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排序方式: 共有1276条查询结果,搜索用时 46 毫秒
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Rajiv V. Dave Baek Kim Alona Courtney Rachel OConnell Tim Rattay Vicky P. Taxiarchi Jamie J. Kirkham Elizabeth M. Camacho Patricia Fairbrother Nisha Sharma Christopher W. J. Cartlidge Kieran Horgan Stuart A. McIntosh Daniel R. Leff Raghavan Vidya Shelley Potter Chris Holcombe Ellen Copson Charlotte E. Coles Ramsey I. Cutress Ashu Gandhi Cliona C. Kirwan 《British journal of cancer》2021,124(11):1785
Background The B-MaP-C study aimed to determine alterations to breast cancer (BC) management during the peak transmission period of the UK COVID-19 pandemic and the potential impact of these treatment decisions.Methods This was a national cohort study of patients with early BC undergoing multidisciplinary team (MDT)-guided treatment recommendations during the pandemic, designated ‘standard’ or ‘COVID-altered’, in the preoperative, operative and post-operative setting.Findings Of 3776 patients (from 64 UK units) in the study, 2246 (59%) had ‘COVID-altered’ management. ‘Bridging’ endocrine therapy was used (n = 951) where theatre capacity was reduced. There was increasing access to COVID-19 low-risk theatres during the study period (59%). In line with national guidance, immediate breast reconstruction was avoided (n = 299). Where adjuvant chemotherapy was omitted (n = 81), the median benefit was only 3% (IQR 2–9%) using ‘NHS Predict’. There was the rapid adoption of new evidence-based hypofractionated radiotherapy (n = 781, from 46 units). Only 14 patients (1%) tested positive for SARS-CoV-2 during their treatment journey.Conclusions The majority of ‘COVID-altered’ management decisions were largely in line with pre-COVID evidence-based guidelines, implying that breast cancer survival outcomes are unlikely to be negatively impacted by the pandemic. However, in this study, the potential impact of delays to BC presentation or diagnosis remains unknown.Subject terms: Breast cancer, Surgical oncology, Health care economics, Quality of life, Health policy 相似文献
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Brenda Happell RN Cert Psych Nurs BA DipEd MEd PhD FACMHN Shifra Waks BA MIHP B Int Global Stud Aine Horgan PhD MSc BNS PGCert T&L RPN Sonya Greaney DipSPH PG Cert Peer Support Fionnuala Manning John Goodwin MA PGDip Bsc BA ALCM DipMgmt RPN Julia Bocking BPhil B Soc & Comm Stud Brett Scholz BHSci PhD Elisabeth Hals MA Arild Granerud PhD Rory Doody B.Soc.Sc. Chris Platania-Phung BA PhD Martha Griffin H. Dip in Community Youth Work Siobhan Russell BSc RPN PhD Liam MacGabhann BSc MSc DrNursSci Jarmo Pulli Annaliina Vatula BA Graeme Browne RN MHN PhD FACMHN Kornelis Jan van der Vaart BN MSci Jerry Allon Einar Bjornsson Heikki Ellilä RN MNSc PhD Mari Lahti MNSc PhD Pall Biering PhD 《Perspectives in psychiatric care》2020,56(4):811-819
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Hannele Siltanen Tiina Aine Heini Huhtala Marja Kaunonen Tuula Vasankari Eija Paavilainen 《Scandinavian journal of primary health care》2020,38(1):47-55
AbstractObjective: To find out how regularly the contents of patient education regarded as essential for COPD patients’ self-management are provided by healthcare professionals in specialised healthcare (SHC) and primary healthcare (PHC) in Finland.Design: A cross-sectional study based on an e-questionnaire with 42 items on the content of self-management education of COPD patients.Setting: The study sample included all public SHC units with pulmonary outpatient clinics (n?=?29) and nine out of 160 health centres in Finland.Subjects: 83 doctors and 162 nurses.Main outcome measures: The respondents’ answers on how regularly they included the contents regarded as essential for COPD patients’ self-management in their education of COPD patients.Results: COPD patients were educated regularly on medical issues regarding COPD treatment, such as smoking cessation, exercise and pharmacological treatment. However, issues vital for coping with the disease, such as psychological well-being, stress management or fatigue, were often ignored. Patient education in SHC seemed to be more systematic than education in PHC. The education provided by the asthma/COPD nurses (n?=?70) was more systematic than the education provided by the other nurses (n?=?84).Conclusion: Healthcare professionals’ continuous education should cover not only the medical but also the psychosocial aspects of coping with COPD. The role of doctors and nurses should be considered to ensure that there is no gap in COPD patients’ education. Training asthma/COPD nurses and promoting specialised nurse-led asthma/COPD clinics in primary care could be beneficial while improving practices of patient education that enhance patients’ ability to cope with the disease.
- KEY POINTS
Issues vital for coping with chronic obstructive pulmonary disease (COPD), such as psychological well-being, stress and fatigue, are irregularly included in self-management education both in primary and specialised healthcare.
Patient education provided by asthma/COPD nurses is more regular than patient education provided by other nurses.
The distribution of work between doctors and nurses should be considered to ensure that there is no gap in COPD patients’ education.
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T. Hsu R. Chen S.C.X. Lin S. Djalalov A. Horgan L.W. Le N. Leighl 《Current oncology (Toronto, Ont.)》2015,22(6):385-391
BackgroundPatient function is a key part of the clinical decision to offer chemotherapy and has, in earlier studies, been associated with chemotherapy toxicity. Objective testing might be more accurate than patient-reported or physician-assessed physical function, and thus might be a stronger predictor of chemotherapy toxicity in older adults.MethodsPatients, 70 years of age and older, with thoracic or colorectal cancer were recruited. Three physical tests were performed before commencement of a new line of chemotherapy: grip strength, 4-m walk test, and the Timed Up and Go (tug). Our pilot study explored the association between those tests and chemotherapy toxicity.ResultsThe 24 patients recruited had a median age of 74.5 years (range: 70–84 years), and 54.2% had an Eastern Cooperative Oncology Group performance status of 0 or 1. Median score on the Charlson comorbidity index was 1 (range: 0–4). Almost two thirds had metastatic disease, 70% were chemonaïve, and 83.3% were about to receive polychemotherapy. Patients had a mean tug of 13.2 ± 5.7 s and a mean gait speed of 0.74 ± 0.24 m/s; 50% had a grip strength test in the lowest 20th percentile. Grades 3–5 chemotherapy toxicities occurred in 34.7% of the patients; two thirds required a dose reduction or delay; and one third discontinued chemotherapy because of toxicity. Hospitalization attributable to chemotherapy was uncommon (12.5%). A trend toward increased severe chemotherapy toxicity with slower gait speed was observed (p = 0.049).ConclusionsAbnormalities in objective markers of physical function are common in older adults with cancer, even in those deemed fit for chemotherapy. However, those abnormalities were not associated with an increased likelihood of chemotherapy toxicity in the population included in this small pilot study. 相似文献