ORCID Profile
0000-0001-7772-5315
Current Organisations
Norwegian Institute of Public Health
,
Helse Bergen
,
Universitetet i Bergen
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Publisher: Elsevier BV
Date: 08-2010
Publisher: Springer Science and Business Media LLC
Date: 25-01-2008
DOI: 10.1007/S11764-008-0043-4
Abstract: The number of cancer survivors is increasing dramatically. Many survivors report long-term psychosocial, physical and other consequences. To understand the issues faced by Australian cancer survivors we conducted focus groups with cancer patients and health professionals. Patients were identified through a peer support program at a major cancer treatment center (Peter Mac). Health professionals were also recruited from Peter Mac. Focus groups followed a semi-structured format based on themes identified from the literature. Questions focused on treatment completion, and 1 year post-treatment. Participants were also asked to suggest solutions to address identified issues. Focus groups were taped, transcribed, cross-checked for accuracy, and analyzed independently. The most common needs (in terms of both frequency and intensity) reported at treatment completion by both survivors and professionals were dealing with fatigue, anxiety about cancer recurrence, others expecting you to be back to normal, having to create new expectations about physical ability, and anxiety about leaving the hospital system. The most common needs at 1 year were anxiety about check-ups and results, and going into early menopause. The most frequently suggested ways of meeting these perceived needs were reassuring survivors the way they feel is normal and putting them in contact with others who have been through the same experience. There was a high level of congruence in the themes identified by survivors and health professionals. These results provide a clear direction for the development of resources to support cancer survivors following treatment completion.
Publisher: Springer Science and Business Media LLC
Date: 05-05-2009
DOI: 10.1007/S11764-009-0086-1
Abstract: Increasing numbers of people survive cancer beyond diagnosis and treatment. Many survivors have ongoing needs and they may encounter fragmented, poorly coordinated follow up care. Survivorship care plans (SCP) have been promoted as a key aspect of survivorship care. This study aimed to survey key stakeholders in the care of people with colorectal cancer (survivors, primary care providers and hospital-based healthcare professionals) regarding follow-up and SCP. In study 1, cancer survivors completed a questionnaire regarding their follow-up and experiences during survivorship. Participants' primary care physicians completed a phone interview regarding proposed SCP elements. A subgroup of survivors reviewed a s le SCP and participated in a phone interview regarding this. In study 2, healthcare professionals working with colorectal cancer patients completed a questionnaire regarding follow-up and proposed elements of a SCP. Twenty survivors completed the questionnaire, 14 primary care providers completed a phone interview and 12 survivors reviewed the s le SCP. Ninety-five healthcare professionals (30 medical professionals and 65 nurses) completed the questionnaire. There was strong support for core elements of the SCP. Additionally, nurses and survivors expressed support for supportive care and psychosocial elements. There was lack of consensus regarding who should prepare and discuss the SCP. There is strong support for the development and use of SCPs for bowel cancer survivors. There is some variation in opinion regarding ideal content of the SCP, who might prepare it, and how it might be discussed and utilised. Overcoming identified barriers to implementing SCPs for bowel cancer survivors is necessary for high quality cancer care.
Publisher: Springer Science and Business Media LLC
Date: 15-08-2007
DOI: 10.1007/S11764-007-0022-1
Abstract: Improvements in cancer screening and treatment are resulting in an increase in the number of cancer patients completing treatment who are apparently cured of their disease. There are few information resources for people at this juncture. An evidence-based DVD was developed for in iduals at this stage with information about experiences encountered as a cancer survivor (CS). Focus groups and a literature review were conducted to establish the DVD content. The DVD was developed in conjunction with a multidisciplinary committee and according to a recommended best-practice framework. Interviews with CS and evidence-based commentary by health professionals (HP) made up the DVD. The final phase of development was to evaluate the usefulness and acceptability of the DVD with CS and HP. A 52-min DVD with nine chapters was developed featuring 13 CS, a medical oncologist and a clinical psychologist. Thirty-two CS and 116 HP evaluated the DVD. Both groups considered the DVD was informative (CS 97% HP 98%), easy to understand (CS and HP 100%), reassuring (CS 91% HP 92%), relevant to their circumstances (CS 68% HP 97%), did not contain too much information (CS 75% HP 71%) and was not distressing to watch (CS 84% HP 80%). The DVD was well accepted by both CS and HP. Modifications were made as a result of the evaluations, the most significant of which was re-filming of commentary by the two HP. Future research should evaluate the effectiveness of the DVD in controlled trials with outcomes such as quality of long term health, symptom burden and cancer specific distress. The DVD is expected to be a useful resource for CS living beyond effective treatment for cancer.
