Search

ObjectiveTo investigate and compare the receipt of patient-centred care amongst rural and urban outpatients undergoing cancer treatment. Methods Cross sectional survey of 444 (331 urban and 113 rural residing) adult cancer patients of heterogeneous cancer types receiving cancer treatment in four outpatient cancer clinics in New South Wales, Australia. Results Patients received a mean of 15.70 out of 21 patient-centred care elements. Only 5% (n=21) of patients received all 21 patientcentred care elements. Information about actual treatment delivery and physical side effects were most frequently received (96%). Practical and psychosocial care were least frequently received (21-31%). Patients' rural or urban residential location was not significantly associated with the receipt of patient-centred care (p=0.963). Conclusion Gaps in practical and psychosocial care occurred in both rural and urban cancer patients. Greater involvement of other healthcare professionals, such as general practitioners, could be considered to meet gaps in patient-centred cancer care. [ABSTRACT FROM AUTHOR]

Objective: We examined whether patients reporting not having adequate time to make a treatment decision is associated with discordance between their preferred and perceived involvement in decision making.Methods: This was a secondary analysis of a cross-sectional study involving Australian outpatients attending five medical or radiation oncology units. Logistic regression modelling was conducted.Results: Four hundred twenty-three patients participated. Patients who reported not having adequate time to make their last important treatment decision had significantly higher odds of experiencing discordance between their preferred and perceived involvement in this decision, compared to those patients who reported having adequate time (OR: 2.76; 95% CI: 1.01-7.55; p = 0.048).Conclusion: Patients should receive adequate time when making cancer treatment decisions. This may help patients "digest" and use the information they received, and become involved in decision making, to the extent they desire. Future research should further investigate what patients consider adequate time for decision making.Practice Implications: Doctors should assess patients' preferences for the amount of time they prefer when making a treatment decision and tailor care accordingly. Offering patients two consultations with some time to think about their options in-between these consultations may be one method in achieving this. [ABSTRACT FROM AUTHOR]

Abstract: We examined whether not having been asked by their clinicians about how involved cancer patients would like to be in their treatment decisions is related to discordance between patients’ preferred and perceived involvement in treatment decision‐making. This was a cross‐sectional survey of adult cancer patients recruited from five medical and radiation oncology outpatient clinics in Australia. Discordance of patients’ preferred and perceived decision‐making roles was assessed via an adapted version of the Control Preferences Scale. Logistic regression modelling was conducted to assess the relationship between role discordance and whether patients were not asked but wanted to be asked about how involved they would like to be in deciding on their treatment. Of 423 study participants, almost a third (n = 128, 31%) reported discordance between their preferred and perceived involvement in their treatment decisions. Of those reporting discordance, 72% (n = 92) were less involved than they would have liked to have been. Not being asked about their preferences for involvement in treatment decisions, despite wanting this, was associated with discordance between patients’ preferred and perceived involvement in treatment decision‐making (p < 0.04). To achieve patient‐centred care, it is vital that clinicians seek patients’ views about how involved they would like to be in deciding on their cancer treatment. [ABSTRACT FROM AUTHOR]

Limited data exist regarding co-occurring alcohol misuse and depression among general practice patients. This study examined the prevalence of depression by level of alcohol misuse, and the sociodemographic factors associated with depression and increased alcohol misuse severity.Across-sectional survey was administered to 3559 Australian general practice patients. Patients completed their demographic details, the Patient Health Questionnaire (9-item) and the Alcohol Use Disorder Identification Test (Consumption items). The prevalence of alcohol misuse and depression was 6.7%, and depression prevalence varied significantly according to level of alcohol misuse (P < 0.001). Age, gender, Aboriginality and number of chronic diseases were associated with depression and higher levels of alcohol misuse. These findings may assist General Practitioners in identifying those at risk of experiencing co-morbid depression and alcohol use, and aid in effective treatment and referral. [ABSTRACT FROM AUTHOR]

To assess support for 12 potential smoking cessation strategies among pregnant Australian Indigenous women and their antenatal care providers. Cross-sectional surveys of staff and women in antenatal services providing care for Indigenous women in the Northern Territory and New South Wales, Australia. Respondents were asked to indicate the extent to which each of a list of possible strategies would be helpful in supporting pregnant Indigenous women to quit smoking. Current smokers (n = 121) were less positive about the potential effectiveness of most of the 12 strategies than the providers (n = 127). For example, family support was considered helpful by 64 % of smokers and 91 % of providers; between 56 and 62 % of smokers considered advice and support from midwives, doctors or Aboriginal Health Workers likely to be helpful, compared to 85-90 % of providers. Rewards for quitting were considered helpful by 63 % of smokers and 56 % of providers, with smokers rating them more highly and providers rating them lower, than most other strategies. Quitline was least popular for both. This study is the first to explore views of pregnant Australian Indigenous women and their antenatal care providers on strategies to support smoking cessation. It has identified strategies which are acceptable to both providers and Indigenous women, and therefore have potential for implementation in routine care. Further research to explore their feasibility in real world settings, uptake by pregnant women and actual impact on smoking outcomes is urgently needed given the high prevalence of smoking among pregnant Indigenous women. [ABSTRACT FROM AUTHOR]