Search results

1 – 10 of over 1000
To view the access options for this content please click here
Article
Publication date: 3 May 2013

Eileen O'Donnell, Paul D'Alton, Conor O'Malley, Finola Gill and Áine Canny

The psycho-oncology and social work services recognised that a cancer diagnosis and treatment can result in considerable emotional consequences for patients, yet the…

Abstract

Purpose

The psycho-oncology and social work services recognised that a cancer diagnosis and treatment can result in considerable emotional consequences for patients, yet the referral rate to both services was extremely low. Only very visibly distressed patients were being referred to the service. The “Distress Thermometer” (DT), a distress screening tool, was introduced as a pilot project with day care and inpatient oncology patients of St Vincent ' s University Hospital, Dublin, in an effort to improve the identification, management and treatment of psychological distress in oncology patients. The purpose of this paper is to evaluate the effectiveness of this new intervention.

Design/methodology/approach

The Psycho-oncology service in conjunction with the Medical Social Work Department and Nursing Management at St Vincent ' s University Hospital, Dublin, initiated a Distress Education Management and Training Programme (DEMP). The initiative involved providing a training programme for oncology nursing staff and the introduction of a distress-screening tool for patients. In 1998, the DT was developed and validated for evaluation of distress (and depression) in cancer. It was adopted into recommendations made by the US National Comprehensive Cancer Network. The DT is a simple, self-report, pencil and paper measure consisting of a line with a 0-10 scale anchored at the zero point with “No distress” and at scale point ten with “Extreme distress”. Patients are given the instruction, “How distressed have you been during the past week on a scale of 0-10”? Patients indicated their level of distress with a mark on the scale. Patients scoring 4 or above were regarded as requiring intervention. The DT includes a problem checklist. The patient is asked to identify those problems from the checklist which are contributing to their score. The use of the DT was evaluated through interviews with patients and professionals.

Findings

Patients who scored four or above (38 per cent of patients), were seen by the Oncology Social Worker for psychosocial assessment and mental health triage. Patients who scored above a certain level (usually above 12/20) in the clinical range on the Hospital Anxiety and Depression scale (3 per cent) were referred to Psycho-oncology. That 38 per cent of oncology patients required intervention from a specialist service accurately reflects international findings on the rate of distress among cancer patients.

Practical implications

Assessment of cancer patients ' distress levels in a structured and planned manner with a Distress Thermometer, as recommended by best international practice, works very effectively and should be considered for all cancer out-patients This will have implications in terms of staff that will be required to manage such a service.

Originality/value

This was the first time that this internationally recognised tool was used to such an extent and to positive effect in an Irish context.

Details

International Journal of Health Care Quality Assurance, vol. 26 no. 4
Type: Research Article
ISSN: 0952-6862

Keywords

To view the access options for this content please click here
Article
Publication date: 9 November 2020

Ellen Belitzky, Christian Bach and Erika Belitzky

This study aims to understand how healthcare social media offer nonmedical psycho-social support for pediatric oncology patients and their care community and how social…

Abstract

Purpose

This study aims to understand how healthcare social media offer nonmedical psycho-social support for pediatric oncology patients and their care community and how social media can be exploited for healthcare knowledge management.

Design/methodology/approach

Social media capabilities were identified and categorized based on psycho-social support services for pediatric oncology patients, caregivers and their community of care. Data were collected from 187 service sites representing more than 100 organizations. These broadly defined capabilities in trusted care organizations were analyzed to understand use of social media in providing psycho-social support.

Findings

Analysis revealed resource guides, stories and in-person support at clinics as the most prevalent forms of technology-guided psycho-social support. Privacy, security and information integrity rose as technical challenges for interactive social media platforms. Medical community trust is inconsistent, leading to immature adoption of critical psycho-social support as a knowledge management source. Findings further indicate the not-for-profit support sector provides robust social media capabilities compared to the healthcare sector.

Research limitations/implications

Future research may extend to maturing healthcare and not-for-profit sector services and to private sector products such as mobile applications and other technologies.

Practical implications

Survivor and caregiver quality of life depend on psycho-social support communities and services delivered via social media.

Social implications

Child protection social implications require significant attention due to sensitivity of security, privacy concerns and longevity of digital footprints for pediatric patients.

Originality/value

Research demonstrates opportunity for medical provider, healthcare organization, not-for-profit sector, patient and caregiver cooperation using social media. Data indicate healthcare technology systems leveraging social media can extend knowledge management capability beyond organization boundaries.

