopathic remedies and cancer were examined. Data were obtained from multiple research disciplines, ranging from basic science to scientifically valid animal and clinical studies. The data from a few laboratory experiments in cancer models show some beneficial effect of homeopathic remedies on selected cancer cell lines. However, in the clinical arena, this effect is not clear. Several published outcome studies and some randomized controlled trials have shown that there may be a role for homeopathy in symptom relief and improving quality of life in patients touched by cancer. Such effects have not been demonstrated unequivocally, and specific antitumor effects have not been shown in any controlled clinical research to date, which raises the need for further clinical trials to investigate the use of homeopathy in cancer care. PMID:20486620

Frenkel, Moshe

2010-01-01

44

Group Family Day Care Provider Handbook  

ERIC Educational Resources Information Center

Group family day care providers need to create high-quality programs where children have opportunities to grow, learn and thrive. Part of providing high-quality child care includes complying with the group family day care regulations from the New York State Office of Children and Family Services (OCFS). This Handbook will help day care providers:…

New York State Office of Children and Family Services, 2006

2006-01-01

45

Do Survivorship Care Plans Make a Difference? A Primary Care Provider Perspective  

PubMed Central

Introduction: The growing numbers of cancer survivors will challenge the ability of oncologists to provide ongoing surveillance care. Tools such as survivorship care plans (SCPs) are needed to effectively care for these patients. The UCLA-LIVESTRONG Survivorship Center of Excellence has been providing SCPs to cancer survivors and their providers since 2006. We sought to examine views on the value and impact of SCPs from a primary care provider (PCP) perspective. Methods: As part of a quality improvement project, we invited 32 PCPs who had received at least one SCP to participate in a semistructured interview focused on (1) the perceived value of SCPs for patient management and (2) PCP attitudes toward follow-up care for cancer survivors. Interviews were tape-recorded, transcribed, and analyzed. Results: Fifteen PCPs participated in the interviews and had received a total of 30 SCPs. Ten of them indicated reading the SCPs before being contacted for the interview. All 10 PCPs indicated that the SCP provided additional information about the patient's cancer history and/or recommendations for follow-up care, and eight reported a resulting change in patient care. PCPs identified useful elements of the SCP that assisted them with patient care, and they valued the comprehensive format of the SCP. PCPs indicated that after reading the SCPs they felt more confident and better prepared to care for the cancer survivor. Conclusion: SCPs were highly valued by these PCPs, increasing their knowledge about survivors' cancer history and recommended surveillance care and influencing patient care. PMID:22211129

Shalom, Marina Mor; Hahn, Erin E.; Casillas, Jacqueline; Ganz, Patricia A.

2011-01-01

46

How Do Health Care Providers Diagnose Vulvodynia?  

MedlinePLUS

... Trials Resources and Publications En Español How do health care providers diagnose vulvodynia? Skip sharing on social media ... been ruled out. To diagnose vulvodynia, 1 a health care provider may recommend that a woman have blood ...

47

How Do Health Care Providers Diagnose Endometriosis?  

MedlinePLUS

... Trials Resources and Publications En Español How do health care providers diagnose endometriosis? Skip sharing on social media ... under a microscope, to confirm the diagnosis. 1 Health care providers may also use imaging methods to produce ...

48

How Do Health Care Providers Diagnose Pheochromocytoma?  

MedlinePLUS

... Trials Resources and Publications En Español How do health care providers diagnose pheochromocytoma? Skip sharing on social media links Share this: Page Content A health care provider uses blood and urine tests that measure ...

49

How Do Health Care Providers Diagnose Hypoparathyroidism?  

MedlinePLUS

... Information Clinical Trials Resources and Publications How do health care providers diagnose hypoparathyroidism? Skip sharing on social media links Share this: Page Content A health care provider will order a blood test to determine ...

50

Child Care Provider's Guide to Safe Sleep  

MedlinePLUS

... Guide to Safe Sleep Family Life Listen A Child Care Provider's Guide to Safe Sleep Article Body Did ... Caused By: Immunizations Vomiting or choking What can child care providers do? Follow these guidelines to help protect ...

51

Family Day Care Provider Support Services Directory.  

ERIC Educational Resources Information Center

This directory profiles numerous organizational support services for family day care providers in the Kansas City metropolitan area. The first chapter, on operating a family day care home, concerns licensing and registration, the processes of starting and marketing a day care business, zoning and municipal regulation, and substitute providers. The…

Galblum, Trudi W.; Boyer-Shesol, Cathy

52

Health Care Provider Initiative Strategic Plan  

ERIC Educational Resources Information Center

This document lays out the strategy for achieving the goals and objectives of NEETF's "Health Care Provider Initiative." The goal of NEETF's "Health Care Provider Initiative" is to incorporate environmental health into health professionals' education and practice in order to improve health care and public health, with a special emphasis on…

National Environmental Education & Training Foundation, 2012

2012-01-01

53

Barriers to Child Care Providers' Professional Development  

Microsoft Academic Search

The current study uses telephone interview data gathered from 647 randomly-selected child care providers (92 center-based directors, 230 center-based providers, and 325 family child care providers) to describe one state's child care workforce and the individual beliefs, pragmatic concerns, and current regulations that may operate as barriers to providers' professional development. Results indicate meaningful differences among the three groups' demographic

Sara Gable; Amy Halliburton

2003-01-01

54

Head & Neck Cancer Care Program  

E-print Network

OROPHARYNGEAL CANCER PROGRAM THYROID AND PARATHYROID PROGRAM · Alexander Colevas, MD · Vasu Divi, MD · ChrisHead & Neck Cancer Care Program NONPROFITORG. U.S.POSTAGE PAID PALOALTO,CA PERMITNO.188900BlakeWilburDrive PaloAlto,CA94304 Starting February 24, 2014, the Head & Neck Cancer Care Program is moving to a new

Bogyo, Matthew

55

Health Care Provider Physical Activity Prescription Intervention  

ERIC Educational Resources Information Center

Purpose: To examine the feasibility and impact of a health care provider’s (HCP) physical activity (PA) prescription on the PA of patients on preventive care visits. Methods: Consenting adult patients completed health and PA questionnaires and were sequentially assigned to intervention groups. HCPs prescribed PA using a written prescription only…

Josyula, Lakshmi; Lyle, Roseann

2013-01-01

56

For Health Care Professional - Office of Cancer Survivorship  

Cancer.gov

This page provides numerous cancer-related resources for health care professionals. For information regarding cancer types, treatment, clinical trials and links to other National Cancer Institute resources, please go to the NCI home page.

57

75 FR 9913 - Request for Measures of Patient Experiences of Cancer Care  

Federal Register 2010, 2011, 2012, 2013

...for Measures of Patient Experiences of Cancer Care AGENCY: Agency for Healthcare Research...in collaboration with the National Cancer Institute (Nd), is soliciting voluntary...respondents to assess the care delivered by cancer care providers. AHRQ is seeking...

2010-03-04

58

CARE: a hypermedia cancer information system  

NASA Astrophysics Data System (ADS)

This paper discusses the CARE (Cancer Attitude Risk Education) system, an interactive user friendly hypermedia information system that will allow users to learn more about various aspects of cancer such as risk factors, diagnosis and available treatment options. The CARE system provides information to the user through various means like text, video, graphics, photographs, animation and sound. A defining feature of the CARE system is that it collects information from the user as well as disseminating information. The CARE system collects items such as name, age, gender and answers to risk assessment questions as the user browses through the system. The data collected through the CARE system is valuable to cancer researchers and support groups.

Fotouhi, Farshad A.; Chander, Prem M.; Ragan, Don P.; Porter, Arthur

1996-02-01

59

Smoking in Cancer Care (PDQ)  

MedlinePLUS

... Dictionary Search for Clinical Trials NCI Publications Español Smoking in Cancer Care (PDQ®) Overview This summary is ... who smoke, why it is important to stop smoking, and ways to get help. It includes information ...

60

Advances in Pancreatic Cancer Care  

MedlinePLUS Videos and Cool Tools

REPLAY IN ADVANCES IN PANCREATIC CANCER CARE PYLORUS-PRESERVING PANCREATICODUODENECTOMY (MINI-WHIPPLE PROCEDURE) THOMAS JEFFERSON UNIVERSITY HOSPITAL PHILADELPHIA, PENNSYLVANIA September 18, 2007 00:00:18 ANNOUNCER: Welcome to Thomas ...

61

Caring: Information for Family Day-Care Providers.  

ERIC Educational Resources Information Center

This series of leaflets provides information for family day care providers on nine topics. Age differences and developmental stages are emphasized. The first topic concerns ways to help young children get along with others. Self-esteem is emphasized, and methods for helping children develop self-esteem are listed. The second leaflet discusses…

California Univ., Berkeley. Cooperative Extension Service.

62

Baylor Health Care System's journey to provide equitable care.  

PubMed

Baylor Health Care System* has a long history of addressing health disparities at its hospitals and clinics and in the communities it serves. The organization's definition of health equity has evolved from simply providing care that looks the same for all patients to providing care that is tailored to and effective at producing equitable outcomes for the highly diverse populations of North Texas. Baylor's overarching framework for achieving health equity requires work in three dimensions: improving access to care, improving care delivery, and ultimately producing equitable outcomes for patients. The strategies and tactics used by Baylor have also evolved over time and range from initiatives supporting volunteerism and community service to the operation of a network of clinics tailored to meet the needs of uninsured and underinsured patients. The factors contributing to disparities among different populations include a broad range of health system, medical, and societal issues, many of which are outside the direct scope of influence of hospitals and other healthcare organizations. We share how Baylor has proactively addressed disparities within the organization and its community in the hope of encouraging other hospitals and providers to engage in similar efforts to improve care for all patients. PMID:25291890

Allison, Joel T; Fullerton, Cliff; Chabira, Adam

2014-01-01

63

Follow-Up Medical Care After Cancer Treatment - Office of Cancer Survivorship  

Cancer.gov

American Cancer Society's Long-Term Guidelines for Prostate Cancer Survivors Newly developed guidelines that provide detailed recommendations about nutrition and physical activity, cancer testing, management of side effects, and coordination of care.

64

Providing high-quality care in primary care settings  

PubMed Central

Abstract Objective To gain a deeper understanding of how primary care (PC) practices belonging to different models manage resources to provide high-quality care. Design Multiple-case study embedded in a cross-sectional study of a random sample of 37 practices. Setting Three regions of Quebec. Participants Health care professionals and staff of 5 PC practices. Methods Five cases showing above-average results on quality-of-care indicators were purposefully selected to contrast on region, practice size, and PC model. Data were collected using an organizational questionnaire; the Team Climate Inventory, which was completed by health care professionals and staff; and 33 individual interviews. Detailed case histories were written and thematic analysis was performed. Main findings The core common feature of these practices was their ongoing effort to make trade-offs to deliver services that met their vision of high-quality care. These compromises involved the same 3 areas, but to varying degrees depending on clinic characteristics: developing a shared vision of high-quality care; aligning resource use with that vision; and balancing professional aspirations and population needs. The leadership of the physician lead was crucial. The external environment was perceived as a source of pressure and dilemmas rather than as a source of support in these matters. Conclusion Irrespective of their models, PC practices’ pursuit of high-quality care is based on a vision in which accessibility is a key component, balanced by appropriate management of available resources and of external environment expectations. Current PC reforms often create tensions rather than support PC practices in their pursuit of high-quality care. PMID:24829023

Beaulieu, Marie-Dominique; Geneau, Robert; Grande, Claudio Del; Denis, Jean-Louis; Hudon, Éveline; Haggerty, Jeannie L.; Bonin, Lucie; Duplain, Réjean; Goudreau, Johanne; Hogg, William

2014-01-01

65

Total Cancer Care  

Cancer.gov

Skip to Main Content at the National Institutes of Health | www.cancer.gov Epidemiology and Genomics Research In NCI's Division of Cancer Control and Population Sciences Menu Search EGRP Site: EGRP Home About the Program Mission & Vision Organizational

66

Review of Pesticide Education Materials for Health Care Providers Providing Care to Agricultural Workers  

ERIC Educational Resources Information Center

Context: Pesticide exposure is an important environmental and occupational health risk for agricultural workers and their families, but health care providers receive little training in it. Objective: To evaluate the medical resources available to providers caring for patients, particularly farmworkers, exposed to pesticides and to recommend a…

Hiott, Ann E.; Quandt, Sara A.; Early, Julie; Jackson, David S.; Arcury, Thomas A.

2006-01-01

67

Weight loss counseling by health care providers.  

PubMed Central

OBJECTIVES: This study explores the pattern of weight loss counseling by health care providers in Connecticut and the associated weight loss efforts by patients. METHODS: Data from the 1994 Connecticut Behavioral Risk Factor Surveillance System survey were analyzed to determine (1) the frequency of weight management counseling by health care providers of overweight adults with and without additional cardiovascular risk factors and (2) the current weight loss practices of overweight subjects. RESULTS: Only 29% of all overweight respondents and fewer than half with additional cardiovascular risk factors, reported that they had been counseled to lose weight. CONCLUSIONS: The findings suggest a need for more counseling of overweight persons, especially those with cardiovascular disease risk factors. PMID:10224993

Nawaz, H; Adams, M L; Katz, D L

1999-01-01

68

Child Care Provider Training Helping Early Childhood Educators  

E-print Network

Child Care Provider Training Helping Early Childhood Educators Provide Quality Care for Today of child care on a regular basis from persons other than their parents (Child Care Aware, 2012). The Texas Workforce Commission estimates that there are over 100,000 child care providers caring for more than 760

69

Family Child Care Providers’ Compliance With State Physical Activity Regulations, Delaware Child Care Provider Survey, 2011  

PubMed Central

Introduction Delaware is one state that has implemented comprehensive child care regulations to foster healthy dietary and physical activity behaviors of young children. This study describes the Delaware family child care environment and providers’ knowledge of and compliance with physical activity regulations. We analyzed the data to determine characteristics associated with predictors of knowledge of and compliance with these regulations. Methods A random stratified sample of 663 licensed Delaware family child care providers was mailed a survey on family child care characteristics and providers’ awareness and practices of the child care regulations. Three logistic regression models were used to explore the association between provider characteristics and their knowledge of and compliance with the regulations. Results Ultimately, 313 of the 663 eligible family child care providers participated in the survey (47.2% response rate). Controlling for covariates, we found that family child care providers’ education level was significantly associated with knowledge of the physical activity regulation. Another model showed that family child care providers with larger amounts of outdoor space were more likely to report compliance with the recommendation for unstructured physical activity than those without this described space (odds ratio, 2.45). A third model showed a significant association between available indoor space for all activities including running and reported greater compliance with the recommendation for structured physical activity than was reported by caregivers with less indoor space (odds ratio, 11.2). Conclusion To provide the recommended levels of physical activity for children in child care, the available physical space environment is an important area of focus for advocates of physical activity recommendations within the family child care environment. PMID:23845175

Leng, Sarah Williams

2013-01-01

70

Realizing IOM Care Recommendations in Practice - Office of Cancer Survivorship  

Cancer.gov

Cancer survivorship, which begins at diagnosis and includes families and caregivers, is a neglected phase of the cancer care trajectory. Few guidelines exist, and most health care providers lack education and training in caring for this population. Survivors themselves often are unaware of the health risks and issues they face and usually are not provided with a plan for follow-up care after treatment is complete.

71

Pediatric Primary Care Providers' Relationships with Mental Health Care Providers: Survey Results  

ERIC Educational Resources Information Center

Background: As many as 20 % of children have diagnosable mental health conditions and nearly all of them receive pediatric primary health care. However, most children with serious mental health concerns do not receive mental health services. This study tested hypotheses that pediatric primary care providers (PPCPs) in relationships with mental…

Pidano, Anne E.; Honigfeld, Lisa; Bar-Halpern, Miri; Vivian, James E.

2014-01-01

72

47 CFR 54.633 - Health care provider contribution.  

Code of Federal Regulations, 2013 CFR

...2013-10-01 2013-10-01 false Health care provider contribution. 54.633...SERVICE Universal Service Support for Health Care Providers Healthcare Connect Fund § 54.633 Health care provider contribution. (a)...

2013-10-01

73

47 CFR 54.633 - Health care provider contribution.  

...2014-10-01 2014-10-01 false Health care provider contribution. 54.633...SERVICE Universal Service Support for Health Care Providers Healthcare Connect Fund § 54.633 Health care provider contribution. (a)...

2014-10-01

74

45 CFR 162.410 - Implementation specifications: Health care providers.  

...Implementation specifications: Health care providers. 162.410 Section...Standard Unique Health Identifier for Health Care Providers § 162.410 Implementation specifications: Health care providers. (a) A covered...

2014-10-01

75

Palliative Care in Cancer  

MedlinePLUS

... methods, such as nutrition therapy , physical therapy , or deep breathing techniques. Also, chemotherapy , radiation therapy , or surgery ... An expert in palliative care can help people explore their beliefs and values so that they can ...

76

Improving home-based providers' communication to primary care providers to enhance care coordination.  

PubMed

Objectives: Health care system fragmentation is a pervasive problem. Research has not delineated concrete behavioral strategies to guide providers to communicate with personnel in other organizations to coordinate care. We addressed this gap within a particular context: home-based providers delivering depression care management (DCM) to older adults requiring coordination with primary care personnel. Our objective was to pilot test a communication protocol ('BRIDGE - BRinging Inter-Disciplinary Guidelines to Elders') in conjunction with DCM. Method: In an open pilot trial (N = 7), home-based providers delivered DCM to participants. Following the BRIDGE protocol, home-based providers made scripted telephone calls and sent structured progress reports to personnel in participants' primary care practices with concise information and requests for assistance. Home-based providers documented visits with participants, contacts to and responses from primary care personnel. A research interviewer assessed participant outcomes [Symptom Checklist-20 (depressive symptoms), World Health Organization Disability Assessment Schedule-12, satisfaction] at baseline, three months, and six months. Results: Over 12 months, home-based providers made 2.4 telephone calls and sent 6.3 faxes to other personnel, on average per participant. Primary care personnel responded to 18 of 22 requests (81.8%; 2 requests dropped, 2 ongoing), with at least one response per participant. Participants' depressive symptoms and disability improved significantly at both post-tests with large effect sizes (d ranged 0.73-2.3). Participants were satisfied. Conclusion: Using BRIDGE, home-based providers expended a small amount of effort to communicate with primary care personnel, who responded to almost all requests. Larger scale research is needed to confirm findings and potentially extend BRIDGE to other client problems, professions, and service sectors. PMID:25401276

Gum, Amber M; Dautovich, Natalie D; Greene, Jennifer; Hirsch, Anne; Schonfeld, Lawrence

2014-11-17

77

Building a safe care-providing robot.  

PubMed

A service robot especially a care-providing robot, works in the vicinity of a human body and is sometimes even in direct contact with it. Conventional safety methods and precautions in industrial robotics are not applicable to such robots. This paper presents a safety approach for designing the safe care-providing robot FRIEND. The approach is applied in each step of design iteratively to identify and assess the potential hazards during design. The steps are explained briefly in this work. The main contribution of this paper is verification of safety requirements using the Ramadge-Wonham (RW) framework. The greater complexity of the tasks the robot will perform, the more complex is the identification of safety requirements. Use of this framework led us to analyze the requirements and verify them formally, systematically and on a modular basis. In our approach human-robot interaction (HRI) is also modeled by a set of uncontrolled events that may happen any time during operation. Subsequently the safety requirements are modified to consider these interactions. As a result the safety module behaves like a controller, running in parallel with the system, which maintains the system safe and works according to the safety requirements by enabling the admissible sequences of events. PMID:22275681

Fotoohi, Leila; Gräser, Axel

2011-01-01

78

How Do Health Care Providers Diagnose Klinefelter Syndrome?  

MedlinePLUS

... Information Clinical Trials Resources and Publications How do health care providers diagnose Klinefelter syndrome (KS)? Skip sharing on ... karyotype (pronounced care-EE-oh-type ) test. A health care provider will take a small blood or skin ...

79

Cancer Supportive Care Program  

E-print Network

catalyst for stress reduction: strengthen major muscle groups; mindfulness based stress-reduction. Gentle Yoga for Recovery Come join us for carefully sequenced yoga postures, breathwork, and mindfulness designed to meet you at your level of ability and help you create a path back to wellness. Gentle yoga

Bogyo, Matthew

80

Quality of cancer follow-up care: a focus on Latina breast cancer survivors  

PubMed Central

Introduction Receiving quality cancer follow-up care influences survivorship outcomes. Among Latinas, breast cancer is the number one cause of cancer death; yet Latinas do not receive adequate follow-up care. This study examined quality of cancer follow-up care among Latina breast cancer survivors (BCS) and whether it differs by participant language and healthcare system variables (provider specialty, and medical setting). Methods Two hundred thirty-two (95 English-speaking Latina and 137 Spanish-speaking) Latina BCS were recruited from the California Cancer Registry, hospital cancer registries, and community agencies. Results English-speaking Latina BCS were more likely to report receiving cancer follow-up care at a doctor’s office (p<0.001). BCS without a regular place for cancer follow-up care were more likely to report not seeing a primary care provider (p<0.05) or cancer specialist (p<0.001) in the past 12 months. English-speaking Latina BCS (p<0.001), BCS who saw a cancer specialist in the past 12 months (p<0.001), and received follow-up care at a doctor’s office (p<0.05) reported higher quality of care. Speaking English, having seen a cancer specialist, and receiving follow-up care at a doctor’s office were independently associated with higher quality of care, explaining 44 % of the variance. Conclusions Our study findings suggest that examining the influence of ethnic and linguistic factors on quality of cancer follow-up care is necessary to address health disparities. Improved access to cancer follow-up care for Spanish-speaking Latina BCS is of particular concern. Implication of Cancer Survivors Identifying follow-up care needs of Latina BCS may contribute to providing high-quality care and improved survivorship outcomes. PMID:24563169

Ashing, Kimlin; Napoles, Anna

2014-01-01

81

Preparing for an epidemic: cancer care in an aging population.  

PubMed

The Institute of Medicine's (IOM) Committee on Improving the Quality of Cancer Care: Addressing the Challenges of an Aging Population was charged with evaluating and proposing recommendations on how to improve the quality of cancer care, with a specific focus on the aging population. Based on their findings, the IOM committee recently released a report highlighting their 10 recommendations for improving the quality of cancer care. Based on those recommendations, this article highlights ways to improve evidence-based care and addresses rising costs in health care for older adults with cancer. The IOM highlighted three recommendations to address the current research gaps in providing evidence-based care in older adults with cancer, which included (1) studying populations which match the age and health-risk profile of the population with the disease, (2) legislative incentives for companies to include patients that are older or with multiple morbidities in new cancer drug trials, and (3) expansion of research that contributes to the depth and breadth of data available for assessing interventions. The recommendations also highlighted the need to maintain affordable and accessible care for older adults with cancer, with an emphasis on finding creative solutions within both the care delivery system and payment models in order to balance costs while preserving quality of care. The implementation of the IOM's recommendations will be a key step in moving closer to the goal of providing accessible, affordable, evidence-based, high-quality care to all patients with cancer. PMID:24857069

Shih, Ya-Chen Tina; Hurria, Arti

2014-01-01

82

Cancer care decision making in multidisciplinary meetings.  

PubMed

Little research has been undertaken on the actual decision-making processes in cancer care multidisciplinary meetings (MDMs). This article was based on a qualitative observational study of two regional cancer treatment centers in New Zealand. We audiorecorded 10 meetings in which 106 patient cases were discussed. Members of the meetings categorized cases in varying ways, drew on a range of sources of authority, expressed different value positions, and utilized a variety of strategies to justify their actions. An important dimension of authority was encountered authority-the authority a clinician has because of meeting the patient. The MDM chairperson can play an important role in making explicit the sources of authority being drawn on and the value positions of members to provide more clarity to the decision-making process. Attending to issues of process, authority, and values in MDMs has the potential to improve cancer care decision making and ultimately, health outcomes. PMID:25281239

Dew, Kevin; Stubbe, Maria; Signal, Louise; Stairmand, Jeannine; Dennett, Elizabeth; Koea, Jonathan; Simpson, Andrew; Sarfati, Diana; Cunningham, Chris; Batten, Lesley; Ellison-Loschmann, Lis; Barton, Josh; Holdaway, Maureen

2015-03-01

83

Integrating cancer care beyond the hospital and across the cancer pathway: a patient-centred approach.  

PubMed

Cancer patients constitute one of the most complex, diverse and growing patient populations in Canada. Like other high-needs patient groups, cancer patients desire a more integrated approach to care delivery that spans organizational and professional boundaries. This article provides an overview of Cancer Care Ontario's experience in fostering a more integrated cancer system, and describes the organization's emerging focus on patient-centred models of integrated care through the whole cancer pathway, from prevention to end-of-life care and survivorship. PMID:25562131

Evans, Jenna M; Matheson, Garth; Buchman, Sandy; MacKinnon, Marnie; Meertens, Elaine; Ross, Jillian; Johal, Hardeep

2015-01-01

84

Proteomic contributions to personalized cancer care.  

PubMed

Cancer impacts each patient and family differently. Our current understanding of the disease is primarily limited to clinical hallmarks of cancer, but many specific molecular mechanisms remain elusive. Genetic markers can be used to determine predisposition to tumor development, but molecularly targeted treatment strategies that improve patient prognosis are not widely available for most cancers. Individualized care plans, also described as personalized medicine, still must be developed by understanding and implementing basic science research into clinical treatment. Proteomics holds great promise in contributing to the prevention and cure of cancer because it provides unique tools for discovery of biomarkers and therapeutic targets. As such, proteomics can help translate basic science discoveries into the clinical practice of personalized medicine. Here we describe how biological mass spectrometry and proteome analysis interact with other major patient care and research initiatives and present vignettes illustrating efforts in discovery of diagnostic biomarkers for ovarian cancer, development of treatment strategies in lung cancer, and monitoring prognosis and relapse in multiple myeloma patients. PMID:18664563

Koomen, John M; Haura, Eric B; Bepler, Gerold; Sutphen, Rebecca; Remily-Wood, Elizabeth R; Benson, Kaaron; Hussein, Mohamad; Hazlehurst, Lori A; Yeatman, Timothy J; Hildreth, Lynne T; Sellers, Thomas A; Jacobsen, Paul B; Fenstermacher, David A; Dalton, William S

2008-10-01

85

Selecting health care providers: “Any willing provider” vs. negotiation  

Microsoft Academic Search

We study how a third-party payer decides what providers to contract with. Two mechanisms are studied and their properties compared. A first mechanism consists of the so-called “any willing provider” where the third-party payer announces a contract and every provider freely decides to sign it or not. The second mechanism is a bargaining procedure with the providers set up by

Pedro Pita Barros; Xavier Martinez-Giralt

2008-01-01

86

Providing and financing aged care in Australia  

PubMed Central

This article focuses on the provision and financing of aged care in Australia. Demand for aged care will increase substantially as a result of population aging, with the number of Australians aged 85 and over projected to increase from 400,000 in 2010 to over 1.8 million in 2051. Meeting this demand will greatly strain the current system, and makes it important to exploit opportunities for increased efficiency. A move to greater beneficiary co-payments is also likely, though its extent may depend on whether aged care insurance and other forms of pre-payment can develop. PMID:22312229

Ergas, Henry; Paolucci, Francesco

2011-01-01

87

Impact of computer-assisted data collection, evaluation and management on the cancer genetic counselor’s time providing patient care  

Microsoft Academic Search

Cancer genetic counseling sessions traditionally encompass collecting medical and family history information, evaluating that\\u000a information for the likelihood of a genetic predisposition for a hereditary cancer syndrome, conveying that information to\\u000a the patient, offering genetic testing when appropriate, obtaining consent and subsequently documenting the encounter with\\u000a a clinic note and pedigree. Software programs exist to collect family and medical history

Stephanie A. CohenDawn; Dawn E. McIlvried

2011-01-01

88

How Do Health Care Providers Diagnose Osteogenesis Imperfecta?  

MedlinePLUS

... Information Clinical Trials Resources and Publications How do health care providers diagnose osteogenesis imperfecta (OI)? Skip sharing on ... Page Content If OI is moderate or severe, health care providers usually diagnose it during prenatal ultrasound at ...

89

How Do Health Care Providers Diagnose Menkes Disease?  

MedlinePLUS

... Information Clinical Trials Resources and Publications How do health care providers diagnose Menkes disease? Skip sharing on social ... 3 months old. To diagnose Menkes disease, a health care provider will order blood tests to measure the ...

90

How Do Health Care Providers Diagnose Prader-Willi Syndrome?  

MedlinePLUS

... Information Clinical Trials Resources and Publications How do health care providers diagnose Prader-Willi syndrome (PWS)? Skip sharing ... a "floppy" body and weak muscle tone, a health care provider may conduct genetic testing for Prader-Willi ...

91

How Do Health Care Providers Diagnose Bacterial Vaginosis (BV)?  

MedlinePLUS

... Information Clinical Trials Resources and Publications How do health care providers diagnose bacterial vaginosis (BV)? Skip sharing on ... BV requires a vaginal exam by a qualified health care provider and the laboratory testing of fluid collected ...

92

How Do Health Care Providers Diagnose Pregnancy Loss or Miscarriage?  

MedlinePLUS

... Trials Resources and Publications En Español How do health care providers diagnose pregnancy loss or miscarriage? Skip sharing ... light spotting, or bleeding, she should contact her health care provider immediately. For diagnosis, the woman may need ...

93

How Do Health Care Providers Diagnose Neural Tube Defects?  

MedlinePLUS

... Information Clinical Trials Resources and Publications How do health care providers diagnose neural tube defects? Skip sharing on ... AFP, as well as high levels of acetylcholinesterase; health care providers might conduct this test to confirm high ...

94

How Do Health Care Providers Diagnose Adrenal Gland Disorders?  

MedlinePLUS

... Trials Resources and Publications En Español How do health care providers diagnose adrenal gland disorders? Skip sharing on ... and urine tests. 1 Cushing’s Syndrome If a health care provider suspects Cushing’s syndrome, he or she may ...

95

How Do Health Care Providers Diagnose Intellectual & Developmental Disabilities (IDDs)?  

MedlinePLUS

... Trials Resources and Publications En Español How do health care providers diagnose IDDs? Skip sharing on social media ... 1 This type of test will help the health care provider examine the ability of a person to ...

96

How Do Health Care Providers Diagnose Down Syndrome?  

MedlinePLUS

... Trials Resources and Publications En Español How do health care providers diagnose Down syndrome? Skip sharing on social media links Share this: Page Content Health care providers can check for Down syndrome during pregnancy ...

97

How Do Health Care Providers Diagnose Phenylketonuria (PKU)?  

MedlinePLUS

... Information Clinical Trials Resources and Publications How do health care providers diagnose phenylketonuria (PKU)? Skip sharing on social ... disabilities. 2 How are newborns tested for PKU? Health care providers conduct a PKU screening test using a ...

98

How Do Health Care Providers Diagnose Traumatic Brain Injury (TBI)?  

MedlinePLUS

... Trials Resources and Publications En Español How do health care providers diagnose traumatic brain injury (TBI)? Skip sharing ... links Share this: Page Content To diagnose TBI, health care providers may use one or more tests that ...

99

How Do Health Care Providers Diagnose Birth Defects?  

MedlinePLUS

... Information Clinical Trials Resources and Publications How do health care providers diagnose birth defects? Skip sharing on social ... to begin before health problems occur. Prenatal Screening Health care providers recommend that certain pregnant women, including those ...

100

How Do Health Care Providers Diagnose Turner Syndrome?  

MedlinePLUS

... Information Clinical Trials Resources and Publications How do health care providers diagnose Turner syndrome? Skip sharing on social media links Share this: Page Content Health care providers use a combination of physical symptoms and ...

101

How Do Health Care Providers Diagnose Fragile X Syndrome?  

MedlinePLUS

... Information Clinical Trials Resources and Publications How do health care providers diagnose Fragile X syndrome? Skip sharing on social media links Share this: Page Content Health care providers often use a blood sample to diagnose ...

102

How Do Health Care Providers Diagnose Primary Ovarian Insufficiency (POI)?  

MedlinePLUS

... Information Clinical Trials Resources and Publications How do health care providers diagnose POI? Skip sharing on social media ... having periods for 4 months or longer, her health care provider may take these steps to diagnose the ...

103

How Do Health Care Providers Diagnose Cushing's Syndrome?  

MedlinePLUS

... Information Clinical Trials Resources and Publications How do health care providers diagnose Cushing’s syndrome? Skip sharing on social ... easily recognized when it is fully developed, but health care providers try to diagnose and treat it well ...

104

How Do Health Care Providers Diagnose Menstrual Irregularities?  

MedlinePLUS

... Trials Resources and Publications En Español How do health care providers diagnose menstrual irregularities? Skip sharing on social media links Share this: Page Content A health care provider diagnoses menstrual irregularities using a combination of ...

105

How Do Health Care Providers Diagnose Rett Syndrome?  

MedlinePLUS

... Information Clinical Trials Resources and Publications How do health care providers diagnose Rett syndrome? Skip sharing on social ... Rett syndrome may not always be present, so health care providers also need to evaluate the child's symptoms ...

106

How Do Health Care Providers Diagnose Polycystic Ovary Syndrome (PCOS)?  

MedlinePLUS

... Trials Resources and Publications En Español How do health care providers diagnose PCOS? Skip sharing on social media links Share this: Page Content Your health care provider may suspect PCOS if you have eight ...

107

47 CFR 54.601 - Health care provider eligibility.  

...under this subpart. (b) Determination of health care provider eligibility for the Healthcare Connect Fund. Health care providers in the Healthcare Connect Fund may certify to the eligibility of particular sites at any time...

2014-10-01

108

A Marketing Kit for Family Day Care Providers.  

ERIC Educational Resources Information Center

This kit is intended to help family day care providers educate the general public about who providers are, what they do, and the importance of what they do. Among the materials in the kit are a marketing tip sheet that lists steps day care providers can take to market their program; steps they can take to improve the image of family day care in…

National Council of Jewish Women, New York, NY.

109

Child Care Provider's Guide to Safe Sleep  

MedlinePLUS

... do? Follow these guidelines to help protect the infants in your care: Create a Safe Sleep Policy Create and use a written safe sleep ... every sleep. To reduce the risks of SIDS, infants should be placed for sleep in a supine position (completely on the back) ...

110

The Role of Child Care Providers in Child Abuse Prevention  

ERIC Educational Resources Information Center

Child care providers are likely to be the professionals who most frequently interact with families with young children. Thus, infant and toddler child care providers are uniquely positioned to recognize and respond to families' needs for information and support. This article describes knowledge, skills, and strategies that support child care

Seibel, Nancy L.; Gillespie, Linda G.; Temple, Tabitha

2008-01-01

111

Teledermatology Consultations Provide Specialty Care for Farmworkers in Rural Clinics  

ERIC Educational Resources Information Center

Context: Rural patients have limited access to dermatologic care. Farmworkers have high rates of skin disease and limited access to care. Purpose: This exploratory study assessed whether teledermatology consultations could help meet the needs of health care providers for farmworkers in rural clinics. Methods: Dermatologists provided 79…

Vallejos, Quirina M.; Quandt, Sara A.; Feldman, Steven R.; Fleischer, Alan B., Jr.; Brooks, Thanh; Cabral, Gonzalo; Heck, Judy; Schulz, Mark R.; Verma, Amit; Whalley, Lara E.; Arcury, Thomas A.

2009-01-01

112

Consumers Learning To Recognize High-Value Health Care Providers  

MedlinePLUS

... salud para tà Newsletters Events Newsroom Navigating the Health Care System Advice Columns from Dr. Carolyn Clancy Former ... 3 2012 Consumers Learning To Recognize High-Value Health Care Providers By Carolyn M. Clancy, M.D. As ...

113

Questions to Ask a Veteran's Health Care Providers  

MedlinePLUS

... caregiver.va.gov Questions to Ask a Veteran’s Health Care Providers . The list of questions below can help ... you accept? . Planning for Discharge from the Hospital/Health Care Facility . As part of the process of planning ...

114

Nutrition in Cancer Care (PDQ)  

MedlinePLUS

... with cancer. Healthy eating habits are important during cancer treatment. Nutrition therapy is used to help cancer patients ... all the nutrients from the food. Cancer and cancer treatments may affect nutrition. For many patients, the effects ...

115

Value of cancer care: ethical considerations for the practicing oncologist.  

PubMed

The value of cancer care has emerged at the center of a national discourse on fiscal responsibility and resource allocation. The cost of cancer care is rising at a higher pace than any other area of health care. As we struggle to address this unsustainable rise in cancer expenditures, oncology providers are forced to examine our practice patterns and our contributions to the overall health care cost burden. This article provides an oncologist-centered examination of our duties to individual patients and how they may seem at odds with our duties to society. It also discusses how oncology providers can do their part to contain health care costs while honoring their professional obligation to do their best for each patient. PMID:24857095

Jagsi, Reshma; Sulmasy, Daniel P; Moy, Beverly

2014-01-01

116

Compassion Fatigue and Secondary Traumatization: Provider Self Care on Intensive Care Units for Children  

Microsoft Academic Search

IntroductionUnexpressed grief in health care providers who care for chronically ill children may lead to the development of some symptoms of compassion fatigue. The purpose of this study was to describe the scope of compassion fatigue in health care providers working on critical care units with children. A secondary aim was to evaluate the effectiveness of providing educational seminars on

Patrick Meadors; Angela Lamson

2008-01-01

117

Selecting Negotiation Processes with Health Care Providers  

Microsoft Academic Search

We address the question of how a third-party payer (e.g. an insurer) de- cides what providers to contract with. Two different mechanisms are stud- ied and their properties compared. A first mechanism consists in the third- party payer setting up a bargaining procedure with both providers. The sec- ond mechanism is the so-called \\

Pedro Pita Barros; Xavier Martinez-Giralt

2004-01-01

118

Selecting Negotiation Processes with Health Care Providers  

Microsoft Academic Search

We address the question of how a third-party payer (e.g. an insurer) decides what providers to contract with. Two different mechanisms are studied and their properties compared. A first mechanism consists in the third party payer setting up a bargaining procedure with both providers. The second mechanism is the so-called \\

Pedro Pita Barros; Xavier Martinez-Giralt

2003-01-01

119

Developing a service model that integrates palliative care throughout cancer care: the time is now.  

PubMed

Palliative care is a fundamental component of cancer care. As part of the 2011 to 2012 Leadership Development Program (LDP) of the American Society of Clinical Oncology (ASCO), a group of participants was charged with advising ASCO on how to develop a service model integrating palliative care throughout the continuum of cancer care. This article presents the findings of the LDP group. The group focused on the process of palliative care delivery in the oncology setting. We identified key elements for models of palliative care in various settings to be potentially equitable, sustainable, feasible, and acceptable, and here we describe a dynamic model for the integrated, simultaneous implementation of palliative care into oncology practice. We also discuss critical considerations to better integrate palliative care into oncology, including raising consciousness and educating both providers and the public about the importance of palliative care; coordinating palliative care efforts through strengthening affiliations and/or developing new partnerships; prospectively evaluating the impact of palliative care on patient and provider satisfaction, quality improvement, and cost savings; and ensuring sustainability through adequate reimbursement and incentives, including linkage of performance data to quality indicators, and coordination with training efforts and maintenance of certification requirements for providers. In light of these findings, we believe the confluence of increasing importance of incorporation of palliative care education in oncology education, emphasis on value-based care, growing use of technology, and potential cost savings makes developing and incorporating palliative care into current service models a meaningful goal. PMID:25199756

Partridge, Ann H; Seah, Davinia S E; King, Tari; Leighl, Natasha B; Hauke, Ralph; Wollins, Dana S; Von Roenn, Jamie Hayden

2014-10-10

120

Contribution of imaging to cancer care costs.  

