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Background: Approximately 3 million people in the United Kingdom are currently living with or beyond cancer. People undergoing treatment for cancer are at risk of complications following treatment. Increasing evidence supports the role of rehabilitation (including prehabilitation) in enhancing psychological and physical well-being in patients with cancer and improving outcomes. Active Together is an evidence-based, multimodal rehabilitation service for patients with cancer, providing support to help patients prepare for and recover from treatment. This paper presents the evaluation protocol for the Active Together service, aiming to determine its impact on patient-reported outcomes and clinical endpoints, as well as understand processes and mechanisms that influence its delivery and outcomes. Methods: This evaluation comprises an outcome and process evaluation, with service implementation data integrated into the analysis of outcome measures. The outcome evaluation will assess changes in outcomes of patients that attend the service and compare health care resource use against historical data. The process evaluation will use performance indicators, semistructured interviews, and focus groups to explore mechanisms of action and contextual factors influencing delivery and outcomes. Integrating psychological change mechanisms with outcome data might help to clarify complex causal pathways within the service. Conclusions: Evidence to support the role of multimodal rehabilitation before, during, and after cancer treatment is increasing. The translation of that evidence into practice is less advanced. Findings from this evaluation will contribute to our understanding of the real-world impact of cancer rehabilitation and strengthen the case for widespread adoption of rehabilitation into routine care for people with cancer. [ABSTRACT FROM AUTHOR]

Background: Bladder cancer (BCa) is one of the most common urological cancers and remains a leading cause of cancer-related mortality worldwide. Bladder cancer is associated with a range of risk factors, with smoking being one of the most significant contributors. In addition to smoking, exposure to certain chemicals, particularly aromatic amines found in industries such as dye, rubber, leather, and textiles, also increases the risk of bladder cancer. In low-and-middle countries with lower Human Development Index (HDI), data on the underlying causes, incident rate, modes of presentation, treatment, and prognosis of bladder cancer remains unclear and often appear to be inadequate. This study aimed to assess the prevalence, mode of presentation, treatment, and risk factors associated with bladder cancer in Johannesburg, South Africa. By examining these factors, the study seeks to identify possible patterns or predisposing factors that contribute to the development and progression of bladder cancer, which could generate insights that could help to reduce the significant morbidity and mortality associated with this cancer. Methods: This retrospective study analyzed secondary data from 115 patients who were treated in the radiation oncology unit of an academic hospital between January 2010 and December 2020. By reviewing the medical records of these patients, the study aimed to gather comprehensive information on the prevalence of bladder cancer, modes of presentation, treatment approaches, and associated risk factors. Bladder cancer in this study was assessed using a comprehensive analysis of patient data on demographics, risk factors, clinicopathological aspects, and the specific therapies received. A comparison of patients with squamous cell carcinoma (SCC) and transitional cell carcinoma (TCC) of the bladder was conducted as part of this study. This comparison aimed to explore differences in demographic profiles, risk factors, clinicopathological characteristics, and treatment outcomes between these two histological subtypes. Results: A total of 115 patients presenting with bladder cancer symptoms were referred to the academic hospital for evaluation and treatment. The incidence rate of bladder cancer was highest among patients with a mean age of 60.7 ± 14.9. Males constituted 60.9% of the cases, resulting in a male-to-female ratio of 1.6:1. The most common risk factors associated with bladder cancer complications included smoking, being male, black ethnicity and increasing age. Transitional cell carcinoma remained the most prevalent histological subtype at the academic hospital, compared to squamous cell carcinoma (SCC). Patients with transitional cell carcinoma (TCC) were more likely to be older (odds ratio (OR): 1.03, 95% Confidence Interval (CI): 1.01–1.06, p = 0.029), male (OR: 2.60, 95% CI:1.10–6.04, p = 0.030). The study also found that most of the TCC cases were among black patients, though white patients were four times more likely to present with TCC compared to SCC (OR:4.22, 95% CI: 1.43–12.48, p = 0.009). Conclusion: Bladder cancer is still widespread in LMICs, with lower HDI, with elderly males being at risk. To aggressively prevent mortality and morbidity from bladder cancer, bladder cancer health awareness must be maintained to improving prevention, as well as early detection, management and comprehensive patient care and health services for bladder cancer patients. These findings highlight the importance of targeted screening and prevention strategies for high-risk groups, particularly older males with a history of smoking. [ABSTRACT FROM AUTHOR]

The quality of cancer care delivery varies across different regions of Ghana, highlighting the need for improved access to quality healthcare services. Telemedicine has emerged as a promising solution to address this disparity, as it can reduce costs and improve access to healthcare services for cancer patients in remote areas. Despite the widely reported benefits of telemedicine, its adoption in low-resource settings has been slow due to several challenges. This study explores strategies for incorporating telemedicine into the current healthcare system in Ghana for the benefit of all patients especially those diagnosed with cancer. The study also highlights the current challenges and opportunities associated with the implementation and utilisation of telemedicine in Ghana. This research was a cross-sectional study conducted in Accra, Ghana that adopted a mixedmethods approach. Participants were selected through multi-stage probability sampling. Quantitative data were collected via a survey whereas qualitative data were obtained by means of in-depth interviews and focus group discussions among healthcare professionals, patients and key stakeholders in the telemedicine industry. The Statistical Program for the Social Sciences (version 21) was used to assemble, analyse and display the research data. The major challenges discussed centered on high initial investment costs, privacy and security concerns, poor internet connectivity, insufficient infrastructure and training of healthcare providers as well as the resistance to change among healthcare professionals. The study contributes to the understanding of telemedicine adoption in Ghana with findings underscoring the potential to address healthcare challenges while highlighting the need to overcome implementation obstacles. The study findings also provide valuable insights for policymakers, healthcare institutions and stakeholders to enhance telemedicine adoption in Ghana. [ABSTRACT FROM AUTHOR]

Background: eHealth may help closing gaps in the long-term follow-up care of former young age cancer patients. While its introduction to medical aftercare appears promising, it also faces obstacles in the course of its implementation. This study explored what prospective eHealth applications have to achieve and what facilitating and hindering factors are associated with the implementation of them. Methods: A qualitative, explorative-descriptive design involving semi-structured interviews was used in this study. General practitioners (GPs) from urban and rural areas as well as former cancer patients were recruited and interviewed. The interview guide focused on expectations of telemedical care services for the patient group of children and adolescents as well as potential facilitating and hindering factors of the implementation of telemedical care services for former cancer patients. Interviews were recorded, transcribed and analyzed on the basis of qualitative content analysis as described by Kuckartz. Results: Empiric saturation was reached after 25 interviews, respectively. The age of the physicians surveyed at the time of the interviews ranged from 27 to 71 years, with an average of 42 years. The former patients ranged in age from 21 to 43 at the time of participation, with an average age of 34. The age at diagnosis ranged from 3 to 31 years. eHealth services were considered an effective way to maintain continuity of care and improve the health literacy of cancer survivors. Cooperation with health insurance companies and gamification-elements were regarded as beneficial for the introduction of eHealth structures. Poor interface compatibility, insufficient network coverage and lack of digital literacy were valued as potential barriers. Conclusions: If properly introduced, eHealth shows the potential to provide stakeholders with tools that increase their self-efficacy and ability to act. As the technology continues to advance, our data provides application-oriented factors for tailored implementation strategies to bring eHealth into the field. [ABSTRACT FROM AUTHOR]

