scholarly journals Evaluation of the delivery of survivorship care plans for South Asian female breast cancer survivors residing in Canada

2018 ◽  
Vol 25 (4) ◽  
Author(s):  
S. Singh-Carlson ◽  
F. Wong ◽  
G. Oshan

Background This paper focuses on phase iii of a study evaluating the development and implementation of a survivorship care plan (scp) that could ultimately improve post-treatment quality of life for South Asian (sa) breast cancer survivors (bcss). Evaluating the utility of the scp was important to understand how sociocultural influences might affect uptake of the scp by sa bcss, especially as they transition from treatment to community care.Methods Post-treatment discharge planning using an individualized scp at discharge for sa female breast cancer patients with stage i or ii disease was offered as a pilot service to oncologists at BC Cancer’s Fraser Valley and Abbotsford centres. A longitudinal study using a mixed-methods approach was used to evaluate the utility of that service at 1 year after discharge.Results Participants (n = 16) completed a survey about their scp delivery experience, and a 1-year post implementation survey about the scp content and its utility. Most participants reported the discharge appointments to be extremely or very helpful with respect to post-treatment care questions. All have visited their family physicians for follow-up as recommended. The three major sources of support were family, faith, and family physician. Qualitative responses from the health care professionals who developed or implemented the scps identified two challenges in scp delivery: engaging patients or family members in relationship, and translating key information through interpreters.Conclusions It is important to evaluate the utility of scps for sa female survivors, who might differ from the general bcs population because of a different understanding of the disease; language barriers; strong influence of family members; societal stigmas; and personal, social, cultural, and religious beliefs and values. A formal nurse-led discharge appointment with discussions about follow-up care and an individualized scp outlining the short- and long-term effects of treatment are recommended. Particular attention has to be paid to the practical and psychosocial needs of sa bcss and their supporting family members.

Healthcare ◽  
2020 ◽  
Vol 8 (3) ◽  
pp. 285
Author(s):  
José Manuel Tánori-Tapia ◽  
Ena Monserrat Romero-Pérez ◽  
Néstor Antonio Camberos ◽  
Mario A. Horta-Gim ◽  
Gabriel Núñez-Othón ◽  
...  

Among female breast cancer survivors, there is a high prevalence of lymphedema subsequent to axillary lymph node dissection and axillary radiation therapy. There are many methodologies available for the screening, diagnosis and follow-up of breast cancer survivors with or without lymphedema, the most common of which is the measurement of patients’ arm circumference. The purpose of this study was to determine the intra-rater minimal detectable change (MDC) in the volume of the upper limb, both segmentally and globally, using circumference measurements for the evaluation of upper limb volume. In this study, 25 women who had received a unilateral mastectomy for breast cancer stage II or III participated. On two occasions separated by 15 min, the same researcher determined 11 perimeters for each arm at 4 cm intervals from the distal crease of the wrist in the direction of the armpit. The MDC at the segmental level ranged from 3.37% to 7.57% (2.7 to 14.6 mL, respectively) and was 2.39% (42.9 mL) at the global level of the arm; thus, minor changes in this value result in a high level of uncertainty in the interpretation of the results associated with the diagnosis of lymphedema and follow-up for presenting patients.


2012 ◽  
Vol 30 (34_suppl) ◽  
pp. 168-168
Author(s):  
Erin E. Hahn ◽  
Kaizeen C. Mody ◽  
Amy Ann Jacobson ◽  
Patricia A. Ganz

168 Background: The American Society of Clinical Oncology (ASCO) released a “Top Five” list of opportunities to improve the quality of cancer care. #4 focused on post-treatment surveillance in breast cancer patients treated with curative intent. The ASCO guideline on breast cancer follow up advises against using advanced imaging and biomarkers in this setting. We undertook an examination of the patterns of follow-up care for breast cancer survivors treated at an academic medical center to evaluate use of non-recommended services. Methods: Claims data and medical records were reviewed and abstracted for early stage (0-IIIA) breast cancer survivors starting one year post diagnosis, with an average of 5 years of follow-up data. A trained abstractor classified imaging tests as diagnostic/surveillance based on medical record content. A 10% random sample was abstracted by a second abstractor and compared for concordance. Descriptive statistics were generated for patient demographic and medical characteristics, and proportions for receipt of non-recommended services, including if imaging procedures were performed for diagnostic/surveillance purposes. Multivariate logistic regression modeling was used to determine factors associated with receiving non-recommended services. Results: Records were available for 258 patients. The mean age was 62 (SD 13), mean time since diagnosis was 6 years (SD 2), 66% were stage 0/1. 35% received at least one abdominal CT, 31% at least one chest CT, 20% at least one PET, 30% at least one bone scan. Of these services, 90 abdominal CT scans (47%), 131 chest CT scans (65%), 77 PET scans (90%), and 29 bone scans (26%) were classified as surveillance. 80% received CEA and/or CA 27.29 tests; 8% received CA 15-3 tests. Logistic regression revealed no consistent association of medical, demographic, or provider factors with receiving non-recommended services. Conclusions: Use of non-recommended services for surveillance occurs frequently among early stage survivors. Providers in this academic center had no personal financial incentive for ordering these services. There are opportunities to increase use of guideline concordant post-treatment care for breast cancer survivors.


