A Retrospective Age Analysis of the Ambulatory Oncology Patient Satisfaction Survey: Differences in Satisfaction across Dimensions of Person-Centred Care and Unmet Needs among Older Adults Receiving Cancer Treatment.

Over half of all new cancer cases in Alberta are diagnosed among people aged 65+ years, a group that encompasses vast variation. Patient-reported experience measures are routinely collected within Cancer Care Alberta; however, the specific consideration of the needs and concerns of older Albertans with cancer is lacking. In 2021, 2204 adults who had received treatment at a cancer centre in Alberta completed the Ambulatory Oncology Patient Satisfaction Survey (AOPSS). In this study, we explored the age differences in satisfaction across six dimensions of person-centred care and in the proportions of unmet needs across eight types of issues, with specific attention to older adults. Using three age groups (18-39, 40-64, 65+), only the physical comfort dimension showed significantly lower satisfaction among those aged 65+ years. Using five age groups (18-39, 40-64, 65-74, 75-84, 85+), significantly lower levels of satisfaction were found related to 'physical comfort' for those aged 65-74 and 75-84, 'coordination and continuity of care' for those aged 75-84 and 85+, and 'information, communication, and education' for those aged 85+. Therefore, grouping together all older adults aged 65+ years obscured lower levels of satisfaction with some dimensions of person-centred care among those aged 75-84 and 85+ years. Unmet needs generally increased with age for all types of issues, with significant differences across age groups for emotional, financial, social/family, and sexual health issues. The lower levels of satisfaction and higher proportions of unmet needs call for tailored interventions to promote optimal care experiences and outcomes among older adults receiving cancer care in Alberta and their families.

Quantifying the Impact of Family Doctors on the Care Experiences of Patients with Cancer: Exploring Evidence from the 2021 Ambulatory Oncology Patient Satisfaction Survey in Alberta, Canada.

Oncology programs across Canada are reaching capacity as more Canadians are diagnosed with and treated for cancer each year. There is an increasing need to share care with family doctors, however it is unclear how this type of care impacts patient experiences, particularly while receiving active treatment. Retrospective data from the 2021 Ambulatory Oncology Patient Satisfaction Survey (AOPSS) in Alberta, Canada was used in this study. A unique question on the Alberta survey asks patients about their family doctor's involvement during their cancer care. Patient satisfaction across the six domains of person-centred care on the AOPSS was analyzed based on how involved a patient's family doctor was. Compared to patients who indicated their family doctor was "Not involved", patients with "Very involved" family doctors had significantly higher satisfaction scores in all six domains of care. The three domains which showed the largest positive impact of family doctor involvement were: Coordination & Integration of Care, Emotional Concerns, and Information, Communication & Education. The results demonstrate that involving family doctors in cancer care can be beneficial for patients. Based on the observed satisfaction increases in this study, shared care models may be preferred by many patients. These models of care can also help alleviate strain and capacity issues within cancer programs. The results could be used to support recommendations for cancer care teams to regularly involve and communicate with family doctors, to ensure that patients receive comprehensive and tailored care from all their health care providers.

Recreational Running Motivations among Breast Cancer Survivors.

Lifestyle-associated factors play an important role in prevention of such malignancies as breast cancer (BC), prostate cancer, or colon cancer. Physical activity (PA) before, during, and after diagnosis improves outcomes for BC. People after BC live with numerous side effects and PA has potential to reduce some of them. Unfortunately, few cancer survivors exercise regularly. The aim of this study was to ascertain motivations for running among BC survivors (in comparison with the motivations of healthy women) in order to better manage their attitudes in terms of PA and active lifestyle. A total of 317 Polish women took part in the study: 152 BC women (age 46.49 ± 7.83; BMI 24.78 ± 3.50) and 165 healthy runners (control group (age 36.91 ± 9.68; BMI 23.41 ± 3.94)) using the diagnostic survey method with the Motivation for Marathoners Scale (MOMS) questionnaire. Study results show that healthy runners had higher scores for health orientation, personal goal achievement, and affiliation compared to the group of BC survivors. The scores for weight concern, recognition, psychological coping, life meaning, and self-esteem were lower than those of BC survivors. These results should be included in the management of PA attitudes among BC survivors.

