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This paper aims to study the impact of combination Lactobacillus Rhamnosus Heriz I and Beta glucan on quality of life (QOL) in breast cancer (BC) patients receiving chemotherapy.

In all, 30 women with BC were enrolled in this randomized double-blind placebo-controlled clinical trial. Intervention group received either daily one capsule of L. rhamnosus strain Heriz I (2 × 10⁷ CFU) and two 10-mg capsules of soluble1–3,1–6,D-beta glucan and the placebo group receiving placebo, interval between two courses of chemotherapy. Health-related QOL was evaluated at baseline and end of the trial using the EORTC QOL Questionnaire version.3.0 (EORTC QLQ-C30).

The results showed that combination of L. rhamnosus Heriz I and Beta glucan supplementation in BC patients during chemotherapy improved functional scales score from 37.3 ± 12.1 to 39.8 ± 6.8 and this increase in comparison with placebo was significant after adjusting baseline value (p = 0.015). Changes in symptoms scores were not significant after intervention (p = 0.05) but the decreased score (66.1 ± 12.9 to 60.6 ± 9.4) was considerable clinically. As well as, changes in global health status/QOL score in intervention group in comparison with the placebo group was not significant (p = 0.93).

The findings suggest that combination of L. rhamnosus Heriz I and Beta glucan may be associated for improving functional scales and symptoms in patients with BC who underwent chemotherapy. To prove positive effect of supplements on other aspects of QOL, further studies are needed.

The purpose of this paper is to identify actual (as-is) patient pathway variation among breast cancer patients and to investigate the relationship between pathways and the cost incurred by patients.

Both quantitative and qualitative methods were employed to analyze data from four Swedish hospital groups. Quantitative methods include event-log data mining and statistical analyses on the related patient cost from the Swedish breast cancer quality registry and case-costing system. Qualitative methods included collaboration with and interviewing domain experts.

Unique pathways, followed by only one patient, were generally costlier than the most and less frequent pathways. Earlier study findings are confirmed for mastectomy patients, with more frequent pathways having a lower cost, whereas contradicting and inconclusive results emerged for the partial mastectomy patient groups. Highest variation in pathways was identified for patients receiving chemotherapy.

The common belief – if one follows a standardized patient pathway, then the cost will be lower – should be re-examined based on the actual pathways that occur in reality.

The relationships between patient pathways and patient cost allow more complex insights, beyond the general causal relationship between successfully implementing a “to-be” care pathway and lower cost. This highlights data-driven research’s importance, where actual pathways (as-is) provide more useful information than to-be care pathways.

The purpose of this paper is to develop a chemotherapy scheduling template that accounts for nurse resource availability and patient treatment needs to alleviate the mid-day patient load and provide quality services for patients.

Owing to treatment complexity in chemotherapy administration, nurses are required at the beginning, end and during treatment. When nurses are not available to continue treatment, the service is compromised, and the resource constraint is violated, which leads to inevitable delay that risks service quality. Consequently, an optimization method is used to create a scheduling template that minimizes the violation between resource assignment and treatment requirements, while leveling patient load throughout a day. A case study from a typical clinic day is presented to understand current scheduling issues, describe nursing resource constraints, and develop a constraint-based optimization model and leveling algorithm for the final template.

The approach is expected to reduce the variation in the system by 24 percent and result in five fewer chemo chairs used during peak hours. Adjusting staffing levels could further reduce resource constraint violations and more savings on chair occupancy. The actual implementation results indicate a 33 percent reduction on resource constraint violations and positive feedback from nursing staff for workload.

Other delays, including laboratory test, physician visit and treatment assignment, are potential research areas.

The study demonstrates significant improvement in mid-day patient load and meeting treatment needs using optimization with a unique objective.

The purpose of this paper is to identify the extent of actual malnutrition and its risk among cancer patients receiving radiotherapy and/or chemotherapy in the Libyan city of Benghazi.

A cross‐sectional nutritional assessment study using the patient‐generated subjective global assessment (PG‐SGA) was carried out on 200 (91 males and 109 females) cancer patients undergoing chemotherapy and/or radiotherapy.