PubMed

Health care costs in the United States are increasing faster than the gross domestic product (GDP), and the growth rate of costs related to diagnostic imaging exceeds those of overall health care expenditures. Here we show that the contribution of imaging to cancer care costs pales in comparison to those of other key cost components, such as cancer drugs. Specifically, we estimate that (18)F-FDG PET or PET/CT accounted for approximately 1.5% of overall Medicare cancer care costs in 2009. Moreover, we propose that the appropriate use of (18)F-FDG PET or PET/CT could reduce the costs of cancer care. Because the U.S. health care system is complex and because it is difficult to find accurate data elsewhere, most cost and use assessments are based on published data from the U.S. Centers for Medicare & Medicaid Services. PMID:22144560

Yang, Yang; Czernin, Johannes

2011-12-01

121

Health Care Provider Value Chain Lukasz Kawczynski, Marco Taisch  

E-print Network

Health Care Provider Value Chain Lukasz Kawczynski, Marco Taisch Department of Management health care system. This paper aims to propose a value definition and a value chain model within the health care. In order to define value patients and experts were surveyed. The proposed definition offers

Boyer, Edmond

122

Asthma Information Handbook for Early Care and Education Providers  

ERIC Educational Resources Information Center

With proper care, most children with asthma can lead normal, active lives and can enter school with the same abilities as other children. For this purpose, the Asthma Information Packet for Early Care and Education Providers was designed to cover the following topics: (1) Basic information; (2) How to improve early care and education environments…

California Childcare Health Program, 2004

2004-01-01

123

The University as Health Care Provider.  

ERIC Educational Resources Information Center

University hospitals came into existence as an ancillary activity, providing future physicians with important educational experiences, then became established as an expected part of the institution. Technological advances and rising costs caused universities to sell hospitals, potentially changing their role in the educational system. Universities…

Trachtenberg, Stephen Joel

1997-01-01

124

Lactose Intolerance: Information for Health Care Providers  

E-print Network

Providers Most tweens* and teens are not getting the recommended 1,300 mg of calcium a day they need in osteoporosis prevention. The tween and teen years are critical for bone development because most bone mass accumulates during this time. In fact, by the time teens finish their growth spurts around age 17, 90 percent

Rau, Don C.

125

Defining Value in Cancer Care: AVBCC 2012 Steering Committee Report  

PubMed Central

Approximately 200 oncologists, payers, employers, managed care executives, pharmacy benefit managers, and other healthcare stakeholders convened in Houston, TX, on March 28–31, 2012, for the Second Annual Conference of the Association for Value-Based Cancer Care (AVBCC). The mission of the conference was to align the various perspectives around the growing need of defining value in cancer care and developing strategies to enhance patient outcomes. The AVBCC conference presented a forum for the various viewpoints from all the stakeholders across the cancer care continuum, featuring more than 20 sessions and symposia led by nearly 30 oncology leaders. The discussions focused on current trends and challenges in optimizing value in oncology by reducing or controlling cost while improving care quality and patient outcomes, introducing emerging approaches to management and tools that providers and payers are using to enhance cancer care collaboratively. The AVBCC Second Annual Conference was opened by a Steering Committee discussion of 11 panel members who attempted to define value in cancer care and articulated action steps that can help to implement value into cancer care delivery. The following summary represents highlights from the Steering Committee discussion, which was moderated by Gene Beed, MD, and Gary M. Owens, MD. PMID:24991320

Beed, Gene; Owens, Gary M.; Benson, Al B.; Klein, Ira M.; Silver, Samuel M.; Beveridge, Roy A.; Malin, Jennifer; Sprandio, John D.; Deligdish, Craig K.; Mitchell, Matthew; Vogenberg, F. Randy; Fox, John; Newcomer, Lee N.

2012-01-01

126

Coordinating care and treatment for cancer patients.  

PubMed

Survival following a diagnosis of cancer is contingent upon an interplay of factors, some non-modifiable (e.g., age, sex, genetics) and some modifiable (e.g., volitional choices) but the majority determined by circumstance (personal, social, health system context and capacity, and health policy). Accordingly, mortality and survival rates vary considerably as a function of geography, opportunity, wealth and development. Quality of life is impacted similarly, such that aspects of care related to coordination and integration of care across primary, community and specialist environments; symptom control, palliative and end-of-life care for those who will die of cancer; and survivorship challenges for those who will survive cancer, differs greatly across low, middle and high-income resource settings. Session 3 of the 4th International Cancer Control Congress (ICCC-4) focused on cancer care and treatment through three plenary presentations and five interactive workshop discussions: 1) establishing, implementing, operating and sustaining the capacity for quality cancer care; 2) the role of primary, community, and specialist care in cancer care and treatment; 3) the economics of affordable and sustainable cancer care; 4) issues around symptom control, support, and palliative/end-of-life care; and 5) issues around survivorship. A number of recommendations were proposed relating to capacity-building (standards and guidelines, protocols, new technologies and training and deployment) for safe, appropriate evidence-informed care; mapping and analysis of variations in primary, community and specialist care across countries with identification of models for effective, integrated clinical practice; the importance of considering the introduction, or expansion, of evidence-supported clinical practices from the perspectives of health economic impact, the value for health resources expended, and sustainability; capacity-building for palliative, end-of-life care and symptom control and integration of these services into national cancer control plans; the need for public education to reduce the fear and stigma associated with cancer so that patients are better able to make informed decisions regarding follow-up care and treatment; and the need to recognize the challenges and needs of survivors, their increasing number, the necessity to integrate survivorship into cancer control plans and the economic and societal value of functional survival after cancer. Discussions highlighted that coordinated care and treatment for cancer patients is both a ' systems'challenge and solution, requiring the consideration of patient and family circumstances, societal values and priorities, the functioning of the health system (access, capacity, resources, etc.) and the importance assigned to health and illness management within public policy. PMID:22631594

Yip, Cheng Har; Samiei, Massoud; Cazap, Eduardo; Rosenblatt, Eduardo; Datta, Niloy Ranjan; Camacho, Rolando; Weller, David; Pannarunothai, Supasit; Goh, Cynthia; Black, Fraser; Kaur, Ranjit; Fitch, Margaret; Sutcliffe, Catherine; Sutcliffe, Simon

2012-01-01

127

Quality of Cancer Care - Applied Research  

Cancer.gov

The purpose of these efforts, substantially supported by the Applied Research Program, is to enhance the state of the science on the quality of cancer care and inform federal and private-sector decision making on care delivery, coverage, regulation, and standard setting. Work is underway to make cancer a working model for quality of care research and the translation of this research into practice.

128

Health in Day Care: A Training Guide for Day Care Providers.  

ERIC Educational Resources Information Center

Written for trainers of day care staff, this guide provides help in communicating to day care personnel the information presented in "Health in Day Care: A Manual for Day Care Providers," originally developed by a division of the Massachusetts Department of Health and adapted for national use by the Georgetown University Child Development Center.…

Pokorni, Judith L.; Kaufmann, Roxane K.

129

Mexican American Males Providing Personal Care for Their Mothers  

ERIC Educational Resources Information Center

We know little about Mexican American (MA) family adaptation to critical events in the informal caregiving experience but, in these days of economic and social turmoil, sons must sometimes step up to provide personal care for their aging mothers. This article compares two empirically real cases of MA males who provided such care, in lieu of a…

Evans, Bronwynne C.; Belyea, Michael J.; Ume, Ebere

2011-01-01

130

Protecting children from sexual abuse by health care providers.  

PubMed

Sexual abuse or exploitation of children is never acceptable. Such behavior by health care providers is particularly concerning because of the trust that children and their families place on adults in the health care profession. The American Academy of Pediatrics strongly endorses the social and moral prohibition against sexual abuse or exploitation of children by health care providers. The academy opposes any such sexual abuse or exploitation by providers, particularly by the academy's members. Health care providers should be trained to recognize and abide by appropriate provider-patient boundaries. Medical institutions should screen staff members for a history of child abuse issues, train them to respect and maintain appropriate boundaries, and establish policies and procedures to receive and investigate concerns about patient abuse. Each person has a responsibility to ensure the safety of children in health care settings and to scrupulously follow appropriate legal and ethical reporting and investigation procedures. PMID:21708795

2011-08-01

131

Grassroots Organizing: A Handbook for Child Care Teachers and Family Child Care Providers. Revised Second Edition.  

ERIC Educational Resources Information Center

The Center for the Child Care Workforce (formerly the Child Care Employee Project), has provided leadership for a nationwide grassroots effort called the Worthy Wage Campaign, an activist initiative to increase public awareness and to press for a public investment of child care funds directly targeted to improving child care jobs. This handbook…

Center for the Child Care Workforce, Washington, DC.

132

Logic Regression for Provider Effects on Kidney Cancer Treatment Delivery  

PubMed Central

In the delivery of medical and surgical care, often times complex interactions between patient, physician, and hospital factors influence practice patterns. This paper presents a novel application of logic regression in the context of kidney cancer treatment delivery. Using linked data from the National Cancer Institute's (NCI) Surveillance, Epidemiology, and End Results (SEER) program and Medicare we identified patients diagnosed with kidney cancer from 1995 to 2005. The primary endpoints in the study were use of innovative treatment modalities, namely, partial nephrectomy and laparoscopy. Logic regression allowed us to uncover the interplay between patient, provider, and practice environment variables, which would not be possible using standard regression approaches. We found that surgeons who graduated in or prior to 1980 despite having some academic affiliation, low volume surgeons in a non-NCI hospital, or surgeons in rural environment were significantly less likely to use laparoscopy. Surgeons with major academic affiliation and practising in HMO, hospital, or medical school based setting were significantly more likely to use partial nephrectomy. Results from our study can show efforts towards dismantling the barriers to adoption of innovative treatment modalities, ultimately improving the quality of care provided to patients with kidney cancer. PMID:24795774

Banerjee, Mousumi; Filson, Christopher; Xia, Rong; Miller, David C.

2014-01-01

133

Home Care Nursing Improves Cancer Symptom Management  

Cancer.gov

Home care nursing (HCN) improves the management of symptoms in breast and colorectal cancer patients who take the oral chemotherapy drug capecitabine, according to a study published online November 16, 2009, in the Journal of Clinical Oncology.

134

Multilevel Factors Affecting Quality: Examples From the Cancer Care Continuum  

PubMed Central

The complex environmental context must be considered as we move forward to improve cancer care and, ultimately, patient and population outcomes. The cancer care continuum represents several care types, each of which includes multiple technical and communication steps and interfaces among patients, providers, and organizations. We use two case scenarios to 1) illustrate the variability, diversity, and interaction of factors from multiple levels that affect care quality and 2) discuss research implications and provide hypothetical examples of multilevel interventions. Each scenario includes a targeted literature review to illustrate contextual influences upon care and sets the stage for theory-informed interventions. The screening case highlights access issues in older women, and the survivorship case illustrates the multiple transition challenges faced by patients, families, and organizations. Example interventions show the potential gains of implementing intervention strategies that work synergistically at multiple levels. While research examining multilevel intervention is a priority, it presents numerous study design, measurement, and analytic challenges. PMID:22623591

Taplin, Stephen H.; Ganz, Patricia; Grunfeld, Eva; Sterba, Katherine

2012-01-01

135

Pesticides and electronic resources for health care providers.  

PubMed

Agricultural workers are at higher risk of occupational injuries, including pesticide exposures. There is general agreement that the training of health care providers to recognize and manage such exposures is limited and in need of improvement. While the Internet presents opportunities for health care providers to access information and continue their medical education, it can be difficult to identify relevant resources in a timely manner. This case report presents a realistic scenario of a suspected pesticide exposure among symptomatic agricultural workers. The discussion that follows presents Web-based resources that health care providers can rely upon in recognizing, managing, and preventing pesticide-related illness. PMID:15927917

Sudakin, Daniel L

2005-01-01

136

Environmental Management of Pediatric Asthma: Guidelines for Health Care Providers  

ERIC Educational Resources Information Center

These guidelines are the product of a new Pediatric Asthma Initiative aimed at integrating environmental management of asthma into pediatric health care. This document outlines competencies in environmental health relevant to pediatric asthma that should be mastered by primary health care providers, and outlines the environmental interventions…

Roberts, James R.; McCurdy, Leyla Erk

2005-01-01

137

Knowledge and Attitudes of Health Care Providers Working in Primary Health Care Units Concerning Emergency Contraception  

Microsoft Academic Search

Aims: The aim of the current study was to explore the extent of knowledge health care providers working in primary health care units in Aydin, Turkey, had about emergency contraception (EC), to determine whether they provide EC counseling, and to understand the barriers and misconceptions in this context. Methods: A total of 120 health care professionals working in primary health

Hilmiye Aksu; Mert Kucuk; Banu Karaoz

2010-01-01

138

Using the National Provider Identifier for Health Care Workforce Evaluation  

PubMed Central

The establishment in recent years of a National Provider Identifier (NPI) offers a new method for counting and categorizing physicians and other health care professionals involved in clinical care. In this paper, I describe how the NPI is assigned, the information collected in association with assigning the NPI, potential ways to enhance information on health professionals through data linkages using the NPI, and how the assessment of the health care workforce could be improved by requiring health care professionals to update their information as a part of maintaining their NPI. PMID:24753977

Bindman, Andrew B.

2013-01-01

139

Providing high-quality care in North Carolina nursing homes.  

PubMed

Quality in North Carolina's nursing facilities is intertwined in multiple dimensions of person-centered care, evidence-based practice, innovation, pursuit of continued excellence, meaningful relationships, and recognition of choice and autonomy. By striving to excel in their role of providing skilled nursing care for medically related acuity, North Carolina's nursing facilities have been a contributor to the growth of the long-term care continuum, enabling North Carolina to have an extensive and well-developed system of skilled care and home- and community-based service models. PMID:25237874

Welsh, Polly Godwin; Kivisto, Eric

2014-01-01

140

Survey of Physician Attitudes Regarding the Care of Cancer Survivors (SPARCCS)  

Cancer.gov

The overall purpose of the Survey of Physician Attitudes Regarding the Care of Cancer Survivors (SPARCCS) is to identify perceptions, knowledge, and practices of primary care and oncology specialist physicians regarding post-treatment follow-up care of adult cancer survivors. This national survey will provide information that is not available from other sources, and will lead to identification of opportunities for improving care delivery experiences for both cancer survivors and their physicians.

141

Integrating advanced practice providers into medical critical care teams.  

PubMed

Because there is increasing demand for critical care providers in the United States, many medical ICUs for adults have begun to integrate nurse practitioners and physician assistants into their medical teams. Studies suggest that such advanced practice providers (APPs), when appropriately trained in acute care, can be highly effective in helping to deliver high-quality medical critical care and can be important elements of teams with multiple providers, including those with medical house staff. One aspect of building an integrated team is a practice model that features appropriate coding and billing of services by all providers. Therefore, it is important to understand an APP's scope of practice, when they are qualified for reimbursement, and how they may appropriately coordinate coding and billing with other team providers. In particular, understanding when and how to appropriately code for critical care services (Current Procedural Terminology [CPT] code 99291, critical care, evaluation and management of the critically ill or critically injured patient, first 30-74 min; CPT code 99292, critical care, each additional 30 min) and procedures is vital for creating a sustainable program. Because APPs will likely play a growing role in medical critical care units in the future, more studies are needed to compare different practice models and to determine the best way to deploy this talent in specific ICU settings. PMID:23460162

McCarthy, Christine; O'Rourke, Nancy C; Madison, J Mark

2013-03-01

142

Development of the cancer survivorship care plan: what's next? Life after cancer treatment.  

PubMed

Long-term information needs are increasingly important as more people are diagnosed with cancer and living well beyond initial diagnosis and treatment. Consequently, cancer is joining the ranks of chronic conditions (e.g., asthma, diabetes) for which ongoing, long-term surveillance and management should be the model of care. However, the post-treatment period is fraught with uncertainty for patients and care providers. The "who, what, and when" of follow-up care, in particular, can be complex and confusing. Therefore, survivorship care plans (SCPs) are recommended. The Minnesota Cancer Alliance, a coalition working to improve quality of life for cancer survivors, developed a patient-focused SCP. This user-friendly SCP could be considered for use in patient care--particularly by nurses, who are well suited and positioned to implement SCPs. PMID:23715704

Jackson, Jody M; Scheid, Kathy; Rolnick, Sharon J

2013-06-01

143

29 CFR 825.125 - Definition of health care provider.  

Code of Federal Regulations, 2013 CFR

...certification of the existence of a serious health condition to substantiate a claim for benefits; and (5) A health care provider listed above who...to diagnose and treat physical or mental health...

2013-07-01

144

29 CFR 825.125 - Definition of health care provider.  

Code of Federal Regulations, 2012 CFR

...certification of the existence of a serious health condition to substantiate a claim for benefits; and (5) A health care provider listed above who...to diagnose and treat physical or mental health...

2012-07-01

145

29 CFR 825.125 - Definition of health care provider.  

Code of Federal Regulations, 2011 CFR

...certification of the existence of a serious health condition to substantiate a claim for benefits; and (5) A health care provider listed above who...to diagnose and treat physical or mental health...

2011-07-01

146

29 CFR 825.125 - Definition of health care provider.  

Code of Federal Regulations, 2010 CFR

...certification of the existence of a serious health condition to substantiate a claim for benefits; and (5) A health care provider listed above who...to diagnose and treat physical or mental health...

2010-07-01

147

29 CFR 825.125 - Definition of health care provider.  

...certification of the existence of a serious health condition to substantiate a claim for benefits; and (5) A health care provider listed above who...to diagnose and treat physical or mental health...

2014-07-01

148

Talk with Your Health Care Provider about High Cholesterol  

MedlinePLUS

... Talk With Your Health Care Provider About High Cholesterol Partnership for HEALTH Here are some questions to ... prevention.va.gov and April 2009 If your cholesterol is in the desirable range and you are ...

149

Check With Your Health Care Provider About Breast Changes  

Cancer.gov

Check with your health care provider if you notice that your breast looks or feels different. No change is too small to ask about. In fact, the best time to call is when you first notice a breast change.

150

Talk with Your Health Care Provider about High Blood Pressure  

MedlinePLUS

... With Your Health Care Provider About High Blood Pressure Partnership for HEALTH Here are some questions to ... you do to prevent or control high blood pressure? 1. Quit smoking and/or chewing tobacco. Ask ...

151

Communication in Cancer Care (PDQ®)  

Cancer.gov

Expert-reviewed information summary about communicating with the cancer patient and his or her family, including unique aspects of communication with cancer patients, factors affecting communication, and training in communication skills.

152

Spirituality in Cancer Care (PDQ)  

MedlinePLUS

... cancer, may cause spiritual distress. Religious and spiritual values are important to patients coping with cancer. Studies have shown that religious and spiritual values are important to Americans. Most American adults say ...

153

Determinants of survivorship care plan use in US cancer programs.  

PubMed

Cancer programs are increasingly required to use survivorship care plans (SCPs). Compliance with SCP use requirements will be evaluated at the cancer program level. Cancer program-level determinants of SCP use may suggest strategies for compliance. The objective of this study was to describe SCP use and identify its cancer program-level determinants. We surveyed employees knowledgeable about survivorship practices in cancer programs throughout the USA with a wide range of annual incident cancers, program types, and cancer care quality improvement organization memberships (81/100 response rate). We used descriptive statistics to describe SCP use and bivariate statistics to identify its cancer program-level determinants. Most respondents (56 %) reported that SCPs were not used. In programs reporting use, SCP use is restricted primarily to breast (82 %) and colorectal (55 %) cancer survivors, and few providers use SCPs. When developed, SCPs seldom reach survivors and their primary care providers. Most respondents (78 %) reported beginning to use SCPs because of requirements. Frequently cited barriers included insufficient resources (76 %), perceived difficulty using SCPs (29 %), and lack of advocacy for SCP use from influential people (24 %). SCP use was positively associated with academic program type (p?=?.009) and membership in the National Cancer Institute's Community Cancer Centers Program (p?=?.009) and negatively associated with freestanding program type (p?=?.02). SCP use in the US cancer programs is highly inconsistent. Many cancer programs plan to implement SCPs to comply with SCP use requirements. Support specifically intended to facilitate SCP use may be more effective than non-specific resources. PMID:24706174

Birken, Sarah A; Deal, Allison M; Mayer, Deborah K; Weiner, Bryan J

2014-12-01

154

Barriers to cancer care, perceived social support, and patient navigation services for korean breast cancer patients.  

PubMed

The present study aimed to examine the relationships among barriers to cancer care, perceived social support, and patient navigation services (PNS) for Korean breast cancer patients. For Korean breast cancer patients, PNS are comprised of five services, including emotional, financial, information, transportation, and disease management. The study findings demonstrated that transportation and disease management barriers were directly associated with PNS, whereas emotional and financial barriers were indirectly associated with PNS through perceived social support. The current study provides a preliminary Korean patient navigation model to identify how barriers to cancer care can be reduced through social support and PNS. PMID:25588096

Lim, Jung-Won

2015-01-01

155

Research Initiatives | Multidisciplinary Cancer Care in the United States  

Cancer.gov

Multidisciplinary cancer care is a developing area of care delivery research within the NCI's Outcomes Research Branch (ORB). This care delivery paradigm is widely implemented in oncology care settings to assure quality cancer care, and involves leveraging the expertise of clinicians from various disciplines to enable complex treatment decision-making and appropriate and timely care for the patient.

156

Veterans with depression in primary care: Provider preferences, matching, and care satisfaction.  

PubMed

Primary care is often the first point of care for individuals with depression. Depressed patients often have comorbid alcohol use disorder (AUD) and posttraumatic stress disorder (PTSD). Understanding variations in treatment preferences and care satisfaction in this population can improve care planning and outcomes. The design involved a cross-sectional comparison of veterans screening positive for depression. Veterans receiving primary care during the previous year were contacted (n = 10, 929) and were screened for depression using the PHQ-2/PHQ-9. Those with probable depression (n = 761) underwent a comprehensive assessment including screens for AUD and PTSD, treatment provider preferences, treatments received, and satisfaction with care. Treatment provider preferences differed based on specific mental health comorbidities, and satisfaction with care was associated with receipt of preferred care. Depressed veterans with comorbid PTSD were more likely to prefer care from more than one provider type (e.g., a psychiatrist and a primary care provider) and were more likely to receive treatment that matched their preferences than veterans without comorbid PTSD. Veterans receiving full or partial treatment matches affirmed satisfaction with care at higher rates, and veterans with comorbid PTSD were least satisfied when care did not match their preferences. Patient satisfaction with care is an increasingly important focus for health care systems. This study found significant variations in depressed patients' satisfaction with care in terms of treatment matching, particularly among those with comorbid PTSD. Delivery of care that matches patient treatment preferences is likely to improve depressed patient's satisfaction with the care provided. (PsycINFO Database Record (c) 2014 APA, all rights reserved). PMID:25090611

Waltz, Thomas J; Campbell, Duncan G; Kirchner, JoAnn E; Lombardero, Anayansi; Bolkan, Cory; Zivin, Kara; Lanto, Andrew B; Chaney, Edmund F; Rubenstein, Lisa V

2014-12-01

157

Clinical Cancer Care Full screening services and diagnostics  

E-print Network

Clinical Cancer Care · Full screening services and diagnostics · Advanced treatments for all forms of cancer · Most frequent cancers at the Cancer Center: Breast 15% Gastrointestinal 13% Skin 17% Lung 13 treatment protocols that link the latest Cancer Center research to clinical care · Familial Cancer Program

Myers, Lawrence C.

158

President's Cancer Panel Begins Regional Meetings on Cancer Care  

Cancer.gov

The President's Cancer Panel (PCP) has begun a series of regional meetings over the next nine months to hear testimony from all 50 states addressing the question, "Why don't all Americans get the best available care"?

159

Finding Medical Care for Colorectal Cancer Symptoms: Experiences among Those Facing Financial Barriers  

ERIC Educational Resources Information Center

Financial barriers can substantially delay medical care seeking. Using patient narratives provided by 252 colorectal cancer patients, we explored the experience of financial barriers to care seeking. Of the 252 patients interviewed, 84 identified financial barriers as a significant hurdle to obtaining health care for their colorectal cancer

Thomson, Maria D.; Siminoff, Laura A.

2015-01-01

160

Human Trafficking: The Role of the Health Care Provider  

PubMed Central

Human trafficking is a major public health problem, both domestically and internationally. Health care providers are often the only professionals to interact with trafficking victims who are still in captivity. The expert assessment and interview skills of providers contribute to their readiness to identify victims of trafficking. The purpose of this article is to provide clinicians with knowledge on trafficking and give specific tools that they may use to assist victims in the clinical setting. Definitions, statistics, and common health care problems of trafficking victims are reviewed. The role of the health care provider is outlined through a case study and clinical practice tools are provided. Suggestions for future research are also briefly addressed. PMID:20732668

Dovydaitis, Tiffany

2011-01-01

161

Human trafficking: the role of the health care provider.  

PubMed

Human trafficking is a major public health problem, both domestically and internationally. Health care providers are often the only professionals to interact with trafficking victims who are still in captivity. The expert assessment and interview skills of providers contribute to their readiness to identify victims of trafficking. The purpose of this article is to provide clinicians with knowledge on trafficking and give specific tools that they may use to assist victims in the clinical setting. Definitions, statistics, and common health care problems of trafficking victims are reviewed. The role of the health care provider is outlined through a case study and clinical practice tools are provided. Suggestions for future research are also briefly addressed. PMID:20732668

Dovydaitis, Tiffany

2010-01-01

162

Chiropractors as Primary Spine Care Providers: precedents and essential measures.  

PubMed

Chiropractors have the potential to address a substantial portion of spinal disorders; however the utilization rate of chiropractic services has remained low and largely unchanged for decades. Other health care professions such as podiatry/chiropody, physiotherapy and naturopathy have successfully gained public and professional trust, increases in scope of practice and distinct niche positions within mainstream health care. Due to the overwhelming burden of spine care upon the health care system, the establishment of a 'primary spine care provider' may be a worthwhile niche position to create for society's needs. Chiropractors could fulfill this role, but not without first reviewing and improving its approach to the management of spinal disorders. Such changes have already been achieved by the chiropractic profession in Switzerland, Denmark, and New Mexico, whose examples may serve as important templates for renewal here in Canada. PMID:24302774

Erwin, W Mark; Korpela, A Pauliina; Jones, Robert C

2013-12-01

163

Chiropractors as Primary Spine Care Providers: precedents and essential measures  

PubMed Central

Chiropractors have the potential to address a substantial portion of spinal disorders; however the utilization rate of chiropractic services has remained low and largely unchanged for decades. Other health care professions such as podiatry/chiropody, physiotherapy and naturopathy have successfully gained public and professional trust, increases in scope of practice and distinct niche positions within mainstream health care. Due to the overwhelming burden of spine care upon the health care system, the establishment of a ‘primary spine care provider’ may be a worthwhile niche position to create for society’s needs. Chiropractors could fulfill this role, but not without first reviewing and improving its approach to the management of spinal disorders. Such changes have already been achieved by the chiropractic profession in Switzerland, Denmark, and New Mexico, whose examples may serve as important templates for renewal here in Canada. PMID:24302774

Erwin, W. Mark; Korpela, A. Pauliina; Jones, Robert C.

2013-01-01

164

Providing Primary Health Care to Children: Integrating Primary Care Services with Health Insurance Principles.  

ERIC Educational Resources Information Center

Examines how health care reform might be structured to provide support for a package of primary care services for children of all socioeconomic strata. An insurance-like financing system, such as the special Medicaid payment system adopted by New York State for public and nonprofit primary health care programs, may be useful as a model for a…

Rosenbaum, Sara

1993-01-01

165

Health in Day Care: A Guide for Day Care Providers in Massachusetts.  

ERIC Educational Resources Information Center

This reference manual and resource guide describes high standards for health policies and day care procedures that reflect current research and recommendations of experts. Chapters 1 and 2, which concern day care's role in health, cover health education in day care and the basics relating to policies, providers, and records. Chapters 3-5 concern…

Kendrick, Abby Shapiro, Ed.; Messenger, Katherine P., Ed.

166

The Journey from Babysitter to Child Care Professional: Military Family Child Care Providers.  

ERIC Educational Resources Information Center

Describes the transformation of women from babysitters to child care professionals as a result of becoming a family child care provider in the U.S. military Family Child Care (FCC) program. Discusses application process, orientation training, the use of peer mentors, initial setup, inspections, enrollment, caregiver training, and accreditation.…

Nielsen, Dianne Miller

2002-01-01

167

We Are Not Babysitters: Family Child Care Providers Redefine Work and Care.  

ERIC Educational Resources Information Center

Drawing on in-depth interviews with 20 family child care providers of diverse race, ethnicity, immigrant status, and social class, this book explores the social, political, and economic forces and processes that draw women into the work of family child care. The articles dispel not only myths about why women choose to be family child care

Tuominen, Mary C.

168

Colorectal Cancer Screening by Primary Care Physicians  

PubMed Central

Background Primary care physicians (hereafter, physicians) play a critical role in the delivery of colorectal cancer (CRC) screening in the U.S. This study describes the CRC screening recommendations and practices of U.S. physicians and compares them to findings from a 1999–2000 national provider survey. Methods Data from 1266 physicians responding to the 2006–2007 National Survey of Primary Care Physicians' Recommendations and Practices for Breast, Cervical, Colorectal, and Lung Cancer Screening (cooperation rate=75%) were analyzed in 2008. Descriptive statistics were used to examine physicians' CRC screening recommendations and practices as well as the office systems used to support screening activities. Sample weights were applied in the analyses to obtain national estimates. Results Ninety-five percent of physicians routinely recommend screening colonoscopy to asymptomatic, average-risk patients; 80% recommend fecal occult blood testing (FOBT). Only a minority recommend sigmoidoscopy, double-contrast barium enema, computed tomographic colonography, or fecal DNA testing. Fifty-six percent recommend two screening modalities; 17% recommend one. Nearly all physicians who recommend endoscopy refer their patients for the procedure. Four percent perform sigmoidoscopy, a 25-percentage-point decline from 1999–2000. Although 61% of physicians reported that their practice had guidelines for CRC screening, only 30% use provider reminders; 15% use patient reminders. Conclusions Physicians' CRC screening recommendations and practices have changed substantially since 1999–2000. Colonoscopy is now the most frequently recommended test. Most physicians do not recommend the full menu of test options prescribed in national guidelines. Few perform sigmoidoscopy. Office systems to support CRC screening are lacking in many physicians' practices. Given ongoing changes in CRC screening technologies and guidelines, the continued monitoring of physicians' CRC screening recommendations and practices is imperative. PMID:19442479

Klabunde, Carrie N.; Lanier, David; Nadel, Marion R.; McLeod, Caroline; Yuan, Gigi; Vernon, Sally W.

2009-01-01

169

Conceptual Models for Integrating Palliative Care at Cancer Centers  

PubMed Central

Abstract Palliative care programs are rapidly evolving in acute care facilities. Increased and earlier access has been advocated for patients with life-threatening illnesses. Existing programs would need major growth to accommodate the increased utilization. The objective of this review is to provide an update on the current structures, processes, and outcomes of the Supportive and Palliative Care Program at the University of Texas M.D. Anderson Cancer Center (UTMDACC), and to use the update as a platform to discuss the challenges and opportunities in integrating palliative and supportive services in a tertiary care cancer center. Our interprofessional program consists of a mobile consultation team, an acute palliative care unit, and an outpatient supportive care clinic. We will discuss various metrics including symptom outcomes, quality of end-of-life care, program growth, and financial issues. Despite the growing evidence to support early palliative care involvement, referral to palliative care remains heterogeneous and delayed. To address this issue, we will discuss various conceptual models and practical recommendations to optimize palliative care access. PMID:22925157

Hui, David

2012-01-01

170

Continuous primary care is central to comprehensive cancer care: are we ready to meet growing needs?  

PubMed Central

Primary care engagement is essential to meet the need for high quality, comprehensive, long-term cancer care. Primary care currently serves an integral role as the point of care for preventive and surveillance cancer screenings. As cancer prevalence rises, primary care will increasingly serve a growing need for care continuity as patients transition between screening, active treatment and continued follow-up care. PMID:24204057

Hudson, Shawna V.

2015-01-01

171

Home Care for Cancer Patients  

MedlinePLUS

... be given by authorized agencies. Contact the insurance company to see which services are covered. Many national organizations, such as the American Cancer Society (ACS), offer services to cancer patients and their families. Services vary among ACS chapters; however, many of ...

172

Understanding & Influencing Multilevel Factors Across the Cancer Care Continuum  

Cancer.gov

The National Cancer Institute (NCI) Division of Cancer Control and Population Sciences is pleased to announce the May 2012 Journal of the National Cancer Institute (JNCI) Special Issue, Understanding and Influencing Multilevel Factors Across the Cancer Care Continuum.

173

Childhood cancer survivor care: development of the Passport for Care.  

PubMed

Survivors of childhood cancer are at risk of long-term adverse effects and late effects of the disease and/or its treatment. In response to national recommendations to improve evidence-based follow-up care, a web-based support system for clinical decision making, the Passport for Care (PFC), was developed for use at the point of care to produce screening recommendations individualized to the survivor. To date, the PFC has been implemented in over half of the nearly 200 clinics affiliated with the Children's Oncology Group across the USA. Most clinician users report that the PFC has been integrated into clinic workflows, and that it fosters improved conversations with survivors about the potential late effects a survivor might experience and about the screening and/or behavioural interventions recommended to improve health status. Furthermore, clinicians using the PFC have indicated that they adhered more closely to follow-up care guidelines. Perspectives on the challenges encountered and lessons learned during the development and deployment of the PFC are reviewed and contrasted with other nationwide approaches to the provision of guidance on survivor follow-up care; furthermore, the implications for the care of childhood cancer survivors are discussed. PMID:25348788

Poplack, David G; Fordis, Michael; Landier, Wendy; Bhatia, Smita; Hudson, Melissa M; Horowitz, Marc E

2014-12-01

174

Breast density legislation. Implications for patients and primary care providers.  

PubMed

Minnesota recently became the 16th state to require facilities that perform mammograms to notify patients if they are found to have dense or extremely dense breasts, as this may make it more difficult to detect a cancer or put them at increased risk for cancer. This article outlines the new law and describes the classification system for breast density, the implications for breast density on screening mammography, and the relationship between breast density and cancer. It also provides guidance for patients who have dense breast tissue regarding supplementary screening. PMID:25158436

Rhodes, Deborah J; Conners, Amy Lynn

2014-07-01

175

Reducing Isolation of Family Child Care Providers by Participation in a Provider-Initiated Support Network.  

ERIC Educational Resources Information Center

Because of the difficulty of finding time for professional and personal development, many family child care (FCC) providers are isolated in their work environment. This practicum study developed a provider-initiated support network to reduce this isolation. The local FCC association provided advertising about the formation of the network. A group…

Wetherington, Patricia Reish

176

How Cancer Survivors Provide Support on Cancer-Related Internet Mailing Lists  

PubMed Central

Background Internet mailing lists are an important and increasingly common way for cancer survivors to find information and support. Most studies of these mailing lists have investigated lists dedicated to one type of cancer, most often breast cancer. Little is known about whether the lessons learned from experiences with breast cancer lists apply to other cancers. Objectives The aim of the study was to compare the structural characteristics of 10 Internet cancer-related mailing lists and identify the processes by which cancer survivors provide support. Methods We studied a systematic 9% sample of email messages sent over five months to 10 cancer mailing lists hosted by the Association of Cancer Online Resources (ACOR). Content analyses were used to compare the structural characteristics of the lists, including participation rates and members’ identities as survivors or caregivers. We used thematic analyses to examine the types of support that list members provided through their message texts. Results Content analyses showed that characteristics of list members and subscriber participation rates varied across the lists. Thematic analyses revealed very little “off topic” discussion. Feedback from listowners indicated that they actively modeled appropriate communication on their lists and worked to keep discussions civil and focused. In all lists, members offered support much more frequently than they requested it; survivors were somewhat more likely than caregivers to offer rather than to ask for support. The most common topics in survivors’ messages were about treatment information and how to communicate with health care providers. Although expressions of emotional support were less common than informational support, they appeared in all lists. Many messages that contained narratives of illness or treatment did not specifically ask for help but provided emotional support by reassuring listmates that they were not alone in their struggles with cancer. Survivors’ explicit expressions of emotional support tended to be messages that encouraged active coping. Such messages also provided senders with opportunities to assume personally empowering “helper” roles that supported self-esteem. Conclusions Many cancer survivors use the Internet to seek informational and emotional support. Across 10 lists for different cancers, informational support was the main communication style. Our finding of an emphasis on informational support is in contrast to most prior literature, which has focused on emotional support. We found the most common expressions of support were offers of technical information and explicit advice about how to communicate with health care providers. Topics and proportions of informational and emotional support differed across the lists. Our previous surveys of ACOR subscribers showed that they join the lists primarily to seek information; this qualitative study shows that they can and do find what they seek. They also find opportunities to play rewarding roles as support givers. PMID:17513283

Lyons, Elizabeth J; Frydman, Gilles; Forlenza, Michael; Rimer, Barbara K

2007-01-01

177

Enhancing the primary care team to provide redesigned care: the roles of practice facilitators and care managers.  

PubMed

Efforts to redesign primary care require multiple supports. Two potential members of the primary care team-practice facilitator and care manager-can play important but distinct roles in redesigning and improving care delivery. Facilitators, also known as quality improvement coaches, assist practices with coordinating their quality improvement activities and help build capacity for those activities-reflecting a systems-level approach to improving quality, safety, and implementation of evidence-based practices. Care managers provide direct patient care by coordinating care and helping patients navigate the system, improving access for patients, and communicating across the care team. These complementary roles aim to help primary care practices deliver coordinated, accessible, comprehensive, and patient-centered care. PMID:23319510

Taylor, Erin Fries; Machta, Rachel M; Meyers, David S; Genevro, Janice; Peikes, Deborah N

2013-01-01

178

Communicating during care transitions for older hip fracture patients: family caregiver and health care provider's perspectives  

PubMed Central

Introduction Older hip fracture patients frequently require care across a variety of settings, from multiple individuals, including their family caregivers. We explored issues related to information sharing during transitional care for older hip fracture patients through the perspectives of both health care providers and family caregivers. Methods Thirty-five semi-structured interviews were conducted with family caregivers (n = 9) and health care providers (n = 26) of six hip fracture patients to gather perspectives on information sharing at each care transition, beginning with post-surgical discharge from acute care. Data were analysed using conventional qualitative content analysis methods using NVivo8 software. Results Both family caregivers and health care providers recognise that family caregivers' involvement has important benefits for patients, but this involvement is frequently limited by poor information sharing. Barriers include limited staff time, patient privacy regulations and lack of a clear structure to guide information sharing. Receiving, not offering, information was the focus of information sharing by both family caregivers and health care providers. Conclusions Specific barriers that lead to poor information sharing between family caregivers and health care providers have been identified in this study. Possible interventions to improve information sharing include encouraging communication with family caregivers as standard care practice, educational strategies and more effective use of health information systems and technologies. PMID:24198738

Glenny, Christine; Stolee, Paul; Sheiban, Linda; Jaglal, Susan

2013-01-01

179

Electronic cigarettes and thirdhand tobacco smoke: two emerging health care challenges for the primary care provider  

PubMed Central

Primary care providers should be aware of two new developments in nicotine addiction and smoking cessation: 1) the emergence of a novel nicotine delivery system known as the electronic (e-) cigarette; and 2) new reports of residual environmental nicotine and other biopersistent toxicants found in cigarette smoke, recently described as “thirdhand smoke”. The purpose of this article is to provide a clinician-friendly introduction to these two emerging issues so that clinicians are well prepared to counsel smokers about newly recognized health concerns relevant to tobacco use. E-cigarettes are battery powered devices that convert nicotine into a vapor that can be inhaled. The World Health Organization has termed these devices electronic nicotine delivery systems (ENDS). The vapors from ENDS are complex mixtures of chemicals, not pure nicotine. It is unknown whether inhalation of the complex mixture of chemicals found in ENDS vapors is safe. There is no evidence that e-cigarettes are effective treatment for nicotine addiction. ENDS are not approved as smoking cessation devices. Primary care givers should anticipate being questioned by patients about the advisability of using e-cigarettes as a smoking cessation device. The term thirdhand smoke first appeared in the medical literature in 2009 when investigators introduced the term to describe residual tobacco smoke contamination that remains after the cigarette is extinguished. Thirdhand smoke is a hazardous exposure resulting from cigarette smoke residue that accumulates in cars, homes, and other indoor spaces. Tobacco-derived toxicants can react to form potent cancer causing compounds. Exposure to thirdhand smoke can occur through the skin, by breathing, and by ingestion long after smoke has cleared from a room. Counseling patients about the hazards of thirdhand smoke may provide additional motivation to quit smoking. PMID:21475626

Kuschner, Ware G; Reddy, Sunayana; Mehrotra, Nidhi; Paintal, Harman S

2011-01-01

180

Strangulation forensic examination: best practice for health care providers.  

