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1

Barriers to Cancer Screening by Rural Appalachian Primary Care Providers  

ERIC Educational Resources Information Center

Rural Appalachia has significantly higher overall cancer mortality compared with national rates, and lack of cancer screening is believed to be one of the contributing factors. Reducing the cancer disparity in this region must include strategies to address suboptimal cancer screening practices by rural Appalachian primary care providers (PCPs). To…

Shell, Renee; Tudiver, Fred

2004-01-01

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

Threading the cloak: palliative care education for care providers of adolescents and young adults with cancer  

PubMed Central

Medical providers are trained to investigate, diagnose, and treat cancer. Their primary goal is to maximize the chances of curing the patient, with less training provided on palliative care concepts and the unique developmental needs inherent in this population. Early, systematic integration of palliative care into standard oncology practice represents a valuable, imperative approach to improving the overall cancer experience for adolescents and young adults (AYAs). The importance of competent, confident, and compassionate providers for AYAs warrants the development of effective educational strategies for teaching AYA palliative care. Just as palliative care should be integrated early in the disease trajectory of AYA patients, palliative care training should be integrated early in professional development of trainees. As the AYA age spectrum represents sequential transitions through developmental stages, trainees experience changes in their learning needs during their progression through sequential phases of training. This article reviews unique epidemiologic, developmental, and psychosocial factors that make the provision of palliative care especially challenging in AYAs. A conceptual framework is provided for AYA palliative care education. Critical instructional strategies including experiential learning, group didactic opportunity, shared learning among care disciplines, bereaved family members as educators, and online learning are reviewed. Educational issues for provider training are addressed from the perspective of the trainer, trainee, and AYA. Goals and objectives for an AYA palliative care cancer rotation are presented. Guidance is also provided on ways to support an AYA's quality of life as end of life nears. PMID:25750863

Wiener, Lori; Weaver, Meaghann Shaw; Bell, Cynthia J; Sansom-Daly, Ursula M

2015-01-01

4

Current practice and knowledge of oral care for cancer patients: a survey of supportive health care providers  

Microsoft Academic Search

BackgroundThe Oral Care Study Section of the Multinational Association of Supportive Care in Cancer (MASCC) and the International Society for Oral Oncology (ISOO) conducted a survey on clinical practices of oral\\/dental management of cancer patients among supportive health care providers. The main purpose was to evaluate the knowledge and current practice for preventing and managing oral side effects associated with

Gerry J. Barker; Joel B. Epstein; Karen B. Williams; Meir Gorsky; Judith E. Raber-Durlacher

2005-01-01

5

Lung Cancer Screening with Low-Dose Computed Tomography for Primary Care Providers  

PubMed Central

This review provides an update on lung cancer screening with low-dose computed tomography (LDCT) and its implications for primary care providers. One of the unique features of lung cancer screening is the potential complexity in patient management if an LDCT scan reveals a small pulmonary nodule. Additional tests, consultation with multiple specialists, and follow-up evaluations may be needed to evaluate whether lung cancer is present. Primary care providers should know the resources available in their communities for lung cancer screening with LDCT and smoking cessation, and the key points to be addressed in informed and shared decision-making discussions with patients. PMID:24830610

Richards, Thomas B.; White, Mary C.; Caraballo, Ralph S.

2015-01-01

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

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

10

Examining Forms of Spiritual Care Provided in the Advanced Cancer Setting.  

PubMed

Spiritual care (SC) is important to the care of seriously ill patients. Few studies have examined types of SC provided and their perceived impact. This study surveyed patients with advanced cancer (N = 75, response rate [RR] = 73%) and oncology nurses and physicians (N = 339, RR = 63%). Frequency and perceived impact of 8 SC types were assessed. Spiritual care is infrequently provided, with encouraging or affirming beliefs the most common type (20%). Spiritual history taking and chaplaincy referrals comprised 10% and 16%, respectively. Most patients viewed each SC type positively, and SC training predicted provision of many SC types. In conclusion, SC is infrequent, and core elements of SC-spiritual history taking and chaplaincy referrals-represent a minority of SC. Spiritual care training predicts provision of SC, indicting its importance to advancing SC in the clinical setting. PMID:25005589

Epstein-Peterson, Zachary D; Sullivan, Adam J; Enzinger, Andrea C; Trevino, Kelly M; Zollfrank, Angelika A; Balboni, Michael J; VanderWeele, Tyler J; Balboni, Tracy A

2014-07-01

11

Palliative Care in Cancer  

MedlinePLUS

... cancer.gov/cancertopics/factsheet/Support/hospice on the Internet. Where do cancer patients receive palliative care? Cancer ... at http://www.getpalliativecare.org/providers on the Internet. The National Hospice and Palliative Care Organization’s Web ...

12

Novel Telemedicine Technologies in Geriatric Chronic Non-Cancer Pain: Primary Care Providers’ Perspectives  

PubMed Central

Objective We sought to identify primary care providers’ interest in, as well as perceived barriers and facilitators to, using novel telemedicine technologies (e.g., smartphones) for managing chronic non-cancer pain (CNCP) in older adults. Design Six focus groups were conducted with 25 primary care providers. Setting Two academically affiliated primary care practices serving older adults with CNCP in New York City. Methods The investigators used content analysis to analyze transcribed focus group data and identify specific themes. Results While most providers reported limited use of telemedicine, they expressed substantial interest in trying devices such as smartphones in the management of older patients with CNCP. Perceived barriers to implementation of telemedicine tools included information overload, lack of mobile device usability among patients and clinicians, liability issues, and cost. To overcome these barriers, participants suggested implementing electronic or human-based pre-analysis of data (e.g., a computer or a person that triages patient data), creating a low-cost and user-friendly mobile device design, and targeting appropriate user populations. Conclusions Primary care providers are interested in applying telemedicine when caring for older adults with CNCP. Although they perceived multiple barriers to device implementation, they offered innovative solutions to address these barriers. Providers felt that novel telemedicine technologies may improve the management of CNCP but wanted evidence that the devices were both cost- and time-efficient, and led to improved patient outcomes before adopting their use in practice. PMID:24341423

Levine, Mimi; Richardson, Joshua E.; Granieri, Evelyn; Reid, M. Cary

2015-01-01

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

[Assistance provided with home nursing care for a terminal cancer patient].  

PubMed

A visiting nursing service was provided for a 90-year-old male patient with terminal stage of pancreatic cancer whose prognosis was to live for two to three months. We provided nursing service not only for the patient's pain control but also for the member of the family by giving specific nursing tips as well as mental support. After the patient passed away, the eldest daughter was quoted saying "we could do everything we wanted to from home nursing care." It appeared that she was totally satisfied with our nursing service. We concluded the following caregiver roles based on this clinical example: 1) Try to alleviate a terminal patient's pain as much as possible so that the patient and the family will be at ease. 2) Arrange the care giver's anxiety individually. 3) Guide the care giver a specific know-how that can be accomplished and let the patient and the care giver choose which one they want. 4) Teach the process of the withholding and with drawing of life and try to consolidate the purpose of nursing intentions among the care givers. 5) Respect the patient and caregiver and make the best out of the situation by being flexible. PMID:20443306

Saito, Mayumi; Yamada, Mai; Kitamikado, Hatsue; Sugihara, Sachiko; Sueda, Mieko; Yagishita, Toshiyuki; Oka, Yoichi

2008-12-01

15

Knowledge and Attitudes of Hispanic Women and Their Health Care Providers about Breast Cancer Risk Factors and Screening  

Microsoft Academic Search

Objectives: The purpose of our study was to develop and evaluate an educational program for health care providers and patients on the topics of general breast cancer risk factors, breast cancer genetics, and breast cancer screening recommendations. The program was designed with specific emphasis on addressing the needs of medically underserved Hispanic women in Southern Texas. We also identified and

Michelle N. Strecker; Aimee J. Williams; Melissa Bondy; Dennis A. Johnston; Hope Northrup

2002-01-01

16

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

17

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 ...

18

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. PMID:25756141

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

2015-01-01

19

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

20

'Palliative care': a contradiction in terms? A qualitative study of cancer patients with a Turkish or Moroccan background, their relatives and care providers  

PubMed Central

Background Palliative cancer care aims to improve quality of life and ultimately quality of dying, while prolonging life is not an objective anymore when death nears. The question is, however, whether these perspectives on palliative care are congruent with the perspectives of immigrant families with a Turkish or Moroccan background. Methods A qualitative design was used as we were looking for the personal views of 'very ill' cancer patients with a Turkish or Moroccan background, their family members and their Dutch care providers. We interviewed 83 people, involved in 33 cases to obtain information about their views, values and norms on 'good care'. Results The main concerns about 'good care' expressed by Turkish and Moroccan families were: maximum treatment and curative care until the end of their lives, never having hope taken away, devoted care by their families, avoiding shameful situations, dying with a clear mind and being buried in their own country. Their views conflict, to some extent, with the dominant principles in palliative care, for example, the emphasis on quality of life and advanced care planning, which includes discussing diagnosis and prognosis with the patient. Conclusions Patients and their families with a Turkish or Moroccan background often have different ideas about 'good care' than their Dutch care providers. As many of them are aiming at cure until the end of life, they find 'good palliative care' a contradiction in terms. PMID:20831777

2010-01-01

21

Social Support, Self-Rated Health, and Lesbian, Gay, Bisexual, and Transgender Identity Disclosure to Cancer Care Providers  

PubMed Central

Purpose/Objectives To describe factors related to diagnosis, identity disclosure, and social support among lesbian, gay, bisexual, and transgender (LGBT) patients with cancer, and to explore associations between these factors and self-rated health. Design Cross-sectional self-report survey design using descriptive and exploratory multivariate statistical approaches. Setting Online, Internet-based. Sample 291 LGBT patients (89% Caucasian; 50% gay, 36% lesbian, 7% bisexual, 3% transgender) with mixed cancers. Methods Participants completed a researcher-designed online survey assessing experiences of cancer diagnosis among LGBT patients at a single time point. Main Research Variables Demographics, which provider(s) delivered the patients’ cancer diagnoses, to whom patients had disclosed their LGBT identity, how they disclosed, who was on their social support team at the time of diagnosis, and current self-rated health. Findings 79% of participants reported disclosing their identities to more than one cancer care provider. Participants most commonly introduced the topic of LGBT identity themselves, sometimes as a way to correct heterosexual assumptions (34%). Friends were the most common members of LGBT patients’ support teams (79%). Four disclosure and support factors were consistently associated with better self-rated health. Conclusions Disclosure of LGBT identity is a common experience in the context of cancer care, and disclosure and support factors are associated with better self-reported health among LGBT patients. Implications for Nursing Creating safe environments for LGBT patients to disclose could improve cancer care delivery to this underserved population. Nurses and other providers should acknowledge and include diverse support team members in LGBT patients’ care. PMID:25542320

Kamen, Charles S.; Smith-Stoner, Marilyn; Heckler, Charles E.; Flannery, Marie; Margolies, Liz

2015-01-01

22

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

23

Rural health professionals' perspectives on providing grief and loss support in cancer care.  

PubMed

Research demonstrates considerable inequalities in service delivery and health outcomes for people with cancer living outside large metropolitan cities. Semi-structured interviews with 11 professionals providing grief and loss support for people with cancer and their families in rural, regional, and remote areas Western Australia revealed the challenges they faced in delivering such support. The data are presented in four themes - Inequity of regional versus metropolitan services, Strain of the 'Jack of all trades' role, Constraints to accessing professional development, and Challenges in delivering post-bereavement services. These challenges are likely to be of growing concern given that populations are declining in rural areas as Australia becomes increasingly urban. The findings have implications in enhancing the loss and grief support services available in rural, regional, and remote Western Australia, including those grieving the death of a loved one through cancer. PMID:23834431

Breen, L J; O'Connor, M

2013-11-01

24

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.

25

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 ...

26

Choosing an HIV Care Provider  

MedlinePLUS

... Reviewed April 16, 2014 Select a Language: Fact Sheet 202 Choosing an HIV Care Provider WHY IS ... general, and HIV in particular. Back to Fact Sheet Categories The AIDS InfoNet is a project of ...

27

Providing palliative care for newborns.  

PubMed

Palliative care principles may be applied in the NICU, may be necessary, and may benefit from the contributions of community pediatricians who have a relationship with families undergoing these tragic circumstances. Clinicians across varied disciplines can cooperate to provide an environment in the delivery room or NICU where palliative care can be integrated into patient and family care plans regardless of whether the treatment goal is obtaining a cure, prolonging life, or exclusively palliation and comfort until an expected death. Regardless of the site of care, the best interests of the patient remain the focus of such care. This care should be consistent with the goals and preferences of the family, and respectful of their culture and faith traditions. The physical comfort of the infant and the emotional, psychosocial, and spiritual well-being of his/her family (including siblings and grandparents) all require active management and support. Finally, bereavement support should be provided following an infant's death to help families integrate their loss into their lives. PMID:15559703

Carter, Brian S

2004-11-01

28

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

29

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.

30

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

31

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.

32

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 ...

33

Child Care Provider's Guide to Safe Sleep  

MedlinePLUS

... an infant medical emergency . Be aware of bereavement/grief resources. Am I a Child Care Provider? Some ... Infectious Diseases in Child Care and Schools Managing Chronic Health Needs in Child Care and Schools NICU ...

34

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

35

Prediction models in cancer care  

PubMed Central

Prediction is ubiquitous across the spectrum of cancer care from screening to hospice. Indeed, oncology is often primarily a prediction problem: many of the early stage cancers cause no symptoms, and treatment is recommended because of a prediction that tumor progression would ultimately threaten a patient's quality of life or survival. Recent years have seen attempts to formalize risk prediction in cancer care. In place of qualitative and implicit prediction algorithms, such as cancer stage, researchers have developed statistical prediction tools that provide a quantitative estimate of the probability of a specific event for an individual patient. Prediction models generally have greater accuracy than reliance on stage or risk groupings; can incorporate novel predictors such as genomic data; can be used more rationally to make treatment decisions. Several prediction models are now widely used in clinical practice, including the Gail model for breast cancer incidence or the Adjuvant! online prediction model for breast cancer recurrence. Given the burgeoning complexity of diagnostic and prognostic information there is simply no realistic alternative to incorporating multiple variables into a single prediction model. As such, the question should not be whether but how prediction models should be used to aid decision making. Key issues will be integration of models into the electronic health record, and more careful evaluation of models, particularly with respect to their effects on clinical outcomes. PMID:21732332

Vickers, Andrew J.

2011-01-01

36

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 ...

37

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 ...

38

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 ...

39

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 ...

40

[Spiritual care model for terminal cancer patients].  

PubMed

Providing spiritual care to patients with advanced cancer may improve the quality of life of these patients and help them experience a good death. Cancer patients are eager for additional spiritual care and for a sense of peace at the end of their life. However, spirituality is an abstract concept. The literature on spiritual care focuses primarily on elaborations of spirituality theory. Thus, first-line medical care professionals lack clear guidelines for managing the spiritual needs of terminal cancer patients. The purposes of this article were to: 1) introduce a spiritual care model based on the concept of repair and recovery of relationships that addresses the relationship between the self and God, others, id, and objects and 2) set out a four-step strategy for this model that consists of understanding, empathizing, guiding, and growing. This article provides operational guidelines for the spiritual care of terminal cancer patients. PMID:25464961

Cheng, Ju-Fen; Lin, Ya-Ching; Huang, Pai-Ho; Wei, Chih-Hsin; Sun, Jia-Ling

2014-12-01

41

Culture competence and the primary care provider  

Microsoft Academic Search

Nurse practitioners and other primary care health providers in the United States increasingly interact with clients of diverse cultures, races, and ethnic backgrounds. If this interaction is not culturally competent, underutilization of health care services, perceived noncompliance, frustration, anger, and, ultimately, inequities in the health status of clients can result. Providing culturally competent care that fosters positive health outcomes is

Ardys McNaughton Dunn

2002-01-01

42

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

43

Personalized Cancer Care Conference  

PubMed Central

The Oslo University Hospital (Norway), the K.G. Jebsen Centre for Breast Cancer Research (Norway), The Radiumhospital Foundation (Norway) and the Fritz-Bender-Foundation (Germany) designed under the conference chairmen (E. Mihich, K.S. Zänker, A.L. Borresen-Dale) and advisory committee (A. Borg, Z. Szallasi, O. Kallioniemi, H.P. Huber) a program at the cutting edge of “PERSONALIZED CANCER CARE: Risk prediction, early diagnosis, progression and therapy resistance.” The conference was held in Oslo from September 7 to 9, 2012 and the science-based presentations concerned six scientific areas: (1) Genetic profiling of patients, prediction of risk, late side effects; (2) Molecular profiling of tumors and metastases; (3) Tumor-host microenvironment interaction and metabolism; (4) Targeted therapy; (5) Translation and (6) Informed consent, ethical challenges and communication. Two satellite workshops on (i) Ion Ampliseq—a novel tool for large scale mutation detection; and (ii) Multiplex RNA ISH and tissue homogenate assays for cancer biomarker validation were additionally organized. The report concludes that individual risk prediction in carcinogenesis and/or metastatogenesis based on polygenic profiling may be useful for intervention strategies for health care and therapy planning in the future. To detect distinct and overlapping DNA sequence alterations in tumor samples and adjacent normal tissues, including point mutations, small insertions or deletions, copy number changes and chromosomal rearrangements will eventually make it possible to design personalized management plans for individualized patients. However, large individualized datasets need a new approach in bio-information technology to reduce this enormous data dimensionally to simply working hypotheses about health and disease for each individual. PMID:25562519

Zänker, Kurt S.; Mihich, Enrico; Huber, Hans-Peter; Borresen-Dale, Anne-Lise

2013-01-01

44

Personalized cancer care conference.  

PubMed

The Oslo University Hospital (Norway), the K.G. Jebsen Centre for Breast Cancer Research (Norway), The Radiumhospital Foundation (Norway) and the Fritz-Bender-Foundation (Germany) designed under the conference chairmen (E. Mihich, K.S. Zänker, A.L. Borresen-Dale) and advisory committee (A. Borg, Z. Szallasi, O. Kallioniemi, H.P. Huber) a program at the cutting edge of "PERSONALIZED CANCER CARE: Risk prediction, early diagnosis, progression and therapy resistance." The conference was held in Oslo from September 7 to 9, 2012 and the science-based presentations concerned six scientific areas: (1) Genetic profiling of patients, prediction of risk, late side effects; (2) Molecular profiling of tumors and metastases; (3) Tumor-host microenvironment interaction and metabolism; (4) Targeted therapy; (5) Translation and (6) Informed consent, ethical challenges and communication. Two satellite workshops on (i) Ion Ampliseq-a novel tool for large scale mutation detection; and (ii) Multiplex RNA ISH and tissue homogenate assays for cancer biomarker validation were additionally organized. The report concludes that individual risk prediction in carcinogenesis and/or metastatogenesis based on polygenic profiling may be useful for intervention strategies for health care and therapy planning in the future. To detect distinct and overlapping DNA sequence alterations in tumor samples and adjacent normal tissues, including point mutations, small insertions or deletions, copy number changes and chromosomal rearrangements will eventually make it possible to design personalized management plans for individualized patients. However, large individualized datasets need a new approach in bio-information technology to reduce this enormous data dimensionally to simply working hypotheses about health and disease for each individual. PMID:25562519

Zänker, Kurt S; Mihich, Enrico; Huber, Hans-Peter; Borresen-Dale, Anne-Lise

2013-01-01

45

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

46

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.

47

Frontiers of cancer care in Asia-Pacific region: cancer care in Australia.  

PubMed

Cancer has a significant impact on the Australian community. One in three men and one in four women will develop cancer by the age of 75. The estimated annual health expenditure due to cancer in 2000-1 in Australia was $2.7 billion, representing 5.5% of the country's total healthcare expenditure. An historical overview of the national cancer control strategies in Australia is provided. In males, the five most common cancers in order of decreasing incidence are: prostate cancer, colorectal cancer, lung cancer, melanoma and lymphoma, while for Australian women, breast cancer is the most common cancer. Key epidemiologic information about these common cancers, current management issues and comprehensive national clinical practice guidelines (where available) are highlighted. Aspects of skin cancer, a particularly common cancer in the Australian environment - with a focus on melanoma - are also included.Cancer outcomes in Australia, measured by selected outcomes, are among the best in the world. However, there is still evidence of health inequalities, especially among patients residing in regional and remote areas, the indigenous population and people from lower socio-economic classes. Limitations of current cancer care practices in Australia, including provision of oncology services, resources and other access issues, as well as suggested improvements for future cancer care, are summarised. Ongoing implementation of national and state cancer control plans and evaluation of their effectiveness will be needed to pursue the goal of optimal cancer care in Australia. PMID:21611000

Koh, Es; Do, Vt; Barton, Mb

2008-07-01

48

Translating genomics in cancer care.  

PubMed

There is increasing enthusiasm for genomics and its promise in advancing personalized medicine. Genomic information has been used to personalize health care for decades, spanning the fields of cardiovascular disease, infectious disease, endocrinology, metabolic medicine, and hematology. However, oncology has often been the first test bed for the clinical translation of genomics for diagnostic, prognostic, and therapeutic applications. Notable hereditary cancer examples include testing for mutations in BRCA1 or BRCA2 in unaffected women to identify those at significantly elevated risk for developing breast and ovarian cancers, and screening patients with newly diagnosed colorectal cancer for mutations in 4 mismatch repair genes to reduce morbidity and mortality in their relatives. Somatic genomic testing is also increasingly used in oncology, with gene expression profiling of breast tumors and EGFR testing to predict treatment response representing commonly used examples. Health technology assessment provides a rigorous means to inform clinical and policy decision-making through systematic assessment of the evidentiary base, along with precepts of clinical effectiveness, cost-effectiveness, and consideration of risks and benefits for health care delivery and society. Although this evaluation is a fundamental step in the translation of any new therapeutic, procedure, or diagnostic test into clinical care, emerging developments may threaten this standard. These include "direct to consumer" genomic risk assessment services and the challenges posed by incidental results generated from next-generation sequencing (NGS) technologies. This article presents a review of the evidentiary standards and knowledge base supporting the translation of key cancer genomic technologies along the continuum of validity, utility, cost-effectiveness, health service impacts, and ethical and societal issues, and offers future research considerations to guide the responsible introduction of NGS technologies into health care. It concludes that significant evidentiary gaps remain in translating genomic technologies into routine clinical practice, particularly in efficacy, health outcomes, cost-effectiveness, and health services research. These caveats are especially germane in the context of NGS, wherein efforts are underway to translate NGS results despite their limited accuracy, lack of proven efficacy, and significant computational and counseling challenges. Further research across these domains is critical to inform the effective, efficient, and equitable translation of genomics into cancer care. PMID:24225968

Bombard, Yvonne; Bach, Peter B; Offit, Kenneth

2013-11-01

49

Lactose Intolerance: Information for Health Care Providers  

E-print Network

Lactose Intolerance: Information for Health Care are at or above their adequate intake of calcium.1 And adolescents who may be lactose intolerant are even less of their adult bone mass is established. As a health care provider, you can help your patients get the calcium

Rau, Don C.

50

Vaccine perceptions among Oregon health care providers.  

PubMed

Health care providers exert a significant influence on parental pediatric vaccination decisions. We conducted hour-long interviews with traditional and alternative health care providers in which we explored a range of associations between vaccination perceptions and practice. A key finding was that the Health Belief Model constructs of perceived susceptibility to and severity of either an illness or an adverse vaccine event partially explained health care provider (HCP) beliefs about the risks or benefits of vaccination, especially among alternative care providers. Low or high perceived susceptibility to a vaccine-preventable disease (VPD) or of the severity of a given VPD affects whether an HCP will promote or oppose pediatric vaccination recommendations. Beyond these perceptions, health and vaccination beliefs are affected by the contextual factors of personal experience, group norms, immunology beliefs, and beliefs about industry and government. Building powerful affective heuristics might be critical to balancing the forces that defeat good public health practices. PMID:23964059

Bean, Sandra J; Catania, Joseph A

2013-09-01

51

Should Health Care Providers be Accountable for Patients' Care Experiences?  

PubMed

Measures of patients' care experiences are increasingly used as quality measures in accountability initiatives. As the prominence and financial impact of patient experience measures have increased, so too have concerns about the relevance and fairness of including them as indicators of health care quality. Using evidence from the Consumer Assessment of Healthcare Providers and Systems (CAHPS®) surveys, the most widely used patient experience measures in the United States, we address seven common critiques of patient experience measures: (1) consumers do not have the expertise needed to evaluate care quality; (2) patient "satisfaction" is subjective and thus not valid or actionable; (3) increasing emphasis on improving patient experiences encourages health care providers and plans to fulfill patient desires, leading to care that is inappropriate, ineffective, and/or inefficient; (4) there is a trade-off between providing good patient experiences and providing high-quality clinical care; (5) patient scores cannot be fairly compared across health care providers or plans due to factors beyond providers' control; (6) response rates to patient experience surveys are low, or responses reflect only patients with extreme experiences; and (7) there are faster, cheaper, and more customized ways to survey patients than the standardized approaches mandated by federal accountability initiatives. PMID:25416601

Anhang Price, Rebecca; Elliott, Marc N; Cleary, Paul D; Zaslavsky, Alan M; Hays, Ron D

2015-02-01

52

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.

53

Health care policy and cancer survivorship.  

PubMed

The United States and the European Union (EU) vary widely in approaches to ensuring affordable health care coverage for our respective populations. Such variations stem from differences in the political systems and beliefs regarding social welfare. These variations are also reflected in past and future initiatives to provide high quality cancer survivorship care. The United States spends considerably more on health care compared to most European countries, often with no proven benefit. In the United States, individuals with chronic illnesses, such as cancer survivors, often experience difficulties affording insurance and maintaining coverage, a problem unknown to EU countries with national health insurance. This article reviews health policy development over time for the United States and EU and the impact for cancer survivors. For the United States, the impact of the Affordable Care Act on improving access to affordable care for cancer survivors is highlighted. For the EU, the importance of multiple-morbidity disease management, cancer plan development, and pan-European data collection for monitoring cancer outcomes is addressed. Given predicted workforce shortages and ever-increasing numbers of aging cancer survivors on both sides of the Atlantic, sharing lessons learned will be critical. PMID:23695931

Virgo, Katherine S; Bromberek, Julia L; Glaser, Adam; Horgan, Denis; Maher, Jane; Brawley, Otis W

2013-06-01

54

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

55

Sick Child Care Book for Parents and Child Care Providers.  

ERIC Educational Resources Information Center

Intended for use by parents and child care providers, this short booklet offers practical information about many common childhood illnesses, providing suggestions for making decisions which concern the sick child. Information is given relating to how parents (especially working parents) can be prepared for their child's illnesses, specific…

Bananas, Inc., Oakland, CA.

56

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

57

Breastfeeding counseling by health care providers.  

PubMed

This study sought to identify the content and source of information given to prospective breastfeeding mothers. The population included 111 mothers attempting to breastfeed at a community hospital during a 3-month period. Questionnaires were used to assess prenatal preparation and specific breastfeeding issues discussed by health care providers. During the prenatal period, 23% of mothers received counsel from their obstetrician, 47% from books, and 21% from classes. Postpartum, nurses provided breastfeeding information to 87% of mothers whereas obstetricians and pediatricians provided advice to 27% and 33% of mothers, respectively. Many women do not receive supportive breastfeeding counseling from physicians. Health care providers must develop better methods of prenatal and postpartum education to enhance breastfeeding initiation and continuation. PMID:9233200

Izatt, S D

1997-06-01

58

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

59

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.

60

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

61

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

Federal Register 2010, 2011, 2012, 2013, 2014

...Research and Quality Request for Measures of Patient Experiences of Cancer Care AGENCY: Agency...researchers, survey firms, cancer care providers, patient advocacy groups, individual cancer patients, and other stakeholders who are...