Kinesiophobia among Breast Cancer Survivors One Year after Hospital Treatment.

Breast cancer (BC) is one of the most dangerous health problems affecting women. Lifestyle-associated determinants like physical activity (PA) play an important role in BC treatment outcomes. Studies suggest that oncology patients are insufficiently physically active. One of the potential barriers is kinesiophobia-fear of movement due to expected pain and fatigue. The aim of this cross-sectional study is to investigate the level of kinesiophobia among women one year after BC hospital treatment depending on socio-demographic variables, stage and type of BC, lifestyle, and comorbidities. Polish women after BC (n = 138, age 46.5 ± 9.2, BMI 24.6 ± 4.0) participated in the study and the Tampa Scale of Kinesiophobia (TSK) questionnaire was used in the diagnostic survey. The study results show that women suffer from kinesiophobia after BC. Moreover, every third woman (32.6%) does not practice sport regularly one year after BC treatment. The lifestyle before BC diagnosis impacts the level of kinesiophobia after treatment-women who were not physically active before BC diagnosis declared higher levels than previously active women. The study result shows that a high level of kinesiophobia correlates with a low level of PA among women after BC. Women with obesity and diabetes also declared higher levels of kinesiophobia than women without comorbidities. The type and stage of BC have no influence on the level of kinesiophobia; however, in terms of socio-demographic variables, a direct association between kinesiophobia and age has been found-the greater the age, the higher the level of kinesiophobia. Further research on fear of movement in oncology is required in order to effectively eliminate hypokinetic attitudes in every type of female and male cancer.

Improving Timely Antibiotic Administration for Pediatric Oncology Patients With Neutropenic Fever Seen in the Emergency Department.

Objective: To improve the care for pediatric oncology patients with neutropenic fever who present to the emergency department (ED) by administering appropriate empiric antibiotics within 60 minutes of arrival. Patients and Methods: We focused on improving the care for pediatric oncology patients at risk of neutropenia who presented to the ED with concern for fever. Our baseline adherence to the administration of empiric antibiotics within 60 minutes for this population was 53% (76/144) from January 1, 2010, to December 21, 2014. During 2015, we reviewed data monthly, finding 73% adherence. We used the Lean methodology to identify the process waste, completed a value-stream map with input from multidisciplinary stakeholders, and convened a root cause analysis to identify causes for delay. The 4 causes were as follows: (1) lack of staff awareness; (2) missing patient information in electronic medical record; (3) practice variation; and 4) lack of clear prioritization of laboratory draws. We initiated Plan-Do-Study-Act cycles to achieve our goal of 80% of patients receiving appropriate empiric antibiotics within 60 minutes of arrival in the ED. Results: Five Plan-Do-Study-Act cycles were completed, focusing on the following: (1) timely identification of patients by utilizing the electronic medical record to initiate a page to the care team; (2) creation of a streamlined intravascular access process; (3) practice standardization; (4) convenient access to appropriate antibiotics; and (5) care team education. Timely antibiotic administration increased from 73%-95% of patients by 2018. More importantly, the adherence was sustained to greater than 90% through 2021. Conclusion: A structured and multifaceted approach using quality improvement methodologies can achieve and sustain improved patient care outcomes in the ED.

Survey Study of Awareness and Perception of Palliative and Hospice Care in a Cancer Center in Rural Pennsylvania.

Purpose: Hospice and palliative medicine (HPM) have been gaining ground especially in large urban settings. However, less is known about their perception in small rural areas. This study assessed the awareness and perception of a rural oncology population of this field and the effects of prognosis on their awareness. Methods: Subjects were patients of the community cancer center in rural Clarion County, Pennsylvania, who volunteered to complete a short nine-question survey (supplemental figure). Results were analyzed based on completed surveys. Results: A total of 65 surveys were collected from the Cancer Center at the Clarion Hospital. Among these patients, 54% stated that they have heard of palliative and hospice medicine. When correlating patient-reported prognosis with their awareness of palliative and hospice care, 100% of the patients with poor prognosis were aware of palliative or hospice care, respectively. In contrast, only <20% of patients with reported good prognosis were aware of HPM. Conclusions: Our study has shown that the awareness of HPM in rural areas is improving. It was observed that more patients are aware of HPM is when their prognosis was poor as compared with those who reported good prognosis.