PubMed

Strangulation is one of the most dangerous forms of interpersonal violence (IVP), yet it is often not reported and missed by the health care provider because of lack of visible injury. The victim of strangulation can have critical injuries and a late onset symptoms. Victims of IVP should be directly asked whether they were choked or whether during the assault they felt like they could not breathe because of pressure on their neck. The objective of this article is to summarize "best practice" for health care providers so that they are better prepared to care for victims who report a history of strangulation. A summary of how to perform a forensic examination of the strangled patient is provided along with important documentation takeaways and useful forms to ensure that the severity of the strangulation is assessed, that critical injuries are identified, and that all injuries and findings are accurately documented for legal proceedings. PMID:24176831

Faugno, Diana; Waszak, Daria; Strack, Gael B; Brooks, Melodie Ann; Gwinn, Casey G

2013-01-01

181

The ABCs of Safe and Healthy Child Care: A Handbook for Child Care Providers.  

ERIC Educational Resources Information Center

Recognizing the importance of maintaining a safe and healthy child care setting, this manual for home or center child care providers contains information and guidelines to help providers maintain child health and reduce sickness and injuries. Part 1, "Introduction," describes how diseases are spread and how to prevent and prepare for unintentional…

Hale, Cynthia M.; Polder, Jacquelyn A.

182

Primary Care Providers' Perceptions of Home Diabetes Telemedicine Care in the IDEATel Project  

ERIC Educational Resources Information Center

Context: Few telemedicine projects have systematically examined provider satisfaction and attitudes. Purpose: To determine the acceptability and perceived impact on primary care providers' (PCP) practices of a randomized clinical trial of the use of telemedicine to electronically deliver health care services to Medicare patients with diabetes in…

Tudiver, Fred; Wolff, L. Thomas; Morin, Philip C.; Teresi, Jeanne; Palmas, Walter; Starren, Justin; Shea, Steven; Weinstock, Ruth S.

2007-01-01

183

Moving from Evaluation to Value in Cancer Care.  

PubMed

Defining clinically meaningful outcomes for clinical trials provides a foundation for assessing and improving the value of cancer care by conducting multi-disciplinary research in clinical trial design, comparative effectiveness, patient preferences, health outcomes and economics captured through analysis of data generated in clinical trials and real world clinical practice. PMID:25336697

Schilsky, Richard L

2014-10-21

184

78 FR 10117 - Use of Medicare Procedures To Enter Into Provider Agreements for Extended Care Services  

Federal Register 2010, 2011, 2012, 2013

...Enter Into Provider Agreements for Extended Care Services AGENCY: Department of Veterans...provider agreements to obtain extended care services from non-VA providers. In addition...rulemaking proposes to include home health care, palliative care, and...

2013-02-13

185

Agents for Change: Nonphysician Medical Providers and Health Care Quality  

PubMed Central

Quality medical care is a clinical and public health imperative, but defining quality and achieving improved, measureable outcomes are extremely complex challenges. Adherence to best practice invariably improves outcomes. Nonphysician medical providers (NPMPs), such as physician assistants and advanced practice nurses (eg, nurse practitioners, advanced practice registered nurses, certified registered nurse anesthetists, and certified nurse midwives), may be the first caregivers to encounter the patient and can act as agents for change for an organization’s quality-improvement mandate. NPMPs are well positioned to both initiate and ensure optimal adherence to best practices and care processes from the moment of initial contact because they have robust clinical training and are integral to trainee/staff education and the timely delivery of care. The health care quality aspects that the practicing NPMP can affect are objective, appreciative, and perceptive. As bedside practitioners and participants in the administrative and team process, NPMPs can fine-tune care delivery, avoiding the problem areas defined by the Institute of Medicine: misuse, overuse, and underuse of care. This commentary explores how NPMPs can affect quality by 1) supporting best practices through the promotion of guidelines and protocols, and 2) playing active, if not leadership, roles in patient engagement and organizational quality-improvement efforts.

Boucher, Nathan A; McMillen, Marvin A; Gould, James S

2015-01-01

186

Intimate partner violence: a guide for primary care providers.  

PubMed

Women, men, children, and adolescents who self-disclose exposures to or at risk for exposures to intimate partner violence or domestic violence may exhibit moderate-to-severe psycho-social-emotional, mental, and physical healthcare problems. Healthcare providers have a unique opportunity to assist this population in the primary care office. PMID:24253530

Shavers, Clarissa Agee

2013-12-10

187

Prevalence and Predictors of Burnout Among Adult Day Care Providers  

Microsoft Academic Search

Over the past decade, an extensive research literature has focused on stress, burden, and coping among family caregivers to improve the quality of care to dependent elders. Although a better understanding of the prevalence and predictors of burnout among formal service providers could be expected to produce similar benefits, little is known about stress and burnout among paid caregivers. The

Kathleen H. Wilber; Clare V. Specht

1994-01-01

188

Primary Care Providers' Views regarding Assessing and Treating Suicidal Patients  

ERIC Educational Resources Information Center

Primary care providers (PCPs) usually do not explore patient suicidality during routine visits. Factors that predict PCP attitudes toward the assessment and treatment of suicidality were examined via an online survey of 195 practicing PCPs affiliated with medical schools in the United States. PCPs who perceived themselves as competent to work with…

Graham, Ryan D.; Rudd, M. David; Bryan, Craig J.

2011-01-01

189

All-cause readmission to acute care for cancer patients.  

PubMed

A recent Canadian Institute for Health Information report on all-cause readmission identified that cancer patients had higher-than-average readmission rates. This study provides further insight on the experience of cancer patients, exploring the risk factors associated with readmission at patient, hospital and community levels. An analysis showed that patient characteristics, including the reason for initial hospitalization, sex, co-morbidity levels, admission through the emergency department and the number of previous acute care admissions, were associated with readmission for cancer patients. In addition, we found that the readmission rate for these patients varied by hospital size and whether the patients lived in rural or urban locations. PMID:22986560

Ji, Hong; Abushomar, Hani; Chen, Xi-Kuan; Qian, Cheng; Gerson, Darren

2012-01-01

190

Veteran, Primary Care Provider, and Specialist Satisfaction With Electronic Consultation  

PubMed Central

Background Access to specialty care is challenging for veterans in rural locations. To address this challenge, in December 2009, the Veterans Affairs (VA) Pittsburgh Healthcare System (VAPHS) implemented an electronic consultation (e-consult) program to provide primary care providers (PCPs) and patients with enhanced specialty care access. Objective The aim of this quality improvement (QI) project evaluation was to: (1) assess satisfaction with the e-consult process, and (2) identify perceived facilitators and barriers to using the e-consult program. Methods We conducted semistructured telephone interviews with veteran patients (N=15), Community Based Outpatient Clinic (CBOC) PCPs (N=15), and VA Pittsburgh specialty physicians (N=4) who used the e-consult program between December 2009 to August 2010. Participants answered questions regarding satisfaction in eight domains and identified factors contributing to their responses. Results Most participants were white (patients=87%; PCPs=80%; specialists=75%) and male (patients=93%; PCPs=67%; specialists=75%). On average, patients had one e-consult (SD 0), PCPs initiated 6 e-consults (SD 6), and VAPHS specialists performed 17 e-consults (SD 11). Patients, PCPs, and specialty physicians were satisfied with e-consults median (range) of 5.0 (4-5) on 1-5 Likert-scale, 4.0 (3-5), and 3.5 (3-5) respectively. The most common reason why patients and specialists reported increased overall satisfaction with e-consults was improved communication, whereas improved timeliness of care was the most common reason for PCPs. Communication was the most reported perceived barrier and facilitator to e-consult use. Conclusions Veterans and VA health care providers were satisfied with the e-consult process. Our findings suggest that while the reasons for satisfaction with e-consult differ somewhat for patients and physicians, e-consult may be a useful tool to improve VA health care system access for rural patients. PMID:25589233

2015-01-01

191

[Update of breast cancer in primary care (IV/V)].  

PubMed

Breast cancer is a prevalent disease affecting all areas of patients' lives. Therefore, family physicians must thoroughly understand this pathology in order to optimize the health care services and make the best use of available resources, for these patients. A series of 5 articles on breast cancer is presented below. It is based on a review of the scientific literature over the last 10 years. This fourth article deals with the treatment of the disease, the role of the primary care physician, and management of major complications. This summary report aims to provide a current and practical review about this problem, providing answers to family doctors and helping them to support their patients and care for them throughout their illness. PMID:24837185

Álvarez-Hernández, C; Brusint, B; Vich, P; Díaz-García, N; Cuadrado-Rouco, C; Hernández-García, M

2015-01-01

192

Private Companies Providing Health Care Price Data: Who Are They and What Information do They Provide?  

PubMed Central

Summary There is interest in making health care price information more transparent given the increase in enrollment in high-deductible and consumer-directed health plans, and as policy efforts intensify to engage consumers to obtain high value care. We examine the role of private companies that market price transparency tools, primarily to self-insured employers – an important yet understudied topic. What companies exist? How did they emerge? What information do they provide? Where do they get that information? How does the price and quality information provided compare across companies?

Phillips, Kathryn A.; Labno, Anna

2014-01-01

193

An action plan for translating cancer survivorship research into care.  

PubMed

To meet the complex needs of a growing number of cancer survivors, it is essential to accelerate the translation of survivorship research into evidence-based interventions and, as appropriate, recommendations for care that may be implemented in a wide variety of settings. Current progress in translating research into care is stymied, with results of many studies un- or underutilized. To better understand this problem and identify strategies to encourage the translation of survivorship research findings into practice, four agencies (American Cancer Society, Centers for Disease Control and Prevention, LIVE STRONG: Foundation, National Cancer Institute) hosted a meeting in June, 2012, titled: "Biennial Cancer Survivorship Research Conference: Translating Science to Care." Meeting participants concluded that accelerating science into care will require a coordinated, collaborative effort by individuals from diverse settings, including researchers and clinicians, survivors and families, public health professionals, and policy makers. This commentary describes an approach stemming from that meeting to facilitate translating research into care by changing the process of conducting research-improving communication, collaboration, evaluation, and feedback through true and ongoing partnerships. We apply the T0-T4 translational process model to survivorship research and provide illustrations of its use. The resultant framework is intended to orient stakeholders to the role of their work in the translational process and facilitate the transdisciplinary collaboration needed to translate basic discoveries into best practices regarding clinical care, self-care/management, and community programs for cancer survivors. Finally, we discuss barriers to implementing translational survivorship science identified at the meeting, along with future directions to accelerate this process. PMID:25249551

Alfano, Catherine M; Smith, Tenbroeck; de Moor, Janet S; Glasgow, Russell E; Khoury, Muin J; Hawkins, Nikki A; Stein, Kevin D; Rechis, Ruth; Parry, Carla; Leach, Corinne R; Padgett, Lynne; Rowland, Julia H

2014-11-01

194

Family Child Care Health and Safety Checklist: A Packet for Family Child Care Providers [with Videotape].  

ERIC Educational Resources Information Center

This checklist and accompanying video are designed to help family child care providers assess the health and safety of the child care home. The checklist includes suggestions for conducting the self-evaluation and for creating a safer, healthier home environment. The areas of the checklist are: your home, out of bounds areas, gates and guards,…

Kendrick, Abby Shapiro; Gravell, Joanne

195

76 FR 71920 - Payment for Home Health Services and Hospice Care by Non-VA Providers  

Federal Register 2010, 2011, 2012, 2013

...governing payment for other non-VA health care providers. Because the newly applicable...methodology for in- and outpatient health care professional services provided...FR 78901. We explained: Home Health Care and Hospice Care [T]he...

2011-11-21

196

NCI Community Cancer Centers Program - Pilot Subcommittees - Quality of Care  

Cancer.gov

The issue of quality of care involves many different components, including what cancer care quality looks like, which patients are more likely to receive poor quality care, and ways to measure healthcare quality.

197

Challenges in providing culturally-competent care to patients with metastatic brain tumours and their families.  

PubMed

Being diagnosed with a metastatic brain tumour can be devastating as it is characterized by very low cure rates, as well as significant morbidity and mortality. Given the poor life expectancy and progressive disability that ensues, patients and family members experience much turmoil, which includes losses that bring about changes to family roles, routines and relationships. Crisis and conflict are common during such major disruptions to a family system, as individual members attempt to make sense of the illness experience based on cultural and spiritual beliefs, past experiences and personal philosophies. It is imperative health care providers strive towards increased awareness and knowledge of how culture affects the overall experience of illness and death in order to help create a mutually satisfactory care plan. Providing culturally-competent care entails the use of proper communication skills to facilitate the exploration of patient and family perspectives and allows for mutual decision making. A case study will illustrate the challenges encountered in providing culturally-competent care to a woman with brain cancer and her family. As the patient's health declined, the family entered into a state of crisis where communication between family members and health care professionals was strained; leading to conflict and sub-optimal outcomes. This paper will address the ethical dilemma of providing culturally-competent care when a patient's safety is at risk, and the nursing implications of upholding best practices in the context of differing beliefs and priorities. PMID:25265763

Longo, Lianne; Slater, Serena

2014-01-01

198

lColon Cancer Patterns of Care in Chicagoof Care in Chicago  

E-print Network

lColon Cancer Patterns of Care in Chicagoof Care in Chicago Progress, preliminary results Disparities in Stage-Specific Colorectal Cancer Mortality: 1960-2005. Am J Public Health. 2010 October 1, 2010;100(10):1912-6. 2 #12;Colon Cancer Patterns of Care in Chicago · XXXXX · Goals 1. Examine how prior screening

Illinois at Chicago, University of

199

The Effect of Care Setting in the Delivery of High-Value Colon Cancer Care  

PubMed Central

BACKGROUND The effect of care setting on value of colon cancer care is unknown. METHODS A Surveillance, Epidemiology, and End Results (SEER)-Medicare cohort study of 6544 patients aged ?66 years with stage IV colon cancer (based on the American Joint Committee on Cancer staging system) who were diagnosed between 1996 and 2005 was performed. All patients were followed through December 31, 2007. Using outpatient and carrier claims, patients were assigned to a treating hospital based on the hospital affiliation of the primary oncologist. Hospitals were classified academic or nonacademic using the SEER-Medicare National Cancer Institute Hospital File. RESULTS Of the 6544 patients, 1605 (25%) received care from providers affiliated with academic medical centers. The unadjusted median cancer-specific survival was 16.0 months at academic medical centers versus 13.9 months at nonacademic medical centers (P<.001). After adjustment, treatment at academic hospitals remained significantly associated with a reduced risk of death from cancer (hazard ratio, 0.87; 95% confidence interval [95% CI], 0.82–0.93 [P<.001]). Adjusted mean 12-month Medicare spending was $8571 higher at academic medical centers (95% CI, $2340–$14,802; P =.007). The adjusted median cost was $1559 higher at academic medical centers; this difference was not found to be statistically significant (95% CI, ?$5239 to $2122; P =.41). A small percentage of patients who received very expensive care skewed the difference in mean cost; the only statistically significant difference in adjusted costs in quantile regressions was at the 99.9th percentile of costs (P<.001). CONCLUSIONS Among Medicare beneficiaries with stage IV colon cancer, treatment by a provider affiliated with an academic medical center was associated with a 2 month improvement in overall survival. Except for patients in the 99.9th percentile of the cost distribution, costs at academic medical centers were not found to be significantly different from those at nonacademic medical centers. PMID:24954628

Veenstra, Christine M.; Epstein, Andrew J.; Liao, Kaijun; Morris, Arden M.; Pollack, Craig E.; Armstrong, Katrina A.

2015-01-01

200

Consumer satisfaction with primary care provider choice and associated trust  

PubMed Central

Background Development of managed care, characterized by limited provider choice, is believed to undermine trust. Provider choice has been identified as strongly associated with physician trust. Stakeholders in a competitive healthcare market have competing agendas related to choice. The purpose of this study is to analyze variables associated with consumer's satisfaction that they have enough choice when selecting their primary care provider (PCP), and to analyze the importance of these variables on provider trust. Methods A 1999 randomized national cross-sectional telephone survey conducted of United States residential households, who had a telephone, had seen a medical professional at least twice in the past two years, and aged ? 20 years was selected for secondary data analyses. Among 1,117 households interviewed, 564 were selected as the final sample. Subjects responded to a core set of questions related to provider trust, and a subset of questions related to trust in the insurer. A previously developed conceptual framework was adopted. Linear and logistic regressions were performed based on this framework. Results Results affirmed 'satisfaction with amount of PCP choice' was significantly (p < .001) associated with provider trust. 'PCP's care being extremely effective' was strongly associated with 'satisfaction with amount of PCP choice' and 'provider trust'. Having sought a second opinion(s) was associated with lower trust. 'Spoke to the PCP outside the medical office,' 'satisfaction with the insurer' and 'insurer charges less if PCP within network' were all variables associated with 'satisfaction with amount of PCP choice' (all p < .05). Conclusion This study confirmed the association of 'satisfaction with amount of PCP choice' with provider trust. Results affirmed 'enough PCP choice' was a strong predictor of provider trust. 'Second opinion on PCP' may indicate distrust in the provider. Data such as 'trust in providers in general' and 'the role of provider performance information' in choice, though import in PCP choice, were not available for analysis and should be explored in future studies. Results have implications for rethinking the relationships among consumer choice, consumer behaviors in making trade-offs in PCP choice, and the role of healthcare experiences in 'satisfaction with amount of PCP choice' or 'provider trust.' PMID:17059611

Chu-Weininger, Ming Ying L; Balkrishnan, Rajesh

2006-01-01

201

A Training Program for Pharmacy Students on Providing Diabetes Care  

PubMed Central

Objective. To compare second- and third-year pharmacy students’ competence, attitudes, and self-confidence in providing diabetes care before and after completing a hand-on diabetes training program and to determine if the program had an impact on students’ attitude and self-confidence based on their year in the curriculum. Design. The program included classroom lectures and hands-on learning sessions in 5 facets of diabetes care. Pre- and post-test instruments measured students’ competence, attitudes, and confidence in diabetes care. Assessment. Students’ competence and the mean overall confidence score significantly improved after completing the program, while mean overall attitude score did not. Third-year students had significantly higher confidence scores than did second-year students on both pre- and post-program tests. No significant difference was found for attitude scores between second- and third-year students. Conclusion. The hands-on learning program was an effective approach to training pharmacy students in diabetes care, improving both their competence and confidence. PMID:24052656

Zeszotarski, Paula; Thai, Anthony; Fuller, RaeAnne; Owusu, Yaw; Tan, Candace; Gomez, Lara; Holuby, Scott

2013-01-01

202

Time to Talk: Tell Your Health Care Provider about Your Use of Complementary and Alternative Medicine  

MedlinePLUS

... external links Menu Time to Talk Tell Your Health Care Provider About Your Use of Complementary Health Practices ... chiropractic manipulation, and acupuncture. Top Why tell your health care providers? Giving your health care providers a full ...

203

45 CFR 162.406 - Standard unique health identifier for health care providers.  

...Standard unique health identifier for health care providers. 162.406 Section...Standard Unique Health Identifier for Health Care Providers § 162.406 Standard unique health identifier for health care providers. (a)...

2014-10-01

204

Cancer supportive care, improving the quality of life for cancer patients. A program evaluation report  

Microsoft Academic Search

Goals of workAs medical care for cancer has become more specialized in diagnosis, treatment has become more technical and fragmented. In order to help cancer patients and their families, we developed a coordinated program called the Stanford Cancer Supportive Care Program (SCSCP) at the Center for Integrative Medicine at Stanford Hospital and Clinics. The Stanford Cancer Supportive Care Program was

Ernest Rosenbaum; Holly Gautier; Pat Fobair; Eric Neri; Bernadette Festa; Margaret Hawn; Alexandra Andrews; Nama Hirshberger; Sabrina Selim; David Spiegel

2004-01-01

205

A need for otolaryngology education among primary care providers  

PubMed Central

Objective Otolaryngic disorders are very common in primary care, comprising 20–50% of presenting complaints to a primary care provider. There is limited otolaryngology training in undergraduate and postgraduate medical education for primary care. Continuing medical education may be the next opportunity to train our primary care providers (PCPs). The objective of this study was to assess the otolaryngology knowledge of a group of PCPs attending an otolaryngology update course. Methods PCPs enrolled in an otolaryngology update course completed a web-based anonymous survey on demographics and a pre-course knowledge test. This test was composed of 12 multiple choice questions with five options each. At the end of the course, they were asked to evaluate the usefulness of the course for their clinical practice. Results Thirty seven (74%) PCPs completed the survey. Mean knowledge test score out of a maximum score of 12 was 4.0±1.7 (33.3±14.0%). Sorted by area of specialty, the mean scores out of a maximum score of 12 were: family medicine 4.6±2.1 (38.3±17.3%), pediatric medicine 4.2±0.8 (35.0±7.0%), other (e.g., dentistry, emergency medicine) 4.2±2.0 (34.6±17.0%), and adult medicine 3.9±2.1 (32.3±17.5%). Ninety one percent of respondents would attend the course again. Conclusion There is a low level of otolaryngology knowledge among PCPs attending an otolaryngology update course. There is a need for otolaryngology education among PCPs. PMID:22754276

Hu, Amanda; Sardesai, Maya G.; Meyer, Tanya K.

2012-01-01

206

Detection of tongue cancer in primary care.  

PubMed Central

BACKGROUND: The incidence of tongue cancer is increasing, and survival has not improved since the majority of patients present at an advanced stage. Patient delay has remained the same over the years and is difficult to influence. Much less is known about the delay in diagnosis caused by physicians and dentists. AIM: To investigate the detection of tongue cancer in primary care in Northern Finland and to examine the consultation prevalence of oral symptoms in primary care in Finland. STUDY: Analysis of data from medical records of tongue cancer patients kept between 1 January 1974 and 31 December 1994 for the general health insurance scheme. SETTING: The two northernmost provinces of Finland (population of 700,000). METHOD: Data were collected on demographic and clinical variables and on the first medical visit on 75 tongue cancer patients. In addition, primary care physicians recorded all patient visits during four weeks in 25 health centres randomly selected throughout Finland in 1996. RESULTS: At the initial visit, the tongue cancer patient was correctly referred for further examinations in 49 (65%) cases. In 12 (16%) of cases the patient was not referred but was scheduled for a follow-up visit, and was neither referred nor followed-up in 14 (19%). When compared with the referred patients the median professional delay was somewhat longer for the unreferred patients but increased dramatically if no follow-up was arranged (0.6 months [range = 0.1-2.4] versus 1.2 [range = 0.3-2.2] versus 5.2 [range = 0.7-18.2], P < 0.001). Compared with the referred patients the adjusted relative hazard of death for the non-referred followed-up patients was 1.4 (95% confidence interval [CI] = 0.31-6.5) and that for the non-referred/not followed-up patients 6.3 (95% CI = 1.7-22.9). The high-risk patients included those who sought an early professional evaluation, those who made the appointment for a completely different reason and only mentioned the symptom suggestive of cancer incidentally, those that had a small ulcerative lesion, and blue-collar workers. Oral symptoms were a rare cause of visits (0.55% of all visits) in primary care in Finland. CONCLUSION: Misdiagnosis of tongue cancer at the initial professional evaluation often leads to a fatal delay if the patient is left without any follow-up. PMID:11217621

Kantola, S; Jokinen, K; Hyrynkangas, K; Mäntyselkä, P; Alho, O P

2001-01-01

207

Identifying barriers and improving communication between cancer service providers and Aboriginal patients and their families: the perspective of service providers  

PubMed Central

Background Aboriginal Australians experience poorer outcomes from cancer compared to the non-Aboriginal population. Some progress has been made in understanding Aboriginal Australians’ perspectives about cancer and their experiences with cancer services. However, little is known of cancer service providers’ (CSPs) thoughts and perceptions regarding Aboriginal patients and their experiences providing optimal cancer care to Aboriginal people. Communication between Aboriginal patients and non-Aboriginal health service providers has been identified as an impediment to good Aboriginal health outcomes. This paper reports on CSPs’ views about the factors impairing communication and offers practical strategies for promoting effective communication with Aboriginal patients in Western Australia (WA). Methods A qualitative study involving in-depth interviews with 62 Aboriginal and non-Aboriginal CSPs from across WA was conducted between March 2006 - September 2007 and April-October 2011. CSPs were asked to share their experiences with Aboriginal patients and families experiencing cancer. Thematic analysis was carried out. Our analysis was primarily underpinned by the socio-ecological model, but concepts of Whiteness and privilege, and cultural security also guided our analysis. Results CSPs’ lack of knowledge about the needs of Aboriginal people with cancer and Aboriginal patients’ limited understanding of the Western medical system were identified as the two major impediments to communication. For effective patient–provider communication, attention is needed to language, communication style, knowledge and use of medical terminology and cross-cultural differences in the concept of time. Aboriginal marginalization within mainstream society and Aboriginal people’s distrust of the health system were also key issues impacting on communication. Potential solutions to effective Aboriginal patient-provider communication included recruiting more Aboriginal staff, providing appropriate cultural training for CSPs, cancer education for Aboriginal stakeholders, continuity of care, avoiding use of medical jargon, accommodating patients’ psychosocial and logistical needs, and in-service coordination. Conclusion Individual CSPs identified challenges in cross-cultural communication and their willingness to accommodate culture-specific needs within the wider health care system including better communication with Aboriginal patients. However, participants’ comments indicated a lack of concerted effort at the system level to address Aboriginal disadvantage in cancer outcomes. PMID:24188503

2013-01-01

208

Palliative care in patients with lung cancer  

PubMed Central

Lung cancer accounts for 12% of all cancers and has the highest annual rate of mortality in men and women. The overall aim is cure or prolongation of life without evidence of disease. Almost 60% of patients at the moment of diagnosis are not eligible for radical treatment. Therefore soothing and supportive treatment is the only treatment of choice. Patients with lung cancer who have symptoms of dyspnea, chronic cough, severe pain, exhaustion and cachexia syndrome, fear and depression and significantly reduced physical and intellectual activities are qualified for inpatient or home palliative care. Knowledge about various methods used in palliative treatment allows one to alleviate symptoms that occur in an advanced stage of disease with an expected short survival period. Methods of oncological treatment that are often used in patients with advanced lung cancer include radiotherapy and chemotherapy. Drawing attention to the earlier implementation of palliative care is an objective of research carried out during recent years. Advances in surgical and conservative treatment of these patients have contributed to better outcomes and longer survival time. PMID:24596508

Farbicka, Paulina

2013-01-01

209

Palliative care for cancer patients in Sudan: an overview  

PubMed Central

Sudan is facing an increasing number of cancer patients every year, and cancer is now among the top ten killer diseases in the country. The majority of cancer patients are diagnosed with an advanced type of cancer where curative treatment has little, if any, effect. The need for palliative care (PC) is urgent. In spite of this, there is no established programme for comprehensive cancer control in the country. In this article we review the state of PC services available for cancer patients. A PC service started in 2010 as an outpatient service at the main oncology centre in Sudan. With the help of international bodies, several training activities in PC were held. Currently the service includes an outpatient clinic, a nine-bed ward, and a limited home-care service. PC has started to reach two other hospitals in the country. Unfortunately, the need is still great; the services provided are not fully supported by the hospital administration. And even now, thousands of patients outside the cities of Khartoum and Medani have no access to oral morphine.

Gafer, Nahla; Elhaj, Ahmed

2014-01-01

210

A primer on EVA for health care providers.  

PubMed

Unlike accounting earnings, economic profit (EVA) is a measure of a company's true earnings because it fully "accounts" for the costs of all forms of financing, including debt and equity. In the EVA view, a company is not truly profitable unless it earns a return on capital that bests the opportunity cost of capital. That being said, the question addressed here is how to measure the economic profit of providers in the health care sector, which is largely comprised of not-for-profit organizations such as clinics, laboratories, and hospitals. PMID:19175230

Grant, James L

2007-01-01

211

Health Care Provider Perspectives on Informal Supporters’ Involvement in HIV Care  

PubMed Central

Positive social support has been associated with medication adherence and slowed disease progression among people living with HIV. The nature of support within the medical context itself has not been adequately investigated, however. The purpose of our study was to describe HIV health care providers’ perspectives on informal supporter-oriented health care and whether and how the involvement of patients’ adult informal supporters in health care and health care decision making is helpful or beneficial. We conducted in-depth qualitative interviews with 11 HIV specialists between March and September, 2005. Using directed qualitative content analysis, we first describe the frequency and course of others’ involvement and the type of support provided. We then situate these findings within the context of role theory and consider the meaning they have in terms of the negotiated relationships among and between patients, providers, and informal supporters. Finally, we provide research and clinical recommendations based on these findings that are designed to improve patient care. PMID:21709129

Mosack, Katie E.; Wendorf, Angela R.

2014-01-01

212

Grantee Research Highlight: Taking Account of the Patient's Perspective when Examining the Quality of Cancer Care  

Cancer.gov

Optimizing patient experiences with care is especially important in cancer because cancer care is often complex and involves communication with and coordination across providers of multiple specialties and across multiple institutional settings. Unsatisfactory interactions with the health care system pose an additional burden on patients when they are already ill and vulnerable. More importantly, less-than-optimal patient experiences can have a significant negative impact on patients’ health-related quality of life.

213

Implementation of a Performance Improvement Initiative in Colorectal Cancer Care  

PubMed Central

Purpose: In the United States, colorectal cancer (CRC) is the third leading cause of cancer after breast and prostate cancer. Numerous improvement programs have been implemented to increase CRC screening rates, but few have focused on improving the care and management of patients with a diagnosis of this malignancy. As national medical organizations focus on quality of care, efforts are necessary to provide clinicians the opportunity for self-assessment and methods for practice improvement. With this goal in mind, a national continuing medical education–certified performance improvement initiative was conceived. Methods: The initiative consisted of three stages: First, participants self-assessed their performance of predetermined topic measures through a review of patient charts. The topic areas included patient safety and supportive care, evidence-based surveillance, and evidenced-based treatment and were derived from current guidelines and other successful quality-improvement initiatives. Second, an actionable plan for practice improvement was developed in at least one of the three topic areas. Third, after a period of self-improvement, participants reassessed their performance of the same topic measures to determine tangible changes in patient care. Results: A total of 540 patient charts were reviewed by 27 clinicians. Notable results showed large gains in areas of supportive care, such as quantitative pain assessments and emotional well-being evaluations, which traditionally have been a minor focus of other quality-improvement initiatives. Participants also showed tangible improvements in the performance of leading measures of quality care. Conclusion: These findings support the need for continued efforts toward performance improvement in both established and emerging areas of CRC patient care. PMID:23277769

Marshall, John L.; Cartwright, Thomas H.; Berry, Carolyn A.; Stowell, Stephanie A.; Miller, Sara C.

2012-01-01

214

77 FR 64340 - Announcement of Requirements and Registration for Cancer Care Video Challenge  

Federal Register 2010, 2011, 2012, 2013

...Announcement of Requirements and Registration for Cancer Care Video Challenge AGENCY: Office of...SUMMARY: The Cancer Care Video Challenge is an opportunity...enhance their ability manage care. The Cancer Care Video Challenge is an [[Page...

2012-10-19

215

Animal Cancer Care and Research Program Summer 2011  

E-print Network

Synergy Animal Cancer Care and Research Program Summer 2011 Michael G. Conzemius, D.V.M., Ph Cancer Care and Research Program 2 · Synergy Summer 2011 COTC016: A pilot study to assess feasibility Clinical Sciences, College of Veterinary Medicine and Masonic Cancer Center T he University of Minnesota

Minnesota, University of

216

Psychosocial Problems in Primary Care: Patient and Provider Perceptions  

Microsoft Academic Search

Primary care physicians and clinics have become the frontline of health care for most Americans—they are the first point of contact and the source of both treatment and referrals. Psychosocial problems, such as difficulty with finances, family, housing, and work, are associated with a high demand for medical care in primary care practice, yet little is known about the prevalence

Karra Bikson; James McGuire; Jessica Blue-Howells; Leah Seldin-Sommer

2009-01-01

217

76 FR 9283 - Medicaid Program; Payment Adjustment for Provider-Preventable Conditions Including Health Care...  

Federal Register 2010, 2011, 2012, 2013

...Provider-Preventable Conditions Including Health Care-Acquired Conditions AGENCY: Centers...of the Patient Protection and Affordable Care Act of 2010 which directs the Secretary...providing medical assistance for health care-acquired conditions. It would also...

2011-02-17

218

76 FR 32815 - Medicaid Program; Payment Adjustment for Provider-Preventable Conditions Including Health Care...  

Federal Register 2010, 2011, 2012, 2013

...Provider-Preventable Conditions Including Health Care-Acquired Conditions; Final Rule Federal...Provider-Preventable Conditions Including Health Care-Acquired Conditions AGENCY: Centers...of the Patient Protection and Affordable Care Act which directs the Secretary of...

2011-06-06

219

76 FR 9968 - Regulation for the Enforcement of Federal Health Care Provider Conscience Protection Laws  

Federal Register 2010, 2011, 2012, 2013

...Regulation for the Enforcement of Federal Health Care Provider Conscience Protection Laws AGENCY...enforcement of the federal statutory health care provider conscience protections will be...protections for individuals and health care entities under the federal health...

2011-02-23

220

The global cancer genomics consortium's third annual symposium: from oncogenomics to cancer care  

PubMed Central

The Global Cancer Genomics Consortium (GCGC) is a cohesive network of oncologists, cancer biologists and structural and genomic experts residing in six institutions from Portugal, United Kingdom, Japan, India, and United States. The team is using its combined resources and infrastructures to address carefully selected, shared, burning questions in cancer medicine. The Third Annual Symposium was organized by the Institute of Molecular Medicine, Lisbon Medical School, Lisbon, Portugal, from September 18 to 20, 2013. To highlight the benefits and limitations of recent advances in cancer genomics, the meeting focused on how to better translate our gains in oncogenomics to cancer patients while engaging our younger colleagues in cancer medicine at-large. Over two hundreds participants actively discussed some of the most recent advances in the areas cancer genomics, transcriptomics and cancer system biology and how to best apply such knowledge to cancer therapeutics, biomarkers discovery and drug development, and an essential role played by bio-banking throughout the process. In brief, the GCGC symposium provided a platform for students and translational cancer researchers to share their excitement and worries as we are beginning to translate the gains in oncogenomics to a better cancer patient treatment.

Costa, Luis; Casimiro, Sandra; Gupta, Sudeep; Knapp, Stefan; Pillai, M.Radhakrishna; Toi, Masakazu; Badwe, Rajendra; Carmo-Fonseca, Maria; Kumar, Rakesh

2014-01-01

221

Examining Potential Colorectal Cancer Care Disparities in the Veterans Affairs Health Care System  

PubMed Central

Purpose Racial disparities in cancer treatment and outcomes are a national problem. The nationwide Veterans Affairs (VA) health system seeks to provide equal access to quality care. However, the relationship between race and care quality for veterans with colorectal cancer (CRC) treated within the VA is poorly understood. We examined the association between race and receipt of National Comprehensive Cancer Network guideline–concordant CRC care. Patients and Methods This was an observational, retrospective medical record abstraction of patients with CRC treated in the VA. Two thousand twenty-two patients (white, n = 1,712; African American, n = 310) diagnosed with incident CRC between October 1, 2003, and March 31, 2006, from 128 VA medical centers, were included. We used multivariable logistic regression to examine associations between race and receipt of guideline-concordant care (computed tomography scan, preoperative carcinoembryonic antigen, clear surgical margins, medical oncology referral for stages II and III, fluorouracil-based adjuvant chemotherapy for stage III, and surveillance colonoscopy for stages I to III). Explanatory variables included demographic and disease characteristics. Results There were no significant racial differences for receipt of guideline-concordant CRC care. Older age at diagnosis was associated with reduced odds of medical oncology referral and surveillance colonoscopy. Presence of cardiovascular comorbid conditions was associated with reduced odds of medical oncology referral (odds ratio, 0.65; 95% CI, 0.50 to 0.89). Conclusion In these data, we observed no evidence of racial disparities in CRC care quality. Future studies could examine causal pathways for the VA's equal, quality care and ways to translate the VA's success into other hospital systems. PMID:24002515

Zullig, Leah L.; Carpenter, William R.; Provenzale, Dawn; Weinberger, Morris; Reeve, Bryce B.; Jackson, George L.

2013-01-01

222

Strategic health communication across the continuum of breast cancer care in limited-resource countries.  

PubMed

Strategic health communication is a critical component of healthcare that should be implemented across the continuum of care. Recognizing the importance of communication strategies and incorporating such strategies into healthcare policies, programs, and interventions is essential to the effective delivery of breast cancer care. The authors reviewed relevant literature and suggested practical evidence-based strategies for effective communication interventions across the continuum of care for breast cancer patients, including early detection, diagnosis, treatment, survivorship, palliative care, and end-of-life care. Examples were provided from limited-resource nations to support health communication recommendations. PMID:18837025

Kreps, Gary L; Sivaram, Rama

2008-10-15

223

Health Care of Young Adult Survivors of Childhood Cancer: A Report from the Childhood Cancer Survivor Study  

PubMed Central

BACKGROUND We wanted to determine the type of outpatient medical care reported by young adult survivors of childhood cancer and to examine factors associated with limited medical care. METHODS We analyzed data from 9,434 adult childhood cancer survivors enrolled in a retrospective cohort study who completed a baseline questionnaire. They had a mean age of 26.8 years (range 18 to 48 years), 47% were female, 12% were minorities, and 16% were uninsured. Four self-reported outcome measures were used to determine outpatient medical care in a 2-year period: general contact with the health care system, general physical examination, cancer-related medical visit, and medical visit at a cancer center. RESULTS Eighty-seven percent reported general medical contact, 71.4% a general physical examination, 41.9% a cancer-related visit, and 19.2%, a visit at a cancer center. Factors associated with not reporting a general physical examination, a cancer-related visit, or a cancer center visit included no health insurance (odds ratio [OR] = 2.34; 95% confidence interval [CI], 1.97–2.77), male sex (OR = 1.65; 95% CI, 1.44–1.88), lack of concern for future health (OR = 1.57; 95% CI, 1.36–1.82), and age 30 years or older in comparison with those 18 to 29 years (OR = 1.56; 95% CI, 1.35–1.81). The likelihood of reporting a cancer-related visit or a general physical examination decreased significantly as the survivor aged or the time from cancer diagnosis increased. This trend was also significant for those treated with therapies associated with substantial risk for cardiovascular disease or breast cancer. CONCLUSIONS Primary care physicians provide health care for most of this growing high-risk population. To optimize risk-based care, it is critical that cancer centers and primary care physicians develop methods to communicate effectively and longitudinally. PMID:15053285

Oeffinger, Kevin C.; Mertens, Ann C.; Hudson, Melissa M.; Gurney, James G.; Casillas, Jacqueline; Chen, Hegang; Whitton, John; Yeazel, Mark; Yasui, Yutaka; Robison, Leslie L.

2004-01-01

224

Human Relationships in Palliative Care of Cancer Patient: Lived Experiences of Iranian Nurses  

PubMed Central

Background: cancer patients require palliative care. Aim: the purpose of this study was to explore the experiences of nurses, who provide palliative care for cancer patients, within the context of Iranian culture. Methods: we conducted a hermeneutic phenomenological study. Semi structured in-depth interviews with 10 nurses were audio taped and transcribed. The transcriptions were then analyzed by Van Manen’s method. Results: one of the most important themes that emerged was “human relationships”, which also contained the subthemes of “comprehensive acceptance” and “psychological support”. Conclusions: the results provide deep understanding of human relationships in palliative care of cancer patients in Iran. PMID:24757399

Borimnejad, Leili; Mardani Hamooleh, Marjan; Seyedfatemi, Naimeh; Tahmasebi, Mamak

2014-01-01

225

Sudden infant death syndrome: review for the obstetric care provider.  

