Objective To develop a set of quality criteria for patient decision support technologies (decision aids). Design and setting Two stage web based Delphi process using online rating process to enable international collaboration. Participants Individuals from four stakeholder groups (researchers, practitioners, patients, policy makers) representing 14 countries reviewed evidence summaries and rated the importance of 80 criteria in 12 quality domains on a 1 to 9 scale. Second round participants received feedback from the first round and repeated their assessment of the 80 criteria plus three new ones. Main outcome measure Aggregate ratings for each criterion calculated using medians weighted to compensate for different numbers in stakeholder groups; criteria rated between 7 and 9 were retained. Results 212 nominated people were invited to participate. Of those invited, 122 participated in the first round (77 researchers, 21 patients, 10 practitioners, 14 policy makers); 104/122 (85%) participated in the second round. 74 of 83 criteria were retained in the following domains: systematic development process (9/9 criteria); providing information about options (13/13); presenting probabilities (11/13); clarifying and expressing values (3/3); using patient stories (2/5); guiding/coaching (3/5); disclosing conflicts of interest (5/5); providing internet access (6/6); balanced presentation of options (3/3); using plain language (4/6); basing information on up to date evidence (7/7); and establishing effectiveness (8/8). Conclusions Criteria were given the highest ratings where evidence existed, and these were retained. Gaps in research were highlighted. Developers, users, and purchasers of patient decision aids now have a checklist for appraising quality. An instrument for measuring quality of decision aids is being developed.

The diversity of methods used in studies hinders analysis of patterns and predictors of unmet need among people with cancer and precludes generalisation. Well-designed, context-specific, prospective studies, using validated instruments and standard methods of analysis and reporting, are needed to benefit future interventional research to identify how best to address the unmet supportive care needs of people with cancer.

BackgroundTranslation of evidence-based interventions into hospital systems can provide immediate and substantial benefits to patient care and outcomes, but successful implementation is often not achieved. Existing literature describes a range of barriers and facilitators to the implementation process. This systematic review identifies and explores relationships between these barriers and facilitators to highlight key domains that need to be addressed by researchers and clinicians seeking to implement hospital-based, patient-focused interventions.MethodsWe searched MEDLINE, PsychInfo, Embase, Web of Science, and CINAHL using search terms focused specifically on barriers and facilitators to the implementation of patient-focused interventions in hospital settings. To be eligible, papers needed to have collected formal data (qualitative or quantitative) that specifically assessed the implementation process, as experienced by the staff involved.ResultsOf 4239 papers initially retrieved, 43 papers met inclusion criteria. Staff-identified barriers and facilitators to implementation were grouped into three main domains: system, staff, and intervention. Bi-directional associations were evident between these domains, with the strongest links evident between staff and intervention.ConclusionsResearchers and health professionals engaged in designing patient-focused interventions need to consider barriers and facilitators across all three identified domains to increase the likelihood of implementation success. The interrelationships between domains are also crucial, as resources in one area can be leveraged to address barriers in others. These findings emphasize the importance of careful intervention design and pre-implementation planning in response to the specific system and staff context in order to increase likelihood of effective and sustainable implementation.Trial registrationThis review was registered on the PROSPERO database: CRD42017057554 in February 2017. Electronic supplementary materialThe online version of this article (10.1186/s13012-018-0726-9) contains supplementary material, which is available to authorized users.

Over the course of March 2020, the everyday life of most people changed from normal to extraordinary around the globe. By the beginning of March, there had been serious outbreaks of COVID-19 in a limited number of countries, such as China, South Korea, Iran and Italy, while many others experienced a lull before the storm. People in unaffected countries understood that the Corona SARS CoV-2 virus might reach their shores at one point; the question was when and how hard it would hit. By the end of March, many governments had ordered drastic measures. Schools and university campuses were shut down. Shops, restaurants and companies were closed. People in many different jobs were asked to work from home, and many were in quarantines.

Young women with breast cancer are particularly vulnerable to FCR. The present study provides preliminary evidence that FCR is associated with higher health costs and lower surveillance rates which may compromise health outcomes. Routine screening for FCR in follow-up care is recommended.

After completing this course, the reader will be able to:1. Discuss the danger inherent in nondisclosure of complementary and alternative medicine (CAM) use due to the potential for herb-or vitamin-drug interactions with conventional treatment.2. Explain the need for greater patient-doctor communication about CAM use in oncology settings in order to maintain patient safety and wellbeing.This article is available for continuing medical education credit at CME.TheOncologist.com. CME CME Results. A total of 21 studies were located, which reported a prevalence of CAM use among patients with cancer ranging between 11% and 95%; of these patients, 20% to 77% did not disclose their CAM use. The main reasons for nondisclosure were the doctor's lack of inquiry; patient's anticipation of the doctor's disapproval, disinterest, or inability to help; and patient's perception that disclosure of CAM use is irrelevant to their conventional care. There is some evidence to suggest that patient-doctor communication about the use of CAM was associated with an enhanced patient-doctor relationship and higher patient satisfaction. ABSTRACT Conclusions. Although the use of CAM by patients with

There is an increasing body of evidence supporting the design of effective evidence-based communication tools but variable access to such tools in practice.

There is an increasing number of long-term survivors of cervical and endometrial cancer for whom quality of life is of major importance. We interviewed 20 women (aged 19-64) to explore the dynamics and components of post-treatment sexual adjustment and its impact on quality of life. Stratification by treatment received (surgery alone, surgery plus external-beam radiation, surgery plus brachytherapy, and surgery plus external-beam radiation and brachytherapy) and time since treatment (immediately post treatment, during the next 2 years and thereafter) was undertaken, to ensure representation of all relevant experiences and views, and to allow time for any long-term side effects to appear. The NUD*IST software (Non-numerical Unstructured Data by Indexing, Searching and Theorising) was used to assist with the coding of audio-taped, transcribed interviews and to search for themes and segments. While the data supported findings reported in the literature, important new themes emerged in the course of the qualitative analysis. These included: (a). issues related to being 'feminine', (b). the role of intimacy in post-treatment adjustment and (c). the importance of communication between health professionals, patients and partners. A model is presented that integrates these issues and highlights the need for effective interventions to improve post-treatment outcomes. The provision of information, support and modification of rehabilitation devices is suggested.