Implementation of a Multidisciplinary Model of Care for Women With Metastatic Breast Cancer: Challenges and Lessons Learned

Blaschke, Sarah; Gough, Karla; Chua, Boon; Francis, Prudence A.; Cockerell, Robyn; Drosdowsky, Allison; Sheeran, Lisa; Krishnasamy, Meinir

doi:10.1016/j.clbc.2018.12.014

Cited by 5 publications

(4 citation statements)

References 20 publications

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“…The MDT collaborative nursing combined hierarchical nursing management model can effectively improve the comfort of patients, because the MDT collaborative nursing combined hierarchical nursing management model can standardize the diet structure, improve the body's defense capabilities, and effectively establish a standardized lifestyle and eating habits, which will help improve the quality of life in the future. At the same time, with emotional nursing, it can target depression, anxiety, and other emotions of patients, carry out submissive psychotherapy, adjust the patient's emotions, and encourage them to maintain an optimistic and positive attitude [ 17 – 20 ]. The MDT collaborative nursing joint-level nursing management model emphasizes the “patient-centered” nursing concept, details the physical and psychological aspects of nursing, and can provide patients with high-quality, professional, and comprehensive nursing services and provide social, physical, emotional, physiological, other aspects, and social support, so as to maximize the physical and psychological comfort of patients, and improve negative emotions [ 21 – 24 ].…”

Section: Discussionmentioning

confidence: 99%

The Effect of MDT Collaborative Nursing Combined with Hierarchical Nursing Management Model on the Quality of Life and Comfort of Patients with Gallbladder Stones Combined with Acute Cholecystitis after Surgery

Yang

Zheng

et al. 2022

Computational and Mathematical Methods in Medicine

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Objective. To explore the effect of MDT (multidisciplinary team) collaborative nursing combined with hierarchical nursing management mode on the quality of life and comfort of patients with gallbladder stones combined with acute cholecystitis after surgery. Methods. A total of 120 patients with gallbladder stones and acute cholecystitis who were treated in our hospital from March 2019 to March 2021 were selected as prospective research objects. According to the order of care, they were divided into control group and observation group with 60 cases each. Among them, the control group implements a hierarchical nursing management model, and the observation group implements MDT collaborative nursing based on this and compares the impact of the two groups on patient’s quality of life scores, daily self-care ability, nursing satisfaction, and comfort after nursing. Results. Before nursing, the comparison of the quality of life score, nursing comfort, and nursing ability of the two groups of patients was not statistically significant ( P > 0.05 ). After nursing, the mental vitality score, social interaction score, emotional restriction score, and mental status of the observation group were significantly higher than those of the control group. Statistics showed that the difference was statistically significant ( P < 0.05 ). After nursing, the scores of social comfort, physical comfort, and psychological comfort of the observation group were significantly higher than those of the control group, and statistics showed that the difference was statistically significant ( P < 0.05 ). The health knowledge level, self-care skills, self-care responsibility, and self-concept of the observation group after nursing were higher than those of the control group, while the score of depression and mood disorder was significantly lower than that of the control group. Statistics showed that this difference was statistically significant ( P < 0.05 ). After nursing, patients in the observation group had higher operating technique scores, service attitude scores, health education scores, psychological intervention scores, and nursing quality scores than those of the control group. Statistics showed that the difference was statistically significant ( P < 0.05 ). Conclusion. MDT collaborative nursing combined with hierarchical nursing management mode can effectively improve the self-care ability of patients with gallbladder stones complicated with acute cholecystitis, effectively improve the quality of life of patients, and improve the satisfaction and comfort of patients with nursing care. The postnursing care of patients after inflammation has a certain reference value.

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Section: Discussionmentioning

confidence: 99%

The Effect of MDT Collaborative Nursing Combined with Hierarchical Nursing Management Model on the Quality of Life and Comfort of Patients with Gallbladder Stones Combined with Acute Cholecystitis after Surgery

Yang

Zheng

et al. 2022

Computational and Mathematical Methods in Medicine

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“…The literature shows that inadequate models result in an underestimation of patient needs, and a high percentage of patients do not benefit from early and continuous access to BCN, despite having multiple and complex health needs (Blaschke et al, 2019; Reed, Scanlon & Fenlon, 2010). Some models recommend that an oncology nurse specialising in advanced breast cancer care attends these patients, while other models advocate a multidisciplinary team dedicated to patients with advanced breast cancer (Blaschke et al, 2019; Vila et al, 2016).…”

Section: Discussionmentioning

confidence: 99%

“…Although this group of patients represents a minority compared to those with early disease, follow‐up can last over 15 years, so the total number of counselling sessions for each patient consumes a significant volume of resources (Blaschke et al, 2019; Cardoso et al, 2020). One recent study showed how an app can facilitate the daily assessment of the most indicative symptoms of discomfort, prompting a modification of the schedule of visits, if required (Schmitz et al, 2020).…”

