scholarly journals Best-Evidence Rehabilitation for Chronic Pain Part 2: Pain during and after Cancer Treatment

2019 ◽  
Vol 8 (7) ◽  
pp. 979 ◽  
Author(s):  
An De Groef ◽  
Frauke Penen ◽  
Lore Dams ◽  
Elien Van der Gucht ◽  
Jo Nijs ◽  
...  
Keyword(s):  
Cancer Treatment ◽  
Health Care Providers ◽  
Exercise Therapy ◽  
Educational Interventions ◽  
Management Approach ◽  
Supporting Evidence ◽  
Care Providers ◽  
Breast Cancer Patients ◽  
General Exercise ◽  
After Cancer

Pain during, and especially after, cancer remains underestimated and undertreated. Moreover, both patients and health care providers are not aware of potential benefits of rehabilitation strategies for the management of pain during and following cancer treatment. In this paper, we firstly provided a state-of-the-art overview of the best evidence rehabilitation modalities for patients having (persistent) pain during and following cancer treatment, including educational interventions, specific exercise therapies, manual therapies, general exercise therapies and mind-body exercise therapies. Secondly, the findings were summarized from a clinical perspective and discussed from a scientific perspective. In conclusion, best evidence suggests that general exercise therapy has small pain-relieving effects. Supporting evidence for mind-body exercise therapy is available only in breast cancer patients. At this moment, there is a lack of high-quality evidence to support the use of specific exercises and manual therapy at the affected region for pain relief during and after cancer treatment. No clinically relevant results were found in favor of educational interventions restricted to a biomedical approach of pain. To increase available evidence these rehabilitation modalities should be applied according to, and within, a multidisciplinary biopsychosocial pain management approach. Larger, well-designed clinical trials tailored to the origin of pain and with proper evaluation of pain-related functioning and the patient’s pain experience are needed.

scholarly journals Mapping the Expert Mind: Integration Method for Revising the ACES Medical Simulation Curriculum

2020 ◽  
Vol 7 ◽  
pp. 238212052091327
Author(s):  
Pierre Cardinal ◽  
Glenn Barton ◽  
Kirk DesRosier ◽  
Sharon Yamashita ◽  
Angèle Landriault ◽  
...  
Keyword(s):  
Critically Ill ◽  
Health Care Providers ◽  
Educational Interventions ◽  
The Body ◽  
Critically Ill Patient ◽  
Critical Event ◽  
Supporting Evidence ◽  
Care Providers ◽  
Early Management ◽  
Knowledge Repository

Purpose: This article shares our experience developing an integrated curriculum for the ACES (Acute Critical Event Simulation) program. The purpose of the ACES program is to ensure that health care providers develop proficiency in the early management of critically ill patients. The program includes multiple different types of educational interventions (mostly simulation-based) and targets both specialty and family physicians practicing in tertiary and community hospitals. Methods: To facilitate integration between different educational interventions, we developed a knowledge repository consisting of cognitive sequence maps that make explicit the flow of cognitive activities carried out by experts facing different situations - the sequence maps then serving as the foundation upon which multimodal simulation scenarios would be built. To encourage participation of experts, we produced this repository as a peer-reviewed ebook. Five national organizations collaborated with the Royal College of Physicians and Surgeons of Canada to identify and recruit expert authors and reviewers. Foundational chapters, centered on goals/interventions, were first developed to comprehensively address most tasks conducted in the early management of a critically ill patient. Tasks from the foundational chapters were then used to complete the curriculum with situations. The curriculum development consisted of two-phases each followed by a peer-review process. In the first phase, focus groups using web-conferencing were conducted to map clinical practice approaches and in the second, authors completed the body of the chapter (e.g., introduction, definition, concepts, etc.) then provided a more detailed description of each task linked to supporting evidence. Results: Sixty-seven authors and thirty-five peer reviewers from various backgrounds (physicians, pharmacists, nurses, respiratory therapists) were recruited. On average, there were 32 tasks and 15 situations per chapter. The average number of focus group meetings needed to develop a map (one map per chapter) was 6.7 (SD ± 3.6). We found that the method greatly facilitated integration between different chapters especially for situations which are not limited to a single goal or intervention. For example, almost half of the tasks of the Hypercapnic Ventilatory Failure chapter map were borrowed from other maps with some modifications, which significantly reduced the authors’ workload and enhanced content integration. This chapter was also linked to 6 other chapters. Conclusions: To facilitate curriculum integration, we have developed a knowledge repository consisting of cognitive maps which organize time-sensitive tasks in the proper sequence; the repository serving as the foundation upon which other educational interventions are then built. While this methodology is demanding, authors welcomed the challenge given the scholarly value of their work, thus creating an interprofessional network of educators across Canada.