Publisher: Elsevier BV
Date: 2012
Abstract: High levels of distress and need for self-care information by patients commencing chemotherapy suggest that current prechemotherapy education is suboptimal. We conducted a randomised, controlled trial of a prechemotherapy education intervention (ChemoEd) to assess impact on patient distress, treatment-related concerns, and the prevalence and severity of and bother caused by six chemotherapy side-effects. One hundred and ninety-two breast, gastrointestinal, and haematologic cancer patients were recruited before the trial closing prematurely (original target 352). ChemoEd patients received a DVD, question-prompt list, self-care information, an education consultation≥24 h before first treatment (intervention 1), telephone follow-up 48 h after first treatment (intervention 2), and a face-to-face review immediately before second treatment (intervention 3). Patient outcomes were measured at baseline (T1: pre-education) and immediately preceding treatment cycles 1 (T2) and 3 (T3). ChemoEd did not significantly reduce patient distress. However, a significant decrease in sensory sychological (P=0.027) and procedural (P=0.03) concerns, as well as prevalence and severity of and bother due to vomiting (all P=0.001), were observed at T3. In addition, subgroup analysis of patients with elevated distress at T1 indicated a significant decrease (P=0.035) at T2 but not at T3 (P=0.055) in ChemoEd patients. ChemoEd holds promise to improve patient treatment-related concerns and some physical sychological outcomes however, further research is required on more erse patient populations to ensure generalisability.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 05-2011
Publisher: American Society of Clinical Oncology (ASCO)
Date: 10-05-2008
Abstract: General practitioners (GPs) play a critical role in the treatment of patients with cancer yet often lack information for optimal care. We developed standardized information for GPs about chemotherapy (CT). In a randomized controlled trial we assessed the impact of sending, by fax, information tailored to the particular patient's CT regimen. Primary end points were: confidence treating patients who were receiving CT (confidence), knowledge of adverse effects and reasons to refer the patient to the treatment center (knowledge), and satisfaction with information and shared care of patients (satisfaction). Focus group work informed the development of the CT information which focused on potential adverse effects and recommended management strategies. GPs of patients due to commence CT were randomly assigned to receive usual correspondence with or without the faxed patient/regimen-specific information. Telephone questionnaire at baseline and 1 week postintervention assessed knowledge, confidence, and satisfaction. Ninety-seven GPs managed 97 patients receiving 23 types of CT. Eighty-one (83.5%) completed the follow-up questionnaire. GPs in the intervention group demonstrated a significantly greater increase in confidence (mean difference, 0.28 95% CI, 0.10 to 0.47) and satisfaction (mean difference, 0.57 95% CI, 0.27 to 0.88) compared with usual care, reflecting a 7.1% and 10.5% difference in score, respectively. No differences were detected for knowledge. GPs receiving the CT sheet found correspondence significantly more useful (P .001) and instructive (P .001) than GPs who received standard correspondence alone. Information about CT faxed to GPs is a simple, inexpensive intervention that increases confidence managing CT adverse effects and satisfaction with shared care. This intervention could have widespread application.
Publisher: Springer Science and Business Media LLC
Date: 30-05-2007
DOI: 10.1007/S00520-007-0273-4
Abstract: Based on meta-analyses regarding the preparation of patients for potentially threatening medical procedures, a DVD, incorporating behavioral role modelling, was developed to prepare patients for chemotherapy and assist them to self-manage side effects. It was hypothesized that patients who watched the DVD (vs those who did not) would report (1) lower anxiety (2) higher self-efficacy related to coping with treatment side effects (3) fewer supportive care needs and (4) higher satisfaction with information received. It was further hypothesized that these effects would be stronger in those perceiving their treatment intent to be curative rather than palliative. Quasi-experimental design using a historical control group was employed. Participants were scheduled to receive their first ever chemotherapy treatment. Group 1 (usual care n = 50) was prospectively recruited before the release of the DVD and group 2 (DVD plus usual care n = 50) after the release. Before commencing chemotherapy, all patients completed reliable and valid measures of self-efficacy, anxiety, and supportive care needs. Data was stratified according to perceived treatment intent. Independent s le t tests were performed for each group (curative vs palliative). Significant differences were found between the usual care and intervention groups: for self-perceived curative patients in relation to self-efficacy for seeking social support (p = 0.044), with increased confidence in those watching the DVD, and for self-perceived palliative patients in relation to their satisfaction with information about side effects (p = 0.026), with increased satisfaction in those watching the DVD. Overall, significant differences were found between self-perceived curative vs palliative patients on measures of self-efficacy and supportive care needs, with self-perceived curative patients reporting more confidence and fewer needs. The educational DVD was considered highly acceptable by patients and was found to increase self-efficacy and reduce supportive care needs. Hence, it is appropriate to give to patients before face-to-face chemotherapy education. Additional pretreatment education is recommended, particularly for self-perceived palliative patients, to reduce their pretreatment anxiety and enhance their confidence in coping with treatment.
No related grants have been discovered for Carl Baravelli.