Exploring facilitators and barriers to daily chlorhexidine gluconate bathing in adult patients undergoing hematopoietic stem cell transplantation.

Unlabelled: Hematopoietic cell transplantation (HCT) is a promising treatment for hematologic malignancies, but intensive conditioning leads to immunosuppression and susceptibility to healthcare-associated infections (HAI). Despite standard prevention measures, bloodstream infections (BSI) impact a significant percentage of immunocompromised HCT patients. Incidence of BSI can be mitigated by chlorhexidine gluconate (CHG) bathing-an underutilized infection-prevention strategy.

Large Language Model Use in Radiology Residency Applications: Unwelcomed but Inevitable.

Objective: This study explores radiology program directors' perspectives on the impact of large language model (LLM) use among residency applicants to craft personal statements.

Methods: Eight program directors from the Radiology Residency Education Research Alliance participated in a mixed-methods study, which included a survey regarding impressions of artificial intelligence (AI)-generated personal statements and focus group discussions (July 2023). Each director reviewed four personal statement variations for five applicants, anonymized to author type: the original and three Chat Generative Pre-trained Transformer-4.

Near-miss and maternal sepsis mortality: A qualitative study of survivors and support persons.

Background: Prior studies have shown that maternal deaths due to sepsis occur due to delays in recognition, treatment, and escalation of care through medical chart reviews. This study was conducted to obtain the patient perspective for near-miss and maternal mortality cases due to sepsis.

Objective: To identify quality improvement opportunities for improving maternal sepsis through patient and support person experiences.

Factors influencing central nervous system medication deprescribing and behavior change in hospitalized older adults.

Background: Central nervous system (CNS) medications are linked to higher morbidity and mortality in older adults. Hospitalization allows for deprescribing opportunities. This qualitative study investigates clinician and patient perspectives on CNS medication deprescribing during hospitalization using a behavioral change framework, aiming to inform interventions and identify recommendations to enhance hospital deprescribing processes.

Identification of barriers at the primary care provider level to improve inflammatory breast cancer diagnosis and management.

The purpose of this study, based in the United States, was to evaluate knowledge gaps and barriers related to diagnosis and care of inflammatory breast cancer (IBC), a rare but lethal breast cancer subtype, amongst Primary Care Providers (PCP) as they are often the first point of contact when patients notice initial symptoms. PCP participants in the Duke University Health System, federally qualified health center, corporate employee health and community practices, nearby academic medical center, Duke physician assistant and advanced practice nurse leadership program alumni were first selected in a convenience sample and for semi-structured interviews (n = 11). Based on these data, an online survey tool was developed and disseminated (n = 78) to assess salient measures of IBC diagnosis, health disparity factors, referral and care coordination practices, COVID-19 impact, and continuing medical education (CME).

Patient Preferences for Postmastectomy Breast Reconstruction.

Importance: Up to 40% of women experience dissatisfaction after breast reconstruction due to unexpected outcomes that are poorly aligned with personal preferences. Identifying what attributes patients value when considering surgery could improve shared decision-making. Adaptive choice-based conjoint (ACBC) analysis can elicit individual-level treatment preferences.

Stakeholder Perspectives on Factors Related to Deprescribing Potentially Inappropriate Medications in Older Adults Receiving Dialysis.

Background: Potentially inappropriate medications, or medications that generally carry more risk of harm than benefit in older adults, are commonly prescribed to older adults receiving dialysis. Deprescribing, a systematic approach to reducing or stopping a medication, is a potential solution to limit potentially inappropriate medications use. Our objective was to identify clinicians and patient perspectives on factors related to deprescribing to inform design of a deprescribing program for dialysis clinics.

Health Care Access Barriers and Self-Reported Health Among Adolescent and Young Adult Cancer Survivors.

Adolescents and young adult (AYA) cancer survivors (15-39 years at diagnosis) are at risk for treatment-related late effects but face barriers in accessing survivorship care. We examined the prevalence of five health care access (HCA) barriers: affordability, accessibility, availability, accommodation, and acceptability. We identified AYA survivors from the University of North Carolina (UNC) Cancer Survivorship Cohort who completed a baseline questionnaire in 2010-2016.

COVID-19 in the Community: Changes to Women's Mental Health, Financial Security, and Physical Activity.

Introduction: This study describes changes in the mental health, financial security, and physical activity levels of women in North Carolina during the COVID-19 pandemic.

Methods: Data were collected from women aged 20-40 years receiving primary care at 2 health centers in North Carolina during 2020-2022. Surveys (N=127) evaluated changes in mental health, financial security, and physical activity during the COVID-19 pandemic.

Describing current use, barriers, and facilitators of patient portal messaging for research recruitment: Perspectives from study teams and patients at one institution.

Introduction: The electronic health record (EHR) and patient portal are used increasingly for clinical research, including patient portal recruitment messaging (PPRM). Use of PPRM has grown rapidly; however, best practices are still developing. In this study, we examined the use of PPRM at our institution and conducted qualitative interviews among study teams and patients to understand experiences and preferences for PPRM.

Managing Chronic Pain in Cancer Survivorship: Communication Challenges and Opportunities as Described by Cancer Survivors.

Objectives: Many cancer survivors experience chronic pain after completing curative-intent treatment. Based on available data, chronic pain may be undertreated in this context; however, little is known about cancer survivors' experiences with clinical management of chronic pain. The purpose of this study was to better understand cancer survivors' pain management experiences after curative-intent treatment.

