Working in silos? – Head &amp; Neck cancer patients during and after treatment with or without early palliative care referral

Ullgren, Helena; Kirkpatrick, Lily; Kilpeläinen, Sini; Sharp, Lena

doi:10.1016/j.ejon.2016.12.003

Cited by 17 publications

(30 citation statements)

References 30 publications

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“…Improving coordination and reducing the fragmentation in care, are central parts of the CCN function. We chose to study care coordination in relation to cancer care transitions, since these were reported to be major areas of concern prior to the study (Regional Cancer Center Stockholm-Gotland, 2013;Ullgren et al, 2017). Our results showed statistically significant improvements in care coordination between baseline and follow-up for only one of the six study specific questions (Table 4).…”

Section: Coordination Of Carementioning

confidence: 82%

“…To evaluate the patients' experience of coordination, we focused on care transitions. The purpose was to try to capture the issues around fragmented care, reported in previous evaluations (Regional Cancer Center Stockholm-Gotland, 2013;Ullgren et al, 2017). We used the items described below from the study specific questionnaire.…”

Section: Coordination Of Carementioning

confidence: 99%

“…The relatively new CN role was developed for cancer care. Early evaluations showed the CN function is only partly implemented (Bjuresäter and Larsson, 2017;Regional Cancer Center Stockholm-Gotland, 2013) and highlights issues related to fragmented care (Regional Cancer Center Stockholm-Gotland, 2013;Ullgren et al, 2017). Poor care coordination in relation to cancer care transitions, https://doi.org/10.1016/j.ejon.2019.05.009 were reported by patients to be major areas of concern (Regional Cancer Center Stockholm-Gotland, 2013;Ullgren et al, 2017).…”

Section: Introductionmentioning

confidence: 99%

“…Early evaluations showed the CN function is only partly implemented (Bjuresäter and Larsson, 2017;Regional Cancer Center Stockholm-Gotland, 2013) and highlights issues related to fragmented care (Regional Cancer Center Stockholm-Gotland, 2013;Ullgren et al, 2017). Poor care coordination in relation to cancer care transitions, https://doi.org/10.1016/j.ejon.2019.05.009 were reported by patients to be major areas of concern (Regional Cancer Center Stockholm-Gotland, 2013;Ullgren et al, 2017). A national CN role description was developed in 2011 (Swedish Association of Local Authorities and Regions, 2013), describing a similar function as the nurse navigators (Campbell et al, 2010;Jeyathevan et al, 2017).…”

Section: Introductionmentioning

confidence: 99%

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Patient-reported perceptions of care after the introduction of a new advanced cancer nursing role in Sweden

Westman

Ullgren

Olofsson

et al. 2019

European Journal of Oncology Nursing

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Extensive research results show quality improvements associated with advanced cancer nursing roles. Despite this, these roles are not implemented in many countries. The aim of this cross-sectional, populationbased study was to compare patients' perception of care, before and after the introduction of a new advanced nursing role, the coordination contact nurse (CCN), in a region in Sweden. Method: All patients (with gynaecological, haematological, Head & Neck, upper gastrointestinal cancers) diagnosed in the region the year prior and one-year post introducing the new CCN role were identified from the Swedish Cancer Register. Data were collected using the European Organization of Research and Treatment of Cancer [EORTC] Quality of Life Questionnaire (QLQ-C30 and QLQ-INFO25) and a study specific questionnaire. Result: The results, based on baseline (n = 869) and follow-up data (n = 1003), show statistically significant patient-reported improvements after the introduction of the CCN role, regarding health-related patient information (EORTC QLQ-INFO25 global mean score increased from 41.23 to 44.16, p = 0.0006). We found statistically significant improvements related to availability of supportive care resources, e.g. increased reported access to contact nurse (from 53% to 66%, p ≤ 0.0001) and individual written care plans (from 40% to 54%, p < 0.0001). We also found some improvements related to patient involvement and care coordination, but also room for further developments. Conclusion: The implementation of the new advanced cancer nursing role may have contributed to important improvements, but it has also identified areas in need of development. Further research with long-term evaluations of CCN roles in other contexts, are both needed and ongoing .

