Psycho-oncology
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Measuring patient's satisfaction with their physician is gaining interest but requires a questionnaire that is valid, reliable and acceptable to patients. We previously published a self-administered visit-specific satisfaction with physician questionnaire for cancer patients. Eighty outpatients at a Canadian Cancer Center completed the Princess Margaret Hospital Patient Satisfaction with Doctor Questionnaire and the FACT-G questionnaires along with demographic information just after clinic visit and again 3-5 days later. ⋯ Confirmatory factor analysis applied to the data from 174 patients in the original study indicated excellent goodness of fit. PMH/PSQ-MD correlated moderately with FACT-G (average r=0.37, p<0.005). The PMH/PSQ-MD questionnaire is a brief, valid and reliable questionnaire that taps two complementary facets of patient satisfaction.
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Cancer patients who are deficient in literacy skills are particularly vulnerable to experiencing different outcomes due to disparities in care or barriers to care. Outcomes measurement in low literacy patients may provide new insight into problems previously undetected due to the challenges of completing paper-and-pencil forms. ⋯ The TT is a practical, user-friendly data acquisition method that provides greater opportunities to measure self-reported outcomes in patients with a range of literacy skills.
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This multi-centred study examined how 93 women due to undergo mastectomy had elected for (n=37) or against (n=56) immediate breast reconstruction. Initial semi-structured interviews were conducted prior to undergoing surgery whilst follow-up interviews 6 and 12 months later examined particpants' experiences of surgery and their views on their decision. Three decision-making styles were identified. ⋯ Experiences of surgery often failed to match patients' pre-surgical expectations and the process of adjusting to the impact of surgery continued throughout the following year, during which women contended with a range of problems including pain, scarring and adjusting to a reconstructed breast. However, most women reported themselves satisfied with their decision and justified their choices by focussing on positive aspects of their surgery. Whilst many women make a quick decision about breast reconstruction, research needs to explore ways of facilitating decision-making amongst those who find this decision particularly difficult.
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The pastoral-care interventions of chaplains at Memorial Sloan-Kettering Cancer Center were documented during two-week periods in each of three years. The study describes the pattern of referrals to and from chaplains and the kinds of interventions performed during the chaplains' contacts with patients and their families and friends. Nearly a fifth of all chaplain interventions were the result of referrals. ⋯ Pastoral visits were significantly shorter when patients were not present. In particular, pastoral-care interventions were found to differ according to the patient's religion and the circumstances of the chaplain's visit to the patient (i.e. patient status). Visit duration also varied by patient status, with pre-operative visits being significantly shorter than post-operative or treatment visits.
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A diagnosis of ovarian cancer requires a woman to reevaluate her interactions with family, friends, and employers, and cope with unexpected and unwanted changes in areas spanning from financial stability to sexuality and fertility. Social well-being is the aspect of a patient's overall quality of life that encompasses these topics, as it has evolved to represent activities related to roles and relationships at work and at home. The purpose of this study was to explore the social well-being of women with ovarian cancer to better define their needs for the health care community. ⋯ Issues related to employment and returning to work (n = 74) focused on both the difficulties in taking time off work to receive treat-ment and sense of achievement felt upon returning to work and regaining normalcy. The themes identified in this study challenge healthcare professionals to provide increased disease-specific support, as well as concomitant sup-port for husbands/partners and children of patients. Additional information on genetic testing and counseling for women at-risk due to a family history of ovarian cancer is also needed.