2010-03-04

62

Providing Quality Primary Care to Older Adults  

Microsoft Academic Search

trend for older adults to seek care from non-pri- mary care specialists at a higher rate than in the recent past. In 2005, 43% of ambulatory care visits by patients aged 65 and over were to primary care physicians and 57% were to non-primary care spe- cialists. In 1980, 62% of ambulatory care visits by patients aged 65 and over

Gregg Warshaw

2009-01-01

63

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

64

47 CFR 54.633 - Health care provider contribution.  

Code of Federal Regulations, 2014 CFR

...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

65

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

66

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

67

Multi-center study looks at "breakdowns" in cancer care  

Cancer.gov

Cancer care is increasingly complex, and as many as one in five cancer patients may experience "breakdowns" in their care, according to a new study in the Journal of Clinical Oncology. Such breakdowns include communication problems between patients and their care providers, as well as more traditional medical errors; both types of problems can create significant harms. In the study, communication problems outnumbered problems with medical care.

68

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

69

Choosing the right health care provider for pregnancy and childbirth  

MedlinePLUS

... have to decide about is what kind of health care provider you would like to care for you ... or a certified nurse-midwife. Each of these health care providers is described below. Each one has different ...

70

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 ...

71

The "specter" of cancer: exploring secondary trauma for health professionals providing cancer support and counseling.  

PubMed

Health professionals are vulnerable to occupational stress and tend to report high levels of secondary trauma and burnout; this is especially so for those working in "high-death" contexts such as cancer support and palliative care. In this study, 38 health professionals (psychologists, social workers, pastoral carers/chaplains, nurses, group facilitators, and a medical practitioner) who provide grief support and counseling in cancer and palliative care each participated in a semistructured interview. Qualitatively, a grounded theory analysis revealed four themes: (a) the role of health professionals in supporting people who are experiencing grief and loss issues in the context of cancer, (b) ways of working with patients with cancer and their families, (c) the unique qualities of cancer-related loss and grief experiences, and (d) the emotional demands of the work and associated self-care. The provision of psychological services in the context of cancer is colored by the specter of cancer, an unseen yet real phenomenon that contributes to secondary trauma and burnout. The participants' reported secondary trauma has serious repercussions for their well-being and may compromise the care they provide. The findings have implications for the retention and well-being of personnel who provide psychosocial care in cancer and the quality and delivery of services for people with cancer and their families. PMID:24079353

Breen, Lauren J; O'Connor, Moira; Hewitt, Lauren Y; Lobb, Elizabeth A

2014-02-01

72

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

73

Who provides GP after-hours care?  

PubMed

Understanding the demographic and financial factors likely to influence the supply side of after-hours GP care is crucial in meeting the increasing demand for these services. This study answers two questions: which GPs are more likely to provide after-hours GP care, and of those who do, which are more likely to take a heavier load. Data from the first wave of the Medicine in Australia: Balancing Employment and Life (MABEL) survey is used, with logistic regression applied to address the decision to undertake after-hours work and linear regression to address the question of the quantum of work. The results show that female, older, and urban GPs are less likely to work outside of normal hours. GPs who are employees are less likely to participate in after-hours work than GPs who are principals or partners of a practice. On the other hand, principals and partners, are likely work more hours in the after-hours period than employee GPs if they do participate in this work. Similarly, those GPs in solo practice who work after-hours also tend to take a heavier after-hours workload than the GPs who are not in solo practice. The role of GP wages and family income does not seem to be compelling. These conclusions are likely to relate to the ways doctors behave independent of the health system. PMID:25616724

Pham, Mai; McRae, Ian

2015-04-01

74

Risk-based health care, the cancer survivor, the oncologist, and the primary care physician.  

PubMed

Cancer survivors face substantial risks for morbidity, reduced quality of life, and premature mortality related to the cancer itself and/or the interventions undertaken to control cancer. Risk-based care that involves a personalized systematic plan of periodic screening, surveillance, and prevention relevant to the cancer experience is recommended to address the comprehensive health needs of the growing population of cancer survivors. Risk-based care and coordination between oncology and primary care providers have been identified as important metrics of quality cancer survivorship care. Various models of survivorship care, treatment summaries, and survivorship care plans have been promoted as methods to facilitate communication among providers across care transitions and improve survivor access to quality survivorship care. However, research supporting the feasibility of implementing these practices and their effectiveness in enhancing health outcomes is limited. This article reviews key concepts underpinning clinical and research initiatives endeavoring to improve access to quality care among long-term survivors and summarizes results of intervention studies implementing these elements in transitioning survivors from oncology to primary care providers for long-term follow-up care. PMID:24331199

McCabe, Mary S; Partridge, Ann H; Grunfeld, Eva; Hudson, Melissa M

2013-12-01

75

Proteomic Contributions to Personalized Cancer Care*  

PubMed Central

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.

2008-01-01

76

Disparity in cancer care: a Canadian perspective  

PubMed Central

Canada is facing cancer crisis. Cancer has become the leading cause of death in Canada. Despite recent advances in cancer management and research, growing disparities in cancer care have been noticed, especially in socio-economically disadvantaged groups and under-served communities. With the rising incidence of cancer and the increasing numbers of minorities and of social disparities in general, and without appropriate interventions, cancer care disparities will become only more pronounced. This paper highlights the concepts and definitions of equity in health and health care and examines several health determinants that increase the risk of cancer. It also reviews cancer care inequity in the high-risk groups. A conceptual framework is proposed and recommendations are made for the eradication of disparities within the health care system and beyond. PMID:23300361

Ahmed, S.; Shahid, R.K.

2012-01-01

77

Quality measurement and system change of cancer care delivery.  

PubMed

Cancer care quality measurement and system change may serve as a case example for larger possibilities in the health care system related to other diseases. Cancer care quality gaps and variation exist across both technical and patient-centered cancer quality measures, especially among vulnerable populations. There is a need to develop measures that address the following dimensions of quality and its context: disparities, overuse, patient-centeredness, and uncertainty. Developments that may promote system change in cancer care delivery include changes in the information market, organizational accountability, and consumer empowerment. Information market changes include public cancer care quality reporting, enabled by health information exchange, and incentivized by pay-for-performance. Moving organizational accountability, reimbursement, and quality measurement from individual episodes of care to multiple providers providing coordinated cancer care may address quality gaps associated with the fragmentation of care delivery. Consumer empowerment through new technologies, such as personal health records, may lead to the collection of patient-centered quality measures and promote patient self-management. Across all of these developments, leadership and ongoing research to guide informed system changes will be necessary to transform the cancer care delivery system. PMID:20940654

Haggstrom, David A; Doebbeling, Bradley N

2011-12-01

78

CAM Provider Use and Expenditures by Cancer Treatment Phase  

PubMed Central

Objective To assess cancer patients’ utilization of complementary and alternative medical providers and the associated expenditures by specific treatment phases. Study Design Cross-sectional analysis of medical services utilization and expenditures during three therapeutic intervals: an initial treatment phase, continuing care, and end-of-life. Methods Analysis of an insurance claims database that had been matched to the Washington State SEER cancer registry. Results Of 2,900 registry-matched cancer patients 63.2% were female, the median age was 54 years, and 92.7% were white. Breast cancer was the most frequent diagnosis (52.7%), followed by prostate cancer (24.7%), lung cancer (10.1%), colon cancer (7.0%), and hematologic malignancies (5.6%). CAM provider using patients were 26.5% of the overall cohort (18.5% used chiropractors, 7.7% naturopathic physicians, 5.3% massage therapists, and 4.2% saw acupuncturists). The proportion of CAM using patients was similar during each treatment phase. All patients used some conventional care. Female gender, a breast cancer diagnosis, age, and white race were significant predictors of CAM use. Diagnosis of a musculoskeletal problem occurred at sometime during the study for 72.1% of cancer patients. CAM provider visits were 7.2% of total outpatient medical visits and 85.1% of CAM visits resulted in a musculoskeletal diagnosis. Expenditures for CAM providers were 0.3%, 1.0%, and 0.1% of all expenditures during the initial, continuing, and end-of-life phases respectively. Conclusion For cancer patients, musculoskeletal issues were the most commonly listed diagnosis made by a CAM provider. Although expenditures associated with CAM are a small proportion of the total, additional studies are necessary to determine the importance patients place on access to these services. PMID:18471036

Lafferty, William E.; Tyree, Patrick T.; Devlin, Sean M.; Andersen, M. Robyn; Diehr, Paula K.

2008-01-01

79

Monitoring care of colorectal cancer patients in  

E-print Network

Monitoring care of colorectal cancer patients in Northern Ireland diagnosed 2006 (with comparisons 1996 & 2001) Colorectal1996-2006 #12;Monitoring care of colorectal cancer patients in Northern Ireland in Northern Ireland diagnosed 2006 (with comparisons 1996 & 2001). N. Ireland Cancer Registry. Available

Müller, Jens-Dominik

80

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

81

Talking about Complementary and Alternative Medicine with Your Health Care Providers: A Workbook and Tips  

MedlinePLUS

... National Institutes of Health Talking about Complementary and Alternative Medicine with Health Care Providers: A Workbook and Tips Office of Cancer Complementary and Alternative Medicine 1 How to use this workbook If ...

82

Patients' Experiences with Navigation for Cancer Care  

PubMed Central

Objective We examined how navigation, defined as the assessment and alleviation of barriers to adequate health care, influences patients' perspectives on the quality of their cancer care. Methods We conducted post-study patient interviews from a randomized controlled trial (usual care vs. patient navigation services) from cancer diagnosis through treatment completion. Patients were recruited from 11 primary care, hospital and community oncology practices in New York. We interviewed patients about their expectations and experience of patient navigation or, for non-navigated patients, other sources of assistance. Results Thirty-five patients newly diagnosed with breast or colorectal cancer. Valued aspects of navigation included emotional support, assistance with information needs and problem-solving, and logistical coordination of cancer care. Unmet cancer care needs expressed by patients randomized to usual care consisted of lack of assistance or support with childcare, household responsibilities, coordination of care, and emotional support. Conclusion Cancer patients value navigation. Instrumental benefits were the most important expectations for navigation from navigated and non-navigated patients. Navigated patients received emotional support and assistance with information needs, problem-solving, and logistical aspects of cancer care coordination. Practice Implications Navigation services may help improve cancer care outcomes important to patients by addressing fragmented, confusing, uncoordinated, or inefficient care. PMID:20006459

Carroll, Jennifer K.; Humiston, Sharon G.; Meldrum, Sean C.; Salamone, Charcy M.; Jean-Pierre, Pascal; Epstein, Ronald M.; Fiscella, Kevin

2010-01-01

83

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

84

Integrating yoga into cancer care.  

PubMed

Although yoga has been practiced in Eastern culture for thousands of years as part of life philosophy, classes in the United States only recently have been offered to people with cancer. The word yoga is derived from the Sanskrit root yuj, meaning to bind, join, and yoke. This reflection of the union of the body, mind, and spirit is what differentiates yoga from general exercise programs. Yoga classes in the United States generally consist of asanas (postures), which are designed to exercise every muscle, nerve, and gland in the body. The postures are combined with pranayama, or rhythmic control of the breath. As a complementary therapy, yoga integrates awareness of breath, relaxation, exercise, and social support--elements that are key to enhancing quality of life in patients with cancer. Yoga practice may assist cancer survivors in managing symptoms such as depression, anxiety, insomnia, pain, and fatigue. As with all exercise programs, participants need to be aware of potential risks and their own limitations. The purpose of this article is to familiarize nurses with yoga as a complementary therapy, including current research findings, types of yoga, potential benefits, safety concerns, teacher training, and ways to integrate yoga into cancer care. PMID:18258582

DiStasio, Susan A

2008-02-01

85

Why Do Cuckolded Males Provide Paternal Care?  

PubMed Central

In most species, males do not abandon offspring or reduce paternal care when they are cuckolded by other males. This apparent lack of adjustment of paternal investment with the likelihood of paternity presents a potential challenge to our understanding of what drives selection for paternal care. In a comparative analysis across birds, fish, mammals, and insects we identify key factors that explain why cuckolded males in many species do not reduce paternal care. Specifically, we show that cuckolded males only reduce paternal investment if both the costs of caring are relatively high and there is a high risk of cuckoldry. Under these circumstances, selection is expected to favour males that reduce paternal effort in response to cuckoldry. In many species, however, these conditions are not satisfied and tolerant males have outcompeted males that abandon young. PMID:23555193

Griffin, Ashleigh S.; Alonzo, Suzanne H.; Cornwallis, Charlie K.

2013-01-01

86

Ten Things Lesbians Should Discuss with Their Health Care Provider  

MedlinePLUS

... for high blood pressure, cholesterol problems, and diabetes. Health care providers can also offer tips on quitting smoking, ... lesbians experience violence in their intimate relationships. However, health care providers do not ask lesbians about intimate partner ...

87

Community Health Centers: Providers, Patients, and Content of Care  

MedlinePLUS

... Number 65, July 2011 Community Health Centers: Providers, Patients, and Content of Care On This Page Key ... NCHS, National Ambulatory Medical Care Survey. Why do patients visit different types of providers? As assessed by ...

88

How Do Health Care Providers Diagnose Birth Defects?  

MedlinePLUS

... Trials Resources and Publications En Español 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 ...

89

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 ...

90

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 ...

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 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 ...

93

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 ...

94

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 ...

95

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 ...

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 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 ...

98

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 ...

99

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 ...

100

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 ...

101

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 ...

102

How Do Health Care Providers Diagnose Fragile X Syndrome?  

MedlinePLUS

... Trials Resources and Publications En Español 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 ...

103

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 ...

104

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

MedlinePLUS

... 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 or fewer periods per ...

105

Delivering High-Quality and Affordable Care Throughout the Cancer Care Continuum  

PubMed Central

The national cost of cancer care is projected to reach $173 billion by 2020, increasing from $125 billion in 2010. This steep upward cost trajectory has placed enormous an financial burden on patients, their families, and society as a whole and raised major concern about the ability of the health care system to provide and sustain high-quality cancer care. To better understand the cost drivers of cancer care and explore approaches that will mitigate the problem, the National Cancer Policy Forum of the Institute of Medicine held a workshop entitled “Delivering Affordable Cancer Care in the 21st Century” in October 2012. Workshop participants included bioethicists, health economists, primary care physicians, and medical, surgical, and radiation oncologists, from both academic and community settings. All speakers expressed a sense of urgency about the affordability of cancer care resulting from the future demographic trend as well as the high cost of emerging cancer therapies and rapid diffusion of new technologies in the absence to evidence indicating improved outcomes for patients. This article is our summary of presentations at the workshop that highlighted the overuse and underuse of screening, treatments, and technologies throughout the cancer care continuum in oncology practice in the United States. PMID:24127450

Shih, Ya-Chen Tina; Ganz, Patricia A.; Aberle, Denise; Abernethy, Amy; Bekelman, Justin; Brawley, Otis; Goodwin, James S.; Hu, Jim C.; Schrag, Deborah; Temel, Jennifer S.; Schnipper, Lowell

2013-01-01

106

Iowa intermediate care facilities: an evaluation of care providers'attitudes toward oral hygiene care.  

PubMed

This study investigated the oral hygiene care (OHC) activities and attitudes of care providers in Intermediate Care Facilities for the Mentally Retarded (ICF/MR) in the state of Iowa. Questionnaires were distributed to care providers employed at three ICF/MRs. About 98% of the staff ranked OHC as important to extremely important for residents. Twenty-three percent disliked OHC occasionally or more frequently. Lack of time and lack of staff were the main reasons preventing care providers from assisting residents with OHC. Residents' behaviors resulted in inadequate OHC for 64.9%, and 49% of residents required complete assistance with OHC. Most common OHC difficulties reported were residents biting the toothbrush, refusing OHC, or not opening their mouths. Subjects reported spending 3.0 minutes brushing a resident's teeth and 3.0 minutes cleaning dentures. Care providers experienced significant behavioral and physical difficulties while providing OHC, but still found OHC important. Training programs for care providers are needed to address these difficulties. PMID:20500704

Thole, Karla; Chalmers, Jane; Ettinger, Ronald L; Warren, John

2010-01-01

107

Improving cancer patient care: development of a generic cancer consumer quality index questionnaire for cancer patients  

PubMed Central

Background To develop a Consumer Quality Index (CQI) Cancer Care questionnaire for measuring experiences with hospital care of patients with different types of cancer. Methods We derived quality aspects from focus group discussions, existing questionnaires and literature. We developed an experience questionnaire and sent it to 1,498 Dutch cancer patients. Another questionnaire measuring the importance of the quality aspects was sent to 600 cancer patients. Data were psychometrically analysed. Results The response to the experience questionnaire was 50 percent. Psychometric analysis revealed 12 reliable scales. Patients rated rapid and adequate referral, rapid start of the treatment after diagnosis, enough information and confidence in the healthcare professionals as most important themes. Hospitals received high scores for skills and cooperation of healthcare professionals and a patient-centered approach by doctors; and low scores for psychosocial guidance and information at completion of the treatment. Conclusions The CQI Cancer Care questionnaire is a valuable tool for the evaluation of the quality of cancer care from the patient’s perspective. Large scale implementation is necessary to determine the discriminatory powers of the questionnaire and may enable healthcare providers to improve the quality of cancer care. Preliminary results indicate that hospitals could improve their psychosocial guidance and information provision. PMID:23617741

2013-01-01

108

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

109

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

110

Child Care Provider Training Helping Early Childhood Educators  

E-print Network

Child Care Provider Training Helping Early Childhood Educators Provide Quality Care for Today that were not conducted by Extension. In addition to the face-to-face conferences, early childhood educators at these conferences on a variety of topics related to child care. Online Training. Extension's Early Childhood

111

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

112

Palliative Care in Iran: Moving Toward the Development of Palliative Care for Cancer.  

PubMed

Cancer is the third leading cause of death in Iran and its incidence has been increasing in recent years. Patients' quality of life is altered rather enormously due to cancer, which doubles the importance of and the need for providing palliative care in Iran. Although many steps have been taken toward the development and providing of palliative care in Iran, there is still a large gap between the status quo and the desirable state. This study presents the current state of palliative care for cancer patients and discusses the barriers, challenges and outlook of palliative care in Iran. If infrastructural projects that have recently been launched prove successful, proper advancement toward the providing of palliative care services in Iran will then not far on the horizon. PMID:25492970

Rassouli, Maryam; Sajjadi, Moosa

2014-12-01

113

Supportive Care Needs of Iranian Cancer Patients  

PubMed Central

Background: A supportive needs assessment is an essential component of any care program. There is no research evidence regarding the supportive care needs of cancer patients in Iran or other Middle Eastern countries. Aims: The aim of this study was to determine the supportive care needs of Iranian cancer patients. Materials and Methods: This descriptive study was conducted in a referral medical center in the northwest of Iran. A total of 274 cancer patients completed the Supportive Care Needs Survey (SCNS-59). Descriptive statistics were used for data analysis. Results: In 18 items of the SCNS, more than 50% of the participants reported that their needs were unmet. Most frequently, unmet needs were related to the health system, information, physical, and daily living domains, and most met needs were related to sexuality, patient care, and support domains. Conclusions: Iranian cancer patients experience many unmet needs and there is an urgent need for establishing additional supportive care services in Iran. PMID:25191012

Rahmani, Azad; Ferguson, Caleb; Jabarzadeh, Faranak; Mohammadpoorasl, Asghar; Moradi, Narges; Pakpour, Vahid

2014-01-01

114

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

115

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 ...

116

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

117

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

118

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.

119

Communication of BRCA1 and BRCA2 genetic test results to health care providers following genetic testing at a tertiary care center  

Microsoft Academic Search

Individuals at high risk for hereditary cancers often receive genetic counseling and testing at tertiary care centers; however,\\u000a they may receive care for long-term management of their cancer risk in community settings. Communication of genetic test results\\u000a to health care providers outside of tertiary care settings can facilitate the long-term management of high risk individuals.\\u000a This study assessed women’s communication

K. Ready; B. K. Arun; K. M. Schmeler; A. Uyei; J. K. Litton; K. H. Lu; C. C. Sun; S. K. Peterson

120

Development of an educational module on provider self-care.  

PubMed

Intensive care providers who care for traumatized populations often face multiple traumas for extended periods and are vulnerable to developing lasting symptoms of compassion fatigue and secondary traumatization. Symptoms are often not recognizable until compassion fatigue or secondary traumatization negatively affects the providers' ability to care for their patients. More attention needs to be given to the care of the provider to ensure high-quality patient care, decrease turnover in the profession, and increase productivity. This article provides a framework for the development of an educational module for healthcare providers' self-care. This educational module created the opportunity to share with providers (a) how to explore their own professional experience; (b) how to recognize the different symptoms of compassion fatigue, primary traumatization, and secondary traumatization; (c) factors related to grief reactions; and (d) personal and professional strategies to decrease compassion fatigue and secondary traumatization. PMID:20683299

Meadors, Patrick; Lamson, Angela; Sira, Natalia

2010-01-01

121

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

122

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 a complex way of looking at the value within the health care sector. The proposal of the value chain model

Boyer, Edmond

123

002 pp: towards an anthropology of care: cancer care practices in the everyday.  

PubMed

A patient affected by cancer is never alone with his/her disease; his/her social surroundings shape and are shaped by the daily practices aiming to manage the disease and its treatments. According to Macmillan Cancer Support report(a), informal caregivers of colorectal cancer patients tend to provide more hours per week of care than those supporting patients affected by other types of cancer (40% of them give at least 20 hours of care versus 25% of all carers). Such care usually requires performing multiple tasks, from emotional support, practical work to advocacy. Psychosocial studies in oncology have successfully attended to the repercussions of cancer and cancer care in the family unit, emphasising the impact of such experiences and transactions for the mental and physical health of family members. In this abstract, I would like to contribute to that research by explaining how an anthropology of care can shed further light on these dynamics, unfolding the practical, cognitive and emotional aspects of care in the everyday contexts of people affected by cancer. My argument is that an anthropology of care would illuminate: (1) the generation of embodied knowledge, emotion work and practical tinkering of caregiving practices by which requirements, side effects and consequences of colorectal cancer treatments are addressed, (2) the ways in which patients and their significant others negotiate the temporalities of treatments and the collective identities as supporters and patients during the day to day life, and (3) the ways in which social-cultural and political and economic arrangements shape people's experiences of cancer treatments. (a)More than a million: Understanding the UK's carers of people with cancer-a report by Ipsos Mori for Macmillan Cancer Support. PMID:25869697

Arteaga Pérez, M I

2015-01-01

124

Cancer Core Europe: a consortium to address the cancer care-cancer research continuum challenge.  

PubMed

European cancer research for a transformative initiative by creating a consortium of six leading excellent comprehensive cancer centres that will work together to address the cancer care-cancer research continuum. Prerequisites for joint translational and clinical research programs are very demanding. These require the creation of a virtual single 'e-hospital' and a powerful translational platform, inter-compatible clinical molecular profiling laboratories with a robust underlying computational biology pipeline, standardised functional and molecular imaging, commonly agreed Standard Operating Procedures (SOPs) for liquid and tissue biopsy procurement, storage and processing, for molecular diagnostics, 'omics', functional genetics, immune-monitoring and other assessments. Importantly also it requires a culture of data collection and data storage that provides complete longitudinal data sets to allow for: effective data sharing and common database building, and to achieve a level of completeness of data that is required for conducting outcome research, taking into account our current understanding of cancers as communities of evolving clones. Cutting edge basic research and technology development serve as an important driving force for innovative translational and clinical studies. Given the excellent track records of the six participants in these areas, Cancer Core Europe will be able to support the full spectrum of research required to address the cancer research- cancer care continuum. Cancer Core Europe also constitutes a unique environment to train the next generation of talents in innovative translational and clinical oncology. PMID:25263570

Eggermont, Alexander M M; Caldas, Carlos; Ringborg, Ulrik; Medema, René; Tabernero, Josep; Wiestler, Otmar

2014-11-01

125

Modeling Market Shares of Competing (e)Care Providers  

NASA Astrophysics Data System (ADS)

In order to address the increasing costs of providing care to the growing group of elderly, efficiency gains through eCare solutions seem an obvious solution. Unfortunately not many techno-economic business models to evaluate the return of these investments are available. The construction of a business case for care for the elderly as they move through different levels of dependency and the effect of introducing an eCare service, is the intended application of the model. The simulation model presented in this paper allows for modeling evolution of market shares of competing care providers. Four tiers are defined, based on the dependency level of the elderly, for which the market shares are determined. The model takes into account available capacity of the different care providers, in- and outflow distribution between tiers and churn between providers within tiers.

van Ooteghem, Jan; Tesch, Tom; Verbrugge, Sofie; Ackaert, Ann; Colle, Didier; Pickavet, Mario; Demeester, Piet

126

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.

127

Could Fish Oil Interfere with Cancer Care?  

MedlinePLUS

... features on this page, please enable JavaScript. Could Fish Oil Interfere With Cancer Care? Answer isn't clear, but research suggests supplements, and certain fish, might reduce effect of chemotherapy (*this news item ...

128

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

129

The Pedagogical Experiences and Practices of Family Child Care Providers  

ERIC Educational Resources Information Center

The work in family child care is becoming increasingly more professional, moving from an image of "mothering" toward one of educare. The growing demand for expertise and competence in family child care providers can be examined in light of their pedagogical experiences and the ways in which children engage in learning in providers' homes. This…

Freeman, Ramona Gail; Vakil, Shernavaz

2007-01-01

130

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

131

Gonadal failure after treatment of hematologic malignancies: from recognition to management for health-care providers  

Microsoft Academic Search

Many cancer treatments induce gonadal failure, which can cause infertility and menopausal symptoms in women. Improvements in treatments for hematologic malignancies have extended survival, thus making treatment-induced gonadal failure (TIGF) a more widespread problem. We reviewed the published literature on TIGF with the goal of providing practical information for health-care providers engaged in the management of hematologic malignancies. We conclude

Kazutaka Nakayama; Andrea Milbourne; Leslie R Schover; Richard E Champlin; Naoto T Ueno

2008-01-01

132

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.

133

Examining Racial Disparities in Colorectal Cancer Care  

Microsoft Academic Search

African Americans are disproportionately burdened with colorectal cancer. Although incidence and mortality rates have declined in the past two decades, the disparity in health outcomes has progressively increased. This comprehensive review examines the existing literature regarding racial disparities in colorectal cancer screening, stage at diagnosis, and treatment to determine if differences exist in the quality of care delivered to African

Jamillah Berry; Kevin Bumpers; Vickie Ogunlade; Roni Glover; Sharon Davis; Margaret Counts-Spriggs; John Kauh; Christopher Flowers

2009-01-01

134

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.

135

Developing a web 2.0 diabetes care support system with evaluation from care provider perspectives.  

PubMed

Diabetes is a life-long illness condition that many diabetic patients end up with related complications resulted largely from lacking of proper supports. The success of diabetes care relies mainly on patient's daily self-care activities and care providers' continuous support. However, the self-care activities are socially bounded with patient's everyday schedules that can easily be forgotten or neglected and the care support from providers has yet been fully implemented. This study develops a Web 2.0 diabetes care support system for patients to integrate required self-care activities with different context in order to enhance patient's care knowledge and behavior adherence. The system also supports care managers in a health service center to conduct patient management through collecting patient's daily physiological information, sharing care information, and maintaining patient-provider relationships. After the development, we evaluate the acceptance of the system through a group of nursing staffs. PMID:21369781

Lin, Yung-Hsiu; Chen, Rong-Rong; Guo, Sophie Huey-Ming; Chang, Hui-Yu; Chang, Her-Kun

2012-08-01

136

Cultural Aspects of Communication in Cancer Care  

Microsoft Academic Search

Cancer is increasing in incidence and prevalence worldwide, and the WHO has recently included cancer and its treatments as\\u000a a health priority in developed and developing countries. The cultural diversity of oncology patients is bound to increase,\\u000a and cultural sensitivity and competence are now required of all oncology professionals. A culturally competent cancer care\\u000a leads to improved therapeutic outcome and

A. Surbone

137

Home Care for Cancer Patients  

MedlinePLUS

... is sometimes difficult to decide which to use. In addition to the local health department, information about home care services is available from organizations such as the National Association for Home Care & Hospice (NAHC). The NAHC publication How To Choose a Home Care Agency: A ...

