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1 – 10 of 427Muhanad Ahmed Ali, Farah Ahmad and Marina Morrow
While there is literature that examines factors associated with low participation in cancer screening among Canadian ethnic groups, there is limited understanding of black visible…
Abstract
Purpose
While there is literature that examines factors associated with low participation in cancer screening among Canadian ethnic groups, there is limited understanding of black visible minorities, particularly Somalis. Thus, the purpose of this study is to synthesize knowledge pertaining to the perceptions, beliefs and barriers of Somali women and men toward screening for breast, cervical and colorectal cancers in countries such as Canada.
Design/methodology/approach
The scoping review methodology was used to search for peer-reviewed articles that explicitly examined perceptions, beliefs and barriers among Somalis toward screening for breast, cervical and colorectal cancers in developed countries. The following electronic databases were searched without time frame restrictions, namely, OVID Medline, Embase, CINHAL, PubMed, Scopes and ProQuest. A total of 402 peer-reviewed articles were identified and screened. Three articles were identified through reference list screening (one eligible) and consultation with experts in the networks (two eligible). In total, 12 studies met the inclusion criteria for synthesis. Thematic analysis was used to analyze the selected articles for key themes and the synthesis was informed by the socio-ecological model.
Findings
The majority of studies originated from the USA and focused primarily on Somali women and cervical cancer screening. Themes that emerged from the literature include individual-level negative experiences and socio-cultural perceptions/beliefs; community-level barriers in cancer screening; and systemic challenges in navigating the health-care system. Many of the studies focused on individual and community-level determinants of cancer screening, with little attention to systemic level determinants. Other gaps identified include factors influencing Somali men’s low participation in cancer screening; limited studies on colorectal cancer and Somali women; and specific cancer-screening barriers faced by Somalis within the Canadian context.
Originality/value
The findings of the review reveal multiple cancer screening challenges for Somali communities and the gained insights should inform both health and social care practitioners and policymakers.
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Nicola Jane Spalding, Fiona Mary Poland, Sheila Gregory, Jane McCulloch, Kevin Sargen and Penny Vicary
– The purpose of this paper is to understand and develop ways to enhance patients’ experiences of preoperative education received prior to surgery for colorectal cancer.
Abstract
Purpose
The purpose of this paper is to understand and develop ways to enhance patients’ experiences of preoperative education received prior to surgery for colorectal cancer.
Design/methodology/approach
Based in the UK, three-action research cycles were undertaken to evaluate preoperative education, identify changes seen by patients and staff as likely to improve the service and to re-evaluate such changes following implementation. Data in each cycle were collected from: observations of clinic interactions; patient questionnaires; individual semi-structured interviews with multidisciplinary colorectal unit staff; longitudinal semi-structured interviews with patients and carers pre-surgery, two weeks post-surgery and 12 weeks post-surgery; patient and carer focus groups post-surgery; and existing educational material.
Findings
In total, 138 participants shared their experiences of either giving or receiving preoperative education. Findings were themed into why patients want preoperative education, and patients’ views of the educational processes.
Practical implications
Patients emphasised the need for educational provision to be fully understandable, comprehensive and client-centred using a range of communication processes. Patients emphasised the need for educational provision to be more fully understandable, comprehensive and client-centred and that important messages should be reinforced using a range of media. At a time of many uncertainties for patients’ lives, such education needed to encompass the experiences patients could expect, delivered by confident healthcare professionals.
Originality/value
Contextualising understanding and facilitating their own actions, enabled patients to regain control in circumstances particularly disruptive of bodily and other life routines. Establishing a sense of control is confirmed as important for patient's wellbeing in preparing for surgery and postoperative rehabilitation.
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Nenna Ndukwe, David W. Borowski, Angela Lee, Anne Orr, Sarah Dexter‐Smith and Anil K. Agarwal
There has been considerable interest in the “two‐week rule” referral pathway efficacy for patients with suspected colorectal cancer. This study aims to explore the psychological…
Abstract
Purpose
There has been considerable interest in the “two‐week rule” referral pathway efficacy for patients with suspected colorectal cancer. This study aims to explore the psychological impact on these patients.
Design/methodology/approach
Consecutive patients referred for urgent investigations under the “two‐week rule” were invited to take part in semi‐structured interviews using interpretative phenomenological analysis (IPA). Interviews were audio‐taped, transcribed verbatim and analysed using investigator triangulation to enhance data trustworthiness.