scholarly journals Massage Therapy in Outpatient Cancer Care: A Metropolitan Area Analysis

2017 ◽  
Vol 22 (4) ◽  
pp. 851-855 ◽  
Author(s):  
Virginia S. Cowen ◽  
Robin Streit Miccio ◽  
Bijal Parikh
Keyword(s):  
Health Care ◽  
Cancer Treatment ◽  
Cancer Patients ◽  
Health Care Providers ◽  
Metropolitan Area ◽  
Health Care Professionals ◽  
Treatment Plan ◽  
Therapeutic Touch ◽  
Care Providers ◽  
Systematic Analysis

Massage offers cancer patients general quality of life benefits as well as alleviation of cancer-related symptoms/cancer-treatment–related symptoms including pain, anxiety, and fatigue. Little is known about whether massage is accessible to cancer patients who receive treatment in the outpatient setting and how massage is incorporated into the overall cancer treatment plan. Outpatient cancer centers (n = 78) in a single metropolitan area were included this mixed-methods project that included a systematic analysis of website information and a telephone survey. Massage was offered at only 40 centers (51.3% of total). A range of massage modalities were represented, with energy-based therapies (Reiki and Therapeutic Touch) most frequently provided. Although massage therapists are licensed health care providers in the states included in this analysis, massage was also provided by nurses, physical therapists, and other health care professionals.

Systematic Review of Preventing Suicide in Old Age: 2005–2010

2011 ◽  
Vol 26 (S2) ◽  
pp. 2020-2020
Author(s):  
C.A. de Mendonça Lima ◽  
R.M. Rodrigues
Keyword(s):  
Health Care ◽  
Old Age ◽  
Health Care Providers ◽  
The Elderly ◽  
Educational Interventions ◽  
List Type ◽  
Care Providers ◽  
Individual Level ◽  
Survivors Of Suicide ◽  
Somatic Disorders

Suicide is a typical phenomenon of the elderly and mainly among men. Besides the importance of suicide in terms of public health there is fewer interest to prevent suicide in old age. This can be explained by stigma, poor evaluation of the dimension of the problem and lack of politic will.Suicide prevention and the care of survivors of suicide depend on the mental health network of care. Interventions to reduce suicide can be made at individual level and at level of the development of policies and strategies. The detection of the persons at risk of suicide and the management of the suicide attempt are two main strategies to prevent suicide. Both received recently an important support from WHO with its publication mhGAP Intervention Guide which was conceived to be used in non-specialized health-care settings by health-care providers working at first- and second-level facilities. It includes guidance on evidence-based interventions to make the diagnosis and manage a number of priority conditions, including suicide.Our review of the literature pointed to the necessity to develop additional research to determine:•the role of somatic disorders as precipitant factor;•the role on suicide of the pre-morbid personality, cognitive functioning, social support and recent and chronic stressing events;•the participation of normal and pathological ageing on the expression of the suicide behavior;•the biological markers of suicide in old age;•the potential impact on suicide rates of educational interventions for the general public and for caregivers.

Social Influence and Health

2015 ◽  
Author(s):  
Leslie R. Martin ◽  
M. Robin DiMatteo
Keyword(s):  
Health Behaviors ◽  
Health Care Providers ◽  
Good Deal ◽  
Educational Interventions ◽  
System Level ◽  
Care Providers ◽  
Positive Health ◽  
Public Health Programs ◽  
Media Messages ◽  
Health Related

Early in the lives of children, parental influences are strong, and interventions targeting parents are essential to behavior change. In adolescence, peers emerge as critical additions to the influence of family members; their influence can support the growth and maintenance of positive health behaviors, or it can encourage unhealthy choices. Social groups continue to feature prominently in various ways throughout adulthood. A crucial role is played by supportive social networks in the improvement and maintenance of a wide variety of health behaviors, and the availability of normative information affects health choices. Health care providers hold a good deal of power in the practitioner–patient relationship and influence their patients toward health outcomes in a variety of ways. Finally, system-level influences such as public health programs, health-related media messages, and educational interventions can help motivate individuals toward ideal health behaviors.

scholarly journals Impact of Treatments on the Family of Breast, Prostate, Colon and Lung Cancer Patients