138

Providing cultural care behind the spotlight at the Olympic Games.  

PubMed

The Olympic Games constitutes the world's largest sporting event. Nurses play an important, but poorly discussed, role in emergency care, routine clinical care and preventive care for athletes from many cultures as well as an enormous influx of spectators. In this article, we discuss five important considerations when preparing nurses to provide safe care for Olympians: elite athletes as a cultural group; caring for the Olympic family; disaster preparedness and security; infection control; and principles of transcultural nursing. Because of the nature of the sports and types of injuries and the effects of climate, these challenges differ somewhat between the summer and winter Olympics. Nevertheless, the Olympic games provide a tremendous opportunity to experience transcultural nursing and to highlight how nurses play a significant role in the care of the athletes, the Olympic family, and the spectators. PMID:25759201

Morse, Janice M; Clark, Lauren; Haynes, Tracii; Noji, Ariko

2015-03-01

139

Developing Successful Models of Cancer Palliative Care Services  

PubMed Central

Objectives This article describes successful institutionally-based programs for providing high quality palliative care to people with cancer and their family members. Challenges and opportunities for program development are also described. Data Sources Published literature from 2000 to present describing concurrent oncology palliative care clinical trials, standards and guidelines were reviewed. Conclusion Clinical trials have demonstrated feasibility and positive outcomes and formed the basis for consensus guidelines that support concurrent oncology palliative care models. Implications for nursing practice Oncology nurses should advocate for all patients with advanced cancer and their families to have access to concurrent oncology palliative oncology care from the time of diagnosis with a life-limiting cancer. PMID:20971407

Bakitas, Marie; Bishop, Margaret Firer; Caron, Paula; Stephens, Lisa

2010-01-01

140

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.

141

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.

142

Rapid-Learning System for Cancer Care  

PubMed Central

Compelling public interest is propelling national efforts to advance the evidence base for cancer treatment and control measures and to transform the way in which evidence is aggregated and applied. Substantial investments in health information technology, comparative effectiveness research, health care quality and value, and personalized medicine support these efforts and have resulted in considerable progress to date. An emerging initiative, and one that integrates these converging approaches to improving health care, is “rapid-learning health care.” In this framework, routinely collected real-time clinical data drive the process of scientific discovery, which becomes a natural outgrowth of patient care. To better understand the state of the rapid-learning health care model and its potential implications for oncology, the National Cancer Policy Forum of the Institute of Medicine held a workshop entitled “A Foundation for Evidence-Driven Practice: A Rapid-Learning System for Cancer Care” in October 2009. Participants examined the elements of a rapid-learning system for cancer, including registries and databases, emerging information technology, patient-centered and -driven clinical decision support, patient engagement, culture change, clinical practice guidelines, point-of-care needs in clinical oncology, and federal policy issues and implications. This Special Article reviews the activities of the workshop and sets the stage to move from vision to action. PMID:20585094

Abernethy, Amy P.; Etheredge, Lynn M.; Ganz, Patricia A.; Wallace, Paul; German, Robert R.; Neti, Chalapathy; Bach, Peter B.; Murphy, Sharon B.

2010-01-01

143

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

144

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

145

The choice of a health care provider in Eritrea  

Microsoft Academic Search

The purpose of the study was to assess the factors that affect patients’ choice of health care service providers and to analyse the effect of each factor, and to examine the policy implications for future health care provision in Eritrea. The data for this study was collected in a 10-month period from January to October 2003. A total of 1657

GebreMichael Kibreab Habtom; Pieter Ruys

2007-01-01

146

The Child Care Provider: Promoting Young Children's Development.  

ERIC Educational Resources Information Center

Based on the view that child development occurs within a relationship involving mutuality and that development and the teaching/learning process are intertwined with the social environment, this book examines the critical relationship between child care providers and the young children they care for and teach. Along with an extended discussion of…

Klass, Carol S.

147

Skin Diseases: Questions for Your Health Care Provider  

MedlinePLUS

Skip Navigation Bar Home Current Issue Past Issues Skin Diseases Questions for Your Health Care Provider Past Issues / Fall 2008 Table of Contents For an enhanced version of this page please turn Javascript on. Photo: iStock Acne How should I care for my skin if I have acne? What will make my ...

148

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

149

Developing a Web 2.0 Diabetes Care Support System with Evaluation from Care Provider Perspectives  

Microsoft Academic Search

Diabetes is a life-long illness condition that many diabetic patients end up with related complications resulted largely from\\u000a lacking of proper supports. The success of diabetes care relies mainly on patient’s daily self-care activities and care providers’\\u000a continuous support. However, the self-care activities are socially bounded with patient’s everyday schedules that can easily\\u000a be forgotten or neglected and the care

Yung-Hsiu Lin; Rong-Rong Chen; Sophie Huey-Ming Guo; Hui-Yu Chang; Her-Kun Chang

150

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

151

Providers' Perceptions of Challenges in Obstetrical Care for Somali Women  

PubMed Central

Background. This pilot study explored health care providers' perceptions of barriers to providing health care services to Somali refugee women. The specific aim was to obtain information about providers' experiences, training, practices and attitudes surrounding the prenatal care, delivery, and management of women with Female Genital Cutting (FGC). Methods. Individual semi-structured interviews were conducted with 14 obstetricians/gynecologists and nurse midwives in Columbus, Ohio. Results. While providers did not perceive FGC as a significant barrier in itself, they noted considerable challenges in communicating with their Somali patients and the lack of formal training or protocols guiding the management of circumcised women. Providers expressed frustration with what they perceived as Somali patients' resistance to obstetrical interventions and disappointment with a perception of mistrust from patients and their families. Conclusion. Improving the clinical encounter for both patients and providers entails establishing effective dialogue, enhancing clinical and cultural training of providers, improving health literacy, and developing trust through community engagement. PMID:24223041

Lazar, Jalana N.; Johnson-Agbakwu, Crista E.; Davis, Olga I.; Shipp, Michele P.-L.

2013-01-01

152

Providers' perceptions of challenges in obstetrical care for somali women.  

PubMed

Background. This pilot study explored health care providers' perceptions of barriers to providing health care services to Somali refugee women. The specific aim was to obtain information about providers' experiences, training, practices and attitudes surrounding the prenatal care, delivery, and management of women with Female Genital Cutting (FGC). Methods. Individual semi-structured interviews were conducted with 14 obstetricians/gynecologists and nurse midwives in Columbus, Ohio. Results. While providers did not perceive FGC as a significant barrier in itself, they noted considerable challenges in communicating with their Somali patients and the lack of formal training or protocols guiding the management of circumcised women. Providers expressed frustration with what they perceived as Somali patients' resistance to obstetrical interventions and disappointment with a perception of mistrust from patients and their families. Conclusion. Improving the clinical encounter for both patients and providers entails establishing effective dialogue, enhancing clinical and cultural training of providers, improving health literacy, and developing trust through community engagement. PMID:24223041

Lazar, Jalana N; Johnson-Agbakwu, Crista E; Davis, Olga I; Shipp, Michele P-L

2013-01-01

153

47 CFR 54.601 - Health care provider eligibility.  

Code of Federal Regulations, 2013 CFR

...CONTINUED) COMMON CARRIER SERVICES (CONTINUED) UNIVERSAL SERVICE Universal Service Support for Health Care Providers Defined...certify to the eligibility of particular sites at any time prior to, or concurrently with, filing...

2013-10-01

154

47 CFR 54.601 - Health care provider eligibility.  

Code of Federal Regulations, 2014 CFR

...CONTINUED) COMMON CARRIER SERVICES (CONTINUED) UNIVERSAL SERVICE Universal Service Support for Health Care Providers Defined...certify to the eligibility of particular sites at any time prior to, or concurrently with, filing...

2014-10-01

155

33 CFR 55.13 - Family child care providers.  

Code of Federal Regulations, 2011 CFR

...DEPARTMENT OF HOMELAND SECURITY PERSONNEL CHILD DEVELOPMENT SERVICES General § 55.13 Family child care providers. When appropriated...to the cost of services at Coast Guard child development centers. 33 CFR Ch. I...

2011-07-01

156

33 CFR 55.13 - Family child care providers.  

Code of Federal Regulations, 2012 CFR

...DEPARTMENT OF HOMELAND SECURITY PERSONNEL CHILD DEVELOPMENT SERVICES General § 55.13 Family child care providers. When appropriated...to the cost of services at Coast Guard child development centers. 33 CFR Ch. I...

2012-07-01

157

33 CFR 55.13 - Family child care providers.  

Code of Federal Regulations, 2013 CFR

...DEPARTMENT OF HOMELAND SECURITY PERSONNEL CHILD DEVELOPMENT SERVICES General § 55.13 Family child care providers. When appropriated...to the cost of services at Coast Guard child development centers. 33 CFR Ch. I...

2013-07-01

158

33 CFR 55.13 - Family child care providers.  

Code of Federal Regulations, 2014 CFR

...DEPARTMENT OF HOMELAND SECURITY PERSONNEL CHILD DEVELOPMENT SERVICES General § 55.13 Family child care providers. When appropriated...to the cost of services at Coast Guard child development centers. 33 CFR Ch. I...

2014-07-01

159

29 CFR 825.125 - Definition of health care provider.  

Code of Federal Regulations, 2014 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...

2014-07-01

160

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

161

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

162

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

163

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

164

Talk with Your Health Care Provider about High Blood Pressure  

MedlinePLUS

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

165

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.

166

Talk with Your Health Care Provider about High Cholesterol  

MedlinePLUS

... nurse. Talk With Your Health Care Provider About High Cholesterol Partnership for HEALTH Here are some questions ... in 5 years. If your cholesterol is borderline high or high, or you have heart disease, your ...

167

33 CFR 55.13 - Family child care providers.  

Code of Federal Regulations, 2010 CFR

...DEPARTMENT OF HOMELAND SECURITY PERSONNEL CHILD DEVELOPMENT SERVICES General § 55.13 Family child care providers. When appropriated...to the cost of services at Coast Guard child development centers. 33 CFR Ch. I...

2010-07-01

168

A new concept in cancer care: The supportive care program  

Microsoft Academic Search

This article describes the findings of a pilot program designed to enter advanced prostate cancer patients into the hospice benefit while they are still being actively treated, but in situations where treatment is known to be primarily palliative in nature. The supportive care program (SCP) combines the medical model’s goal to prolong life with the goal of hospice to palliate

Peg Esper; Janet N. Hampton; John Finn; David C. Smith; Sandra Regiani; Kenneth J. Pienta

1999-01-01

169

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.

170

Nutrition in Cancer Care (PDQ)  

MedlinePLUS

... is common in patients with tumors of the lung , pancreas , and upper gastrointestinal tract . It is important to watch for and treat cachexia early in cancer treatment because it is hard to correct. Cancer patients may have anorexia and cachexia at the same ...

171

Supportive and palliative care of pancreatic cancer.  

PubMed

Pancreatic cancer is one of the most lethal malignancies. An estimated 32,300 patients will die of pancreatic cancer in year 2006. It is the tenth most common malignancy in the United States. Despite recent advances in pathology, molecular basis and treatment, the overall survival rate remains 4% for all stages and races. Palliative care represents an important aspect of care in patient with pancreatic malignancy. Identifying and treating disease related symptomology are priorities. As a physician taking care of these patients it is essential to know these symptoms and treatment modalities. This review discusses symptom management and supportive care strategies. Common problems include pain, intestinal obstruction, biliary obstruction, pancreatic insufficiency, anorexia-cachexia and depression. Success is needed in managing these symptoms to palliate patients with advanced pancreatic cancer. Pancreatic cancer is a model illness to learn the palliative and supportive management in cancer patient. It is important for oncologists to recognize the importance of control measures and supportive measures that can minimize the symptoms of advanced disease and side effects of cancer treatment. PMID:17356251

Fazal, Salman; Saif, Muhammad Wasif

2007-01-01

172

Assessing Patient-Centered Communication in Cancer Care: Stakeholder Perspectives  

PubMed Central

Purpose: Patient-centered communication is critical to quality cancer care. Effective communication can help patients and family members cope with cancer, make informed decisions, and effectively manage their care; suboptimal communication can contribute to care breakdowns and undermine clinician-patient relationships. The study purpose was to explore stakeholders' views on the feasibility and acceptability of collecting self-reported patient and family perceptions of communication experiences while receiving cancer care. The results were intended to inform the design, development, and implementation of a structured and generalizable patient-level reporting system. Methods: This was a formative, qualitative study that used semistructured interviews with cancer patients, family members, clinicians, and leaders of health care organizations. The constant comparative method was used to identify major themes in the interview transcripts. Results: A total of 106 stakeholders were interviewed. Thematic saturation was achieved. All stakeholders recognized the importance of communication and endorsed efforts to improve communication during cancer care. Patients, clinicians, and leaders expressed concerns about the potential consequences of reports of suboptimal communication experiences, such as damage to the clinician-patient relationship, and the need for effective improvement strategies. Patients and family members would report good communication experiences in order to encourage such practices. Practical and logistic issues were identified. Conclusion: Patient reports of their communication experiences during cancer care could increase understanding of the communication process, stimulate improvements, inform interventions, and provide a basis for evaluating changes in communication practices. This qualitative study provides a foundation for the design and pilot testing of such a patient reporting system. PMID:23943884

Mazor, Kathleen M.; Gaglio, Bridget; Nekhlyudov, Larissa; Alexander, Gwen L.; Stark, Azadeh; Hornbrook, Mark C.; Walsh, Kathleen; Boggs, Jennifer; Lemay, Celeste A.; Firneno, Cassandra; Biggins, Colleen; Blosky, Mary Ann; Arora, Neeraj K.

2013-01-01

173

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

174

Working Together in the Neonatal Intensive Care Unit: Provider Perspectives  

Microsoft Academic Search

OBJECTIVES: To elicit healthcare provider perceptions of working together in a neonatal intensive care unit (NICU).STUDY DESIGN: We conducted focus groups to elicit descriptions of how providers work together. The groups included one each of transport nurses, staff nurses, residents, fellows, attending physicians and two multiple provider groups. To identify themes and their descriptive elements we performed qualitative data analysis.RESULTS:

Eric J Thomas; Gwen D Sherwood; Jennipher L Mulhollem; J Bryan Sexton; Robert L Helmreich

2004-01-01

175

Outcomes Research Branch | Assessing Patients' Experiences of Cancer Care  

Cancer.gov

Two ORB studies have addressed the need for comprehensive, psychometrically sound, cancer-specific measures of patients' experience of and satisfaction with the care they receive during the post-treatment, survivorship phase of the cancer care continuum. The Assessment of Patients' Experience of Cancer Care (APECC) Study, funded as a SEER Rapid Response Surveillance Study (RRSS), developed and pilot tested a survey instrument to assess patients' experiences and satisfaction with care for colorectal cancer, bladder cancer, and leukemia.

176

Providing Culturally Congruent Care for Saudi Patients and their Families.  

PubMed

Abstract This article aims to increase an awareness of caring for Saudi families by non-Saudi nurses to improve their understanding of culturally competent care from a Saudi perspective. Healthcare providers have a duty of a care to deliver holistic and culturally specific health care to their patients. As a consequence of 'duty of care' obligations, healthcare providers must facilitate culturally congruent care for patients of diverse cultural backgrounds. For the Saudi family considerable cultural clashes may arise when Saudi patients are hospitalised and receive care from healthcare professionals who do not understand Islamic principles and Saudi cultural beliefs and values. The healthcare workforce in Saudi Arabia is a unique multicultural workforce that is mix of Saudi and significant other nationalities. Saudi nurses for example represent only 36.3% of the workforce in the different health sectors. Whilst the different ethnic and cultural background expatriate nurses represent 63.7% (Ministry of Health, 2010). This article also could increase the awareness of healthcare professionals caring for Arab and Muslims patients in another context in the world. PMID:24138356

Al Mutair, Abbas Saleh; Plummer, Virginia; O'Brien, Anthony Tony; Clerehan, Rosemary

2013-10-19

177

Mexican-American Males Providing Personal Care for their Mothers.  

PubMed

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 female relative. The cases are selected from a federally-funded, descriptive, longitudinal, mixed methods study of 110 MA caregivers and their care recipients. In case-oriented research, investigators can generate propositions (connected sets of statements) that reflect their findings and conclusions, and can be tested against subsequent cases: Caregiving strain and burden in MA males may have more to do with physical and emotional costs than financial ones; MA males providing personal care for their mothers adopt a matter-of-fact approach as they act "against taboo"; and this approach is a new way to fulfill family obligations. PMID:21643486

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

2011-05-01

178

Repeated sexual abuse allegations: a problem for primary care providers.  

PubMed

Sexual abuse of children is a problem of epidemic proportions in the United States. Primary care providers, including pediatric nurse practitioners, are increasingly presented with the problem of alleged sexual abuse in their patients, and primary care providers typically find it difficult to perform medical evaluations of children for sexual abuse. Having a child present repeatedly with sexual abuse concerns that cannot be substantiated is a stressful and frustrating experience for primary care providers. A case study is presented that illustrates the complexity and difficulty of one such case. A review of the literature will discuss the impact of divorce and Munchausen syndrome by proxy on repeated allegations of sexual abuse. Implications for practice are discussed, and a plan that addresses repeated sexual allegations in primary care settings is outlined. PMID:11246195

Hornor, G

2001-01-01

179

Mexican-American Males Providing Personal Care for their Mothers  

PubMed Central

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 female relative. The cases are selected from a federally-funded, descriptive, longitudinal, mixed methods study of 110 MA caregivers and their care recipients. In case-oriented research, investigators can generate propositions (connected sets of statements) that reflect their findings and conclusions, and can be tested against subsequent cases: Caregiving strain and burden in MA males may have more to do with physical and emotional costs than financial ones; MA males providing personal care for their mothers adopt a matter-of-fact approach as they act “against taboo”; and this approach is a new way to fulfill family obligations. PMID:21643486

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

2011-01-01

180

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

181

Promoting gynecologic cancer awareness at a critical juncture--where women and providers meet.  

PubMed

Given the absence of effective population-based screening tests for ovarian, uterine, vaginal, and vulvar cancers, early detection can depend on women and health care providers recognizing the potential significance of symptoms. In 2008, the Centers for Disease Control and Prevention's (CDC) Inside Knowledge campaign began distributing consumer education materials promoting awareness of gynecologic cancer symptoms. We investigated providers' in-office use of CDC gynecologic cancer materials and their recognition of the symptoms highlighted in the materials. We analyzed data from a national 2012 survey of US primary care physicians, nurse practitioners, and gynecologists (N?=?1,380). Less than a quarter of providers (19.4%) reported using CDC gynecologic cancer education materials in their offices. The provider characteristics associated with the use of CDC materials were not consistent across specialties. However, recognition of symptoms associated with gynecologic cancers was consistently higher among providers who reported using CDC materials. The possibility that providers were educated about gynecologic cancer symptoms through the dissemination of materials intended for their patients is intriguing and warrants further investigation. Distributing consumer education materials in health care provider offices remains a priority for the Inside Knowledge campaign, as the setting where women and health care providers interact is one of the most crucial venues to promote awareness of gynecologic cancer symptoms. PMID:24214840

Cooper, Crystale Purvis; Gelb, Cynthia A; Rodriguez, Juan; Hawkins, Nikki A

2014-06-01

182

Providing home care services in a for-profit environment.  

PubMed

It is no surprise that politics and ideology will determine the future of home health and long-term care. Those same forces will also dictate whether home care services will become more or less dependent upon federal support. At the moment the prospects are not promising. Over the last several years our national reimbursement policies have pointed toward more and more stringent use of Medicare home health care benefits, despite the assumptions (and the data) that prospective payment systems might legitimately increase their use. The implementation of tight cost limits, consolidation to ten regional fiscal intermediaries, and increased claim denials have signaled home care agencies that cost containment is the aim of the present conservative administration. Private insurance companies, however, have begun to examine the prospects for long-term care and home care policies. Presently, most home care benefits are available through employment-based policies, which, of course, are nearly useless to the elderly, the major users of home care services. But what if businesses provided more comprehensive health care policies so that their employees could have better protection in the case of long-term illnesses? What if the giant corporation such as IBM, Xerox, General Electric, General Motors, and so forth, established programs to underwrite the cost of long-term care? What if private insurance companies attempted to spread the risks among thousands of policy holders so that long-term care insurance premiums were affordable to most older Americans? Rather than new sources of funding, it is more reasonable to expect that the financing of home care services will be reshaped by innovative reimbursement strategies. The future will probably bring prospective, resource-sensitive, or capitated schemes. There are no easy remedies. We must secure the participation of all sectors of our country--both public and private--in a cooperative endeavor. And at the same time we are struggling to reshape the home care financing system, we must continue the effort to reshape the delivery system itself, because the two go hand-in-glove. It is only then that we can begin to allay one of the major deficiencies of our present health care system--the enormous gap in providing and paying for home health care. PMID:3130617

Shamansky, S L

1988-06-01

183

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

184

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

185

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.

186

Training providers on issues of race and racism improve health care equity.  

PubMed

Race is an independent factor in health disparity. We developed a training module to address race, racism, and health care. A group of 19 physicians participated in our training module. Anonymous survey results before and after the training were compared using a two-sample t-test. The awareness of racism and its impact on care increased in all participants. White participants showed a decrease in self-efficacy in caring for patients of color when compared to white patients. This training was successful in deconstructing white providers' previously held beliefs about race and racism. Pediatr Blood Cancer 2015;62:915-917. © 2015 Wiley Periodicals, Inc. PMID:25683782

Nelson, Stephen C; Prasad, Shailendra; Hackman, Heather W

2015-05-01

187

A Review and Characterization of the Various Perceptions of Quality Cancer Care  

PubMed Central

BACKGROUND It is important to maintain high-quality cancer care while reducing spending. This requires an understanding of how stakeholders define “quality.” The objective of this literature review was to understand the perceptions patients, physicians, and managed care professionals have about quality cancer care, especially chemotherapy. METHODS A computerized literature search was conducted for articles concerning quality cancer care in patients who received chemotherapy. Among >1100 identified sources, 25 presented interviews/survey results from stakeholders. RESULTS Patients defined quality cancer care as being treated well by providers, having multiple treatment options, and being part of the decision-making process. Waiting to see providers, having problems with referrals, going to different locations for treatment, experiencing billing inaccuracies, and navigating managed care reimbursement negatively affected patients' quality-of-care perceptions. Providers perceived quality cancer care as making decisions based on the risks-benefits of specific chemotherapy regimens and patients' health status rather than costs. Providers objected to spending substantial time interacting with payers instead of delivering care to patients. Payers must control the costs of cancer care but do not want an adversarial relationship with providers and patients. Payers' methods of managing cancer more efficiently involved working with providers to develop assessment and decision-assist tools. CONCLUSIONS Delivering quality cancer care is increasingly difficult because of the shortage of oncologists and rising costs of chemotherapy agents, radiation therapy, and imaging tests. The definition of quality cancer care differed among stakeholders, and healthcare reform must reflect these various needs to maintain and improve quality while controlling costs. Cancer 2011. © 2010 American Cancer Society PMID:20939015

Colosia, Ann D; Peltz, Gerson; Pohl, Gerhardt; Liu, Esther; Copley-Merriman, Kati; Khan, Shahnaz; Kaye, James A

2011-01-01

188

Achieving provider engagement: providers' perceptions of implementing and delivering integrated care.  

PubMed

The literature on integrated care is limited with respect to practical learning and experience. Although some attention has been paid to organizational processes and structures, not enough is paid to people, relationships, and the importance of these in bringing about integration. Little is known, for example, about provider engagement in the organizational change process, how to obtain and maintain it, and how it is demonstrated in the delivery of integrated care. Based on qualitative data from the evaluation of a large-scale integrated care initiative in London, United Kingdom, we explored the role of provider engagement in effective integration of services. Using thematic analysis, we identified an evolving engagement narrative with three distinct phases: enthusiasm, antipathy, and ambivalence, and argue that health care managers need to be aware of the impact of professional engagement to succeed in advancing the integrated care agenda. PMID:25212855

Ignatowicz, Agnieszka; Greenfield, Geva; Pappas, Yannis; Car, Josip; Majeed, Azeem; Harris, Matthew

2014-12-01

189

The oncology palliative care clinic at the Princess Margaret Cancer Centre: an early intervention model for patients with advanced cancer.  

PubMed

Several recently published randomized controlled trials have demonstrated the benefits of early palliative care involvement for patients with advanced cancer. In the oncology outpatient setting, palliative care clinics are an ideal site for the provision of early, collaborative support, which can be maintained throughout the cancer trajectory. Despite this, access to ambulatory palliative care clinics is limited, even at tertiary cancer centres. Existing programs for outpatient palliative care are variable in scope and are not well described in the literature. We describe the development and expansion of an outpatient palliative care clinic at the Princess Margaret Cancer Centre, Toronto, Canada, demonstrating how the clinic functions at a local and regional level. This clinic served as the intervention for a recent large cluster-randomized trial of early palliative care. The model for this service can be adapted by other palliative care programs that aim to provide early, integrated oncology care. PMID:25281230

Hannon, Breffni; Swami, Nadia; Pope, Ashley; Rodin, Gary; Dougherty, Elizabeth; Mak, Ernie; Banerjee, Subrata; Bryson, John; Ridley, Julia; Zimmermann, Camilla

2015-04-01

190

Are latinos less satisfied with communication by health care providers?  

Microsoft Academic Search

OBJECTIVE: To examine associations of patient ratings of communication by health care providers with patient language (English vs Spanish)\\u000a and ethnicity (Latino vs white).\\u000a \\u000a \\u000a METHODS: A random sample of patients receiving medical care from a physician group association concentrated on the West Coast was\\u000a studied. A total of 7,093 English and Spanish language questionnaires were returned for an overall response

Leo S. Morales; William E. Cunningham; Julie A. Brown; Honghu Liu; Ron D. Hays

1999-01-01

191

Diffusion of Breast Cancer Risk Assessment in Primary Care  

PubMed Central

Background Physicians who provide primary care to women have the opportunity to identify patients at high risk for breast cancer who are candidates for risk reduction strategies. Objective To determine the prevalence and determinants of adoption of breast cancer risk assessment by primary care physicians. Design A cross-sectional survey Participants A nationally representative random sample of 351 internists, family practitioners and obstetricians-gynecologists. Measures A questionnaire that assessed knowledge, attitudes, discussion of breast cancer risk, use of software to calculate breast cancer risk and ordering of BRCA1/2 testing. Results 88% of physicians reported discussing breast cancer risk at least once in the prior 12 months, 48% had ordered or referred a patient for BRCA1/2 testing and 18% had used a software program to calculate breast cancer risk. Physicians who had used BRCA1/2 testing or discussed breast cancer risk factors were more likely to be obstetrician-gynecologists and not in solo practice; whereas use of risk software was also more common among obstetrician gynecologists but was also associated with having a family member with breast cancer and a greater knowledge about breast cancer risk. Having patients ask for risk information was associated with discussion of risk factors but not with the other risk assessment strategies. Conclusions Diffusion of breast cancer risk assessment is occurring in primary care practices, with a greater adoption of BRCA1/2 testing than of risk assessment software. Adoption of these strategies appears to be related to the salience of breast cancer personally and in the practice and the size of the practice, rather than attitudes about thee risk assessment methods. PMID:19429733

Guerra, Carmen E.; Sherman, Melani; Armstrong, Katrina

2010-01-01

192

University of Wisconsin-Milwaukee Certification of Health Care Provider  

E-print Network

is to completed by treating physician, practitioner or counselor and returned to the employee for the employee of treatment if known, and period required for recovery if any: b. If any of these treatments will be provided of the period during which care will be provided, includin

Saldin, Dilano

193

Tips and Tidbits: A Book for Family Day Care Providers.  