Objective: To assess the knowledge levels and fertility preservation (FP) intentions of urban Chinese cancer patients. Methods: A cross-sectional study was conducted on Hong Kong Chinese male and female cancer patients aged 18–54 years (N = 325) who were recruited by a local non-governmental organization for cancer patients between July 2020 to January 2021. Patients completed a self-administered questionnaire on knowledge, perceptions, and intentions to use FP services/seek FP-related information. Multivariable logistic regression was used to explore the correlates of intention to seek additional FP information and intention to undergo FP treatments. Results: Although cancer patients demonstrated a good knowledge of the available FP treatment options, they were less knowledgeable about the legal restrictions of these procedures. Only one in seven cancer patients first became aware of FP through a health provider and the majority of cancer patients felt they did not have adequate knowledge about FP to make informed FP decisions at the current time. Yet, over one-third of cancer patients would consider FP options even if their cancer or cancer treatment had < 5% chance of causing infertility, and 13.4% of females and 14.6% of males would delay their cancer treatment by ≥ 3 months to undergo FP procedures. However, for both sexes, the main perceived barrier to obtaining FP was its financial cost. Patients with older-aged spouses were less likely to seek FP treatments or seek more information about FP. Conclusion: There is an unmet need for more FP information and FP services for reproductive-aged cancer patients in East Asian populations. Greater integration of FP services into cancer treatment requires a reduction of cost barriers, greater provision of timely FP information, and improved referral systems. [ABSTRACT FROM AUTHOR]

Objective: To develop and validate tools for measuring inpatient gastroenterology (GI) consultation quality on oncologic patients. Methods: A total of 145 inpatient GI consults were analyzed using electronic health records in this cross-sectional study. Essential Consult Elements on oncologic-hospitalized patients (EE-COH) and Hospitalized Oncologic Patients Enhanced Quality of Consult Assessment Tool (HOPE-QCAT) were used for grading. Interrater reliability was assessed. Results: Both EE-COH and HOPE-QCAT showed near-perfect interrater reliability across most measures in the validation cohort. On application of these measures for quality assessment, basic evaluation by the requesting hospitalist was partially complete in 24.8%, the request for GI consultation was inappropriate in 18.6%, while the rationale for recommended studies from the GI consultant was provided in 55.7% of cases suggesting key areas for quality improvement. Conclusion: We developed highly reliable quality measures for inpatient GI consults on oncology patients. The EE-COH and HOPE-QCAT tools can be utilized in future studies of inpatient GI consult quality and to form the basis for interventions to improve communication between consultants and hospitalists. Such tools could be adapted for inpatient quality assessment across other specialties and settings. [ABSTRACT FROM AUTHOR]

Background: Palliative care has shown benefit in patients with cancer; however, little is known about the overall utilization of palliative care services in patients with pancreatic cancer and the impact of aggressive end-of-life interventions. This study aimed to explore the incidence of palliative care consultations (PCCs) in hospitalized patients with pancreatic cancer in the United States and the association between palliative care consultations and the use of aggressive interventions at the end of life. Methods: We conducted a retrospective study of patients hospitalized with pancreatic cancer. We examined patient records for 6 months prior to death for the presence of PCCs and aggressive end-of-life (EOL) interventions—emergency department visits, chemotherapy, and ICU stays. The use of EOL interventions was compared between those who did and those who did not receive PCCs, using Chi-square and Whitney U tests. Results: Of the 2883 identified patients, 858 had evidence of a PCC in their record in the last 6 months of life. Patients receiving PCCs were older at the time of death and more likely to receive chemotherapy (22.4% vs. 10.6%) in the last 6 months of life compared to those not receiving a palliative care consult. Similarly, patients with PCCs were more likely to have aggressive interventions in the EOL period. Conclusions: Less than 30% of patients with pancreatic cancer received a PCC. Those who received a PCC had more aggressive interventions in the end-of-life period, differing from what the prior literature has shown. Future investigations are necessary to explore the components and timing of PC and investigate their influence on the utilization of aggressive interventions and patient-centered outcomes. [ABSTRACT FROM AUTHOR]

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Background: Developing cancer in young adulthood is a non-normative life event and associated with adverse physical, social and psychological consequences. High psychological distress is common in AYA cancer patients including anxiety, depression or fear of recurrence. At the same time, it is well known that AYA often report unmet needs for support, particularly in terms of informational exchange and emotional support from peers in order to benefit from shared experiences and enhance self-efficacy. Especially in the AYA group, interactions with other same-aged cancer patients may represent an essential resource in terms of coping with the disease, as family members and friends are often overwhelmed and struggling with helplessness. Currently, there is a lack of professional support services using peer support (e.g. psycho-oncological support, aftercare consultations, social legal counselling) or evaluated peer support interventions in Germany. Our aim is to assess the effectiveness of the Peer2Me intervention for AYAs, in which acute patients (mentees) are accompanied by an AYA survivor (mentor) over a period of three months. Methods: A prospective Comprehensive Cohort Design with repeated measures will be used to evaluate the effectiveness of Peer2Me for AYA. A sample of 180 patients in active cancer treatment aged 18 to 39 years will be enrolled and randomized to the intervention or control condition (a single AYA-specific consultation). Following mentor training, mentees and mentors are matched by diagnosis, age, and gender. The primary outcome is self-efficacy; secondary outcomes include measures of anxiety, depression, health literacy, life satisfaction and social support life. Outcomes will be measured at baseline before the intervention (t1), immediately after completion of the three-month intervention (t2) and three months after completion the intervention (t3). For the final analyses, we will use an intention-to-treat approach (ITT) and compare patients in the assigned treatment groups. Discussion: Peer2Me might be an important addition to existing professional psychosocial support services for young cancer patients. At the end of the study, a psycho-oncological intervention for young cancer patients undergoing acute treatment should be available, from which both mentors and mentees could benefit. The long-term continuity of Peer2Me should be ensured through collaboration with different partners. Trial Registration: The study was retrospectively registered on February 4, 2022 at clinicaltrials.gov (NCT05336318). [ABSTRACT FROM AUTHOR]