2017 ◽  
Vol 6 (1) ◽  
pp. 61
Author(s):  
Philippe Groux ◽  
Sandro Anchisi ◽  
Thomas Szucs
Keyword(s):  
Lung Cancer ◽  
Health Care ◽  
Cancer Treatment ◽  
Health Care Providers ◽  
Private Practice ◽  
Cancer Type ◽  
Care Providers ◽  
Cancer Treatments ◽  
Lung Cancer Patients ◽  
The Family

Objective: Many patients describe travel to cancer treatment as inconvenient and a practical hardship and it may be perceived or experienced as a barrier to treatment. We investigated which impact cancer treatments has on the family of the patients, especially for the most frequent cancer type prostate, breast, colon and lung cancer.The aim was to identify groups of patients with an increased burden for the family.Method: All patients coming in February 2012 for chemotherapy to one of the four centres of the hospital or to the unique private practice were asked to answer a survey. The questionnaire covered items as gender, date of birth, living place, kind of cancer, kind of treatment and questions covering different aspects of the travel: how the patient travelled to the centre, how long the travel lasted, which kind of support was necessary to travel and who provided this support, whether the accompanying person had to absent herself from her workplace, whether the patient lives alone or not and how many journeys to health care providers the patients had in the last month were included in the analysisResults: 298 patients answered to all required questions (73%). 186 came accompanied, a vast majority by a member of the family and one out of four of the accompanying person had to leave the workplace. Help at home is almost exclusively provided by family members. Patients have several journeys to health care providers per month.Conclusions: The type of cancer has an impact on the support needed and must added to the previously published factors as age, gender and distance. The journey to the cancer treatment is not the unique journey to health care providers the patients have and increase the burden for the patient and the family.

scholarly journals Seeking Mind, Body and Spirit Healing–-Why Some Men with Prostate Cancer Choose CAM (Complementary and Alternative Medicine) over Conventional Cancer Treatments

2008 ◽  
Vol 3 ◽  
pp. IMI.S377 ◽  
Author(s):  
Margaret A. White ◽  
Marja J. Verhoef ◽  
B.J. Davison ◽  
Hal Gunn ◽  
Karen Cooke
Keyword(s):  
Prostate Cancer ◽  
Alternative Medicine ◽  
Cancer Treatment ◽  
Complementary And Alternative Medicine ◽  
Health Care Providers ◽  
Conventional Treatment ◽  
Lifestyle Changes ◽  
Care Providers ◽  
Prostate Cancer Treatment ◽  
Complementary And Alternative

Little is known about men with prostate cancer who decline conventional treatment and use only complementary and alternative medicine (CAM). Objectives To 1) explore why men decline conventional prostate cancer treatment and use CAM 2) understand the role of holistic healing in their care, and 3) document their recommendations for health care providers. Methods Semi-structured interviews and follow-up focus groups. Sample Twenty-nine men diagnosed with prostate cancer who declined all recommended conventional treatments and used CAM. Results Based on strong beliefs about healing, study participants took control by researching the risks of delaying or declining conventional treatment while using CAM as a first option. Most perceived conventional treatment to have a negative impact on quality of life. Participants sought healing in a broader mind, body, spirit context, developing individualized CAM approaches consistent with their beliefs about the causes of cancer. Most made significant lifestyle changes to improve their health. Spirituality was central to healing for one-third of the sample. Participants recommended a larger role for integrated cancer care. Conclusion Men who decline conventional prostate cancer treatment and use CAM only may benefit from a whole person approach to care where physicians support them to play an active role in healing while carefully monitoring their disease status.

scholarly journals Developmental and Behavioral Pediatricians' Attitudes Toward Screening for Fragile X

2013 ◽  
Vol 118 (4) ◽  
pp. 284-293 ◽  
Author(s):  
Kruti Acharya ◽  
Abigail Schindler
Keyword(s):  
Health Care ◽  
Newborn Screening ◽  
Fragile X Syndrome ◽  
Health Care Providers ◽  
Response Rate ◽  
Fragile X ◽  
Educational Interventions ◽  
Care Providers ◽  
Cross Sectional Survey ◽  
Cross Sectional

Abstract Developmental and behavioral pediatricians (DBP) diagnose and care for children with fragile X syndrome. Their attitudes toward FMR1 newborn screening (NBS) and FMR1 carrier testing in childhood could highlight potential pitfalls with FMR1 NBS. We conducted a cross-sectional survey with an adjusted response rate of 61%. Among DBP, 74% supported universal FMR1 NBS, preferring to identify both full mutations and premutations. DBP also support FMR1 testing of asymptomatic siblings. Although DBP support testing for premutations at various points in the lifespan, DBP are not familiar with the array of fragile X–associated disorders (FXAD). Targeted educational interventions are needed to ensure that all health care providers have the knowledge and competence to consent and to counsel families on FXAD.