Section: Discussionmentioning

confidence: 99%

Self‐assessment of a breast care nursing model within a Breast Unit: learning process and keys to improving breast care

Rodriguez-Ortega

Ferro

Pérez

et al. 2023

Journal of Clinical Nursing

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Aim and objectives To assess the adherence of a nursing care model in a multidisciplinary breast cancer unit in a tertiary hospital to the recommended competencies and quality indicators. Background Aligning the competencies of the breast care nurse with international recommendations for this role helps better fulfil patient needs, increases satisfaction and ensures continuity of care. Design Cohort study. Methods Breast care nursing was assessed in all patients treated at the Functional Breast Unit from 1 July 2016 to 30 June 2017. Patients were followed for 1 year. Sociodemographic, clinical and pathological data, treatments performed and nursing interventions were collected. The strobe checklist has been used to report this study. Results We analysed nursing interventions carried out in 382 patients attended over 1 year in a multidisciplinary breast cancer unit. All patients with early disease had contact with the nurse at different times during their primary treatment. Only 58% of patients with advanced disease had contact with the nurse during their first year of illness. Moreover, first contact with the nurse was delayed by more than a week from diagnosis, the interval recommended by international guidelines. Conclusion The nursing care model meets the core competencies defined for the breast care nurse in patients with early breast cancer, but the first visit should be organised earlier, and follow‐up should extend beyond completion of primary treatment. Relevance to clinical practice This study evaluated the breast care nurse model in one breast cancer unit according to international guidelines. Nursing care adhered to most guideline requirements in patients with early breast cancer, but not in those with advanced disease. New models of care need to be developed for women with advanced breast cancer in order to achieve true patient‐centred care. Patient or public contribution No contribution from the patient or the public because the data collected was entered into the clinical history by the health professionals of the Breast Unit as part of their usual clinical practice.

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“…Breast cancer, one of the main causes of women's mortality, is characterized by highly complex presentation patterns [1]. Even though population-based screening programs [1], new therapies [2], advanced technologies [3], and multidisciplinary approaches [4] have improved survival and quality of life [4] in the previous decades, cure remains a challenge in some sub-groups of patients. Consequently, hypothesis-based tailored treatments that are adapted to each individual patient's specific features are being explored in an approach termed personalized medicine.…”

Section: Introductionmentioning

confidence: 99%

The Assisi Think Tank Meeting Breast Large Database for Standardized Data Collection in Breast Cancer—ATTM.BLADE

Marazzi

Masiello

Masciocchi

et al. 2021

JPM

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During the 2016 Assisi Think Tank Meeting (ATTM) on breast cancer, the panel of experts proposed developing a validated system, based on rapid learning health care (RLHC) principles, to standardize inter-center data collection and promote personalized treatments for breast cancer. Material and Methods: The seven-step Breast LArge DatabasE (BLADE) project included data collection, analysis, application, and evaluation on a data-sharing platform. The multidisciplinary team developed a consensus-based ontology of validated variables with over 80% agreement. This English-language ontology constituted a breast cancer library with seven knowledge domains: baseline, primary systemic therapy, surgery, adjuvant systemic therapies, radiation therapy, follow-up, and toxicity. The library was uploaded to the BLADE domain. The safety of data encryption and preservation was tested according to General Data Protection Regulation (GDPR) guidelines on data from 15 clinical charts. The system was validated on 64 patients who had undergone post-mastectomy radiation therapy. In October 2018, the BLADE system was approved by the Ethical Committee of Fondazione Policlinico Gemelli IRCCS, Rome, Italy (Protocol No. 0043996/18). Results: From June 2016 to July 2019, the multidisciplinary team completed the work plan. An ontology of 218 validated variables was uploaded to the BLADE domain. The GDPR safety test confirmed encryption and data preservation (on 5000 random cases). All validation benchmarks were met. Conclusion: BLADE is a support system for follow-up and assessment of breast cancer care. To successfully develop and validate it as the first standardized data collection system, multidisciplinary collaboration was crucial in selecting its ontology and knowledge domains. BLADE is suitable for multi-center uploading of retrospective and prospective clinical data, as it ensures anonymity and data privacy.

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Implementation of a Multidisciplinary Model of Care for Women With Metastatic Breast Cancer: Challenges and Lessons Learned

Cited by 5 publications

References 20 publications

The Effect of MDT Collaborative Nursing Combined with Hierarchical Nursing Management Model on the Quality of Life and Comfort of Patients with Gallbladder Stones Combined with Acute Cholecystitis after Surgery

The Effect of MDT Collaborative Nursing Combined with Hierarchical Nursing Management Model on the Quality of Life and Comfort of Patients with Gallbladder Stones Combined with Acute Cholecystitis after Surgery

Self‐assessment of a breast care nursing model within a Breast Unit: learning process and keys to improving breast care

The Assisi Think Tank Meeting Breast Large Database for Standardized Data Collection in Breast Cancer—ATTM.BLADE

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