A total of 25 per cent of the subjects were severely malnourished while 73.5 per cent were either at risk of malnutrition or suspected to be malnourished. Almost all (99.5 per cent) needed some degree of intervention (critical in nature for 83.5 per cent). Family income and physical activity were associated with nutritional status (p<0.05). Body Mass Index alone is an insensitive criterion for identifying malnutrition among such patients. All the sections and subsections of the PG‐SGA had a statistically significant positively correlation with its total score (r=0.51‐0.96, p<0.05). Dieticians played a very limited role in patient nutritional care.

It is suggested that dieticians should play a more participatory and prominent role in a multidisciplinary team involved in patient nutritional care. The PG‐SGA can help identify areas where tailor made strategies to counteract specific malnutrition or its risk can be planned, implemented and monitored.

There exists a considerable prevalence of malnutrition among Benghazi cancer patients undergoing chemotherapy and/or radiotherapy, most of whom need critical intervention.

Cancer has become a priority among today’s health problems. Therefore, providing facilities that ensure high-quality cancer treatment has become an essential design problem. Additionally, a considerable number of studies have introduced the ‘healing environment concept’ as a substantial input for healthcare buildings. The purpose of this paper is to present a design guide for cancer treatment services that is compatible with the healing environment concept.

In this context, studies on the healing environment have been analyzed, and the legislation of some selected countries has been assessed. Then, all the filtered data are used to form the design guideline for chemotherapy department, radiation oncology department and inpatient care services under a new series of analysis criteria.

The resulting principles are revealed according to the criteria of general settlement principles, internal function relations, medical necessities, user experience, interior design, social interaction/privacy, safety, landscape design and outdoor relations by the help of proposed plans, diagrams and schematic drawings.

This research constitutes the first and yet only study in its field that aims to increase efficiency and user satisfaction and provide better patient-centered care while providing a design guide on health-care architecture.

Breast cancer is a type of cancer affecting the health of women in many countries. The aim of this study is to determine the effect of breast cancer and its treatment procedures on the quality of life.

The study was carried out in Hacettepe University Oncology Hospital and The European Organization for Research and Treatment of Cancer Quality of Life Questionnaire and Breast Cancer Module were used.

It was found that 29.8 per cent of the patients were in phase 4 of the disease, 86.8 per cent already had an operation while 84.1 per cent had chemotherapy. There were statistically significant differences between the levels of the life quality for pain dimension in the symptom scale, body image dimension in the module functional scale, sexual function dimension in the module functional scale, arm symptoms dimension in module symptom scale and age groups; the levels of life quality for dyspnoea dimension in the symptom scale, anorexia dimension of the symptom scale, financial difficulties dimension of the symptom scale and the duration of the disease; the levels of life quality for fatigue dimension in the symptom scale, diarrhea dimension in the symptom scale and the phase of the cancer; the levels of life quality for physical functionality dimension in the functional scale, constipation dimension in the symptom scale and receiving chemotherapy. In the light of the findings, attempts to improve health and creation of different behaviours are important for life quality.

This is original research that sheds light on life quality issues for women diagnosed with breast cancer.

The purpose of this study is to explore how vulnerable healthcare consumers foster social support through visual storytelling in social media in navigating healthcare consumption experiences.

This study employs a dual qualitative approach of visual and textual analysis of 180 Instagram posts from female breast cancer patients and survivors who use the platform to narrate their healthcare consumption experiences.

This study demonstrates how visual storytelling on social media normalises hidden aspects of healthcare consumption experiences through healthcare disclosures (procedural, corporeal, recovery), normalising practices (providing learning resources, cohering the illness experience, problematising mainstream recovery narratives) and enabling digital affordances, which in turn facilitates social support among vulnerable healthcare consumers.

This study highlights the potential for visual storytelling on social media to address shortcomings in the healthcare service system and contribute to societal well-being through co-creative efforts that offer real-time and customised support for vulnerable healthcare consumers.