ERIC Educational Resources Information Center

This book provides practical information and advice designed to help family day care providers solve problems they confront in their daily work with children. The book is organized into 7 sections. Part I, "Effective Ways to Change Unacceptable Behavior," offers recommendations about discipline, alternatives to punishment, modeling, and praise.…

Gonzalez-Mena, Janet

194

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

195

Homeless youths' interpersonal perspectives of health care providers.  

PubMed

In the United States, youth run away from home due to poor interpersonal relationships with parents or guardians; often times, they have been the recipients of parental neglect or abuse. As youth become increasingly entrenched in street-based living and problem substance use, their ability to rehabilitate their lives is incumbent upon trusting and engaging relationships with adult service providers. A total of 54 substance-using homeless youth (18-25 years) participated in focus groups to provide their perspectives on encounters and interpersonal relationships with health care providers. Participants were recruited from shelters in Hollywood, California, and from a drop-in shelter in Santa Monica, California. Four themes related to interpersonal barriers to care from service providers were identified: authoritative communication, one-way communication, disrespect, and empathy. Participants appreciate care providers who convey information in a helpful, meaningful manner and prefer providers who can, themselves, share similar life experiences. Implications point to the need for agencies and services specifically tailored to homeless, drug-using youth. These agencies should employ care providers who are trained to understand the developmental needs and histories of runaway youth. For proper reintegration of this vulnerable population into mainstream society, the narratives of these youth underscore the necessity of targeted services. PMID:19052945

Hudson, Angela L; Nyamathi, Adeline; Sweat, Jeff

2008-12-01

196

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

197

[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

198

An evaluation of provider educational needs in geriatric care.  

PubMed

Providers of geriatric care in Arkansas were surveyed to determine the desire for more information on their specialty as well as opportunities for further training. Those in the nursing profession were most interested in further training, and the major area of interest for all providers was in cognitive decline and mental health information. Specifically, information was sought in the areas of dementia, depression, and memory loss. It is recommended that improvement in geriatric care in the future should focus on nursing education and on raising the level of knowledge and academic prestige in the treatment of elderly patients, especially in the mental health areas. PMID:14994562

Larson, James S; Chernoff, Ronni; Sweet-Holp, Tim J

2004-03-01

199

Guide to providing mouth care for older people.  

PubMed

The authors provide an overview of oral health, why it is important for older people and how poor oral health can affect nutritional status and quality of life. Practical advice is given on assessment of oral health; cleaning of natural teeth and dentures; and care of oral problems that commonly affect older people. An oral healthcare education session is recommended to provide hands-on advice to caregivers. The article is not intended as an exhaustive reference and the reader should always ask for professional dental advice and assistance if in doubt about any aspect of oral care. PMID:22256725

Bissett, Susan; Preshaw, Philip

2011-12-01

200

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.

201

Health Care Providers and Dying Patients: Critical Issues in Terminal Care.  

ERIC Educational Resources Information Center

Identifies three major areas of concern in relationship between health care providers and dying patients: (1) nature of difficulties and stresses associated with terminal care; (2) education of providers for work; and (3) influence of organizational structure and institutionalized values on services for dying patients and families. Reviews…

Benoliel, Jeanne Quint

1988-01-01

202

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

203

DeltaCare USA DeltaCare USA provides you and your family with  

E-print Network

- No deductibles - Out-of-pocket costs are clearly defined - Out-of-area dental emergency coverage up to $100 eachDeltaCare USA DeltaCare USA provides you and your family with quality dental benefits regularly to maintain your dental health. When you enroll, you select a contract dentist to provide services

Qiu, Weigang

204

42 CFR 440.60 - Medical or other remedial care provided by licensed practitioners.  

Code of Federal Regulations, 2012 CFR

...remedial care provided by licensed practitioners. 440.60 Section 440...remedial care provided by licensed practitioners. (a) “Medical care...care provided by licensed practitioners” means any medical or...

2012-10-01

205

42 CFR 440.60 - Medical or other remedial care provided by licensed practitioners.  

Code of Federal Regulations, 2011 CFR

...remedial care provided by licensed practitioners. 440.60 Section 440...remedial care provided by licensed practitioners. (a) “Medical care...care provided by licensed practitioners” means any medical or...

2011-10-01

206

42 CFR 440.60 - Medical or other remedial care provided by licensed practitioners.  

Code of Federal Regulations, 2014 CFR

...remedial care provided by licensed practitioners. 440.60 Section 440...remedial care provided by licensed practitioners. (a) “Medical care...care provided by licensed practitioners” means any medical or...

2014-10-01

207

42 CFR 440.60 - Medical or other remedial care provided by licensed practitioners.  

Code of Federal Regulations, 2013 CFR

...remedial care provided by licensed practitioners. 440.60 Section 440...remedial care provided by licensed practitioners. (a) “Medical care...care provided by licensed practitioners” means any medical or...

2013-10-01

208

New analysis reexamines the value of cancer care in the United States compared to Western europe.  

PubMed

Despite sharp increases in spending on cancer treatment since 1970 in the United States compared to Western Europe, US cancer mortality rates have decreased only modestly. This has raised questions about the additional value of US cancer care derived from this additional spending. We calculated the number of US cancer deaths averted, compared to the situation in Western Europe, between 1982 and 2010 for twelve cancer types. We also assessed the value of US cancer care, compared to that in Western Europe, by estimating the ratio of additional spending on cancer to the number of quality-adjusted life-years saved. Compared to Western Europe, for three of the four costliest US cancers-breast, colorectal, and prostate-there were approximately 67,000, 265,000, and 60,000 averted US deaths, respectively, and for lung cancer there were roughly 1,120,000 excess deaths in the study period. The ratio of incremental cost to quality-adjusted life-years saved equaled $402,000 for breast cancer, $110,000 for colorectal cancer, and $1,979,000 for prostate cancer-amounts that exceed most accepted thresholds for cost-effective medical care. The United States lost quality-adjusted life-years despite additional spending for lung cancer: -$19,000 per quality-adjusted life-year saved. Our results suggest that cancer care in the United States may provide less value than corresponding cancer care in Western Europe for many leading cancers. PMID:25732488

Soneji, Samir; Yang, JaeWon

2015-03-01

209

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

210

Provider Influence | accrualnet.cancer.gov  

Cancer.gov

Skip to content The National Cancer Institute www.cancer.gov The National Institutes of Health AccrualNetTM STRATEGIES, TOOLS AND RESOURCES TO SUPPORT ACCRUAL TO CLINICAL TRIALS User menu Register Sign In Search form Search Main menu Protocol Accrual

211

Transforming health care service delivery and provider selection.  

PubMed

Commoditization pressures in medicine have risked transforming service provider selection from "survival of the fittest" to "survival of the cheapest." Quality- and safety-oriented mandates by the Institute of Medicine have led to the creation of a number of data-driven quality-centric initiatives including Pay for Performance and Evidence-Based Medicine. A synergistic approach to creating quantitative accountability in medical service delivery is through the creation of consumer-oriented performance metrics which provide patients with objective data related to individual service provider quality, safety, cost-efficacy, efficiency, and customer service. These performance metrics could in turn be customized to the individual preferences and health care needs of each individual patient, thereby providing an objective methodology for service provider selection while empowering health care consumers. PMID:21468775

Reiner, Bruce I

2011-06-01

212

Weight stigma in maternity care: women’s experiences and care providers’ attitudes  

PubMed Central

Background Weight stigma is pervasive in Western society and in healthcare settings, and has a negative impact on victims’ psychological and physical health. In the context of an increasing focus on the management of overweight and obese women during and after pregnancy in research and clinical practice, the current studies aimed to examine the presence of weight stigma in maternity care. Addressing previous limitations in the weight stigma literature, this paper quantitatively explores the presence of weight stigma from both patient and care provider perspectives. Methods Study One investigated associations between pre-pregnancy body mass index (BMI) and experiences of maternity care from a state-wide, self-reported survey of 627 Australian women who gave birth in 2009. Study Two involved administration of an online survey to 248 Australian pre-service medical and maternity care providers, to investigate their perceptions of, and attitudes towards, providing care for pregnant patients of differing body sizes. Both studies used linear regression analyses. Results Women with a higher BMI were more likely to report negative experiences of care during pregnancy and after birth, compared to lower weight women. Pre-service maternity care providers perceived overweight and obese women as having poorer self-management behaviours, and reported less positive attitudes towards caring for overweight or obese pregnant women, than normal-weight pregnant women. Even care providers who reported few weight stigmatising attitudes responded less positively to overweight and obese pregnant women. Conclusions Overall, these results provide preliminary evidence that weight stigma is present in maternity care settings in Australia. They suggest a need for further research into the nature and consequences of weight stigma in maternity care, and for the inclusion of strategies to recognise and combat weight stigma in maternity care professionals’ training. PMID:23339533

2013-01-01

213

Addressing sexual dysfunction in colorectal cancer survivorship care  

PubMed Central

Despite the high prevalence of sexual dysfunction in survivors of colorectal cancer, studies have shown that patients and providers rarely discuss how these symptoms may be influencing overall quality of life. The type and severity of symptoms of sexual dysfunction can vary greatly depending on the type of colorectal cancer and treatment, and assessment of sexual dysfunction is key to understanding how patients may be affected by these symptoms. Although patients would like to discuss these issues with their provider, they are often reluctant to ask questions about sexual functioning during appointments. Likewise, health care providers may hesitate to address sexual dysfunction due to time limitations or lack of knowledge regarding treatment of sexual problems. Health care providers can facilitate discussion of sexual dysfunction by (I) assessing sexual functioning throughout treatment; (II) initiating discussions about symptoms of sexual dysfunction at each appointment; and (III) maintaining adequate referral resources for treatment of sexual dysfunction. PMID:25276411

Averyt, Jennifer C.

2014-01-01

214

Emerging biomarkers in breast cancer care.  

PubMed

Currently, decision-making for breast cancer treatment in the clinical setting is mainly based on clinical data, histomorphological features of the tumor tissue and a few cancer biomarkers such as steroid hormone receptor status (estrogen and progesterone receptors) and oncoprotein HER2 status. Although various therapeutic options were introduced into the clinic in recent decades, with the objective of improving surgery, radiotherapy, biochemotherapy and chemotherapy, varying response of individual patients to certain types of therapy and therapy resistance is still a challenge in breast cancer care. Therefore, since breast cancer treatment should be based on individual features of the patient and her tumor, tailored therapy should be an option by integrating cancer biomarkers to define patients at risk and to reliably predict their course of the disease and/or response to cancer therapy. Recently, candidate-marker approaches and genome-wide transcriptomic and epigenetic screening of different breast cancer tissues and bodily fluids resulted in new promising biomarker panels, allowing breast cancer prognosis, prediction of therapy response and monitoring of therapy efficacy. These biomarkers are now subject of validation in prospective clinical trials. PMID:20701440

Napieralski, Rudolf; Brünner, Nils; Mengele, Karin; Schmitt, Manfred

2010-08-01

215

Agents for change: nonphysician medical providers and health care quality.  

PubMed

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. PMID:25663213

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

2015-01-01

216

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. PMID:25663213

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

2015-01-01

217

Deficiencies in culturally competent asthma care for ethnic minority children: a qualitative assessment among care providers  

PubMed Central

Background Asthma outcomes are generally worse for ethnic minority children. Cultural competence training is an instrument for improving healthcare for ethnic minority patients. To develop effective training, we explored the mechanisms in paediatric asthma care for ethnic minority patients that lead to deficiencies in the care process. Methods We conducted semi-structured interviews on care for ethnic minority children with asthma (aged 4-10 years) with paediatricians (n?=?13) and nurses (n?=?3) in three hospitals. Interviews were analysed qualitatively with a framework method, using a cultural competence model. Results Respondents mentioned patient non-adherence as the central problem in asthma care. They related non-adherence in children from ethnic minority backgrounds to social context factors, difficulties in understanding the chronic nature of asthma, and parents’ language barriers. Reactions reported by respondents to patients’ non-adherence included retrieving additional information, providing biomedical information, occasionally providing referrals for social context issues, and using informal interpreters. Conclusions This study provides keys to improve the quality of specialist paediatric asthma care to ethnic minority children, mainly related to non-adherence. Care providers do not consciously recognise all the mechanisms that lead to deficiencies in culturally competent asthma care they provide to ethnic minority children (e.g. communicating mainly from a biomedical perspective and using mostly informal interpreters). Therefore, the learning objectives of cultural competence training should reflect issues that care providers are aware of as well as issues they are unaware of. PMID:22551452

2012-01-01

218

Monitoring care of female breast cancer patients in  

E-print Network

Monitoring care of female breast cancer patients in Northern Ireland diagnosed 2006 (with in Northern Ireland diagnosed 2006 (with comparisons to 1996 & 2001). N. Ireland Cancer Registry 2010 .............................................................................................................. 9 OVERVIEW OF BREAST CANCER IN NORTHERN IRELAND ............................................. 12

Müller, Jens-Dominik

219

Michigan Day Care Provider Training Project, Year One: An Evaluation.  

ERIC Educational Resources Information Center

A Title XX funded statewide training program offering 20 hours of instruction for 1,662 licensed center and home child care providers who served Title XX eligible children in Michigan was evaluated at the end of its first year of operation. The first three chapters of this evaluation report discuss (1) the history, philosophy, and goals of the…

Kaplan, Melissa G.; And Others

220

CERTIFICATION OF HEALTH CARE PROVIDER FOR EMPLOYEE'S PREGNANCY DISABILITY  

E-print Network

CERTIFICATION OF HEALTH CARE PROVIDER FOR EMPLOYEE'S PREGNANCY DISABILITY HUMAN RESOURCES Employee by pregnancy, childbirth or related medical conditions, you are eligible to take a pregnancy disability leave condition related to her pregnancy or childbirth. Please answer, fully and completely, all applicable parts

Eirinaki, Magdalini

221

CERTIFICATION OF HEALTH CARE PROVIDER FOR EMPLOYEE'S PREGNANCY DISABILITY  

E-print Network

CERTIFICATION OF HEALTH CARE PROVIDER FOR EMPLOYEE'S PREGNANCY DISABILITY California Pregnancy to a disability resulting from her pregnancy, childbirth, or related medical condition which may qualify to submit a timely, complete, and sufficient medical certification to support your request for pregnancy

Gleeson, Joseph G.

222

Mining for future health care providers in Appalachian Kentucky.  

PubMed

Recent studies project a significant shortage of U.S. health care providers within the next decade. To address southeastern Kentucky's persistent undersupply of medical professionals, a multi-county Health Career Enrichment Camp for rising 9th and 10th grade students was implemented in 2008. This report describes the annual camp's development and preliminary outcomes. PMID:22643617

Gross, David A; Bates, Pamela; Knox, Tamara L; Gayheart, Michael W

2012-05-01

223

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.

224

Integrated transitional care: patient, informal caregiver and health care provider perspectives on care transitions for older persons with hip fracture  

PubMed Central

Introduction Complex older adults, such as those with hip fracture, frequently require care from multiple professionals across a variety of settings. Integrated care both between providers and across settings is important to ensure care quality and patient safety. The purpose of this study was to determine the core factors related to poorly integrated care when hip fracture patients transition between care settings. Methods A qualitative, focused ethnographic approach was used to guide data collection and analysis. Patients, their informal caregivers and health care providers were interviewed and observed at each care transition. A total of 45 individual interviews were conducted. Interview transcripts and field notes were coded and analysed to uncover emerging themes in the data. Results Four factors related to poorly integrated transitional care were identified: confusion with communication about care, unclear roles and responsibilities, diluted personal ownership over care, and role strain due to system constraints. Conclusions Our research supports a broader notion of collaborative practice that extends beyond specific care settings and includes an appropriate, informed role for patients and informal caregivers. This research can help guide system-level and setting-specific interventions designed to promote high-quality, patient-centred care during care transitions. PMID:22977426

Toscan, Justine; Mairs, Katie; Hinton, Stephanie; Stolee, Paul

2012-01-01

225

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

226

Achieving health care cost containment through provider payment reform that engages patients and providers.  

PubMed

The best opportunity to pursue cost containment in the next five to ten years is through reforming provider payment to gradually diminish the role of fee-for-service reimbursement. Public and private payers have launched many promising payment reform pilots aimed at blending fee-for-service with payment approaches based on broader units of care, such as an episode or patients' total needs over a period of time, a crucial first step. But meaningful cost containment from payment reform will not be achieved until Medicare and Medicaid establish stronger incentives for providers to contract in this way, with discouragement of nonparticipation increasing over time. In addition, the models need to evolve to engage beneficiaries, perhaps through incentives for patients to enroll in an accountable care organization and to seek care within that organization's network of providers. PMID:23650327

Ginsburg, Paul B

2013-05-01

227

[Breast cancer update in primary care: (V/V)].  

PubMed

Breast cancer is a prevalent disease affecting all areas of patients' lives. Therefore, family physicians ought to know thoroughly this pathology to optimize the health care services for these patients making the best use of available resources. A series of five articles on breast cancer is presented below. It is based on a review of the scientific literature over the last ten years. In this final section, the social, psychological, occupational and family issues related to the disease will be reviewed, as well as presenting some special situations of breast cancer, including breast cancer in men, during pregnancy and last stages of life. This summary report aims to provide a current and practical review about this disease, providing answers to family doctors and helping them to be by the patients for their benefit throughout their illness. PMID:25002350

Díaz García, Noiva; Cuadrado Rouco, Carmen; Vich, Pilar; Alvarez-Hernandez, Cristina; Brusint, Begoña; Redondo Margüello, Esther

2015-03-01

228

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

229

Providing care for immigrant, migrant, and border children.  

PubMed

This policy statement, which recognizes the large changes in immigrant status since publication of the 2005 statement "Providing Care for Immigrant, Homeless, and Migrant Children," focuses on strategies to support the health of immigrant children, infants, adolescents, and young adults. Homeless children will be addressed in a forthcoming separate statement ("Providing Care for Children and Adolescents Facing Homelessness and Housing Insecurity"). While recognizing the diversity across and within immigrant, migrant, and border populations, this statement provides a basic framework for serving and advocating for all immigrant children, with a particular focus on low-income and vulnerable populations. Recommendations include actions needed within and outside the health care system, including expansion of access to high-quality medical homes with culturally and linguistically effective care as well as education and literacy programs. The statement recognizes the unique and special role that pediatricians can play in the lives of immigrant children and families. Recommendations for policies that support immigrant child health are included. PMID:23650300

2013-06-01

230

Cancer patient supportive care and pain management. Special listing  

SciTech Connect

This Special Listing of Current Cancer Research Projects is a publication of the International Cancer Research Data Bank (ICRDB) Program of the National Cancer Institute. Each Listing contains descriptions of ongoing projects in one selected cancer research area. The research areas include: Infectious disease in cancer patients; Immunological aspects of supportive care of cancer patients; Nutritional evaluation and support of cancer patients; Pain management of cancer patients.

Not Available

1981-04-01

231

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? PMID:25678764

Phillips, Kathryn A.; Labno, Anna

2014-01-01

232

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

Federal Register 2010, 2011, 2012, 2013, 2014

...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

233

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

234

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

235

Process of diffusing cancer survivorship care into oncology practice.  

PubMed

The LIVESTRONG Centers of Excellence were funded to increase the effectiveness of survivorship care in oncology practice. This study describes the ongoing process of adopting and implementing survivorship care using the framework of the diffusion of innovation theory of change. Primary data collection included telephone interviews with 39 members from the eight centers and site visits. Organizational characteristics, overall progress, and challenges for implementation were collected from proposals and annual reports. Creating an awareness of cancer survivorship care was a major accomplishment (relative advantage). Adoption depended on the fit within the cancer center (compatibility), and changed over time based on trial and error (trialability). Implementing survivorship care within the existing culture of oncology and breaking down resistance to change was a lengthy process (complexity). Survivorship care became sustainable as it became reimbursed, and more new patients were seen (observability). Innovators and early adopters were crucial to success. Diffusion of innovation theory can provide a strategy to evaluate adoption and implementation of cancer survivorship programs into clinical practice. PMID:24073165

Tessaro, Irene; Campbell, Marci K; Golden, Shannon; Gellin, Mindy; McCabe, Mary; Syrjala, Karen; Ganz, Patricia A; Jacobs, Linda; Baker, Scott; Miller, Kenneth D; Rosenstein, Donald L

2013-06-01

236

Health care providers' perspectives on the provision of prenatal care to immigrants.  

PubMed

In addition to facing barriers to health care and experiencing poor health status, immigrants to Canada and Sweden tend to have more negative birth outcomes than the native-born population, including low birth weight and perinatal mortality rates. Explored through interviews with health care professionals, including midwives, nurse practitioners, social workers and obstetrician gynaecologists, this paper evaluates their experiences in providing prenatal care to immigrants in Hamilton, Ontario, Canada. Results reveal the complexity of delivering care to immigrants, particularly with respect to expectations surrounding language, culture and type and professionalism of care. The paper concludes by discussing future research options and implications for the delivery of prenatal care to this population. PMID:21390947

Ng, Carita; Newbold, K Bruce

2011-05-01

237

Cultural aspects of communication in cancer care  

Microsoft Academic Search

Cultural competence in oncology requires the acquisition of specific knowledge, clinical skills, and attitudes that facilitate\\u000a effective cross-cultural negotiation in the clinical setting, thus, leading to improved therapeutic outcomes and decreased\\u000a disparities in cancer care. Cultural competence in oncology entails a basic knowledge of different cultural attitudes and\\u000a practices of communication of the truth and of decision-making styles throughout the

Antonella Surbone

2008-01-01

238

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

239

Leveraging state cancer registries to measure and improve the quality of cancer care: a potential strategy for california and beyond.  

PubMed

Despite recent increased attention to healthcare performance and the burden of disease from cancer, measures of quality of cancer care are not readily available. In 2013, the California HealthCare Foundation convened an expert workgroup to explore the potential for leveraging data in the California Cancer Registry (CCR), one of the world's largest population-based cancer registries, for measuring and improving the quality of cancer care. The workgroup assessed current registry operations, the value to be gained by linking CCR data with health insurance claims or encounter data and clinical data contained in health system electronic health records, and potential barriers to these linkages. The workgroup concluded that: 1) The CCR mandate should be expanded to include use of its data for quality of cancer care measurement and public reporting; and 2) a system should be developed to support linkage of registry data with both claims data and provider electronic health record data. PMID:25766400

Hiatt, Robert A; Tai, Caroline G; Blayney, Douglas W; Deapen, Dennis; Hogarth, Michael; Kizer, Kenneth W; Lipscomb, Joseph; Malin, Jennifer; Phillips, Stephen K; Santa, John; Schrag, Deborah

2015-01-01

240

Nurse practitioners--co-providers of health care.  

PubMed

What single program can a group practice institute to increase patient satisfaction, contain costs, improve provider accessibility, expand patient education and other services, increase market share, and most importantly, improve the overall quality of patient care? Expanding the role of nurses as co-providers of care can do all this and more for your group. The experience over the past eight years of a large multispecialty group in central Illinois offers many lessons in the successful integration of a nurse practitioner/clinician program into a group practice. Discussed in this thorough report are the scope of practice, benefits to patients and the organization, and identification of issues needing further resolution: legality, third-party reimbursement, income, distribution, and control of practice. PMID:10266635

D'Angelo, L; Reifsteck, S W; Green, R D

1984-01-01

241

Teamwork: building healthier workplaces and providing safer patient care.  

PubMed

A changing healthcare landscape requires nurses to care for more patients with higher acuity during their shift than ever before. These more austere working conditions are leading to increased burnout. In addition, patient safety is not of the quality or level that is required. To build healthier workplaces where safe care is provided, formal teamwork training is recommended. Formal teamwork training programs, such as that provided by the MedTeams group, TeamSTEPPS (Team Strategies and Tools to Enhance Performance and Patient Safety), or participatory action research programs such as the Healthy Workplace Intervention, have decreased errors in the workplace, increased nurse satisfaction and retention rates, and decreased staff turnover. This article includes necessary determinants of teamwork, brief overviews of team-building programs, and examples of research programs that demonstrate how teamwork brings about healthier workplaces that are safer for patients. Teamwork programs can bring about these positive results when implemented and supported by the hospital system. PMID:19542973

Clark, Paul R

2009-01-01

242

Vaccination campaigns in postsocialist Ukraine: health care providers navigating uncertainty.  

PubMed

Vaccination anxieties grew into a public health issue during the 2008 failed measles and rubella immunization campaign in Ukraine. Here I explore how health care providers bend official immunization policies as they navigate media scares about vaccines, parents' anxieties, public health officials' insistence on the need for vaccination, and their own sense of expertise and authority. New hierarchies are currently being renegotiated, and I follow health care providers as they attempt to parcel out their new position in the Ukrainian society and beyond. Public health control is reframed in a postsocialist context as a condition of acceptance into the European community as a sanitary democracy, and a contestation point between citizens and state. I untangle how relationships between citizens and states shape the construction of medical risk. PMID:22338289

Bazylevych, Maryna

2011-12-01

243

Cancer care management through a mobile phone health approach: key considerations.  

PubMed

Greater use of mobile phone devices seems inevitable because the health industry and cancer care are facing challenges such as resource constraints, rising care costs, the need for immediate access to healthcare data of types such as audio video texts for early detection and treatment of patients and increasing remote aids in telemedicine. Physicians, in order to study the causes of cancer, detect cancer earlier, act in prevention measures, determine the effectiveness of treatment and specify the reasons for the treatment ineffectiveness, need to access accurate, comprehensive and timely cancer data. Mobile devices provide opportunities and can play an important role in consulting, diagnosis, treatment, and quick access to health information. There easy carriage make them perfect tools for healthcare providers in cancer care management. Key factors in cancer care management systems through a mobile phone health approach must be considered such as human resources, confidentiality and privacy, legal and ethical issues, appropriate ICT and provider infrastructure and costs in general aspects and interoperability, human relationships, types of mobile devices and telecommunication related points in specific aspects. The successful implementation of mobile-based systems in cancer care management will constantly face many challenges. Hence, in applying mobile cancer care, involvement of users and considering their needs in all phases of project, providing adequate bandwidth, preparation of standard tools that provide maximum mobility and flexibility for users, decreasing obstacles to interrupt network communications, and using suitable communication protocols are essential. It is obvious that identifying and reducing barriers and strengthening the positive points will have a significant role in appropriate planning and promoting the achievements of mobile cancer care systems. The aim of this article is to explain key points which should be considered in designing appropriate mobile health systems in cancer care as an approach for improving cancer care management. PMID:24175759

Mohammadzadeh, Niloofar; Safdari, Reza; Rahimi, Azin

2013-01-01

244

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

245

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. PMID:25624872

Gafer, Nahla; Elhaj, Ahmed

2014-01-01

246

Palliative care for cancer patients in Sudan: an overview.  

