The Comprehensive Cancer Center

This open access book provides a valuable resource for hospitals, institutions, and health authorities worldwide in their plans to set up and develop comprehensive cancer care centers. The development and implementation of a comprehensive cancer program allows for a systematic approach to evidence-based strategies of prevention, early detection, diagnosis, treatment, and palliation. Comprehensive cancer programs also provide a nexus for the running of clinical trials and implementation of novel cancer therapies with the overall aim of optimizing comprehensive and holistic care of cancer patients and providing them with the best opportunity to improve quality of life and overall survival. This book's self-contained chapter format aims to reinforce the critical importance of comprehensive cancer care centers while providing a practical guide for the essential components needed to achieve them, such as operational considerations, guidelines for best clinical inpatient and outpatient care, and research and quality management structures. Intended to be wide-ranging and applicable at a global level for both high and low income countries, this book is also instructive for regions with limited resources. The Comprehensive Cancer Center: Development, Integration, and Implementation is an essential resource for oncology physicians including hematologists, medical oncologists, radiation oncologists, surgical oncologists, and oncology nurses as well as hospitals, health departments, university authorities, governments and legislators

“Is there anything else you would like to tell us?” – A thematic analysis of free-text comments from a self-management questionnaire with people affected by cancer

Background: Researchers are frequently using open-ended questions at the end of questionnaires that invite respondents to add, in their own words, further information about issues covered in the questionnaire. The aim of this study was to present the qualitative findings from the further information section at the end of a questionnaire that was designed to collect data on aspects of self-management in people affected by cancer. Methods: Respondents were asked: ‘Thinking about how you manage your health and health care, if there is anything else you would like to tell us about your experience, please write in the box below.’ Free-text responses were analysed thematically. Results: 128 participants completed the free-text response at the end of the questionnaire. The main overarching theme was the concept of the participants “moving on” from cancer and developing a meaningful life for themselves following diagnosis and treatment. For most, this incorporated making adjustments to their physical, social, psychological, spiritual and emotional wellbeing. “Luck” was another overwhelming theme where many participants stated they were “glad to still be alive” and “consider myself very lucky.” Participants reported adjustments made to health behaviours such as leading an active lifestyle and making changes to their diet and nutrition. The final theme incorporates the participants identifying their main sources of support, both clinical and non-clinical, some of which they stated “could not have done it without them.” Conclusions: The findings highlight the valuable insight that free-text comments can add as a data source at the end of self-completion questionnaires with people affected by cancer

Addressing Distress Management Challenges: Recommendations From the Consensus Panel of the American Psychosocial Oncology Society and the Association of Oncology Social Work

Distress management (DM) (screening and response) is an essential component of cancer care across the treatment trajectory. Effective DM has many benefits, including improving patients’ quality of life; reducing distress, anxiety, and depression; contributing to medical cost offsets; and reducing emergency department visits and hospitalizations. Unfortunately, many distressed patients do not receive needed services. There are several multilevel barriers that represent key challenges to DM and affect its implementation. The Consolidated Framework for Implementation Research was used as an organizational structure to outline the barriers and facilitators to implementation of DM, including: 1) individual characteristics (individual patient characteristics with a focus on groups who may face unique barriers to distress screening and linkage to services), 2) intervention (unique aspects of DM intervention, including specific challenges in screening and psychosocial intervention, with recommendations for resolving these challenges), 3) processes for implementation of DM (modality and timing of screening, the challenge of triage for urgent needs, and incorporation of patient-reported outcomes and quality measures), 4) organization—inner setting (the context of the clinic, hospital, or health care system); and 5) organization—outer setting (including reimbursement strategies and health-care policy). Specific recommendations for evidence-based strategies and interventions for each of the domains of the Consolidated Framework for Implementation Research are also included to address barriers and challenges. CA Cancer J Clin 2021;71:407-436. © 2021 The Authors. CA: A Cancer Journal for Clinicians published by Wiley Periodicals LLC on behalf of American Cancer Society. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial- NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made

Perioperative Care

Perioperative care practices worldwide are in the midst of a seeing change with the implementation of multidisciplinary processes that improve surgical outcomes through (1) better patient education, engagement, and participation; (2) enhanced pre-operative, intra-operative, and post-operative care bundles; and (3) interactive audit programs that provide feedback to the surgical team. These improved outcomes include reductions in the frequency and severity of complications and improved throughput, which ultimately reduce operative stress. Practices in theatre as well as ward are becoming more collaborative and evidence-driven.This book is best utilized by perioperative care team members engaged in quality improvement, collaborative practice, and application of innovations in surgical care

Development and Initial Testing of a Care Coordination mHealth Application for Families of Children with Down Syndrome

Children with Down syndrome (DS) often require health care from multiple providers and are at increased risk for missed care coordination, potentially leading to gaps in care. Care coordination or the linking together of health information and members of health care team, is vital to ensure components of health care are not missed. This responsibility, along with maintaining health information, often falls to a family caregiver. A personal health record (PHR) is the health information maintained by caregivers outside of the medical record and helps caregivers manage care coordination. To support caregivers, we needed to better understand their care coordination needs. This dissertation was designed to describe the care coordination needs of caregivers of children with DS and design a mHealth application addressing those needs to be used as a PHR. A scoping review of literature explored prior research on the care coordination needs of families of children with DS found that communication, information, and utilization of resources were critical components of successful care coordination. A mixed methods study investigated care coordination needs and technology use of caregivers and health care providers. Both caregivers and health care providers reported valuing communication as well as the ability to manage health information and resources, monitor adherence to current health care guidelines for children with DS, and coordinate appointment schedules. These findings were then used to develop prototype of a mHealth app to serve as a PHR and support family caregivers’ care coordination needs. 321Connect was developed using principles of user centered design with end users, caregivers of children with DS, participating in each phase of the design process. Initial usability testing elicited positive feedback from family caregivers who reported 321Connect had strong potential for supporting caregivers in coordinating care and maintaining a PHR.Doctor of Philosoph

Home cancer care research: a bibliometric and visualization analysis (1990-2021)

Home cancer care research (HCCR) has accelerated, as considerable attention has been placed on reducing cancer-related health costs and enhancing cancer patients' quality of life. Understanding the current status of HCCR can help guide future research and support informed decision-making about new home cancer care (HCC) programs. However, most current studies mainly detail the research status of certain components, while failing to explore the knowledge domain of this research field as a whole, thereby limiting the overall understanding of home cancer care. We carried out bibliometric and visualization analyses of Scopus-indexed papers related to home cancer care published between 1990-2021, and used VOSviewer scientometric software to investigate the status and provide a structural overview of the knowledge domain of HCCR (social, intellectual, and conceptual structures). Our findings demonstrate that over the last three decades, the research on home cancer care has been increasing, with a constantly expanding stream of new papers built on a solid knowledge base and applied to a wide range of research themes