Context Multiple organizations have raised concerns about the lack of standard definitions for terminology in the supportive and palliative oncology literature. Objectives We aimed to determine: 1) the frequency of 10 commonly used terms in the supportive and palliative oncology literature; 2) the proportion of articles that provided definitions for each term; and 3) how each term was defined. Methods We systematically searched MEDLINE, PubMed, PsycINFO, the Cochrane Library, Embase, ISI Web of Science, and CINAHL for original studies, review articles and systematic reviews related to palliative care and cancer in the first six months of 2004 and 2009. We counted the number of occurrences for “palliative care,” “supportive care,” “best supportive care,” “hospice care,” “terminal care,” “end-of-life,” “terminally ill,” “goals of care,” “actively dying,” and “transition of care” in each article, reviewed them for the presence of definitions, and documented the journal characteristics. Results Among the 1213 articles found, 678 (56%) were from 2009. “Palliative care” and “end-of-life” were the most frequently used terms. “Palliative care,” “end-of-life” and “terminally ill” appeared more frequently in palliative care journals, while “supportive care” and “best supportive care” were used more often in oncology journals (P<0.001). Among 35 of 601 (6%) articles with a definition for “palliative care,” there were 16 different variations (21 of 35 articles used the World Health Organization definition). “Hospice care” had 13 definitions among 13 of 151 (9%) articles. “Supportive care” and other terms were rarely defined (less than 5% of articles that used the term). Conclusion Our findings highlight the lack of definitional clarity for many important terms in the supportive and palliative oncology literature. Standard definitions are needed to improve administrative, clinical and research operations.
The current state of the palliative oncology literature is unclear. We examined and compared the quantity, research design, and research topics of palliative oncology publications in the first 6 months of 2004 with the first 6 months of 2009. We systematically searched MEDLINE, PsychInfo, EMBASE, ISI Web of Science, and CINAHL for original studies, review articles, and systematic reviews related to "palliative care" and "cancer" during the
The algorithm is a road map for nurses or physicians to provide evidence-based recommendations, knowledge of physical activity importance, and personalized exercise prescriptions for chronic disease risk reduction and to improve quality of life in a target population.
This article describes the experiences of librarians at the Research Medical Library embedded within clinical teams at The University of Texas MD Anderson Cancer Center and their efforts to enhance communication within their teams using Web 2.0 tools. Pros and cons of EndNote Web, Delicious, Connotea, PBWorks, and SharePoint are discussed.
111 Background: A fundamental tenet of survivorship care is to identify and deliver a wide range of supportive care services. Survivors rely on clinicians to provide integrated care personalized to their own supportive care needs. Yet there is lack of evidence demonstrating which method is “best practice” when assessing survivor’s needs. The aim of our Plan-Do-Study-Act quality improvement project was to determine the best method to identify survivors’ supportive care needs and coordinate services. Methods: We used the appointment list of the Breast Survivorship Clinic to identify 114 adult survivors seen for their initial survivorship visit between January-March 2014. Survivors were asked to complete a questionnaire assessing their needs related to: 1) energy-balance, 2) complementary medicine, 3) lymphedema, 4) psychosocial concerns, 5) sexual health, and 6) tobacco use. Survivors were randomly assigned into 3 groups to identify the best method to assess their health care needs: 1) Mail, 2) Secure Electronic Messaging, and 3) Navigation Visit with Health Educator (HE). Questionnaires for the mail and electronic messaging groups were distributed before being seen in the clinic. Navigation participants completed the questionnaire during the visit with HE. Descriptive statistics were used to describe and compare group characteristics. Results: A total of 114 patients were randomized to complete the assessment by either mail (N=28), secured electronic message (N=50), or during the navigation visit (N=36). The in-person, navigation visit had the highest completion rate (78%) compared to secured message (22%), and mail (7%). An overwhelming majority of survivors’ in the navigation group (93%) indicated they had needs in in at least one of the 6 domains. The top two needs across all groups were nutrition and physical activity. Conclusions: This evaluation suggests the use of a health navigator to guide the survivor through the needs assessment was the most successful way to assess needs of long-term breast cancer survivors. Enhanced navigation during a cancer survivor’s visit can be used to tailor integrative health services, which can improve their well-being and mental health outcomes.
Background: Cancer survivors are susceptible to cancer recurrence and other cancers and this is an opportune time to focus on cancer prevention. The American Institute of Cancer Research (AICR) and the American Cancer Society estimate that modifications to the behaviors of diet and physical activity in addition to maintaining a normal body mass index (BMI) can help reduce cancer incidence by one third. The AICR and the American College of Sports Medicine (ACSM) have established guidelines on nutrition and physical activity respectively for cancer risk reduction. Cancer patients' transition to survivorship is an ideal time for them to make lifestyle modifications and adopt these guidelines. Although studies have evaluated structured exercise regimens and nutritional interventions, data is lacking on how to best achieve long term lifestyle changes in this population. By introducing a patient-centered intervention that utilizes motivational interviewing to our breast cancer survivors, we plan to increase the rate of adherence to the AICR and ACSM guidelines through tailored counseling focused on patient-driven lifestyle modifications. Methods: Breast cancer survivors 5 years out from their diagnosis seen in the survivorship clinic were also scheduled to be seen by a health education specialist (HES) for a baseline visit. One year follow up visits were scheduled with the HES for reassessment of their nutrition and physical activity goals. All patients completed a survey of questions assessing their adherence to the nutritional and physical activity guidelines on cancer risk reduction at baseline and at 1 year follow up visit. Anthropometric measures including height, weight, BMI, pulse, respirations, and blood pressure were collected at each visit with their provider. Baseline demographic data was collected on all participants including age, race/ethnicity, cancer stage, previous cancer treatment(s), and comorbid conditions. Frequency of interactions (i.e clinic visit, telephone call, or secure message) with the HES were extracted from the medical record. Results: From October 6, 2014 to May 31, 2016, 200 breast cancer survivors were seen in the survivorship clinic and by a HES. Fifty women who completed a baseline and 1 year follow up survey were selected to assess their adherence to the AICR and ACSM guidelines on cancer risk reduction. Sixty percent of patients decreased their BMI, 5% maintained their BMI, and 35% had an increase in BMI after one year follow up. There was an increase in the percentage of patients adhering to all of the guidelines after one year of follow up in comparison to baseline. There were notable increases in adherence to physical activity guidelines with 24% of survivors achieving at least 150 minutes of moderate exercise each week at baseline assessment and 34% of survivors meeting this guideline at the 1 year follow up visit. Discussion: Through our intervention with a HES in our survivorship clinic, we were able to see trends toward increased adherence to the AICR and ACSM guidelines. Further analysis is ongoing to assess the frequency of interactions with the HES and their adherence to the guidelines. This analysis will give us a better understanding of the ideal target population for this intervention. Citation Format: Thomas PS, Klimitchek A, Nelson B, Damani S, Bevers TB. A patient centered intervention for adaptation of cancer risk reduction guidelines in breast cancer survivors [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P5-13-10.
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