Objective: Some patients with cancer admitted to palliative care have relatively long survivals of 1 year or more. The objective of this study was to find out factors associated with prolonged survival. Methods: Retrospective case-control study comparing the available data of patients with cancer who survived more than 1 year after admission in a palliative care service with patients with cancer who survived 6 months or less. The intended proportion was 4 controls for each case. Patients were identified through electronic records from 2012 until 2018. Results: And 1721 patients were identified. Of those patients, 111 (6.4%) survived for at least 1 year, and 363 (21.1%) were included as controls according to the established criteria. The intended proportion could not be reached; the proportion was only 3.3:1. The median survival of cases was 581 days (range: 371-2763), and the median survival of controls was 57 days (range: 1-182). In the multivariable analysis, patients with a hemoglobin ≥ 10.6 g/dL and a creatinine level >95 µmol/L had a higher probability of living more than 1 year. In contrast, patients with abnormal cognition, pain, anorexia, liver metastases, an Eastern Cooperative Oncology Group performance status >1, and a neutrophil/lymphocyte ratio ≥ 3.43 had a low probability of living more than 1 year. Conclusion: Several factors were statistically associated positively or negatively with prolonged survival. However, the data of this study should be confirmed in other studies. [ABSTRACT FROM AUTHOR]

Background: Accessing healthcare services is a multifaceted phenomenon involving various elements, encompassing the demand, identification, reach, and utilization of healthcare needs. The literature offers methods for capturing patients' perceptions of healthcare access. However, to accurately measure patient perceptions, it is imperative to ensure the validity and reliability of such instruments by designing and implementing localized language versions. Aim: The primary aim of this study was to validate the Amharic version of the perceived access to health-care services among patients diagnosed with cervical cancer in Ethiopia. Method: A cross-sectional study was conducted among cervical cancer patients at oncology centers in Addis Ababa, Ethiopia. A consecutive sampling approach was used and data collection took place from January 1 to March 30, 2023. Following initial validation and pretesting, a KoboCollect mobile phone application was employed for data collection. Subsequently, the collected data underwent cleaning in Microsoft Excel and analysis through Amos software v.26 and R programming. Various validity and reliability tests, such as content validity, convergent validity, face validity, divergent validity, known-group validity, and reliability tests, were executed. A second-order confirmatory factor analysis was developed to calculate incremental model fit indices, including CFI and TLI, along with absolute measures, namely SRMR and RMSEA. Results: A total of 308 participants were involved in the study, with 202 (65.6%) being patients referred from outside Addis Ababa. The initial evaluation of content validity by expert panels indicated that all criteria were met, with a CVR range of 0.5 to 1, I-CVI values ranging from 0.75 to 1, an S-CVI value of 0.91, and face validity values ranging from 2.4 to 4.8. The internal consistency of items within the final constructs varied from 0.76 to 0.93. Convergent, known-group, and most divergent validity tests fell within acceptable fit ranges. Common incremental fit measures for CFI and TLI were achieved with corresponding values of 0.95 and 0.94, respectively. The absolute fit measures of SRMR and RMSEA were 0.04 and 0.07, indicating good and moderate fit, respectively. Conclusion: The study indicated a high internal consistency and validity of items with good fit to the data, suggesting potential accuracy of the domains. A five-domain structure was developed which enables adequate assessment of perceived access to health-care services of patients with cervical cancer in Ethiopia. We suggest that the tool can be utilized in other patient populations with a consideration of additional constructs, such as geographic accessibility. [ABSTRACT FROM AUTHOR]

The COVID‐19 pandemic had a major impact on cancer patients and services but has been difficult to quantify. We examined how the entire cancer pathway—from incidence, presentation, diagnosis, stage, treatment and survival—was affected in Northern Ireland during April–December 2020 compared to equivalent 2018–2019 periods using retrospective, observational cancer registry data from the Northern Ireland Cancer Registry (NICR). There were 6748 cancer cases in April–December 2020 and an average 7724 patients in April–December 2018–2019. Incident cases decreased by 13% (almost 1000). Significant differences were found across age cohorts and deprivation quintiles, with reductions greatest for younger people (<55 years; 19% decrease) and less deprived (22% decrease). A higher proportion had emergency admission (16%‐to‐20%) with lower proportions diagnosed pathologically (85%‐to‐83%). There was a significant stage shift, with lower proportions of early stage (29%‐to‐25%) and higher late‐stage (21%‐to‐23%). Lower proportions received surgery (41%‐to‐38%) and radiotherapy (24%‐to‐22%) with a higher proportion not receiving treatment (29%‐to‐33%). One‐year observed‐survival decreased from 73.7% to 69.8% and 1‐year net‐survival decreased from 76.1% to 72.9%, with differences driven by five tumours; Lung (40.3%‐to‐35.0%), Head‐and‐Neck (77.4%‐to‐68.4%), Oesophageal (53.5%‐to‐42.3%), Lymphoma (81.1%‐to‐75.2%) and Uterine cancer (87.4%‐to‐80.4%). Our study reveals profound adverse impact of COVID‐19 on the entire cancer patient pathway, with 13% fewer cases, greater emergency admissions and significant stage‐shift from early to more advanced‐stage disease. There was major treatment impact with lower rates of surgery and radiotherapy and higher proportions receiving no treatment. There were significant reductions in 1‐year survival. Our study will support service recovery and protect cancer services in future pandemics or disruptions. [ABSTRACT FROM AUTHOR]

Purpose The female sex is reported to have a higher risk of adverse events (AEs) from cytotoxic chemotherapy. Few studies examined the sex differences in AEs and their impact on the use of medical services during adjuvant chemotherapy. This sub-study aimed to compare the incidence of any grade and grade = 3 AEs, healthcare utilization, chemotherapy completion rate, and dose intensity according to sex. Materials and Methods This is a sub-study of a multicenter cohort conducted in Korea that evaluated the impact of healthcare reimbursement on AE evaluation in patients who received adjuvant chemotherapy between September 2013 and December 2016 at four hospitals in Korea. Results A total of 1,170 patients with colorectal, gastric, or non-small cell lung cancer were included in the study. Female patients were younger, had fewer comorbidities, and experienced less postoperative weight loss of > 10%. Females had significantly higher rates of any grade AEs including nausea, abdominal pain, stomatitis, vomiting, and neutropenia, and experienced more grade = 3 neutropenia, nausea, and vomiting. The dose intensity of chemotherapy was significantly lower in females, and they also experienced more frequent dose reduction after the first cycle. Moreover, female patients receiving platinum-containing regimens had significantly higher rates of unscheduled outpatient visits. Conclusion Our study found that females experienced a higher incidence of multiple any-grade AEs and severe neutropenia, nausea, and vomiting, across various cancer types, leading to more frequent dose reductions. Physicians should be aware of sex differences in AEs for chemotherapy decisions. [ABSTRACT FROM AUTHOR]

