scholarly journals Sociodemographic Predictors of Breast Reconstruction Procedure Choice: Analysis of the Mastectomy Reconstruction Outcomes Consortium Study Cohort

2015 ◽  
Vol 2015 ◽  
pp. 1-9 ◽  
Author(s):  
Tiffany N. S. Ballard ◽  
Yeonil Kim ◽  
Wess A. Cohen ◽  
Jennifer B. Hamill ◽  
Adeyiza O. Momoh ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Breast Reconstruction ◽  
Prophylactic Mastectomy ◽  
Patient Centered Care ◽  
Sociodemographic Factors ◽  
Study Cohort ◽  
Full Time ◽  
Patient Centered ◽  
Centered Care ◽  
The Impact

Background. To promote patient-centered care, it is important to understand the impact of sociodemographic factors on procedure choice for women undergoing postmastectomy breast reconstruction. In this context, we analyzed the effects of these variables on the reconstructive method chosen. Methods. Women undergoing postmastectomy breast reconstruction were recruited for the prospective Mastectomy Reconstruction Outcomes Consortium Study. Procedure types were divided into tissue expander-implant/direct-to-implant and abdominally based flap reconstructions. Adjusted odds ratios were calculated from logistic regression. Results. The analysis included 2,203 women with current or previous breast cancer and 202 women undergoing prophylactic mastectomy. Compared with women <40 years old with current or previous breast cancer, those 40 to 59 were significantly more likely to undergo an abdominally based flap. Women working or attending school full-time were more likely to receive an autologous procedure than those working part-time or volunteering. Women undergoing prophylactic mastectomy who were ≥50 years were more likely to undergo an abdominal flap compared to those <40. Conclusions. Our results indicate that sociodemographic factors affect the reconstructive procedure received. As we move forward into a new era of patient-centered care, providing tailored treatment options to reconstruction patients will likely lead to higher satisfaction and better outcomes for those we serve.

Socioeconomic Disparities in Post-Mastectomy Breast Reconstruction: Modifiable Difference or Patient-Centered Care?

2020 ◽  
Vol 231 (4) ◽  
pp. S42
Author(s):  
Trista J. Stankowski-Drengler ◽  
Esra Alagoz ◽  
Jessica R. Schumacher ◽  
Samuel O. Poore ◽  
Heather B. Neuman
Keyword(s):  
Breast Reconstruction ◽  
Patient Centered Care ◽  
Socioeconomic Disparities ◽  
Patient Centered ◽  
Centered Care

The impact of breast reconstruction on the decision to undergo contralateral prophylactic mastectomy.

2011 ◽  
Vol 29 (27_suppl) ◽  
pp. 96-96
Author(s):  
L. J. McGhan ◽  
B. A. Pockaj ◽  
R. J. Gray ◽  
S. P. Bagaria ◽  
S. A. McLaughlin ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Multivariate Analysis ◽  
Breast Reconstruction ◽  
Prophylactic Mastectomy ◽  
Contralateral Prophylactic Mastectomy ◽  
Tumor Grade ◽  
Breast Cancer Patients ◽  
Unilateral Breast Cancer ◽  
The Impact ◽  
Implant Reconstruction

