Introduction to special section: Living with Incurable Cancer: Addressing Gaps in Cancer Survivorship

Lustberg, Maryam B.; Carlson, Martha; Nekhlyudov, Larissa

doi:10.1007/s11764-021-01047-1

Cited by 10 publications

(8 citation statements)

References 11 publications

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“…These models of funding also excluded patients in the survivorship phase and families/caregivers from PSO services. The denial of services to certain patient groups, such as those in the survivorship and bereavement stages, is at odds with recent literature highlighting the importance of addressing the psychosocial needs of the growing survivorship cohort [ 35 ] and of holistically addressing family units and caregiver contexts [ 36 ]. Participants suggested that the discrepancy between best practice recommendations and the clinical reality is at least partially driven by the fact that health authorities regard PSO as a “nonessential dimension of cancer care”, which is supported by prior research reports [ 14 ] and affects the funding allocation to PSO services.…”

Section: Discussionmentioning

confidence: 99%

Evidence-Based Practice in Psychosocial Oncology from the Perspective of Canadian Service Directors

Mackay

Dewez

et al. 2023

Current Oncology

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Evidence-based practices facilitate the effective delivery of psychological services, yet research on the implementation of evidence-based practices in psychosocial oncology (PSO) is scarce. Responding to this gap, we interviewed a diverse sample of 16 directors of Canadian psychosocial oncology services about (a) how evidence-based practices in psychosocial oncology are being implemented in clinical care and how the service quality is monitored and (b) what are barriers and facilitators to evidence-based practice in psychosocial oncology services? Responses were grouped according to three main themes emerging from the data: screening for distress and referral to PSO services, delivery of evidence-based PSO services, and monitoring of PSO services. Our findings highlight facilitators and barriers to evidence-based practice in psychosocial oncology, which were related to the political, social, economic, and geographic contexts. The stepped care model was identified as a science-informed approach to improve the cost-effectiveness of triage systems and treatment delivery while facilitating more equitable access to services. Other facilitators included electronic screening and referral systems as well as protected time for clinicians to communicate more within their teams and participate in knowledge exchange. High caseloads presented a major barrier to acquiring and implementing evidence-based practices. Recommen–dations include increased support for evidence-based onboarding and continued training as well as for data collection regarding service needs, quality, and quantity to inform service monitoring and advocacy for more financial resources. Our findings are relevant to healthcare decision makers, implementation researchers, as well as service directors and practitioners providing psychosocial oncology care.

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Section: Discussionmentioning

confidence: 99%

Evidence-Based Practice in Psychosocial Oncology from the Perspective of Canadian Service Directors

Mackay

Dewez

et al. 2023

Current Oncology

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“…It has been consistently reported that patients with advanced or metastatic cancer are under‐represented in survivorship research and services, given the complexity of their supportive care needs 35 . In this small cohort study, we found that a short‐term telehealth exercise programme may result in meaningful physical function and balance improvements while preserving QoL in advanced melanoma patients.…”

Section: Discussionmentioning

confidence: 61%

Feasibility of supervised telehealth exercise for patients with advanced melanoma receiving checkpoint inhibitor therapy

et al. 2023

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Purpose To determine the feasibility, safety and preliminary efficacy of a telehealth supervised exercise programme in patients with advanced melanoma receiving checkpoint inhibitor therapy. Methods A 8‐week non‐randomised feasibility pilot trial utilising a telehealth delivered multimodal exercise programme undertaken thrice weekly with assessments at baseline and post‐intervention. The study was considered feasible if there were no severe or life‐threatening adverse events as a result of exercise, and three or more of the following criteria were met: the recruitment rate was >50%, completion rate was >80%, median programme attendance was >75%, median exercise compliance >75%, and average tolerance was >70%. Preliminary efficacy was assessed for objective measures of physical function (2‐min step test, repeated chair stand test, 30‐s push‐up test, and a modified static balance test) and quality of life (QoL), fatigue and other patient‐reported outcomes were assessed using the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core 30. Results Eleven patients (32–80 years) were included in the study (6 female, 5 male). The recruitment rate was 48%, completion rate 91%, programme attendance 88%, median exercise compliance 82.1% and 84.9% for resistance and aerobic exercise, respectively, and tolerance 88%, with no severe or life‐threatening adverse events as a result of exercise. In terms of preliminary efficacy, physical function significantly improved while QoL was maintained following the intervention. Conclusion An 8‐week telehealth exercise intervention is feasible and safe for patients with advanced melanoma and appears to improve physical function while preserving QoL during checkpoint inhibitor therapy.

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“…When available, care from a breast care nurse was highly regarded and complemented and extended care from the oncologist. These gaps and inequities in care are potentially concerning given the increasing attention on cancer survivorship in those with advanced cancer [ 35 , 36 ], the rapidly expanding number of people living long-term with advanced cancer [ 37 ], and the focus on making cancer care patient-centred, comprehensive and integrated [ 38 – 40 ].…”

Section: Discussionmentioning

confidence: 99%

Potential inequities in availability of care from breast care nurses: a qualitative study reporting the experiences and perspectives of women with metastatic breast cancer in Australia

Smith

Boyle

Lewis

2022

BMC Health Serv Res

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Background International consensus guidelines recommend patients with metastatic breast cancer have access to a nurse experienced in the treatment of metastatic breast cancer. This study aimed to explore women’s experiences of supportive care from breast care nurses, including their perspectives on the role breast care nurses currently play in providing support to people with metastatic breast cancer. Methods Multiple semi-structured qualitative interviews with 38 women with metastatic breast cancer in Australia. Data relating to nursing care were extracted and analysed using thematic analysis. Results Three themes were identified: (1) feeling that supportive care needs are unrecognised; (2) confusion about role and relevance of breast care nurse to those with metastatic breast cancer; (3) care from metastatic breast care nurses (when available) was appreciated, valued and beneficial. Participants’ experiences differed in relation to ease of access to, amount of contact with, and level of care provided by breast care nurses. Contact and care ranged from little or none to comprehensive and ongoing. A key system-level challenge was that the diversity of diagnostic and treatment pathways for metastatic breast cancer meant that no systematic means existed to support routine or regular contact between breast care nurses and participants. Participants who did report having access to a specialised metastatic breast care nurse placed considerable value on the care received. For these participants, care from the breast care nurse extended and complemented care from the oncologist and included much needed psychosocial and practical support. For these participants, the breast care nurse assumed the role of key contact and care coordinator and was valued for their availability, accessibility and responsiveness. High levels of trust developed between patient and breast care nurse. Conclusions Findings indicate that there may be gaps and inequities in supportive care in Australia for people diagnosed with metastatic breast cancer, a finding that supports earlier reports of limited access to breast care nurses for people with metastatic breast cancer in Australia. The specialised metastatic breast care nurse could potentially play a key role in addressing the high level of unmet supportive care needs and improve continuity of care for these patients.

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Introduction to special section: Living with Incurable Cancer: Addressing Gaps in Cancer Survivorship

Cited by 10 publications

References 11 publications

Evidence-Based Practice in Psychosocial Oncology from the Perspective of Canadian Service Directors

Evidence-Based Practice in Psychosocial Oncology from the Perspective of Canadian Service Directors

Feasibility of supervised telehealth exercise for patients with advanced melanoma receiving checkpoint inhibitor therapy

Potential inequities in availability of care from breast care nurses: a qualitative study reporting the experiences and perspectives of women with metastatic breast cancer in Australia

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