Details

Measuring Business Excellence, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 1368-3047

Keywords

To view the access options for this content please click here
Article
Publication date: 31 December 2020

Risha Fayyaz, Fasih Ali Ahmed, Adeel Abid, Afshan Akhtar, Rabail Jarwar, Anila Jasmine, Sameer Ahmad Khan, Shahira Shahid, Iraj Khan, Aneeq Muhammad Yousuf and Imtiaz Jehan

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…

Abstract

Purpose

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.

Design/methodology/approach

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.

Findings

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.

Research limitations/implications

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.

Practical implications

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.

Social implications

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.

Originality/value

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.

Details

International Journal of Health Care Quality Assurance, vol. 34 no. 1
Type: Research Article
ISSN: 0952-6862

Keywords

To view the access options for this content please click here
Book part
Publication date: 23 October 2003

Erica S Breslau

The sequence of stress, distress and somatization has occupied much of the late twentieth-century psychological research. The anatomy of stress can be viewed from…

Abstract

The sequence of stress, distress and somatization has occupied much of the late twentieth-century psychological research. The anatomy of stress can be viewed from interactional and hybrid theories that suggest that the individual relates with the surroundings by buffering the harmful effects of stressors. These acts or reactions are called coping strategies and are designed as protection from the stressors and adaptation to them. Failure to successfully adapt to stressors results in psychological distress. In some individuals, elevated levels of distress and failed coping are expressed in physical symptoms, rather than through feelings, words, or actions. Such “somatization” defends against the awareness of the psychological distress, as demonstrated in the psychosocial literature. The progression of behavior resulting from somatic distress moves from a private domain into the public arena, involving an elaborate medicalization process, is however less clear in sociological discourse. The invocation of a medical diagnosis to communicate physical discomfort by way of repeated use of health care services poses a major medical, social and economic problem. The goal of this paper is to clarify this connection by investigating the relevant literature in the area of women with breast cancer. This manuscript focuses on the relationship of psychological stress, the stress response of distress, and the preoccupation with one’s body, and proposes a new theoretical construct.

Details

Gender Perspectives on Health and Medicine
Type: Book
ISBN: 978-1-84950-239-9

To view the access options for this content please click here
Article
Publication date: 3 November 2020

Yasemın Özyer and Safiye Yanmış

This review, which was created specifically for cancer care by reviewing the literature, was prepared to provide suggestions for determining the current difficulties in…

Abstract

Purpose

This review, which was created specifically for cancer care by reviewing the literature, was prepared to provide suggestions for determining the current difficulties in cancer care during COVID-19 outbreak and managing these difficulties. It is thought that this review can contribute to the identification of deficiencies related to the subject, to create interest in this issue in our country and in the world and to guide patients in the care during the COVID-19 pandemic process.

Design/methodology/approach

The literature search was carried out using the following electronic seven databases. Search terms used included: “COVID-19”, “management of cancer care” and “cancer care”. Articles meeting the following criteria were included in the current review: articles published in English, articles published in peer-reviewed journals and articles and guidelines published in 2020, articles suggesting management of cancer care during the COVID-19 outbreak.

Findings

The findings suggest that new guidelines need to be created to assess the level of problems in cancer treatment and in hospital, to respond appropriately with the best available resources during COVID-19 outbreak.

Originality/value

This paper seeks to provide suggestions for determining the current difficulties in cancer care during COVID-19 outbreak and managing these difficulties. By doing so, it is believed the suggestions presented will contribute significantly to the quality of cancer care during COVID-19 outbreak.

Details

International Journal of Emergency Services, vol. 10 no. 1
Type: Research Article
ISSN: 2047-0894

Keywords

To view the access options for this content please click here
Case study
Publication date: 20 January 2017

Tim Calkins and Aggarwal Nayna

This case looks at an important business task: forecasting a new product. The case can be used to teach finance, marketing (new product introduction), and healthcare…

Abstract

This case looks at an important business task: forecasting a new product. The case can be used to teach finance, marketing (new product introduction), and healthcare strategy. The product is one of Amgen's most important new products: denosumab. On the surface, the case is fairly easy; students simply have to do some simple mathematical calculations. However, the challenges of forecasting quickly become apparent; every forecast depends on some critical assumptions, and the answer can vary dramatically.

Highlight the importance of forecasting as a business task. Give students the opportunity to create a forecast, using logical assumptions to generate an answer. Illustrate how dramatically forecasts can vary. Demonstrate why sensitivity analysis and customer understanding are both critical when trying to forecast a new product launch.

