Background:As the advent of genomic technology accelerates personalized medicine and complex care, multidisciplinary care is essential for management of breast cancer.Objectives:To assess whether healthcare delivery systems are related to patients’ perceptions of care in breast cancer treatment institutions.Methods:We conducted a cross-sectional nationwide study of breast cancer treatment institutions approved by the Japanese Breast Cancer Society in Japan. From 128 of the 457 institutions, 1,206 patients were included in the analysis. Each patient completed a questionnaire regarding perceptions of care that consisted of a multidisciplinary care subscale and a patient-centered care subscale.Results:Multiple regression analysis revealed that the multidisciplinary care subscale was significantly related to implementation of patient-based medical record system that was paper-based (p<0.05). The results of the secondary analysis showed a significant relationship between the interdepartmental medical record system and the patient’s perception of multidisciplinary care (p<0.05) and patient-centered care (p<0.05). When a multidisciplinary case conference took place regularly or multidisciplinary viewpoints were incorporated into the conference records, the conference had a significantly higher correlation with both subscales (p<0.001).Conclusions:Integrated patient-based information and regular multidisciplinary case conferences that include records of viewpoints from different professionals improve patients’ perceptions of comprehensive breast cancer care.
Objective
Patients with malignant gliomas have to adjust their daily lives because of the threat of impending death and declining abilities. Thus, clarifying the process of life adjustment in such patients would help them lead a normal life. To clarify the process of life adjustment in patients at the onset of glioma, who continuously receive oral anticancer drug.
Methods
The study institution consisted of two designated cancer centers. Semi-structured interviews were conducted with 10 patients, and the data were analyzed using the Modified Grounded Theory Approach of Kinoshita (M-GTA).
Results
As a core category representing the process of life adjustment in patients at the onset of glioma, “trials and errors for self-fulfillment even in a limited lifespan” was extracted. Patients began “seeking information about the unfamiliar life-threatening disease,” and “imaging their uncertain lives after the disease and the resulting disability” while “conducting repeated trials and errors to establish coping methods according to their abilities.” When facing difficulties in such trials and errors, they reported “losing self-confidence due to unexpected limitations.” However, they regulated their feelings by “resigning themselves to their unchangeable reality.” Contrarily, as “functional improvement enhanced their motivation to recover,” they attempted to promote functional recovery and organized their daily lives in “fulfilling their desires in their limited lifespan.”
Conclusion
The process of life adjustment in patients with malignant gliomas involved identifying a way of living despite limited lifespan. To ensure appropriate nursing care for patients at the onset of glioma, it is important to help them establish coping methods in accordance with their abilities.
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