Personalized symptom management: a quality improvement collaborative for implementation of patient reported outcomes (PROs) in 'real-world' oncology multisite practices.

Background: Little research has focused on implementation of electronic Patient Reported Outcomes (e-PROs) for meaningful use in patient management in 'real-world' oncology practices. Our quality improvement collaborative used multi-faceted implementation strategies including audit and feedback, disease-site champions and practice coaching, core training of clinicians in a person-centered clinical method for use of e-PROs in shared treatment planning and patient activation, ongoing educational outreach and shared collaborative learnings to facilitate integration of e-PROs data in multi-sites in Ontario and Quebec, Canada for personalized management of generic and targeted symptoms of pain, fatigue, and emotional distress (depression, anxiety).

Patients And Methods: We used a mixed-methods (qualitative and quantitative data) program evaluation design to assess process/implementation outcomes including e-PROs completion rates, acceptability/use from the perspective of patients/clinicians, and patient experience (surveys, qualitative focus groups).

Psychosocial Aspects of Delivering Cancer Care to Indigenous People: An Overview.

Globally, a growing body of evidence has reported significant disparities in cancer outcomes between indigenous and nonindigenous people. Although some effort is being made to address these disparities, relatively little attention has been directed toward identifying and focusing on the psychosocial aspects of cancer care for indigenous patients, which are critical components in improving cancer care and outcomes. The purpose of this article is to describe the results of a scoping review of the psychosocial aspects of cancer care for indigenous people.

Best Practices in Oncology Distress Management: Beyond the Screen.

The field of psychosocial oncology is a young discipline with a rapidly expanding evidence base. Over the past few decades, several lines of research have established that psychosocial problems, such as anxiety, depression, post-traumatic stress, fatigue, sexual dysfunction, and cognitive complaints, are common and consequential in patients with cancer. The word "distress" was chosen deliberately to capture a broad concept; consequently, distress screening is meant to function as an initial step in the more targeted evaluation of the source(s) of the patient's distress.

A nutrition referral priority rating system in an outpatient oncology centre.

Purpose: An oncology nutrition referral priority rating system (NRPRS) was developed and evaluated as a tool to classify patients into nutrition risk categories and allocate reasonable wait times.

Methods: A retrospective chart audit (n=112), patient focus groups (n=14), and a prospective chart audit (n=179) were conducted to refine the tool. Using the NRPRS, the dietitians assigned a priority rating from the information on the referral and then compared it with a second rating after the first visit.

Implementing screening for distress, the 6th vital sign: a Canadian strategy for changing practice.

Objective: Distress is prevalent among cancer patients at all stages of illness and has been endorsed as the 6th Vital Sign in cancer care. Despite its prevalence, and calls to be monitored, few cancer programs are Screening for Distress in a standardized manner. In this paper, the implementation strategy employed in Canada to change practice by integrating Screening for Distress in routine care is described.

Evaluation of cancer patient education and services.

On their first visit to the Regional Cancer Program, all patients are provided with the "Information for Patients and Families" binder that was designed by an interdisciplinary cancer patient education team. Patients were asked to complete a survey to evaluate the usefulness of this binder. Timely delivery of the "Information for Patients and Families" binder validates a higher level of satisfaction with oncology services because patients are better informed and this translates into a reduction of psychosocial problems.

Clinician-patient communication: a systematic review.

Goal Of Work: The goal of this work was to identify methods of clinician-patient cancer-related communication that may impact patient outcomes associated with distress at critical points in the course of cancer care.

Materials And Methods: A systematic review of practice guidelines, systematic reviews, or randomized trials on this topic was conducted. Guidelines for quality was evaluated using the Appraisal of Guidelines for Research and Evaluation Instrument, and the contributive value for recommendations was assessed.

Hear How I Feel.

In an effort to heighten the awareness of the high school population, a support group program for young people whose parents were diagnosed with cancer received funding to produce an educational video titled Hear How I Feel. This article reports on the evaluation of the video by 146 high school teachers, guidance counselors, and students; elementary school teachers; university undergraduate social work students; and health care and social service providers. A qualitative analysis of the evaluations indicated that high school teachers and guidance counselors were reluctant to use the video in the high school setting because they could not respond expertly to emotions that might be elicited.