PubMed

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. PMID:25624872

Gafer, Nahla; Elhaj, Ahmed

2014-01-01

247

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

PubMed

Breast cancer is a prevalent disease affecting all areas of patients' lives. Therefore, family doctors need to thoroughly understand this disease in order to optimize the health care services for these patients, making the best use of available resources. 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. The second one deals with population screening and its controversies, screening in high-risk women, and the current recommendations. This summary report aims to provide a current and practical review about this problem, providing answers to family doctors, and helping them to be able to care for their patients for their benefit throughout their illness. PMID:24953002

Brusint, B; Vich, P; Ávarez-Hernández, C; Cuadrado-Rouco, C; Díaz-García, N; Redondo-Margüello, E

2014-10-01

248

Provider's Constraints and Difficulties in Primary Health Care System  

PubMed Central

Background: The contractualization of human resource in recent years has resulted into various human resource management issues. Objective: To explore the administrative and management issues of contractual model of human resource under primary health care system in Delhi. Materials and Methods: Comparative study was conducted on randomly selected sample of 333, comprised of Medical Officers, ANMs, Pharmacist and Laboratory Assistants and Technicians, both regular and contractual cadre. The data was collected using the semi-structured interview schedule and thematic content analysis was done. Results: The five major themes emerged in the analysis; these are (i) physical infrastructure, (ii) organization's working environment, (iii) privileges of staff, (iv) discontentment, (v) human resource development. Comparative analysis of themes between regular and contractual staff revealed significant differences in factors which are embedded into the organization's culture. Element of discontentment is high amongst contractual staff particularly for discrimination in job, undermining of authority, patient care relationship and privileges provided to regular staff. This reflects the area of dissatisfaction which varies between regular and contractual staff in the organization. Conclusion: If primary health care system fails to address genuine constraints of human resources of both regular and contractual cadre and perception of discrimination persists, it is bound to result into poor motivation for good performance in the system of health care. So, adopting good practices in human resource management keeping regular and contractual employees grievances at forefront are urgently needed to ensure the availability of adequately trained and motivated personnel's in health facilities. PMID:25161964

Kumar, Pawan; Khan, Abdul Majeed; Inder, Deep; Anu

2014-01-01

249

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

250

System and Patient Barriers to Appropriate HIV Care for Disadvantaged Populations: The HIV Medical Care Provider Perspective  

Microsoft Academic Search

Little is known about the perception of system and patient barriers to adequate HIV care by an essential resource in the provision of HIV care, HIV medical care providers. To evaluate such perceptions, be- tween November 2000 and June 2001 a survey was mailed to 526 HIV medical care providers who cared for HIV-infected individuals in Atlanta, Baltimore, Los Angeles,

Eduardo E. Valverde; Drenna Waldrop-Valverde; Pamela Anderson-Mahoney; Anita M. Loughlin; Carlos Del Rio; Lisa Metsch; Lytt I. Gardner

2006-01-01

251

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.

252

76 FR 51381 - Supplemental Awards to Seven Unaccompanied Alien Shelter Care Providers  

Federal Register 2010, 2011, 2012, 2013, 2014

...Supplemental Awards to Seven Unaccompanied Alien Shelter Care Providers AGENCY: Office...supplement grants to seven Unaccompanied Alien Shelter Care Providers...supplement grants to seven unaccompanied alien shelter care providers for a total...

2011-08-18

253

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

MedlinePLUS

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

254

Provider-client interactions and quantity of health care use.  

PubMed

This paper considers three types of provider-client interactions that influence quantity of health care use: rationing, effort, and persuasion. By rationing, we refer to a quantity limit set by a provider; effort, the productive inputs supplied by a provider to increase a client's demand; persuasion, the unproductive inputs used by a provider to induce a client's demand. We construct a theoretical model incorporating all three mechanisms as special cases. When the general model is specialized into one of three mechanisms, a set of empirical implications emerges. We test for the presence of each mechanism using data of patients receiving outpatient treatment for alcohol abuse in the Maine Addiction Treatment System. We find evidence for rationing and persuasion, but not effort. PMID:15556245

Lien, Hsien-Ming; Albert Ma, Ching-To; McGuire, Thomas G

2004-11-01

255

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

256

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

Federal Register 2010, 2011, 2012, 2013, 2014

...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

257

Benefit finding through caring: The cancer caregiver experience  

Microsoft Academic Search

Objectives: The aim of this study was to explore benefit finding in cancer carers taking account of timeline and care recipient, in relation to burden of care, perceived stress, optimism, resilience, self efficacy, perceived support and psychological distress.Methods: A cohort sequential survey was conducted with a group of 842 female cancer carers who were caring for a spouse, a parent

Tony Cassidy

2012-01-01

258

A Framework for Fibromyalgia Management for Primary Care Providers  

PubMed Central

Fibromyalgia is a chronic widespread pain disorder commonly associated with comorbid symptoms, including fatigue and nonrestorative sleep. As in the management of other chronic medical disorders, the approach for fibromyalgia management follows core principles of comprehensive assessment, education, goal setting, multimodal treatment including pharmacological (eg, pregabalin, duloxetine, milnacipran) and nonpharmacological therapies (eg, physical activity, behavioral therapy, sleep hygiene, education), and regular education and monitoring of treatment response and progress. Based on these core management principles, this review presents a framework for primary care providers through which they can develop a patient-centered treatment program for patients with fibromyalgia. This proactive and systematic treatment approach encourages ongoing education and patient self-management and is designed for use in the primary care setting. PMID:22560527

Arnold, Lesley M.; Clauw, Daniel J.; Dunegan, L. Jean; Turk, Dennis C.

2012-01-01

259

Determinants of job satisfaction among selected care providers in Kuwait.  

PubMed

The study reports job satisfaction among a sample of 370 physicians, nurses, pharmacists, and medical laboratory technologists in the Ministry of Health hospitals in Kuwait. Job satisfaction was measured using Dunnette's scale. The respondents in all four categories were satisfied with all aspects of their jobs except salary. The medical laboratory technologists were, however, dissatisfied with professional advancement as well. The physicians were found to be most satisfied, closely followed by nurses and pharmacists, while medical laboratory technologists were least satisfied. Multivariate analysis was used to assess the net effects of background and work environment characteristics on overall job satisfaction. Introduction to job, in-service training, and monthly income had significant positive effects on overall job satisfaction. These findings may have serious implications for health care delivery systems that recruit expatriate care providers. PMID:11398232

Shah, M A; Chowdhury, R I; al-Enezi, N; Shah, N M

2001-01-01

260

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

261

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

PubMed

Breast cancer is a prevalent disease affecting all areas of the patients' lives. Therefore, family physicians should have a thorough knowledge of this disease in order to optimize the health care services for these patients, and making the best use of available resources. 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. The first article reviews the epidemiology, risk factors, and protective factors in this disease This summary report aims to provide a current and practical review on breast cancer, providing answers to family doctors and helping them to support the patients for their benefit throughout their illness. PMID:25002351

Vich, P; Brusint, B; Alvarez-Hernández, C; Cuadrado-Rouco, C; Diaz-García, N; Redondo-Margüello, E

2014-09-01

262

Palliative cancer care in Middle Eastern countries: accomplishments and challenges †  

PubMed Central

Background In larger parts of the Middle East palliative care is still misunderstood among health professionals, cancer patients and the public at large. One reason to that is because the term does not obviously communicate the intent of this clinical discipline, which is lending better quality of life while combating cancer. Further, culture, tradition and religion have contributed to this misgiving and confusion especially at the terminal stage of the disease. Methods The Middle East Cancer Consortium jointly with the American Society of Clinical Oncology, the American Oncology Nursing Society, the San Diego Hospice Center for Palliative Medicine and the Children's Hospital & Clinics of Minnesota initiated a series of training courses and workshops in the Middle East to provide updated training to physicians, nurses, social workers and psychologists from throughout the region with basic concepts of palliative care and pain managements in adults and children cancers. Results During the past 6 years hundreds of professionals took part in these educational and training activities, thereby creating the core of trained caregivers who start to make the change in their individual countries. Conclusions The outcome of consecutive training activities can overcome geopolitical instabilities, and yield a genuine change in approach of both regulators, medical administrators, medical staff and the public; as to the important contribution of palliative care services to the welfare of the patient and his/her family. PMID:22628412

Silbermann, M.; Arnaout, M.; Daher, M.; Nestoros, S.; Pitsillides, B.; Charalambous, H.; Gultekin, M.; Fahmi, R.; Mostafa, K.A.H.; Khleif, A.D.; Manasrah, N.; Oberman, A.

2012-01-01

263

Survey on Pediatric Palliative Care Care For Healthcare Providers (SPPCHP): Identifying Knowledge, Barriers, and Support Needs  

Microsoft Academic Search

Objective: A significant number of children suffer from life-limiting illnesses, with many dying each year in the U.S. Services, beyond standard medical care, aimed at increasing overall quality of life for children with life-limiting illnesses, are greatly needed within and outside of our hospitals. Palliative care is conceptualized as treatment provided to relieve symptoms and improve quality of life. Despite

Mary E Grimley

2011-01-01

264

Family planning clinic patients: their usual health care providers, insurance status, and implications for managed care  

Microsoft Academic Search

Purpose: To understand the extent to which family planning clinic patients have health insurance or access to other health care providers, as well as their preferences for clinic versus private reproductive medical care.Method: An anonymous self-report questionnaire was administered at three Planned Parenthood clinics in Los Angeles County to 780 female patients aged 12–49 years. Dependent variables included insurance status,

Susan Sugerman; Neal Halfon; Arleen Fink; Martin Anderson; Laurie Valle; Robert H Brook

2000-01-01

265

Views of breast and colorectal cancer survivors on their routine follow-up care  

PubMed Central

Objective Our understanding of optimum health care delivery for cancer survivors is limited by the lack of a patient-centred perspective. The objectives of the present study were to explore the views of breast and colorectal cancer survivors on their routine follow-up care, with respect to needs, preferences, and quality of follow-up, and their views on cancer specialist– compared with family physician (fp)–led follow-up care. Methods In Nova Scotia, Canada, 23 cancer survivors (13 breast, 10 colorectal) participated in either a focus group or a one-on-one interview. Participants were asked to reflect upon their lives as cancer survivors and on the type and quality of care and support they received during the follow-up period. Each focus group or interview was transcribed verbatim, and the transcripts were audited and subjected to a thematic analysis. Results Six themes were identified: My care is my responsibilityHow I receive information on follow-up careI have many care needsI want to be prepared and informedThe role of my fp in my cancer experience and follow-up careThe role of media Survivors often characterized the post–primary treatment experience as lacking in information and preparation for follow-up and providing inadequate support to address many of the care needs prevalent in survivor populations. Despite valuing fp participation in follow-up care, many survivors continued to receive comfort and reassurance from specialist care. Conclusions Our findings point to the need to implement strategies that better prepare breast cancer and colorectal cancer survivors for post-treatment care and that reassure survivors of the ability of their fp to provide quality care during this period. PMID:23300354

Urquhart, R.; Folkes, A.; Babineau, J.; Grunfeld, E.

2012-01-01

266

Chater 4 Roles of Child Health-Care Providers Roles of Child Health-Care  

E-print Network

and again at 12 months, provide infor- mation about: · Hazards of deteriorating lead-based paint in older Lead Poisoning Prevention Roles of Child Health-Care Providers 1. Use and disseminate information from state and local public health agencies. 2. Give anticipatory guidance. 3. Perform routine blood lead

267

Firearm injury prevention: Internet resources for the health care provider.  

PubMed

This annotated bibliography examines public health and advocacy web sites related to firearm injury prevention. In 1998, on average, 1 child or adolescent died from firearm-related injuries almost every 2 hours, resulting in about 3800 youth deaths that year. Including adults, the death toll was 30,708. In this context, advocacy groups, consisting of health care professionals and community leaders, are reframing the concepts of firearm injury as a major public health issue. At the beginning of this new century, many of these advocacy groups are disseminating information over the Internet. Concurrently, professional medical organizations are encouraging health care professionals to stay updated on the latest health statistics, intervention techniques and legislative issues related to firearm injury prevention. In order to stay abreast of this rapidly changing information, physicians are utilizing Internet resources in a complimentary fashion to more traditional means of research (i.e. Medline). This article assists physicians in their online research of firearm injury prevention by providing a select list of effective, informative web sites. Despite the pitfalls of on-line searches, physicians with minimal time and effort can discover useful, complementary information on patient care, injury prevention and community advocacy. PMID:11419366

Craig-Shashko, A L; Katcher, M L

2001-01-01

268

Integrating genetic and genomic information into effective cancer care in diverse populations  

PubMed Central

This paper provides an overview of issues in the integration of genetic (related to hereditary DNA) and genomic (related to genes and their functions) information in cancer care for individuals and families who are part of health care systems worldwide, from low to high resourced. National and regional cancer plans have the potential to integrate genetic and genomic information with a goal of identifying and helping individuals and families with and at risk of cancer. Healthcare professionals and the public have the opportunity to increase their genetic literacy and communication about cancer family history to enhance cancer control, prevention, and tailored therapies. PMID:24001763

Fashoyin-Aje, L.; Sanghavi, K.; Bjornard, K.; Bodurtha, J.

2013-01-01

269

Integrating genetic and genomic information into effective cancer care in diverse populations.  

PubMed

This paper provides an overview of issues in the integration of genetic (related to hereditary DNA) and genomic (related to genes and their functions) information in cancer care for individuals and families who are part of health care systems worldwide, from low to high resourced. National and regional cancer plans have the potential to integrate genetic and genomic information with a goal of identifying and helping individuals and families with and at risk of cancer. Healthcare professionals and the public have the opportunity to increase their genetic literacy and communication about cancer family history to enhance cancer control, prevention, and tailored therapies. PMID:24001763

Fashoyin-Aje, L; Sanghavi, K; Bjornard, K; Bodurtha, J

2013-10-01

270

Primary care provider views of the current referral-to-eye-care process: focus group results.  

PubMed

Purpose. To understand the barriers facing primary care providers (PCPs), including nurse practitioners (NPs) and physician assistants (PAs), in the current referral-to-eye-care process and to solicit suggestions from PCPs on how to improve the current referral system. Methods. Four focus groups were conducted with a total of 17 PCPs: two groups with physicians (MDs): one in a rural setting and one in an academic medical center setting and one group of NPs and one of PAs, both in an academic setting. All discussions were audiotaped and transcribed, and both authors performed content analysis of the transcripts with the assistance of qualitative software. Results. The most frequently cited referral barriers included: (1) poor communication from eye care providers (ECPs), (2) patients' lack of finances/insurance coverage, and (3) difficulty in scheduling an eye care appointment. Suggestions made in all groups on ways to improve the current referral system included (1) implementing electronic medical records (EMRs), (2) receiving better communication/feedback from ECPs, (3) having ophthalmologists hold clinic days in primary care facilities, and (4) performing retinal scans in primary care clinics. We found few differences between the opinions of MDs and those of NPs and PAs. Conclusions. PCPs desire change(s) in the current referral-to-eye-care system. Better communication between PCPs and ECPs, further implementation of EMRs, and increasing eye screening in primary care clinics were common themes. Implementing specific suggestions, such as modernizing medical record systems, may help to increase eye care utilization among patients at high risk for advancing eye disease and vision loss. PMID:19875660

Holley, Clay D; Lee, Paul P

2010-04-01

271

Ten "tips and tricks" to provide trauma care without residents.  

PubMed

The utilization of medical students, residents, and fellows within the orthopaedic trauma team helps alleviate workload demands. However, many nonacademic hospitals lack these clinical resources. Therefore, orthopaedic trauma surgeons often must be creative in developing alternative methods to better manage time, staff, and patients. Incorporating midlevel providers and maximizing surgical technician assistance are favorable for both the hospital and the patient. In addition, using currently available medical devices in unique and innovative ways can help simplify patient procedures and optimize care. The purpose of this article is to detail precise tips and tricks for overcoming challenges observed during orthopaedic trauma cases when residents are unavailable. PMID:23880559

Caron, Troy; Finley, Phillip J; Austin, Cindy

2013-10-01

272

Providing semantic interoperability between clinical care and clinical research domains.  

PubMed

Improving the efficiency with which clinical research studies are conducted can lead to faster medication innovation and decreased time to market for new drugs. To increase this efficiency, the parties involved in a regulated clinical research study, namely, the sponsor, the clinical investigator and the regulatory body, each with their own software applications, need to exchange data seamlessly. However, currently, the clinical research and the clinical care domains are quite disconnected because each use different standards and terminology systems. In this article, we describe an initial implementation of the Semantic Framework developed within the scope of SALUS project to achieve interoperability between the clinical research and the clinical care domains. In our Semantic Framework, the core ontology developed for semantic mediation is based on the shared conceptual model of both of these domains provided by the BRIDG initiative. The core ontology is then aligned with the extracted semantic models of the existing clinical care and research standards as well as with the ontological representations of the terminology systems to create a model of meaning for enabling semantic mediation. Although SALUS is a research and development effort rather than a product, the current SALUS knowledge base contains around 4.7 million triples representing BRIDG DAM, HL7 CDA model, CDISC standards and several terminology ontologies. In order to keep the reasoning process within acceptable limits without sacrificing the quality of mediation, we took an engineering approach by developing a number of heuristic mechanisms. The results indicate that it is possible to build a robust and scalable semantic framework with a solid theoretical foundation for achieving interoperability between the clinical research and clinical care domains. PMID:23008263

Laleci, Gokce Banu; Yuksel, Mustafa; Dogac, Asuman

2013-03-01

273

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

274

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

275

Cancer Patients Prefer Care That Includes Their Input  

MedlinePLUS

... features on this page, please enable JavaScript. Cancer Patients Prefer Care That Includes Their Input But whether ... Doctor THURSDAY, Feb. 12, 2015 (HealthDay News) -- Cancer patients who let their doctors make all the decisions ...

276

Pancreatic cancer-improved care achievable.  

PubMed

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

2014-08-14

277

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

278

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

279

Provider and Clinic Cultural Competence in a Primary Care Setting  

PubMed Central

A multilevel approach that enhances the cultural competence of clinicians and healthcare systems is suggested as one solution to reducing racial/ethnic disparities in healthcare. The primary objective of this cross-sectional study was to determine if there is a relationship between the cultural competence of primary care providers and the clinics where they work. Forty-nine providers from 23 clinics in Baltimore, Maryland and Wilmington, Delaware, USA. completed an on-line survey which included items assessing provider and clinic cultural competence. Using simple linear regression, it was found that providers with attitudes reflecting greater cultural motivation to learn were more likely to work in clinics with a higher percent of nonwhite staff, and those offering cultural diversity training and culturally adapted patient education materials. More culturally appropriate provider behavior was associated with a higher percent of nonwhite staff in the clinic, and culturally adapted patient education materials. Enhancing provider and clinic cultural competence may be synergistic strategies for reducing healthcare disparities. PMID:18164114

Paez, Kathryn A; Allen, Jerilyn K; Carson, Kathryn A; Cooper, Lisa A

2008-01-01

280

The Cost of Cancer Care in Clinical Trials  

Cancer.gov

NCI has supported a number of studies that investigate the cost of patient care for patients enrolled in NCI-sponsored clinical trials compared to care received for comparable patients in standard community care. These data are essential to inform ongoing policy debates about the financial coverage by public and private health insurance plans of care received in cancer clinical trials.

281

Patient and oncologist discussions about cancer care costs  

PubMed Central

Purpose Patient out of pocket costs are higher for cancer care than for any other health care sector. Oncologist-patient discussions of costs are not well understood. We conducted an exploratory interview study to examine the frequency, patterns, attitudes, and preferences of both patients and providers on discussion of treatment costs. Methods We conducted semi-structured telephone interviews with oncology clinicians and people receiving chemotherapy at a large nonprofit health system. Multiple investigators conducted thematic analysis using modified content analysis, grounded theory, and interaction analysis methods. Results Patient themes included the relevance of cost to their experience, preference for the doctor to be the starting point of cost discussions, but relative infrequency of discussions with doctors or other care team member. Provider themes were an emphasis on clinical benefit above costs, conviction that cost-related decisions should rest with patients, and lack of access to treatment costs. Interest in discussing costs and barriers accessing cost information were common themes from both patients and providers. Conclusions Doctors and patients want to discuss treatment costs but lack access to them. These data support growing evidence for a provider role in discussions of cost during cancer treatment planning. PMID:24276955

Henrikson, Nora B.; Tuzzio, Leah; Loggers, Elizabeth Trice; Miyoshi, Janice; Buist, Diana SM

2014-01-01

282

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

Federal Register 2010, 2011, 2012, 2013, 2014

...section 1701 no longer contains a subsection...noninstitutional extended care services provided...T]he term `noninstitutional...provide extended care services for...potential for long-term care. We determined...emotional health risks caused by...

2013-02-13

283

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

Federal Register 2010, 2011, 2012, 2013, 2014

...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

284

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.

285

Caring for a child with cancer: impact on mother's health.  

PubMed

The life of a mother undergoes a dramatic change after a child is diagnosed with cancer. The present study aimed to determine effects on the everyday life process and health status of mothers with children suffering from leukemia. This qualitative study was based on a grounded theory approach with sixteen mothers. The results indicate that after onset of disease in their children, they marginalized their own health and tied their identities to taking care of the child and keeping the child healthy by ignoring themselves, becoming imprisoned in a taking-care-of-the-child position, and trying very hard for seek balance and stability Enduring physical pressures on the one hand, and constantly attempting to achieve balance and stability in family processes on the other hand, gradually cause exhaustion. It seems that health care providers and nurses should pay much more attention to the health status of this group of mothers. PMID:24641400

Rafii, Forugh; Oskouie, Fatemeh; Shoghi, Mahnaz

2014-01-01

286

[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

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

2014-01-01

287

The spiritual dimension of cancer care  

Microsoft Academic Search

Spirituality is more about constant questioning than about providing fixed or final answers. Cancer patients do not expect spiritual solutions from oncology team members, but they wish to feel comfortable enough to raise spiritual issues and not be met with fear, judgmental attitudes, or dismissive comments. Spiritual needs may not be explicit in all illness phases, yet spirituality is not

Antonella Surbone; Lea Baider

2010-01-01

288

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

289

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

290

Assessing Gynecologic and Breast Cancer Survivors’ Sexual Health Care Needs (Sexual Care Needs of Cancer Survivors)  

PubMed Central

Objectives To identify patterns of female cancer survivors’ interest in receiving care for sexual concerns. Methods Survey and medical record data were collected June 2008 to March 2009 from 261 gynecologic and breast cancer patients. Logistic regression was used to estimate the effect of age and months since treatment on interest in receiving sexual health care. Results Participants’ mean age was 55 years (range 21–88). Only 7% had recently sought medical help for sexual issues, yet 41.6% were interested in receiving care. More than 30% responded that they would be likely to see a physician to address sexual matters and 35% of all women were willing to be contacted if a formal program was offered. When compared to older women (>65 years), younger women (18–47 years) were significantly more likely to report interest in receiving care to address sexual issues (OR 2.94, 95% CI 1.14–7.54), to see a physician to address sexual matters (OR 4.51, 95% CI 1.51–13.43) and more willing to be contacted for a formal program (AOR 5.00, 95% CI 1.63–15.28). Compared to those currently in treatment, women who last received treatment more than 12 months prior were significantly more interested in receiving care (AOR 2.02, 95% CI 1.02–4.01) and more willing to be contacted (AOR 2.49, 95% CI 1.18–5.26). Conclusions More than 40% of survivors expressed interest in receiving sexual health care, but few had ever sought such care. There is an unmet need for attention to sexual concerns among women with gynecologic and breast cancer. PMID:21656742

Hill, Emily K.; Sandbo, Stacey; Abramsohn, Emily; Makelarski, Jennifer; Wroblewski, Kristen; Wenrich, Emily Rose; McCoy, Stacy; Temkin, Sarah M.; Yamada, S. Diane; Lindau, Stacy Tessler

2010-01-01

291

Breast cancer in limited-resource countries: health care systems and public policy.  

PubMed

As the largest cancer killer of women around the globe, breast cancer adversely impacts countries at all levels of economic development. Despite major advances in the early detection, diagnosis, and treatment of breast cancer, health care ministries face multitiered challenges to create and support health care programs that can improve breast cancer outcomes. In addition to the financial and organizational problems inherent in any health care system, breast health programs are hindered by a lack of recognition of cancer as a public health priority, trained health care personnel shortages and migration, public and health care provider educational deficits, and social barriers that impede patient entry into early detection and cancer treatment programs. No perfect health care system exists, even in the wealthiest countries. Based on inevitable economic and practical constraints, all health care systems are compelled to make trade-offs among four factors: access to care, scope of service, quality of care, and cost containment. Given these trade-offs, guidelines can define stratified approaches by which economically realistic incremental improvements can be sequentially implemented within the context of resource constraints to improve breast health care. Disease-specific "vertical" programs warrant "horizontal" integration with existing health care systems in limited-resource countries. The Breast Health Global Initiative (BHGI) Health Care Systems and Public Policy Panel defined a stratified framework outlining recommended breast health care interventions for each of four incremental levels of resources (basic, limited, enhanced, and maximal). Reallocation of existing resources and integration of a breast health care program with existing programs and infrastructure can potentially improve outcomes in a cost-sensitive manner. This adaptable framework can be used as a tool by policymakers for program planning and research design to make best use of available resources to improve breast health care in a given limited-resource setting. PMID:16430399

Anderson, Benjamin O; Yip, Cheng-Har; Ramsey, Scott D; Bengoa, Rafael; Braun, Susan; Fitch, Margaret; Groot, Martijn; Sancho-Garnier, Helene; Tsu, Vivien D

2006-01-01

292

Learning to deal constructively with troubled conscience related to care providers' perceptions of not providing sufficient activities for residents.  

PubMed

The aim of this study was to illuminate an intervention process to assist care providers in municipal care of older people to constructively deal with their troubled conscience generated from their perceived shortcomings about not providing sufficient activities for residents. The study design was grounded in participatory action research. Twelve care providers and their manager participated in intervention sessions. Content analysis was used to analyze the transcriptions. By sharing their experiences with each other, care providers became aware of, and confirmed in one another, what types of activities were meaningful for residents and actions were taken to provide such activities. The importance of being attentive and relying on residents' responses, that is, providing person-centered activities, was found to be satisfying to residents and eased the care providers' troubled conscience. An enlightened conscience can be an important asset, which may prevent ill-health and improve quality of care. PMID:24021209

Ericson-Lidman, Eva; Strandberg, Gunilla

2015-04-01

293

Translating basic research in cancer patient care.  

PubMed

With the advent of molecular targeted therapies and the development of high-throughput biotechnologies, it has become evident that progress in cancer research is largely due to the creation of multidisciplinary teams able to plan clinical trials supported by appropriate molecular hypotheses. These efforts have culminated in the identification and validation of biomarkers predictive of response, as well as in the generation of more accurate prognostic tools. The identification of cancer stem cells has provided further insights into mechanisms of cancer, and many studies have tried to translate this biological notion into prognostic and predictive information. In this regard, new agents targeting key stemness-related pathways have entered the clinical development, and preliminary data suggested an encouraging antitumor activity. PMID:21430342

Maugeri-Saccà, Marcello; De Maria, Ruggero

2011-01-01

294

Being prepared: essential to self-care and quality of life for the person with cancer.  

PubMed

Being adequately prepared for an experience such as cancer empowers patients, lowers distress, improves coping, supports self-management, promotes recovery, and improves quality of life. However, patients with cancer report unmet informational and support needs across the cancer trajectory. The purpose of this article is to describe the relationship of information preparation and patient outcomes, identify information and support needs across the cancer trajectory, and describe the role of oncology nurses in the delivery of high-quality patient-centered cancer care. The middle range theory of "Carrying On" was used to identify information and support needs during different phases of the cancer trajectory from treatment to survivorship. The authors concluded that nurses should engage the patient in a relational exchange of information; provide concrete, understandable information across specific times in the cancer experience; and use creative approaches to minimize barriers in meeting patient needs to achieve high-quality patient-centered cancer care. PMID:23715703

Knobf, M Tish

2013-06-01

295

Childhood cancer survivors: Considerations for surgeons in the transition from pediatric to adult care.  

PubMed

There are over 380,000 childhood cancer survivors (CCS) alive in the US, and the population is growing. CCS face significant long-term morbidity and mortality as a consequence of their cancer treatment and thus require lifelong, risk-based health care focused on surveillance and early intervention to minimize the impact of late effects and second malignant neoplasms (SMN). Surgeons play a critical role in the treatment of childhood cancer and the subsequent management of long-term health complications. In this review, we provide an overview of late effects associated with cancer surgeries, potential late effects that may require surgery as an adult, and cancer therapies that may impact future safe surgery and anesthesia. We also describe the barriers to successful transition from pediatric to adult health care for CCS and the importance of treatment summaries, surveillance guidelines, and survivorship care plans for surgeons caring for CCS. PMID:25770371

Henderson, Tara O; Nathan, Paul C

2015-04-01

296

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.