PubMed

Sudden infant death syndrome (SIDS) is the leading cause of death among infants aged 1 to 12 months. In this article, we review risk factors that may predispose infants to increased vulnerability. Maternal characteristics, including nonmodifiable and modifiable factors, antenatal medical conditions, labor and delivery events, and infant characteristics, are reviewed, with the purpose of helping obstetric care providers target risk reduction efforts. We have reviewed over 85 case-control, retrospective, and prospective cohort studies published between 1975 and 2011. Major modifiable risk factors include maternal and paternal smoking, drug use, alcohol use, and insufficient prenatal care. Infants at increased risk include males, premature infants, infants of low birth weight or growth-restricted infants, and infants in multiple gestations. By targeting modifiable and nonmodifiable risk factors, it may be possible to decrease the incidence of SIDS. Efforts should be put on decreasing high-risk behaviors and encouraging sufficient antenatal follow-up. In view of recent increases in ethnic and social disparity with SIDS, it is essential that risk reduction guidelines, which have recently been expanded by the American Association of Pediatrics, be explained in a culturally sensitive manner. PMID:23292938

Van Nguyen, Julie My; Abenhaim, Haim A

2013-10-01

226

Assessing and Enhancing Health Care Providers' Response to Domestic Violence  

PubMed Central

This study aimed to examine possible changes from 2008 to 2012 in the skills of health care staff in identifying and intervening in domestic violence (DV). A longitudinal descriptive study design with volunteer samples (baseline; n = 68, follow-up; n = 100) was used to acquire information regarding the present state and needs of the staff in practices related to DV. The results of the baseline survey were used as a basis for planning two interventions: staff training and drafting practical guidelines. Information was collected by questionnaires from nurses, physicians, and social workers and supplemented by responses from the interviews. The data were analysed using both quantitative and qualitative methods. A chi-square test was used to test the statistical significance of the data sets. In addition, participants' quotes are used to describe specific phenomena or issues. The comparison showed that overall a small positive change had taken place between the study periods. However, the participants were aware of their own shortcomings in identifying and intervening in DV. Changes happen slowly, and administrative support is needed to sustain such changes. Therefore, this paper offers recommendations to improve health care providers' response to DV. Moreover, there is a great need for evaluating the training programme used. PMID:24864205

Leppäkoski, Tuija; Paavilainen, Eija

2014-01-01

227

Not Babysitting: Work Stress and Well-Being for Family Child Care Providers  

ERIC Educational Resources Information Center

Family child care providers contend with a number of work stressors related to the dual roles of operating a small business and providing child care in their home. Research has documented many sources of work related stress for family child care providers; however, research examining family child care providers' experiences outside of the…

Gerstenblatt, Paula; Faulkner, Monica; Lee, Ahyoung; Doan, Linh Thy; Travis, Dnika

2014-01-01

228

Pancreatic cancer-improved care achievable  

PubMed Central

Pancreatic adenocarcinoma is one of the most aggressive cancers, and the decline in mortality observed in most other cancer diseases, has so far not taken place in pancreatic cancer. Complete tumor resection is a requirement for potential cure, and the reorganization of care in the direction of high patient-volume centers, offering multimodal treatment, has improved survival and Quality of Life. Also the rates and severity grade of complications are improving in high-volume pancreatic centers. One of the major problems worldwide is underutilization of surgery in resectable pancreatic cancer. Suboptimal investigation, follow up and oncological treatment outside specialized centers are additional key problems. New chemotherapeutic regimens like FOLFIRINOX have improved survival in patients with metastatic disease, and different adjuvant treatment options result in well documented survival benefit. Neoadjuvant treatment is highly relevant, but needs further evaluation. Also adjuvant immunotherapy, in the form of vaccination with synthetic K-Ras-peptides, has been shown to produce long term immunological memory in cytotoxic T-cells in long term survivors. Improvement in clinical outcome is already achievable and further progress is expected in the near future for patients treated with curative as well as palliative intention. PMID:25132756

Buanes, Trond A

2014-01-01

229

Mind-body practices in cancer care.  

PubMed

Being diagnosed with a life-threatening disease such as cancer and undergoing treatment can cause unwanted distress and interferes with quality of life. Uncontrolled stress can have a negative effect on a number of biological systems and processes leading to negative health outcomes. While some distress is normal, it is not benign and must be addressed, as failure to do so may compromise health and QOL outcomes. We present the evidence for the role of stress in cancer biology and mechanisms demonstrating how distress is associated with worse clinical outcomes. The National Comprehensive Cancer Network states that all patients be screened with the single-item distress thermometer and to also indicate the source of distress and to get appropriate referral. In addition to the many conventional approaches for managing distress from the fields of psychology and psychiatry, many patients are seeking strategies to manage their distress that are outside conventional medicine such as mind-body techniques. Mind-body techniques such as meditation, yoga, tai chi, and qigong have been found to lower distress and lead to improvements in different aspects of quality of life. It is essential that the standard of care in oncology include distress screening and the delivery of different techniques to help patients manage the psychosocial challenges of diagnosis and treatment of cancer. PMID:25325936

Chaoul, Alejandro; Milbury, Kathrin; Sood, Anil K; Prinsloo, Sarah; Cohen, Lorenzo

2014-12-01

230

Ten Things Lesbians Should Discuss with Their Health Care Provider  

MedlinePLUS

... types of gynecological (GYN) cancers compared to straight women. Having regular pelvic exams and pap tests can find cancers early and offer the best chance of cure. 5. Fitness Research shows that lesbians are more likely to ...

231

Joining together to improve outcomes: integrating specialty palliative care into the care of patients with cancer.  

PubMed

This article addresses the misconception that patients with cancer should undergo a definitive "transition" to palliative care at some point in their trajectory, and instead proposes that a gradual shift should occur from primary palliative care provided by the oncologist to specialty palliative care when the need exists. The goal is to help practitioners identify which patients are in need of specialty palliative care, suggest when oncologists should consider making a referral, and offer a model for sharing the responsibilities of care once palliative care clinicians become involved. This model enhances the patient and family experience through improving symptom control and quality of life, and may even prolong survival. It also minimizes patients' perception of abandonment at the end of life, while reducing the risk of physician burnout in practicing oncologists. Lastly, the misconceptions of oncologists are addressed regarding how patients and families will accept the idea of a palliative care consultation, and suggestions are offered for responding to patient and/or family resistance to referral when it arises. PMID:24158970

Vergo, Maxwell T; Cullinan, Amelia M

2013-09-01

232

Research Initiatives | CanCORS: Research Gaps Identified in Cancer Care Quality and Outcomes  

Cancer.gov

CanCORS has prospectively studied the quality of care and health outcomes of approximately 5,000 lung cancer patients and approximately 5,000 colorectal cancer patients. The study design, which blends patient, provider, and caregiver surveys with detailed clinical data from medical records, provides a rich and comprehensive data resource, allowing the investigators to examine care processes and outcomes during initial treatment as well as long-term survivorship in greater detail than previously possible.

233

PALB2 and the Risks for Cancer: Implications for Clinical Care.  

PubMed

Mutations in the PALB2 gene are responsible for a small but significant percentage of cancer risks in familial breast and pancreatic cancer families. PALB2 mutations may be associated with an increase in other cancer risks as well. This article will provide an overview of the PALB2 gene, cancer risks associated with carrying a PALB2 mutation, and implications for patient care. PMID:25542327

Smith, Edith C

2015-01-01

234

HIV status, trust in health care providers, and distrust in the health care system among Bronx women  

Microsoft Academic Search

Trust in health care providers and the health care system are essential. This study examined factors associated with trust in providers and distrust in the health care system among minority HIV-positive and -negative women.Interviews were conducted and laboratory tests performed with 102 women from the Women's Interagency HIV Study Bronx site. Interviews collected information about trust in providers, distrust in

C. O. Cunningham; N. L. Sohler; L. Korin; W. Gao; K. Anastos

2007-01-01

235

[Update of breast cancer in Primary Care (III/V)].  

PubMed

Breast cancer is a prevalent disease with implications in all aspects of patients? life, therefore, family doctors must know this pathology in depth, in order to optimize the health care provided to these patients with the best available resources. This series of five articles on breast cancer is based on a review of the scientific literature of the last ten years. This third article will review the clinical context and the staging and prognostic factors of the disease. This summary report aims to provide a global, current and practical review about this problem, providing answers to family doctors and helping them to be by the patients for their benefit throughout their illness. PMID:24953699

Alvarez Hernández, C; Vich Pérez, P; Brusint, B; Cuadrado Rouco, C; Díaz García, N; Robles Díaz, L

2014-01-01

236

75 FR 26276 - Publication of Model Notices for Health Care Continuation Coverage Provided Pursuant to the...  

Federal Register 2010, 2011, 2012, 2013

...Publication of Model Notices for Health Care Continuation Coverage Provided...Reconciliation Act (COBRA) and Other Health Care Continuation Coverage, as Required...of the Availability of the Model Health Care Continuation Coverage Notices...

2010-05-11

237

75 FR 13595 - Publication of Model Notices for Health Care Continuation Coverage Provided Pursuant to the...  

Federal Register 2010, 2011, 2012, 2013

...Publication of Model Notices for Health Care Continuation Coverage Provided...Reconciliation Act (COBRA) and Other Health Care Continuation Coverage, as Required...of the availability of the Model Health Care Continuation Coverage Notices...

2010-03-22

238

75 FR 2562 - Publication of Model Notices for Health Care Continuation Coverage Provided Pursuant to the...  

Federal Register 2010, 2011, 2012, 2013

...Publication of Model Notices for Health Care Continuation Coverage Provided...Reconciliation Act (COBRA) and Other Health Care Continuation Coverage, as Required...of the Availability of the Model Health Care Continuation Coverage Notices...

2010-01-15

239

Routine Prenatal Care Visits by Provider Specialty in the United States, 2009-2010  

MedlinePLUS

... Data Brief Number 145, March 2014 Routine Prenatal Care Visits by Provider Specialty in the United States, ... ambulatory obstetric care The percentage of routine prenatal care visits at which women saw non-ob/gyn ...

240

The relationship between care providers’ relational behaviors and residents mood and behavior in long-term care settings  

Microsoft Academic Search

Background: Care providers’ interactions with residents are an important element in long-term care settings. This study aimed at examining the association between care providers’ relational behaviors and affect and mood of residents with dementia over different caregiving situations and with different residents.Methods: This study utilized a repeated-measures design. Thirty-eight residents with a diagnosis of dementia and 35 care providers from

Katherine S. McGilton; Souraya Sidani; Veronique M. Boscart; Sepali Guruge; Maryanne Brown

2011-01-01

241

The relationship between care providers’ relational behaviors and residents mood and behavior in long-term care settings  

Microsoft Academic Search

Background: Care providers’ interactions with residents are an important element in long-term care settings. This study aimed at examining the association between care providers’ relational behaviors and affect and mood of residents with dementia over different caregiving situations and with different residents.Methods: This study utilized a repeated-measures design. Thirty-eight residents with a diagnosis of dementia and 35 care providers from

Katherine S. McGilton; Souraya Sidani; Veronique M. Boscart; Sepali Guruge; Maryanne Brown

2012-01-01

242

Physician “Costs” in Providing Behavioral Health in Primary Care  

Microsoft Academic Search

Objective: To examine pediatricians time spent, and resulting reimbursement payments for, addressing behavioral health concerns in a rural primary care pediatric practice. Methods: Research assistants observed 228 patient visits in a rural pediatric primary care office. The length of the visit (in minutes), content of visit, number and type of codes billed, and related insurance reimbursement amounts were recorded. Interrater

Tawnya Meadows; Rachel Valleley; Mary Kelly Haack; Ryan Thorson; Joseph Evans

2011-01-01

243

Racial Segregation and Disparities in Breast Cancer Care and Mortality  

PubMed Central

Objectives To examine whether residential segregation is a mediator of racial/ ethnic disparities in breast cancer care and breast cancer mortality, or has a differential effect by race/ ethnicity. Methods Data from the Surveillance, Epidemiology and End Results-Medicare database on white, black, and Hispanic women age 66 to 85 years with breast cancer were examined to look at the receipt of adequate breast cancer care. Results Blacks were less likely than whites to receive adequate breast cancer care (odds ratio {OR} 0.78; 95% confidence interval {CI} 0.71 - 0.86). Individuals, both black and white, who lived in areas with greater black segregation were less likely to receive adequate breast cancer care (0.73; 0.64 – 0.82). Black segregation was a mediator of the black/ white disparity in breast cancer care, explaining 8.9% of the difference. After adjustment, adequate care for Hispanics did not significantly differ from whites, but individuals, both Hispanic and white, who lived in areas with greater Hispanic segregation were less likely to receive adequate breast cancer care (0.73; 0.61 – 0.89). While Blacks experienced greater breast cancer mortality than whites, black segregation did not substantially mediate the black-white disparity in survival, and was not significantly associated with mortality (hazard ratio 1.03; CI 0.87– 1.21). Breast cancer mortality did not differ between Hispanics and whites. Conclusions Among seniors, segregation mediates some of the black-white disparity in breast cancer care, but not mortality. Individuals who live in more segregated areas are less likely to receive adequate breast cancer care. PMID:18798230

Haas, Jennifer S.; Earle, Craig C.; Orav, John E.; Brawarsky, Phyllis; Keohane, Marie; Neville, Bridget A.; Williams, David R.

2008-01-01

244

Family Child Care Providers' Perspectives regarding Effective Professional Development and Their Role in the Child Care System: A Qualitative Study  

ERIC Educational Resources Information Center

This study examines family child care providers' perspectives regarding effective professional development and their role in the early learning and care system. Four focus groups were conducted annually for 3 years involving a total of 54 licensed family child care providers. Supportive social relationships emerged as an important dimension of…

Lanigan, Jane D.

2011-01-01

245

Public Perception of Cancer Care in Poland and Austria  

PubMed Central

Background. We compared the public perception of cancer care in Poland and Austria. Both countries are members of the European Union (EU) but reflect two extremes in health-related per capita spending. Recently, the EUROCARE-5 study reported on very discrepant cancer outcomes between the two countries. Methods. A one-time survey was conducted to compare the public perception of cancer treatment in Poland and Austria. In total, 3,649 subjects, representing the general population, cancer patients, and cancer patients’ family members, were surveyed. Results. In both countries, cancer was considered the most challenging problem of the health care system, and health care was indicated as the most important issue influencing political election decisions. Polish compared with Austrian cancer patients gave a significantly lower positive assessment of overall cancer treatment efficacy and detection methods. Cancer cure rates estimated by Polish and Austrian citizens were 29% and 44%, respectively. The majority of all citizens interviewed thought that cancer patients should have access to all available registered cancer drugs. However, only 18% of Poles versus 62% of Austrians agreed with the notion that the available cancer treatment in their countries is of a standard comparable to that of other EU countries. Consequently, 24% of Poles and 7% of Austrians identified financial status, age, gender, and residence as factors influencing the availability of cancer treatments. Conclusion. In both countries, cancer is considered the most challenging problem of the health care system, and health care issues may strongly influence decisions for political elections. Vast differences in the two populations’ perceptions of cancer care reflect actual cancer outcomes and the national per capita spending on health-related issues. PMID:25520325

J?drzejewski, Mariusz; Thallinger, Christiane; Mrozik, Magda; Kornek, Gabriela; Zielinski, Christoph

2015-01-01

246

NIH scientists provide new insight into rare kidney cancer:  

Cancer.gov

NIH scientists have discovered a unique feature of a rare, hereditary form of kidney cancer that may provide a better understanding of its progression and metastasis, possibly laying the foundation for the development of new targeted therapies.

247

Certification of Health Care Provider Family and Medical Leave Act (FMLA) of 1993  

E-print Network

of a health care provider, or by a provider of health care services (e.g., physical therapist) under orders of) required? 10. Yes No Does (or will) the patient require assistance for basic medical, hygiene, nutritional, or physical or mental condition that involves one of the following: 1. Hospital Care Inpatient care (i

Logan, David

248

Ontology-based Modeling of Clinical Practice Guidelines: A Clinical Decision Support System for Breast Cancer Follow-up Interventions at Primary Care Settings  

E-print Network

for Breast Cancer Follow-up Interventions at Primary Care Settings Samina R. Abidi, Syed SR. Abidi, Sajjad, Canada Abstract Breast cancer follow-up care can be provided by family phy- sicians after specialists complete the primary treatment. Can- cer Care Nova Scotia has developed a breast cancer follow- up Clinical

Abidi, Syed Sibte Raza

249

“Not the ‘Grim Reaper Service’”: An Assessment of Provider Knowledge, Attitudes, and Perceptions Regarding Palliative Care Referral Barriers in Heart Failure  

PubMed Central

Background Although similar to cancer patients regarding symptom burden and prognosis, patients with heart failure (HF) tend to receive palliative care far less frequently. We sought to explore factors perceived by cardiology, primary care, and palliative care providers to impede palliative care referral for HF patients. Methods and Results We conducted semistructured interviews regarding (1) perceived needs of patients with advanced HF; (2) knowledge, attitudes, and experiences with specialist palliative care; (3) perceived indications for and optimal timing of palliative care referral in HF; and (4) perceived barriers to palliative care referral. Two investigators analyzed data using template analysis, a qualitative technique. We interviewed 18 physician, nurse practitioner, and physician assistant providers from 3 specialties: cardiology, primary care, and palliative care. Providers had limited knowledge regarding what palliative care is, and how it can complement traditional HF therapy to decrease HF?related suffering. Interviews identified several potential barriers: the unpredictable course of HF; lack of clear referral triggers across the HF trajectory; and ambiguity regarding what differentiates standard HF therapy from palliative care. Nevertheless, providers expressed interest for integrating palliative care into traditional HF care, but were unsure of how to initiate collaboration. Conclusions Palliative care referral for HF patients may be suboptimal due to limited provider knowledge and misperceptions of palliative care as a service reserved for those near death. These factors represent potentially modifiable targets for provider education, which may help to improve palliative care referral for HF patients with unresolved disease?related burden. PMID:24385453

Kavalieratos, Dio; Mitchell, Emma M.; Carey, Timothy S.; Dev, Sandesh; Biddle, Andrea K.; Reeve, Bryce B.; Abernethy, Amy P.; Weinberger, Morris

2014-01-01

250

Influenza vaccination and decisional conflict among regulated and unregulated direct nursing care providers in long-term-care homes.  

PubMed

The purpose of this study was to determine whether direct nursing care providers have decisional conflict about receiving influenza vaccinations and characteristics associated with decisional conflict. The researchers used a self-administered questionnaire mailed to direct nursing care providers in two long-term-care organizations. Most direct nursing care providers in both organizations (80% and 93%, respectively) intended to get the influenza vaccine. Unregulated direct nursing care providers had more decisional conflict than regulated providers, especially related to feeling uninformed about the pros and cons of influenza vaccination. Unclear valuing of the pros and cons of influenza vaccination was related to the age of the direct care providers in both organizations. Decisional conflict and influenza vaccination practices may be determined, in part, by age and by the culture of a health care organization. A decision aid to improve knowledge and clarify values may improve decision quality and increase influenza vaccination rates. PMID:18306650

Sullivan, Shannon M; Pierrynowski-Gallant, Donna; Chambers, Larry; O'Connor, Annette; Bowman, Sherry; McNeil, Shelly; Strang, Robert; Knoefel, Frank

2008-02-01

251

When Health Care Providers May Communicate About You with Your Family, Friends, or Others Involved in Your Care  

MedlinePLUS

... GUIDE TO THE HIPAA PRIVACY RULE: When Health Care Providers May Communicate About You with Your Family, Friends, or Others Involved In Your Care U.S. Department of Health and Human Services • Office ...

252

Cultural perceptions in cancer care among African-American and Caucasian patients.  

PubMed Central

PURPOSE: This exploratory study examined perceptions and beliefs of African Americans and Caucasians related to cancer care. Understanding belief systems and cultures optimizes cancer treatment and care delivery to ethnic minority individuals. PATIENTS AND METHODS: Focus groups were conducted with 39 African-American and Caucasian cancer patients. Data analysis included whole group analysis with a team of five researchers. RESULTS: Regardless of ethnicity, cancer patients share many of the same emotions and experiences, and want complete information and quality care. Differences were also apparent. African-American participants were more likely to report increased religious behaviors, believe that healthcare providers demonstrate care with simple actions and provision of practical assistance, and use church and community information sources. Caucasian participants were more likely to report spiritual but not overtly religious changes, and depend on healthcare providers for information. CONCLUSION: Understanding how culture colors perceptions, communication and information requirements is critical to providing effective care to ethnically diverse cancer patients. Findings have implications for professionals understanding ways patients seek information, the role of spirituality and religion in care, and ways healthcare providers demonstrate care. PMID:17987914

Matsuyama, Robin K.; Grange, Christina; Lyckholm, Laurie J.; Utsey, Shawn O.; Smith, Thomas J.

2007-01-01

253

Challenges in volunteering from cancer care volunteers perspectives.  

PubMed

The involvement of non-government organizations (NGOs) and support groups has helped strengthen public health services in addressing cancer care burden. Owing to the contribution of volunteers in cancer care, this article documents a qualitative study that examined challenges in attracting and retaining cancer care volunteers as part of the effort to develop a volunteer recruitment model. Data were collected through three focus group discussions involving 19 cancer support group members in Malaysia. Findings of the study revealed that mobility and locality appeared to be significant in Malaysian context, while the need for financial support and time flexibility are challenges faced by cancer support groups to attract and retain volunteers. The findings imply that cancer care initiatives can benefit from more local volunteers but at the same time these volunteers require flexibility and financial support to sustain their engagement. PMID:24083746

Kamaludin, Kauthar Mohamad; Muhammad, Mazanah; Wahat, Nor Wahiza Abdul; Ibrahim, Rahimah

2013-01-01

254

Diet and Nutrition in Cancer Survivorship and Palliative Care  

PubMed Central

The primary goal of palliative cancer care is typically to relieve suffering and improve quality of life. Most approaches to diet in this setting have focused only on eating as many calories as possible to avoid cachexia. However, as the concept of palliative care has evolved to include all aspects of cancer survivorship and not just end of life care, there is an increasing need to thoughtfully consider diet and nutrition approaches that can impact not only quality of life but overall health outcomes and perhaps even positively affect cancer recurrence and progression. In this regard, there has been a recent emphasis in the literature on nutrition and cancer as an important factor in both quality of life and in the pathophysiology of cancer. Hence, the primary purpose of this paper is to review the current data on diet and nutrition as it pertains to a wide range of cancer patients in the palliative care setting. PMID:24288570

Bazzan, Anthony J.; Newberg, Andrew B.; Cho, William C.; Monti, Daniel A.

2013-01-01

255

The Impact of Technology on Patients, Providers, and Care Patterns.  

ERIC Educational Resources Information Center

Examines the problems technical innovation has brought to health care professionals, administrators, and patients from the standpoints of increased specialization, equipment obsolescence, bureaucracy, retraining, regulations, high costs of services, depersonalization, and ethical dilemmas. (CT)

Fagerhaugh, Shizuko; And Others

1980-01-01

256

Increased health care utilisation among 10-year breast cancer survivors  

Microsoft Academic Search

Objective  We investigated self-reported health care utilisation of women who survived breast cancer for 10 years and identified predictors of health care utilisation.Methods  The population-based Eindhoven Cancer Registry was used to select all women who were diagnosed with breast cancer in 1993, in six hospitals in the Netherlands, and were disease-free at the time of data collection. Health status, psychological well-being, satisfaction with

L. V. van de Poll-Franse; F. Mols; A. J. J. M. Vingerhoets; A. C. Voogd; R. M. H. Roumen; J. W. W. Coebergh

2006-01-01

257

Practice Patterns and Perceptions of Thoracic Oncology Providers on Tobacco Use and Cessation in Cancer Patients  

PubMed Central

Introduction Tobacco use is associated with poor outcomes in cancer patients, but there is little information on the practice patterns or perceptions of tobacco use and smoking cessation by oncology providers. Methods An online survey of practices, perceptions, and barriers to tobacco assessment and cessation in cancer patients was conducted in members of the International Association for the Study of Lung Cancer (IASLC). Responses of physician level respondents were analyzed and reported. Results Responses from 1,507 IASLC members who completed the survey are reported representing 40.5% of IASLC members. Over 90% of physician respondents believe current smoking affects outcome and that cessation should be a standard part of clinical care. At the initial patient visit, 90% ask patients about tobacco use, 79% ask patients if they will quit, 81% advise patients to stop tobacco use, but only 40% discuss medication options, 39% actively provide cessation assistance, and fewer yet address tobacco at follow-up. Dominant barriers to physician cessation effort are pessimism regarding their ability to help patients stop using tobacco (58%) and concerns about patient resistance to treatment (67%). Only 33% report themselves adequately trained to provide cessation interventions. Discussion Physicians who care for lung cancer patients recognize the importance of tobacco cessation as a necessary part of clinical care, but many still do not routinely provide assistance to their patients. Increasing tobacco cessation will require increased assessment and cessation at diagnosis and during follow-up, increased clinician education, and improved tobacco cessation methods. PMID:23529191

Warren, Graham W.; Marshall, James R.; Cummings, K. Michael; Toll, Benjamin; Gritz, Ellen R.; Hutson, Alan; Dibaj, Seyedeh; Herbst, Roy; Dresler, Carolyn

2013-01-01

258

Lung Cancer Assistant: a hybrid clinical decision support application for lung cancer care  

PubMed Central

Multidisciplinary team (MDT) meetings are becoming the model of care for cancer patients worldwide. While MDTs have improved the quality of cancer care, the meetings impose substantial time pressure on the members, who generally attend several such MDTs. We describe Lung Cancer Assistant (LCA), a clinical decision support (CDS) prototype designed to assist the experts in the treatment selection decisions in the lung cancer MDTs. A novel feature of LCA is its ability to provide rule-based and probabilistic decision support within a single platform. The guideline-based CDS is based on clinical guideline rules, while the probabilistic CDS is based on a Bayesian network trained on the English Lung Cancer Audit Database (LUCADA). We assess rule-based and probabilistic recommendations based on their concordances with the treatments recorded in LUCADA. Our results reveal that the guideline rule-based recommendations perform well in simulating the recorded treatments with exact and partial concordance rates of 0.57 and 0.79, respectively. On the other hand, the exact and partial concordance rates achieved with probabilistic results are relatively poorer with 0.27 and 0.76. However, probabilistic decision support fulfils a complementary role in providing accurate survival estimations. Compared to recorded treatments, both CDS approaches promote higher resection rates and multimodality treatments. PMID:24990290

Sesen, M. Berkan; Peake, Michael D.; Banares-Alcantara, Rene; Tse, Donald; Kadir, Timor; Stanley, Roz; Gleeson, Fergus; Brady, Michael

2014-01-01

259

Cancer Care in the United States: What's Right, What's Wrong? - September 16, 1999  

Cancer.gov

CANCER CARE IN THE UNITED STATES: WHAT'S RIGHT, WHAT'S WRONG? ENSURING THE QUALITY OF CANCER CARE Robert Hiatt, M.D., Ph.D., Deputy Director of the Division of Cancer Control and Population Sciences National Cancer Institute National Institutes

260

Health Sciences Center Department of Internal Medicine Employee Health Promotion Program Health Care Provider Report  

E-print Network

Health Sciences Center Department of Internal Medicine Employee Health Promotion Program Health Care Provider Report Dear Health Care Provider: Your patient, ______________________________, has applied for enrollment in a fitness program sponsored by the University of New Mexico, Employee Health

New Mexico, University of

261

How Do Health Care Providers Diagnose Precocious Puberty and Delayed Puberty?  

MedlinePLUS

... Information Clinical Trials Resources and Publications How do health care providers diagnose precocious puberty & delayed puberty? Skip sharing ... and analyzing his or her medical history, a health care provider may perform tests to diagnose precocious puberty, ...

262

How Do Health Care Providers Diagnose Preeclampsia, Eclampsia, and HELLP Syndrome?  

MedlinePLUS

... Trials Resources and Publications En Español How do health care providers diagnose preeclampsia, eclampsia, and HELLP syndrome? Skip ... social media links Share this: Page Content A health care provider should check a pregnant woman's blood pressure ...

263

Private payers and cancer care: land of opportunity.  

PubMed

The costs of cancer care are unsustainable in the present US health care system. Private payers have taken a leading role in oncology payment reform. This benefits all payers, including the Center for Medicare and Medicaid Services (CMS). Private payers' ability to set up systems of measurement and quality improvement is a strategy to support pay-for-value contracting. This facilitates workflow changes in oncology office practice as a way to bend the cost trends while enhancing patient care. Oncology practitioners demand speed and flexibility in deploying customized information technology solutions in exchange for new contracting terms. Pathway and guideline support tools have been proven effective in validating the use of evidence-based medicine and in systematizing office operations to reduce avoidable costs. The future of oncology practice should see further enhancement of these capabilities. A common health information exchange pipeline will allow patients, physicians, and other health care providers to share structured information from multiple electronic medical record/electronic health record platforms. By allowing multiple payers, including CMS, to access commonly accepted clinical decision support rules, any payer can create contracts and relationships with oncology practices. In this manner, future changes in payment for oncology services mandated by CMS can be sustained within the infrastructures being built today through payer-provider collaborations. PMID:24084888

Klein, Ira; Kolodziej, Michael

2014-01-01

264

Trauma-Informed Medical Care: A CME Communication Training for Primary Care Providers  

PubMed Central

BACKGROUND AND OBJECTIVES: Trauma exposure predicts mental disorders, medical morbidity, and healthcare costs. Yet trauma-related impacts have not received sufficient attention in primary care provider (PCP) training programs. This study adapted a theory-based approach to working with trauma survivors, Risking Connection, into a 6-hour CME course, Trauma-Informed Medical Care (TI-Med), and evaluated its efficacy. METHODS: We randomized PCPs to training or wait-list (delay) conditions; waitlist groups were trained after reassessment. The primary outcome assessing newly acquired skills was a patient-centeredness score derived from Roter Interactional Analysis System ratings of 90 taped visits between PCPs and standardized patients (SPs). PCPs were Family Medicine residents (n=17) and community physicians (n=13; 83% Family Medicine specialty), from four sites in the Washington DC metropolitan area. RESULTS: Immediately trained PCPs trended toward a larger increase in patient-centeredness than did the delayed PCPs (p < .09), with a moderate effect size (.66). The combined trained PCP groups showed a significant increase in patient-centeredness pre to post training, p < .01, Cohen’s D = .61. CONCLUSIONS: This is a promising approach to supporting relationship-based trauma-informed care among PCPs to help promote better patient health and higher compliance with medical treatment plans. PMID:25646872

Green, Bonnie L.; Saunders, Pamela A.; Power, Elizabeth; Dass-Brailsford, Priscilla; Schelbert, Kavitha Bhat; Giller, Esther; Wissow, Larry; Hurtado-de-Mendoza, Alejandra; Mete, Mihriye

2014-01-01

265

A review of recent literature - nurse case managers in diabetes care: equivalent or better outcomes compared to primary care providers.  

PubMed

Primary care has changed remarkably with chronic disease burden growth. Nurse case managers assist with this chronic disease by providing if not significantly better care, than equivalent care to that provided by usual primary care providers. Chronic disease management requires patient-centered skills and tools, such as registries, panel management, review of home data, communicating with patients outside of face-to-face care, and coordinating multiple services. Evidence reviewed in this article demonstrates that registered nurse care managers (RNCM) perform many actions required for diabetes chronic disease management including initiation and titration of medications with similar or improved physiologic and patient satisfaction outcomes over usual care providers. Selection and training of the nurse case managers is of utmost importance for implementation of a successful chronic disease management program. Evidence based guidelines, algorithms, protocols, and adequate ongoing education and mentoring are generally cited as necessary support tools for the nurse case managers. PMID:24816751

Watts, Sharon A; Lucatorto, Michelle

2014-07-01

266

47 CFR 54.613 - Limitations on supported services for rural health care providers.  

Code of Federal Regulations, 2010 CFR

...Limitations on supported services for rural health care providers. ...telecommunications carrier, each eligible rural health care provider is entitled...rate no higher than the highest urban rate, as defined in § 54...This section shall not affect a rural health care provider's...

2010-10-01

267

47 CFR 54.613 - Limitations on supported services for rural health care providers.  

...Limitations on supported services for rural health care providers. 54...Limitations on supported services for rural health care providers. ...telecommunications carrier, each eligible rural health care provider is entitled...rate no higher than the highest urban rate, as defined in §...

2014-10-01

268

47 CFR 54.613 - Limitations on supported services for rural health care providers.  

Code of Federal Regulations, 2011 CFR

...Limitations on supported services for rural health care providers. ...telecommunications carrier, each eligible rural health care provider is entitled...rate no higher than the highest urban rate, as defined in § 54...This section shall not affect a rural health care provider's...

2011-10-01

269

47 CFR 54.613 - Limitations on supported services for rural health care providers.  

Code of Federal Regulations, 2013 CFR

...Limitations on supported services for rural health care providers. 54...Limitations on supported services for rural health care providers. ...telecommunications carrier, each eligible rural health care provider is entitled...rate no higher than the highest urban rate, as defined in §...

2013-10-01

270

47 CFR 54.613 - Limitations on supported services for rural health care providers.  

Code of Federal Regulations, 2012 CFR

...Limitations on supported services for rural health care providers. ...telecommunications carrier, each eligible rural health care provider is entitled...rate no higher than the highest urban rate, as defined in § 54...This section shall not affect a rural health care provider's...

2012-10-01

271

Primary Care Providers' Perceptions of and Experiences with an Integrated Healthcare Model  

ERIC Educational Resources Information Center

Objective and Participants: The authors examined the experiences of primary care providers participating in an integrated healthcare service between mental health and primary care in a university health center. In this program, behavioral health providers work collaboratively with primary care providers in the treatment of students. Participants…

Westheimer, Joshua M.; Steinley-Bumgarner, Michelle; Brownson, Chris

2008-01-01

272

Controversies on individualized prostate cancer care: gaps in current practice  

PubMed Central

Prostate cancer (PCa) is a heterogeneous disease with a wide spectrum of aggressiveness. Evidence-based guidelines are invaluable but cannot be expected to be extensive enough to provide detailed guidance on the management of all patients. As such, the use of individualized, risk-adapted approaches to the management of PCa is indispensable. However, wide variation in treatment approaches observed for patients in practice suggests that there is an unmet need to improve the individualized approach towards patient care. A holistic approach that encompasses guidelines and evidence-based medicine could be used to guide individualized care for patients with PCa, from first contact through to final outcomes. As a result of an international expert meeting, this paper proposes this approach and highlights some of the factors that can be considered when aiming to identify patients’ profiles; individualize treatment; and improve communication between patients and the healthcare teams. PMID:24082918

Joniau, Steven; Pfister, David; de la Taille, Alexandre; Gaboardi, Franco; Thompson, Alan

2013-01-01

273

Following through: the consistency of survivorship care plan use in United States cancer programs.  

PubMed

The Institute of Medicine suggests that consistent survivorship care plan (SCP) use involves developing and delivering SCPs to all cancer survivors and their primary care providers (PCPs). We describe the consistency of SCP use in US cancer programs and assess its relationship with cancer-program-level determinants. We surveyed employees knowledgeable about survivorship practices in cancer programs reporting current SCP use (n?=?36, 81 % response rate). We operationalized consistent SCP use as whether SCPs were (1) developed for ?75 % survivors, (2) delivered to ?75 % survivors, (3) delivered to ?75 % PCPs, and (4) all of the above. We use descriptive statistics to report SCP use consistency and evaluate associations using Fisher's exact and Wilcoxon rank sum tests. SCPs were developed for ?75 % survivors in five programs (15 %), eight (25 %) delivered ?75 % SCPs to survivors, seven (23 %) delivered ?75 % SCPs to PCPs, and only one program (4 %) met all three criteria. We found relationships between SCP use consistency and geographic region (p?=?.05), initiating SCP use in response to survivors' requests (p?=?.03), and membership in the National Cancer Institute's National Community Cancer Centers Program (p?=?.01). SCP use is highly inconsistent. Survivors and cancer care quality improvement organizations may play a key role in improving the consistency of SCP use in US cancer programs. Survivors can initiate SCP use. Cancer care quality improvement organizations can specify how cancer programs' compliance with SCP guidelines will be assessed. Future research should identify mechanisms underlying the relationships that we found. PMID:24577781

Birken, Sarah A; Deal, Allison M; Mayer, Deborah K; Weiner, Bryan J

2014-12-01

274

Primary care utilization patterns before and after lung cancer diagnosis.  

PubMed

The objective of this study was to evaluate change in primary care utilization rates after lung cancer diagnosis in the Veterans Health Administration. We used electronic medical record data (1997-2005) to identify male veterans (n = 323) with incident lung cancers. Primary care utilization rates were assessed in the 12-month period before and after cancer diagnosis. Statistical analysis included paired t-tests. Rates of primary care utilization decreased by 0.02 visits per person-month (VPPM) in the 12-month period after cancer diagnosis (P > 0.05). Utilization for acute conditions decreased by 20% (P < 0.01) in the 12-month period after diagnosis, from 0.32 VPPM before diagnosis to 0.12 VPPM after diagnosis. Utilization for chronic conditions remained stable after diagnosis (0.29 VPPM vs. 0.29 VPPM, P > 0.05). Indications for primary care utilization after diagnosis were similar to indications for utilization prior to diagnosis. Common indications for utilization included hypertension and lower respiratory infections. We speculate that primary care utilization for acute conditions was lower after cancer diagnosis because several of the acute conditions (e.g. upper respiratory infection) treated prior to the cancer may have been harbingers of the cancer diagnosis. Additional research is required to illuminate how primary care can best be delivered during the initial phase of cancer treatment. PMID:19267732

Jones, L E; Carney Doebbeling, C

2009-03-01

275

The relationship between providing neonatal palliative care and nurses' moral distress: an integrative review.  

PubMed

Moral distress has been identified in multiple clinical settings especially in critical care areas. The neonatal intensive care unit (NICU) has frequent situations in which moral distress may occur including providing palliative care. The purpose of this integrative review was to determine the relationship between the provision of palliative care in a NICU and nurses' moral distress. The evidence reviewed supports that moral distress does occur with the provision of neonatal palliative care. An interdisciplinary care team, an established protocol, and educational interventions may decrease moral distress in nurses providing end-of-life care to infants in the NICU. PMID:25022749

Cavinder, Christina

2014-10-01

276

Lessons Learned from Home Visiting with Home-Based Child Care Providers  

ERIC Educational Resources Information Center

Caring for Quality and Partners in Family Child Care are home visiting programs designed to improve the quality of home-based child care. This article describes the experiences of two different home visitors to demonstrate how programs such as these can help providers improve the overall quality of care, increase children's development, and lead…

McCabe, Lisa A.; Peterson, Shira M.; Baker, Amy C.; Dumka, Marsha; Brach, Mary Jo; Webb, Diana

2011-01-01

277

78 FR 26250 - Payment for Home Health Services and Hospice Care to Non-VA Providers  

Federal Register 2010, 2011, 2012, 2013

...governing payments for certain non-VA health care, 38 CFR 17.56, applicable to...rule, we estimate that each home health care and hospice provider that does...negotiated contracts offer home health care or hospice care to veterans...

2013-05-06

278

Turning the Lens Inward: Cultural Competence and Providers' Values in Health Care Decision Making  

ERIC Educational Resources Information Center

The population of older adults in the United States is growing in size and diversity, presenting challenges to health care providers and patients in the context of health care decision making (DM), including obtaining informed consent for treatment, advance care planning, and deliberations about end-of-life care options. Although existing…

Chettih, Mindy

2012-01-01

279

Changes in daily experiences: perceptions of the care provider of the traumatic brain injured.  