96 Background: In the last decade there has been an increase in the incidence of contralateral prophylactic mastectomy (CPM) for unilateral breast cancer. Although many factors have been proposed to explain this trend, the impact of breast reconstruction on the decision to undergo CPM has not been extensively studied. Methods: A retrospective review of breast cancer patients from Surveillance, Epidemiology and End Results (SEER) registry data (2004-2008) was conducted. Characteristics of patients undergoing CPM were evaluated. Results: 71,176 patients with a diagnosis of stage I-III infiltrating ductal or lobular breast cancer underwent mastectomy for their primary lesion. Among these, 10,558 patients (15%) underwent a CPM. A significantly higher proportion of women undergoing CPM had reconstruction performed (44%) than those patients not undergoing CPM (13%), p<0.001. On multivariate analysis (Table), significant variables predicting CPM included age <50 years (OR 10.12), breast reconstruction (OR 3.58), and lobular histology (OR 1.41), all p<0.001. Of the 12,466 patients (18%) who underwent reconstruction, 4,636 (37%) had implant reconstruction, 4,498 (36%) had tissue reconstruction, and 1,122 (9%) had combined tissue/implant reconstruction (no data for 18%). On multivariate analysis, predictors of reconstruction included age <50 years (OR 20.5; CI 18.5-22.7), year of surgery (2008 vs. 2004; OR 1.60; CI 1.49-1.71), low tumor grade (OR 1.19; CI 1.13-1.25) and ER+ status (OR 1.16; 95% CI 1.10-1.23). The use of radiation therapy was associated with a lower likelihood of pursuing reconstruction (OR 0.61; CI 0.58-0.65). Conclusions: Apart from age, the factor most strongly associated with CPM is the decision to have reconstructive surgery performed. This suggests that CPM may not be purely associated with risk-reduction but also with treatment factors such as cosmesis. [Table: see text]

scholarly journals A Multilevel Study of Patient-Centered Care Perceptions In Mental Health Teams

2020 ◽  
Author(s):  
Francois Durand ◽  
Marie-Josée Fleury
Keyword(s):  
Mental Health ◽  
Interprofessional Collaboration ◽  
Patient Centered Care ◽  
Multidisciplinary Teams ◽  
Patient Centered ◽  
Cross Sectional ◽  
Team Processes ◽  
Interprofessional Care ◽  
Centered Care ◽  
The Impact

Abstract Background: The combination of interprofessional collaboration in teams and patient-centered care is a necessary amalgamation when it comes to delivering complex mental healthy care and services. Yet collaboration is challenging and patient-centered care is intricate to manage. This study examines the impact of predictors of patient-centered care such as team adaptivity and proactivity, collaboration, belief in interprofessional collaboration, informal role self-efficacy in multidisciplinary mental health teams.Method: Cross-sectional multilevel design using self-administered bilingual validated questionnaires.Results: This study showed that belief in interprofessional collaboration’s impact on patient-centered perceptions is increased in teams with high collaboration. We also showed that collaboration is a mediator; that is, a process by which team adaptive and proactive behaviors are transformed into positive patient-centered perceptions.Conclusions: In terms of research our results are in line with recent theorising on team processes and specifically established collaboration as key in a multilevel examination of predictors of patient-centered care perceptions. In terms of practice, we showed that multidisciplinary teams should know that working hard on collaboration as an answer to the complexity of patient-centered care impacts the teams’ ability to respond to its challenges but also impacts individuals’ beliefs central to the delivery of interprofessional care.

Screening Ultrasound for Women with Dense Breasts in the Age of Patient-centered Care

2018 ◽  
Vol 1 ◽  
pp. 14
Author(s):  
Stamatia Destounis ◽  
Andrea Arieno ◽  
Amanda Santacroce
Keyword(s):  
Breast Cancer ◽  
Risk Factor ◽  
Breast Imaging ◽  
Breast Tissue ◽  
Patient Centered Care ◽  
Dense Breast ◽  
Patient Centered ◽  
Dense Breast Tissue ◽  
Dense Breasts ◽  
Centered Care

As the field of medicine moves toward practicing patient-centered care, radiologists in breast imaging must continue to look for ways to increase the value of their practice in the eyes of patients. Providing adjunct screening of women with dense breasts provides such an opportunity. The presence of dense breast tissue is not only an independent risk factor for breast cancer but also a risk factor for the delayed diagnosis of breast cancer as dense tissue reduces the efficacy of screening mammograms due to the tissue masking effect. As legislation for notifying women of their breast density becomes commonplace, both women and referring physicians need to understand the risks of dense breast tissue as well as the benefits of additional screening affords. Breast radiologists can become integral to their patients’ care team by offering education to both referring providers and patients on the topic of dense breasts and supplemental screening solutions, such as screening breast ultrasound, which has been shown to have benefit in overcoming mammography’s shortcomings in this demographic of women.