Contemporary society is aware that there are different types of diseases that people try to live with. Acceptance of the disease, managing emotions at the time of diagnosis, reducing worries are goals of psychotherapeutic program for cancer patients. The overall objective of this research is to identify and measure factors that contribute to activating resilience in cancer patients and their families and to evaluate the effectiveness of psychosociomedical services. The group of participants will consist of approximately ten patients diagnosed with cancer, enrolled in social programs for the chronically ill, some of them being residents of Năvodari, Constanţa, Romania. We will apply to these patients instruments to assess their emotional state, satisfaction and quality of life participating in sociopsychooncological support groups. The following questionnaires were applied in the three stages of the research: initial evaluation, evaluation after 6 months and evaluation after 12 months: Questionnaire on Distress in Cancer Patients - short form (QSC-R10); The Depression, Anxiety and Stress Scale - 21 Items (DASS-21); The Beck Depression Inventory (BDI-II). The comparison of the results obtained by applying the assessment instruments during the first year of operation of the psychooncological support group reveals a significant difference between the scores obtained at the first assessment and the scores obtained at the end of the year, which validates our belief that the group meetings, the psycho-oncological intervention methods applied and the psychosocial and sociomedical information decreased the patients’ distress, increased their ability to adapt to the new life context, and increased their quality of life. Integrated approach to the needs of the person, in relation to his/her socio-economic situation, health status, level of education and social living environment, through Social Services are proactive. Based on the needs of each person, social services can have a broad reach, including people diagnosed with cancer, their family members and people who have overcome the disease. [ABSTRACT FROM AUTHOR]

Background: Palliative care helps patients and their families deal with the hardships that come with a life-threatening illness. However, patients were not fully utilizing the palliative care services provided by healthcare facilities for a number of reasons. In Ethiopia, there hasn't been any research done on the variables that influence the utilization of palliative care services. Objective: To assess palliative care service utilization & associated factors affecting cancer patients at public hospitals oncology units in Addis Ababa, Ethiopia. Methods: An institution-based cross-sectional study design was carried out. A structured and pre-tested questionnaire was administered to 404 participants at Tikur Anbesa Specialized Hospital and Saint Paul's Hospital Millennium Medical College from July 4 to August 2, 2022. A systematic random sampling technique was used to select the study participants. The data was collected by ODK-Collect version 3.5 software and exported to excel and then to SPSS version 25 for recoding, cleaning, and analysis. Logistic regression model was employed. P-values <0.05 were regarded as statistically significant. Result: About 404 participants' responded questionnaire giving a 97.6% response rate. The extent of Palliative care service utilization was 35.4% [95% CI: 31.4, 40.3%]. College or university education were 2.3 times more likely and living in a distance of <23 km from PC service centers were 1.8 times more likely to use palliative care services. Factors hindering palliative care service utilization were inability to read & write, treatment side effects, long distance to a health institution, and low satisfaction with the health care service. Conclusion and recommendation: The extent of palliative care service utilization which was low. Factors to palliative care service utilization were clients' education level, treatment side effects, distance to a health institution, and patients' satisfaction. Interventions to enhance health education and counseling of cancer patients, early detection and management of treatment side effects and accessibility of palliative care services for cancer patients should be emphasized and implemented by all concerned stakeholders. [ABSTRACT FROM AUTHOR]

The objective of this study was to investigate the satisfaction of cancer patients with the service quality of a Brazilian public hospital located in the city of Rio de Janeiro. The study is quantitative, based on application of a questionnaire to a sample composed of 245 outpatients of the hospital. The data were treated with structural equation modeling supported by partial least squares (PLS-SEM). The results indicated the patients place value on the quality of the service rendered by physicians, quality of the administrative service, quality of the hospital facilities and quality of the nursing service, in that order. The main theoretical contribution is the identification, in contrast to previous findings in the literature, that the cancer patients in our sample attributed little importance to the nursing service, even though nurses are the healthcare professionals who interact the most with patients. [ABSTRACT FROM AUTHOR]

Background: The Norwegian health authorities introduced standardized cancer patient pathways (CPPs) in 2015, aiming to reduce practice variations across hospitals and regions, and improve the continuity, coordination and overall quality of the health care service provided to cancer patients. There has been few studies investigating this change, and that have looked into the organisational and economic benefits of standardized pathways, however the element of care and the patient perspective has been especially neglected. This study explored the care element in cancer patient pathways through an in-depth study of patient experiences. Methods: The patients were enrolled approximately three years after the introduction of standardized CPPs in Norway. Through a qualitative design with in-depth interviews, a total of 21 interviews were conducted with seven patients between 2018 and 2020. The first interview took place after the diagnosis was established and before treatment, the second interview during treatment, and the final interview approximately one year after the completion of active treatment. The empirical catchment area was eastern Norway. Data were analysed using a theoretical thematic analysis. Results: This study sheds light on the complex challenges patients' faces, while navigating CPPs, including the need for better transition support, improved coordination and continuity in care, and a more holistic approach that encompasses emotional well-being and family support. Three overarching themes were identified: [1] Navigating CPPs: patient care and transition challenges, [2] Fragmented cancer care: challenges in coordination and continuity [3] Unmet needs and overlooked opportunities in CPPs. Conclusions: Patients experience that cancer patient pathways offer good medical treatment, but that the care element deserves more attention. Current CPPs are trapped in a logic of choice, preventing room for the element of care to receive the attention it requires for the patient to truly experience holistic person-centred care and continuous, well-coordinated services. Based in our study we argue there is a need to look into the missed opportunities for using the CPPs as points of departure for more holistic collaborative models for cancer care. [ABSTRACT FROM AUTHOR]

Introduction: Precision medicine (PM) or personalized medicine is an innovative approach that aims to tailor disease prevention and treatment to consider the differences in people's genes, environments, and lifestyles. Although many efforts have been made to accelerate the universal adoption of PM, several challenges need to be addressed in order to advance PM in Africa. Therefore, our study aimed to establish baseline data on the knowledge and perceptions of the implementation of PM in the Rwandan healthcare setting. Method: A descriptive qualitative study was conducted in five hospitals offering diagnostics and oncology services to cancer patients in Rwanda. To understand the existing policies regarding PM implementation in the country, two additional institutions were surveyed: the Ministry of Health (MOH), which creates and sets policies for the overall vision of the health sector, and the Rwanda Biomedical Center (RBC), which coordinates the implementation of health sector policies in the country. The researchers conducted 32 key informant interviews and assessed the functionality of available PM equipment in the 5 selected health facilities. The data were thematically categorized and analyzed. Results: The study revealed that PM is perceived as a complex and expensive program by most health managers and health providers. The most cited challenges to implementing PM included the following: the lack of policies and guidelines; the lack of supportive infrastructures and limited suppliers of required equipment and laboratory consumables; financial constraints; cultural, behavioral, and religious beliefs; and limited trained, motivated, and specialized healthcare providers. Regarding access to health services for cancer treatment, patients with health insurance pay 10% of their medical costs, which is still too expensive for Rwandans. Conclusion: The study participants highlighted the importance of PM to enhance healthcare delivery if the identified barriers are addressed. For instance, Rwandan health sector leadership might consider the creation of specialized oncology centers in all or some referral hospitals with all the necessary genomic equipment and trained staff to serve the needs of the country and implement a PM program. [ABSTRACT FROM AUTHOR]