PubMed

Occupational therapy practitioners are rapidly becoming more involved in community-based services. Practitioners must understand the effect on program participants as well as family or paid care providers. This study gives voice to care providers in a community-based program for survivors of traumatic brain injury run by occupational therapists and occupational therapy students. Roles, routines, and occupational choices of care providers changed dramatically with program involvement. These findings have implications for community-based programming and the collaborative integration of care providers. Implications for program outcomes and the health and well being of care providers are discussed. PMID:23927617

Simmons, Douglas; Ludwig, Ferol

2004-01-01

280

Challenges in the Gynecologic Care of Premenopausal Women With Breast Cancer  

PubMed Central

Premenopausal women with a new diagnosis of breast cancer are faced with many challenges. Providing health care for issues such as gynecologic comorbidities, reproductive health concerns, and vasomotor symptom control can be complicated because of the risks of hormone treatments and the adverse effects of adjuvant therapies. It is paramount that health care professionals understand and be knowledgeable about hormonal and nonhormonal treatments and their pharmacological parameters so they can offer appropriate care to women who have breast cancer, with the goal of improving quality of life. Articles for this review were identified by searching the PubMed database with no date limitations. The following search terms were used: abnormal uterine bleeding, physiologic sex steroids, endometrial ablation, hysteroscopic sterilization, fertility preservation in endometrial cancer, tranexamic acid and breast cancer, menorrhagia treatment and breast cancer, abnormal uterine bleeding and premenopausal breast cancer, levonorgestrel IUD and breast cancer, tamoxifen and gynecologic abnormalities, tamoxifen metabolism, hormones and breast cancer risk, contraception and breast cancer, pregnancy and breast cancer, and breast cancer and infertility treatment. PMID:21307388

Bakkum-Gamez, Jamie N.; Laughlin, Shannon K.; Jensen, Jani R.; Akogyeram, Clement O.; Pruthi, Sandhya

2011-01-01

281

Huntsman Cancer Institute study shows young cancer survivors often forgo medical care due to costs  

Cancer.gov

Many survivors of adolescent and young adult cancers avoid routine medical care because it's too expensive, despite the fact that most have health insurance. That is the conclusion of a new study published early online in Cancer.

282

Providing maternal and child care in rural Malaysia.  

PubMed

Since Independence, gained in 1957, major changes have occurred in the rural areas of Malaysia not least amongst which has been the provision of maternal and child care services to hitherto neglected areas. In the first part of this paper, the demographic and disease patterns are described. The second part outlines the general development efforts and describes in greater detail the rural health services that have been organized in Malaysia. In the concluding section, changes in mortality and morbidity are examined. PMID:610030

Chen, P C

1977-12-01

283

Massage therapy in cancer care: an overview of the past, present, and future.  

PubMed

Despite a plethora of research using various touch-based therapies on people in treatment or recovery from cancer, as well as at the end of life, there are still some misconceptions about massage in the minds of oncology providers, touch therapists, and patients. A number of influences have contributed to the confusion about massage in cancer care: (1) the past myth and misconception that massage could cause metastasis; (2) mixed perceptions about massage; (3) a lack of cancer-related training in general massage education. The goal of this commentary is to speak to past and present influences within the massage profession that impact its role in cancer care. Understanding these forces may provide clarity to other health care practitioners of the present limitations within the massage field as well as the immense potential for the future. PMID:25362212

MacDonald, Gayle

2014-10-01

284

CNMs\\/CMs as primary care providers: scope of practice issues  

Microsoft Academic Search

Since the proliferation of managed care organizations and the expansion of the central role of the primary care provider in the early 1990s, certified nurse-midwives and certified midwives have debated the merits and drawbacks of their inclusion in this category of provider. The present article explores the history of primary care and reviews the most commonly accepted definition of primary

Nancy H Sullivan

2000-01-01

285

One in fifteen family physicians principally provide emergency or urgent care.  

PubMed

A small but nontrivial proportion of US family physicians devote most of their time providing emergency or urgent care. With considerable attention focused on expanding access to primary care, it is important to account for providers principally working outside of traditional primary care. PMID:25001998

Petterson, Stephen; Peterson, Lars; Phillips, Robert L; Moore, Miranda; Finnegan, Sean; Coffman, Megan; Bazemore, Andrew

2014-01-01

286

Ethics for Health Care Providers: Codes as Guidance for Practice in Prisons  

Microsoft Academic Search

While recognizing prisons as unhealthy and detrimental places for all people, health care providers, including nurses, social workers, physicians, and others, can do a great deal to offer respectful health promoting care, to protect prisoners from research abuse, and to advocate for alternatives to imprisonment. In doing so, health care providers exercise their moral agency as practitioners, researchers, and advocates

Janet Storch; Cindy Peternelj-Taylor

287

Type of Plan and Provider Network (Affordable Care Act)  

MedlinePLUS

... choose Marketplace insurance Type of plan and provider network Comparing health plans Marketplace insurance categories Monthly premiums ... of-pocket costs Type of plan and provider network Benefits How to keep your doctor How to ...

288

Medicare Launches Efforts to Improve Care for Cancer Patients  

Cancer.gov

The Centers for Medicare & Medicaid Services (CMS) today issued two national coverage decisions for improving care for cancer patients by expanding coverage for diagnostic tests and chemotherapy treatments for Medicare beneficiaries.

289

State Variability in Supply of Office-based Primary Care Providers: United States, 2012  

MedlinePLUS

... State Variability in Supply of Office-based Primary Care Providers: United States, 2012 On This Page Key ... During the last decade, the supply of primary care physicians was lower than the supply of specialty ...

290

Time To Talk with Your Health Care Providers: 4 Tips to Start the Conversation  

MedlinePLUS

... to Talk Tips Time To Talk With Your Health Care Providers: 4 Tips To Start the Conversation When ... fully informed and can help patients make wise health care decisions. Here are 4 tips to help you ...

291

Can we select health professionals who provide safer care  

PubMed Central

In order to improve patient safety, health services are looking to other industries' experiences and as a result are adopting a systems approach to learning from error, rather than simply focusing the blame on the individual. However, in health care the individual will remain an important contributor to safety and this paper looks at other literatures besides health to consider a number of individual characteristics and the role they might play in terms of work practices that affect patient safety. It considers the effects of a variety of personality profiles including sensation seeking, Type A, and those with high self esteem; looks at our ability to select for psychological wellbeing; and discusses the ways that psychometrics have been used in medicine to predict performance. It concludes that although rarely used, psychometrics has been shown to be useful in predicting some aspects of performance in medicine and suggests that this is an area well worth further study for the benefit of patient care. Nevertheless, we are a long way away from being able to select safer staff and should instead be developing this knowledge to enable us to recognise and address potential difficulties. PMID:14645743

Firth-Cozens, J; Cording, H; Ginsburg, R

2003-01-01

292

Follow-up of cancer in primary care versus secondary care: systematic review  

PubMed Central

Background Cancer follow-up has traditionally been undertaken in secondary care, but there are increasing calls to deliver it in primary care. Aim To compare the effectiveness and cost-effectiveness of primary versus secondary care follow-up of cancer patients, determine the effectiveness of the integration of primary care in routine hospital follow-up, and evaluate the impact of patient-initiated follow-up on primary care. Design of study Systematic review. Setting Primary and secondary care settings. Method A search was carried out of 19 electronic databases, online trial registries, conference proceedings, and bibliographies of included studies. The review included comparative studies or economic evaluations of primary versus secondary care follow-up, hospital follow-up with formal primary care involvement versus conventional hospital follow-up, and hospital follow-up versus patient-initiated or minimal follow-up if the study reported the impact on primary care. Results There was no statistically significant difference for patient wellbeing, recurrence rate, survival, recurrence-related serious clinical events, diagnostic delay, or patient satisfaction. GP-led breast cancer follow-up was cheaper than hospital follow-up. Intensified primary health care resulted in increased home-care nurse contact, and improved discharge summary led to increased GP contact. Evaluation of patient-initiated or minimal follow-up found no statistically significant impact on the number of GP consultations or cancer-related referrals. Conclusion Weak evidence suggests that breast cancer follow-up in primary care is effective. Interventions improving communication between primary and secondary care could lead to greater GP involvement. Discontinuation of formal follow-up may not increase GP workload. However, the quality of the data in general was poor, and no firm conclusions can be reached. PMID:19566990

Lewis, Ruth A; Neal, Richard D; Williams, Nefyn H; France, Barbara; Hendry, Maggie; Russell, Daphne; Hughes, Dyfrig A; Russell, Ian; Stuart, Nicholas SA; Weller, David; Wilkinson, Clare

2009-01-01

293

The Work-Family Support Roles of Child Care Providers across Settings  

ERIC Educational Resources Information Center

This paper presents a qualitative investigation of the work-family support roles of a sample of 29 child care providers serving low-income families in the Chicago area (16 family, friend, and neighbor providers (FFN), 7 licensed family child care providers (FCC), and 6 center-based teachers). Providers report offering low-income parents…

Bromer, Juliet; Henly, Julia R.

2009-01-01

294

Systematic review of guidelines for the management of suspected lung cancer in primary care  

PubMed Central

Abstract Objective To systematically review the literature and provide an update and integration of existing peer-reviewed guidelines with recent systematic reviews and with primary studies related to the early recognition and management of lung cancer in primary care. Data sources MEDLINE and EMBASE were searched for relevant articles. The quality of the evidence to support existing guideline recommendations, and the consistency of recommendations with updated evidence, were assessed. Applicability in a Canadian primary care setting was also evaluated. Study selection All studies that explored signs or symptoms of or risk factors for lung cancer in the primary care setting were included. All diagnostic studies in which symptomatic primary care patients underwent 1 or more investigations were also searched. Synthesis Recommendations were consistent among guidelines despite a paucity of supporting evidence. Updated evidence provided further support for the recommendations. Recommendations for identifying signs and symptoms of lung cancer presenting in primary care and for initial management can be adopted and applied within a Canadian primary care setting. Conclusion This updated review of recommendations might help promote evidence-based practice and, ultimately, more timely management and improved prognosis for lung cancer patients. It might also assist in the development of lung cancer diagnostic assessment programs. PMID:25122830

Giudice, M. Elisabeth Del; Young, Sheila-Mae; Vella, Emily T.; Ash, Marla; Bansal, Praveen; Robinson, Andrew; Skrastins, Roland; Ung, Yee; Zeldin, Robert; Levitt, Cheryl

2014-01-01

295

Current Directions in Military Health-care Provider Resilience.  

PubMed

After more than a decade of war, the US military continues to place significant emphasis on psychological health and resilience. While research and programs that focus on the broader military community's resilience continue to emerge, less is known about and until recently little focus has been placed on military medical provider resilience. In this article, we review the literature on military medical provider resilience, provide an overview of the programmatic and technological advances designed to sustain and develop military medical provider resilience, and finally offer recommendations for future research. PMID:25617036

Lester, Paul B; Taylor, Lauren C; Hawkins, Stacy Ann; Landry, Lisa

2015-02-01

296

Delivery of affordable and equitable cancer care in India.  

PubMed

The delivery of affordable and equitable cancer care is one of India's greatest public health challenges. Public expenditure on cancer in India remains below US$10 per person (compared with more than US$100 per person in high-income countries), and overall public expenditure on health care is still only slightly above 1% of gross domestic product. Out-of-pocket payments, which account for more than three-quarters of cancer expenditures in India, are one of the greatest threats to patients and families, and a cancer diagnosis is increasingly responsible for catastrophic expenditures that negatively affect not only the patient but also the welfare and education of several generations of their family. We explore the complex nature of cancer care systems across India, from state to government levels, and address the crucial issues of infrastructure, manpower shortages, and the pressing need to develop cross-state solutions to prevention and early detection of cancer, in addition to governance of the largely unregulated private sector and the cost of new technologies and drugs. We discuss the role of public insurance schemes, the need to develop new political mandates and authority to set priorities, the necessity to greatly improve the quality of care, and the drive to understand and deliver cost-effective cancer care programmes. PMID:24731888

Pramesh, C S; Badwe, Rajendra A; Borthakur, Bibhuti B; Chandra, Madhu; Raj, Elluswami Hemanth; Kannan, T; Kalwar, Ashok; Kapoor, Sanjay; Malhotra, Hemant; Nayak, Sukdev; Rath, Goura K; Sagar, T G; Sebastian, Paul; Sarin, Rajiv; Shanta, V; Sharma, Suresh C; Shukla, Shilin; Vijayakumar, Manavalan; Vijaykumar, D K; Aggarwal, Ajay; Purushotham, Arnie; Sullivan, Richard

2014-05-01

297

Quality indicators of clinical cancer care (QC3) in colorectal cancer  

PubMed Central

Objectives Assessing the quality of cancer care (QoCC) has become increasingly important to providers, regulators and purchasers of care worldwide. The aim of this study was to develop evidence-based quality indicators (QIs) for colorectal cancer (CRC) to be applied in a population-based setting. Design A comprehensive evidence-based literature search was performed to identify the initial list of QIs, which were then selected and developed using a two-step-modified Delphi process involving two multidisciplinary expert panels with expertise in CRC care, quality of care and epidemiology. Setting The QIs of the clinical cancer care (QC3) population-based project, which involves all the public and private hospitals and clinics present on the territory of Canton Ticino (South Switzerland). Participants Ticino Cancer Registry, The Colorectal Cancer Working Group (CRC-WG) and the external academic Advisory Board (AB). Main outcome measures Set of QIs which encompass the whole diagnostic-treatment process of CRC. Results Of the 149 QIs that emerged from 181 sources of literature, 104 were selected during the in-person meeting of CRC-WG. During the Delphi process, CRC-WG shortened the list to 89 QI. AB finally validated 27 QIs according to the phase of care: diagnosis (N=6), pathology (N=3), treatment (N=16) and outcome (N=2). Conclusions Using the validated Delphi methodology, including a literature review of the evidence and integration of expert opinions from local clinicians and international experts, we were able to develop a list of QIs to assess QoCC for CRC. This will hopefully guarantee feasibility of data retrieval, as well as acceptance and translation of QIs into the daily clinical practice to improve QoCC. Moreover, evidence-based selected QIs allow one to assess immediate changes and improvements in the diagnostic-therapeutic process that could be translated into a short-term benefit for patients with a possible gain both in overall and disease-free survival. PMID:23869102

Bianchi, Valentina; Spitale, Alessandra; Ortelli, Laura; Mazzucchelli, Luca; Bordoni, Andrea

2013-01-01

298

Cancer Care Outcomes Research & Surveillance Consortium (CanCORS)  

Cancer.gov

Although many studies have documented disparities in cancer care, few have explored the reasons for these disparities. Few data are available about relationships between quality of care and outcomes among patients who would not meet criteria for enrollment in many clinical trials; these include elderly patients and patients with substantial co-morbidity.

299

Vanderbilt study reveals racial disparities in prostate cancer care  

Cancer.gov

A study led by investigators from Vanderbilt-Ingram Cancer Center (VICC), Nashville, Tenn., finds that black men with prostate cancer receive lower quality surgical care than white men. The racial differences persist even when controlling for factors such as the year of surgery, age, comorbidities and insurance status.

300

African Americans' and Hispanics' Information Needs About Cancer Care.  

PubMed

Few studies have reported on African American and Hispanic (AA and H) populations' informational needs when seeking cancer care at an institution that offers clinical trials. Moffitt Cancer Center (MCC) sought to identify and examine the decision making process, the perceptions, and the preferred channels of communication about cancer care services for AA and H communities in order to develop a list of marketing recommendations. Five focus groups (N?=?45) consisting of two AA and three H were conducted in four counties of the MCC catchment area in Tampa, FL. Participants were asked about their perceptions, knowledge, attitudes, and beliefs about cancer care and MCC. Focus groups were audio-recorded and verbatim transcripts were analyzed using content analysis. Similarities in responses were found between AA and H participants. Participants received general health and cancer information from media sources and word of mouth and preferred to hear patient testimonials. There were concerns about costs, insurance coverage, and the actual geographic location of the cancer center. In general, H participants were not opposed to participating in cancer clinical trials/research, whereas, AA participants were more hesitant. A majority of participants highly favored an institution that offered standard care and clinical trials. AA and H participants shared similar concerns and preferences in communication channels, but each group had specific informational needs. The perceptions and preferences of AA and H must be explored in order to successfully and efficiently increase cancer clinical trial participation. PMID:25189798

Muñoz-Antonia, Teresita; Ung, Danielle; Montiel-Ishino, F Alejandro; Nelson, Alison; Canales, Jorge; Quinn, Gwendolyn P

2014-09-01

301

Informational Flyer for the Patient-Centered Communication in Cancer Care monograph  

Cancer.gov

National Cancer Institute PATIENT-CENTERED COMMUNICATION IN CANCER CARE Promoting Healing and Reducing Suffering U.S. DEPARTMENT OF HEAL TH AND HUMAN SERVICES National Institutes of Health PATIENT-CENTERED COMMUNICATION IN CANCER CARE Promoting

302

The Passport for Care Program - Office of Cancer Survivorship  

Cancer.gov

The Passport for Care (PFC) Program is in development as an online resource for childhood cancer survivors. These patients face late and long-term physiological effects; psychosocial, employment, and insurance issues; and often lack consistent long-term follow-up care. Patients who successfully complete treatment usually transition back to primary care physicians who may lack understanding of the survivor's medical history and may not be familiar with medical issues faced by this population.

303

Disparities in Care for Cancer Survivors  

Microsoft Academic Search

\\u000a People who have survived cancer face distinctive health problems for the rest of their lives after their primary cancer diagnosis.\\u000a Morbidity and mortality for cancer survivors can occur due to the development of chronic health conditions, called late effects,\\u000a as a result of previous cancer therapy [1, 2]. Examples of late effects include infertility, cardiopulmonary disease, endocrine\\u000a dysfunction, renal impairment,

Jacqueline Casillas; John Z. Ayanian

304

Integrative Oncology:Complementary Therapies in Cancer Care  

Microsoft Academic Search

Many cancer patients experience both physical and emotional symptoms associated with cancer and cancer treatments. Complementary\\u000a therapies are gentle, noninvasive techniques that alleviate symptoms. They are offered along with conventional care to improve\\u000a quality of life. Alternative therapies, on the other hand, are unproved and potentially harmful. They are administered in\\u000a lieu of mainstream treatment and should be avoided. Healthcare

Barrie Cassileth; Jyothirmai Gubili

305

Bayesian Networks for Clinical Decision Support in Lung Cancer Care  

PubMed Central

Survival prediction and treatment selection in lung cancer care are characterised by high levels of uncertainty. Bayesian Networks (BNs), which naturally reason with uncertain domain knowledge, can be applied to aid lung cancer experts by providing personalised survival estimates and treatment selection recommendations. Based on the English Lung Cancer Database (LUCADA), we evaluate the feasibility of BNs for these two tasks, while comparing the performances of various causal discovery approaches to uncover the most feasible network structure from expert knowledge and data. We show first that the BN structure elicited from clinicians achieves a disappointing area under the ROC curve of 0.75 (± 0.03), whereas a structure learned by the CAMML hybrid causal discovery algorithm, which adheres with the temporal restrictions, achieves 0.81 (± 0.03). Second, our causal intervention results reveal that BN treatment recommendations, based on prescribing the treatment plan that maximises survival, can only predict the recorded treatment plan 29% of the time. However, this percentage rises to 76% when partial matches are included. PMID:24324773

Sesen, M. Berkan; Nicholson, Ann E.; Banares-Alcantara, Rene; Kadir, Timor; Brady, Michael

2013-01-01

306

Can Differences in Breast Cancer Utilities Explain Disparities in Breast Cancer Care?  

PubMed Central

BACKGROUND Black, older, and less affluent women are less likely to receive adjuvant breast cancer therapy than their counterparts. Whereas preference contributes to disparities in other health care scenarios, it is unclear if preference explains differential rates of breast cancer care. OBJECTIVE To ascertain utilities from women of diverse backgrounds for the different stages of, and treatments for, breast cancer and to determine whether a treatment decision modeled from utilities is associated with socio-demographic characteristics. PARTICIPANTS A stratified sample (by age and race) of 156 English-speaking women over 25 years old not currently undergoing breast cancer treatment. DESIGN AND MEASUREMENTS We assessed utilities using standard gamble for 5 breast cancer stages, and time-tradeoff for 3 therapeutic modalities. We incorporated each subject's utilities into a Markov model to determine whether her quality-adjusted life expectancy would be maximized with chemotherapy for a hypothetical, current diagnosis of stage II breast cancer. We used logistic regression to determine whether socio-demographic variables were associated with this optimal strategy. RESULTS Median utilities for the 8 health states were: stage I disease, 0.91 (interquartile range 0.50 to 1.00); stage II, 0.75 (0.26 to 0.99); stage III, 0.51 (0.25 to 0.94); stage IV (estrogen receptor positive), 0.36 (0 to 0.75); stage IV (estrogen receptor negative), 0.40 (0 to 0.79); chemotherapy 0.50 (0 to 0.92); hormonal therapy 0.58 (0 to 1); and radiation therapy 0.83 (0.10 to 1). Utilities for early stage disease and treatment modalities, but not metastatic disease, varied with socio-demographic characteristics. One hundred and twenty-two of 156 subjects had utilities that maximized quality-adjusted life expectancy given stage II breast cancer with chemotherapy. Age over 50, black race, and low household income were associated with at least 5-fold lower odds of maximizing quality-adjusted life expectancy with chemotherapy, whereas women who were married or had a significant other were 4-fold more likely to maximize quality-adjusted life expectancy with chemotherapy. CONCLUSIONS Differences in utility for breast cancer health states may partially explain the lower rate of adjuvant therapy for black, older, and less affluent women. Further work must clarify whether these differences result from health preference alone or reflect women's perceptions of sources of disparity, such as access to care, poor communication with providers, limitations in health knowledge or in obtaining social and workplace support during therapy. PMID:16961753

Schleinitz, Mark D; DePalo, Dina; Blume, Jeffrey; Stein, Michael

2006-01-01

307

Challenges facing providers caring for HIV/HCV-coinfected patients  

PubMed Central

Despite the high prevalence of Hepatitis C virus (HCV) infection among injection drug users also infected with Human immunodeficiency virus (HIV), and the synergistic adverse effect of the two diseases on patients' health and survival, the research on the clinical management of these patients and particularly the low uptake of HCV therapy is limited. We conducted qualitative interviews with 17 HIV providers from two urban public hospitals. We discovered that the limitations of the current state of medical knowledge, the severe side effects of HIV and HCV therapies, and the psychosocial vulnerability of HIV/HCV-coinfected patients combined with their resistance to becoming informed about HCV posed significant challenges for providers. To contend with these challenges, providers incorporated key dimensions of patient-centered medicine in their practice such as considering their patients' psychosocial profiles and the meaning patients assign to being coinfected, and finding ways to engage their patients in a therapeutic alliance. PMID:21825278

Lekas, Helen-Maria; Siegel, Karolynn; Leider, Jason

2015-01-01

308

77 FR 72738 - Contracts and Provider Agreements for State Home Nursing Home Care  

Federal Register 2010, 2011, 2012, 2013

...Agreements for State Home Nursing Home Care AGENCY: Department of Veterans Affairs...agreements with State homes for the nursing home care of certain disabled veterans. This rulemaking...in law that revises how VA will pay for care provided to these veterans and...

2012-12-06

309

Catholic providers in NY manage Medicaid special needs through innovative foster care pilot.  

PubMed

Care management for special-needs populations: Brooklyn-based Fidelis Care New York's unique pilot project managing foster children should help it prepare for managed Medicaid special-needs populations statewide. How the partners in the pilot structured their care management model can guide providers in developing their own programs. PMID:10177374

1998-01-01

310

Provider Perspectives about Latino Patients: Determinants of Care and Implications for Treatment  

ERIC Educational Resources Information Center

Primary care settings are the gateway through which the majority of Latinos access care for their physical and mental health concerns. This study explored the perspectives of primary care providers concerning their Latino patients, in particular issues affecting their patients' access to and utilization of services. Interviews were conducted with…

Valdez, Carmen R.; Dvorscek, Michael J.; Budge, Stephanie L.; Esmond, Sarah

2011-01-01

311

More than Motherhood: Reasons for Becoming a Family Day Care Provider  

ERIC Educational Resources Information Center

This article examines motivations for entering family day care work as they relate to responsibilities of motherhood and the prominence of these motivations for the women providing day care within and across groups of workers. Using data from a large-scale representative survey of family day care workers in Illinois, the author examines the range…

Armenia, Amy B.

2009-01-01

312

Stress among Care Givers: The Impact of Nursing a Relative with Cancer  

PubMed Central

Aims: The aim of the present study is to assess the level and areas of stress among care givers nursing their loved ones suffering from cancer. Setting and Design: An assessment of care givers’ stress providing care to cancer patients at Cipla Palliative Care Center was conducted. The study involves data collection using a questionnaire and subsequent analysis. Materials and Methods: A close-ended questionnaire that had seven sections on different aspects of caregivers’ stress was developed and administered to 137 participants and purpose of conducting the survey was explained to their understanding. Caregivers who were willing to participate were asked to read and/or explained the questions and requested to reply as per the scales given. Data was collected in the questionnaires and was quantitatively analyzed. Results: The study results showed that overall stress level among caregivers is 5.18 ± 0.26 (on a scale of 0-10); of the total, nearly 62% of caregivers were ready to ask for professional help from nurses, medical social workers and counselors to cope up with their stress. Conclusion: Stress among caregivers ultimately affects quality of care that is being provided to the patient. This is also because they are unprepared to provide care, have inadequate knowledge about care giving along with financial burden, physical and emotional stress. Thus interventions are needed to help caregivers to strengthen their confidence in giving care and come out with better quality of care. PMID:24600180

Kulkarni, Priyadarshini; Kulkarni, Pradeep; Ghooi, Ravindra; Bhatwadekar, Madhura; Thatte, Nandini; Anavkar, Vrushali

2014-01-01

313

Health Care Providers: A Missing Link in Understanding Acceptability of the Female Condom  

ERIC Educational Resources Information Center

Health care providers can play a key role in influencing clients to initiate and maintain use of the female condom, an underused method for HIV/STI and pregnancy prevention. In 2001-2002, based on semistructured interviews with 78 health care providers from four types of settings in New York City, we found that most providers had seen the female…

Mantell, Joanne E.; West, Brooke S.; Sue, Kimberly; Hoffman, Susie; Exner, Theresa M.; Kelvin, Elizabeth; Stein, Zena A.

2011-01-01

314

Factors Related to the Recruitment, Training, and Retention of Family Child Care Providers.  

ERIC Educational Resources Information Center

Identified factors related to the recruitment, training, and retention of family child care (FCC) providers in two rural communities who participated in an FCC training program. Findings point to the relative success of efforts to recruit and train high quality family child care providers and the relative difficulty of retaining these providers

Mueller, Charles W.; Orimoto, Lisa

1995-01-01

315

Promoting Wellness: A Nutrition, Health and Safety Manual for Family Child Care Providers.  

ERIC Educational Resources Information Center

This manual provides a reference source for use by sponsor organizations of the Child and Adult Care Food Program (CACFP) in training family child care providers. The manual begins with separate introductory sections for trainers and for providers. The trainer's section includes materials on: how adults learn, strengths and limitations of various…

Tatum, Pam S.

316

Cancer and Communication in the Health Care Setting: Experiences of Older Vietnamese Immigrants, A Qualitative Study  

PubMed Central

Background As patients grow older, accurate communication with health care providers about cancer becomes increasingly important. However, little is known about the cancer communication experiences of older Asian immigrants. Objective To learn about the cancer-related communication experiences of older Vietnamese immigrants from the insider perspective. Design Qualitative study (grounded theory, constant comparative method) using individual interviews with older Vietnamese immigrants with the purpose of discussing how they learn about cancer. Interviews were conducted in Vietnamese. Participants Vietnamese immigrants aged 50–70 years, recruited through community-based organizations. Most had low education and limited English proficiency. The sample size of 20 was sufficient to achieve theoretical saturation. Results We identified 3 categories of themes concerning informants’ experiences with cancer communication in the health care setting: (1) attitudes about addressing screening with providers, (2) issues/problems communicating with physicians about cancer, and (3) language/translation difficulties. There was substantial overlap between informants who mentioned each theme category, and 40% of the participants mentioned all 3 categories. Conclusion Clinicians should be aware of and act upon specific cancer communication needs/challenges of their older immigrant patients. Moreover, health care systems need to be prepared to address the needs of an increasingly multiethnic and linguistically diverse patient population. Finally, community-level interventions should address baseline knowledge deficits while encouraging immigrant patients to engage their doctors in discussions about cancer screening. PMID:18030538

Barg, Frances K.; Armstrong, Katrina; Holmes, John H.; Hornik, Robert C.

2007-01-01

317

Myths and realities in cancer care: another point of view.  

PubMed

Cancer care is advancing, and the cancer community is right to celebrate that progress. Simultaneously, however, the cost of cancer therapy is rising along with all medical costs. In a matter of just a few years, the cost of health coverage is projected to reach heights that are simply unsustainable for most American families, overshadowing every other daily expense. Such an overwhelming burden will continue to undermine the progress made in developing new, more effective treatment and care for cancer patients. There cannot be a celebration of discoveries if there is no way to pay for them. It is from that perspective that I react and respond here to the commentary of Dana Goldman and Tomas Philipson, who debunk five myths in cancer care. I concur with the authors' assessment of the value and impact of progress in cancer care. However, I also argue that researchers and policy makers must pay more attention to the impact of cost on patients' adherence and experience and the speed with which new treatment and care are being developed. PMID:25288426

Newcomer, Lee N

2014-10-01

318

University of Wisconsin-Milwaukee Certification of Health Care Provider  

E-print Network

by another provider of health services (e.g., physical therapist), please state the nature of the treatments a general description of such regimen (e.g., prescription drugs, physical therapy requiring special of the employee with a serious health condition, does the patient require assistance for basic medical or personal

Saldin, Dilano

319

Mission Impossible? Providing Direction for Your Child Care Organization  

ERIC Educational Resources Information Center

Managers of early childhood education programs know that it is imperative that their organization's collective energy be focused in a single direction, one that has been envisioned and determined by the organization's leadership, with input from all who will affect or be affected by it. A mission statement provides a constant reminder within an…

Bess, Gary; Myers, Jim

2004-01-01

320

Improving transitions of care at hospital discharge--implications for pediatric hospitalists and primary care providers.  

PubMed

Delays, omissions, and inaccuracy of discharge information are common at hospital discharge and put patients at risk for adverse outcomes. We assembled an interdisciplinary team of stakeholders to evaluate our current discharge process between hospitalists and primary care providers (PCPs). We used a fishbone diagram to identify potential causes of suboptimal discharge communication to PCPs. Opportunities for improvement (leverage points) to achieve optimal transfer of discharge information were identified using tally sheets and Pareto charts. Quality improvement strategies consisted of training and implementation of a new discharge process including: (1) enhanced PCP identification at discharge, (2) use of an electronic discharge order and instruction system, and (3) autofaxing discharge information to PCPs. The new discharge process's impact was evaluated on 2,530 hospitalist patient discharges over a 34-week period by measuring: (1) successful transfer of discharge information (proportion of discharge information sheets successfully faxed to PCPs), (2) timeliness (proportion of sheets faxed within 2 days of discharge), and (3) content (presence of key clinical elements in discharge sheets). Postintervention, success, and timeliness of discharge information transfer between pediatric hospitalists and PCPs significantly improved while content remained high. PMID:20854359

Harlan, Gregory A; Nkoy, Flory L; Srivastava, Rajendu; Lattin, Gena; Wolfe, Doug; Mundorff, Michael B; Colling, Dayvalena; Valdez, Angelika; Lange, Shay; Atkinson, Sterling D; Cook, Lawrence J; Maloney, Christopher G

2010-01-01

321

The international cancer expert corps: a unique approach for sustainable cancer care in low and lower-middle income countries.  

PubMed

The growing burden of non-communicable diseases including cancer in low- and lower-middle income countries (LMICs) and in geographic-access limited settings within resource-rich countries requires effective and sustainable solutions. The International Cancer Expert Corps (ICEC) is pioneering a novel global mentorship-partnership model to address workforce capability and capacity within cancer disparities regions built on the requirement for local investment in personnel and infrastructure. Radiation oncology will be a key component given its efficacy for cure even for the advanced stages of disease often encountered and for palliation. The goal for an ICEC Center within these health disparities settings is to develop and retain a high-quality sustainable workforce who can provide the best possible cancer care, conduct research, and become a regional center of excellence. The ICEC Center can also serve as a focal point for economic, social, and healthcare system improvement. ICEC is establishing teams of Experts with expertise to mentor in the broad range of subjects required to establish and sustain cancer care programs. The Hubs are cancer centers or other groups and professional societies in resource-rich settings that will comprise the global infrastructure coordinated by ICEC Central. A transformational tenet of ICEC is that altruistic, human-service activity should be an integral part of a healthcare career. To achieve a critical mass of mentors ICEC is working with three groups: academia, private practice, and senior mentors/retirees. While in-kind support will be important, ICEC seeks support for the career time dedicated to this activity through grants, government support, industry, and philanthropy. Providing care for people with cancer in LMICs has been a recalcitrant problem. The alarming increase in the global burden of cancer in LMICs underscores the urgency and makes this an opportune time fornovel and sustainable solutions to transform cancer care globally. PMID:25478326

Coleman, C Norman; Formenti, Silvia C; Williams, Tim R; Petereit, Daniel G; Soo, Khee C; Wong, John; Chao, Nelson; Shulman, Lawrence N; Grover, Surbhi; Magrath, Ian; Hahn, Stephen; Liu, Fei-Fei; DeWeese, Theodore; Khleif, Samir N; Steinberg, Michael; Roth, Lawrence; Pistenmaa, David A; Love, Richard R; Mohiuddin, Majid; Vikram, Bhadrasain

2014-01-01

322

California Early Care and Education Workforce Study: Licensed Family Child Care Providers Statewide, 2006  

ERIC Educational Resources Information Center

This report presents the results of First 5 California's 2004 statewide and regional study of the early care and education (ECE) workforce in licensed family child care. The goal of the study was to collect information on the characteristics of this workforce (i.e., educational background and potential need and demand for professional…

Whitebook, Marcy; Sakai, Laura; Kipnis, Fran; Lee, Yuna; Bellm, Dan; Speiglman, Richard; Almaraz, Mirella; Stubbs, LaToya; Tran, Paulina

2006-01-01

323

[Use of family resources in future need of care. Care preferences and expected willingness of providing care among relatives: a population-based study].  

PubMed

The family is an important resource in elderly care. It is of great interest if persons who might be in need of care in the future would use this resource. Our study assessed wishes and expectations regarding family care in a representative sample of the general population (??45 years, N?=?1,445) using questionnaires. Logistic regressions were performed to analyze the potential impact on the willingness to use or provide family care. One quarter of the participants reported experience in family care. In case of own need 62.9% of participants would prefer care provided by relatives and 56.7% would prefer professional care. Participants are more likely to use family care if they report having relatives, are experienced in care of relatives or do not associate old age with being a burden, e.g. report low values in the image of age "being a burden/demanding". Perceived willingness of the relatives to provide care is more likely if there is little regional distance to the relatives, in male participants and if participants talked about future care with their relatives. Besides structural factors, negative images of old age might have a negative influence on the willingness to use family care. Talking about care in old age seems to have a positive impact. PMID:22842889

Spangenberg, L; Glaesmer, H; Brähler, E; Strauß, B

2012-08-01

324

Delivering affordable cancer care in high-income countries.  

PubMed

The burden of cancer is growing, and the disease is becoming a major economic expenditure for all developed countries. In 2008, the worldwide cost of cancer due to premature death and disability (not including direct medical costs) was estimated to be US$895 billion. This is not simply due to an increase in absolute numbers, but also the rate of increase of expenditure on cancer. What are the drivers and solutions to the so-called cancer-cost curve in developed countries? How are we going to afford to deliver high quality and equitable care? Here, expert opinion from health-care professionals, policy makers, and cancer survivors has been gathered to address the barriers and solutions to delivering affordable cancer care. Although many of the drivers and themes are specific to a particular field-eg, the huge development costs for cancer medicines-there is strong concordance running through each contribution. Several drivers of cost, such as over-use, rapid expansion, and shortening life cycles of cancer technologies (such as medicines and imaging modalities), and the lack of suitable clinical research and integrated health economic studies, have converged with more defensive medical practice, a less informed regulatory system, a lack of evidence-based sociopolitical debate, and a declining degree of fairness for all patients with cancer. Urgent solutions range from re-engineering of the macroeconomic basis of cancer costs (eg, value-based approaches to bend the cost curve and allow cost-saving technologies), greater education of policy makers, and an informed and transparent regulatory system. A radical shift in cancer policy is also required. Political toleration of unfairness in access to affordable cancer treatment is unacceptable. The cancer profession and industry should take responsibility and not accept a substandard evidence base and an ethos of very small benefit at whatever cost; rather, we need delivery of fair prices and real value from new technologies. PMID:21958503

Sullivan, Richard; Peppercorn, Jeffrey; Sikora, Karol; Zalcberg, John; Meropol, Neal J; Amir, Eitan; Khayat, David; Boyle, Peter; Autier, Philippe; Tannock, Ian F; Fojo, Tito; Siderov, Jim; Williamson, Steve; Camporesi, Silvia; McVie, J Gordon; Purushotham, Arnie D; Naredi, Peter; Eggermont, Alexander; Brennan, Murray F; Steinberg, Michael L; De Ridder, Mark; McCloskey, Susan A; Verellen, Dirk; Roberts, Terence; Storme, Guy; Hicks, Rodney J; Ell, Peter J; Hirsch, Bradford R; Carbone, David P; Schulman, Kevin A; Catchpole, Paul; Taylor, David; Geissler, Jan; Brinker, Nancy G; Meltzer, David; Kerr, David; Aapro, Matti

2011-09-01

325

75 FR 69449 - Draft Guidance for Industry and Food and Drug Administration Staff on Dear Health Care Provider...  

Federal Register 2010, 2011, 2012, 2013

...Drug Administration Staff on Dear Health Care Provider Letters: Improving Communication...and FDA staff entitled ``Dear Health Care Provider Letters: Improving Communication...Important Safety Information.'' Dear Health Care Provider (DHCP) Letters are...

2010-11-12

326

How can we deliver high-quality cancer care in a healthcare system in crisis?  

PubMed

This provocative question was addressed in a report from the Institute of Medicine ([IOM], 2013), Delivering High-Quality Cancer Care: Charting a New Course for a System in Crisis. An interdisciplinary committee synthesized many of the changes that are occurring in our society and health care that will challenge our existing cancer care system. These changes are familiar to many of us: an aging population along with the resulting increase in the number of cancer survivors, an inadequate number of and increased demand for trained healthcare providers, and rising healthcare costs. The IOM report recommended a framework of six interconnected components for improving the quality of cancer care (see Figures 1 and 2). Each of these components is worthy of an editorial and more. I would like to focus, however, on one of them: an adequately staffed, trained, and coordinated workforce. And, for good reason, as I want to retire someday and know that others will be taking my place in caring for cancer survivors across the care continuum. So let's explore this one component in more detail. PMID:25095288

Mayer, Deborah K

2014-08-01

327

Preparation for cancer care: perceptions of newly qualified health care professionals.  

PubMed

The present paper is derived from a larger survey which examined the perceptions of recently qualified health care professionals' experience on evidence-based practice, team working and cancer care. This study reports solely on the findings relating to cancer care. The perceptions of recently qualified professionals in relation to their initial educational input on issues such as confidence, anxiety, communication skills and practice in cancer care as well as adequacy of support, professional supervision and use of reflection were gathered using a cross-sectional postal survey design. A total of 50 graduates from each professional category in nursing, occupational therapy, physiotherapy, and social work were sampled yielding a total sample of 200. Eighty-five questionnaires were returned yielding a response rate of 43%. Twenty-eight (33%) respondents stated that they were currently involved in working with people with cancer. These were as follows: 5 nurses, 8 physiotherapists, 9 occupational therapists and 6 social workers. Despite the low response rate, the findings suggest that health care professionals' educational input and experiences of working with people with cancer were overall positive; for example, in the respondents' confidence, communication skills, decrease in anxiety and application of knowledge gained in classroom to professional practice. Moreover, most respondents learnt about caring for cancer patients through practice rather than classroom teaching. A high percentage (i.e. 64%;18) across all groups felt supported when caring for people with cancer and reported receiving professional supervision as well as being able to actively reflect on their practice. The implications for education and practice were discussed particularly as there have been few studies conducted in relation to the specific needs and collaborative learning of these health care professional groups. PMID:17126078

Copp, Gina; Caldwell, Kay; Atwal, Anita; Brett-Richards, Madeline; Coleman, Kate

2007-04-01

328

Caring for patients with cancer in non-specialist wards: the nurse experience.  

