Race, Zoonoses and Animal Assisted Interventions in Pediatric Cancer.

Emerging evidence accumulates regarding the benefits of animal-assisted interventions (AAIs) in facilitating pediatric cancer treatment and alleviating symptomatology through positive changes in the patients' emotional, mental, and even physical status. A major concern expressed by healthcare providers and parents in implementing AAIs in hospital settings is the transmission of disease from animals to patients. Immunocompromised children, such as pediatric cancer patients are at increased risk for pet-associated diseases. Furthermore, existing disparities among the racial and ethnic minority groups of pediatric cancer patients can potentially exacerbate their risk for zoonoses. This literature review highlights the most common human infections from therapy animals, connections to the race and ethnic background of pediatric oncology patients, as well as means of prevention. The discussion is limited to dogs, which are typically the most commonly used species in hospital-based animal-assisted therapy. The aim is to highlight specific preventive measures, precautions and recommendations that must be considered in hospitals' protocols and best practices, particularly given the plethora of benefits provided by AAI for pediatric cancer patients, staff and families.

Cancer Communication Outside of the Physician-Patient Relationship: The Experience of Communicating and Understanding the Meaning of Prognosis.

RESEARCH QUESTION: How does the process of engagement and integration of sources of information outside patient-physician interaction affect how individuals with cancer interpret their treatment experience and prognosis? BACKGROUND: Studies of patient-physician communication of prognosis in oncology highlight areas where misunderstanding occurs: understanding consequences of treatment, likelihood of treatment success, probability of cure, status/progression of illness, and prognosis. Theories proposing mechanisms that underlie this discrepancy cannot account for all instances of misunderstanding, including when complete and direct physician disclosure occurs. Prior research focused on patient-physician communication event(s) and immediate antecedents and consequences. However, less is known about what happens to information once it has been communicated and how a patient's process to interpret the meaning of their experience affects their understanding of it. Our study explores this question by examining patient communication with sources of information other than treating physicians. METHODOLOGY: We conducted 10 semi-structured qualitative interviews with individuals diagnosed with 4 types of cancer at different stages. The interviews were analyzed using inductive qualitative analysis. RESULTS: Participants in our sample consulted a variety of additional sources to give context and understanding to their communicated prognosis. These were important contributors to how they understood their prognosis and incorporated that understanding. They included family, friends/acquaintances, cancer survivors, support/survivor groups, secondary health-care staff, and relevant informational materials. Different motivations for seeking out these sources were also expressed. Participants expressed a link between their understanding of their prognosis and the variety of outside sources they enlisted for input and support.

The Doctor-Patient Relationship and Information-Seeking Behavior: Four Orientations to Cancer Communication.

BACKGROUND: In cancer communication, patients and physicians often understand a patient's experience and situation differently. This can negatively impact health outcomes and the physician-patient relationship. AIM: To explore how cancer patients' interpretations of the physician's role as information giver affect the communication relationship with the physician and their information-seeking behavior regarding different aspects of their cancer care. DESIGN: Participants completed a semistructured qualitative interview addressing their treatment experience and communication with their physician. Interviews were coded and analyzed using inductive thematic analysis. SETTING/PARTICIPANTS: Ten patients with cancer treated at a regional cancer center in central Illinois participated in the study. Cancer stages I to IV and 4 cancer types were represented. RESULTS: Participants' orientations to the relationship with their physician (and their information-seeking behavior) were classified into 4 general categories: (1) "questioners" have a general mistrust toward their physicians and the information doctors are giving; (2) "the undecided" focuses on physician "fit," often requiring time to step away in order to make decisions and process information; (3) "cross-checkers" are concerned with content of their treatment protocol, often double-checking the treatment plan; and (4) "the experience-oriented" feel a gap between their experience and their physician's experience (and perspective), often seeking information from other survivors. All categories described a perceived lack of adequate exchange of information and the need to seek information outside of the physician-patient relationship to compensate. CONCLUSION: Participants exhibited different information-seeking behaviors based on how they interpreted the role of their physician as information giver. This affected what kind of information they sought and how they understood the information received, which in turn affected understanding of their broader experience and care.

Analysis of the demographic characteristics and medical conditions of the uninsured utilizing a free clinic.

The number of medically uninsured people in the United States rose from 46 million in 2008 to an astonishing 50.7 million in 2009. This population is unable to seek medical care due, in part, to the decrease in employment-based health insurance and the increase in the cost of health care. Free health clinics exist to ensure access to health care by providing a safety net for underserved populations, ultimately decreasing health disparities among people of different socioeconomic statuses. The purpose of this study was to determine the demographic characteristics of the uninsured people who utilized a free health clinic and the purpose for their visits. Investigators gathered information from over 2,000 hand-written medical records to determine whether the demographic characteristics and health conditions of the uninsured differed from the general population. While there was no predominate medical condition in this population, special attention is needed to the prevention of smoking and obesity among the uninsured. This uninsured population had a significantly higher rate of smoking (P < 0.01) and obesity (P < 0.05) than the general population. In addition to treatment for medical conditions, 1 in 4 patients came for a physical exam. This study adds to the literature by describing characteristics of a free clinic population and their medical conditions. This research can contribute to the improvement of a health care delivery system that is challenged in providing access to medical care by low-income and uninsured populations.