Baseline evaluation of the patient-centered oncology care model.

2014 ◽  
Vol 32 (30_suppl) ◽  
pp. 50-50
Author(s):  
Manasi A. Tirodkar ◽  
Sarah Hudson Scholle
Keyword(s):  
Patient Centered Care ◽  
Care Planning ◽  
Coordinated Care ◽  
Motivation To Change ◽  
Care Model ◽  
Patient Centered ◽  
Centered Care ◽  
Oncology Care ◽  
The Impact ◽  
The Way

50 Background: The patient-centered medical home (PCMH) model of care is being widely adopted as a way to provide accessible, proactive, coordinated care and self-care through primary care practices. During active treatment for cancer, the oncology practice is often the primary setting supporting the patient and coordinating cancer treatment. For this project, we are implementing a Patient-centered Oncology Care model in five oncology practices and evaluating the impact on cost, quality, and patient experiences. Methods: To determine the structures and processes present in the practices at baseline, we conducted a self-assessment on the standards, followed with an on-site “audit” for compliance with the standards. To get a sense for organizational culture and motivation to change, we conducted site visits which included interviews with providers, staff and patients and observation of clinical encounters and workflow. Results: Among the highest priority structures and processes, the most common were telephone triage, symptom management, advance care planning, and the use of evidence-based guidelines. The least common were patient/family orientation, availability of same day appointments, discussion and documentation of goals of therapy, symptom assessment, and tracking of appointments. All of the practices had made patient-centered care a priority and staff were motivated to change. There was variation in the way providers and the care team used health information technology during clinical workflow. There was also variation in which staff coordinated care for patients and whether or not financial counseling was offered. All of the practices stated that they needed to work on implementing survivorship care planning, shared decision-making, and patient engagement in quality improvement and practice transformation Conclusions: The pilot oncology practices have many structures and processes in common. However, there is little standardization within practices in the way these processes are established and documented. Practices vary in how they are implementing patient-centered care processes. However, with motivation to change, staff and providers are actively engaged in the transformation process.

scholarly journals Multimorbidity: An Issue of Growing Importance for Oncologists

2011 ◽  
Vol 7 (6) ◽  
pp. 371-374 ◽  
Author(s):  
Christine S. Ritchie ◽  
Elizabeth Kvale ◽  
Michael J. Fisch
Keyword(s):  
Cancer Care ◽  
Patient Centered Care ◽  
Care Plan ◽  
Patient Centered ◽  
Centered Care ◽  
The Impact

Recognition of the impact of multiple co-occurring conditions on a patient's cancer care plan and development of strategies to address the challenges associated with multimorbidity will enable oncologists to provide higher quality, patient-centered care.

scholarly journals Patient-centered care at Joslin: Reflections of a mirror

2014 ◽  
Vol 02 (01) ◽  
pp. 045-047
Author(s):  
Paul Madden
Keyword(s):  
Personal Communication ◽  
Patient Centered Care ◽  
Patient Centered ◽  
The Past ◽  
Diabetes Educator ◽  
Past Half Century ◽  
Centered Care ◽  
Real Essence ◽  
The Impact ◽  
Past Half

AbstractThis personal communication describes the practical aspects of patient-centered care (PCC), as viewed by a person with diabetes, who is also a diabetes educator. He describes his encounters with two leading diabetologists, who practiced the real essence of PCC. The author also explains the impact these patient-centered doctors had on him, and how it has shaped his personal as well as professional life, over the past half century.

Optimizing Patient-Centered Care in Breast Reconstruction

2013 ◽  
Vol 132 (2) ◽  
pp. 212e-220e ◽  
Author(s):  
Adelyn L. Ho ◽  
Anne F. Klassen ◽  
Stefan Cano ◽  
Amie M. Scott ◽  
Andrea L. Pusic
Keyword(s):  
Breast Reconstruction ◽  
Patient Centered Care ◽  
Patient Centered ◽  
Centered Care
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