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Section: Coordination Of Carementioning

confidence: 82%

Section: Coordination Of Carementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Patient-reported perceptions of care after the introduction of a new advanced cancer nursing role in Sweden

Westman

Ullgren

Olofsson

et al. 2019

European Journal of Oncology Nursing

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“…A partnership model of care was emphasised as integral by healthcare professionals, representing a more gradual transition from one team to another. This is noteworthy as service issues can arise when integration between teams is lacking for those caring for HNC patients [33]. A broad MDT approach is needed to best optimise care, in particular focusing on information and psycho-social needs.…”

Section: How This Study Relates To Existing Literaturementioning

confidence: 99%

A qualitative study exploring patient, family carer and healthcare professional perceptions of providing palliative care for advanced head and neck cancer

Mayland

Doughty

Rogers

et al. 2019

Preprint

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Purpose: To explore patient, family carer and healthcare professionals’ perspectives about providing palliative care for advanced head and neck cancer patients and potential components which could inform a future model of care. Methods: Using a naturalistic, interpretative approach, within Northwest England, a purposive sample of adult head and neck cancer patients was selected. Their family carers were also invited to participate. Healthcare professionals (representing head and neck surgery and specialist nursing; oncology; specialist palliative care; general practice and community nursing) were recruited. All participants underwent face-to-face or telephone interviews. A thematic approach, using a modified version of Colazzi’s framework, was used to analyse the data. Results: In total, 17 interviews were conducted (nine patients, four joint with family carers and eight healthcare professionals). Three main themes relating to challenges in providing palliative care were identified: the ‘need for support at critical moments’ in the patients’ disease trajectory; ‘communication challenges’ and ‘complexity of decision-making’. Additionally, three themes related to key components to inform a future model of care: ‘partnership model’; ‘timely and responsive engagement of Specialist Palliative Care’; and ‘good linkage and connections’. Conclusions: Conceptually, the identified ‘critical moments’ in the patients’ disease trajectory should be a focus for future interventions to help improve and support care. These interventions should direct improvements in the provision of information and psychological support. Models of palliative care for this population need to be developed in partnership with existing services to ensure care is delivered in a coordinated and timely manner.

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Palliative care outcome measures used in head and neck cancer: A scoping review

Sriram,

Xie,

Gersten

et al. 2024

Head & Neck

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BackgroundThe palliative care (PC) needs of patients with head and neck cancer (HNC) are complex, due to high and unique symptom burdens. Uniform outcome measures are critical to assessing the impact of PC interventions in HNC.MethodsA scoping review of outcome measures used in patients with HNC receiving PC was performed using PubMed, Embase, and Web of Science from 1980 to 2022.ResultsOf 20 eligible studies, 19 unique instruments were identified which assessed 22 physical, 5 mental, 4 social, 7 related quality of life, and 9 advanced care planning outcomes. Instruments were underutilized, with a larger number of outcomes measurable for instruments used than were reported. The average instrument assessed three domains whereas the average study only reported outcomes from two domains.ConclusionsComparison across studies is limited due to heterogeneity in outcome measures. Future work is needed to develop core PC outcome measures for use in HNC care.

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Working in silos? – Head & Neck cancer patients during and after treatment with or without early palliative care referral

Abstract: To avoid H&N cancer care in silos, a closer integration between the oncology and the palliative care team is needed. Further research on the complex situation of having oncological treatment concurrent with palliative care, is needed.

Cited by 17 publications

References 30 publications

Patient-reported perceptions of care after the introduction of a new advanced cancer nursing role in Sweden

Patient-reported perceptions of care after the introduction of a new advanced cancer nursing role in Sweden

A qualitative study exploring patient, family carer and healthcare professional perceptions of providing palliative care for advanced head and neck cancer

Palliative care outcome measures used in head and neck cancer: A scoping review

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