Solution-focused brief therapy (SFBT) is an empirically-supported psychotherapeutic intervention in treating mental health issues in the general population. When being delivered to adolescents and young adults (AYAs) diagnosed with cancer, specific techniques and skills of SFBT need to be tailored to meet the unique bio-psycho-social challenges of the AYA cancer population. Using a patient-centered approach, our team interviewed 14 AYAs with cancer who received SFBT for cancer (SFBT-C) to inform the tailoring and refinement of the existing SFBT intervention specifically for the AYA cancer population. Themes emerged within three broad categories that informed the tailoring and refinement of SFBT for AYAs with cancer, i.e., general experiences, strengths, and weaknesses of SFBT-C. AYAs with cancer found SFBT-C overall positively different from other approaches. Strengths include SFBT-C's collaborative nature, using positive emotion as an important change mechanism, and a good balance between being relevant to cancer and not focusing too much on their cancer. Areas of improvement include assignment flexibility and different strategies to address resistance. The findings of this paper significantly inform the delivery of SFBT-C to AYAs with cancer using patient-centered feedback and input. [ABSTRACT FROM AUTHOR]

(1) Background: A pharmacist-led deprescribing service previously developed within the Consultation-Based Palliative Care Team (CB-PCT) was implemented for terminal cancer patients. (2) Objective: To evaluate the clinical outcomes of the developed deprescribing service for terminal cancer patients in CB-PCT. (3) Methods: A retrospective analysis compared the active care (AC) group to the historical usual care (UC) group. The clinical outcomes included the deprescribing rate of preventive medications, the proportion of patients with one or more medication-related problems (MRPs) resolved upon discharge, and the clinical significance. The implementability of the service was also gauged by the acceptance rates of pharmacists' interventions. (4) Results: Preventive medications included lipid-lowering agents, gastroprotective agents, vitamins, antihypertensives, and antidiabetic agents. The AC group revealed a higher deprescribing rate (10.4% in the UC group vs. 29.6% in the AC group, p < 0.001). At discharge, more AC patients had one or more MRPs deprescribed (39.7% vs. 2.97% in UC, p < 0.001). The clinical significance consistently had a very significant rating (mean score of 2.96 out of 4). Acceptance rates were notably higher in the AC group (30.0% vs. 78.0%. p = 0.003). (5) Conclusions: The collaborative deprescribing service in CB-PCT effectively identified and deprescribed MRPs that are clinically significant and implementable in practice. [ABSTRACT FROM AUTHOR]

Introduction: To date, there are no known studies that have investigated the new need for volunteer services among cancer patients during the Covid-19 pandemic. However, it is essential for volunteer associations to heighten such knowledge to best guide their offer in this challenging period. Aim: The present study aims to provide a mapping of the cancer patients' needs for volunteer services followed at Istituto Nazionale dei Tumori in Milan (Italy) during the Covid-19 pandemic. Since there are no specific questionnaires for this purpose, we created an ad hoc tool for which we report the preliminary result. Method: We used a mixed-method multiphase approach. Phase I: in April-May 2020 40 ad hoc paper questionnaires were distributed at the entrance of the aforementioned hospital, with the aim of investigating patients' needs through two open-ended questions then analyzed through thematic analysis. Phase II: the contents that emerged from Phase I were transformed into items and submitted to the judgment of a small group of "peers" (patients) and "experts" (professionals) in November-December 2020 to evaluate their comprehensiveness, representativeness and intrusiveness. Phase III: in January-February 2021 paper questionnaires, containing the items reviewed in Phase II, were distributed within the hospital to a representative sample of cancer patients. We applied descriptive statistics, Exploratory Factor Analysis (EFA) and Cronbach's Alpha. Results: 32 patients completed Phase I, 3 "peers" and 9 "experts" participated in Phase II, 214 patients completed the questionnaire in Phase III. EFA highlights five kinds of needs during the Covid-19 pandemic, in order of priority: (1) need to be supported at the hospital; (2) need for emotional support; (3) need for daily errands; (4) need for practical support to family members; (5) need to share free time. Preliminary results on the tool are encouraging, although further studies are needed. These results will allow local volunteer associations to adapt their services during the pandemic. [ABSTRACT FROM AUTHOR]

Background: Infusion rate is one of the essential elements that should be included in all intravenous orders. Patients may experience adverse consequences or risks associated with inappropriate infusion. Meanwhile, there is growing pressure on the chemotherapy unit to deliver treatment quickly, efficiently, and safely, and thus it is very necessary to improve the chemotherapy process and service to cancer patients. Clinicians should consider how to further standardize infusion therapy, and innovate new infusion strategies to increase efficacy, reduce toxicity, improve patient satisfaction and save health resource costs. Sporadic studies have evaluated the effects of infusion rates of anticancer agents on clinical outcomes, economic benefits, and administration efficiency. However, an update review has not been available.Methods: Relevant literature was identified by search of PubMed until September 2023.Results: Infusion rates may have significant effect on the efficacy of anticancer agents (e.g., methotrexate, fluorouracil, and arsenic trioxide). Slow infusion is safer for platinum compounds, doxorubicin and carmustine, whereas fast infusion is safer than slow infusion of gemcitabine. Optimal flow rates of paclitaxel and fluorouracil are based on the balance between multiple risks of toxicity. Optimal infusion rate may bring economic benefits. If efficacy and safety are not compromised, shortened infusion may result in higher patient satisfaction, improved institutional efficiency and more nursing time available for other activities (e.g., biosimilar products, endostar). Other concerns about infusion rate include clinical indications (eg, paclitaxel and rituximab, methotrexate), severity and type of hypersensitivity reactions (e.g., platinum compounds), formulation features (e.g., paclitaxel, doxorubicin), and genetic polymorphism (e.g., gemcitabine, methotrexate).Conclusion: The latest knowledge of infusion rate concerns will enhance the appropriateness and accuracy in intravenous administration. Interdisciplinary teams should collaborate and implement relevant risk management and healthcare policy. It is worthwhile to conduct comparative studies of intravenous therapy with different infusion speeds. [ABSTRACT FROM AUTHOR]

Purpose: Out of Pocket costs (OOP) sustained by cancer patients also in public NHS contribute to disease-related financial toxicity. Aim of the study was to investigate the amount and the types of OOP sustained by Italian cancer patients for care services.Methods: A sample survey was conducted by FAVO in December 2017-June 2018, in 39 adhering hospitals and 1289 patients diagnosed from 1985 to 2018, by standardized questionnaire inquiring on: yearly expenditure by cancer service, age, year of diagnosis, disease phase, cancer site, sex, marital status, education, residence. Univariate and multivariable regression analyses were performed between OOP and each variable. Multilevel mixed-effects negative binomial regression was used to assess the combined effects of patients characteristics on the differences in acquiring health services.Results: The yearly average OOP was 1841.81€, with the highest values for transports (359.34€) and for diagnostic examinations (259.82€). Significantly higher OOP were found in North and Centre than South and Islands (167.51 vs. 138.39). In the fully adjusted multivariable analysis, the variables significantly associated with higher than reference expenditure were: medium/high education (OR 1.22 [1.05-1.42], upper gastrointestinal tract cancer (OR 1.37 [1.06-1.77]), disease phase of treatments for cancer progression or pain therapy (OR 1.59 [1.30-1.93]).Conclusion: Italian cancer patients in 2018 sustained OOP quite similar to those measured in 2012 to supplement NHS services. The main component of the OOP costs were diagnostic examination and transportation. The NHS should pay attention to potentiate its ability to answer unmet needs of patients with advanced cancer who are the most fragile ones.Implications For Cancer Survivors: Reinforcing the services where the main OOP expenses are located can help in promoting public health actions and reduce socio-economic needs that could compromise the receipt of optimal care along the whole disease course, from diagnosis to rehabilitation. [ABSTRACT FROM AUTHOR]