Próteses Bucomaxilofaciais na Reabilitaçâo Estético-Funcional de Pacientes Oncológicos / Maxillofacial Protheses in the Aesthetic-functional Rehabilitation of Cancer Patients

Introdução: As próteses bucomaxilofaciais são uma opção terapêutica para o reparo de estruturas afetadas na região facial e/ou intraoral do paciente oncológico submetido à cirurgia. Objetivo: Relatar a utilização de próteses bucomaxilofaciais na reabilitação estético-funcional de pacientes oncológicos. Relato dos casos: Os dois primeiros casos ilustram reabilitações extraorais por próteses adesivas de silicone, ambos em pacientes do sexo feminino. O primeiro trata-se de uma paciente de 83 anos, com diagnóstico de carcinoma basocelular em asa nasal direita, submetida a ressecção cirúrgica e reabilitada por prótese nasal há 7 meses. O segundo, de uma paciente de 51 anos, diagnosticada com múltiplos carcinomas basocelulares esclerodermiformes, tratada com cirurgia e reabilitada há 8 meses com prótese facial. O terceiro caso aborda a reabilitação de uma paciente do sexo feminino, 58 anos, diagnosticada com carcinoma de células escamosas em palato duro, tratada com cirurgia e radioterapia, reabilitada há 1 ano e 6 meses com prótese obturadora de palato feita de polimetilmetacrilato. Conclusão: Os casos apresentados evidenciam as próteses bucomaxilofaciais como ferramentas essenciais no reestabelecimento da estética e função dos pacientes oncológicos, bem como a sua contribuição nas questões psicológicas, no processo de reinserção no convívio social e na melhora da qualidade de vida destes indivíduos. Além disso, ratificam a importância da inserção do cirurgião-dentista na equipe multiprofissional em oncologia, com ênfase na reabilitação pós-operatória através das próteses bucomaxilofaciais.

Introduction: Maxillofacial prostheses are a therapeutic option for repairing affected structures in the facial and/or intraoral region of cancer patients submitted to surgery. Objective: To report the use of maxillofacial prosthetics in the aesthetic-functional rehabilitation of cancer patients. Case reports: The first two cases show extraoral rehabilitations using adhesive silicone prosthetics in female patients. The first one, an 83-year-old woman, diagnosed with basal cell carcinoma in the right nasal wing, who underwent surgical resection and was rehabilitated with a nasal prosthesis 7 months ago. The second case refers to a 51-year-old female, diagnosed with multiple sclerodermiform basal cell carcinomas, treated with surgery and rehabilitated with a facial prosthesis 8 months ago. The third case addresses the rehabilitation of a 58-year-old female patient, diagnosed with squamous cell carcinoma of the hard palate, treated with surgery and radiotherapy. She was rehabilitated 1 year and 6 months ago with a polymethylmethacrylate obturator prosthesis. Conclusion: The presented cases show that maxillofacial prostheses are essential tools in the reestablishment of esthetics and function of cancer patients, as well as their contribution to psychological issues, in the process of reinsertion in social life and by improving the quality of life of these individuals. Furthermore, they confirm the importance of inserting the dentist in the multidisciplinary oncology team, with an emphasis on postoperative rehabilitation through maxillofacial prostheses.

Disseminated Histoplasmosis: A Rare Cause of Pancytopenia in an Immunocompromised Patient.