10.2196/23414 ◽  
2020 ◽  
Vol 9 (12) ◽  
pp. e23414
Author(s):  
Akshat Kapoor ◽  
Priya Nambisan

Background Breast cancer is the most common form of cancer among American women, accounting for 23% of all cancer survivors nationally. Yet, the availability of adequate resources and tools for supporting breast cancer survivors has not kept up with the rapid advancement in treatment options, resulting in unmet supportive care needs, particularly among low-income and minority populations. This study explores an alternative means of delivering breast cancer survivorship care plans (SCPs), with the aim of improving survivor morbidity, patient knowledge, and self-management of treatment-related symptoms, as well as addressing inconsistencies in follow-up care visits. Objective The overall goal of this study is to improve the uptake of SCP recommendations via an educational intervention for breast cancer survivors, to improve treatment-related morbidity, patient knowledge, self-management, and adherence to follow-up visits. The specific aims of the study are to (1) evaluate the feasibility of the online SCP, and (2) assess the impact of the online SCP on survivorship outcomes. Methods We will enroll 50 breast cancer survivors who have completed initial breast cancer treatment into a 2-armed, randomized, waitlist-controlled pilot trial, and collect data at baseline and 6 months. For the first aim, we will use mixed methods, including surveys and personal interviews among the intervention group, to determine the feasibility of providing an online, interactive SCP (called ACESO) based on the survivors’ online user experience and their short-term adoption. For the secondary aim, we will compare the 2 groups to assess the primary outcomes of survivor knowledge, self-efficacy for self-management, perceived peer support, and adherence to SCP-recommended posttreatment follow-up visits to oncology and primary care; and the secondary outcomes of treatment-related morbidity (body weight, fatigue, depression, anxiety, sexual function, distress, and sleep quality). We assess these outcomes by using measurements from validated instruments with robust psychometric properties. Results We have developed and refined the online breast cancer survivorship plan, ACESO, with consultation from breast cancer oncologists, nurses, and survivors. Approval for the study protocol has been obtained from the Institutional Review Board. An advisory board has also been established to provide oversight and recommendations on the conduct of the study. The study will be completed over a period of 2 years. Conclusions The results of this pilot study will inform the feasibility and design of a larger-scale pragmatic trial to evaluate the impact of an online breast cancer SCP on treatment-related morbidity and self-efficacy for self-management. International Registered Report Identifier (IRRID) PRR1-10.2196/23414


Author(s):  
Juan Gavala-González ◽  
Amanda Torres-Pérez ◽  
José Carlos Fernández-García

The aim of this study was to determine whether a rowing training program improved the quantity and quality of physical activity and quality of life in female breast cancer survivors (stage I - 4.35%; II - 30.43%; III - 52.17%; and IV - 8.7%) diagnosed 6.57 ± 5.02 years previously, who had undergone a subsequent intervention (preservation 53.52%; total mastectomy 39.13% and double mastectomy 4.35%) and had a current mean age of 53.70 ± 7.88 years. The participants (N = 30) engaged in a 12-week training program, each week comprising three sessions and each session lasting 60-90 minutes. An anthropometric evaluation was performed before and after the program. The short form of the International Physical Activity Questionnaire (IPAQ-SF) and the Short Form 36 Health Survey (SF-36) were also administered. The results showed statistically significant improvements in levels of physical activity and in the dimensions of quality of life. We can conclude that a 12-week rowing training program tailored to women who have had breast cancer increases physical activity levels, leading to improved health status and quality of life.


2012 ◽  
Vol 10 (Supplement) ◽  
pp. 1-15 ◽  
Author(s):  
Teri A. Martin ◽  
Rose M. Moran-Kelly ◽  
Joanna G. Powe ◽  
Lucy M. Roberts ◽  
Sandra N. Farrell ◽  
...  

2021 ◽  
Vol 11 (10) ◽  
pp. 135
Author(s):  
Francisco Aguiar-Fernández ◽  
Yolanda Rodríguez-Castro ◽  
Mercedes Botija ◽  
Rosana Martínez-Román

The objective of this study was to analyze the experiences of returning to work of women who had overcome breast cancer, identifying its physical and psychological consequences, the process they underwent, their motivations, and difficulties. A total of 19 female breast cancer survivors, with an age range of 30 to 57 years, participated in two focus groups. A semi-structured script was prepared about their experiences of returning to work. The results indicated that survivors’ self-perception was weakened by the physical and psychological consequences of the treatment of the disease; economic difficulties were one of the main reasons for going back to work; lastly, returning to work was a difficult process, mainly because of their physical/psychological limitations, the scarcity of job adaptation measures, and the limited support of the various public administrations. In addition, most of the women had to cope with seeking a new job without any guidance or job training. Significant difficulties related to the maintenance and return to work of female breast cancer survivors have been revealed. Findings highlighted the need to provide more and better information and guidance to cancer patients concerning their return to work or the search for a new job.


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