The Cancer Diseases Hospital (CDH) 2019 annual report revealed an upsurge in the number of new cancer patients accessing services from 35 patients in 2006 to 3,008 in 2019. This study explored the experiences and coping strategies of women caring for their husbands with cancer attending the CDH. A phenomenological research design was used with stratified purposeful sampling. Data were collected using an interview schedule and analysed using thematic analysis. The women's challenges included mobility difficulties and hospital admissions/problems; socio-economic problems, psychological and emotional distress; and caregiving liability and spiritual anguish. The benefits that female spouses experienced during caring for their loved ones included knowledge about cancer and infection prevention, a strong marital relationship, tolerance and perseverance, resilience and hope and good relationship with other caregivers. The women's needs included financial support, physical needs, psychosocial counselling, caregiver accommodation, time off from caregiving, information needs and sexual intimacy and contact. Their coping strategies included spiritual support from spiritual carers, prayer and meditation, music and storytelling, social support and a good marital relationship. The findings demonstrate that wives of patients with cancer experience many challenges in their caring journey. Nurses must anticipate and/or intervene as part of their nursing practice to reduce the negative impact on female caretakers in this situation. Hospital standard operating procedures must be developed to put both the patients and their caregivers at the centre of oncology nursing care, particularly in settings with limited allied professional support, e.g., psychologists. Caretaker coping strategies highlighted in this study must be made available for both the patients and their wives, e.g., linking wives to trained spiritual carers upon their husband's admission to the hospital, to aid a smooth caregiving experience. [ABSTRACT FROM AUTHOR]

Cancer is a major public health issue with a high mortality rate globally. Owing to advancements in diagnostic and treatment strategies, the survival rate of cancer patients has increased. This has also led to an increase in the frequency of emergency service use in cancer patients. Here, we retrospectively extracted and analyzed the data of patients who presented at the emergency department of Ondokuz Mayıs University's Faculty of Medicine as outpatients or via emergency services and then required oncology consultation between January 1, 2018, and January 1, 2019. Specifically, we analyzed their demographic characteristics and clinical data, including reasons for admission, cancer stage and performance status at admission, and emergency department stay length. In total, 542 visits by 376 patients (mean age, 60.8 ± 12.8 years; 162 women, 214 men) were recorded during the study period. The most common cancer types were breast cancer in women (30.9%) and lung cancer in men (33.2%). The most common reason for admission was signs of infection, whereas the most common diagnosis was neutropenic fever (17.3%). Furthermore, 223 (59.3%) visits resulted in hospitalization. Finally, 63.1% of the patients stayed in the emergency department for <24 h. The current results may aid in developing strategies for reducing workload and costs and improving service quality for cancer patients in emergency departments. [ABSTRACT FROM AUTHOR]

Background: Breast and cervical cancers remain the most common cancers and the leading cause of cancer deaths in Ghana. Non-communicable diseases such as cancers, have been associated with psychological burdens such as anxiety and depression disorders as well as severe mental disorders such as bipolar disorder. As such the World Health Organisation has noted that mental health and well-being are crucial in reducing the NCD burden. Methods: A convergent mixed method approach was used to ascertain the psychosocial burden of breast and cervical cancer patients who sought treatment in three major cancer hospitals in Ghana. Primary data were collected using a questionnaire and an interview guide from 298 breast and cervical cancer patients seeking treatment at the Korle-Bu and Komfo Anokye Teaching Hospitals as well as the Sweden Ghana Medical Centre. Qualitative analysis was done using thematic content analysis while quantitative analysis was done using logistic regression. Results: The findings of the study showed that patients not only battled with psychological burdens such as anxiety, depression, pain, stigma, fear of death and loss of spouses but also struggled with physical, social, and dietary restrictions. Patients with low educational levels and income status, retired or unemployed, and/or had larger household sizes suffered more psychosocial burdens. Conclusion: There is a need for liaison psychiatrists and health psychologists to assist oncologists to provide psychological support such as free and routine counselling services for cancer patients and their caregivers. Educational campaigns on mainstream and social media need to be intensified to demystify the stigma surrounding cancers in Ghana. [ABSTRACT FROM AUTHOR]

Purpose: We compared the perception of office-based haematologists and oncologists regarding the availability of outpatient psycho-social support services (PSSS) for patients with cancer and a migration background, as well as their different experiences with these services. Methods: Data were collected via an online survey addressing the doctors' socio-demographic characteristics and their perception of-and experience with PSSS. The association between socio-demographic characteristics of the doctors and their experiences with PSSS was tested using Pearson's chi-squared test and Kruskal–Wallis test. Results: A total of 55 doctors were included in this study. More than three doctors in four reported non-sufficient presence of PSSS in foreign languages in their region; one in two reported that the services for patients with migration background should be improved. Most doctors reported missing PSSS in Turkish and Arabic in their region. Doctors with less experience referred patients more often to PSSS hosted in patients' associations (75% vs 25%; p = 0.02), than doctors with more experience. Doctors working in larger cities referred patients less often to PSSS in cancer counselling centres (12% vs 88%; p = 0.01), than doctors working in small or middle-large cities. Male doctors were more satisfied with the network of PSSS' providers, than female doctors (mean score = 2.8 vs 2.2; p = 0.05). Conclusions: Our results suggest that efforts should be made for a higher regional availability of overall and specific PSSS for non-German speaking patients (especially for Turkish- and Arabic-speaking patients). The experience with PSSS was associated with the doctors' work experience and gender, as well as the location of the practice. [ABSTRACT FROM AUTHOR]

When patients are diagnosed with cancer, they lose the mode of living they have been accustomed to and face difficulties in coping with the new complexed medical condition. In the case of advanced stages of cancer, patients lose the ability to take an active role in decisions related to priority in treatment modality, decision-making, and planning. In addition, these patients lose the ability of choice-to agree to a certain mode of treatment, who will treat them, and where. Thus, these kinds of decisions are between family members and the treating team. This can happen only when both the formal caregivers and to lesser degree the informal partners are exposed to ongoing educational activities and training by both local experienced palliative care experts and international initiated courses (both frontal and remote). This article provides recommendations needed for an effective strategy at national levels to develop appropriate ways, whereby governmental agencies and non-governmental organizations can promote the establishment of palliative care services at all levels from primary to tertiary in each individual country. The basis for the above will rely on the experience that was gained through the application of palliative care principles. [ABSTRACT FROM AUTHOR]