PubMed

This study aims to describe the experiences of nurses caring for cancer patients in non-specialist wards. The study was conducted in a large (420 beds) and small (32 beds) hospital in an area health service with urban and rural populations in the west of Sydney. A qualitative descriptive approach was utilized to collect data from the nurses. Data were collected using a survey and in-depth interviews of nurses working in non-specialist cancer wards. Transcribed data were managed with Nudist Vivo software and analysed for common themes using process of constant comparison and contrast. Twenty-five surveys were returned and five nurses volunteered to be interviewed. The six major themes that emerged from analysis of data were: emotional nature of care, lack of time, lack of knowledge of cancer treatment, family support, environment not conducive to proper care and dealing with patient's non-acceptance of cancer diagnosis. The nurses in this study wished to provide quality supportive care for cancer patients and their families but the inconducive environment and inadequate relevant training hindered the nurses' efforts. This then presents further need of relevant training for nurses in cancer care and time management, to meet up with these challenges. PMID:15952970

Mohan, S; Wilkes, L M; Ogunsiji, O; Walker, A

2005-07-01

329

Training Providers and Patients to Talk about End-of-Life Care  

Cancer.gov

Failing to discuss the transition from active cancer treatment to end-of-life care can leave doctors unsure of what a patient truly wants. Failing to receive end-of-life care in line with their values and wishes can cause patients and their families great distress. Researchers have developed innovative, evidence-based programs to help doctors and patients improve their communication skills and grow comfortable with these discussions.

330

Cancers Covered by Patterns of Care/Quality of Care  

Cancer.gov

Skip to Main Content at the National Institutes of Health | www.cancer.gov Print Page E-mail Page Search: Please wait while this form is being loaded.... Home Browse by Resource Type Browse by Area of Research Research Networks Funding Information About

331

Trust in health care providers: factors predicting trust among homeless veterans over time.  

PubMed

We examined whether a combination of predisposing, enabling, need, and primary care experience variables would predict trust in medical health care providers for homeless veterans over 18 months. Linear mixed model analysis indicated that, among these variables, race, social support, service-connected disability status, and satisfaction and continuity with providers predicted trust in provider over time. Trust in providers improved during the initial stages of the relationship between patient and provider and then declined to slightly below baseline levels over time. Further research is needed to determine generalizability and effects of provider trust on patient health care status over longer periods of time. PMID:25130239

van den Berk-Clark, Carissa; McGuire, James

2014-08-01

332

Communication and Cultural Issues in Providing Reproductive Health Care to Immigrant Women: Health Care Providers’ Experiences in Meeting Somali Women Living in Finland  

Microsoft Academic Search

Communication problems due to language and cultural differences between health care professionals and patients are widely\\u000a recognized. Finns are described as more silent whereas one concurrent large immigrant group, the Somalis, are described as\\u000a more open in their communication. The aim of the study was to explore physicians-nurses\\/midwives’ communication when providing\\u000a reproductive and maternity health care to Somali women in

Filio Degni; Sakari Suominen; Birgitta Essén; Walid El Ansari; Katri Vehviläinen-Julkunen

333

[Update on current care guidelines: ovarian cancer].  

PubMed

Ovarian cancer is the most lethal gynaecological cancer. It appears that seemingly ovarian or primary peritoneal carcinomas, in fact, originate from fimbriae. BRCA1/2 mutation carriers are recommended for the removal of ovaries and fimbriae, to reduce the risk of cancer. Treatment of epithelial ovarian cancer is based on the combination of surgery and chemotherapy. The residual tumour volume at the primary operation is the most important predictive factor of survival. The best response at the primary treatment is observed with combination chemotherapy with taxane and platinum. Adding bevacitzumab to first line chemotherapy may improve survival. PMID:22822606

Leminen, Arto; Auranen, Annika; Bützow, Ralf; Hietanen, Sakari; Komulainen, Marja; Kuoppala, Tapio; Mäenpää, Johanna; Puistola, Ulla; Vuento, Maarit; Vuorela, Piia; Yliskoski, Merja

2012-01-01

334

Enhancing provider knowledge and patient screening for palliative care needs in chronic multimorbid patients receiving home-based primary care.  

PubMed

This article describes a pilot model to increase palliative care (PC) knowledge and collaboration among providers and to systematically identify chronic multimorbid home care patients who would benefit from focused discussion of potential PC needs. Thirty health care providers from a home-based primary care team attended interdisciplinary trainings. The Palliative Performance Scale (PPS) tool was used to trigger discussions of potential palliative needs at team rounds for patients who scored below a cutoff point on the tool. Palliative Performance Scale implementation added little burden on nurses and triggered a discussion in 51 flagged patients. The tool successfully identified 75% of patients who died or were discharged. Screening was systematic and consistent and resulted in targeted discussions about PC needs without generating additional burden on our PC consult service. This model shows promise for enhancing collaborative patient care and access to PC. PMID:24280188

Wharton, Tracy; Manu, Erika; Vitale, Caroline A

2015-02-01

335

The language of sedation in end-of-life care: The ethical reasoning of care providers in three countries.  

PubMed

The application of ethically controversial medical procedures may differ from one place to another. Drawing on a keyword and text-mining analysis of 156 interviews with doctors and nurses involved in end-of-life care ('care providers'), differences between countries in care providers' ethical rationales for the use of sedation are reported. In the United Kingdom, an emphasis on titrating doses proportionately against symptoms is more likely, maintaining consciousness where possible. The potential harms of sedation are perceived to be the potential hastening of social as well as biological death. In Belgium and the Netherlands, although there is concern to distinguish the practice from euthanasia, rapid inducement of deep unconsciousness is more acceptable to care providers. This is often perceived to be a proportionate response to unbearable suffering in a context where there is also greater pressure to hasten dying from relatives and others. This means that sedation is more likely to be organised like euthanasia, as the end 'moment' is reached, and family farewells are organised before the patient is made unconscious for ever. Medical and nursing practices are partly responses to factors outside the place of care, such as legislation and public sentiment. Dutch guidelines for sedation largely tally with the practices prevalent in the Netherlands and Belgium, in contrast with those produced by the more international European Association for Palliative Care whose authors describe an ethical framework closer to that reportedly used by UK care providers. PMID:25389235

Seale, Clive; Raus, Kasper; Bruinsma, Sophie; van der Heide, Agnes; Sterckx, Sigrid; Mortier, Freddy; Payne, Sheila; Mathers, Nigel; Rietjens, Judith

2014-11-10

336

Quality palliative care for cancer and dementia in five European countries: some common challenges  

PubMed Central

Objectives There is a growing consensus worldwide that palliative care needs to be both more inclusive of conditions other than cancer and to improve. This paper explores some common challenges currently faced by professionals providing palliative care for patients with either cancer or dementia across five countries. Method One focus group (n = 7) and 67 interviews were conducted in 2012 across five countries: England, Germany, Italy, the Netherlands and Norway, with professionals from dementia, cancer and palliative care settings. Results The interviews revealed five common challenges faced across the five countries: communication difficulties (between services; and between professionals, and patients and their families); the variable extent of structural/functional integration of services; the difficulties in funding of palliative care services; problematic processes of care (boundaries, definitions, knowledge, skills and inclusiveness) and, finally, time constraints. Conclusion These are not problems distinct to palliative care, but they may have different origins and explanations compared to other areas of health care. This paper explored deeper themes hidden behind a discourse about barriers and facilitators to improving care. PMID:24131061

Davies, Nathan; Maio, Laura; van Riet Paap, Jasper; Mariani, Elena; Jaspers, Birgit; Sommerbakk, Ragni; Grammatico, Daniela; Manthorpe, Jill; Ahmedzai, Sam; Vernooij-Dassen, Myrra; Iliffe, Steve

2013-01-01

337

Defining Value in Cancer Care: AVBCC 2013 Steering Committee Report  

PubMed Central

The AVBCC Annual Meeting experiences exponential growth in attendance and participation as oncologists, payers, employers, managed care executives, patient advocates, and drug manufacturers convened in Hollywood, FL, on May 2–5, 2013, for the Third Annual Conference of the Association for Value-Based Cancer Care (AVBCC). The conference presented an all-inclusive open forum for stakeholder dialogue and integration across the cancer care continuum, facilitating an open dialogue among the various healthcare stakeholders to align their perspectives around the urgent need to address value in cancer care, costs, patient education, safety, outcomes, and quality. The AVBCC 2013 Steering Committee was held on the first day of the conference to define value in cancer care. The committee was divided into 7 groups, each representing a key stakeholder in oncology. The goal of the Steering Committee was to define value from the particular point of view of each of the stakeholder groups and to suggest how that particular perspective can contribute to the value proposition in oncology, by balancing cost, quality, and access to care to improve overall patient outcomes. The following summary highlights the major points addressed by each group. PMID:24991360

Zweigenhaft, Burt; Bosserman, Linda; Kenney, James T.; Lawless, Grant D.; Marsland, Thomas A.; Deligdish, Craig K.; Burgoyne, Douglas S.; Knopf, Kevin B.; Long, Douglas M.; McKercher, Patrick; Owens, Gary M.; Hennessy, John E.; Lang, James R.; Malin, Jennifer; Natelson, Leonard; Palmgren, Matthew C.; Slotnik, Jayson; Shockney, Lillie D.; Vogenberg, F. Randy

2013-01-01

338

General Care of the Older Cancer Patient  

Microsoft Academic Search

With increasing age, there are greater numbers of older people who will be diagnosed with cancer. It must be remembered that such individuals have increased frailty and have a number of geriatric syndromes and conditions particularly pertinent to older age, including incontinence, poor cognition and impaired nutrition. It is often difficult to define the effects of cancer and its treatment

M. Gosney

2009-01-01

339

Improving Breast Cancer Care for Older Women  

Cancer.gov

Earlier diagnosis, improved treatment, and the overall increase in average lifespan continue to expand the number of breast cancer survivors who are aged 65 and older. This population is already estimated to be one million of the total 2.3 million breast cancer survivors.

340

Human trafficking: Role of oral health care providers.  

PubMed

Trafficking in human beings is a modern form of slavery and is a well-known phenomenon throughout the European Union and beyond. After drug dealing and the weapons industry, human trafficking is the second largest criminal activity in the world today and it is a growing crime. The aim of governmental and non-governmental agencies, which are either directly or indirectly involved in combating trafficking in human beings, is the identification and referral of victims of trafficking and also to encourage self-referrals. Identification is the most important step to provide protection and assistance to victims of trafficking. Victims often have a variety of physical and mental health needs, including psychological trauma, injuries from violence, head and neck trauma, sexually transmitted infections and other gynaecological problems, dental/oral problems and have poor nutrition. The author's experience in the field of community dentistry in presented within. Volunteer dental services are offered to non-European Union patients held in a centre for asylum seekers in Bari (Italy). Dental professionals can, in fact, contribute to the identification, assistance and protection of trafficked persons, as well as offering forensic services to assist the police investigation in order to identify crimes and find the criminal organizations behind them. As for domestic violence and child abuse cases, there are ethical concerns involved in the identification and protection of the trafficked persons, as well as the need for interdisciplinary work and awareness. Adequate training in behavioural science and intercultural learning is paramount in order to avoid misunderstandings and increase sensitivity. PMID:25557409

Nuzzolese, E

2014-01-01

341

Cancer Survivorship: Moving the Science and Art of Research and Care Beyond Cure - March 31, 2003  

Cancer.gov

Cancer Survivorship: Moving the Science and Art of Research and Care Beyond Cure Statement of Julia H. Rowland, Ph.D. Director, Office of Cancer Survivorship Division of Cancer Control and Population Sciences National Cancer Institute National

342

Racial Disparities in Access to Care for Men in a Public Assistance Program for Prostate Cancer  

Microsoft Academic Search

California’s IMPACT program provides all its enrollees with health insurance and social service resources. We hypothesized\\u000a that racial\\/ethnic disparities in access to care might be attenuated among men served by this program. Our objective was to\\u000a evaluate racial\\/ethnic differences in health services utilization and patient-reported health care outcomes among disadvantaged\\u000a men in a prostate cancer public-assistance program, and to identify

David C. Miller; Lillian Gelberg; Lorna Kwan; Sevan Stepanian; Arlene Fink; Ronald M. Andersen; Mark S. Litwin

2008-01-01

343

Choosing a Primary Health Care Provider (PCP): A Guide for Young Women  

MedlinePLUS

Choosing a Primary Health Care Provider (PCP): General Information Posted under Health Guides . Updated 12 June 2013. +Related Content Key Facts Having a PCP ... needs. How do I find the names of health care providers? You should first make a list of ...

344

Choosing a Primary Health Care Provider (PCP): A Guide for Young Men  

MedlinePLUS

C hoosing a Primary Health Care Provider (PCP) Choosing a PCP Check-Ups How to Find a PCP When to Visit Your PCP Health Plans If ... Qualifications of PCPs Confidentiality Going to a primary health care provider (PCP) is a very important part of ...

345

Improved Prevention Counseling by HIV Care Providers in a Multisite, Clinic-Based Intervention: Positive STEPs  

ERIC Educational Resources Information Center

The Centers for Disease Control and Prevention have recommended that HIV care clinics incorporate prevention into clinical practice. This report summarizes HIV care providers' attitudes and counseling practices before and after they received training to deliver a counseling intervention to patients. Providers at seven HIV clinics received training…

Thrun, Mark; Cook, Paul F.; Bradley-Springer, Lucy A.; Gardner, Lytt; Marks, Gary; Wright, Julie; Wilson, Tracey E.; Quinlivan, E. Byrd; O'Daniels, Christine; Raffanti, Stephen; Thompson, Melanie; Golin, Carol

2009-01-01

346

Child-Care Provider Survey Reveals Cost Constrains Quality. Research Brief. Volume 96, Number 5  

ERIC Educational Resources Information Center

A survey of 414 child care providers in southeastern Wisconsin reveals that cost as well as low wages and lack of benefits for workers can constrain providers from pursuing improvements to child-care quality. Of survey respondents, approximately half of whom are home-based and half center-based, 13% have at least three of five structural factors…

Public Policy Forum, 2008

2008-01-01

347

Deciding Who To See: Lesbians Discuss Their Preferences in Health and Mental Health Care Providers.  

ERIC Educational Resources Information Center

Few researchers have studied how lesbians choose health and mental health care providers. This article reports on community focus groups in which 33 lesbians reported that decision making was based on their past experiences and their hopes for high quality care. They encountered a continuum of provider reactions consisting of five categories:…

Saulnier, Christine Flynn

2002-01-01

348

The use of antenatal and postnatal care: perspectives and experiences of women and health care providers in rural southern Tanzania  

PubMed Central

Background Although antenatal care coverage in Tanzania is high, worrying gaps exist in terms of its quality and ability to prevent, diagnose or treat complications. Moreover, much less is known about the utilisation of postnatal care, by which we mean the care of mother and baby that begins one hour after the delivery until six weeks after childbirth. We describe the perspectives and experiences of women and health care providers on the use of antenatal and postnatal services. Methods From March 2007 to January 2008, we conducted in-depth interviews with health care providers and village based informants in 8 villages of Lindi Rural and Tandahimba districts in southern Tanzania. Eight focus group discussions were also conducted with women who had babies younger than one year and pregnant women. The discussion guide included information about timing of antenatal and postnatal services, perceptions of the rationale and importance of antenatal and postnatal care, barriers to utilisation and suggestions for improvement. Results Women were generally positive about both antenatal and postnatal care. Among common reasons mentioned for late initiation of antenatal care was to avoid having to make several visits to the clinic. Other concerns included fear of encountering wild animals on the way to the clinic as well as lack of money. Fear of caesarean section was reported as a factor hindering intrapartum care-seeking from hospitals. Despite the perceived benefits of postnatal care for children, there was a total lack of postnatal care for the mothers. Shortages of staff, equipment and supplies were common complaints in the community. Conclusion Efforts to improve antenatal and postnatal care should focus on addressing geographical and economic access while striving to make services more culturally sensitive. Antenatal and postnatal care can offer important opportunities for linking the health system and the community by encouraging women to deliver with a skilled attendant. Addressing staff shortages through expanding training opportunities and incentives to health care providers and developing postnatal care guidelines are key steps to improve maternal and newborn health. PMID:19261181

Mrisho, Mwifadhi; Obrist, Brigit; Schellenberg, Joanna Armstrong; Haws, Rachel A; Mushi, Adiel K; Mshinda, Hassan; Tanner, Marcel; Schellenberg, David

2009-01-01

349

Cancer Prevalence and Cost of Care Projections - SEER Cancer Statistics  

Cancer.gov

SEER is an authoritative source of information on cancer incidence and survival in the United States. SEER currently collects and publishes cancer incidence and survival data from population-based cancer registries covering approximately 28 percent of the U.S. population.

350

The experiences of stress of palliative care providers in malaysia: a thematic analysis.  

PubMed

A qualitative study was conducted with semistructured interviews to explore the experiences of stress in 20 palliative care providers of University Malaya Medical Centre in Malaysia. The results were thematically analyzed. Nine basic themes were generated: (1) organizational challenges, (2) care overload, (3) communication challenges, (4) differences in opinion, (5) misperceptions and misconceptions, (6) personal expectations, (7) emotional involvement, (8) death and dying thoughts, and (9) appraisal and coping. A total care model of occupational stress in palliative care was conceptualized from the analysis. This model may inform the development of interventions in the prevention and management of stress in palliative care. PMID:24023263

Beng, Tan Seng; Chin, Loh Ee; Guan, Ng Chong; Yee, Anne; Wu, Cathie; Pathmawathi, Subramaniam; Yi, Kweh Ting; Kuan, Wong Sook; Jane, Lim Ee; Meng, Christopher Boey Chiong

2015-02-01

351

Care coordination between specialty care and primary care: a focus group study of provider perspectives on strong practices and improvement opportunities.  

PubMed

Care coordination between the specialty care provider (SCP) and the primary care provider (PCP) is a critical component of safe, efficient, and patient-centered care. Veterans Health Administration conducted a series of focus groups of providers, from specialty care and primary care clinics at VA Medical Centers nationally, to assess 1) what SCPs and PCPs perceive to be current practices that enable or hinder effective care coordination with one another and 2) how these perceptions differ between the two groups of providers. A qualitative thematic analysis of the gathered data validates previous studies that identify communication as being an important enabler of coordination, and uncovers relationship building between specialty care and primary care (particularly through both formal and informal relationship-building opportunities such as collaborative seminars and shared lunch space, respectively) to be the most notable facilitator of effective communication between the two sides. Results from this study suggest concrete next steps that medical facilities can take to improve care coordination, using as their basis the mutual understanding and respect developed between SCPs and PCPs through relationship-building efforts. PMID:25653538

Kim, Bo; Lucatorto, Michelle A; Hawthorne, Kara; Hersh, Janis; Myers, Raquel; Elwy, A Rani; Graham, Glenn D

2015-01-01

352

Care coordination between specialty care and primary care: a focus group study of provider perspectives on strong practices and improvement opportunities  

PubMed Central

Care coordination between the specialty care provider (SCP) and the primary care provider (PCP) is a critical component of safe, efficient, and patient-centered care. Veterans Health Administration conducted a series of focus groups of providers, from specialty care and primary care clinics at VA Medical Centers nationally, to assess 1) what SCPs and PCPs perceive to be current practices that enable or hinder effective care coordination with one another and 2) how these perceptions differ between the two groups of providers. A qualitative thematic analysis of the gathered data validates previous studies that identify communication as being an important enabler of coordination, and uncovers relationship building between specialty care and primary care (particularly through both formal and informal relationship-building opportunities such as collaborative seminars and shared lunch space, respectively) to be the most notable facilitator of effective communication between the two sides. Results from this study suggest concrete next steps that medical facilities can take to improve care coordination, using as their basis the mutual understanding and respect developed between SCPs and PCPs through relationship-building efforts. PMID:25653538

Kim, Bo; Lucatorto, Michelle A; Hawthorne, Kara; Hersh, Janis; Myers, Raquel; Elwy, A Rani; Graham, Glenn D

2015-01-01

353

Are VA primary care providers aware of HIV testing recommendations for Veterans? Findings at an urban VA primary care clinic.  

PubMed

Given the prevalence of human immunodeficiency virus (HIV) in veterans and that nearly 90% of veterans have not been HIV tested, the Veterans Affairs (VA) has recommended routine HIV testing of all veterans.The objective of this study carried out at an urban VA primary care clinic was to assess provider knowledge of recent U.S. Centers for Disease Control and Prevention (CDC) and VA HIV testing recommendations and policies. Fifty-six primary care providers completed a survey. Nearly 40% of providers were unaware of the CDC recommendation to test all persons ages 13 to 64 in health care settings or the VA policy to test veterans of all ages. Over 75% of providers were unaware of the latest requirements for pre- and posttest counseling, and many were unaware of the latest consent process requirements. Educating VA providers about recent HIV testing recommendations and policies may improve the low HIV testing prevalence in the VA. PMID:23707836

Arya, Monisha; Bush, Amber L; Kallen, Michael A; Rodriguez-Barradas, Maria C; Giordano, Thomas P

2013-04-01

354

42 CFR 403.764 - Basis and purpose of religious nonmedical health care institutions providing home service.  

...purpose of religious nonmedical health care institutions providing home service...PROJECTS Religious Nonmedical Health Care Institutions-Benefits, Conditions...purpose of religious nonmedical health care institutions providing home...

2014-10-01

355

The Increasing Incidence of Thyroid Cancer: The Influence of Access to Care  

PubMed Central

Background The rapidly rising incidence of papillary thyroid cancer may be due to overdiagnosis of a reservoir of subclinical disease. To conclude that overdiagnosis is occurring, evidence for an association between access to health care and the incidence of cancer is necessary. Methods We used Surveillance, Epidemiology, and End Results (SEER) data to examine U.S. papillary thyroid cancer incidence trends in Medicare-age and non–Medicare-age cohorts over three decades. We performed an ecologic analysis across 497?U.S. counties, examining the association of nine county-level socioeconomic markers of health care access and the incidence of papillary thyroid cancer. Results Papillary thyroid cancer incidence is rising most rapidly in Americans over age 65 years (annual percentage change, 8.8%), who have broad health insurance coverage through Medicare. Among those under 65, in whom health insurance coverage is not universal, the rate of increase has been slower (annual percentage change, 6.4%). Over three decades, the mortality rate from thyroid cancer has not changed. Across U.S. counties, incidence ranged widely, from 0 to 29.7 per 100,000. County papillary thyroid cancer incidence was significantly correlated with all nine sociodemographic markers of health care access: it was positively correlated with rates of college education, white-collar employment, and family income; and negatively correlated with the percentage of residents who were uninsured, in poverty, unemployed, of nonwhite ethnicity, non-English speaking, and lacking high school education. Conclusion Markers for higher levels of health care access, both sociodemographic and age-based, are associated with higher papillary thyroid cancer incidence rates. More papillary thyroid cancers are diagnosed among populations with wider access to healthcare. Despite the threefold increase in incidence over three decades, the mortality rate remains unchanged. Together with the large subclinical reservoir of occult papillary thyroid cancers, these data provide supportive evidence for the widespread overdiagnosis of this entity. PMID:23517343

Sikora, Andrew G.; Tosteson, Tor D.

2013-01-01

356

Genetics and Common Disorders: Implications for Primary Care and Public Health Providers  

SciTech Connect

We developed this program for primary care providers (PCPs) and public health professionals (PHPs) who are interested in increasing their understanding of the genetics of common chronic diseases and of the implications of genetics and genomics for their fields. The program differs from virtually all previous educational efforts in genetics for health professionals in that it focuses on the genetics of common chronic disease and on the broad principles that emerge when one views disease from the perspectives of variation and individuality, which are at the heart of thinking genetically. The CD-ROM introduces users to content that will improve their understanding of topics such as: • A framework for genetics and common disease; • Basic information on genetics, genomics, genetic medicine, and public health genetics, all in the context of common chronic disease; • The status of research on genetic contributions to specific common diseases, including a review of research methods; • Genetic/environmental interaction as the new “central dogma” of public health genetics; • The importance of taking and analyzing a family history; • The likely impact of potential gene discovery and genetic testing on genetic counseling and risk assessment and on the practices of PCPs and PHPs; • Stratification of populations into low-, moderate-, and high-risk categories; • The potential role of PCPs and PHPs in identifying high-risk individuals and families, in providing limited genetics services, and in referring to clinical genetics specialists; the potential for standard referral algorithms; • Implications of genetic insights for diagnosis and treatment; • Ethical, legal, and social issues that arise from genetic testing for common chronic diseases; and • Specific prevention strategies based on understanding of genetics and genetic/ environmental interactions. The interactive content – developed by experts in genetics, primary care, and public health – is organized around two case studies designed to appeal to primary care providers (thrombophilia) and public health professionals (development of a screening grogram for colorectal cancer). NCHPEG has distributed more than 0000 copies of the CD-ROM to NCHPEG member organizations and to other organizations and individuals in response to requests. The program also is available at www.nchpeg.org.

McInerney, Joseph D.; Greendale, Karen; Peay, Holly L.

2005-06-01

357

Structured Decision-Making: Using Personalized Medicine to Improve the Value of Cancer Care  

PubMed Central

Cancer care is often inconsistently delivered with inadequate incorporation of patient values and objective evidence into decision-making. Utilization of time limited trials of care with predefined decision points that are based on iteratively updated best evidence, tools that inform providers about a patient’s experience and values, and known information about a patient’s disease will allow superior matched care to be delivered. Personalized medicine does not merely refer to the incorporation of genetic information into clinical care, it involves utilization of the wide array of data points relevant to care, many of which are readily available at the bedside today. By pushing uptake of personalized matching available today, clinicians can better address the triple aim of improved health, lowers costs, and enhanced patient experience, and we can prepare the health care landscape for the iterative inclusion of progressively more sophisticated information as newer tests and information become available to support the personalized medicine paradigm.

Hirsch, Bradford R.; Abernethy, Amy P.

2012-01-01

358

Primary care provider interventions for the delayed disclosure of adolescent sexual assault.  

PubMed

Acute sexual assault is a serious and underreported crime with the potential for causing grave physical and emotional harm to its victim. As a result of developmental and psychological factors, the adolescent victim may delay the disclosure of such an assault and therefore experience detrimental, acute, and long-term effects. By understanding the reasons for delayed disclosure and integrating this with currently established guidelines for acutely assaulted patients, primary care providers can better tailor the care they provide when faced with the delayed disclosure of adolescent sexual assault. Furthermore, based on this review, it becomes clear that standardized protocols are necessary to more efficiently care for these patients. Recommendations are provided to allow tailoring of primary care provider's interventions based on established protocols and new understandings when caring for adolescents who delay the disclosure of their sexual assault. PMID:15662358

Lessing, Jessica E

2005-01-01

359

Finding medical care for colorectal cancer symptoms: experiences among those facing financial barriers.  

PubMed

Financial barriers can substantially delay medical care seeking. Using patient narratives provided by 252 colorectal cancer patients, we explored the experience of financial barriers to care seeking. Of the 252 patients interviewed, 84 identified financial barriers as a significant hurdle to obtaining health care for their colorectal cancer symptoms. Using verbatim transcripts of the narratives collected from patients between 2008 and 2010, three themes were identified: insurance status as a barrier (discussed by n = 84; 100% of subsample), finding medical care (discussed by n = 30; 36% of subsample) and, insurance companies as barriers (discussed by n = 7; 8% of subsample). Our analysis revealed that insurance status is more nuanced than the categories insured/uninsured and differentially affects how patients attempt to secure health care. While barriers to medical care for the uninsured have been well documented, the experiences of those who are underinsured are less well understood. To improve outcomes in these patients it is critical to understand how financial barriers to medical care are manifested. Even with anticipated changes of the Affordable Care Act, it remains important to understand how perceived financial barriers may be influencing patient behaviors, particularly those who have limited health care options due to insufficient health insurance coverage. PMID:25394821

Thomson, Maria D; Siminoff, Laura A

2015-02-01

360

Value and cancer care: toward an equitable future.  

PubMed

Health care expenses in the United States are increasing inexorably. At the current rate of growth, it is anticipated that 20% of the gross national product will consist of health-related expenditures within the next decade. Cancer is the second leading cause of death in the United States, and it is increasing in prevalence because of the aging of the population and the limited number of successful prevention strategies. As the biological characteristics of cancer come into sharper focus, targeted therapies are being developed that offer the promise of increased clinical benefit with fewer toxicities than are associated with conventional treatment. Although spectacular successes are infrequent with this approach, to date, the majority of targeted therapies are modestly effective at best, and extremely costly. This observation suggests that a broadly acceptable definition of value in a cancer therapeutic agent is not at hand, but is sorely needed from the vantage points of the patient and society. A corollary issue of enormous import is how to equitably distribute the health care dollar in the service of achieving the greatest good for the greatest number. Although cancer is responsible for only 5% of the health care budget, its cost is increasing and it can be viewed as paradigmatic when contemplating the problem of equity in health care. Here, a number of concepts are discussed that focus on this goal and its implications for the cancer patient and society at large. PMID:21169254

Schnipper, Lowell E; Meropol, Neal J; Brock, Dan W

2010-12-15

361

The Comprehensiveness of Family Cancer History Assessments in Primary Care  

Microsoft Academic Search

Background: Accurate family history information is required for adequate breast and colorectal cancer risk assessments. Few studies have examined the comprehensiveness of the family medical history interview in primary care. Methods: We compared family cancer history information collected through a self-completed survey with that documented within medical charts for 310 patients. Results: Forty-three percent (18\\/42) of individuals at increased risk

Harvey J. Murff; Robert A. Greevy; Sapna Syngal

2007-01-01

362

Concussion management for the adolescent patient: an algorithm for primary-care providers.  

PubMed

A sharp increase in the number of diagnosed concussions has been observed for the traditional adultathlete, as well as the young recreational athlete. An enhancing awareness and growing concern has been noted for the potentially larger number of concussions that go undiagnosed and the unknown capability for long-term complications associated with this injury. This increase in concussion awareness has appropriately led to an enhanced utilization of the health-care system for concussion evaluation and management. As is always the case in the practice of medicine, it is important for healthcare providers, from all points of entry in the healthcare system, to provide consistent management for the best outcomes for any disease process. Millions of sport-related concussions occur each year in the United States, placing a large demand on the healthcare system. Utilization of appropriate and congruent treatment plans during the medical discourse when transferring care of patients between providers is paramount. In the co-management model of care, subspecialists lend expertise to assist primary-care providers (PCPs) in gaining the core competencies necessary to provide appropriate levels of care for certain conditions. Increased use of co-management could make the health-care system more efficient and collaborative, leading to: increased access for patients, lower overall costs, and improved quality of care and health outcomes. Co-management allows patients and families to have access to the expert knowledge of subspecialist while receiving more of their care from their PCP, increasing their comfort and making treatment more convenient. The intent of this paper is to distribute an algorithm created by a multidisciplinary group of medical providers to provide a rational approach, congruent with the standard of care, for the primary-care provider to institute an individualized stepwise progression. PMID:23061213

Kostyun, Regina O; Hafeez, Imran

2012-09-01

363

Preparing Trainees to Deliver Patient-Centered Care in an Ambulatory Cancer Clinic.  

PubMed

The purpose of this paper is to describe how an interprofessional cancer care clinic at the Cleveland Veteran's Affairs Medical Center (VAMC) is training health care professionals in patient-centered care. Teaching strategies included patient huddle discussions pre- and post-clinic, role-play, noon "lunch and learn" conferences, and, most importantly, patient interactions, which were evaluated with the patient perception of patient centeredness (PPPC) instrument. This instrument is designed to capture patient and provider perceptions of the provider's patient centeredness. Early findings demonstrated that patient responses were overwhelmingly positive and lacked variability. In response to the lack of variability, the educator in the clinic participated in the evaluation and patient, provider, and trainer responses were compared. Discussion of the weekly evaluations provided helpful formative feedback on patient centeredness to the trainees rotating through this specialty care clinic. PMID:25189797

Mazanec, Polly; Arfons, Lisa; Smith, Jennifer; Curry, Sonya; Berman, Susan; Dimick, Jennifer; Lynch, Melanie; Alvarado, Nannette; Latini, David M

2014-09-01

364

African american women and prenatal care: perceptions of patient-provider interaction.  

PubMed

Poor patient-provider interaction among racial/ethnic minorities is associated with disparities in health care. In this descriptive, cross-sectional study, we examine African American women's perspectives and experiences of patient-provider interaction (communication and perceived discrimination) during their initial prenatal visit and their influences on perceptions of care received and prenatal health behaviors. Pregnant African American women (n = 204) and their providers (n = 21) completed a pre- and postvisit questionnaire at the initial prenatal visit. Women were also interviewed face to face at the subsequent return visit. Women perceived high quality patient-provider communication (PPC) and perceived low discrimination in their interaction with providers. Multiple regression analyses showed that PPC had a positive effect on trust in provider (p < .001) and on prenatal care satisfaction (p < .001) but not on adherence to selected prenatal health behaviors. Findings suggest that quality PPC improves the prenatal care experience for African American women. PMID:24838492

Dahlem, Chin Hwa Y; Villarruel, Antonia M; Ronis, David L

2015-02-01

365

Transitional care challenges of rehospitalized veterans: listening to patients and providers.  

PubMed

Readmissions to the hospital are common and costly, often resulting from poor care coordination. Despite increased attention given to improving the quality and safety of care transitions, little is known about patient and provider perspectives of the transitional care needs of rehospitalized Veterans. As part of a larger quality improvement initiative to reduce hospital readmissions, the authors conducted semi-structured interviews with 25 patients and 14 of their interdisciplinary health care providers to better understand their perspectives of the transitional care needs and challenges faced by rehospitalized Veterans. Patients identified 3 common themes that led to rehospitalization: (1) knowledge gaps and deferred power; (2) difficulties navigating the health care system; and (3) complex psychiatric and social needs. Providers identified different themes that led to rehospitalization: (1) substance abuse and mental illness; (2) lack of social or financial support and homelessness; (3) premature discharge and poor communication; and (4) nonadherence with follow-up. Results underscore that rehospitalized Veterans have a complex overlapping profile of real and perceived physical, mental, and social needs. A paradigm of disempowerment and deferred responsibility appears to exist between patients and providers that contributes to ineffective care transitions, resulting in readmissions. These results highlight the cultural constraints on systems of care and suggest that process improvements should focus on increasing the sense of partnership between patients and providers, while simultaneously creating a culture of empowerment, ownership, and engagement, to achieve success in reducing hospital readmissions. PMID:23560514

Stephens, Caroline; Sackett, Nathan; Pierce, Read; Schopfer, David; Schmajuk, Gabriela; Moy, Nicholas; Bachhuber, Melissa; Wallhagen, Margaret I; Lee, Sei J

2013-10-01

366

Racial Disparities in Cancer Care in the Veterans Affairs Health Care System and the Role of Site of Care  

PubMed Central

Objectives. We assessed cancer care disparities within the Veterans Affairs (VA) health care system and whether between-hospital differences explained disparities. Methods. We linked VA cancer registry data with VA and Medicare administrative data and examined 20 cancer-related quality measures among Black and White veterans diagnosed with colorectal (n?=?12?897), lung (n?=?25?608), or prostate (n?=?38?202) cancer from 2001 to 2004. We used logistic regression to assess racial disparities for each measure and hospital fixed-effects models to determine whether disparities were attributable to between- or within-hospital differences. Results. Compared with Whites, Blacks had lower rates of early-stage colon cancer diagnosis (adjusted odds ratio [AOR]?=?0.80; 95% confidence interval [CI]?=?0.72, 0.90), curative surgery for stage I, II, or III rectal cancer (AOR?=?0.57; 95% CI?=?0.41, 0.78), 3-year survival for colon cancer (AOR?=?0.75; 95% CI?=?0.62, 0.89) and rectal cancer (AOR?=?0.61; 95% CI?=?0.42, 0.87), curative surgery for early-stage lung cancer (AOR?=?0.50; 95% CI?=?0.41, 0.60), 3-dimensional conformal or intensity-modulated radiation (3-D CRT/IMRT; AOR?=?0.53; 95% CI?=?0.47, 0.59), and potent antiemetics for highly emetogenic chemotherapy (AOR?=?0.87; 95% CI?=?0.78, 0.98). Adjustment for hospital fixed-effects minimally influenced racial gaps except for 3-D CRT/IMRT (AOR?=?0.75; 95% CI?=?0.65, 0.87) and potent antiemetics (AOR?=?0.95; 95% CI?=?0.82, 1.10). Conclusions. Disparities in VA cancer care were observed for 7 of 20 measures and were primarily attributable to within-hospital differences. PMID:25100422

Samuel, Cleo A.; Landrum, Mary Beth; McNeil, Barbara J.; Bozeman, Samuel R.; Williams, Christina D.

2014-01-01

367

Malpractice Burden, Rural Location, and Discontinuation of Obstetric Care: A Study of Obstetric Providers in Michigan  

PubMed Central

Context It has long been a concern that professional liability problems disproportionately affect the delivery of obstetrical services to women living in rural areas. Michigan, a state with a large number of rural communities, is considered to be at risk for a medical liability crisis. Purpose This study examined whether higher malpractice burden on obstetric providers was associated with an increased likelihood of discontinuing obstetric care and whether there were rural-urban differences in the relationship. Methods Data on 500 obstetrician-gynecologists and family physicians who had provided obstetric care at some point in their career (either currently or previously) were obtained from a statewide survey in Michigan. Statistical tests and multivariate regression analyses were performed to examine the interrelationship among malpractice burden, rural location, and discontinuation of obstetric care. Findings After adjusting for other factors that might influence a physician’s decision about whether to stop obstetric care, our results showed no significant impact of malpractice burden on physicians’ likelihood to discontinue obstetric care. Rural-urban location of the practice did not modify the nature of this relationship. However, family physicians in rural Michigan had a nearly four fold higher likelihood of withdrawing obstetric care when compared to urban family physicians. Conclusions The higher likelihood of rural family physicians to discontinue obstetric care should be carefully weighed in future interventions to preserve obstetric care supply. More research is needed to better understand the practice environment of rural family physicians and the reasons for their withdrawal from obstetric care. PMID:19166559

Xu, Xiao; Siefert, Kristine A.; Jacobson, Peter D.; Lori, Jody R.; Gueorguieva, Iana; Ransom, Scott B.

2011-01-01

368

Gynecologic care for breast cancer survivors: assisting in the transition to wellness  

PubMed Central

Currently, there are >2 million survivors of breast cancer in the United States. Two years after cancer treatment, patients may transition to primary care providers and/or gynecologists. Many of these survivors may have difficulties with menopausal symptoms. If they do not know already, some of these women may want or need risk assessment for hereditary-or treatment-induced second cancers. At least 20% will also have significant psychologic, sexual, and/or relationship difficulties that require attention. All of the women will need assistance to learn and follow recommendations for surveillance, detecting recurrence, and promoting wellness. Thus, gynecologists play a critical role in helping these patients in their health care transitions. To assist the gynecologists, we have reviewed the evaluation and management of common sequelae of breast cancer diagnoses and treatments. PMID:22177185

Salani, Ritu; Andersen, Barbara L.

2013-01-01

369

The challenges of managing cancer related venous thromboembolism in the palliative care setting  

PubMed Central

Cancer patients with venous thromboembolism (VTE) pose particular management challenges since they have an increased risk of bleeding and recurrent thrombosis compared to the non?cancer population. Also, as the disease progresses so do the hazards of anticoagulation, and patients in the palliative stages of their cancer could be viewed as a separate disease group with respect to diagnosis and management. As the focus from curative treatment moves towards symptom control, physicians face several challenges in providing the most appropriate care. Palliative care patients have rarely been included in research on VTE and the supporting evidence needs to be extrapolated cautiously. Quality of life aspects of VTE and their management may be a more appropriate outcome measure in this stage of disease than radiological end points. This paper looks at the challenges facing professionals in the management of VTE in the advanced cancer patient. PMID:17989265

Noble, S

2007-01-01

370

Pharmacopuncture for cancer care: a systematic review.  