Findings
Ten out of 23 (43.5 per cent) patients consented to interviews; none were diagnosed with cancer. Four super‐ordinate themes were explored, referring to the “making sense of the threat to health”, impact on self, impact on others, reflections on the “two‐week rule” referral, and its investigative process. Participants reported their anxiety, fear, vulnerability and coping mechanisms, but also raised concerns about the communication received during the “two‐week rule” referral process. Female participants preferred a female endoscopist.
Originality/value
This study is the first of its kind exploring the psychological effects of the “two‐week rule” process for colorectal cancer, highlighting potential areas for improvement in patient information, and satisfaction with the referral process.
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Outlines the main proven dietary links for various forms of cancer – breast, colorectal, lung, prostate, bladder, gastric, cervical and ovarian, endometrial, pancreatic…
Abstract
Outlines the main proven dietary links for various forms of cancer – breast, colorectal, lung, prostate, bladder, gastric, cervical and ovarian, endometrial, pancreatic, oesophageal, laryngeal, oral and pharyngeal, testicular and melanoma. Provides some practical dietary advice in line with the UK Government’s recommendations.
Joanne Crawford, Farah Ahmad, Dorcas E. Beaton and Arlene S. Bierman
The purpose of this paper is to gain an in-depth understanding of beliefs, attitudes, and reasons for decision making about colorectal cancer (CRC) screening among South Asian…
Abstract
Purpose
The purpose of this paper is to gain an in-depth understanding of beliefs, attitudes, and reasons for decision making about colorectal cancer (CRC) screening among South Asian (SA) immigrants.
Design/methodology/approach
Six focus groups conducted in English, Punjabi, and Urdu were held with 42 SA immigrants, 50-74 years old and at average risk for CRC, from November 2012 to May 2013. All focus group discussions were audio-taped and transcribed verbatim. Data analysis used an inductive and systematic approach employing constant comparison techniques.
Findings
Three dominant themes emerged. Beliefs and attitudes towards cancer and screening represented SA immigrant’s perceptions that early detection was beneficial; screening was not necessary in the absence of symptoms; cancer was scary; and the loss of previously established bowel practices upon immigration as potential risks for CRC. Knowledge and awareness focused on unscreened participants’ cancer stories; screened participants’ knowledge of CRC, risk factors, and screening; experiential learning from focus groups; and screened participants’ strategies to promote screening. Support and accessibility concentrated on physician support and responsibility to provide information, explanation, and recommend screening to facilitate access.
Originality/value
Findings provide novel insights on socio-cultural context, beliefs, and barriers to CRC screening among SA immigrants. Culturally appropriate community-based strategies included story-telling, the use of social networks, and greater physician engagement. Enhancing collaborative partnerships with physicians and public health may minimize structural barriers and reduce health disparities. Future research could explore effectiveness of outreach strategies including these collaborations.
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David W. Borowski, Sarah Cawkwell, Syed M. Amir Zaidi, Matthew Toward, Nicola Maguire and Talvinder S. Gill
Higher caseloads are associated with better outcomes for many conditions treated in secondary and tertiary care settings, including colorectal cancer (CRC). There is little known…
Abstract
Purpose
Higher caseloads are associated with better outcomes for many conditions treated in secondary and tertiary care settings, including colorectal cancer (CRC). There is little known whether such volume-outcome relationship exist in primary care settings. The purpose of this paper is to examine general practitioner (GP) CRC-specific caseload for possible associations with referral pathways, disease stage and CRC patients’ overall survival.
Design/methodology/approach
The paper retrospectively analyses a prospectively maintained CRC database for 2009-2014 in a single district hospital providing bowel cancer screening and tertiary rectal cancer services.
