Assessment of Patient Satisfaction Among Cancer Patients Undergoing Radiotherapy.

The patient-provider relationship is a key driver of patient satisfaction as it relates to overall healthcare experience. We surveyed patients undergoing radiation therapy to determine what they consider to be the most valued qualities in their interactions with the healthcare team. An ethics-approved 35-item patient satisfaction survey was developed in-house to gain insights on patients' perception of their relationship with the healthcare team throughout their cancer journey. There were 199 completed survey, median age 68 years, 54% women and 45% men. Almost all (95%) "agreed" or "strongly agreed" that their physicians had been sensitive and compassionate. Over 90% felt that they received adequate explanations about their treatment, and had their questions answered. The vast majority (93%) felt included in the decision-making process. Patients reported the 5 most highly rated qualities among their healthcare providers (HCPs) as knowledge, kindness, honesty, good communication, and a cheerful attitude. Overall satisfaction was high but areas for improvement were identified including being offered future appointments for further discussion, more information about clinical trials, other treatments, and community resources. Patients noted their HCPs tended to focus on the physical and emotional needs of patients, but spiritual and cultural needs were rarely addressed. Patients receiving radiotherapy reported high rates of satisfaction across many aspects of their care. These findings also reinforce the different aspects of holistic care that can be improved, and serve as a reminder to clinicians that patients perceive their role as more than just that of a medical expert.

The importance of humour in oncology: a survey of patients undergoing radiotherapy.

Background: Humour has long been considered an important coping tool for patients with cancer, but published quantitative data about its significance are limited. The purpose of our study was to survey patients with cancer undergoing radiotherapy regarding their opinions about the use of humour in their care. Methods: An anonymous 35-item questionnaire evaluating the patient experience, including the value of humour, was developed by an interdisciplinary team of health care providers (hcps) working within the Radiation Medicine program. This anonymous, voluntary, paper-based survey for self-completion required approximately 10 minutes to finish and was administered during the fall of 2018 and the spring of 2019. Results: For the 199 patients who completed the survey [108 women, 89 men (2 respondents did not specify)], median age was 68 years. That group represents approximately 30%-35% of the patients on treatment during the study period. Almost all respondents (86%) indicated that, during their visits to the cancer centre, it was "somewhat important" or "very important" for health care providers (hcps) to use appropriate humour, and 61% of respondents indicated using humour "frequently" or "always" when dealing with their individual cancers. Most respondents (79%) said that humour decreased anxiety, and 86% indicated that laughing was considered "somewhat important" or "very important." Approximately 4% of respondents even listed "sense of humour" as being the most important quality that they looked for in their interactions with their hcps. Conclusions: Cancer patients undergoing radiotherapy clearly view humour as being important for coping and dealing with their disease, and oncology hcps should routinely consider incorporating the use of appropriate humour into the care that they provide.

Characteristics of children with florid vitamin D deficient rickets in the Auckland region in 1998.

AIM: To describe the characteristics of children with vitamin D deficiency rickets and identify common features and predisposing factors. METHODS: A review of the clinical notes of all children less than five years of age with radiological evidence of rickets and serum 25-hydroxyvitamin D levels of less than 10 micrograms/L. Patients were identified by searching all low vitamin D levels performed at the Endocrinology laboratory at Auckland Hospital and children presenting to the Starship Childrens' Hospital with rickets in 1998. RESULTS: In 1998, there were eighteen children (ten males and eight females) with vitamin D deficient rickets. The age range was 3 to 36 months with a median of 12 months. There were twelve children of Indian ethnic origin, one Maori, one Tongan, one Western Samoan, one Ethiopian, one Moroccan and one Indonesian. All children had an elevated alkaline phosphatase level and most had very low serum 25-hydroxyvitamin D levels (< or = 5 micrograms/L), and over half were hypocalcaemic. The common presenting features were delayed walking and bowed legs, swollen wrists or ankles, hypocalcaemic seizure, incidental radiological abnormalities and failure to thrive. CONCLUSIONS: There are a significant number of children in Auckland presenting with florid clinical rickets. The majority with vitamin D deficient rickets in this survey were of Indian ethnic origin. Strategies are needed to detect children at risk of vitamin D deficiency and supplement them with vitamin D.

Effect of biofeedback-assisted relaxation on migraine headache and changes in cerebral blood flow velocity in the middle cerebral artery.

Twenty-three patients with diagnosed migraine headaches were randomly assigned to a biofeedback-assisted relaxation therapy group or to a group who relaxed on their own. The biofeedback trained group decreased pain and medication more than the self relax group. Cerebral blood flow velocity was measured in the middle cerebral artery with transcranial doppler (TCD). The trained group significantly reduced systolic and mean cerebral blood flow velocity on the side with the highest velocity.