297

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

298

Antenatal and obstetric care in Afghanistan – a qualitative study among health care receivers and health care providers  

PubMed Central

Background Despite attempts from the government to improve ante- and perinatal care, Afghanistan has once again been labeled “the worst country in which to be a mom” in Save the Children’s World’s Mothers’ Report. This study investigated how pregnant women and health care providers experience the existing antenatal and obstetric health care situation in Afghanistan. Methods Data were obtained through one-to-one semi-structured interviews of 27 individuals, including 12 women who were pregnant or had recently given birth, seven doctors, five midwives, and three traditional birth attendants. The interviews were carried out in Kabul and the village of Ramak in Ghazni Province. Interviews were taped, transcribed, and analyzed according to the principles of Giorgi’s phenomenological analysis. Results Antenatal care was reported to be underused, even when available. Several obstacles were identified, including a lack of knowledge regarding the importance of antenatal care among the women and their families, financial difficulties, and transportation problems. The women also reported significant dissatisfaction with the attitudes and behavior of health personnel, which included instances of verbal and physical abuse. According to the health professionals, poor working conditions, low salaries, and high stress levels contributed to this matter. Personal contacts inside the hospital were considered necessary for receiving high quality care, and bribery was customary. Despite these serious concerns, the women expressed gratitude for having even limited access to health care, especially treatment provided by a female doctor. Health professionals were proud of their work and enjoyed the opportunity to help their community. Conclusion This study identified several obstacles which must be addressed to improve reproductive health in Afghanistan. There was limited understanding of the importance of antenatal care and a lack of family support. Financial and transportation problems led to underuse of available care, especially by poorly educated rural women. Patients frequently complained of being treated disrespectfully, and health care providers correspondingly complained about poor working conditions leading to exhaustion and a lack of compassion. Widespread corruption, including the necessity of personal contacts inside hospitals, was also emphasized as an obstacle to equitable antenatal and obstetric health care. PMID:23642217

2013-01-01

299

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

300

A Health Services Research Agenda for Cellular, Molecular and Genomic Technologies in Cancer Care  

PubMed Central

Background In recent decades, extensive resources have been invested to develop cellular, molecular and genomic technologies with clinical applications that span the continuum of cancer care. Methods In December 2006, the National Cancer Institute sponsored the first workshop to uniquely examine the state of health services research on cancer-related cellular, molecular and genomic technologies and identify challenges and priorities for expanding the evidence base on their effectiveness in routine care. Results This article summarizes the workshop outcomes, which included development of a comprehensive research agenda that incorporates health and safety endpoints, utilization patterns, patient and provider preferences, quality of care and access, disparities, economics and decision modeling, trends in cancer outcomes, and health-related quality of life among target populations. Conclusions Ultimately, the successful adoption of useful technologies will depend on understanding and influencing the patient, provider, health care system and societal factors that contribute to their uptake and effectiveness in ‘real-world’ settings. PMID:19367091

Wideroff, Louise; Phillips, Kathryn A.; Randhawa, Gurvaneet; Ambs, Anita; Armstrong, Katrina; Bennett, Charles L.; Brown, Martin L.; Donaldson, Molla S.; Follen, Michele; Goldie, Sue J.; Hiatt, Robert A.; Khoury, Muin J.; Lewis, Graham; McLeod, Howard L.; Piper, Margaret; Powell, Isaac; Schrag, Deborah; Schulman, Kevin A.; Scott, Joan

2009-01-01

301

Pharmaceutical care management: a modern approach to providing seamless and integrated health care.  

PubMed

Institutional pharmaceutical services have widely evolved over the past 20-30 years. Hospital pharmacy practice has changed from a profession concerned chiefly with the bulk preparation and distribution of drug products to one centred on ensuring optimal drug therapy. Whereas hospital pharmacists were charged with maintaining large drug stock on nursing units, many of them now provide individualized patient therapies. The practice of hospital pharmacy has therefore become one encompassing all aspects of drug therapy, from the procurement of drugs and drug delivery devices, their preparation and distribution, to their most appropriate selection and use for each patient. Hospital pharmacy services have traditionally had little involvement at the key stages in patients' hospital care. This leads to the conclusion that the model of clinical pharmacy practice adopted by many pharmacy department hospitals is no longer appropriate for the demands of today's health-care services. Reviews many new models proposed for clinical pharmacy practice including an integrated model for providing a pharmaceutical care management approach in the health-care system. This model is a response to the failures of traditional drug therapy. It is primarily an idea about how health professionals and patient should integrate their work to obtain outcomes important to patients and clinicians. PMID:11729625

al-Shaqha, W M; Zairi, M

2001-01-01

302

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

303

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

304

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

305

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

306

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

PubMed

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

2014-09-01

307

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

Federal Register 2010, 2011, 2012, 2013, 2014

...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

308

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

Federal Register 2010, 2011, 2012, 2013, 2014

...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

309

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

Federal Register 2010, 2011, 2012, 2013, 2014

...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

310

Symptom interpretation and health care seeking in ovarian cancer  

PubMed Central

Background Ovarian cancer is the leading cause of death among women suffering from gynaecological malignancies in the Western world. Worldwide, approximately 200,000 women are diagnosed with the disease each year. This article deals with the health care seeking and symptom interpretation process among Danish women, who have a very high mortality rate. Methods The health seeking and symptom interpretation process was analysed via combining study methods. The material consisted of registry data dealing with the use of public health care and hospital services of Danish women, newly diagnosed with ovarian cancer. These results were combined with findings from semi-structured qualitative research interviews on women's bodily experiences with symptom development. Results A number of 663 Danish women with ovarian cancer attended 27 different kinds of primary health care providers in a total of 14,009 visits during 2007. The women also had 6,214 contacts with various hospitals, and obtained 562 different diagnoses. From the main theme "Women's experiences with the onset of symptoms" three sub-themes were identified: "Bodily sensations", "From bodily sensation to symptom", and "Health seeking and treatment start". In all cases the General Practitioner represented the first contact to public health care, acting as gate-keeper to specialist and hospital referral. The women were major users of public health care throughout the diagnostic process and subsequent treatment. All women held personal knowledge concerning the onset of their symptoms. The early symptoms of ovarian cancer might be uncharacteristic and non-disease-specific when interpreted as personal experiences, but they had similarities when analysed together. Conclusions Diagnostic delay in ovarian cancer seems far from being exclusively a medical problem, as the delay proved to be influenced by organisational, cultural, and social factors, too. Initiatives facilitating the diagnostic process and research concerning the selection of individuals for further investigation are indicated. The way in which the women interpreted their symptoms was influenced by their personal experiences, their cultural, and their social background. This became crucial to the diagnostic process. These issues need to be explored through further research on women's experiences during the diagnostic process. PMID:21699682

2011-01-01

311

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

312

Advancing Cancer Care Delivery Research in the Next Decade  

Cancer.gov

A more substantial and coordinated effort is needed to advance the science of cancer care delivery to help address the complex problems facing our health care systems. In response, NCI has created a new Healthcare Delivery Research Program (HDRP) to strengthen its support and coordination of research in ways that both improve survival and enhance patient care experiences.

313

Health care professionals' perspectives of the experiences of family caregivers during in-patient cancer care.  

PubMed

Being a family member of a patient who is being treated in an acute care setting for cancer often involves a number of challenges. Our study describes Norwegian cancer care health professionals' perceptions of family members who served as family caregivers (FCs) and their need for support during the in-hospital cancer treatment of their ill family member. Focus group discussions were conducted with a multidisciplinary team of 24 experienced social workers, physicians, and nurses who were closely involved in the patients' in-hospital cancer treatment and care. Drawing on qualitative hermeneutic analysis, four main themes describe health professionals' perceptions of FCs during the patient's in-hospital cancer care: an asset and additional burden, infinitely strong and struggling with helplessness, being an outsider in the center of care, and being in different temporalities. We conclude that it is a challenge for health care professionals to support the family and create room for FC's needs in acute cancer care. System changes are needed in health care, so that the patient/FC dyad is viewed as a unit of care in a dual process of caregiving, which would enable FCs to be given space and inclusion in care, with their own needs simultaneously considered alongside those of the patient. PMID:25385131

Ekstedt, Mirjam; Stenberg, Una; Olsson, Mariann; Ruland, Cornelia M

2014-11-01

314

Providing Perinatal Mental Health Services in Pediatric Primary Care  

ERIC Educational Resources Information Center

After birth, newborns and their caregivers are seen routinely and frequently in pediatric primary care settings. The close succession of visits in the first few months of life puts pediatric primary care professionals in a unique position to enhance infant mental health by developing strong relationships with caregivers, supporting babies and…

Talmi, Ayelet; Stafford, Brian; Buchholz, Melissa

2009-01-01

315

Bereaved informal cancer carers making sense of their palliative care experiences at home.  

PubMed

This qualitative study explored the positive meanings constructed and ascribed to the experience of providing palliative care at home by bereaved informal cancer carers, a group of individuals who are in a position to make sense of their caring experiences as a coherent whole. Twenty-two bereaved cancer carers, living in New South Wales (NSW), Australia, were interviewed as part of a larger mixed-method study examining the experience of informal cancer care. Participants were recruited through cancer support groups and cancer clinics, and through the Cancer Council NSW. Accounts of positive aspects of palliative caring were analysed using a thematic analytical approach from a constructionist perspective. The findings indicated that these bereaved carers gave accounts that accentuated the benefit and satisfaction derived from providing direct palliative care at home, which enabled them to construct positive meanings associated with their participation in the dying process, and as a result to ascribe subjectively meaningful interpretations to their loved ones' death and their sense of loss. This included a sense of reward for doing something good, meeting the expressed needs of the patient, continuing with normal life as much as possible, improving the conditions of the relationship and meeting cultural expectations of the right thing to do. Being present at the point of death was positioned as rewarding because it facilitated the process of saying goodbye, fostered inclusion of others, provided closure and was a spiritual experience. These findings suggest that there are positive and rewarding aspects associated with providing informal cancer care in a palliative context, and these aspects were pertinent and meaningful for carers in their endeavours to reconcile the difficulties and loss they experienced. This has implications for the prevention and amelioration of distress experienced by informal cancer carers, and suggests that future research should not ignore the positive aspects of providing palliative care. PMID:19207604

Wong, W K Tim; Ussher, Jane

2009-05-01

316

“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

317

The intelligent clinical laboratory as a tool to increase cancer care management productivity.  

PubMed

Studies of the causes of cancer, early detection, prevention or treatment need accurate, comprehensive, and timely cancer data. The clinical laboratory provides important cancer information needed for physicians which influence clinical decisions regarding treatment, diagnosis and patient monitoring. Poor communication between health care providers and clinical laboratory personnel can lead to medical errors and wrong decisions in providing cancer care. Because of the key impact of laboratory information on cancer diagnosis and treatment the quality of the tests, lab reports, and appropriate lab management are very important. A laboratory information management system (LIMS) can have an important role in diagnosis, fast and effective access to cancer data, decrease redundancy and costs, and facilitate the integration and collection of data from different types of instruments and systems. In spite of significant advantages LIMS is limited by factors such as problems in adaption to new instruments that may change existing work processes. Applications of intelligent software simultaneously with existing information systems, in addition to remove these restrictions, have important benefits including adding additional non-laboratory-generated information to the reports, facilitating decision making, and improving quality and productivity of cancer care services. Laboratory systems must have flexibility to change and have the capability to develop and benefit from intelligent devices. Intelligent laboratory information management systems need to benefit from informatics tools and latest technologies like open sources. The aim of this commentary is to survey application, opportunities and necessity of intelligent clinical laboratory as a tool to increase cancer care management productivity. PMID:24761839

Mohammadzadeh, Niloofar; Safdari, Reza

2014-01-01

318

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 ...

319

Quality measures for supportive cancer care: the Cancer Quality-ASSIST Project.  

PubMed

Patients and physicians often cite symptom control as one of their most important goals in cancer care. Despite this, a previous systematic review found few tools for evaluating the quality of supportive cancer management. We developed a comprehensive set of quality indicators for evaluating pain and nonpain symptom management as well as care planning needs in cancer patients. Based on the prevalence and quality-of-life data, clinician-researchers prioritized pain, psychosocial distress, dyspnea, nausea and vomiting, fatigue and anorexia, treatment-associated toxicities, and information and care planning for quality-indicator development. Using search terms and selection criteria, we identified English-language documents from Medline (1997-2007) and Internet-based searches. Based on this evidence, clinician-reviewers proposed process quality indicators. We then used the VA Health Services Research and Development (VA HSR & D) appropriateness methods to compile the ratings of a multidisciplinary, international expert panel of the validity and feasibility of each indicator. The panel judged 92 out of 133 (69%) proposed quality indicators valid and feasible (15 out of 23 pain, 5 out of 6 depression, 8 out of 11 dyspnea, 15 out of 19 nausea and vomiting, 13 out of 26 fatigue and anorexia, 23 out of 32 other treatment-associated toxicities, and 13 out of 16 information and care planning). Of the final indicators, 67 are potentially useful for inpatient and 81 for outpatient evaluation, and 26 address screening, 12 diagnostic evaluation, 20 management, and 21 follow-up. These quality indicators provide evidence-explicit tools for measuring processes critical to ensuring high-quality supportive cancer care. Research is needed to characterize adherence to recommended practices and to evaluate the use of these measures in quality improvement efforts. PMID:19359135

Lorenz, Karl A; Dy, Sydney M; Naeim, Arash; Walling, Anne M; Sanati, Homayoon; Smith, Patricia; Shanman, Roberta; Roth, Carol P; Asch, Steven M

2009-06-01

320

Quality of integrated care for patients with nonsmall cell lung cancer: variations and determinants of care  

Microsoft Academic Search

BACKGROUND: In the current study, the authors focused on determinants influencing the quality of care and variations in the actual quality of integrated care for patients with nonsmall cell lung cancer (NSCLC) to estimate whether there is room for improvement. METHODS: The authors tested the quality of integrated care for 276 NSCLC patients with 14 quality indicators of professional (4

Mariëlle M. M. T. J. Ouwens; Rosella R. P. M. G. Hermens; René A. R. Termeer; Saskia Y. Vonk-Okhuijsen; Vivianne C. G. Tjan-Heijnen; Ad F. T. M. Verhagen; Marlies M. E. J. L. Hulscher; Henri A. M. Marres; Hub C. H. Wollersheim; Richard P. T. M. Grol

2007-01-01

321

UNIVERSITY of NEW HAMPSHIRE CERTIFICATION OF HEALTH CARE PROVIDER FORM *  

E-print Network

-care, and is incapacitated because of a mental or physical disability. 1C. SIGNATURE OF EMPLOYEE I authorize release is chronic, meaning ongoing, or a pregnancy, state whether the patient is presently incapacitated and also

New Hampshire, University of

322

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

323

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.

324

Providing primary health care through integrated microfinance and health services in Latin America.  

PubMed

The simultaneous burdens of communicable and chronic non-communicable diseases cause significant morbidity and mortality in middle-income countries. The poor are at particular risk, with lower access to health care and higher rates of avoidable mortality. Integrating health-related services with microfinance has been shown to improve health knowledge, behaviors, and access to appropriate health care. However, limited evidence is available on effects of fully integrating clinical health service delivery alongside microfinance services through large scale and sustained long-term programs. Using a conceptual model of health services access, we examine supply- and demand-side factors in a microfinance client population receiving integrated services. We conduct a case study using data from 2010 to 2012 of the design of a universal screening program and primary care services provided in conjunction with microfinance loans by Pro Mujer, a women's development organization in Latin America. The program operates in Argentina, Bolivia, Mexico, Nicaragua, and Peru. We analyze descriptive reports and administrative data for measures related to improving access to primary health services and management of chronic diseases. We find provision of preventive care is substantial, with an average of 13% of Pro Mujer clients being screened for cervical cancer each year, 21% receiving breast exams, 16% having a blood glucose measurement, 39% receiving a blood pressure measurement, and 46% having their body mass index calculated. This population, with more than half of those screened being overweight or obese and 9% of those screened having elevated glucose measures, has major risk factors for diabetes, high blood pressure, and cardiovascular disease without intervention. The components of the Pro Mujer health program address four dimensions of healthcare access: geographic accessibility, availability, affordability, and acceptability. Significant progress has been made to meet basic health needs, but challenges remain to ensure that health care provided is of reliable quality to predictably improve health outcomes over time. PMID:25792337

Geissler, Kimberley H; Leatherman, Sheila

2015-05-01

325

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

326

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

327

Talk With Your Health Care Provider About Taking Aspirin to Prevent Heart Attack  

MedlinePLUS

... with your doctor or nurse. Talk With Your Health Care Provider About Taking Aspirin to Prevent Heart Attacks ... strokes. Please see the brochure Talk with Your Health Care Provider About Taking Aspirin to Prevent Strokes for ...

328

Talk With Your Health Care Provider About Taking Aspirin to Prevent Strokes  

MedlinePLUS

... with your doctor or nurse. Talk With Your Health Care Provider About Taking Aspirin to Prevent Strokes Partnership ... attacks. Please see the brochure Talk with Your Health Care Provider About Taking Aspirin to Prevent Heart Attacks ...

329

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 ...

330

Provision of psychosocial care for cancer patients: service delivery in urban and rural settings.  

PubMed

Although common, psychosocial distress is frequently under diagnosed and untreated in the US health care system. Previous research shows that cancer patients have unmet psychosocial needs, and provision of psychosocial care frequently falls to primary care providers who may lack the resources to adequately deal with complex psychosocial issues. We conducted 25 in-depth key informant interviews with health care professionals working within medical facilities that provide care to cancer patients. Cancer care centers included in the sample were located within both rural and urban communities in a midwestern state, and included providers of both inpatient and outpatient services. Interview questions addressed the assessment of psychosocial needs, availability of psychosocial care, perceptions of the effectiveness of psychosocial services, and perceptions of organizational processes to manage psychosocial needs among their patients. Respondents were also queried regarding recommendations for improving psychosocial care for patients with cancer. Assessment of psychosocial need in most settings was often subjective, not performed, or completed without access to an accepted standardized assessment tool, and clinical pathways to direct psychosocial care were often lacking. Because of the lack of systematic assessment, access to psychosocial care was frequently dependent on the subjective judgment of busy clinicians. This study shows the clear need for organizational and practice redesign initiatives in both rural and urban settings to improve the delivery of psychosocial services to cancer patients. A number of possible system improvements were identified, including the use of allied health providers, standardized screening, and information technology to increase the ease and efficiency of psychosocial assessment. PMID:23804837

Abrahamson, Kathleen; Durham, Morgan; Norton, Kelli; Doebbeling, Bradley N; Doebbeling, Caroline Carney; Anderson, James G

2011-10-01

331

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

332

Systematic review of clinical features of suspected prostate 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 prostate cancer in primary care. Data sources We searched MEDLINE and EMBASE 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 conducted in the primary care setting that provided information on clinical features predictive of prostate cancer were included. Also, studies that assessed the accuracy of nomograms to predict prostate cancer were reviewed. Synthesis The findings suggest that lower urinary tract symptoms are not highly predictive of prostate cancer. However, evidence suggests that FPs might be good at discriminating between patients with and without prostate cancer using digital rectal examination and prostate-specific antigen testing. Nomograms might also be useful in assessing patients for aggressive prostate cancers. Conclusion The results of this review can be used to inform recommendations for referral for suspected prostate cancer in the primary care setting. They could also inform development of prostate cancer diagnostic assessment programs.

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

2015-01-01

333

Managed Care and Clinical Decision-Making in Child and Adolescent Behavioral Health: Provider Perceptions  

Microsoft Academic Search

This study investigated how managed care affects clinical decision-making in a behavioral health care system. Providers serving children and adolescents under both managed and unmanaged care (n=28) were interviewed about their awareness of differences between the benefit arrangements, how benefits affect clinical decision-making, outcomes and quality of care; and satisfaction with care. Quantitative and qualitative findings indicated that providers saw

Philip T. Yanos; Christine I. Garcia; Stephen Hansell; Mark G. Rosato; Shula Minsky

2003-01-01

334

Racial and Ethnic Differences in Beliefs About Lung Cancer Care  

PubMed Central

Background: Disparities in lung cancer treatment and palliative care are well documented. However, the mechanisms underlying these disparities are not fully understood. In this study, we evaluated racial and ethnic differences in beliefs and attitudes about lung cancer treatment and palliative care among patients receiving a new diagnosis of lung cancer. Methods: Patients were recruited from four medical centers in New York City and surveyed about their beliefs regarding lung cancer care, including disease-directed treatments, palliative and end-of-life care, and fatalistic and spiritual beliefs. We used univariate and multiple regression analyses to compare the distribution of beliefs among minority (black and Hispanic) and nonminority patients. Results: Of the 335 patients, 21% were black, 20% were Hispanic, and 59% were nonminority. Beliefs about chemotherapy and radiotherapy were similar across the three groups (P > .05), whereas black patients were more likely to believe that surgery might cause lung cancer to spread (P = .008). Fatalistic beliefs potentially affecting cancer treatment were more common among both minority groups (P ? .02). No significant differences were found in attitudes toward clinician communication about cancer prognosis (P > .05). However, both blacks and Hispanics were more likely to have misconceptions about advance directives and hospice care (P ? .02). Conclusions: Similarities and differences in beliefs about disease-directed treatment were observed between minority and nonminority patients with lung cancer. Minority patients hold more fatalistic views about the disease and misperceptions about advance care planning and hospice care. Further research is needed to assess the impact of these beliefs on decisions about lung cancer care and patient outcomes. PMID:22700777

Jonnalagadda, Sirisha; Lin, Jenny J.; Nelson, Judith E.; Powell, Charles A.; Salazar-Schicchi, John; Berman, Andrew R.; Keller, Steven M.; Smith, Cardinale B.; Lurslurchachai, Linda; Halm, Ethan A.; Leventhal, Howard

2012-01-01

335

End-of-Life Care at a Community Cancer Center  

PubMed Central

Purpose: The evidence-based use of resources for cancer care at end of life (EOL) has the potential to relieve suffering, reduce health care costs, and extend life. Internal benchmarks need to be established within communities to achieve these goals. The purpose for this study was to evaluate data within our community to determine our EOL cancer practices. Methods: A random sample of 390 patients was obtained from the 942 cancer deaths in Wicomico County, Maryland, for calendar years 2004 to 2008. General demographic, clinical event, and survival data were obtained from that sample using cancer registry and hospice databases as well as manual medical record reviews. In addition, the intensity of EOL cancer care was assessed using previously proposed indicator benchmarks. The significance of potential relationships between variables was explored using ?2 analyses. Results: Mean age at death was 70 years; 52% of patients were male; 34% died as a result of lung cancer. Median survival from diagnosis to death was 8.4 months with hospice admission and 5.8 months without hospice (P = .11). Four of eight intensity-of-care indicators (ie, intensive care unit [ICU] admission within last month of life, > one hospitalization within last month of life, hospital death, and hospice referral < 3 days before death) all significantly exceeded the referenced benchmarks. Hospice versus nonhospice admissions were associated (P < .001) with ICU admissions (2% v 13%) and hospital deaths (2% v 54%). Conclusion: These data suggest opportunities to improve community cancer center EOL care. PMID:23180997

Cowall, David E.; Yu, Bennett W.; Heineken, Sandra L.; Lewis, Elizabeth N.; Chaudhry, Vishal; Daugherty, Joan M.

2012-01-01

336

Providing information about breast cancer via public forums.  

PubMed

This study examines whether persons who attended a breast cancer education summit or received written materials (i) exhibited improved knowledge about breast cancer; and (ii) used the information themselves, share it with others, or implemented community education/screening programs. Participants (92 lay persons, 67 health professionals who attended; 44 who did not attend but received written materials) were primarily female, with a mean age of 47. They completed a 10-item knowledge questionnaire on four occasions (pre-conference, immediately post-conference, 9 weeks, 6 months). On the third and fourth occasion, participants also were asked how they had used the information. Paired samples t tests revealed that lay individuals (p < 0.001) and health professionals (p < 0.001) exhibited improved knowledge of breast cancer after attending the conference, used the information in their personal health care, and shared it with others, and some implemented education and screening programs. Of nonattendees, only the health professional group retained knowledge gain over time. A conference can produce increased knowledge about breast cancer and stimulate attendees to use information for themselves and share it with others. For lay persons, conference attendance is superior (p < 0.01) to written materials alone, in achieving long-term gain in knowledge. PMID:9232329

Beisecker, A E; Hayes, J; Ashworth, J K; Reese, P L

1997-01-01

337

NCCN Task Force Report: Bone Health in Cancer Care  

PubMed Central

Bone health and maintenance of bone integrity are important components of comprehensive cancer care in both early and late stages of disease. Risk factors for osteoporosis are increased in patients with cancer, including women with chemotherapy-induced ovarian failure, those treated with aromatase inhibitors for breast cancer, men receiving androgen-deprivation therapy for prostate cancer, and patients undergoing glucocorticoid therapy. The skeleton is a common site of metastatic cancer recurrence, and skeletal-related events are the cause of significant morbidity. The National Comprehensive Cancer Network (NCCN) convened a multidisciplinary task force on Bone Health in Cancer Care to discuss the progress made in identifying effective screening and therapeutic options for management of treatment-related bone loss; understanding the factors that result in bone metastases; managing skeletal metastases; and evolving strategies to reduce bone recurrences. This report summarizes presentations made at the meeting. PMID:19555589

Gralow, Julie R.; Biermann, J. Sybil; Farooki, Azeez; Fornier, Monica N.; Gagel, Robert F.; Kumar, Rashmi N.; Shapiro, Charles L.; Shields, Andrew; Smith, Matthew R.; Srinivas, Sandy; Van Poznak, Catherine H.

2011-01-01

338

Respite care for Alzheimer's families: Research findings and their relevance to providers  

Microsoft Academic Search

A research project to evaluate a respite care program for caregivers of patients with Alzheimer's disease and related conditions provided information relevant to service providers of respite care. Providers must under-stand the psychological needs of caregivers that enter into their willingness to use respite care. Caregiving equity, caregiving modeling, the moral imperative of caregiving, caregiving as a challenge, caregiving as

M. Powell Lawton; Elaine Brody; Avalie Saperstein

1989-01-01

339

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

340

Health care provider attitudes and beliefs about people living with HIV: Initial validation of the Health Care Provider HIV/AIDS Stigma Scale (HPASS).  