Findings
Of 1,145 CRC patients, 937 (81.8 per cent) were diagnosed as symptomatic cancers. In total, 210 GPs from 44 practices were stratified according to their CRC caseload over the study period into low volume (LV, 1-4); medium volume (MV, 5-7); and high volume (HV, 8-21 cases). Emergency presentation (LV: 49/287 (17.1 per cent); MV: 75/264 (28.4 per cent); HV: 105/386 (27.2 per cent); p=0.007) and advanced disease at presentation (LV: 84/287 (29.3 per cent); MV: 94/264 (35.6 per cent); HV: 144/386 (37.3 per cent); p=0.034) was more common amongst HV GPs. Three-year mortality risk was significantly higher for HV GPs (MV: (hazard ratio) HR 1.185 (confidence interval=0.897-1.566), p=0.231, and HV: HR 1.366 (CI=1.061-1.759), p=0.016), but adjustment for emergency presentation and advanced disease largely accounted for this difference. There was some evidence that HV GPs used elective cancer pathways less frequently (LV: 166/287 (57.8 per cent); MV: 130/264 (49.2 per cent); HV: 182/386 (47.2 per cent); p=0.007) and more selectively (CRC/referrals: LV: 166/2,743 (6.1 per cent); MV: 130/2,321 (5.6 per cent); HV: 182/2,508 (7.3 per cent); p=0.048).
Originality/value
Higher GP CRC caseload in primary care may be associated with advanced disease and poorer survival; more work is required to determine the reasons and to develop targeted intervention at local level to improve elective referral rates.
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Mansoor Akhtar, Mohamed Boshnaq and Sathyan Nagendram
Delay in histologically confirming rectal cancer may lead to late treatment as histological confirmation is required prior to chemo-radiotherapy or surgical intervention…
Abstract
Purpose
Delay in histologically confirming rectal cancer may lead to late treatment as histological confirmation is required prior to chemo-radiotherapy or surgical intervention. Multidisciplinary colorectal meetings indicate that there are patients who require multiple tissue biopsy episodes prior to histologically confirming rectal cancer. The purpose of this paper is to examine a quality improvement (QI) measure’s impact on tissue biopsy process diagnostic yield.
Design/methodology/approach
The authors performed the study in two phases (pre- and post-QI), between February 2012 and April 2014 in a district general hospital. The QI measures were derived from process mapping a rectal cancer diagnostic pathway. The primary outcome was to assess the tissue biopsy process diagnostic yield. The secondary outcome included total breaches for a 62-day target in the pre- and post-QI study phases.
Findings
There was no significant difference in demographics or referral mode in both study phases. There were 81 patients in the pre-QI phase compared to 38 in the post-QI phase, 68 per cent and 74 per cent were referred via the two-week wait urgent pathway, respectively. Diagnostic tissue biopsy process yield improved from 58.1 to 77.6 per cent after implementing the QI measure (p=0.02). The 62-day target breach was reduced from 14.8 to 3.5 per cent (p=0.42).
Practical implications
Simple QI measures can achieve significant improvements in rectal cancer diagnostic tissue biopsy process yields. A multidisciplinary approach, involving process mapping and cause and effect modelling, proved useful tools.
Originality/value
A process mapping exercise and QI measures resulted in significant improvements in diagnostic yield, reducing the episodes per patient before histological diagnosis was confirmed.
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Cheryl L. Holt, Theresa A. Wynn, Ivey Lewis, Mark S. Litaker, Sanford Jeames, Francine Huckaby, Leonardo Stroud, Penny L. Southward, Virgil Simons, Crystal Lee, Louis Ross and Theodies Mitchell
Prostate and colorectal cancer (CRC) rates are disproportionately high among African‐American men. The purpose of this paper is to describe the development of an intervention in…
Abstract
Purpose
Prostate and colorectal cancer (CRC) rates are disproportionately high among African‐American men. The purpose of this paper is to describe the development of an intervention in which barbers were trained to educate clients about early detection for prostate and CRC.
Design/methodology/approach
Working with an advisory panel of local barbers, cancer survivors and clients, educational materials are developed and pilot tested through use of focus groups and cognitive response interviews.
Findings
The advisory panel, focus groups, and interviews provide key recommendations for core content, intervention structure, and evaluation strategies. The men suggest a variety of things they want to know about prostate cancer, however the perceived need for CRC information is much broader, suggesting a knowledge gap. The men prefer print materials that are brief, use graphics of real African‐American men, and provide a telephone number they can call for additional information.
Research limitations/implications
Community involvement is key in developing a well‐accepted and culturally‐relevant intervention.
Originality/value
The paper usefully describes the process of developing and pilot testing educational materials for use in an intervention in which barbers would be trained as community health advisors, to educate their clients about CRC screening and informed decision making for prostate cancer screening.
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