PubMed

Background. Pharmacopuncture, injection to acupoints with pharmacological medication or herbal medicine, is a new acupuncture therapy widely available in Korea and China for cancer-related symptoms. However, the evidence is yet to be clear. Objective. To determine pharmacopuncture's effectiveness on cancer-related symptoms. Methods. Eleven databases were searched for randomized controlled trials of pharmacopuncture in cancer patients. The Cochrane risk of bias (ROB) assessment tool was used for quality assessment. Results. Twenty-two studies involving 2,459 patients were included. Five trials of chemotherapy-induced nausea and vomiting (CINV) underwent meta-analysis. Pharmacopuncture significantly relieved severity of CINV compared with control group (3 trials, risk ratio (RR) 1.28, 95% confidence interval (CI) = 1.14-1.44). The frequency of CINV was also significantly reduced with pharmacopuncture (2 trials, RR 2.47, 95% CI = 2.12-2.89). Seventeen trials studied various symptoms, and in most studies, pharmacopuncture significantly relieved pain, ileus, hiccup, fever, and gastrointestinal symptoms and improved quality of life in various cancer patients. ROB was generally high. Conclusion. It may be suggested with caution that pharmacopuncture may help various symptom relief in cancer patients, but it is hard to draw a firm conclusion due to clinical heterogeneity and high ROB of the included studies, hence warranting further investigation. PMID:24899911

Cheon, Soyeon; Zhang, Xiuyu; Lee, In-Seon; Cho, Seung-Hun; Chae, Younbyoung; Lee, Hyangsook

2014-01-01

371

Cultural considerations when providing care to New Zealand M?ori opting for conservative care.  

PubMed

There is significant variation between cultural groups in the way the end of life is discussed and handled (1). This guide does not seek to be an exhaustive resource on M?ori cultural practices as they apply to healthcare or the end of life. Dr Stallworthy is a New Zealander of European descent and a renal physician with an interest in renal supportive care and Advance Care Planning. Ms Glavish is from the Ngati Whatua iwi (M?ori tribe) and is Chief Advisor-Tikanga (M?ori protocol) for Auckland and Waitemata District Health Boards in New Zealand. Where statements in this section are based on Ms Glavish's expert opinion this is noted by '(NG)' following the statement. PMID:23586424

Stallworthy, Elizabeth J; Glavish, R Naida

2013-04-16

372

Study finds cancer programs in Michigan follow care guidelines for common cancers  

Cancer.gov

A majority of Michigan oncology practices participating in a statewide consortium followed treatment guidelines for common cancers, but had gaps in managing symptoms and end-of-life care, according to a new study.

373

Education of patients with chronic kidney disease at the interface of primary care providers and nephrologists.  

PubMed

Patient education is promoted as an integral part of effective kidney disease management. Programs and tools are available for providers and patients to support patient CKD education in primary care and nephrology. Challenges to providing patient education across practice settings include patients' lack of awareness of CKD as a medical entity, physician perceptions of their own lack of skill and ability to educate patients, differences in how primary care and nephrology physicians perceive collaborative care, and shortage of staff and time to support educational efforts. In addition, there is little research available to guide evidence-based practices for implementing early patient CKD education interventions across medical disciplines. Development and testing of patient education programs using early CKD multidisciplinary care, educational websites, and phone-based applications are all areas of growing research. More work is needed to provide evidence and support that physicians and other health professionals need to ensure a seamless patient education experience across the continuum of care. PMID:23809290

Wright Nunes, Julie A

2013-07-01

374

Challenges and Opportunities to Conduct Cancer Care Research in China: Experience from a Pilot Project  

PubMed Central

Background Cancer has become the leading cause of death in China. Effective cancer control and population science research programs are desperately needed in China. China Medical Board (CMB) funding has provided us with an opportunity to build a research team specializing in cancer care utilization and access research and demonstrate the usefulness of the accrued data. Their CMB project will describe patterns of cancer screening, incidence, and treatment in Shandong Province in China and enable the researchers to understand possible causes of disparities in cancer control in China. Yao initiated his research of cancer care in China as a PhD student when he was at The Pennsylvania State University but could not find any cancer related public data. Findings Although CMB projects do not provide salary support for American faculty, they do provide Chinese scholars in the US an excellent opportunity to help improve health care in China. There are many challenges and opportunities in health care service and utilization research. For example, public data for this type of research does not exist. They had to acquire secondary data from several governmental organizations. They have reconciled regional variations in data management. Once they acquired all the data, They could create the most comprehensive cancer access, utilization, and outcomes research database to date in China and possibly expand this research in Shandong and other provinces. Students and analysts need to be trained to ensure the confidentiality of data linked to personal identifiers of patients and providers. They have also discovered holes in the data. Students and analysts will need to learn to manipulate and analyze large scale, messy, secondary data. Discussion They hope that their key findings will identify innovative scientific opportunities to improve cancer control and reduce inequities in communities. They intend to write Chinese articles and reports to disseminate findings to communities, policy makers, and health care providers and to the scientific community. From the policy perspective, this study is a demonstration project drawing policy makers’ attention to the importance of comprehensive cancer prevention and control data collection, both for accurate assessment and informed decision making with a high likelihood to effect desired change.

Yao, Nengliang; Sun, Xiaojie

2014-01-01

375

Legislation, policy, and tobacco use among youth: implications for health care providers.  

PubMed

This paper addresses implications of recent tobacco legislation, policy, and tobacco use among youth in the context of health care policy and services. Tobacco use prevalence and definitions and diagnoses of nicotine addiction and dependence are described. Assessment of smoking prevalence in Texas provides a case study of the problem and potential solutions for tobacco use among youth. The case study highlights specific implications to be considered when providing health care focused on prevention and risk reduction for youth. The paper concludes with implications and critical Internet resources for health care providers engaging in youth tobacco control. PMID:11314281

Stevens, K R; Barron, A M; Ledbetter, C A; Foarde, K M; Menard, S W

2001-03-01

376

Gender Differences in Rural and Urban Practice Location among Mid-Level Health Care Providers  

ERIC Educational Resources Information Center

Context: Mid-level providers comprise an increasing proportion of the health care workforce and play a key role in providing health services in rural and underserved areas. Although women comprise the majority of mid-level providers, they are less likely to work in a rural area than men. Maldistribution of health providers between urban and rural…

Lindsay, Sally

2007-01-01

377

Coverage and Quality of Antenatal Care Provided at Primary Health Care Facilities in the ‘Punjab’ Province of ‘Pakistan’  

PubMed Central

Background Antenatal care is a very important component of maternal health services. It provides the opportunity to learn about risks associated with pregnancy and guides to plan the place of deliveries thereby preventing maternal and infant morbidity and mortality. In ‘Pakistan’ antenatal services to rural population are being provided through a network of primary health care facilities designated as 'Basic Health Units and Rural Health Centers. Pakistan is a developing country, consisting of four provinces and federally administered areas. Each province is administratively subdivided in to ‘Divisions’ and ‘Districts’. By population ‘Punjab’ is the largest province of Pakistan having 36 districts. This study was conducted to assess the coverage and quality antenatal care in the primary health care facilities in ‘Punjab’ province of ‘Pakistan’. Methods Quantitative and Qualitative methods were used to collect data. Using multistage sampling technique nine out of thirty six districts were selected and 19 primary health care facilities of public sector (seventeen Basic Health Units and two Rural Health Centers were randomly selected from each district. Focus group discussions and in-depth interviews were conducted with clients, providers and health managers. Results The overall enrollment for antenatal checkup was 55.9% and drop out was 32.9% in subsequent visits. The quality of services regarding assessment, treatment and counseling was extremely poor. The reasons for low coverage and quality were the distant location of facilities, deficiency of facility resources, indifferent attitude and non availability of the staff. Moreover, lack of client awareness about importance of antenatal care and self empowerment for decision making to seek care were also responsible for low coverage. Conclusion The coverage and quality of the antenatal care services in ‘Punjab’ are extremely compromised. Only half of the expected pregnancies are enrolled and out of those 1/3 drop out in follow-up visits. PMID:25409502

Majrooh, Muhammad Ashraf; Hasnain, Seema; Akram, Javaid; Siddiqui, Arif; Memon, Zahid Ali

2014-01-01

378

Grandparents Providing Care to Grandchildren: A Population-Based Study of Continuity and Change  

ERIC Educational Resources Information Center

This study examines transitions in grandchild care and the characteristics of grandparents making these transitions, using longitudinal data from a nationally representative sample of 13,626 grandparents in the 1998-2008 Health and Retirement Study. More than 60% of grandparents provided grandchild care over the 10-year period; more than 70% of…

Luo, Ye; LaPierre, Tracey A.; Hughes, Mary Elizabeth; Waite, Linda J.

2012-01-01

379

The Relationship between Practices and Child Care Providers' Beliefs Related to Child Feeding and Obesity Prevention  

ERIC Educational Resources Information Center

Objective: To examine the association between child care practices and child care provider knowledge and beliefs about their role in supporting children's healthful eating. Design: Longitudinal design using survey and observation data from baseline and year 1 of the Encouraging Healthy Activity and Eating in Childcare Environments (ENHANCE) pilot…

Lanigan, Jane D.

2012-01-01

380

Infectious diseases, immune status, and health insurance among child care providers in Houston, Texas  

Microsoft Academic Search

The objectives of this study were to compare female child-care providers with female university workers and with mothers of children in child-care centers for: (1) frequency of illness and work loss days due to infectious diseases, (2) prevalence of antibodies against measles, rubella, mumps, hepatitis B, hepatitis A, chickenpox and cytomegalovirus (CMV), and (3) status regarding health insurance and job

Marco Fornasini

1994-01-01

381

Teaching Child Care Providers to Reduce the Risk of SIDS (Sudden Infant Death Syndrome)  

ERIC Educational Resources Information Center

Keeping children safe and healthy is one of the main concerns of parents and child care providers. SIDS (Sudden Infant Death Syndrome) is the leading cause of death in infants 1 month to 12 months of age. Over 2,000 infants die from SIDS every year in the United States, and almost 15% of these deaths occur in child care settings. A targeted…

Byington, Teresa; Martin, Sally; Reilly, Jackie; Weigel, Dan

2011-01-01

382

Using Primary Care Services Can Help Reduce the Burden of Colorectal Cancer  

MedlinePLUS

... Care Services Can Help Reduce the Burden of Colorectal Cancer The full report is titled “Primary Care Utilization and Colorectal Cancer Incidence and Mortality Among Medicare Bene?ciaries. A Population- ...

383

Supportive care considerations for older adults with cancer.  

PubMed

The treatment of cancer presents specific concerns that are unique to the growing demographic of elderly patients. Because the incidence of cancer is strongly correlated with aging, the expansion of supportive care and other age-appropriate therapies will be of great importance as the population of elderly patients with cancer increases in the coming years. Elderly patients are especially likely to experience febrile neutropenia, complications from chemotherapy-induced nausea, anemia, osteoporosis (especially in patients diagnosed with breast or prostate cancer), depression, insomnia, and fatigue. These issues are often complicated by other chronic conditions related to age, such as diabetes and cardiac disease. For many patients, symptoms may be addressed both through lifestyle management and pharmaceutical approaches. Therefore, the key to improving quality of life for the elderly patient with cancer is an awareness of their specific needs and a familiarity with emergent treatment options. PMID:25071112

Naeim, Arash; Aapro, Matti; Subbarao, Rashmi; Balducci, Lodovico

2014-08-20

384

Shared Decision Making in Cancer Care  

ERIC Educational Resources Information Center

Cancer treatment outcomes have improved over the past 20 years, but treatment decision making in this context remains complex. There are often a number of reasonable treatment alternatives, including no treatment in some circumstances. Patients and doctors often have to weigh up uncertain benefits against uncertain costs. Shared decision making…

Butow, Phyllis; Tattersall, Martin

2005-01-01

385

Evidence-based medicine: medical librarians providing evidence at the point of care.  

PubMed

Evidence-based medicine is the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients. .. by best available external clinical evidence we mean clinically relevant research.' Health care reform authorized by the Affordable Care Act is based on the belief that evidence-based practice (EBP) generates cost savings due to the delivery of more effective care.2 Medical librarians, skilled in identifying appropriate resources and working with multiple complex interfaces, can support clinicians' efforts to practice evidence based medicine by providing time and expertise in articulating the clinical question and identifying the best evidence. PMID:25507879

Yaeger, Lauren H; Kelly, Betsy

2014-01-01

386

Evidence-based medicine: medical librarians providing evidence at the point of care.  

PubMed

Evidence-based medicine is the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients. .. by best available external clinical evidence we mean clinically relevant research.' Health care reform authorized by the Affordable Care Act is based on the belief that evidence-based practice (EBP) generates cost savings due to the delivery of more effective care.2 Medical librarians, skilled in identifying appropriate resources and working with multiple complex interfaces, can support clinicians' efforts to practice evidence based medicine by providing time and expertise in articulating the clinical question and identifying the best evidence. PMID:25438362

Yaeger, Lauren H; Kelly, Betsy

2014-01-01

387

Primary Care Practice Organization Influences Colorectal Cancer Screening Performance  

PubMed Central

Objective To identify primary care practice characteristics associated with colorectal cancer (CRC) screening performance, controlling for patient-level factors. Data Sources/Study Setting Primary care director survey (1999–2000) of 155 VA primary care clinics linked with 38,818 eligible patients' sociodemographics, utilization, and CRC screening experience using centralized administrative and chart-review data (2001). Study Design Practices were characterized by degrees of centralization (e.g., authority over operations, staffing, outside-practice influence); resources (e.g., sufficiency of nonphysician staffing, space, clinical support arrangements); and complexity (e.g., facility size, academic status, managed care penetration), adjusting for patient-level covariates and contextual factors. Data Collection/Extraction Methods Chart-based evidence of CRC screening through direct colonoscopy, sigmoidoscopy, or consecutive fecal occult blood tests, eliminating cases with documented histories of CRC, polyps, or inflammatory bowel disease. Principal Findings After adjusting for sociodemographic characteristics and health care utilization, patients were significantly more likely to be screened for CRC if their primary care practices had greater autonomy over the internal structure of care delivery (p<.04), more clinical support arrangements (p < .03), and smaller size (p < .001). Conclusions Deficits in primary care clinical support arrangements and local autonomy over operational management and referral procedures are associated with significantly lower CRC screening performance. Competition with hospital resource demands may impinge on the degree of internal organization of their affiliated primary care practices. PMID:17489907

Yano, Elizabeth M; Soban, Lynn M; Parkerton, Patricia H; Etzioni, David A

2007-01-01

388

Communication about symptoms and quality of life issues in patients with cancer: provider perceptions.  

PubMed

This study used qualitative data collection and analysis methods to describe provider perceptions of addressing patient-initiated communication about common or sensitive symptom and quality of life issues (SQIs) in oncology. Eligible participants were health care providers who had participated in a larger trial testing a patient-centered technology to assess cancer SQIs and support self-care. Audio-recorded vignettes were simulated based on recorded clinic visits from the larger trial and presented during semi-structured cognitive interviews with each participant. Transcripts of the interviews were content analyzed. Twelve providers participated. Participants' responses included four themes: the institutional and clinical context, the complexity of addressing SQIs, strategies used to understand SQIs, and creating a plan to address SQIs. Participants felt that approaching SQIs inside and outside of the clinic required ongoing communication within a multidisciplinary team both to gather information and manage the SQI. Forming a relationship with the patient was one strategy to facilitate assessing SQIs. Most participants expressed a need for guidance about effective SQI communication. Providers perceived approaching SQIs as a routine part of interdisciplinary clinical care. The specific symptom and the complexity of its management influenced the process of assessing and managing SQIs. Findings have implications for institutional processes, training, evaluation, and program development. PMID:24748096

Underhill, Meghan L; Sheldon, Lisa Kennedy; Halpenny, Barbara; Berry, Donna L

2014-12-01

389

How to provide care for patients suffering from terminal non-oncological diseases: barriers to a palliative care approach.  

PubMed

Despite the seemingly evident pertinence of palliative care for patients suffering from non-oncological long-term life-threatening diseases, everyday clinical practice is far from that assumption. This study aims to explore palliative care service provision for these patients in Spain. Patients, family caregivers and healthcare professionals were interviewed, individually or in a group, aiming at identifying barriers in the provision of care and strategies to overcome them. Ritchie and Spencer's framework was used for data analysis. The barriers identified were as follows: lack of clarity about prognosis, the hegemony of the curative approach, avoiding words and the desire to cheat death. Provision of palliative care services for these patients should be guided by the characteristic trajectory of each type of disease. Even if healthcare systems were capable of providing specialized palliative care services to this large group of patients, other barriers should not be overlooked. It would then seem appropriate to provide therapeutic and palliative care simultaneously, thus facilitating adaptation processes for both patients and relatives. PMID:20817747

Mahtani-Chugani, Vinita; González-Castro, Inmaculada; de Ormijana-Hernández, Amaia Sáenz; Martín-Fernández, Roberto; de la Vega, Enrique Fernández

2010-12-01

390

RESEARCH ARTICLE Open Access Breast cancer care compared with clinical  

E-print Network

these factors is not well known. In two French regions, we measured compliance with Clinical Practice Guidelines). Results: 926 women were included. Non-compliance with clinical decisions for treatment was associatedRESEARCH ARTICLE Open Access Breast cancer care compared with clinical Guidelines: an observational

Paris-Sud XI, Université de

391

Paths to partnership: Veterans Health Administration's Journey in pilot testing breast cancer care quality measures.  

PubMed

Prioritizing personalized, proactive, patient-driven health care is among the Veterans Health Administration's (VHA's) transformational initiatives. As one of the largest integrated healthcare systems, the VHA sets standards for performance measures and outcomes achieved in quality of care. Evidence-based practice (EBP) is a hallmark in oncology nursing care. EBP can be linked to positive outcomes and improving quality that can be influenced directly by nursing interventions. VHA oncology nurses had the opportunity to partner with the Oncology Nursing Society (ONS), ONS Foundation, and the Joint Commission in the multiyear development of a comprehensive approach to quality cancer care. Building on a platform of existing measures and refining measurement sets culminated in testing evidence-based, nursing-sensitive quality measures for reliability through the ONS Foundation-supported Breast Cancer Care (BCC) Quality Measures Set. The BCC Measures afforded the VHA to have its many sites collectively assess documentation of the symptoms of patients with breast cancer, the use of colony-stimulating factors, and education about neutropenia precautions provided. Parallel paths of the groups, seeking evidence-based measures, led to the perfect partnership in the VHA's journey in pilot testing the BCC Measures in veterans with breast cancer. This generated further quality assessments and continuous improvement projects for spread and sustainability throughout the VHA. PMID:25252994

Hogg, Lori Hoffman

2014-10-01

392

PLENARY SESSION: Posttreatment Follow-up Care for Cancer Survivors - Office of Cancer Survivorship  

Cancer.gov

The growing population of cancer survivors at risk for serious adverse effects after treatment, both psychological and physical, is in need of practitioners who understand the complicated health issues they face. Follow-up care needs vary with the survivor; pediatric, young adult, and older adult cancer survivors all face distinct challenges.

393

Communication and cultural issues in providing reproductive health care to immigrant women: health care providers' experiences in meeting the needs of [corrected] Somali women living in Finland.  

PubMed

Communication problems due to language and cultural differences between health care professionals and patients are widely recognized. Finns are described as more silent whereas one concurrent large immigrant group, the Somalis, are described as more open in their communication. The aim of the study was to explore physicians-nurses/midwives' communication when providing reproductive and maternity health care to Somali women in Finland. Four individual and three focus group interviews were carried out with 10 gynecologists/obstetricians and 15 nurses/midwives from five selected clinics. The health care providers considered communication (including linguistic difficulties), cultural traditions, and religious beliefs to be problems when working with Somali women. Male and female physicians were generally more similar in communication style, interpersonal contacts, and cultural awareness than the nurses/midwives who were engaged in more partnership-building with the Somali women in the clinics. Despite the communication and cultural problems, there was a tentative mutual understanding between the Finnish reproductive health care professionals and the Somali women in the clinics. PMID:21465142

Degni, Filio; Suominen, Sakari; Essén, Birgitta; El Ansari, Walid; Vehviläinen-Julkunen, Katri

2012-04-01

394

Capturing Information Needs of Care Providers to Support Knowledge Sharing and Distributed Decision Making  

PubMed Central

Background This paper reports on work carried out to elicit information needs at a trans-disciplinary, nurse-managed health care clinic that serves a medically disadvantaged urban population. The trans-disciplinary model provides a “one-stop shop” for patients who can receive a wide range of services beyond traditional primary care. However, this model of health care presents knowledge sharing challenges because little is known about how data collected from the non-traditional services can be integrated into the traditional electronic medical record (EMR) and shared with other care providers. There is also little known about how health information technology (HIT) can be used to support the workflow in such a practice. Objectives The objective of this case study was to identify the information needs of care providers in order to inform the design of HIT to support knowledge sharing and distributed decision making. Methods A participatory design approach is presented as a successful technique to specify requirements for HIT applications that can support a trans-disciplinary model of care. Results Using this design approach, the researchers identified the information needs of care providers working at the clinic and suggested HIT improvements to integrate non-traditional information into the EMR. These modifications allow knowledge sharing among care providers and support better health decisions. Conclusions We have identified information needs of care providers as they are relevant to the design of health information systems. As new technology is designed and integrated into various workflows it is clear that understanding information needs is crucial to acceptance of that technology. PMID:23616896

Rogers, M.; Zach, L.; An, Y.; Dalrymple, P.

2012-01-01

395

Who provides walk-in services? Survey of primary care practice in Ontario.  

PubMed Central

OBJECTIVE: To compare walk-in clinics with other primary care settings on characteristics associated with best practices in primary care. DESIGN: A mailed self-administered questionnaire asked about organizational and clinical characteristics of primary care practices located in major urban and suburban areas in Ontario. SETTING: Four types of fee-for-service group practices: walk-in and urgent-care clinics (WICs), mixed practices (MPs), after-hours clinics (AHCs), and group family practices (GFPs). PARTICIPANTS: A physician or a staff member involved in practice administration. MAIN OUTCOME MEASURES: The four practice types were compared on organizational characteristics and measures of access, continuing care, comprehensiveness, coordination, and mechanisms for monitoring quality of care. RESULTS: Walk-in clinics, MPs, and AHCs were open more hours during evenings and weekends and were more likely to see patients without appointments; GFPs were more likely to have on-call arrangements. Group family practices saw a larger proportion of patients for whom they provided ongoing care; WICs and MPs reported that more than 60% of their visits were with "regular" patients. Walk-in clinics were less likely to provide preventive services and psychological counseling than were GFPs and MPs. A few WICs, MPs, and GFPs had procedures to support coordination of care or to monitor quality of care. CONCLUSION: Although WICs, MPs, and AHCs provided walk-in services to Ontario patients, WICs and MPs also provided a substantial amount of ongoing care and preventive services. Independent AHCs appeared to most closely fit the "walk-in clinic" stereotype. PMID:11935716

Barnsley, Jan; Williams, A. Paul; Kaczorowski, Janusz; Vayda, Eugene; Vingilis, Evelyn; Campbell, Alan; Atkin, Karen

2002-01-01

396

Public perceptions of quality care and provider profiling in New York: implications for improving quality care and public health.  

PubMed

Despite a growing emphasis on providing health care consumers with more information about quality care, useful and valid provider-specific information often has not been available to the public or has been underutilized. To assess this issue in New York State, random telephone surveys were conducted in September 2002 and March 2003, respectively, of 1,001 and 500 English- or Spanish-speaking persons, 18 years or older. Results indicated that 33% of New Yorkers were very concerned about the quality of care, with African Americans being particularly concerned. Less than half of the respondents recalled hearing or seeing information about health care quality in the past year and less than 20% actually used this information in medical decision making. African Americans were the least likely to recall receiving or being exposed to quality-related information, whereas women and more educated adults were the most likely to report being exposed. Furthermore, New Yorkers received quality information from multiple sources, with about 20% saying that they obtained information about physician and hospital quality from media (eg, newspaper) and nonmedia (eg, recommendation by family member) sources. Evaluations of different kinds of information suggested that some types (eg, whether or not a doctor is board certified) carried more weight in health care decision making than other types (eg, government ratings). Unexpectedly, those who used information to make health care decisions were more likely to have reported experiencing a medical error in the household. Finally, in the 6-month follow-up survey, concerns about the quality of care in the state remained about the same, while fears of terrorism decreased and preparations for future terrorist attacks increased. In the survey, few major differences were found in results based on payer status (eg, private insurance versus Medicaid/no insurance). These findings have implications for both the private and public health care sectors. Specifically, they suggest that greater access to and use of provider-specific health care information by the public is a viable way to improve quality, particularly if health care professionals support the public use of these data. PMID:15253520

Boscarino, Joseph A; Adams, Richard E

2004-01-01

397

Milwaukee County Child Care Providers Appear Ready for YoungStar: Local Providers Compare Favorably to State as a Whole. Research Brief. Volume 99, Number 4  

ERIC Educational Resources Information Center

In collaboration with the Wisconsin Early Childhood Association (WECA), the Public Policy Forum surveyed 1,425 child care center directors, center employees, and family child care providers statewide. The survey was designed to provide a picture of the status of Wisconsin's child care workforce in terms of educational attainment, experience,…

Kovach, Melissa

2011-01-01

398

The Patient Protection and Affordable Care Act: the impact on urologic cancer care.  

PubMed

In March 2010, the Patient Protection and Affordable Care Act as well as its amendments were signed into law. This sweeping legislation was aimed at controlling spiraling healthcare costs and redressing significant disparities in healthcare access and quality. Cancer diagnoses and their treatments constitute a large component of rising healthcare expenditures and, not surprisingly, the legislation will have a significant influence on cancer care in the USA. Because genitourinary malignancies represent an impressive 25% of all cancer diagnoses per year, this legislation could have a profound impact on urologic oncology. To this end, we will present key components of this landmark legislation, including the proposed expansion to Medicaid coverage, the projected role of Accountable Care Organizations, the expected creation of quality reporting systems, the formation of an independent Patient-Centered Outcomes Research Institute, and enhanced regulation on physician-owned practices. We will specifically address the anticipated effect of these changes on urologic cancer care. Briefly, the legal ramifications and current barriers to the statutes will be examined. PMID:22819697

Keegan, Kirk A; Penson, David F

2013-10-01

399

The Patient Protection and Affordable Care Act: The Impact on Urologic Cancer Care  

PubMed Central

In March 2010, the Patient Protection and Affordable Care Act as well as its amendments were signed into law. This sweeping legislation was aimed at controlling spiraling healthcare costs and redressing significant disparities in healthcare access and quality. Cancer diagnoses and their treatments constitute a large component of rising healthcare expenditures and, not surprisingly, the legislation will have a significant influence on cancer care in the United States. Because genitourinary malignancies represent an impressive 25% of all cancer diagnoses per year, this legislation could have a profound impact on urologic oncology. To this end, we will present key components of this landmark legislation, including the proposed expansion to Medicaid coverage, the projected role of Accountable Care Organizations, the expected creation of quality reporting systems, the formation of an independent Patient-Centered Outcomes Research Institute, and enhanced regulation on physician-owned practices. We will specifically address the anticipated effect of these changes on urological cancer care. Briefly, the legal ramifications and current barriers to the statutes will be examined. PMID:22819697

Keegan, Kirk A.; Penson, David F.

2012-01-01

400

A survey of Alabama eye care providers in 2010–2011  

PubMed Central

Background State level information regarding eye care resources can provide policy makers with valuable information about availability of eye care services. The current study surveyed ophthalmologists, optometrists and vision rehabilitation providers practicing in Alabama. Methods Three mutually exclusive provider groups were identified, i.e., all ophthalmologists, optometrists, and vision rehabilitation providers working in Alabama in 2010. Eligible providers were contacted in 2010 and 2011 and information was requested regarding provider demographics and training, practice type and service characteristics, and patient characteristics. Descriptive statistics (e.g., means, proportions) were used to characterize provider groups by their demographic and training characteristics, practice characteristics, services provided and patients or clients served. In addition, county level figures demonstrate the numbers and per capita ophthalmologists and optometrists. Results Ophthalmologists were located in 24 of Alabama’s 67 counties, optometrists in 56, and 10 counties had neither an ophthalmologist nor an optometrist. Overall, 1,033 vision care professionals were identified as eligible to participate in the survey: 217 ophthalmologists, 638 optometrists, and 178 visual rehabilitation providers. Of those, 111 (51.2%) ophthalmologists, 246 (38.6%) optometrists, and 81 (45.5%) rehabilitation providers participated. Most participating ophthalmologists, optometrists, and vision rehabilitation providers identified themselves as non-Hispanic White. Ophthalmologists and optometrists estimated that 27% and 22%, respectively, of their patients had diabetes but that the proportion that adhered to eye care guidelines was 61% among ophthalmology patients and 53% among optometry patients. Conclusions A large number of Alabama communities are isolated from eye care services. Increased future demand for eye care is anticipated nationally given the aging of the population and decreasing numbers of providers; however, Alabama also has a high and growing prevalence of diabetes which will result in greater numbers at risk for diabetic retinopathy, glaucoma, and cataracts. PMID:24708636

2014-01-01

401

The eICU research institute - a collaboration between industry, health-care providers, and academia.  

PubMed

As the volume of data that is electronically available promliferates, the health-care industry is identifying better ways to use this data for patient care. Ideally, these data are collected in real time, can support point-of-care clinical decisions, and, by providing instantaneous quality metrics, can create the opportunities to improve clinical practice as the patient is being cared for. The business-world technology supporting these activities is referred to as business intelligence, which offers competitive advantage, increased quality, and operational efficiencies. The health-care industry is plagued by many challenges that have made it a latecomer to business intelligence and data-mining technology, including delayed adoption of electronic medical records, poor integration between information systems, a lack of uniform technical standards, poor interoperability between complex devices, and the mandate to rigorously protect patient privacy. Efforts at developing a health care equivalent of business intelligence (which we will refer to as clinical intelligence) remains in its infancy. Until basic technology infrastructure and mature clinical applications are developed and implemented throughout the health-care system, data aggregation and interpretation cannot effectively progress. The need for this approach in health care is undisputed. As regional and national health information networks emerge, we need to develop cost-effective systems that reduce time and effort spent documenting health-care data while increasing the application of knowledge derived from that data. PMID:20659837

McShea, Michael; Holl, Randy; Badawi, Omar; Riker, Richard R; Silfen, Eric

2010-01-01

402

Asking questions of a palliative care nurse practitioner on a pancreatic cancer website.  

PubMed

Objective: Increasing evidence demonstrates the benefits of online cancer interventions but very little about the needs of those with pancreatic cancer or interaction with online providers. Our study was done to (1) see how many people would visit a webpage where they could interact with a palliative care nurse practitioner (PCNP), (2) see how many would ask the PCNP questions, (3) determine the type of questions, and (4) obtain feedback regarding the usefulness of the webpage. Method: Mixed-methods descriptive design. Results: There were 2174 visits to the webpage, and a total of 84 participants sent 110 questions/comments. Some 28 (33%) were people worried that they might have pancreatic cancer. Most questions (59, 53%) had to do with palliative care issues, with the largest subgroup (26, 23%) involving psychological concerns. A total of 39 completed an online survey and were relatives (20, 52%), or patients (17, 44%). They rated the webpage at 3.3/4 as being helpful at learning about the physical symptoms/treatments of pancreatic cancer, at 3.1/4 for learning about emotional issues, at 3/4 for learning about palliative care, at 2.8/4 for learning about hospice, and at 3.3/4 for reading other people's questions. Significance of results: The PCNP webpage was a helpful resource. Most asking questions were worried about having or getting pancreatic cancer. More research is needed into online providers, interventions, and conducting research online. PMID:24909893

Grant, Marian S; Wiegand, Debra L; Dy, Sydney M

2014-06-01

403

Providing care to military personnel and their families: how we can all contribute.  

PubMed

Providing medical care to members of the military and their families remains a societal duty carried out not only by military physicians but also, and in large part, by civilian providers. As many military families are geographically dispersed, it is probable that all physicians at some point in their training or careers will care for this unique patient population. Understanding the military culture can help physicians provide the best care possible to our military families, and inclusion of military cultural competency curricula in all medical schools is a first step in advancing this understanding. The authors review the knowledge, skills, and attitudes that all health professionals should acquire to be able to care for those who serve and offer recommendations for developing these among all students and trainees. PMID:24979291

Gleeson, Todd D; Hemmer, Paul A

2014-09-01

404

The lived experience of college student lesbians' encounters with health care providers. A preliminary investigation.  

PubMed

The purpose of this preliminary study was to explore the lived experience of four self-identified college student lesbians coming out and their encounters with health care providers. This study used a qualitative method of phenomenology for data collection and analysis. Results of the study revealed a phenomenological model that embodied the core theme of navigating self-disclosure. Two major themes stemming from the core theme were also uncovered. Navigating self-disclosure in homophobic waters and navigating self-disclosure encounters with health care providers unveiled a continuum of self-disclosure to nondisclosure experiences encountered by lesbians. Strategies are offered to enhance interactions between lesbians and health care providers in primary and acute care settings. PMID:11847835

Williams-Barnard, C L; Mendoza, D C; Shippee-Rice, R V

2001-06-01

405

Cancer, Palliative and End of Life Care ResearchProjects2012  

E-print Network

Cancer, Palliative and End of Life Care ResearchProjects2012 #12;2 5 4 Cancer, Palliative and End and students working together to transform care and improve outcomes for individuals affected by cancer, other the right questions to generate theory, influence policy and change practice. Cancer survivorship

Anderson, Jim

406

Complementary medicine in palliative care and cancer symptom management.  

PubMed

Complementary and alternative medicine (CAM) use among cancer patients varies according to geographical area, gender, and disease diagnosis. The prevalence of CAM use among cancer patients in the United States has been estimated to be between 7% and 54%. Most cancer patients use CAM with the hope of boosting the immune system, relieving pain, and controlling side effects related to disease or treatment. Only a minority of patients include CAM in the treatment plan with curative intent. This review article focuses on practices belonging to the CAM domains of mind-body medicine, CAM botanicals, manipulative practices, and energy medicine, because they are widely used as complementary approaches to palliative cancer care and cancer symptom management. In the area of cancer symptom management, auricular acupuncture, therapeutic touch, and hypnosis may help to manage cancer pain. Music therapy, massage, and hypnosis may have an effect on anxiety, and both acupuncture and massage may have a therapeutic role in cancer fatigue. Acupuncture and selected botanicals may reduce chemotherapy-induced nausea and emesis, and hypnosis and guided imagery may be beneficial in anticipatory nausea and vomiting. Transcendental meditation and the mindfulness-based stress reduction can play a role in the management of depressed mood and anxiety. Black cohosh and phytoestrogen-rich foods may reduce vasomotor symptoms in postmenopausal women. Most CAM approaches to the treatment of cancer are safe when used by a CAM practitioner experienced in the treatment of cancer patients. The potential for many commonly used botanical to interact with prescription drugs continues to be a concern. Botanicals should be used with caution by cancer patients and only under the guidance of an oncologist knowledgeable in their use. PMID:17034678

Mansky, Patrick J; Wallerstedt, Dawn B

2006-01-01

407

Provider-sponsored coordinated care organizations: designing systems for patient-centered care.  

PubMed

PCCOs should take inventory of the information demands in the critical areas of quality, resource, and outcomes management, and standardize the data elements and definitions as the enterprise data model. The focus must be on internal and external reporting requirements as, ultimately, the data model must expedite clinical practice improvement initiatives. The Informational Processing Architecture utilizes the data warehouse for enterprise decision support to derive clinical/business rules and the operational data store/applications for clinical decision support to deploy those same rules at the point of care. As a result, clinical and financial systems should be tightly linked, associating outcomes, process, and cost. In designing these systems, the Systems Development Life Cycle methodology has the advantages of documented deliverables and a well proven methodology for outlining requirements put forth in an RFP, which is indispensable for vendor evaluation and selection. Employing these techniques ensures a user driven process that has the best chance of implementing the complex requirements of PCCOs. PMID:10163171

Gilbreath, R E

1996-01-01

408

Breast cancer in young women: special considerations in multidisciplinary care  

PubMed Central

Breast cancer is one of the most prevalent cancers in females, and 5%–7% of breast cancer cases occur in women under 40 years of age. Breast cancer in the young has gained increased attention with an attempt to improve diagnosis and prognosis. Young patients tend to have different epidemiology, presenting with later stages and more aggressive phenotypes. Diagnostic imaging is also more difficult in this age group. Multidisciplinary care generally encompasses surgeons, medical oncologists, radiation oncologists, radiologists, and social workers. Other special considerations include reconstruction options, fertility, genetics, and psychosocial issues. These concerns enlarge the already diverse multidisciplinary team to incorporate new expertise, such as reproductive specialists and genetic counselors. This review encompasses an overview of the current multimodal treatment regimens and the unique challenges in treating this special population. Integration of diagnosis, treatment, and quality of life issues should be addressed and understood by each member in the interdisciplinary team in order to optimize outcomes. PMID:25300196

Reyna, Chantal; Lee, Marie Catherine

2014-01-01

409

Cancer Phenotype Diagnosis and Drug Efficacy within Japanese Health Care  

PubMed Central

An overview on targeted personalized medicine is given describing the developments in Japan of lung cancer patients. These new targeted therapies with novel personalized medicine drugs require new implementations, in order to follow and monitor drug efficacy and outcome. Examples from IRESSA (Gefitinib) and TARCEVA (Erlotinib) treatments used in medication of lung cancer patients are presented. Lung cancer is one of the most common causes of cancer mortality in the world. The importance of both the quantification of disease progression, where diagnostic-related biomarkers are being implemented, in addition to the actual measurement of disease-specific mechanisms relating to pathway signalling activation of disease-progressive protein targets is summarised. An outline is also presented, describing changes and adaptations in Japan, meeting the rising costs and challenges. Today, urgent implementation of programs to address these needs has led to a rebuilding of the entire approach of medical evaluation and clinical care. PMID:22685658

Nishimura, Toshihide; Kato, Harubumi; Ikeda, Norihiko; Kihara, Makoto; Nomura, Masaharu; Kato, Yasufumi; Marko-Varga, György

2012-01-01

410

[Nursing care for ovarian cancer patients with intraperitoneal chemotherapy].  

PubMed

Ovarian cancer, known as a "silent killer", is the leading cause of gynecologic cancer death. Standard treatments for ovarian cancer are debulking surgery combined with platinum chemotherapy drugs to prolong the survival of patients. According to clinical trials run by the American Society of Gynecologic Oncology, patients who received intraperitoneal (IP) chemotherapy survived longer on average than patients who received intravenous chemotherapy alone. Thus, intraperitoneal chemotherapy is a new potential approach for treating ovarian cancer patients. However, the toxicities and undesirable complications of IP chemotherapy are the major challenges of this treatment approach. This article helps nurses recognize the toxicities and complications of IP chemotherapy and may be used as reference for future revisions to patient care guidelines. PMID:25631188

Lu, Yu-Ying; Chou, Ju-Fen; Tsao, Lee-Ing; Liang, Shu-Yuan; Wu, Shu-Fang

2015-02-01

411

Advanced ovarian cancer: what should be the standard of care?  

PubMed Central

The standard treatment of advanced ovarian cancer is rapidly changing. As we begin to understand that epithelial ovarian cancer is a heterogeneous disease, our treatment strategies are evolving to include novel biologic drugs that specifically exploit altered pathways. Surgery remains an essential component in the treatment of ovarian cancer; however, the importance of surgical specialization and defining "optimal cytoreduction" as no visible residual disease has been further validated. Ongoing studies are defining the role of neoadjuvant chemotherapy in the upfront treatment of advanced ovarian cancer. In addition, clinical trials are evaluating intraperitoneal, dose dense, antiangiogenic drugs as well as targeted maintenance therapies which will establish new standards of care in the near future. PMID:23346317

2013-01-01

412

The impact of supportive nursing care on the needs of men with prostate cancer: a study across seven European countries  

PubMed Central

Background: Prostate cancer is for many men a chronic disease with a long life expectancy after treatment. The impact of prostate cancer therapy on men has been well defined, however, explanation of the consequences of cancer treatment has not been modelled against the wider variables of long-term health-care provision. The aim of this study was to explore the parameters of unmet supportive care needs in men with prostate cancer in relation to the experience of nursing care. Methods: A survey was conducted among a volunteer sample of 1001 men with prostate cancer living in seven European countries. Results: At the time of the survey, 81% of the men had some unmet supportive care needs including psychological, sexual and health system and information needs. Logistic regression indicated that lack of post-treatment nursing care significantly predicted unmet need. Critically, men's contact with nurses and/or receipt of advice and support from nurses, for several different aspects of nursing care significantly had an impact on men's outcomes. Conclusion: Unmet need is related not only to disease and treatment factors but is also associated with the supportive care men received. Imperative to improving men's treatment outcomes is to also consider the access to nursing and the components of supportive care provided, especially after therapy. PMID:24064968

Cockle-Hearne, J; Charnay-Sonnek, F; Denis, L; Fairbanks, H E; Kelly, D; Kav, S; Leonard, K; van Muilekom, E; Fernandez-Ortega, P; Jensen, B T; Faithfull, S

2013-01-01

413

General Information: Chiropractors provide a valuable health care service to the general public. These health care  

E-print Network

. Different chiropractic colleges emphasize different approaches. As such, students must determine which specific chiropractic colleges and determine which one(s) provide the type of education they desire. Links curriculum for Chiropractic College is fairly uniform for accredited schools. Courses required

Walker, Lawrence R.