Histoplasma capsulatum  is a dimorphic fungus endemic to North and South America. This organism's ubiquity outside the traditionally defined region of the Mississippi and Ohio River Valley makes it an important yet often forgotten cause of systemic inflammatory disease. Progressive disseminated histoplasmosis is an uncommon opportunistic infection, largely affecting immunocompromised individuals with defects in T-cell immunity. The initial manifestations of disseminated histoplasmosis present non-specifically with symptoms such as fever, malaise, anorexia, and weight loss. Given this fungi's endemic nature, disseminated histoplasmosis is an essential disease for physicians to diagnose accurately. Diagnosis can be established through antigen detection in the blood or urine, although the gold standard is tissue diagnosis or fungal culture. Treatment of mild to moderate disease consists of an itraconazole regimen for a year, yet severe disease requires an additional 14-day induction therapy with amphotericin B. We present a case of disseminated histoplasmosis in a breast cancer patient, recently treated with neoadjuvant chemotherapy, who presented with new-onset pancytopenia.

Adult oncology patients' experiences of living with a central venous catheter: a systematic review and meta-synthesis.

BACKGROUND: The incidence of cancer is increasing globally, and a greater number of patients will receive treatments though central vascular access devices (CVADs). Only a few qualitative studies describe the experience of adult oncology patients living with CVADs, and no systematic review of literature has been published on this topic. We therefore aimed to systematically synthesize the evidence of the qualitative studies on the experience of adult oncology patients with CVADs to report the implications of living with this device, and to inform healthcare professionals (HCPs) about problematic aspects of care for this population. METHODS: A comprehensive literature review was conducted on PUBMED, MEDLINE, SCOPUS, COCHRANE, and WEB OF SCIENCE, and was updated on May 25, 2021. Nine studies fulfilled the inclusion criteria. The evidence was synthesized using the meta-aggregation approach proposed by the Joanna Briggs Institute. RESULTS: Four themes emerged: During catheter implantation oncology patients typically experience reluctance, apprehension and acceptance; The nature of the information, knowledge transmission and HCPs' competence all influence the patient's confidence; How the presence of a catheter impacts the patient's daily life, their self-perception and their social behavior; The catheter is a symbol of disease, a friend that helps prevent problems, and its removal is perceived as physical and psychological liberation. CONCLUSION: This systematic review evidenced some problematic aspects related to patient information, education and device management, and gaps in nursing skills on handling the device. The results of this review should be used as a framework for improvement interventions.

Comparison of Patient-Reported Experience of Patients Receiving Radiotherapy Measured by Two Validated Surveys.

Patient-reported experience is associated with improved patient safety and clinical outcomes. Quality improvement programs rely on validated patient-reported experience measures (PREMs) to design projects. This descriptive study compares the experience of cancer patients treated with radiation as recorded through the Ambulatory Oncology Patient Satisfaction Survey (AOPSS) or as recorded through Your Voice Matters (YVM) between February and August 2019. Six questions were compared ("overall experience with care", "discussion of worries", "involvement in decisions", "trusting providers with confidential information", "providing family with information", and "knowing who to contact"). Positive experience scores were calculated by cohort and by tumor groups. Multivariable logistic regression models evaluated factors associated with positive experience. Two cohorts (220 and 200 patients) met the eligibility criteria for the AOPSS and YVM, respectively. Positive experience was reported similarly between the two PREMs for "overall experience with care", "discussion of worries", and "trusting providers with confidential information" with a score difference of 1-4% at the cohort level. Positive experience score difference ranged from 5% to 44% across questions at the tumor group level. Different experience gaps were identified with the two measures, mainly at the tumor group level. Programs interested in using these PREMS might consider this when designing projects.

The Effect of Concealing the Hydration Fluid on Anticipatory Nausea-Vomiting in Pediatric Hematology-Oncology Patients Undergoing Chemotherapy Treatment: A Randomized Controlled Study.

