The clinical-care focused psychological interview (CLiC): A structured tool for the assessment of cancer patients’ needs

Integrating the psychosocial perspective in oncology is warranted. Here, we introduce a structured psychological intervention, the clinical-care focused psychological interview (CLiC), to address patients\u2019 needs in the relationship with health professionals, clinical pathway and decision-making process. The perceived utility and feasibility of the CLiC were evaluated in a preliminary sample of 30 patients who were candidates to undergo a radical cystectomy at the European Institute of Oncology, Milan, Italy. Patients reported a very high satisfaction with the interview, because it prepared them for their upcoming surgery by gathering more information about their clinical pathway and allowed them to discover the information they still needed. 30% stated that CLiC helped them to reorganise their thoughts and 36.7% understood the role of psychological intervention in the clinical pathway. Only 20% considered the CLiC useful in helping to build their relationship with the clinical staff. Before an invasive surgery such as radical cystectomy, patients\u2019 need for information regarding the upcoming surgery seems to prevail. Knowing the future consequences and adjusting toward the disease could be paramount for patients in facing uncertainty and they might feel that creating a relationship with physicians could be a secondary issue. However, our data show that a structured psychological intervention such as the CLiC interview can collect important information for patients and healthcare professionals to develop real patient-centred care

The patient perspective: Investigating patient empowerment enablers and barriers within the oncological care process

Patient empowerment is a multi-factorial concept and its relevance has led to a growing body of literature; despite this attention, there is still no agreement regarding the elements that define its expression. While several studies have already investigated the positive effect of empowerment interventions on the care process outcome, the aim of this study is to investigate which factors can foster an empowered management of the cancer condition from the patient\u2019s perspective. To examine patients\u2019 perception of empowerment enablers, we asked for participants\u2019 input on the role of three factors frequently cited as positively affected by empowerment: care quality, perception of direct control and relationships within the care context, during the care process. Three focus groups were conducted with 34 cancer patients. The results highlight the perception of direct control on their treatment as the least valued element (2.87, SD 0.566) when compared with care quality (3.75, SD 0.649) and relational support in the care context (3.91, SD 0.274). Unlike traditional approaches to empowerment, patient\u2019s expression of empowerment does not mainly reside in the direct control of their condition as much as in an active role within the relationship with caretakers, such as the ability to choose the doctor, the care team or the health organisation in charge of their healthcare. Emerging aspects from this analysis of patient\u2019s perspective are central in order to adequately consider empowerment in the care process and to provide more effective care strategies

Design, Conduct and Use of Patient Preference Studies in the Medical Product Life Cycle

Objectives: To investigate stakeholder perspectives on how patient preference studies (PPS) should be designed and conducted to allow for inclusion of patient preferences in decision-making along the medical product life cycle (MPLC), and how patient preferences can be used in such decision-making. Methods: Two literature reviews and semi-structured interviews (n = 143) with healthcare stakeholders in Europe and the US were conducted; results of these informed the design of focus group guides. Eight focus groups were conducted with European patients, industry representatives and regulators, and with US regulators and European/Canadian health technology assessment (HTA) representatives. Focus groups were analyzed thematically using NVivo. Results: Stakeholder perspectives on how PPS should be designed and conducted were as follows: 1) study design should be informed by the research questions and patient population; 2) preferred treatment attributes and levels, as well as trade-offs among attributes and levels should be investigated; 3) the patient sample and method should match the MPLC phase; 4) different stakeholders should collaborate; and 5) results from PPS should be shared with relevant stakeholders. The value of patient preferences in decision-making was found to increase with the level of patient preference sensitivity of decisions on medical products. Stakeholders mentioned that patient preferences are hardly used in current decision-making. Potential applications for patient preferences across industry, regulatory and HTA processes were identified. Four applications seemed most promising for systematic integration of patient preferences: 1) benefit-risk assessment by industry and regulators at the marketing-authorization phase; 2) assessment of major contribution to patient care by European regulators; 3) cost-effectiveness analysis; and 4) multi criteria decision analysis in HTA. Conclusions: The value of patient preferences for decision-making depends on the level of collaboration across stakeholders; the match between the research question, MPLC phase, sample, and preference method used in PPS; and the sen

Fateci domande intelligenti. Adolescenti e adulti alla ricerca di prossimità nelle valli e dolomiti friulane. Nuova ediz

Gli adolescenti e gli adulti del nuovo millennio sperimentano, per motivi diversi, una condizione inedita di incertezza che si riflette nelle relazioni e si palesa soprattutto nei contesti educativi (famiglia, scuola, parrocchia, vita sociale...). Trovare una “bussola” per orientarsi è una sfida che chiede sia agli uni sia agli altri di cercarsi, trovarsi e comprendersi. Dalla consapevolezza che è compito di tutta la comunità nelle sue molteplici ramificazioni sostenere questa sfida è nata l’iniziativa di ricerca-azione partecipata raccontata nel volume, che ha coinvolto il Tavolo Educativo Don Milani, i Servizi Sociali che operano nel territorio delle Valli e Dolomiti friulane e l’Osservatorio Giovani dell’Istituto Toniolo. Il progetto si è avvalso della metodologia già utilizzata per la ricerca nazionale dell’Osservatorio Giovani al fine di dar voce agli adolescenti, avviare uno scambio-confronto con gli adulti e promuovere un’autentica “generatività sociale”

People’s willingness to donate blood: Agent-based approach

In cases where a trial-and-error experiment is costly or impossible, especially in healthcare industry, researchers have used simulation modeling to avoid the risk caused by a trial-and-error experiment. In healthcare industry, blood supply plays an important role because the shortage of blood could make people’s life at risk. In most countries in Southeast Asia, including Indonesia, blood services have not been considered as an essential service for healthcare support program. Moreover, blood supply chain in low-and-middle-income countries has different characteristics and challenges compared to the high-income countries. For developing countries, one of the important factors is the number of donors. This research conducted to see how the agent makes decision about donating their blood. Finding