414

[Professional practice of nurses who care for cancer patients in general hospitals].  

PubMed

The present article discusses a qualitative study which aimed to understand the typical of nurses' professional practice caring for patient with cancer in general hospitals. In order to find out the reasons that motivate nurse's action, and to put in evidence what is original, significant, specific and typical about this phenomenon, we have taken into consideration the premises of the philosopher Alfred Schütz, which provide us with subsidies to unveil them. The data collected through semi-structured interviews reported that nurses admit not having the required theoretical knowledge and experience or enough practice to take care of a cancer patient. Thus, they don't feel capable of developing actions which may positively influence care on patients and their family members. PMID:23032337

da Silva, Josiane Travençolo; Matheus, Maria Clara Cassuli; Fustinoni, Suzete Maria; de Gutiérrez, Maria Gaby Rivero

2012-01-01

415

Differential patient-caregiver opinions of treatment and care for advanced lung cancer patients.  

PubMed

This study examined the differences of opinion between cancer patients and caregivers with regard to treatment and care decisions. 184 advanced lung cancer patients and 171 primary caregivers were recruited as a convenience sample from hospitals in Cleveland, Ohio. A telephone interview was conducted to collect data using a semi-structured questionnaire. Nonparametric tests and regression analysis were performed. The findings showed that patients and caregivers reported significant disagreement on three main issues: trade-off between treatment side effects and benefits; reporting treatment side effects to physicians, and hospice care. Caregivers were more concerned about patient's quality of life and more willing to discuss hospice issues than were patients (p < or = 01). Perceived family disagreement is associated with depression in both patients and caregivers (p < or = 01; R(2)=8%). The study provided empirical evidence for patient-caregiver disagreement about treatment and care decisions and its significant adverse impact on both patients and caregivers. PMID:20137849

Zhang, Amy Y; Zyzanski, Stephen J; Siminoff, Laura A

2010-04-01

416

Attitudes About and Practices of Health Promotion and Prevention Among Primary Care Providers.  

PubMed

The Patient Protection and Affordable Care Act's emphasis on health promotion and prevention activities required an examination of the current practices of primary care providers in these areas. A total of 196 primary care providers completed a survey to assess current health promotion and prevention attitudes, practices, and barriers. Results of this study showed that family physicians in Pennsylvania recognize the importance of and their role in providing health promotion and prevention and offer advice in key behavioral and disease prevention areas. Results from the study suggest that their ability to provide these services is hindered by a lack of time and the heavy workload. Although most family physicians provided advice to patients in several health promotion and prevention areas, few participants reported that they referred patients to other health professionals. Finally, when it comes to preventive services, participants ranked blood pressure screening, tobacco use screening, and tobacco use cessation interventions as the most important services. Effective implementation of the Patient Protection and Affordable Care Act will require necessary resources and support of primary care providers to help patients achieve healthier lives. PMID:25445979

Luquis, Raffy R; Paz, Harold L

2014-12-01

417

Health care providers' readiness to screen for intimate partner violence in Northern Nigeria.  

PubMed

Research on screening for intimate partner violence (IPV) within health care in a sub-Saharan African context is rare. This paper assessed factors associated with the readiness to screen for IPV among care providers (HCP, n = 274) at Kano hospital, Nigeria. Readiness was measured using the Domestic Violence Health Care Providers' survey instrument, which measures grade of perceived self-efficacy in screening for IPV, fear for victim/provider safety, access to system support to refer IPV victims, professional roles resistant/ fear of offending clients, and blaming the victim for being abused victim. Social workers perceived a higher self-efficacy and better access to system support networks to refer victims than peers in other occupation categories. Female care providers and doctors were less likely to blame the victim than males and social workers, respectively. Younger care providers of Yoruba ethnicity and social workers were less likely to perceive conflicting professional roles related to screening than older providers of Hausa ethnicity and doctors, respectively. Implications of our findings for interventions and further research are discussed. PMID:21061873

John, I A; Lawoko, Stephen; Svanström, L; Mohammed, A Z

2010-01-01

418

Primary care referral to a commercial provider for weight loss treatment versus standard care: a randomised controlled trial  

PubMed Central

Summary Background The increasing prevalence of overweight and obesity needs effective approaches for weight loss in primary care and community settings. We compared weight loss with standard treatment in primary care with that achieved after referral by the primary care team to a commercial provider in the community. Methods In this parallel group, non-blinded, randomised controlled trial, 772 overweight and obese adults were recruited by primary care practices in Australia, Germany, and the UK. Participants were randomly assigned with a computer-generated simple randomisation sequence to receive either 12 months of standard care as defined by national treatment guidelines, or 12 months of free membership to a commercial programme (Weight Watchers), and followed up for 12 months. The primary outcome was weight change over 12 months. Analysis was by intention to treat (last observation carried forward [LOCF] and baseline observation carried forward [BOCF]) and in the population who completed the 12-month assessment. This trial is registered, number ISRCTN85485463. Findings 377 participants were assigned to the commercial programme, of whom 230 (61%) completed the 12-month assessment; and 395 were assigned to standard care, of whom 214 (54%) completed the 12-month assessment. In all analyses, participants in the commercial programme group lost twice as much weight as did those in the standard care group. Mean weight change at 12 months was ?5·06 kg (SE 0·31) for those in the commercial programme versus ?2·25 kg (0·21) for those receiving standard care (adjusted difference ?2·77 kg, 95% CI ?3·50 to ?2·03) with LOCF; ?4·06 kg (0·31) versus ?1·77 kg (0·19; adjusted difference ?2·29 kg, ?2·99 to ?1·58) with BOCF; and ?6·65 kg (0·43) versus ?3·26 kg (0·33; adjusted difference ?3·16 kg, ?4·23 to ?2·11) for those who completed the 12-month assessment. Participants reported no adverse events related to trial participation. Interpretation Referral by a primary health-care professional to a commercial weight loss programme that provides regular weighing, advice about diet and physical activity, motivation, and group support can offer a clinically useful early intervention for weight management in overweight and obese people that can be delivered at large scale. Funding Weight Watchers International, through a grant to the UK Medical Research Council. PMID:21906798

Jebb, Susan A; Ahern, Amy L; Olson, Ashley D; Aston, Louise M; Holzapfel, Christina; Stoll, Julia; Amann-Gassner, Ulrike; Simpson, Annie E; Fuller, Nicholas R; Pearson, Suzanne; Lau, Namson S; Mander, Adrian P; Hauner, Hans; Caterson, Ian D

2011-01-01

419

Chronic kidney disease and support provided by home care services: a systematic review  

PubMed Central

Background Chronic diseases, such as chronic kidney disease (CKD), are growing in incidence and prevalence, in part due to an aging population. Support provided through home care services may be useful in attaining a more efficient and higher quality care for CKD patients. Methods A systematic review was performed to identify studies examining home care interventions among adult CKD patients incorporating all outcomes. Studies examining home care services as an alternative to acute, post-acute or hospice care and those for long-term maintenance in patients’ homes were included. Studies with only a home training intervention and those without an applied research component were excluded. Results Seventeen studies (10 cohort, 4 non-comparative, 2 cross-sectional, 1 randomized) examined the support provided by home care services in 15,058 CKD patients. Fourteen studies included peritoneal dialysis (PD), two incorporated hemodialysis (HD) and one included both PD and HD patients in their treatment groups. Sixteen studies focused on the dialysis phase of care in their study samples and one study included information from both the dialysis and pre-dialysis phases of care. Study settings included nine single hospital/dialysis centers and three regional/metropolitan areas and five were at the national level. Studies primarily focused on nurse assisted home care patients and mostly examined PD related clinical outcomes. In PD studies with comparators, peritonitis risks and technique survival rates were similar across home care assisted patients and comparators. The risk of mortality, however, was higher for home care assisted PD patients. While most studies adjusted for age and comorbidities, information about multidimensional prognostic indices that take into account physical, psychological, cognitive, functional and social factors among CKD patients was not easily available. Conclusions Most studies focused on nurse assisted home care patients on dialysis. The majority were single site studies incorporating small patient populations. There are gaps in the literature regarding the utility of providing home care to CKD patients and the impact this has on healthcare resources. PMID:25033891

2014-01-01

420

Discordance in HIV-Positive Patient and Health Care Provider Perspectives on Death, Dying, and End-of-Life Care.  

PubMed

The purpose of this study was to investigate how HIV-positive patients and infectious disease health care providers think about death, dying, and end-of-life care (EOLC) planning. We conducted separate in-depth qualitative interviews with 47 patients and 11 providers. Interview data were transcribed and analyzed using a secondary comparative method. Patients and providers demonstrated profound differences in their perspectives on patient empowerment and attributions of control related to disease progression, imminence of death, and EOLC decision making. Notably, patients described fears related to life-extending interventions that generally went unaddressed within the clinical context. We argue for the routinization of EOLC discussions and suggest novel research approaches to improve patient empowerment and medical engagement. PMID:24316681

Mosack, Katie E; Wandrey, Rachael L

2015-03-01

421

Survivorship Care in Reducing Symptoms in Young Adult Cancer Survivors  

ClinicalTrials.gov

Bone Cancer; Breast Cancer; Cancer Survivor; Depression; Fatigue; Female Reproductive Cancer; Gastrointestinal Cancer; Leukemia; Lymphoma; Male Reproductive Cancer; Pain; Sleep Disorders; Soft Tissue Sarcoma

2014-10-31

422

Qualitative inquiry: a method for validating patient perceptions of palliative care while enrolled on a cancer clinical trial  

PubMed Central

Background Palliative care is a vital component of patient-centered care. It has increasingly become central to the management and care of seriously ill patients by integrating physical, psychosocial, and spiritual supportive services. Through qualitative inquiry, this paper examines cancer patients’ perceptions of the process and outcomes of the pain and palliative care consultative services they received while enrolled in a clinical trial. Methods A qualitative analysis of open-ended questions was conducted from a sub-sample of patients (n?=?34) with advanced cancers enrolled in a randomized controlled trial exploring the efficacy of a palliative care consult service. Two open-ended questions focused on patient perceptions of continued participation on their primary cancer clinical trials and their perceptions of interdisciplinary communication. Results Three overarching themes emerged when asked whether receiving pain and palliative care services made them more likely to remain enrolled in their primary cancer clinical trial: patients’ past experiences with care, self-identified personal characteristics and reasons for participation, and the quality of the partnership. Four themes emerged related to interdisciplinary communication including: the importance of developing relationships, facilitating open communication, having quality communication, and uncertainty about communication between the cancer clinical trial and palliative care teams. Conclusions Our findings suggest the importance of qualitative inquiry methods to explore patient perceptions regarding the efficacy of palliative care services for cancer patients enrolled in a cancer clinical trial. Validation of patient perceptions through qualitative inquiry regarding their pain and palliative care needs can provide insight into areas for future implementation research. Trial registration NIH Office of Human Subjects Research Protection OHSRP5443 and University of Pennsylvania 813365 PMID:25276094

2014-01-01

423

“Someone’s got to do it” – Primary care providers (PCPs) describe caring for rural women with mental health problems  

PubMed Central

Objective Little is known about how primary care providers (PCPs) approach mental health care for low-income rural women. We developed a qualitative research study to explore the attitudes and practices of PCPs regarding the care of mood and anxiety disorders in rural women. Method We conducted semi-structured interviews with 19 family physicians, internists, and obstetrician-gynecologists (OBGYNs) in office-based practices in rural central Pennsylvania. Using thematic analysis, investigators developed a coding scheme. Questions focused on 1) screening and diagnosis of mental health conditions, 2) barriers to treatment among rural women, 3) management of mental illnesses in rural women, and 4) ideas to improve care for this population. Results PCP responses reflected these themes: 1) PCPs identify mental illnesses through several mechanisms including routine screening, indicator-based assessment, and self-identification by the patient; 2) Rural culture and social ecology are significant barriers to women in need of mental healthcare; 3) Mental healthcare resource limitations in rural communities lead PCPs to seek creative solutions to care for rural women with mental illnesses; 4) To improve mental healthcare in rural communities, both social norms and resource limitations must be addressed Conclusion Our findings can inform future interventions to improve women’s mental healthcare in rural communities. Ideas include promoting generalist education in mental healthcare, and expanding access to consultative networks. In addition, community programs to reduce the stigma of mental illnesses in rural communities may promote healthcare seeking and receptiveness to treatment.

Colon-Gonzalez, Maria C.; McCall-Hosenfeld, Jennifer S.; Weisman, Carol S.; Hillemeier, Marianne M.; Perry, Amanda N.; Chuang, Cynthia H.

2014-01-01

424

[Lung cancer screening with low dose CT requires careful consideration.  

PubMed

Results from the American National Lung Screening Trial (NLST) show a significant reduction in lung cancer and all-cause mortality in a high risk population screened with annual low-dose CT. Handling of pulmonary nodules, false positive tests, overdiagnosis, psychosocial consequences and cost-efficiency etc. are all aspects that require careful consideration. This paper gives an overview of the current knowledge on these issues. Before a recommendation can be made, we need an overall evaluation of both the benefits and harms in CT screening for lung cancer. PMID:25316363

Saghir, Zaigham; Dirksen, Asger; Ashraf, Haseem; Bach, Karen Skjøldstrup; Brodersen, John; Clementsen, Paul Frost; Døssing, Martin; Hansen, Hanne; Kofoed, Klaus Fuglsang; Larsen, Klaus Richter; Mortensen, Jann; Rasmussen, Jakob Fraes; Thomsen, Laura Hohwü; Wille, Mathilde Marie Winkler; Seersholm, Niels; Skov, Birgit Guldhammer; Thorsen, Hanne; Tønnesen, Philip; Pedersen, Jesper Holst

2014-10-13

425

Perspectives of Foster-Care Providers, Service Provicers, and Judges Regarding Privtized Foster-Care Services  

E-print Network

conducted. The impact ofprivatization on access to services (i.e., men- tal health, appropriate out-of-home placement, aftercare, family support and family preservation, and reunification), communication, caseload levels, and spending is discussed...) services provided during out-of-home placements (reuni- fication and appropriate placements); and (d) services after re- unification (aftercare; see Figure 1). Participants reported both positive and negative impacts for some types of services, and only...

Humphrey, Kristen R.; Turnbull, Ann P.; Turnbull, H. Rutherford

2006-01-01

426

Dying to be Screened: Exploring the Unequal Burden of Head and Neck Cancer in Health Provider Shortage Areas.  

PubMed

Multiple factors contribute to disparities in head and neck cancer prevalence across the sociodemographic spectrum, including a lack of screening efforts in mostly underserved minority communities. African Americans and other ethnic minorities are at greater risk for late-stage diagnoses due to the lack of routine screenings and examinations. Advanced stage diagnosis profoundly limits treatment options, disease recovery, and survivorship. Differential access to care is frequently cited as contributing to delayed diagnosis in minority patients. Access to care is a complex concept that includes not only insurance status but also the equitable spatial distribution of health-care services. Recognizing this complexity, we explored the distribution of head and neck cancer cases seen at Grady Health System from 2010 to 2012 in order to identify geographic trends in disease prevalence compared to the distribution of oral health-care providers at the zip code level. We identified 53 cases of head and neck cancer spread across 36 zip codes primarily in the metropolitan Atlanta region. Geographic information systems analysis showed a spatial mismatch: increased disease prevalence and provider shortage in the mostly minority zip codes, and decreased disease prevalence and greater provider presence in the majority zip codes. PMID:25420766

Rereddy, Shruthi K; Jordan, Demetrice R; Moore, Charles E

2014-11-26

427

Health Care Provider Adoption of eHealth: Systematic Literature Review  

PubMed Central

Background eHealth is an application of information and communication technologies across the whole range of functions that affect health. The benefits of eHealth (eg, improvement of health care operational efficiency and quality of patient care) have previously been documented in the literature. Health care providers (eg, medical doctors) are the key driving force in pushing eHealth initiatives. Without their acceptance and actual use, those eHealth benefits would be unlikely to be reaped. Objective To identify and synthesize influential factors to health care providers’ acceptance of various eHealth systems. Methods This systematic literature review was conducted in four steps. The first two steps facilitated the location and identification of relevant articles. The third step extracted key information from those articles including the studies’ characteristics and results. In the last step, identified factors were analyzed and grouped in accordance with the Unified Theory of Acceptance and Use of Technology (UTAUT). Results This study included 93 papers that have studied health care providers’ acceptance of eHealth. From these papers, 40 factors were identified and grouped into 7 clusters: (1) health care provider characteristics, (2) medical practice characteristics, (3) voluntariness of use, (4) performance expectancy, (5) effort expectancy, (6) social influence, and (7) facilitating or inhibiting conditions. Conclusions The grouping results demonstrated that the UTAUT model is useful for organizing the literature but has its limitations. Due to the complex contextual dynamics of health care settings, our work suggested that there would be potential to extend theories on information technology adoption, which is of great benefit to readers interested in learning more on the topic. Practically, these findings may help health care decision makers proactively introduce interventions to encourage acceptance of eHealth and may also assist health policy makers refine relevant policies to promote the eHealth innovation. PMID:23608679

Talaei-Khoei, Amir; Seale, Holly; Ray, Pradeep; MacIntyre, C Raina

2013-01-01

428

Identifying the Barriers and Enablers to Nutrition Care in Head and Neck and Esophageal Cancers: An International Qualitative Study.  

PubMed

Background: The goal of this work was to identify barriers and enablers to the implementation of nutrition care in head and neck and esophageal (HNE) cancers and to prioritize barriers to help improve the nutrition care process. Materials and Methods: This study used a multimethod qualitative study design (including semistructured interviews, focus group). Interviews (n = 29) were conducted at 5 European sites providing care and treatment to patients with HNE cancers. A focus group (n = 21) reviewed and corroborated interview findings and identified priorities for nutrition care. Participants were healthcare providers and researchers with direct experience in the field of HNE cancer. Results: Five themes with accompanying barriers and enablers were identified related to nutrition care: (1) evidence for the benefit of nutrition interventions, (2) implementation of nutrition care processes (assessment, intervention, and follow-up), (3) characteristics of healthcare providers, (4) site factors, and (5) patient characteristics. Focus group discussions identified 2 priorities that must be acted on to improve nutrition care: (1) improve the evidence base and (2) develop standardized nutrition care pathways. Conclusion: Themes related to nutrition care in HNE cancers were similar between sites, but barriers and enablers differed. Interview and focus group participants agreed the following actions will result in improvements in nutrition care: (1) enhance the evidence base to test the benefit of nutrition interventions, with a focus on resolving specific controversies regarding nutrition therapy, and (2) establish a minimum data set with a goal to create standardized nutrition care pathways where roles and responsibilities for care are clearly defined. PMID:25288589

Martin, Lisa; de van der Schueren, Marian A E; Blauwhoff-Buskermolen, Susanne; Baracos, Vickie; Gramlich, Leah

2014-10-01

429

Addressing Needs of Rural Health Care Providers via Distance Learning. Draft.  

ERIC Educational Resources Information Center

This document describes a distance learning program designed to meet the needs of rural health care providers. The program allows students to complete an Associate of Applied Science (AS) in the Meramec Physical Therapist Assistant (PTA) program through St. Louis Community College (SLCC). The first section of the document provides a draft of the…

Adeyemi, Gloria; And Others

430

The Impact of State TANF Policy Decisions on Kinship Care Providers  

ERIC Educational Resources Information Center

Based on a survey of public assistance and child welfare agency staff, this article examines how state Temporary Assistance for Needy Families (TANF) policy decisions have affected kinship care providers. Findings indicate that most states have continued using TANF to provide income support to kinship caregivers, and some have used TANF to find…

Anderson, Steven G.

2006-01-01

431

Providing Outcomes Information to Nursing Homes: Can It Improve Quality of Care?  

ERIC Educational Resources Information Center

Purpose: This study examined whether providing outcomes information to 120 nursing homes facilitated improvements in quality over a 12-month period, as compared with 1,171 facilities not receiving this information. The outcomes information provided consisted of a report mailed to administrators that examined six measures of care quality. These…

Castle, Nicholas G.

2003-01-01

432

Infections in Children: A Sourcebook for Educators and Child Care Providers. Second Edition.  

ERIC Educational Resources Information Center

Noting the rapid changes occurring in the world of infectious diseases, this book provides updated information for care providers, educators, and parents on the increasingly complex issues of childhood infection. The book is organized into two parts. The first part discusses general considerations for group settings. Chapter 1 introduces the…

Andersen, Richard D.; And Others

433

Family Home Care Providers' and Parents' Beliefs and Practices Concerning Mathematics with Young Children.  

ERIC Educational Resources Information Center

Examined aspects of early childhood environment related to developing mathematical concepts in three studies. Found that family day care providers rated math skills as less important than others, but believed skills were acquired the same way. Parents and providers reported similar frequencies for engaging children in math activities. Activity…

Blevins-Knabe, Belinda; Austin, Ann Berghout; Musun, Linda; Eddy, Annette; Jones, Randall M.

2000-01-01

434

What Role Can School Health Providers Play in Health Care Reform?  

ERIC Educational Resources Information Center

President Barack Obama is wasting no time in unfolding his plan to provide health coverage for all Americans. He started in February by signing legislation to reinstate the State Children's Health Insurance Program, which expands eligibility criteria to provide 4 million more children access to health care. This first step is one of many needed to…

Fleming, Robin

2009-01-01

435

Keeping Kids Safe: A Guide for Safe Food Handling & Sanitation for Child Care Providers.  

ERIC Educational Resources Information Center

Because children under age 5 are susceptible to food-borne illnesses and children in diapers present special sanitation and health problems, food safety and sanitation are emerging as important issues for child care providers. This booklet is designed to give providers and parents a quick and easy reference for food safety and sanitation. The…

Food Safety and Inspection Service (USDA), Washington, DC.

436

“They told me to leave”: How health care providers address intimate partner violence  

PubMed Central

Background Intimate partner violence (IPV) victims frequently seek medical treatment though rarely for IPV. Recommendations for health care providers (HCPs) include: IPV screening, counseling, and safety referral. Objective Report women’s experiences discussing IPV with HCPs. Design Structured interviews with women reporting IPV HCP discussions; descriptive analyses; bivariate and multivariate analyses and association with patient demographics and substance abuse. Participants Women from family court, community-based, inner-city primary care practice, and tertiary care-based outpatient psychiatric practice. Key Results A total 142 women participated: family court (N=44; 31%), primary care practice (N=62; 43.7%), and psychiatric practice (N=36; 25.4%) Fifty-one percent (n=72) reported HCPs knew of their IPV. Of those, 85% (n=61) told a primary care provider. Regarding IPV attitudes, 85% (n=61) found their HCP open, and 74% (n=53) knowledgeable. Regarding approaches, 71% (n= 51) believed their HCP advocated leaving the relationship. While 31% (n=22) received safety information, only 8% (n=6) received safety information and perceived their HCP as not advocating leaving the abusive relationship. Conclusions Half of participants disclosed IPV to their HCP’s but if they did, most perceived their provider advocated them leaving the relationship. Only 31% reported HCPs provided safety planning despite increased risks associated with leaving. We suggest healthcare providers improve safety planning with patients disclosing IPV. PMID:22570397

Morse, Diane S.; Lafleur, Ross; Fogarty, Colleen T.; Mittal, Mona; Cerulli, Catherine

2012-01-01

437

Cultural, ethical, and spiritual competencies of health care providers responding to a catastrophic event.  

PubMed

Compassion is a language that is understood across cultures, religions, and nations. Being compassionate and empathetic is a basic responsibility of health care providers responding to disasters. Compassion and empathy cannot be operationalized unless providers show culturally competent, ethically right, and spiritually caring behavior. In addition to being accepting of cultures other than their own, providers must read literature and familiarize themselves with the predominant cultures of the affected population. Ethically right decision making is essentially an act of balancing the risks and benefits to the entire society. Spiritual care is an important dimension of total health, and therefore recognition and resolution of the spiritual needs of disaster victims is an essential role of health care providers. Disaster management is teamwork and therefore requires that health care providers draw on the expertise and support of other team members; coordinating efforts with local religious, social governmental organizations, and NGOs to deal with the intangible effects of the cultural and spiritual impact of a disaster and to prevent further demoralization of the affected community is imperative. Disasters occur, and the only thing that can ameliorate their devastating effects is to improve disaster preparedness and respond collectively and courageously to every catastrophic event. PMID:21095554

Jose, Mini M

2010-12-01

438

Lymphedema care for the breast cancer patient: An integrative approach.  

PubMed

Lymphedema is a serious complication that involves the accumulation of protein-rich fluid in the interstitial space. Lymphedema is common after treatment for breast cancer, especially for those patients receiving axillary lymph node dissection. Severe lymphedema is associated with serious morbidities such as swelling, fibrosis, decreased function, reduced range of motion, infection, and pain. Here, we discuss a unique, multi-disciplinary approach to effectively manage patients during and after breast cancer therapy. In this approach, patient education and screening are implemented in various departments throughout the health care system, including Physical Therapy and Rehabilitation, Integrative Medicine, and the Breast Care Center, which houses the Lymphedema Clinic. Early patient education and regular screening are combined with aggressive treatment for overt disease to effectively manage lymphedema in the at-risk population. PMID:25467312

Patricolo, Gail Elliott; Armstrong, Karen; Riutta, Justin; Lanni, Thomas

2015-02-01

439

Patient-provider perceptions on engagement in HIV care in Argentina.  

PubMed

Approximately 30% of patients participating in the national antiretroviral therapy (ART) program in Argentina fail to achieve an undetectable viral load, and approximately 25% are not retained in care. This qualitative study was designed to explore and identify factors associated with engagement and retention in public and private health care in Buenos Aires, Argentina. Qualitative data from key informants (n = 12) and focus groups (n = 4 groups) of patients and providers from private and public HIV treatment facilities were recorded and transcribed. Predetermined and arising themes related to adherence, engagement, and retention in care were coded and analyzed using qualitative data analysis software. Reasons identified for patients' lack of adherence or engagement in care differed between patients and providers, and patients attributed limitations to low self-efficacy, fear and concerns about HIV, and lack of provider involvement in treatment. In contrast, providers viewed themselves as decision-makers in patient care and patients as responsible for their own nonadherence due to lack of commitment to their own health or due to medication side effects. Patients reported health care system limitations and HIV concerns contributed to a lack of engagement, and providers identified limited HIV literacy and stigma as additional problems. Both agreed that chronic illness and substance addiction impacted adherence and retention, and agreed on the importance of trust, honesty, and communication in the patient-provider relationship. Results support the incorporation of system-, provider-, and patient-focused components into interventions to facilitate patient engagement, adherence, and retention in public and private settings in Argentina. PMID:24138788

Bofill, Lina Margarita; Lopez, Maria; Dorigo, Analia; Bordato, Alejandra; Lucas, Mar; Cabanillas, Graciela Fernandez; Sued, Omar; Cahn, Pedro; Cassetti, Isabel; Weiss, Stephen; Jones, Deborah

2014-01-01

440

Patient-centered Communication in Cancer Care Symposium  

Cancer.gov

On May 15-16, 2006, the Outcomes Research Branch (ORB) and the Health Communication and Informatics Research Branch (HCIRB) organized a symposium on Patient-centered Communication (PCC) in Bethesda, MD. Participants included more than 25 researchers and practitioners from federal agencies, private sector healthcare systems, cancer centers, and other academic departments. The expert panel of researchers and practitioners represented various areas of expertise, including oncology, nursing, primary care, health services research, large delivery systems, communication and behavioral sciences, and patient advocacy.

441

Patient and provider interventions for managing osteoarthritis in primary care: protocols for two randomized controlled trials  

PubMed Central

Background Osteoarthritis (OA) of the hip and knee are among the most common chronic conditions, resulting in substantial pain and functional limitations. Adequate management of OA requires a combination of medical and behavioral strategies. However, some recommended therapies are under-utilized in clinical settings, and the majority of patients with hip and knee OA are overweight and physically inactive. Consequently, interventions at the provider-level and patient-level both have potential for improving outcomes. This manuscript describes two ongoing randomized clinical trials being conducted in two different health care systems, examining patient-based and provider-based interventions for managing hip and knee OA in primary care. Methods / Design One study is being conducted within the Department of Veterans Affairs (VA) health care system and will compare a Combined Patient and Provider intervention relative to usual care among n?=?300 patients (10 from each of 30 primary care providers). Another study is being conducted within the Duke Primary Care Research Consortium and will compare Patient Only, Provider Only, and Combined (Patient + Provider) interventions relative to usual care among n?=?560 patients across 10 clinics. Participants in these studies have clinical and / or radiographic evidence of hip or knee osteoarthritis, are overweight, and do not meet current physical activity guidelines. The 12-month, telephone-based patient intervention focuses on physical activity, weight management, and cognitive behavioral pain management. The provider intervention involves provision of patient-specific recommendations for care (e.g., referral to physical therapy, knee brace, joint injection), based on evidence-based guidelines. Outcomes are collected at baseline, 6-months, and 12-months. The primary outcome is the Western Ontario and McMasters Universities Osteoarthritis Index (self-reported pain, stiffness, and function), and secondary outcomes are the Short Physical Performance Test Protocol (objective physical function) and the Patient Health Questionnaire-8 (depressive symptoms). Cost effectiveness of the interventions will also be assessed. Discussion Results of these two studies will further our understanding of the most effective strategies for improving hip and knee OA outcomes in primary care settings. Trial registration NCT01130740 (VA); NCT 01435109 (NIH) PMID:22530979

2012-01-01

442

Ethical and professional considerations providing medical evaluation and care to refugee asylum seekers.  

PubMed

A significant number of asylum seekers who largely survived torture live in the United States. Asylum seekers have complex social and medical problems with significant barriers to health care access. When evaluating and providing care for survivors, health providers face important challenges regarding medical ethics and professional codes. We review ethical concerns in regard to accountability, the patient-physician relationship, and moral responsibilities to offer health care irrespective of patient legal status; competing professional responsibility toward society and the judiciary system; concerns about the consistency of asylum seekers' claims; ethical concerns surrounding involving trainees and researching within the evaluation setting; and the implication of broader societal views towards rights and social justice. We discuss contributing factors, including inadequate and insufficient provider training, varying and inadequate institutional commitment, asylum seekers' significant medical and social problems, and the broader health and social system issues. We review existing resources to address these concerns and offer suggestions. PMID:23767428

Asgary, Ramin; Smith, Clyde L

2013-01-01

443

Deciding who to see: lesbians discuss their preferences in health and mental health care providers.  

PubMed

Few researchers have studied how lesbians choose health and mental health care providers. Using a series of studies, the Lesbian Health Care Project of Western New York gathered region-specific information concerning lesbians' preferences and decision making. This article reports on community focus groups in which 33 working class, middle class, African American, young, and older lesbians, as well as lesbians who frequent bars, reported that decision making was based on their past experiences and their hopes for high quality care. They encountered a continuum of provider reactions that helped shape their decisions. The continuum and consisted of five categories: homophobia, heterosexism, tolerance, lesbian sensitivity, and lesbian affirmation. Each category is discussed and examples are provided. PMID:12450007

Saulnier, Christine Flynn

2002-10-01

444

Irish midwives’ experiences of providing maternity care to non-Irish women seeking asylum  

PubMed Central

Background Immigration and asylum seeking has been an important social and political phenomenon in Ireland since the mid 1990s. Inward migration to Ireland was seen in unprecedented numbers from 1995 onward, peaking in 2002 with 11,634 applications for refugee status. Asylum and immigration is an issue of national and international relevance as the numbers of displaced people worldwide continues to grow, reaching the highest level in 20 years at 45.2 million in 2012. Midwives provide the majority of care to childbearing women around the world, whether working as autonomous practitioners or under the direction of an obstetrician. Limited data currently exist on the perspectives of midwives who provide care to childbearing women while they are in the process of seeking asylum. Such data are important to midwifery leaders, educators, and policy-makers. The aims of this study were to explore midwives’ perceptions and experiences of providing care to women in the asylum process and to gain insight into how midwives can be equipped and supported to provide more effective care to this group in the future. Methods Data were collected via indepth unstructured interviews with a purposive sample of ten midwives from two sites, one a large urban inner city hospital, and the second, a smaller more rural maternity hospital. The interviews were audio-recorded and transcribed verbatim. The data were analyzed using content analysis. Results Five themes emerged from the data, barriers to communication, understanding cultural difference, challenges of caring for women who were unbooked, the emotional cost of caring, and structural barriers to effective care. Conclusion Findings highlight a need to focus on support and education for midwives, improved maternity services for immigrant women, and urgent policy revision. PMID:24516340

Tobin, Carolyn L; Murphy-Lawless, Jo

2014-01-01

445

Job Satisfaction of Primary Health-Care Providers (Public Sector) in Urban Setting  

PubMed Central

Introduction: Job satisfaction is determined by a discrepancy between what one wants in a job and what one has in a job. The core components of information necessary for what satisfies and motivates the health work force in our country are missing at policy level. Therefore present study will help us to know the factors for job satisfaction among primary health care providers in public sector. Materials and Methods: Present study is descriptive in nature conducted in public sector dispensaries/primary urban health centers in Delhi among health care providers. Pretested structured questionnaire was administered to 227 health care providers. Data was analyzed using SPSS and relevant statistical test were applied. Results: Analysis of study reveals that ANMs are more satisfied than MOs, Pharmacist and Lab assistants/Lab technicians; and the difference is significant (P < 0.01). Age and education level of health care providers don’t show any significant difference in job satisfaction. All the health care providers are dissatisfied from the training policies and practices, salaries and opportunities for career growth in the organization. Majority of variables studied for job satisfaction have low scores. Five factor were identified concerned with job satisfaction in factor analysis. Conclusion: Job satisfaction is poor for all the four groups of health care providers in dispensaries/primary urban health centers and it is not possible to assign a single factor as a sole determinant of dissatisfaction in the job. Therefore it is recommended that appropriate changes are required at the policy as well as at the dispensary/PUHC level to keep the health work force motivated under public sector in Delhi. PMID:24479088

Kumar, Pawan; Khan, Abdul Majeed; Inder, Deep; Sharma, Nandini

2013-01-01

446

Improving care for women with a history of gestational diabetes: a provider perspective.  

PubMed

To identify perceived roles with regard to care for women with gestational diabetes mellitus (GDM) history and resources for improving care among women with a history of GDM from the perspective of obstetrician/gynecologists (OB/GYNs), certified nurse midwives (CNM), family practitioners, and internists. In 2010, a survey was sent to a random sample of OB/GYNs, CNM, family practitioners, and internists (n = 2,375) in Ohio to assess knowledge, attitudes, and postpartum practices regarding diabetes prevention for women with a history of GDM. A total of 904 practitioners completed the survey (46 %). Over 70 % of CNMs strongly agreed it is part of their job to help women with GDM history improve diet and increase exercise, compared with 60 % of family practitioners/internists and 55 % of OB/GYNs (p < 0.001). More OB/GYNs and CNMs identified a need for more local nutrition specialists and patient education materials, compared with family practitioners/ internists. Between 60 and 70 % of OB/GYNs and CNMs reported lifestyle modification programs and corresponding reimbursement would better support them to provide improved care. Health care providers giving care to women with GDM history have varying perceptions of their roles, however, there was agreement on resources needed to improve care. PMID:24343308

Oza-Frank, Reena; Ko, Jean Y; Wapner, Andrew; Rodgers, Loren; Bouchard, Jo M; Conrey, Elizabeth J

2014-09-01

447

Providing more than health care: the dynamics of humanitarian surgery efforts on the local microeconomy.  

PubMed

Humanitarian cleft surgery has long been provided by teams from resource-rich countries traveling for short-term missions to resource-poor countries. After identifying an area of durable unmet need through surgical missions, Operation Smile constructed a permanent center for cleft care in Northeast India. The Operation Smile Guwahati Comprehensive Cleft Care Center (GCCCC) uses a high-volume subspecialized institution to provide safe, quality, comprehensive, and cost-effective cleft care to a highly vulnerable patient population in Assam, India. The purpose of this study was to profile the expenses of several cleft missions carried out in Assam and to compare these to the expenditures of the permanent comprehensive cleft care center. We reviewed financial data from 4 Operation Smile missions in Assam between December 2009 and February 2011 and from the GCCCC for the 2012-2013 fiscal year. Expenses from the 2 models were categorized and compared. In the studied period, 33% of the mission expenses were spent locally compared to 94% of those of the center. The largest expenses in the mission model were air travel (48.8%) and hotel expenses (21.6%) for the team, whereas salaries (46.3%) and infrastructure costs (19.8%) made up the largest fractions of expenses in the center model. The evolution from mission-based care to a specialty hospital model in Guwahati incorporated a transition from vertical inputs to investments in infrastructure and human capital to create a sustainable local care delivery system. PMID:25162554

Nagengast, Eric S; Caterson, E J; Magee, William P; Hatcher, Kristin; Ramos, Margarita S; Campbell, Alex

2014-09-01

448

Outpatient treatment costs and their potential impact on cancer care  

PubMed Central

Cancer creates a tremendous financial burden. Cancer-related costs are categorized into direct, indirect, and psychosocial costs. Although there have been many reports on medical care costs, which are direct, those on other costs are extremely scarce. We estimated travel time and costs required for cancer patients to receive outpatient treatment. We studied 521 cancer patients receiving anti-cancer treatment between February 2009 and December 2012 at the Outpatient Chemotherapy Center of Teikyo University Chiba Medical Center. Address data were extracted from Data Warehouse electronic medical records, and travel distance and time required for outpatient treatment were calculated via MapInfo and ACT Distance Calculator Package. Transportation costs were estimated on the basis of ¥274 (=$3.00) per kilometer. The study design was approved by an ethics review board of Teikyo University (12–851). Average round-trip travel distance, time, and cost for all patients were 26.7 km, 72.5 min, and ¥7,303 ($79.99), respectively. Cancer patients incurred a travel cost of ¥4000–¥9000 ($40.00 to $100.00) for each outpatient treatment. With population aging, seniors living alone and senior households are increasing, and outpatient visits are becoming a common burden. PMID:25060622

Isshiki, Takahiro

2014-01-01

449

Outpatient treatment costs and their potential impact on cancer care.  

PubMed

Cancer creates a tremendous financial burden. Cancer-related costs are categorized into direct, indirect, and psychosocial costs. Although there have been many reports on medical care costs, which are direct, those on other costs are extremely scarce. We estimated travel time and costs required for cancer patients to receive outpatient treatment. We studied 521 cancer patients receiving anti-cancer treatment between February 2009 and December 2012 at the Outpatient Chemotherapy Center of Teikyo University Chiba Medical Center. Address data were extracted from Data Warehouse electronic medical records, and travel distance and time required for outpatient treatment were calculated via MapInfo and ACT Distance Calculator Package. Transportation costs were estimated on the basis of ¥274 (=$3.00) per kilometer. The study design was approved by an ethics review board of Teikyo University (12-851). Average round-trip travel distance, time, and cost for all patients were 26.7 km, 72.5 min, and ¥7,303 ($79.99), respectively. Cancer patients incurred a travel cost of ¥4000-¥9000 ($40.00 to $100.00) for each outpatient treatment. With population aging, seniors living alone and senior households are increasing, and outpatient visits are becoming a common burden. PMID:25060622

Isshiki, Takahiro

2014-12-01