This research highlights that visual storytelling on image-based social media offers transformative possibilities for vulnerable healthcare consumers seeking social support in negotiating the challenges of their healthcare consumption experiences.

This study presents a framework of visual storytelling for vulnerable healthcare consumers on image-based social media. Our paper offers three key contributions: that visual storytelling fosters informational and companionship social support for vulnerable healthcare consumers; recognising this occurs through normalising hidden healthcare consumption experiences; and identifying healthcare disclosures, normalising practices and enabling digital affordances as fundamental to this process.

This study aims to assess the quality of care among adult oncology patients in tertiary care hospitals in Karachi by using an international standard of quality of care and to identify domains where improvement is needed.

This is a cross-sectional study carried out at two tertiary care hospitals of Karachi, Pakistan, belonging to private and public sector, respectively, between February and April 2018. Face-to-face interviews were conducted using a modified questionnaire having five-point Likert scale questions regarding satisfaction of patients with doctors, nursing staff, information provided and the hospital standards. SPSS 20 was used for statistical analysis, and the results were expressed using mean, frequencies, percentages and p-values.

The authors approached 415 patients, out of which 389 patients agreed to participate in the study. For both hospitals, the lowest mean scores were for sections pertaining to satisfaction with psychosocial support and information provided. The mean satisfaction score of patients from the private hospital were found to be significantly higher as compared to patients from the public hospital for all domains of patient care (p-value < 0.01 using t-test for two independent samples). The data showed an increasing trend of “satisfied” responses as the household income increased.

A comparative study should be conducted with the aim of pinpointing the differences in areas in which there is a significant difference in positive satisfaction levels between private and public sectors. Similar research could also be expanded adding other variables that affect quality of care such as doctor's approach to their patients, time given during each consultation and patient's understanding of doctor's knowledge. Further studies can be done to bridge the gaps between what a doctor views as standard care and what the patient knows will help them receive a more holistic approach to care.

Assessing the quality of care helps determine gaps in care and allocating health resources accordingly. In clinical practice, emphasis needs to be given on increased duration and improved quality of patient counselling to improve the low satisfaction levels of patients regarding the psychosocial support. Addressing patients' concerns should be made part of clinical teaching from an undergraduate level. As far as patient access to doctors of the specific speciality is concerned, hospital managements should adopt systems to ensure continuum of care and come up with mechanisms to bridge the discrepancy between a patient's needs and doctor availability.

After being identified as a major deficiency, training doctors in the sensitivities of the population and demographics, especially with respect to socio-economic statuses, can aid in enhancing patient satisfaction to the treatment. Implementation of patient-centred care leads to greater satisfaction with care, which, in turn, increases a patient's self efficacy in managing important aspects of their care and improves health care-related quality of life.

Cancer patients have long-term exposure to the hospital environment. A patient's satisfaction with the quality of care is an important determinant in patient compliance to the treatment protocol and required hospital visits. There is a dearth of research on the outpatient quality of care in the oncology departments in Karachi. This study provides an overview of the quality of care available to cancer patients in Karachi both in public and private sectors. The results of our study identify the gaps in the quality of care being provided to the patients in a developing country like Pakistan, which can be used to improve the quality of care, leading to better patient outcomes.

The purpose of this article is to highlight the importance of the foundational construct of “connection” in linking design and service in performing vital functions in the healthcare sector. “Connection” facilitates patients receiving life-saving and life-improving care at the right time, in the right place, in the right way.

This article discusses various design-improvement initiatives making clear that healthcare, like any labor-intensive service delivered to people, is a human endeavor whose systems and features can be materially and cleverly enhanced once their intricacies are analyzed, understood and then redesigned to move closer to excellence.

By designing connection into healthcare and thinking holistically about the needs and preferences of users (patients), the functionality and the appeal of healthcare services can be enhanced.

The gap between the service that healthcare aims to deliver – and what it actually delivers – is unacceptably large. This article calls for incorporating connection through design into healthcare as a way to bridge this gap.