Modifiable Barriers and Facilitators for Breast Cancer Care: A Thematic Analysis of Patient and Provider Perspectives.

Introduction: We sought to examine patient and provider perspectives regarding modifiable contributors to breast cancer treatment and to assess perceptual alignment between these two groups.

Materials: Participants were women≥18 y with stage 0-IV breast cancer who received all oncologic care in a single health system and physicians and advanced practice providers who provided medical, radiation, or surgical oncology care for breast cancer. All completed ∼45-min semistructured interviews that were recorded and transcribed verbatim.

Clinician Perspectives on Managing Chronic Pain After Curative-Intent Cancer Treatment.

Purpose: Among cancer survivors who have completed curative-intent treatment, the high prevalence and adverse consequences of chronic pain are well documented. Yet, research on clinicians' experiences with and perspectives on managing chronic pain among cancer survivors is critically lacking.

Methods: We conducted semistructured interviews with 17 clinicians (six oncology, three palliative care, and eight primary care) affiliated with an academic medical center.

Development and Psychometric Evaluation of Healthcare Access Measures among Women with Ovarian Cancer.

Several proposed theoretical frameworks have defined the complex nature of healthcare access (HCA) [...

Assessing Knowledge and Barriers at the Primary Care Provider Level that Contribute to Disparities in Inflammatory Breast Cancer Diagnosis and Treatment.

Purpose: The purpose of this study was to evaluate knowledge gaps and barriers related to diagnosis and care of inflammatory breast cancer (IBC), a rare but most lethal breast cancer subtype, amongst Primary Care Providers (PCP) as they are often the first point of contact when patients notice initial symptoms.

Methods: PCP participants within Duke University Health System, federally qualified health center, corporate employee health and community practices, nearby academic medical center, Duke physician assistant, and nurse leadership program alumni were first selected in a convenience sample (n=11) for semi-structured interviews (n=11). Based on these data, an online survey tool was developed and disseminated (n=78) to assess salient measures of IBC diagnosis, health disparity factors, referral and care coordination practices, COVID impact, and continued medical education (CME).

"You start feeling comfortable, you just start sharing:" A qualitative study of patient distress screening in Black and White patients with endometrial cancer.

Objectives: Black patients with endometrial cancer are less likely to express distress and receive referrals for support services compared to White patients. We aim to characterize patient perceptions of the National Comprehensive Cancer Network Distress Thermometer and Problem List (NCCN DT & PL), a common distress screening tool, among Black and White patients with endometrial cancer and determine strategies to improve equity in referral to appropriate support services.

Methods: We conducted semi-structured interviews with 15 Black and 15 White patients with endometrial cancer who reported varying levels of distress on the NCCN DT & PL.

A Qualitative Assessment of Patient Experience following Systematic Implementation of Goals of Care Conversations in the Ambulatory Gynecologic Oncology Setting.

Objective: Although skilled goals of care (GOC) conversations are known to reduce aggressive futile end-of-life care, they have not been widely implemented nor standardized in the care of gynecologic malignancies. Clinicians express concern regarding patient readiness and willingness to participate in these conversations, which may be a barrier to GOC discussions.

Methods: This is a qualitative study, conducted at an academic institution in the United States, of patients with gynecologic malignancies at high risk of death within six months and who had recently completed a GOC discussion with their oncology clinician during an ambulatory visit.

Modifiable patient-reported factors associated with cancer-screening knowledge and participation in a community-based health assessment.

Background: We sought to identify modifiable factors associated with cancer screening in a community-based health assessment.

Methods: 24 organizations at 47 community events in central North Carolina distributed a 91-item survey from April-December 2017. Responses about (1) interest in disease prevention, (2) lifestyle choices (e.

Community collaboration to improve access and outcomes in breast cancer reconstruction: protocol for a mixed-methods qualitative research study.

Introduction: Breast reconstruction plays an important role for many in restoring form and function of the breast after mastectomy. However, rates of breast reconstruction in the USA vary significantly by race, ethnicity and socioeconomic status. The lower rates of breast reconstruction in non-white women and in women of lower socioeconomic status may reflect a complex interplay between patient and physician factors and access to care.

Understanding the needs and perspectives of ovarian cancer patients when considering PARP inhibitor maintenance therapy: Findings from two online community events.

Objective: The online environment is an ideal setting to understand how many women seek, receive, and understand information about cancer treatment. The purpose of this study was to understand women's needs and information-seeking around Poly ADP ribose polymerase (PARP) inhibitors, an oral medication commonly prescribed as maintenance therapy at the conclusion of primary chemotherapy for ovarian cancer.

Methods: We held online discussion events with two social media communities, #gyncsm social media on Twitter and the Smart Patients ovarian cancer community, in November 2020, to sample ovarian cancer patient perceptions of, and information seeking about PARP inhibitors.

Hidden Curriculum and the Demographic Stoicism That Keeps Women and Minorities Away From Radiology: A Mixed-Methods Study of Medical Students.

Objective: To understand how women and historically underrepresented minority medical students perceive radiology as a potential career choice.

Methods: Medical students representing a broad spectrum of radiology exposure from a single institution were invited to participate in a mixed-methods study. Participants completed a 16-item survey about demographics and perceptions of radiology.