PURPOSE: The aim of this study was to assess the effectiveness of concealing the hydration fluid bottle in order to reduce the experience of anticipatory nausea and vomiting before chemotherapy treatment in pediatric hematology oncology patients undergoing chemotherapy treatment. DESIGN AND METHODS: The study was carried out as a randomized controlled clinical trial. The study was conducted sixty-two pediatric oncology patients who underwent chemotherapy in a hospital in Ankara, Turkey. The patients were randomly alloceted to an intervention group (n = 32) or a control group (n = 30). Patients in the intervention group concealing the hydration fluid bottle throughout the duration of hydration; patients in the control group received routine procedure (No concealment intervention) during hydration degree of nausea and vomiting were measured by the Baxter Retching Faces (BARF) scale. RESULTS: This study found no differences in the characteristics of the patients or in degree of nausea and vomiting between groups at enrollment. After concealing the hydration fluid bottle during the hydration, BARF scores were lower in the intervention group (p < .001). CONCLUSION: Concealing the hydration fluid had significant effects on degree of nausea and vomiting in pediatric oncology patient who received hydration before chemotherapy. APPLICATION TO PRACTICE: This approach can be added as routine care as an effective non pharmacological intervention for pediatric oncology patient with receiving chemotherapy.

The impact of advanced nurse practitioner (ANP) role on adult patients with cancer: A quantitative systematic review.

AIM: This study aims to identify how Advanced Nurse Practitioners (ANPs) can contribute to oncology care. BACKGROUND: The position of ANPs has grown significantly in recent years and ANPs have been shown to make significant contributions to various areas of healthcare. Due to improvements in research and techniques elder cancer patients are living longer, as beneficial, as this is to patients it is putting a strain on the provision of care as support is required at various stages. As there have been discussions about how ANPs +. can be most effectively employed this study identifies that ANPs, due to their skills and knowledge, may be able to assist elderly patients with long-term conditions specifically oncology patients. Therefore, research has been undertaken to identify how ANPs are currently employed in oncology. METHODS: A systematic review was conducted in order to gain background information into how the role of ANPs in oncology is perceived and to gain understanding of some of the issues that they face and identify the skills that they have in order to be able to make a positive contribution. This was followed by a study of quantitative Randomized Control Trials, which looked at the roles of ANPs in oncology. Thematic Analysis was conducted in order to gain a perspective of how ANPs are best currently employed with elderly oncology patients. RESULTS: Five studies were reviewed which showed that ANPs provide support to elder patients which helps to alleviate stress and improve the quality of life of cancer patients. Furthermore, it was seen that ANPs can aid patients in symptom management. CONCLUSION: This study has shown that ANPs are effectively used in clinical support for cancer patients. Further studies are required to verify the extent of this support and to determine if this support is effective only in the short term or can it be applied just as effectively over a period of time. ANPs have high-level knowledge and skills but more research is required to determine how they work effectively.

Novel mobile application for direct communication between pharmacists and patients treated with oral antineoplastic agents.

PURPOSE: Initial experience with use of a smartphone application to enhance communication with and home monitoring of hematology/oncology patients under treatment with oral antineoplastic agents (OAAs) is described. SUMMARY: Broad use of OAAs is changing the landscape of hematology/oncology patient care, with this form of therapy giving patients greater autonomy but also raising concerns about correct OAA administration and management of adverse effects (AEs) or interactions. Information and communication technologies, specifically mobile health technologies, are ideal tools in this new environment. A multidisciplinary team at a large hospital in Spain developed a smartphone application for patients receiving OAA therapy that consists of 5 modules or functionalities: (1) a treatment agenda, or electronic journal of patient activity, including medication use; (2) a treatment record; (3) continuous recording of vital signs (blood pressure and temperature), health-related quality of life, and AEs, with management of AEs based on an algorithm that displays different recommendations according to AE severity; (4) 2-way messaging capability; and (5) information and links to websites of interest. From June through November 2017, 37 patients downloaded and used the application. About two-thirds (68%) of the patients sent a total of 182 messages to the pharmacist on duty; 58% of the patients registered at least 1 AE. The mean time of registration of the first AE after initiation of OAA therapy was 8 days. As a result of patient use of the application, 2 emergency room visits were avoided and 3 patients were referred to a general practitioner. CONCLUSION: The application has allowed real-time monitoring of patients treated with OAAs. This new patient-pharmacist communication channel has facilitated the early detection of AEs, contributing to the safety of treatment and patient satisfaction with healthcare.