PubMed

HIV stigma is a pressing concern for people living with HIV, and particularly when it is perpetuated by health care providers, as it may affect quality of life and access to health care services. The current study describes the development and initial validation of a contextually appropriate HIV stigma scale for health care providers in North America. A ground-up qualitative approach was used to develop the scale, and it was assessed psychometrically with health care trainees across Canada. The measure demonstrates excellent internal consistency reliability and test-retest reliability, as well as convergent and divergent validity. The study supports a tripartite model of HIV stigma consisting of stereotyping, prejudice and discrimination. The scale provides a new tool to assess HIV stigma in health care providers and can be used to inform training, intervention and self-evaluation of stigmatizing attitudes, beliefs and behaviors among providers. PMID:24965675

Wagner, Anne C; Hart, Trevor A; McShane, Kelly E; Margolese, Shari; Girard, Todd A

2014-12-01

341

The Role of Mobile Technologies in Health Care Processes: The Case of Cancer Supportive Care  

PubMed Central

Background Health care systems are gradually moving toward new models of care based on integrated care processes shared by different care givers and on an empowered role of the patient. Mobile technologies are assuming an emerging role in this scenario. This is particularly true in care processes where the patient has a particularly enhanced role, as is the case of cancer supportive care. Objective This paper aims to review existing studies on the actual role and use of mobile technology during the different stages of care processes, with particular reference to cancer supportive care. Methods We carried out a review of literature with the aim of identifying studies related to the use of mHealth in cancer care and cancer supportive care. The final sample size consists of 106 records. Results There is scant literature concerning the use of mHealth in cancer supportive care. Looking more generally at cancer care, we found that mHealth is mainly used for self-management activities carried out by patients. The main tools used are mobile devices like mobile phones and tablets, but remote monitoring devices also play an important role. Text messaging technologies (short message service, SMS) have a minor role, with the exception of middle income countries where text messaging plays a major role. Telehealth technologies are still rarely used in cancer care processes. If we look at the different stages of health care processes, we can see that mHealth is mainly used during the treatment of patients, especially for self-management activities. It is also used for prevention and diagnosis, although to a lesser extent, whereas it appears rarely used for decision-making and follow-up activities. Conclusions Since mHealth seems to be employed only for limited uses and during limited phases of the care process, it is unlikely that it can really contribute to the creation of new care models. This under-utilization may depend on many issues, including the need for it to be embedded into broader information systems. If the purpose of introducing mHealth is to promote the adoption of integrated care models, using mHealth should not be limited to some activities or to some phases of the health care process. Instead, there should be a higher degree of pervasiveness at all stages and in all health care delivery activities. PMID:25679446

Cucciniello, Maria; Guerrazzi, Claudia

2015-01-01

342

Sun-care product advertising in parenting magazines: what information does it provide about sun protection?  

PubMed

This study analyzed the content of sun-care product advertisements in five major U.S. parenting magazines with high circulation: Family Circle, Parents, Family Fun, Parenting (Early Years), and Parenting (School Years). The study examined what information sun-care product advertisements tell parents about skin cancer prevention and about sunscreen use for themselves or for their children based on the Health Belief Model concepts of perceived benefits and perceived barriers. Results showed that the most commonly mentioned benefit of the product was that it blocks ultraviolet A (UVA) and ultraviolet B (UVB) rays. One-third of the ads promoted the product's effectiveness in overcoming four of the barriers that prevent people from using sunscreens: eye irritation, skin irritation, an unpleasant smell, and the need to reapply sunscreen too often or after physical activity. However, only a few of the ads provided information about the consequences of unprotected sun exposure or mentioned methods of sun protection or skin cancer prevention other than sunscreen use. We discuss the implications of these messages for parents' ability to understand correctly how to protect their children from damaging sun exposure. PMID:23066971

Kang, Hannah; Walsh-Childers, Kim

2014-01-01

343

Roles of perceived provider cultural sensitivity and health care justice in African American/Black patients' satisfaction with provider.  

PubMed

The present study tests a refined first component of the Patient-Centered Culturally Sensitive Health Care (PC-CSHC) Model-the evidence supported component that links perceived provider cultural sensitivity to patient satisfaction with provider care and identifies trust of provider as the mediator of this linkage. The refined first component of the PC-CSHC Model tested in the present study is novel in that it includes the three dimensions of provider cultural sensitivity and includes perceived provider impartiality (fairness), a core aspect of perceived health care justice, as a mediator in addition to trust of provider (the other core aspect of perceived health care justice). Study participants were 298 African American/Black primary care clinic patients with low household incomes. Mediation analyses revealed that the three dimensions of patients' perceived provider cultural sensitivity were significant predictors of the participating patients' reported satisfaction with their provider, and that some of these predictive relationships were partially mediated by (1) patients' perceived provider impartiality (fairness), and (2) patients' trust of their provider. Implications of these findings for providers' interactions with patients, development of the PC-CSHC Model, and the roles of psychologists in facilitating patient-provider interactions are discussed. PMID:24913783

Tucker, Carolyn M; Moradi, Bonnie; Wall, Whitney; Nghiem, Khanh

2014-09-01

344

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

345

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

346

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

Federal Register 2010, 2011, 2012, 2013, 2014

...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

347

Rural Health Care Providers in the United States.  

ERIC Educational Resources Information Center

Reviews the rural physician shortage and related policy and research needs. Discusses geographic distribution of physicians, quality of rural care, rural recruitment and retention, rural residency training, factors in medical education affecting entry into rural practice, physician productivity and income, reimbursement, federal and state programs…

Hart, L. Gary; Salsberg, Edward; Phillips, Debra M.; Lishner, Denise M.

2002-01-01

348

Insurer-Provider Networks in the Medical Care Market  

Microsoft Academic Search

Managed care health insurers in the US restrict their enrollees' choice of hospitals to specific networks. This paper investigates the causes and welfare effects of the observed hospital networks. A simple profit maximization model explains roughly 63 per cent of the observed contracts between insurers and hospitals. I estimate a model that includes an additional effect: hospitals that do not

Katherine Ho

2005-01-01

349

Pediatric oncology nursing: Providing care through decades of change  

Microsoft Academic Search

Pediatric oncology nursing practice has evolved over the years as new technology and trends in health care have precipitated change. Three pediatric oncology nursing leaders share their perspectives on nursing practice as it relates to treatment of a child with leukemia during four different points in time. Their comments illustrate the challenges, resources, and rewards. Their reflections, combined with a

Kathy Forte

2001-01-01

350

Medicaid Personal Care Services for Children with Intellectual Disabilities: What Assistance Is Provided? When Is Assistance Provided?  

ERIC Educational Resources Information Center

We report on the nature and timing of services provided to children with an intellectual disability (ID) identified by a new comprehensive assessment and care planning tool used to evaluate children's needs for Medicaid Personal Care Services (PCS) in Texas. The new assessment procedure resulted from a legal settlement with the advocacy…

Elliot, Timothy R.; Patnaik, Ashweeta; Naiser, Emily; Fournier, Constance J.; McMaughan, Darcy K.; Dyer, James A.; Phillips, Charles D.

2014-01-01

351

Bringing cancer care to the poor: experiences from Rwanda.  

PubMed

The knowledge and tools to cure many cancer patients exist in developed countries but are unavailable to many who live in the developing world, resulting in unnecessary loss of life. Bringing cancer care to the poor, particularly to low-income countries, is a great challenge, but it is one that we believe can be met through partnerships, careful planning and a set of guiding principles. Alongside vaccinations, screening and other cancer-prevention efforts, treatment must be a central component of any cancer programme from the start. It is also critical that these programmes include implementation research to determine programmatic efficacy, where gaps in care still exist and where improvements can be made. This article discusses these issues using the example of Rwanda's expanding national cancer programme. PMID:25355378

Shulman, Lawrence N; Mpunga, Tharcisse; Tapela, Neo; Wagner, Claire M; Fadelu, Temidayo; Binagwaho, Agnes

2014-12-01

352

The experience of primary care providers with an integrated mental health care program in safety-net clinics.  

PubMed

Primary care providers participating in a statewide implementation of an integrated mental health care program for "safety-net" patients in primary care clinics were surveyed to elicit their experiences and level of satisfaction. Quantitative analyses were performed to identify respondent characteristics and satisfaction with the program. Qualitative analyses were done to identify common themes in response to the question "How could psychiatric consultation [in the program] be improved?" Primary care providers were generally satisfied with the integrated mental health care program and raised several concerns that suggest important principles for successful future implementations of these types of programs. PMID:25739063

Bentham, Wayne D; Ratzliff, Anna; Harrison, David; Chan, Ya-Fen; Vannoy, Steven; Unützer, Jürgen

2015-01-01

353

Transcultural nursing: providing culturally congruent care to the Hausa of Northwest Africa.  

PubMed

Research around the world is now beginning to validate the theory of Cultural Care as an important means to provide culturally congruent care to clients, families, and groups of diverse cultures. Knowledge of Leininger's Theory of Cultural Care Diversity and Universality can provide meaningful care to clients who have different traditional and current beliefs and values. The Leininger Sunrise Model can serve as a valuable guide to discover care meanings and practices related to the theory, and to provide practical and meaningful culture specific care decisions and actions by nurses. The three major modes of action, namely, cultural care maintenance or preservation, accommodation or negotiation, and repatterning or restructuring, are important differential means to provide culturally congruent care to clients within their own cultural setting. This article considers the application of such care for the Hausa of Northwest Africa.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:1747206

Chmielarczyk, V

1991-01-01

354

Watch for Cancer Care and Economics Research Blog!  

Cancer.gov

ARP's Health Services and Economics Branch (HSEB) will soon launch its Cancer Care and Economics Research blog. HSEB studies demographic, social, economic, and health system factors as they relate to screening, diagnostic, treatment, and survivorship care, and it develops and improves the methods and techniques of economic and health services research across the cancer control continuum. The blog is intended to facilitate dialogue about HSEB's research resources and research initiatives.

355

Providing effective trauma care: the potential for service provider views to enhance the quality of care (qualitative study nested within a multicentre longitudinal quantitative study)  

PubMed Central

Objective To explore views of service providers caring for injured people on: the extent to which services meet patients’ needs and their perspectives on factors contributing to any identified gaps in service provision. Design Qualitative study nested within a quantitative multicentre longitudinal study assessing longer term impact of unintentional injuries in working age adults. Sampling frame for service providers was based on patient-reported service use in the quantitative study, patient interviews and advice of previously injured lay research advisers. Service providers’ views were elicited through semistructured interviews. Data were analysed using thematic analysis. Setting Participants were recruited from a range of settings and services in acute hospital trusts in four study centres (Bristol, Leicester, Nottingham and Surrey) and surrounding areas. Participants 40 service providers from a range of disciplines. Results Service providers described two distinct models of trauma care: an ‘ideal’ model, informed by professional knowledge of the impact of injury and awareness of best models of care, and a ‘real’ model based on the realities of National Health Service (NHS) practice. Participants’ ‘ideal’ model was consistent with standards of high-quality effective trauma care and while there were examples of services meeting the ideal model, ‘real’ care could also be fragmented and inequitable with major gaps in provision. Service provider accounts provide evidence of comprehensive understanding of patients’ needs, awareness of best practice, compassion and research but reveal significant organisational and resource barriers limiting implementation of knowledge in practice. Conclusions Service providers envisage an ‘ideal’ model of trauma care which is timely, equitable, effective and holistic, but this can differ from the care currently provided. Their experiences provide many suggestions for service improvements to bridge the gap between ‘real’ and ‘ideal’ care. Using service provider views to inform service design and delivery could enhance the quality, patient experience and outcomes of care. PMID:25005598

Beckett, Kate; Earthy, Sarah; Sleney, Jude; Barnes, Jo; Kellezi, Blerina; Barker, Marcus; Clarkson, Julie; Coffey, Frank; Elder, Georgina; Kendrick, Denise

2014-01-01

356

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

357

Vascular access creation and care should be provided by nephrologists.  

PubMed

The long-term survival and quality of life of patients on hemodialysis is dependent on the adequacy of dialysis via an appropriately placed vascular access. Recent clinical practice guidelines recommend the creation of native arteriovenous fistula or synthetic graft before start of chronic hemodialysis therapy to prevent the need for complication-prone dialysis catheters. The direct involvement of nephrologists in the management of referral patterns, predialysis follow-up, policy of venous preservation, preoperative evaluation, vascular access surgery and vascular access care seems to be important and productive targets for the quality of care delivered to the patients with end-stage renal disease. Early referral to nephrologists is important for delay progression of both kidney disease and its complications by specific and adequate treatment, for education program which should include modification of lifestyle, medication management, selection of treatment modality and instruction for vein preservation and vascular access. Nephrologists are responsible for on-time placement and adequate maturation of vascular access. The number of nephrologists around the world who create their own fistulas and grafts is growing, driven by a need for better patient outcomes on hemodialysis. Nephrologists have also a key role for care of vascular access during hemodialysis treatment by following vascular access function using clinical data, physical examination and additional ultrasound evaluation. Timely detection of malfunctioning vascular access means timely surgical or radiological intervention and increases the survival of vascular access. PMID:25751545

Malovrh, Marko

2015-03-01

358

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

359

Identification of Quality Indicators of End-of-Life Cancer Care From Medical Chart Review Using a Modified Delphi Method in Japan  

Microsoft Academic Search

End-of life care is one of the principle components of cancer care. Measurement of the quality of care provided for end-of-life cancer patients is an important issue. The aim of this study was to identify the quality indicators (QIs) for end-of-life cancer care for Japanese patients using a medical chart review. A modified Delphi method for the development of QIs

Mitsunori Miyashita; Asumi Nakamura; Tatsuya Morita; Seiji Bito

2008-01-01

360

Pain control in cancer patients in tertiary care setting  

Microsoft Academic Search

Objective: To investigate the prevalence of significant pain and the appropriateness of analgesics treatment prescribed among cancer patients with pain in tertiary care hospitals. Material and Method: A cross-sectional study was conducted between October 2007 and June 2008 on 228 cancer patients with pain in the outpatient pain clinic of a university hospital and the inpatient ward of a regional

Naiyana Patcharapisarn; Penkae Ketumarn

361

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.

362

Care-seeking behavior of Japanese gynecological cancer survivors suffering from adverse effects  

PubMed Central

Background Post-treatment follow-up visits for gynecological cancer survivors should provide opportunities for management of adverse physical/psychological effects of therapy and early recurrence detection. However, the adequacy of such visits in Japan is poorly documented. We qualitatively explored care-seeking experiences of Japanese gynecological cancer survivors and deduced factors influencing care-seeking behaviors and treatment access. Methods We conducted 4 semi-structured focus groups comprising altogether 28 Japanese gynecological cancer survivors to collect a variety of participants’ post-treatment care-seeking behaviors through active interaction with participants. Factors influencing access to treatment for adverse effects were analyzed qualitatively. Results Survivors sought care through specialty clinic visits when regular post-treatment gynecological follow-ups were inadequate or when symptoms seemed to be non-treatment related. Information provided by hospital staff during initial treatment influenced patients’ understanding and response to adverse effects. Lack of knowledge and inaccurate symptom interpretation delayed help-seeking, exacerbating symptoms. Gynecologists’ attitudes during follow-ups frequently led survivors to cope with symptoms on their own. Information from mass media, Internet, and support groups helped patients understand symptoms and facilitated care seeking. Conclusions Post-treatment adverse effects are often untreated during follow-up visits. Awareness of possible post-treatment adverse effects is important for gynecological cancer survivors in order to obtain appropriate care if the need arises. Consultation during the follow-up visit is essential for continuity in care. PMID:23295104

2013-01-01

363

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.

364

Family Members Providing Home-Based Palliative Care to Older Adults: The Enactment of Multiple Roles  

ERIC Educational Resources Information Center

Canadians are experiencing increased life expectancy and chronic illness requiring end-of-life care. There is limited research on the multiple roles for family members providing home-based palliative care. Based on a larger ethnographic study of client-family-provider relationships in home-based palliative care, this qualitative secondary analysis…

Clemmer, Sarah J.; Ward-Griffin, Catherine; Forbes, Dorothy

2008-01-01

365

Child Care Providers' Strategies for Supporting Healthy Eating: A Qualitative Approach  

Microsoft Academic Search

Recent research has revealed child care settings and providers to be important influences on children's developing behaviors. Yet most research on children's nutritional development has focused on home settings and parents. Thus, through semistructured interviews with child care providers, this study aimed to develop a better understanding of the strategies they perceive to encourage healthy eating in child care settings.

Meghan Lynch; Malek Batal

2012-01-01

366

A Formative Study of Colon Cancer Surveillance Care: Implications for Survivor-Centered Interventions.  

PubMed

Colon cancer is one of the most commonly diagnosed cancers in the United States, and an increasing number of survivors has underscored the need for improved colon cancer surveillance care quality. Post-treatment surveillance includes follow-up care visits and tests as well as psychosocial support and lifestyle counseling. This formative study explored the individual, interpersonal, and organizational-level factors related to adherence to surveillance care guidelines to identify modifiable factors for potential educational intervention strategies. A convenience sample of 22 survivors (12 women and 10 men) from two cancer centers were recruited to participate in focus groups or key informant telephone interviews to explore their experiences with care after completing treatment and complete a brief survey. Content analysis was used to identify themes. Results confirmed that survivors navigated a complex surveillance care schedule and described a strong trust in their health care providers that guided their follow-up care experiences. Participants defined the terms "survivorship" and "follow-up" in a variety of different ways. Individual-level themes critical to survivors' experiences included having a positive attitude, relying on one's faith, and coping with fears. Interpersonal-level themes centered around interactions and communication with family and health care providers in follow-up care. While organizational-level factors were highlighted infrequently, participants rated office reminder systems and communication among their multiple providers as valuable. Educational interventions capitalizing on survivors' connections with their physicians and focusing on preparing survivors for what to expect in the next phase of their cancer experience, could be beneficial at the end of treatment to activate survivors for the transition to the post-treatment period. PMID:25411092

Sterba, Katherine Regan; Zapka, Jane; LaPelle, Nancy; Armeson, Kent; Ford, Marvella E

2014-11-20

367

Attitudes of primary care physicians toward cancer-prevention trials: a focus group analysis.  

PubMed Central

PURPOSE: Recruitment of low-income and minority women to cancer-prevention trials requires a joint effort from specialists and primary care providers. We sought to assess primary care providers' attitudes toward participating in cancer-prevention trial recruitment. PROCEDURES: We conducted a focus group with seven Boston-based primary care providers serving low-income and minority women. Providers discussed knowledge, attitudes, and beliefs regarding their role in recruitment to prevention trials. FINDINGS: A qualitative analysis of the focus group transcript revealed nine categories. Three categories related specifically to the primary care physician: 1) the dual role physicians play as advocates for both patient and research; 2) threats to maintaining the primary care relationship; and 3) general philosophy toward prevention. An additional six categories could be subdivided as they apply to the primary care physician, the patient, and the community: 4) trust/commitment; 5) benefits of the research; 6) access to the research; 7) knowledge and recall of the research; 8) influences of media coverage about the research; and 9) cultural sensitivity. CONCLUSIONS: Investigators conducting cancer-prevention trials must address the concerns of primary care physicians to optimize recruitment of subjects- especially low-income and minority women-into trials. PMID:11730121

Frayne, S. M.; Mancuso, M.; Prout, M. N.; Freund, K. M.

2001-01-01

368

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.

369

Type of Plan and Provider Network (Affordable Care Act)  

MedlinePLUS

... choose Marketplace insurance Type of plan and provider network Select an article Comparing health plans Marketplace insurance ... of-pocket costs Type of plan and provider network Benefits How to keep your doctor How to ...

370

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 ...

371

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

372

The Cost of Care Index: A Case Management Tool for Screening Informal Care Providers.  

ERIC Educational Resources Information Center

The Cost of Care Index (CCI) has been developed as a case management tool to assist professionals in family assessments and to identify actual or perceived problem areas of families in the care of elderly relatives. The 20-item CCI focuses upon five dimensions related to family care of the elderly. (Author/ABB)

Kosberg, Jordan I.; Cairl, Richard E.

1986-01-01

373

My Daddy Takes Care of Me! Fathers as Care Providers. Current Population Reports. Household Economic Studies.  

ERIC Educational Resources Information Center

This report examines statistical data on fathers caring for their children during mothers' working hours and which types of fathers are the most likely to take care of their children. Data are taken from the Survey of Income and Program Participation, a longitudinal survey conducted at four-month intervals by the Census Bureau. Care by fathers is…

Casper, Lynne M.

1997-01-01

374

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

375

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

376

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

377

Indonesia: status of cancer pain and palliative care.  

PubMed

Indonesia is a large archipelago with an estimated 203,000-365,400 new cancer cases a year. Most cases present in the advanced stage. Pain is the chief complaint in 89% of the patients of the palliative care unit at Dr. Soetomo hospital. The program is a community-based, family-oriented, and culturally adapted home care, widely applicable throughout the country. The service and medication should be affordable, simple, and available. The WHO three-step ladder has been adopted as the method of choice in cancer pain relief. Facilities supportive for the program are the existing health-care delivery system and non-formal support system (Indonesian Cancer Foundation and Organization for Family Welfare Promotion, PKK). The chief constraints for program implementation are the geographical and population problems, lack of resources and funding for the training of health-care workers, and limited availability of oral morphine. PMID:8754994

Soebadi, R D; Tejawinata, S

1996-08-01

378

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

379

Women's healthcare providers' range of services and collaborative care.  

PubMed

Physician shortages and healthcare reform are important topics in the healthcare field today. The utilization of the skills and professional competencies of nonphysician healthcare providers, as well as collaboration between physicians and nonphysician healthcare providers may in part provide a solution to some current healthcare concerns. The purposes of this study were to describe the range of services provided by nonphysician women's healthcare providers (WHCPs), and to begin to explore the collaborative relationship between obstetrician-gynecologists (ob-gyns) and WHCPs. Questionnaires were sent to ob-gyns, certified nurse-midwives, certified midwives, nurse practitioners (NPs), and physician's assistants (PAs) with questions regarding the types of services WHCPs provide, as well as collaboration between ob-gyns and WHCPs. Overall, 62.1% of ob-gyns employ WHCPs. NPs are the most common type of WHCP employed in our sample. WHCPs are more likely to be younger than ob-gyns, and an overwhelming majority of WHCPs in our sample are female. Most reported that they are anticipating an expansion in the roles and services they provide over the next 5 years. In an era of healthcare reform, WHCPs may in part provide a solution to the growing physician shortage. Collaboration between ob-gyns and WHCPs is a key aspect of the changing healthcare environment. PMID:22913302

Farrow, Victoria A; Lawrence, Hal; Schulkin, Jay

2014-01-01

380

Communication in cancer care: psycho-social, interactional, and cultural issues. A general overview and the example of India  

PubMed Central

Communication is a core aspect of psycho-oncology care. This article examines key psychosocial, cultural, and technological factors that affect this communication. Drawing from advances in clinical work and accumulating bodies of empirical evidence, the authors identify determining factors for high quality, efficient, and sensitive communication and support for those affected by cancer. Cancer care in India is highlighted as a salient example. Cultural factors affecting cancer communication in India include beliefs about health and illness, societal values, integration of spiritual care, family roles, and expectations concerning disclosure of cancer information, and rituals around death and dying. The rapidly emerging area of e-health significantly impacts cancer communication and support globally. In view of current globalization, understanding these multidimensional psychosocial, and cultural factors that shape communication are essential for providing comprehensive, appropriate, and sensitive cancer care. PMID:25452741

Chaturvedi, Santosh K.; Strohschein, Fay J.; Saraf, Gayatri; Loiselle, Carmen G.

2014-01-01

381

Leveraging Primary Care in the Fight Against Lung Cancer  

PubMed Central

In recent years, the decline in youth smoking rates has stopped as the tobacco industry strives to successfully reclaim market areas where it has lost favor. The plateau in lung cancer incidence and stagnation in progress toward smoking abstinence illustrates the necessity for renewed efforts to fight tobacco use. Barriers to fighting tobacco use exist in both the clinical arena and within the general population, but can be overcome. Primary care physicians (PCPs) are uniquely poised to successfully treat nicotine dependence with strategic targeting of these barriers, improved training in smoking cessation techniques, and focused political efforts in tobacco control. Herein, this article describes the landscape of tobacco use in America and provides background, methodology, and resources for PCPs to help achieve the goals of Healthy People 2010 in reducing the illness, disability, and death that occur as a result of tobacco use and exposure to secondhand smoke. PMID:18172737

Sanders, Jason L.

2008-01-01

382

Follow-up Care After Cancer Treatment  

MedlinePLUS

... home care services, nutrition counseling, physical therapy, pain management, and occupational or vocational therapy. Some patients may also need financial aid or assistance with transportation to and from ...

383

What are important for patient centered care? A quantitative study based on perception of patients' with cancer  

PubMed Central

Introduction: Today in all aspects of health care, there is a considerable emphasis on the provision of patient centered care. Various researches in cancer wards have demonstrated that from view of patients, there were some similarities and differences in importance of care in different cultural area. This study aimed to assess what are important for patient centered care in cancer wards. Methods: This is a descriptive study conducted with  participation of 200 patients with cancer  from a cancer center in Tabriz. Convenience sampling was used. The data were collected using Care-Questionnaire, developed by Larson. The Caring behaviors were ordered in 6 dimensions: "Being accessible", "Explains and facilitates", "Comforts", "Anticipates", "Trusting relationship", "Monitors and follows through" and ordered on a 5-point Likert-type scale. The data were analyzed using SPSS ver. 13.0. Results: The results showed that patients with cancer evaluated most of nurses caring behaviors with higher scores (moderate to high) and  assigned the "Monitors and follows through" and "Being accessible" as patients' higher priorities vs the "Comforts" 4.06 (0.50) and "Trusting Relationships" as lower priorities. Conclusion: The findings of the present study, indicate that the "Monitors and follows through" and "Being accessible" caring behaviors have more importance by patients with cancer, so these conduces nurses to notice and perform these behaviors in their nursing care. By so doing, moving to the main goal of patient centered care can be provided. PMID:25276741

Azimzadeh, Roghayeh; Valizadeh, Leila; Zamanzadeh, Vahid; Rahmani, Azad

2013-01-01

384

Adolescent substance use: brief interventions by emergency care providers.  

PubMed

Use of tobacco, alcohol and other drugs plays a major role in adolescent morbidity and mortality. When under the influence of alcohol or other drugs, adolescents are at increased risk for injuries, unprotected sex, or interpersonal violence. Alcohol and other drugs are major factors in adolescent deaths, contributing to motor vehicle crashes, homicides, and suicides. Adolescents tend to have shorter substance use histories therefore they often experience emergency/acute care health treatment resulting from substance use related trauma and/or overdose. Substance use screening of adolescents who present to an Emergency Department (ED) is vitally important. The CRAFFT is a valid and reliable screening tool that was developed for use with adolescents. If an adolescent screens positive, then the next step is to determine their stage of use and readiness for change in preparation for doing a brief intervention. Helping patients to recognize the potential relation between their substance use and health related consequences, may motivate them to decrease their use for harm reduction. Motivational interviewing is an effective, evidence-based approach to helping people change their high risk behavior. PMID:16280955

Burke, Pamela J; O'Sullivan, Joanne; Vaughan, Brigid L

2005-11-01

385

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.

386

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

387

Health care provider perceptions of pain treatment in Hispanic patients.  

PubMed

Despite increasing numbers of Hispanic patients in the United States, this group continues to face disparities in access and quality of pain treatment. Although previous surveys have examined treatment disparities experienced by minority patients, none have provided a provider-centric perspective on issues and concerns surrounding pain relief among pain patients of Hispanic/Latino origin. The goal of this study was to assess the relationship between provider characteristics (ie, Spanish fluency, Hispanic caseload size, and experience with Hispanic pain patients) and their perceptions of pain treatment in these patients. One hundred eighty-seven health professionals completed an online survey. The major findings indicated that: (1) less than 20% of health professionals treating Hispanic pain patients reported Spanish proficiency at an advanced level; (2) surveyed health professionals were involved treating a significant proportion of Hispanic patients in their caseloads, but reported a lack of cultural competence training; (3) Spanish fluency and experience with Hispanic pain patients exerts a strong effect on the use of established pain treatment practices; (4) providers with greater Spanish fluency report a significantly greater effect of patients' cultural beliefs and attitudes on treatment; and (5) providers did not regard cultural or language barriers as significantly impacting opioid prescribing or patient compliance. PMID:21070592

Chiauzzi, Emil; Black, Ryan A; Frayjo, Kezia; Reznikova, Margarita; Grimes Serrano, Jill M; Zacharoff, Kevin; Wood, Mollie

2011-01-01

388

Mapping a Research Agenda for Home Care Safety: Perspectives from Researchers, Providers, and Decision Makers  

ERIC Educational Resources Information Center

The purpose of this qualitative interpretive design was to explore the perspectives of researchers, health care providers, policy makers, and decision makers on key risks, concerns, and emerging issues related to home care safety that would inform a line of research inquiry. Defining safety specifically in this home care context has yet to be…

Macdonald, Marilyn; Lang, Ariella; MacDonald, Jo-Anne

2011-01-01

389

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

390

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

Federal Register 2010, 2011, 2012, 2013, 2014

...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

391

The Impact of Child Care Providers??? Feeding on Children???s Food Consumption  

Microsoft Academic Search

In young children, the eating environment is an important social context within which eating behaviors develop. Among many low-income young children, the responsibility for feeding may have shifted from family members to child care providers because these children spend the majority of their day in child care settings. To examine the influence of feeding among low-income children in child care

Sheryl O. Hughes; Heather Patrick; Thomas G. Power; Jennifer O. Fisher; Cheryl B. Anderson; Theresa A. Nicklas

2007-01-01

392

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

393

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.