Details

Kellogg School of Management Cases, vol. no.
Type: Case Study
ISSN: 2474-6568
Published by: Kellogg School of Management

Keywords

To view the access options for this content please click here
Article
Publication date: 13 June 2016

Y. L. Basta, K. M.A.J. Tytgat, J. H.G. Klinkenbijl, P. Fockens and E. M.A. Smets

Guidelines stating maximum waiting times fail to take cancer patients’ expectations into account. Therefore, the purpose of this paper is to assess patients’ expectations…

Abstract

Purpose

Guidelines stating maximum waiting times fail to take cancer patients’ expectations into account. Therefore, the purpose of this paper is to assess patients’ expectations and experiences with their waiting time at a fast-track clinic.

Design/methodology/approach

Patients were selected using a purposeful sampling strategy and were interviewed four times: before the visit; one day after; two weeks after the visit; and one week after starting treatment. Interviews were audiotaped and independently coded by two researchers.

Findings

All patients (n=9) preferred a short waiting time before the first visit; they feared that their disease would spread and believed that cancer warrants priority treatment. Six patients experienced the waiting time as short, one had no expectations and two felt they waited longer than expected; three patients changed this evaluation during the study. Six patients received treatment – four preferred to wait before treatment and two wanted to start treatment immediately. Reasons to wait included putting one’s affairs in order, or needing to adjust to the diagnosis.

Practical implications

Cancer patients prefer a short waiting time before the first visit but have different expectations and needs regarding waiting time before treatment. Ideally, their expectations are managed by their treating physician to match waiting time reality.

Originality/value

This is the first study to assess cancer patients’ waiting time experiences and how these experiences change over time. This study paves the way for establishing a framework to better assess patient satisfaction with oncology care waiting time. An important aspect, is managing patients’ expectations.

Details

International Journal of Health Care Quality Assurance, vol. 29 no. 5
Type: Research Article
ISSN: 0952-6862

Keywords

To view the access options for this content please click here
Article
Publication date: 13 September 2011

Diwa Pandey, Mohammed H. Buzgeia, Safaa A.E. Badr, Faiza Gheith Senussi, Haifa Ibrahim El‐Mokasabi and Aisha Mohammed El‐Shahomi

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…

Abstract

Purpose

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.

Design/methodology/approach

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.

Findings

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.

Practical implications

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.

Originality/value

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

Details

Nutrition & Food Science, vol. 41 no. 5
Type: Research Article
ISSN: 0034-6659

Keywords

To view the access options for this content please click here
Article
Publication date: 21 March 2008

Anna Gagliardi, Louise Lemieux‐Charles, Adalsteinn Brown, Terry Sullivan and Vivek Goel

The purpose of this paper is to show that performance data use could be promoted with a better understanding of the type of indicators that are important to different…

Abstract

Purpose

The purpose of this paper is to show that performance data use could be promoted with a better understanding of the type of indicators that are important to different stakeholders. This study explored patient, nurse, physician and manager preferences for cancer care quality indicators.

Design/methodology/approach

Interviews were held with 30 stakeholders between March and June 2004. They were asked to describe how they would use a cancer “report card”, and which indicators they would want reported. Transcripts were reviewed using qualitative analysis.

Findings

Role (patient, nurse, physician, manager) influenced preferences and perceived use of performance data. Patients and physicians were more skeptical than nurses and managers; patients and managers expressed some preferences distinct from nurses and physicians; and patients and nurses interpreted indicators more broadly than physicians and managers. All groups preferred technical process over outcome or interpersonal process indicators.

Research limitations/implications

Expressed views are not directly applicable beyond this setting, or to the general public but findings are congruent with attitudes to performance data for other conditions, and serve as a conceptual basis for further study.

Practical implications

Strategies for maximizing the relevance of performance reports might include technical process indicators, selection by multi‐stakeholder deliberation, information that facilitates information application and customizable report interfaces.

Originality/value

Performance data preferences have not been thoroughly examined, particularly in the context of cancer care. Factors were identified that influence stakeholder views of performance data, and this framework could be used to confirm findings among larger and different populations.

Details

International Journal of Health Care Quality Assurance, vol. 21 no. 2
Type: Research Article
ISSN: 0952-6862

Keywords

To view the access options for this content please click here
Article
Publication date: 11 February 2019

Yu-Li Huang, Sarah M. Bach and Sherry A. Looker

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…

Abstract

Purpose

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.

Design/methodology/approach

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.

Findings

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.

Research limitations/implications

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

Originality/value

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

Details

International Journal of Health Care Quality Assurance, vol. 32 no. 1
Type: Research Article
ISSN: 0952-6862

Keywords

1 – 10 of over 1000