Generating Oncology Patient Trust in the Nurse: An Integrative Review.

An integrative review was conducted to evaluate the extent and quality of literature regarding adult oncology patients' trust in nurses. Nineteen studies met the inclusion criteria. Three themes were identified, which are as follows: nurse trust facilitating behaviors, nurse attributes, and the influence of patient-nurse trust on health and psychosocial well-being. Findings indicate that the extent of literature is limited in specific examples of nurse interventions that facilitate interpersonal patient-nurse trust. Future research should include more detailed nurse actions and attributes that build patient-nurse trust to fully understand the benefits of trust in oncology patients.

A Cross-Sectional Analysis of Ambulatory Oncology Experience by Treatment Intent.

The Ambulatory Oncology Patient Satisfaction Survey (AOPSS) is a standardized instrument to assess the overall cancer patient experience. This study retrospectively investigated differences in care experiences and satisfaction among ambulatory oncology patients who self-identified as receiving outpatient therapies for curative intent or for symptom or disease control. This cross-sectional study analyzed data from the AOPSS collected between February and April 2019 within the provincial cancer program in Alberta, Canada. There were 2104 participants who returned the survey, representing a 52.7% response rate. This nationally validated survey gathers patient care experiences and satisfaction across six domains of person-centred care. Treatment intent was characterized by adding a new "goal of treatment" question. Statistical analysis was performed using Mann-Whitney U tests and analysis of covariance (ANCOVAs). Cancer patients' treatment goals were found to be significantly associated with key patient characteristics like age, sex, tumour group, and the locations where they received care. Patients whose self-identified goal of treatment was to cure their cancer reported significantly higher levels of satisfaction and a more positive experience in five out of the six person-centred care domains. Results identify marked differences in satisfaction and experience between these two patient groups even though they both received care in the same ambulatory environments. A better understanding of the experience and satisfaction of non-curative cancer patients could allow for a more holistic and supportive approach to patient care. In addition, an early palliative approach to care is recommended for improved patient outcomes.

Guía práctica sobre cuidado en casa para adultos con cáncer y neutropenia asociada / Practical Guide to Home Care for Adults with Cancer and Associated Neutropenia

El presente trabajo responde a una necesidad en la práctica de Enfermería por haber sido realizado en el marco de una maestría de profundización, en la que se busca la transferencia o aplicación del conocimiento construido a la sociedad. El trabajo se refiere a los cuidados que requiere una persona con cáncer que se encuentra en tratamiento y, a su vez, presenta neutropenia, abordando la familia o cuidador principal como ente de protección desde la educación y adquisición de conocimientos frente al cuidado de la inmunosupresión. El objetivo fue elaborar una guía práctica de cuidado dirigida a cuidadores de adultos con cáncer que cursan con neutropenia. Se contó con la participación de los cuidadores de personas con cáncer y profesional experto en el área de oncología quienes validaron el contenido de la propuesta, acorde con las orientaciones emitidas por la Organización Panamericana de la Salud para la elaboración de material educativo. Se obtuvo como producto una cartilla comprensible y válida que es útil como instrumento para el desarrollo de procesos pedagógicos con cuidadores de personas con cáncer que cursan con neutropenia. Palabras clave: Cáncer, neutropenia, cuidador, neutropenia febril, paciente oncológico.

This thesis responds to a need in Nursing practice as it was carried out within the framework of a deepening master's degree, in which the transfer or application of knowledge built to society is sought. The thesis refers to the care required by a person with cancer who is undergoing treatment and in turn, has neutropenia, addressing the family or main caregiver as a protective entity from the education and acquisition of knowledge regarding the care of immunosuppression. The objective was to develop a practical care guide aimed at caregivers of adults with cancer who present with neutropenia. The caregivers of people with cancer and an expert professional in the area of oncology participated, who validated the content of the proposal, in accordance with the guidelines issued by the Organizacion Panamericana de la Salud for the preparation of educational material. It was obtained like a product a book understandable and useful as an instrument for the development of pedagogical processes with caregivers of people with cancer who present with neutropenia. Keywords: Cancer, neutropenia, caregiver, febrile neutropenia, oncology patient.