Introduction: Evidence-based services to support cancer patients with pain via clinical pharmacy services are currently lacking. Therefore, there is a need to undertake a randomized controlled trial (RCT) to explore the effectiveness of clinical pharmacists (CPs)' input into the multidisciplinary team (MDT) in providing better therapeutic outcomes for cancer pain management. Objectives: The main aim of this pilot RCT is to determine the feasibility and preliminary efficacy of integrating CPs into the MDT for cancer pain management on the clinical outcomes of cancer patients experiencing pain. Methods: This study protocol outlines two-armed multicenter pilot RCT. Cancer patients suffering from pain will be randomly allocated to receive either clinical pharmacy services, i.e., PharmaCAP trial intervention from the CP, or the usual standard care (i.e., control group). Patients will be recruited consecutively from two hospitals in Kathmandu valley, Nepal. The outcomes will be assessed at baseline (pre-intervention) and 4 weeks post-intervention. The primary feasibility outcomes will include eligibility rate, recruitment rate, willingness to participate, acceptability of screening procedures and random allocation, possible contamination between the groups, intervention fidelity and compliance, treatment satisfaction, and patient understanding of the provided interventions. Subsequently, the primary clinical outcome, i.e., pain intensity of cancer patients, will be assessed. The secondary clinical outcomes will include health-related quality of life (HRQoL), anxiety, depression, adverse drug reactions, and patient medication compliance following the integration of CP into the healthcare team. Discussion: The feasibility and potential for integrating CP involvement in MDT to improve clinical outcomes of cancer patients with pain will be evaluated through the PharmaCAP trial. Trial registration: ClinicalTrials.gov NCT05021393. Registered on 25th August 2022. [ABSTRACT FROM AUTHOR]

Cancer research is a crucial pillar for countries to deliver more affordable, higher quality, and more equitable cancer care. Patients treated in research-active hospitals have better outcomes than patients who are not treated in these settings. However, cancer in Europe is at a crossroads. Cancer was already a leading cause of premature death before the COVID-19 pandemic, and the disastrous effects of the pandemic on early diagnosis and treatment will probably set back cancer outcomes in Europe by almost a decade. Recognising the pivotal importance of research not just to mitigate the pandemic today, but to build better European cancer services and systems for patients tomorrow, the Lancet Oncology European Groundshot Commission on cancer research brings together a wide range of experts, together with detailed new data on cancer research activity across Europe during the past 12 years. We have deployed this knowledge to help inform Europe's Beating Cancer Plan and the EU Cancer Mission, and to set out an evidence-driven, patient-centred cancer research roadmap for Europe. The high-resolution cancer research data we have generated show current activities, captured through different metrics, including by region, disease burden, research domain, and effect on outcomes. We have also included granular data on research collaboration, gender of researchers, and research funding. The inclusion of granular data has facilitated the identification of areas that are perhaps overemphasised in current cancer research in Europe, while also highlighting domains that are underserved. Our detailed data emphasise the need for more information-driven and data-driven cancer research strategies and planning going forward. A particular focus must be on central and eastern Europe, because our findings emphasise the widening gap in cancer research activity, and capacity and outcomes, compared with the rest of Europe. Citizens and patients, no matter where they are, must benefit from advances in cancer research. This Commission also highlights that the narrow focus on discovery science and biopharmaceutical research in Europe needs to be widened to include such areas as prevention and early diagnosis; treatment modalities such as radiotherapy and surgery; and a larger concentration on developing a research and innovation strategy for the 20 million Europeans living beyond a cancer diagnosis. Our data highlight the important role of comprehensive cancer centres in driving the European cancer research agenda. Crucial to a functioning cancer research strategy and its translation into patient benefit is the need for a greater emphasis on health policy and systems research, including implementation science, so that the innovative technological outputs from cancer research have a clear pathway to delivery. This European cancer research Commission has identified 12 key recommendations within a call to action to reimagine cancer research and its implementation in Europe. We hope this call to action will help to achieve our ambitious 70:35 target: 70% average survival for all European cancer patients by 2035. [ABSTRACT FROM AUTHOR]

Introduction: health care benefits have undergone major changes during the COVID-19 pandemic. This has led to an explosive growth in teleconsultation services mainly for cancer patients. The purpose of this study was to assess the perception and experience of Moroccan oncologists with the use of teleconsultation during the COVID-19 pandemic. Methods: a 17-question anonymous cross-sectional survey was conducted on Google forms and emailed to all Moroccan oncologists. Statistical analysis was performed using the statistical software Jamovi (version 2.2). Results: out of a total of 500 oncologists who received the questionnaire, 126 responded, with a response rate of 25%. During the pandemic, only 59.5% of oncologists used teleconsultation, with no significant differences among the three groups (radiation oncologists, medical oncologists and cancer surgeons (p=0.294)). Most participants were satisfied with being able to explain medical diagnosis, provide assessment results, and provide treatment recommendations during teleconsultation. Finally, 47.2% of participants were willing to continue conducting teleconsultations after the COVID-19 pandemic, with no significant differences among the three groups. Conclusion: oncology physicians were satisfied with their experiences with teleconsultation and agreed that it is likely to be part of their long-term practice. Future studies are needed to assess patient satisfaction with teleconsultation and to improve patient care through this virtual technology. [ABSTRACT FROM AUTHOR]

Background: Radiation Therapists (RTs) are a key professional grouping in the delivery of health services for cancer patients. The education of RTs in New Zealand has evolved in response to regulatory and clinical workforce requirements. To date, it has lacked a fundamental underpinning of educational theory. Stakeholders, including students, were canvassed for their perspectives on the drivers behind the current curriculum with a view to developing theory which could shape future curricular development. Methods: A focus group was conducted with eight student RTs enrolled at the time of the study. A process driven by Constructivist Grounded Theory principles was adopted for the analysis of the resulting data. Results: Four themes were established to represent the data: "Being" is prized over "doing", Change is inevitable, A framework for Professional Identity formation and Modelling is key to learning. Conclusions: There is utility in exploring the student perspective around curriculum. The data suggest that students on this programme are engaged with the process of preparing for practice and the connected learning experiences. There is a focus on the patient and the personal values and qualities which result from that focus. While specialist knowledge and technical skills are required for delivering patient care, it is fully expected those aspects of the clinical role will significantly change over time. Even at this early stage in their careers, students recognise the development and need for professional identity formation. Role models are perceived to be a vital part of student learning, be they positive or negative. Scrutiny of the study findings provides reason to question some assumptions which are sometimes made about student practitioners based on factors such as age and gender and the assumed universal ability of practitioners to teach the next generation. The perspectives gained inform the next stage of data collection from this group and theory building that will be reported outside the confines of this article. [ABSTRACT FROM AUTHOR]