394

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

395

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.

396

Lesbian Experiences and Needs During Childbirth: Guidance for Health Care Providers  

Microsoft Academic Search

JOGNN 13 Objective: To provide an overview of the litera- ture regarding lesbian experiences of childbirth and to offer health care providers guidance in supporting the childbearing lesbian couple. Data Sources: A search of the literature from 1980 through 2004 was conducted using PsycINFO, Ovid, PubMed, Ebscohost, and CINAHL, and the key words, lesbian, childbirth, parenting health care provid- ers,

Alison J. McManus; Lauren P. Hunter; Hope Renn

2006-01-01

397

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

398

Primary Care Providers’ Willingness to Recommend BRCA1/2 Testing to Adolescents  

PubMed Central

Introduction Clinical practice guidelines discourage pediatric genetic testing for BRCA1/2 mutations due to a lack of timely medical benefit and psychosocial risk. Yet, some high risk families approach primary care providers (PCPs) about testing adolescents, and little is known about PCPs attitudes regarding these requests. Methods We assessed recommendations for testing to a composite patient (a healthy 13 year-old female, mother is a BRCA mutation carrier) among 161 adolescent and family PCPs attending a national medical conference. Testing recommendations were measured with a multidimensional scale that assessed perspectives on informed consent, genetic counseling, and insurance coverage. Results PCPs expressed moderate willingness to recommend testing; surprisingly, 31% recommended adolescent testing “unconditionally.” In multivariable regression modeling, recommendation was positively associated with higher clinical practice volume (p<.05) and greater frequency of ordering other pediatric genetic tests (p<.01). Conclusion Despite a decade of clinical practice guideline advice to the contrary, experienced PCPs may still be inclined to recommend BRCA1/2 genetic testing to adolescents from high risk families. When paired with emerging data on the relative safety and efficacy of breast cancer genetic testing for high risk women, and the advent of direct-to-consumer marketing of BRCA1/2 cancer genetic tests, professional societies may need to explore best practices to counsel high risk families and their PCPs about the potential risks and benefits of pediatric BRCA1/2 testing. PMID:19390990

O'Neill, Suzanne C.; Luta, George; Walker, Leslie R.; Peshkin, Beth N.; Abraham, Anisha; Tercyak, Kenneth P.

2012-01-01

399

Primary care providers' willingness to recommend BRCA1/2 testing to adolescents.  

PubMed

Clinical practice guidelines discourage pediatric genetic testing for BRCA1/2 mutations due to a lack of timely medical benefit and psychosocial risk. Yet, some high risk families approach primary care providers (PCPs) about testing adolescents, and little is known about PCPs attitudes regarding these requests. We assessed recommendations for testing to a composite patient (a healthy 13-year-old female, mother is a BRCA mutation carrier) among 161 adolescent and family PCPs attending a national medical conference. Testing recommendations were measured with a multidimensional scale that assessed perspectives on informed consent, genetic counseling, and insurance coverage. PCPs expressed moderate willingness to recommend testing; surprisingly, 31% recommended adolescent testing "unconditionally." In multivariable regression modeling, recommendation was positively associated with higher clinical practice volume (P < .05) and greater frequency of ordering other pediatric genetic tests (P < .01). Despite a decade of clinical practice guideline advice to the contrary, experienced PCPs may still be inclined to recommend BRCA1/2 genetic testing to adolescents from high risk families. When paired with emerging data on the relative safety and efficacy of breast cancer genetic testing for high risk women and the advent of direct-to-consumer marketing of BRCA1/2 cancer genetic tests, professional societies may need to explore best practices to counsel high risk families and their PCPs about the potential risks and benefits of pediatric BRCA1/2 testing. PMID:19390990

O'Neill, Suzanne C; Peshkin, Beth N; Luta, George; Abraham, Anisha; Walker, Leslie R; Tercyak, Kenneth P

2010-03-01

400

Pathways of Adult Children Providing Care to Older Parents  

ERIC Educational Resources Information Center

Guided by life course and stress process theory, this study investigated pathways of adult child caregivers' family (caregiving, marital, parenting) and nonfamily (employment) roles. Eight waves of data from the Health and Retirement Study were analyzed for 1,300 adult child caregivers. Latent class analysis provided strong evidence for a 4-class…

Barnett, Amanda E.

2013-01-01

401

INTRODUCTION Parental care is a widespread reproductive strategy that provides  

E-print Network

developmental needs including water balance, energy balance and thermoregulation (Clutton-Brock, 1991). Although and benefit to the thermoregulation and energy budget of offspring (Liang et al., 2002; Weston and Elgar, 2005 thermoregulation (e.g. basking). Non-thermal benefits provided by python brooding are much less understood

Denardo, Dale

402

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

Federal Register 2010, 2011, 2012, 2013, 2014

...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

403

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.

404

From Self-care for Healthy People to Self-management for Cancer Patients with Cancer Portals.  

PubMed

Self-care to prevent cancer and self-management to cope with the disease are two discrete effective mechanisms for improving of control and management of neoplasia. Both them have certain strategies and practices. Often the two are used interchangeably despite their different approaches. Strategies of self-care usually refer to prevention at different levels include primary, secondary and tertiary. In contrast, strategies of self-management are related to management and alleviation of unpleasant cancer-related symptoms and treatment-related side effects for improving the quality of life of cancer survivors. Successful promoting of self-care and self-management strategies need people and survivor empowerment. Within this context, innovative approaches open a new window. In this paper after a brief review of related strategies and practices, we provide an explanation of how cancer portals may play an important role in the empowerment process and what are key potentials for implementing of self- care and self-management strategies for cancer. PMID:25743792

Azadmanjir, Zahra; Safdari, Reza; Ghazisaeidi, Marjan

2015-01-01

405

Cancer as a problem to be solved: internet use and provider communication by men with cancer.  

PubMed

Increasingly, cancer-related Web sites have been developed to provide information for patients. More needs to be done to understand the experience of men with cancer using the Internet. Heideggerian hermeneutics is the interpretive approach used to guide this study. Fifteen men with cancer who used the Internet were recruited through a prostate cancer support group and snowball sampling. Participants were individually interviewed and asked to tell stories of Internet use and practices. Transcribed interviews provided data for interpretive analysis. The overall constitutive pattern describing the men's experience is "cancer diagnosis as a problem to be solved." Five related themes included (1) seeking disease and treatments information from the Internet for decision making, to become comfortable with treatment plan; (2) organizing information to facilitate provider encounters and to monitor for reoccurrence; (3) evaluating Web information by credibility and usability with trust in the physician influencing the end decision point; (4) symptom management by knowing possibilities by hearing patient stories; and (5) navigating through the healthcare system politics and power. Men with cancer are incorporating Internet use into their cancer journey. They perceive changing provider-patient relationships when they participate in treatment decisions and monitor for reoccurrence. PMID:20975535

Dickerson, Suzanne S; Reinhart, Amber; Boemhke, Marcia; Akhu-Zaheya, Laila

2011-07-01

406

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

407

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

408

Representation of expatriates among cancer patients in Kuwait and the need for culturally-competent care.  

PubMed

From 2000 to 2007, 11,793 cancer patients received treatment in Kuwait. Non-Kuwaitis accounted for 6,016 (51%) patients. They came from 68 countries, mainly from the World Health Organization Eastern Mediterranean (59%) and South-East Asian (20%) regions. The majority (69%) was from low- and low-middle income countries. Thirty-seven percent were from non-Arabic speaking countries. To provide culturally-competent care for expatriate patients, there is a need to explore the impact of their ethnic, sociocultural, economic, language diversity, and expatriation-related stressors on different aspects of cancer care. PMID:22571250

Alshemmari, Salem H; Refaat, Samar M; Elbasmi, Amani A; Alsirafy, Samy A

2012-01-01

409

70 FR 40034 - Hematologic Cancer Healthcare Provider Education Program  

Federal Register 2010, 2011, 2012, 2013, 2014

...signs, symptoms and current treatment of blood cancer. Awardee Activities for this program are...services on the signs and symptoms of all blood cancers. Develop a custom designed blood cancer Web site with the most up-to-date...

2005-07-12

410

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

411

Early lessons from accountable care models in the private sector: partnerships between health plans and providers.  

PubMed

New health care delivery and payment models in the private sector are being shaped by active collaboration between health insurance plans and providers. We examine key characteristics of several of these private accountable care models, including their overall efforts to improve the quality, efficiency, and accountability of care; their criteria for selecting providers; the payment methods and performance measures they are using; and the technical assistance they are supplying to participating providers. Our findings show that not all providers are equally ready to enter into these arrangements with health plans and therefore flexibility in design of these arrangements is critical. These findings also hold lessons for the emerging public accountable care models, such as the Medicare Shared Savings Program-underscoring providers' need for comprehensive and timely data and analytic reports; payment tailored to providers' readiness for these contracts; and measurement of quality across multiple years and care settings. PMID:21900663

Higgins, Aparna; Stewart, Kristin; Dawson, Kirstin; Bocchino, Carmella

2011-09-01

412

Affordable Care Act and Clinical Trials: Resources for Patients | accrualnet.cancer.gov  

Cancer.gov

The American Society of Clinical Oncology's patient education website, Cancer.Net, provides a detailed article for patients that explains health insurance coverage of clincial trials and a fact sheet that gives an overview of the Affordable Care Act (ACA) provisions.

413

Step by step development of clinical care pathways for older cancer patients: necessary or desirable?  

Microsoft Academic Search

Medical and nursing staff in oncology for older cancer patients are confronted with a range of problems including co-morbidity, poly-pharmacy, cognitive impairments, emotional problems, functional limitations, sensory impairment and a lack of social support. Comprehensive geriatric assessment identifies many of the existing problems and can be used to estimate life expectancy and tolerance of treatment. However, health care providers have

MARUSCHA DE VRIES; JULIA C. M. VAN WEERT; JESSE JANSEN; VALERY E. P. P. LEMMENS; HUUB A. A. M. MAAS

2007-01-01

414

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

415

Outside the box: will information technology be a viable intervention to improve the quality of cancer care?  

PubMed

The use of health information technology (IT) to resolve the crisis in communication inherent within the fragmented service environment of medical care in the United States is a strategic priority for the Department of Health and Human Services. Yet the deployment of health IT alone is not sufficient to improve quality in health service delivery; what is needed is a human factors approach designed to optimize the balance between health-care users, health-care providers, policies, procedures, and technologies. An evaluation of interface issues between primary and specialist care related to cancer reveals opportunities for human factors improvement along the cancer care continuum. Applications that emphasize cognitive support for prevention recommendations and that encourage patient engagement can help create a coordinated health-care environment conducive to cancer prevention and early detection. An emphasis on reliability, transparency, and accountability can help improve the coordination of activities among multiple service providers during diagnosis and treatment. A switch in emphasis from a transaction-based approach to one emphasizing long-term support for healing relationships should help improve patient outcomes during cancer survivorship and end-of-life care. Across the entire continuum of care, an emphasis on "meaningful use" of health IT-rather than on IT as an endpoint-should help put cancer on a path toward substantive continuous quality improvement. The accompanying research questions will focus on reducing the variance between the social and technical subsystems as IT is used to improve patient outcomes across the interfaces of care. PMID:20386056

Hesse, Bradford W; Hanna, Christopher; Massett, Holly A; Hesse, Nicola K

2010-01-01

416

Outside the Box: Will Information Technology Be a Viable Intervention to Improve the Quality of Cancer Care?  

PubMed Central

The use of health information technology (IT) to resolve the crisis in communication inherent within the fragmented service environment of medical care in the United States is a strategic priority for the Department of Health and Human Services. Yet the deployment of health IT alone is not sufficient to improve quality in health service delivery; what is needed is a human factors approach designed to optimize the balance between health-care users, health-care providers, policies, procedures, and technologies. An evaluation of interface issues between primary and specialist care related to cancer reveals opportunities for human factors improvement along the cancer care continuum. Applications that emphasize cognitive support for prevention recommendations and that encourage patient engagement can help create a coordinated health-care environment conducive to cancer prevention and early detection. An emphasis on reliability, transparency, and accountability can help improve the coordination of activities among multiple service providers during diagnosis and treatment. A switch in emphasis from a transaction-based approach to one emphasizing long-term support for healing relationships should help improve patient outcomes during cancer survivorship and end-of-life care. Across the entire continuum of care, an emphasis on “meaningful use” of health IT—rather than on IT as an endpoint—should help put cancer on a path toward substantive continuous quality improvement. The accompanying research questions will focus on reducing the variance between the social and technical subsystems as IT is used to improve patient outcomes across the interfaces of care. PMID:20386056

Hanna, Christopher; Massett, Holly A.

2010-01-01

417

Perspectives of College Students and Their Primary Health Care Providers on Substance Abuse Screening and Intervention  

ERIC Educational Resources Information Center

The authors conducted a needs assessment among students and health-care providers of a southwestern university health center with the goal of developing health-care -provider training addressing substance-abuse screening and intervention. They collected data from focus groups of undergraduate students and structured interviews and questionnaires…

Baldwin, Julie A.; Johnson, Rhonda M.; Gotz, Nina K.; Wayment, Heidi A.; Elwell, Kristan

2006-01-01

418

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 ...

419

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 ...

420

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

421

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

422

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.

423

A unique interactive cognitive behavioral training program for front-line cancer care professionals.  

PubMed

For between one third and one half of all cancer survivors, disturbances in mood and cognition do not end with the conclusion of treatment. Recognizing this problem, the Institute of Medicine emphasized in its 2008 report, the importance of addressing psychosocial issues, such as distress, to providing quality cancer care. The National Cancer Institute (NCI) has recognized that there is a severe lack of trained professionals who can address these needs. In response to this need, an interactive training program was developed and implemented to teach frontline cancer care professionals Cognitive Behavioral Therapy (CBT) skills. This training includes a structured curriculum, centered around a 3-day training workshop that includes didactic discussion, small group interactive sessions, role playing, post course support, and follow-up evaluation. Four of the planned eight workshops have been conducted thus far and indicate successful recruitment and implementation of a unique training model related to the CBT skills learned. PMID:23090589

Clark, Karen; Greene, Paul; DuHamel, Kate; Loscalzo, Matthew; Grant, Marcia; Glazier, Kim; Redd, William

2012-12-01

424

Pharmacopuncture for Cancer Care: A Systematic Review  

PubMed Central

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

425

Cancer Care and Cancer Survivorship Care in the United States: Will We Be Able to Care for These Patients in the Future?  

Microsoft Academic Search

Studies have predicted a shortfall in the workforces of oncolo- gists and primary care physicians in the coming years. These estimates are based on the number of current physicians, those leaving the profession, and the rate of new physicians joining each profession, as benchmarked against the number of pa- tients needing care. For active cancer treatment, and particularly for the

Lawrence N. Shulman; Linda A. Jacobs; Sheldon Greenfield; Barbara Jones; Mary S. McCabe; Karen Syrjala; Lisa Diller; Charles L. Shapiro; Alfred C. Marcus; Marci Campbell; Sheila Santacroce; Marjorie Kagawa-Singer; Patricia A. Ganz

2009-01-01

426

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

427

Providing better access to health care: a pediatric nurse practitioner WIC-based clinic for one-stop health care.  

PubMed

The University of Texas Women, Infants, and Children (WIC) Well Child Clinic was established in January 1992 to provide high-quality "user-friendly" health care to children in Houston, Texas. As the name implies, the traditional services of the WIC nutritional program are coupled with primary care to offer more comprehensive and greater access to care. The services are provided by pediatric nurse practitioners and focus on health maintenance, with an emphasis on anticipatory guidance and immunizations. Acute care and management of chronic illness are also provided. The clinic serves as a teaching site for pediatric nurse practitioner and medical students. This article addresses the rationale for and planning of a WIC-based clinic and the implementation of the plan and addresses issues concerning reproducibility in other settings. PMID:8040798

Stevenson, L J; Coody, D K; Evans, K D; Plumb, S C; Montgomery, D F; Yetman, R J

1994-01-01

428

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

429

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. PMID:25664325

Yao, Nengliang; Sun, Xiaojie

2014-01-01

430

Continuous Improvements of a Clinical Pathway Increased Its Feasibility and Improved Care Providers' Perception in TKA  

PubMed Central

Purpose We aimed to determine 1) whether dropout rate decreased and 2) whether health care providers' perceptions were changed with continued improvements of contents of clinical pathway (CP) for total knee arthroplasty (TKA). Materials and Methods This retrospective study included two separate analyses of patients and health care providers. In the analysis of patients, dropout rates and reasons were evaluated in two cohorts of patients who underwent TKA with CP applied at two different time periods (384 patients from 2009 to 2010 and 242 patients from 2012 to 2013). Contents of CP were continuously improved during the 3-year interval. Self-administered questionnaire surveys targeted to health care providers were carried out twice (2010 and 2013) and compared. Results Dropout rate decreased from 19.1% in the first time period to 10.4% in the second time period. Although overall satisfaction of care providers was high at both time-points, doctors had more favorable perceptions than nurses; most positive changes of perception were noted in nurses. The health care providers' perceptions for potential concerns of CP were improved while the perceptions for potential benefits and satisfaction were maintained. Conclusions Continuously improved CP has increased feasibility for TKA patients and reduced health care providers' concern about its value. We propose that CP can be implemented and actively used to improve the outcomes and efficacy of patient care for TKA, regardless of the rotation of care providers. PMID:25505701

Chang, Moon Jong; Kim, Seok Jin; Song, Young Dong; Kim, Sei Kyoung

2014-01-01

431

Iraqi primary care system in Kurdistan region: providers’ perspectives on problems and opportunities for improvement  

PubMed Central

Background As part of a comprehensive study on the primary health care system in Iraq, we sought to explore primary care providers’ perspectives about the main problems influencing the provision of primary care services and opportunities to improve the system. Methods A qualitative study based on four focus groups involving 40 primary care providers from 12 primary health care centres was conducted in Erbil governorate in the Iraqi Kurdistan region between July and October 2010. A topic guide was used to lead discussions and covered questions on positive aspects of and current problems with the primary care system in addition to the priority needs for its improvement. The discussions were fully transcribed and the qualitative data was analyzed by content analysis, followed by a thematic analysis. Results Problems facing the primary care system included inappropriate health service delivery (irrational use of health services, irrational treatment, poor referral system, poor infrastructure and poor hygiene), health workforce challenges (high number of specialists, uneven distribution of the health workforce, rapid turnover, lack of training and educational opportunities and discrepancies in the salary system), shortage in resources (shortage and low quality of medical supplies and shortage in financing), poor information technology and poor leadership/governance. The greatest emphasis was placed on poor organization of health services delivery, particularly the irrational use of health services and the related overcrowding and overload on primary care providers and health facilities. Suggestions for improving the system included application of a family medicine approach and ensuring effective planning and monitoring. Conclusions This study has provided a comprehensive understanding of the factors that negatively affect the primary care system in Iraq’s Kurdistan region from the perspective of primary care providers. From their experience, primary care providers have a role in informing the community and policy makers about the main problems affecting this system, though improvements to the health care system must be taken up at the national level and involve other key stakeholders. PMID:23016849

2012-01-01

432

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

433

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

434

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

435

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

436

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

437

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- ...

438

Patients’ and Family Members’ Views on Patient-Centered Communication During Cancer Care  

PubMed Central

Objectives To explore patients’ and family members’ views on communication during cancer care, and to identify those aspects of clinician-patient communication which were most important to patients and family members. Methods We conducted a secondary data analysis of qualitative data from 137 patients with cancer and family members of patients with cancer. We used a modified version of the constant comparative method and coding paradigm of grounded theory. Results Patients want sensitive, caring clinicians who provide information that they need, when they need it, in a way that they can understand; who listen and respond to questions and concerns, and who attempt to understand the patient’s experience. Effective information exchange and a positive interpersonal relationship with the clinician were of fundamental importance to patients and family members. These were interrelated; for instance, failure to provide information a patient needed could damage the relationship, while excellent listening could foster the relationship. Information exchange and relationship were also integral to decision making, managing uncertainty, responding to emotions, and self-management. Clinicians who were responsive to patients’ needs beyond the immediate medical encounter were valued. Conclusions The complexity of cancer care today suggest that efforts to improve communication must be multi-level, acknowledging and addressing patient, clinician, organizational and policy barriers and facilitators. Measurement tools are needed to assess cancer patients’ and family members’ experiences with communication over the course of cancer care in order to provide meaningful, actionable feedback to those seeking to optimize their effectiveness in communicating with patients with cancer. PMID:23780672

Mazor, Kathleen M.; Beard, Renee L.; Alexander, Gwen L.; Arora, Neeraj K.; Firneno, Cassandra; Gaglio, Bridget; Greene, Sarah M.; Lemay, Celeste A.; Robinson, Brandi E.; Roblin, Douglas W.; Walsh, Kathleen; Street, Richard L.; Gallagher, Thomas H.

2013-01-01

439

Is provider type associated with cancer screening and prevention: advanced practice registered nurses, physician assistants, and physicians  

PubMed Central

Background Physician recommendations for cancer screening and prevention are associated with patient compliance. However, time constraints may limit physicians’ ability to provide all recommended preventive services, especially with increasing demand from the Affordable Care Act in the United States. Team-based practice that includes advanced practice registered nurses and physician assistants (APRN/PA) may help meet this demand. This study investigates the relationship between an APRN/PA visit and receipt of guideline-consistent cancer screening and prevention recommendations. Methods Data from the 2010 National Health Interview Survey were analyzed with multivariate logistic regression to assess provider type seen and receipt of guideline-consistent cancer screening and prevention recommendations (n?=?26,716). Results In adjusted analyses, women who saw a primary care physician (PCP) and an APRN/PA or a PCP without an APRN/PA in the past 12 months were more likely to be compliant with cervical and breast cancer screening guidelines than women who did not see a PCP or APRN/PA (all p?provider type). Women and men who saw a PCP and an APRN/PA or a PCP without an APRN/PA were also more likely to receive guideline consistent colorectal cancer screening and advice to quit smoking and participate in physical activity than women and men who did not see a PCP or APRN/PA (all p?provider type). Conclusions Seeing a PCP alone, or in conjunction with an APRN/PA is associated with patient receipt of guideline-consistent cancer prevention and screening recommendations. Integrating APRN/PA into primary care may assist with the delivery of cancer prevention and screening services. More intervention research efforts are needed to explore how APRN/PA will be best able to increase cancer screening, HPV vaccination, and receipt of behavioral counseling, especially during this era of healthcare reform. PMID:24685149

2014-01-01

440

Medical Family Therapy in Cancer Care: Patient and Family Experiences  

Microsoft Academic Search

This study used a phenomenological approach to explore the experience of patients and family members who received Medical Family Therapy (MedFT) services as a part of their cancer care treatment. Narratives were collected from fourteen participants, resulting in the formation of 3 main categories and 13 thematic clusters. Participants described in detail what made the services unique to their treatment,

Jennifer L. Hodgson; Susan L. McCammon; Daniel P. Marlowe; Ryan J. Anderson

2012-01-01

441

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.

442

Variations in provider capacity to offer accessible health care for people with disabilities.  

PubMed

Since social workers are likely to practice in a range of health care settings, their training focusing on human behavior in the social environment could help providers develop strategies to improve access to care for people with disabilities. In this article, results from a comprehensive survey of providers about access to health care for people with a broad range of disabilities are reported. Results suggest that a minority of providers report difficulty serving people with disabilities. However, dentists and mental health/substance abuse providers are significantly less likely than other providers to report that they provide accessible services to individuals with disabilities. These providers are less likely to report having had training related to mobility impairments, providing mirrors at their facility, having an accessible door, or providing assistance with personal care needs, and are more likely to report that their building poses a barrier for people with disabilities. Social workers are well positioned to take a leadership role in working with providers and patients to improve access to health care for people with disabilities. A social work framework of understanding the individual in a social environment may be the most appropriate perspective for creating innovative strategies for addressing the complex, multidimensional needs of people with disabilities who experience limited access to care. PMID:17989034

Bachman, Sara S; Vedrani, Mark; Drainoni, Mari-Lynn; Tobias, Carol; Andrew, Jennifer

2007-01-01

443

Transitional Care Challenges of Rehospitalized Veterans: Listening to Patients and Providers  

PubMed Central

Abstract 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. (Population Health Management 2013;16:326–331) PMID:23560514

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

2013-01-01

444

Health care delivery for head-and-neck cancer patients in Alberta: a practice guideline  

PubMed Central

Background The treatment of head-and-neck cancer is complex and requires the involvement of various health care professionals with a wide range of expertise. We describe the process of developing a practice guideline with recommendations about the organization and delivery of health care services for head-and-neck cancer patients in Alberta. Methods Outcomes of interest included composition of the health care team, qualification requirements for team members, cancer centre and team member volumes, infrastructure needs, and wait times. A search for existing practice guidelines and a systematic review of the literature addressing the organization and delivery of health care services for head-and-neck cancer patients were conducted. The search included the Standards and Guidelines Evidence (sage) directory of cancer guidelines and PubMed. Results One practice guideline was identified for adaptation. Three additional practice guidelines provided supplementary evidence to inform guideline recommendations. Members of the Alberta Provincial Head and Neck Tumour Team (consisting of various health professionals from across the province) provided expert feedback on the adapted recommendations through an online and in-person review process. Selected experts in head-and-neck cancer from outside the province participated in an external online review. SUMMARY The recommendations outlined in this practice guideline are based on existing guidelines that have been modified to fit the Alberta context. Although specific to Alberta, the recommendations lend credence to similar published guidelines and could be considered for use by groups lacking the resources of appointed guideline panels. The recommendations are meant to be a guide rather than a fixed protocol. The implementation of this practice guideline will depend on many factors, including but not limited to availability of trained personnel, adequate funding of infrastructure, and collaboration with other associations of health care professionals in the province. PMID:25302041

Harris, J.R.; Lau, H.; Surgeoner, B.V.; Chua, N.; Dobrovolsky, W.; Dort, J.C.; Kalaydjian, E.; Nesbitt, M.; Scrimger, R.A.; Seikaly, H.; Skarsgard, D.; Webster, M.A.

2014-01-01

445

Patient Perceptions and Expectations From Primary Health-care Providers in India  

PubMed Central

Introduction: The study of patient satisfaction at the primary care level has been mostly neglected in India. Aim: This objective of this study was to assess indices of Patient Satisfaction at the level of the family physician which is usually the first point of contact between the patient and the health-care system. Materials and Methods: This study was carried out at a Private Primary Health-Care Center in a semirural area in New Delhi, by exit interviews in the form of a questionnaire from patients randomly selected from people visiting the center during the study period. Statistical Analysis: Descriptive statistical analysis was carried out on the data collected. Results: The findings revealed that 83.58% of the patients were satisfied with the general experience and the behavior of the health-care provider and 85.9% were satisfied with the treatment and care provided, only 65.5% were satisfied with the physical environment of the clinic. However, the percentage of patients who would recommend the facility to their friends was overwhelming (94.6%). Conclusion: These results show that private health-care providers are still the first choice for any form of medical care. However, there was definitely a gap between the increasing expectations of the patients for more information, better Patient–