Communication with cancer patient.

The oncological patients meet the diverse physicians in the different stages of their illness. It is important for other physicians to know a basic rules of supportive effective communication. There are big differences between patients in the communication style and type of information they accept. Patient´s information requirements may also change at various stages of the disease. Providing bad news is a frequent and important communication challenge for physicians. Internationally recognized and proven recommendation for communication is the six steps known as the SPIKES. Prolonging survival of cancer patients means not only communicating disease information but also information about irreversible and potentially irreversible side effects of treatment, disease complications, and limited prognosis. The communication skills are not inborn and do not necessarily improve with the clinical experience, this skill should be learned through structured communication training. Its the effective communication that lets talk sensitively about serious facts in the time-limited consultation.

Characteristics and outcomes of oncology unit patients requiring admission to an Australian intensive care unit.

BACKGROUND: Patients with advanced malignancies have historically been considered poor candidates for admission to the intensive care unit (ICU); however, prognosis is continually improving, and requirements for ICU access are increasing. AIM: To understand the characteristics and outcomes of oncology unit patients admitted to an Australian ICU and identify potential prognostic factors. METHODS: A single-centre, retrospective, cohort study conducted at a tertiary public hospital with a quaternary ICU in Sydney, Australia. All patients admitted under the medical oncology team requiring ICU admission between June 2014 and June 2016 were evaluated. Clinical outcomes were determined including mortality, ICU requirements (ventilation, dialysis, vasopressors, infection) and prognostic scores (Acute Physiologic and Chronic Health Evaluation (APACHE) II and Sequential Organ Failure Assessment (SOFA) score). RESULTS: There were 96 patients with mean age 61 years, 58% were male and 76% had metastatic disease. Most were receiving palliative treatment (89%), with recent chemotherapy (43%), immunotherapy (10%) and other therapies (5%). Of the 10 patients with recent immunotherapy, three (all with melanoma) required ICU admission due to immunotoxicity; 13% were admitted due to an oncological emergency. Mean APACHE II score was 17 (standard deviation (SD) 5.33), mean SOFA score was 3.99 (SD 2.70), ICU mortality was 5% and hospital mortality was 22%. Using multivariate logistic regression analysis, cancer stage, infection during ICU admission, intracranial mass effect on ICU admission and SOFA score were associated with 30-day mortality. CONCLUSION: Our patient population had good short-term survival outcomes despite most receiving palliative treatment. Cancer patients can achieve positive outcomes after ICU admission, and appropriate selection of patients is crucial.

Cuidados Paliativos: cartilha educativa para cuidadores de pacientes oncológicos / Educational booklet for caregivers of oncology patients in palliative care

Introdução: O câncer e seu tratamento são impactantes tanto para a família, quanto para o cuidador de paciente oncológico em cuidados paliativos. Como consequência, podem ocorrem várias alterações biopsicossociais e sintomas como ansiedade, fadiga, estresse, exaustão, isolamento social, instabilidade emocional. Esses problemas podem estar associados à mudança da rotina de vida do cuidador em relação ao cuidado oferecido ao paciente. O cuidador, na maioria das vezes, apresenta uma insegurança oriunda aos cuidados proporcionados ao paciente oncológico. Identifica-se que a maioria das vezes as orientações são fornecidas aos cuidadores de forma oral, mas não são fornecidas na forma impressa e nem disponibilizadas em mídias. Desta forma, há a possibilidade da redução da compreensão das informações fornecidas, podendo diminuir a efetividade do cuidado hospitalar, domiciliar e o entendimento sobre os cuidados paliativos. Métodos: Estudo metodológico, desenvolvido em duas etapas: levantamento bibliográfico e a elaboração da cartilha educativa para cuidadores de pacientes oncológicos em cuidados paliativos. Estudo descritivo sobre a elaboração de uma cartilha educativa em cuidados paliativos. Resultados: O uso do material educativo elaborado visa uma assistência mais humanizada prestada pelo cuidador ao paciente em cuidados paliativos, assim como um conhecimento preciso da magnitude do problema. Conclusão: A cartilha educativa foi elaborada como instrumento capaz de favorecer os cuidadores de pacientes oncológicos em cuidados paliativos sobre os principais sintomas, cuidados e informações que visam amenizar os momentos finais da vida desses pacientes. (AU)

