Evidence on municipality-based cancer rehabilitation is sparse. This longitudinal study explores: 1) Rehabilitation needs, 2) effectiveness of municipality-based rehabilitation, and 3) whether rehabilitative services are stratified according to individual needs in breast cancer patients. MethodsWe collected data from a longitudinal survey among 82 breast cancer patients referred to municipalitybased rehabilitation at the Copenhagen Centre for Cancer and Health. Rehabilitation needs, Health Related Quality of Life (HRQoL) and functional status were collected using patient reported outcomes (PROs) including: Distress thermometer, problem list, Functional Assessment of Cancer Therapy -Breast questionnaire (FACT-B), and upper body function with the abbreviated Disability of the arm, shoulder and hand questionnaire (Quick-DASH). Data collection time points: entry, follow-up and end of intervention. ResultsAt referral, scores were (mean (range)): distress 4.0 (0-10), problems 9.5 (0-24), and FACT-B 103.0 (49.8-135.5). HRQoL increased during rehabilitation (FACT-B ∆ mean 8.1 points (> MID, p <0.0001)); 56% had a positive change, 34% no difference, and 11% a decline. Those with the lowest FACT-B entry score had significantly longer duration of rehabilitation (10.9 vs. 8.7 month, p<0.001), higher number of services (7.0 vs 5.3, p<0.003), and participated more in group-based exercise (+3 sessions: 57% vs 8%, P<0.001). Conclusion 3This is the first study to report on pragmatic municipality-based cancer rehabilitation. The results suggest that services are aimed at patients with rehabilitation needs, improves HRQoL, and are properly stratified to those who need it the most. We suggest future monitoring of municipality-based rehabilitation services to ensure quality of care.
a b s t r a c tIntroduction: The Convention on the Rights of the Child will be absorbed into Swedish law by 2020, which highlights the need to promote equality in communication between health care professionals and communicatively vulnerable children. In this regard, participation and person-centredness is important in the interaction with each child to provide adequate information on the peri-radiographic process in a way that the child can understand. Hence, the aim was to develop communication support for interaction with children during acute radiographic procedures. Method: The study has a qualitative design adapting a multiphase structure. A participatory design was used which included four phases conducted in succession to each other. Interviews were conducted with children from Elementary School and Special School. Questionnaires were collected from their parents and from radiographers in four different Radiology Departments. Results: The analysis of the data highlighted the need for information in the peri-radiographic process. Parents and children wanted material that is easy to use and could be adapted in a person-centred way. Conclusion: A prototype of the ICIR (interactive communication support in radiology settings), with illustrations and accompanying text was developed that can be useful as information sharing in interaction between children, parents and health care professionals in the radiographic context. Implications for practice: The ICIR can be a usable tool for information sharing in the interaction between children, parents and health care professionals during radiographic procedures.
Introduction:The radiography profession is challenged by greater responsibilities and shortage of educated radiographers. Implementation of task shifting is one strategy to deal with the current situation in health care. The aim of this studiy was to evaluate radiographers' perception of assistant nurses and nurses carrying out tasks that traditionally were undertaken within the radiography profession in a Swedish context. Methods: An electronic questionnaire was distributed to radiographers at eleven hospitals in Sweden. The questionnaire included background questions and questions about radiographers' perception about task shifting to nurses and assistant nurses. The respondents rated their agreement level regarding task shifting on a five-point Likert scale. Data was statistically evaluated in SPSS using Mann Whitney U test. Results: Sixty-five radiographers participated in the study. Most radiographers responded negatively to task shifting to nurses (72%) or assistant nurses (65%). Most radiographers disagree that nurses should perform mammography screening or work within interventional radiography, while the attitude towards nurses calculating glomerular filtration rate was more positive. A majority disagree regarding assistant nurses performing conventional radiographs, informing the patient about contrast media administration or inserting peripheral intravenous catheters, while there was a positive attitude towards assistant nurses preparing patients for examinations. The attitude towards task shifting was not influenced by age, however radiographers with less working experience were more positive to task shifting in general. Conclusion:A majority of the radiographers had a negative attitude towards task shifting to nurses and assistant nurses. The radiographers were more positive to hand over tasks related to patient care and administrative tasks than technical related tasks within the profession. Implications for practice: Knowledge about radiographers' perception on task shifting within the profession is essential when planning and implementing strategies for task shifting in the clinical settings.
BackgroundHigh technological environments can be challenging for children with autism spectrum disorders (ASD), because they can be sensitive to new environments, new faces and changes in daily routines. Those children are frequent visitors in those settings, and due to their heightened healthcare needs and their comorbidities, it could constitute a challenge for healthcare professionals to encounter those children. Exploring the healthcare professionals' experiences can contribute to facilitate the procedure for a child with ASD.MethodA qualitative descriptive retrospective design with a critical incident technique has been used to capture the situations. Twenty healthcare professionals were interviewed about situations affecting the procedure in the high‐technology environments, defined as anaesthesia and radiology departments.ResultThe findings revealed both favourable situations and unfavourable situations affecting the procedure in the high‐technology environment. The situations described by the healthcare professionals often involved their interactions with the child and the parents. The interactions were influenced by the parents' attitudes to the procedure and also the healthcare professionals and the parents' different expectations on the procedure. Other experiences described by the healthcare professionals were the unpredictability in different situations. Those situations were related to the child's unpredictable behaviour in those environments and also to the unpredictable effect of premedication provided to the child. Moreover, the result revealed the organizational prerequisites for facilitating a procedure, such as not feeling any time pressure when leading a child through a procedure.ConclusionsInteractions between healthcare professionals, children with ASD and parents in the high‐technology environment are complex. Unpredictability characterizes situations when leading a child with ASD through a procedure. This place demands on the healthcare professional, the environment and the organization.
Background Children with autism spectrum disorders are frequent visitors in high technology environments, and their needs might differ from typically developed peers. A procedure in high technology environment can constitute a challenge for those children and their parents, as the environments presents many challenges in relation to the child’s impairment. The aim of this systematic review was to explore the experiences that children with autism spectrum disorders, and their parents have of procedures in a high technology environment. Method For this systematic review, the following sources were searched: Cochrane CENTRAL trials, CINAHL, Dentistry & Oral Sciences Source, MEDLINE, PsycInfo, Scopus, and the Web of Science Core Collection. Search terms included variants of the following concepts: 1) children with autism spectrum disorder and/or their parents; and 2) anesthesia or radiographic departments. Publications were not limited by date or study design. Result Out of 13389 bibliographic records, nine studies were eligible for synthesis. None of the studies reported the children’s experiences, all nine reported the parents’ experiences. Only one study was from the radiographic context. After a renewed search during October 2022 one more study was eligible for synthesis. The parents’ experiences were both positive and negative and categorized into two main categories 1) challenges in a new environment; and 2) health care professionals’ approaches. Conclusion There is a lack of studies describing children’s experiences of procedures in high technology environments. The parents experienced a need for the health care professionals to work in structured ways with their child and to be able to make adaptations before the encounter in conjunction with the procedure. Systematic review registration: This systematic review was registered in advance on the Open Science Framework, https://doi.org/10.17605/OSF.IO/5TXWJ.
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