scholarly journals Use of traditional and complementary medicine among Norwegian cancer patients in the seventh survey of the Tromsø study

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Agnete Egilsdatter Kristoffersen ◽  
Trine Stub ◽  
Ann Ragnhild Broderstad ◽  
Anne Helen Hansen
Keyword(s):  
Health Care ◽  
Herbal Medicine ◽  
Cancer Treatment ◽  
Cancer Patients ◽  
Complementary Medicine ◽  
Health Care Providers ◽  
Care Providers ◽  
Conventional Cancer Treatment ◽  
Self Help ◽  
Natural Remedies

Abstract Background Traditional and complementary medicine (T&CM) is commonly used by cancer patients in Northern Norway, in particular spiritual forms like traditional healing. T&CM is mainly used complementary to conventional cancer treatment and is rarely discussed with conventional health care providers, increasing the risk of negative interaction with conventional cancer care. The aim of this study was to investigate the use of T&CM among cancer patients in Tromsø, and to investigate the differences in T&CM use between people living with cancer, people with cancer previously, and people without a history of cancer. Method Data was drawn from the seventh survey of the Tromsø study conducted in 2015–2016. All inhabitants of Tromsø aged 40 and above were invited to participate (n = 32,591) of whom n = 21,083 accepted the invitation (response rate 65%). Data was collected thorough three self-administered questionnaires and a comprehensive clinical examination. Pearson chi-square tests, Fisher exact tests and one-way ANOVA tests were used to describe differences between the groups while binary logistic regressions were used for adjusted values. Results Eight percent of the participants (n = 1636) reported to have (n = 404) or have had (n = 1232) cancer. Of the participants with cancer at present 33.4% reported use of T&CM within the last year, 13.6% had consulted a T&CM provider, 17.9% had used herbal medicine/natural remedies and 6.4% had practiced self-help techniques. The participants with cancer at present were more likely to have visited a T&CM provider than participants with cancer previously (13.6% vs. 8.7%, p = 0.020). Among the participants with cancer at present, 6.4% reported to have consulted a TM provider, 5.8% had consulted an acupuncturist, while 4.7% had consulted other CM providers. Women were significantly more likely than men to have used acupuncture and self-help techniques. No significant gender differences were found regarding visits to other CM providers, TM providers nor use of herbal medicine/natural remedies. Conclusion The findings are in line with previous research suggesting that both men and women use TM complementary to other CM modalities outside the official health care system. As herbal medicine might interact with conventional cancer treatment, health care providers need to discuss such use with their patients.

scholarly journals Improving Access to Cancer Treatments: The Role of Biosimilars

2017 ◽  
Vol 3 (5) ◽  
pp. 596-610 ◽  
Author(s):  
Rakesh Chopra ◽  
Gilberto Lopes
Keyword(s):  
Health Care ◽  
Cancer Treatment ◽  
Health Care Providers ◽  
Cost Effective ◽  
Cancer Therapies ◽  
Care Providers ◽  
Cancer Treatments ◽  
Reference Drug ◽  
Effective Use ◽  
The Cost

Biologics play a key role in cancer treatment and are principal components of many therapeutic regimens. However, they require complex manufacturing processes, resulting in high cost and occasional shortages in supply. The cost of biologics limits accessibility of cancer treatment for many patients. Effective and affordable cancer therapies are needed globally, more so in developing countries, where health care resources can be limited. Biosimilars, which have biologic activity comparable to their corresponding reference drugs and are often more cost effective, have the potential to enhance treatment accessibility for patients and provide alternatives for decision makers (ie, prescribers, regulators, payers, policymakers, and drug developers). Impending patent expirations of several oncology biologics have opened up a vista for the development of corresponding biosimilars. Several countries have implemented abbreviated pathways for approval of biosimilars; however, challenges to their effective use persist. Some of these include designing appropriate clinical trials for assessing biosimilarity, extrapolation of indications, immunogenicity, interchangeability with the reference drug, lack of awareness and possibly acceptance among health care providers, and potential political barriers. In this review, we discuss the potential role and impact of biosimilars in oncology and the challenges related to their adoption and use. We also review the safety and efficacy of some of the widely used biosimilars in oncology and other therapeutic areas (eg, bevacizumab, darbepoetin, filgrastim, rituximab, and trastuzumab).

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