Introduction: Cancer and its treatment have an impact both on the family and on the caregiver of oncology patients on palliative care. As a consequence, several biopsychosocial changes and symptoms including anxiety, fatigue, stress, exhaustion, social isolation and emotional instability are likely to occur. These problems may be associated with changes in the caregiver's routine in the context of caring for oncology patients. The caregiver is often unsure of how to provide them with such care. Guidance is usually given orally in caregiver training, without any printed or online material available. Therefore, there is a chance of reduced comprehension of the information provided, which could then reduce the effectiveness of both hospital and home care as well as the understanding of palliative care. Method: This methodological study followed two steps: first a literature review was conducted and then an educational booklet was prepared for caregivers of oncology patients in palliative care. Results: The use of this educational material aims to favor a more humanized care provided by the caregiver to the patient in palliative care and a more accurate knowledge of the magnitude of the problem. Conclusions: The educational booklet was designed as an instrument that could guide caregivers of oncology patients in palliative care about main symptoms, care procedures and other information with the purpose of softening the final phase of life of those patients. (AU)

Oncology Patient Interest in the Use of New Technologies to Manage Their Disease: Cross-Sectional Survey.

BACKGROUND: Information and communication technologies (ICTs) in oncology can revolutionize the medical care of cancer patients. ICTs can promote patients' empowerment and real-time disease monitoring. There is limited information about the impact of ICTs in cancer patients or their level of interest in using these tools for greater management of their condition. OBJECTIVE: This study aimed to understand the ICT usage profile in hematology-oncology patients to identify their needs and determine their level of interest in these technologies as a means of managing their disease. METHODS: A 28-item questionnaire was drawn up by a multidisciplinary team including pharmacists and oncologists. The questions were organized into 3 blocks, which were as follows: block A-sociodemographic characteristics; block B-use of ICTs when searching for health-related information; and block C-usage preferences for health apps. Hematology-oncology patients receiving treatment between May and July 2017 were included. A paper copy of the questionnaire was handed over to patients in either the day hospital or the pharmaceutical care consultancy in pharmacy services. RESULTS: A total of 650 questionnaires were handed out, with a participation of 94.0% (611/650). Patient sociodemographic characteristics were as follows: mean age was 57.8 years (age range: 19-91). Of 611 participants, 40.7% (249/611) had a university education, and 45.1% (276/611) of participants reported their overall state of health to be good. Results from use of ICTs when searching for health-related information were as follows: 87.1% (532/611) of participants were interested in being informed about health-related matters. Of all participants, 75.5% (532/611) sought information from health professionals and 61.3% (375/611) on the internet. Before going to their doctor's appointment, 21.8% (133/611) of patients looked up information about their disease or treatment on the internet. This access to the internet rose to 50.9% (311/611) after their first medical appointment with their oncologist. Usage preferences for health apps were as follows: 82.7% (505/611) had a smartphone, whereas 20.3% (124/611) had a health app installed. Overall, 81.5% (498/611) would use an app if their health professional recommended it to them, but 39.6% (242/611) were not willing to pay for it. CONCLUSIONS: The hematology-oncology patients showed a great deal of interest in searching for health-related information by means of ICTs, especially using smartphones and apps. The issues that drew the most interest in terms of apps were appointment management, advice on disease management, and communication with health professionals. Free access to these features and the recommendation by a health professional are important factors when it comes to their use. Therefore, the health care provider is a key element in the recommendation of ICTs, providing their knowledge and experience concerning their correct usage.