Aim: The global burden of colorectal cancer (CRC) is set to increase by 60% by 2030. An aging population and increasing treatment complexity add difficulties for patients and clinicians in CRC management. Patient preferences can be investigated using attribute‐based stated preference (AbSP) techniques to explore trade‐offs between different treatments. These techniques include discrete‐choice experiments (DCEs), conjoint analysis and time‐trade off (TTO) methods. This systematic review with a narrative synthesis aimed to determine the use and design of AbSP studies in CRC treatment and to identify patient choice themes. Methods: The searches were performed using MEDLINE, Embase, PsycInfo and Cochrane Library in March 2021. All manuscripts featuring the use of AbSP techniques in CRC treatment were included. Data synthesis was performed using a narrative approach. Results: The search strategy returned 271 articles. Eighteen AbSP studies were included featuring 1890 patients and 296 clinicians. AbSP techniques compromised DCE (38.9%, n = 7), TTO (38.9%, n = 7) and conjoint analysis (22.2%, n = 4). Eleven studies (61.1%) involved piloting of tasks and the average task completion rate was 75%. CRC treatments included chemotherapy (33%, n = 6), combined treatments (33%, n = 6), surgery (17%, n = 3), targeted therapy (11%, n = 2) and radiotherapy (6%, n = 1). The most examined domain was physical health, investigated with 49 (59.8%) attributes. Conclusions: Life expectancy was the main attribute in chemotherapy treatment. With surgery, patients were willing to trade life‐expectancy to avoid adverse outcomes or a permanent stoma. Communication skills, treatment cost, and clinicians' views were important attributes for patients in cancer services. Further research in the elderly population, and other quality of life domains, are needed to deliver patient‐centred CRC care. [ABSTRACT FROM AUTHOR]

Background and Aims: Patient satisfaction is an important quality indicator of health care service. The concept of home‐based palliative care has been recently introduced in Bangladesh, but the patients' satisfaction with this care remained unexplored. This study aimed to assess the satisfaction of the cancer patients receiving this care. Methods: This cross‐sectional study was conducted among 51 surviving cancer patients above 18 years of age registered under the home‐based care service of the Department of Palliative Medicine, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh. Data were collected by face‐to‐face interviews using a structured questionnaire based on the FAMCARE P16 questionnaire from February to March 2019. Descriptive analysis was done for the sociodemographic and satisfaction‐related indicators. A correlation matrix was done to see the correlation among the satisfaction indicators. Result: The majority of the patients (88.2%) were satisfied with the service provided by the home care team. Most (76.5%) of the patients were women, and the mean age was 56.25 ± 14.8 years. The median duration of getting home‐based care was 4 months. Main satisfaction indicators were—assessment of physical symptoms (70.6%), providing information about pain management (70.6%), the inclusion of the family in decision making (76.5%), coordination of care between the members of the home care team (84.3%) and availability of doctors, nurses and palliative care assistants (74.5%). A high correlation was observed between satisfaction regarding the care of physical symptoms and provision of information (R = 0.814, p < 0.001). Also, satisfaction regarding the provision of information and support provided to the family is highly correlated (R = 0.722, p < 0.001). Conclusion: Despite the limitations, the overall satisfaction level of the patients regarding home‐based palliative care services in Bangladesh is very high. Home‐based palliative can be a solution to provide palliative care to patients who are unable to access institution‐based care and improve their quality of life. [ABSTRACT FROM AUTHOR]

Introduction: The detrimental impact of smoking tobacco can be mitigated when cancer patients quit smoking. Smoking cessation clinical pathways are inconsistently implemented within Australian cancer services. The aim of this study was to pilot test and evaluate the reach, adoption, and implementation of a smoking cessation checklist within oncology services. Methods: The checklist was implemented over a 6‐month period in medical and radiation oncology services at two metropolitan and one rural hospital. The RE‐AIM framework guided the evaluation process. Implementation strategies included training, process mapping, and identifying champions. Evaluation measures included a clinical data audit, surveys, and semi‐structured interviews with healthcare professionals (HCPs). Results: Healthcare professionals (HCPs; N = 63; 41% oncologists, 32% nurses, 27% others) completed 1276 checklists with cancer patients between November 2019 and December 2020. Of the 126 (10%) identified current smokers, 34 (27%) accepted a referral to either Quitline, Nicotine Replacement Therapy, to a general practitioner or dedicated HCP for follow‐up telephone support. There was variation in screening adoption by HCPs across the three hospitals, with 16%, 92% and 89.5% of patients screened respectively. Contextual factors, such as perceived commitment, role identity, and communication processes appeared to influence the outcomes. Conclusion: A checklist is a simple, effective, and versatile intervention used to standardise smoking cessation practices in medical and radiation oncology services. The checklist supports standardisation of referral practices to smoking cessation services for cancer patients by either oncologist and/or nurses. [ABSTRACT FROM AUTHOR]

Background: Cancer patients face multiple challenges, such as infertility caused by exposure to gonadotoxic agents and gonadal irradiation during cancer treatment. Little is known about the health practitioners' knowledge and practice regarding fertility preservation and its available options in Saudi Arabia. Thus, this study is designed to evaluate the level of knowledge, attitude, and practice (KAP) towards fertility preservation in cancer patients among health practitioners in an environmental region in Saudi Arabia.Methods: The cross-sectional study was carried out between September 2020 and January 2021. A self-administered questionnaire was distributed among health practitioners from a variety of specialties who work closely with cancer patients.Results: Out of 100 participants, 90% need more knowledge about fertility preservation. The lack of fertility preservation clinics in the patient's area and its unaffordable expenses significantly influenced the health practitioners' attitude towards fertility preservation discussion with cancer patients. The results revealed that 92% of the participants agreed that the Saudi Ministry of Health should establish practice guidelines and provide fertility preservation services for cancer patients.Conclusions: The present study showed that clinical practitioners' knowledge remains insufficient. Education of health practitioners and the establishment of practice guidelines and fertility preservation clinics for cancer patients are required. [ABSTRACT FROM AUTHOR]

Nursing is a vital health profession. In almost all clinical and hospital settings, nurses offer primary palliative care. Nurses are recognized for their strong philosophy of care for a wide spectrum of disorders. No matter the sickness, condition, or clinical situation, palliative care is considered essential in nursing practice. Palliative care nursing is the provision of palliative care services to cancer patients and their families, regardless of whether cancer can be cured or not. A large body of evidence shows that early palliative care nursing integration improves the quality of life and survival of cancer patients. Due to the intricacy of cancer, the landscape of cancer care is shifting. Cancer is a life-threatening disease with a high mortality rate. Oncology nurses' skills and experience are vital in providing specialized patient care and fulfilling the needs of patients and their families. The current study examines the shifting environment of palliative care nursing in oncology. However, new palliative care nursing approaches are required to adapt to the evolving cancer scenario. [ABSTRACT FROM AUTHOR]