Georgia Cancer Survivorship Conference - PowerPoint PPT Presentation

Loading...

PPT – Georgia Cancer Survivorship Conference PowerPoint presentation | free to download - id: e949-MjFjY



Loading


The Adobe Flash plugin is needed to view this content

Get the plugin now

View by Category
About This Presentation
Title:

Georgia Cancer Survivorship Conference

Description:

... Population of Cancer Survivors in American Society with Many Communication Challenges ... American Cancer Society, 2007. Prostate Cancer & African ... – PowerPoint PPT presentation

Number of Views:318
Avg rating:3.0/5.0
Slides: 41
Provided by: gben
Learn more at: http://health.state.ga.us
Category:

less

Write a Comment
User Comments (0)
Transcript and Presenter's Notes

Title: Georgia Cancer Survivorship Conference


1
Georgia Cancer Survivorship Conference
  • Patient-Provider Communication Expanding the
    Boundaries to Improve Decision Making and Quality
    of Life for Cancer Survivors
  • Gerald Bennett, PhD, APRN, FAANRosalind Jones,
    DNP, APRN-BC

2
(No Transcript)
3
PatientProvider Communication
  • PatientProvider Communication
  • Provides meaningful dialogue for health issues
  • Involves patients in their care
  • Builds trust
  • Fosters patient understanding for good healthcare
    decision-making
  • Empowers patients

4
(No Transcript)
5
Limitations to Traditional Patient-Provider
Communication Practices
  • Time limits on each interaction
  • Small number of interactions
  • Patients interactive role in communication often
    limited by anxiety, limited understanding,
    information overload and feeling one down in
    the medical environment

6
Components of Effective Patient-Provider
Communication
  • Patient enlisted as a partner in care
  • Culturally tailored
  • Information shared and evidenced-based treatment
    options considered
  • Empathic support and concern conveyed
  • Problem solving and symptom management strategies
    routinely reviewed

7
Men with Prostate Cancer and their Partnersa
Fast Growing Population of Cancer Survivors in
American Society with Many Communication
Challenges
8
Prostate Cancer Statistics
  • Prostate Cancer
  • 218,890 newly diagnosed in 2007
  • 27,050 deaths estimated in 2007
  • Most common serious cancer in men
  • Second leading cause of cancer death among men
  • American Cancer Society, 2007

9
Prostate Cancer African Americans
  • African Americans
  • Suffer twice the incidence of White Americans
  • Suffer twice the mortality rate of White
    Americans
  • More likely to be diagnosed at an advanced stage
  • Major health disparity

10
Prostate Cancer Burden
  • Physical Complications
  • Pain - hips, thighs, legs
  • Urinary, Bowel, and Sexual Symptoms
  • Fatigue
  • Psychosocial Complications
  • Stress
  • Depression
  • Relationship/family distress
  • Threat to quality of life

11
(No Transcript)
12
PatientProvider Communication
  • There are many ways patients and providers
    communicate
  • Face to face
  • Written information (letters, information sheets,
    newsletters)
  • Online (email, websites)
  • Telephonically

13
Expanding Communication Channels in Cancer
Care
Communication
14
Current Projects Headed by Drs. Bennett and Jones
at MCG
  • Georgia Cancer Coalition research grant to pilot
    Telephone Interpersonal Counseling with African
    American men and their partners data analysis
    continuing
  • NIH/U. of WA R01Sub-contract Personal Patient
    Profile Prostate (P4) A Randomized, Multi-Site
    Trial beginning 2nd year in 3 year study

15
Telephone Interpersonal Counseling Intervention
(TIP-C)
  • Developed by Dr. Terry Badger at U of AZ
  • 6-8 weeks intervention
  • Delivered over the telephone
  • Sessions average 30 minutes
  • Patients receive 6-8 sessions
  • Partners 3-4 sessions

16
Telephone Interpersonal Counseling
(T.A. Badger)
17
Telephone Interpersonal Counseling
  • TIP-C
  • Allows providers to stay in touch with their
    patients
  • Able to reach patients anywhere they have phone
    access
  • Provides a communication experience for the
    patient outside of the context of the busy
    treatment center atmosphere
  • Patientprovider communication is enhanced by
    one-on-one check-ins

18
(No Transcript)
19
Basic Elements of TIP-C Intervention
  • Symptoms can be managed with education and
    problem-solving
  • Emphasizes interpersonal influences/interventions
    to treat symptoms
  • Intervention is short-term
  • Focuses on here and now
  • Intervention delivered entirely by phone

20
Personal Patient Profile Prostate (P4) A
Randomized Multi-Site Trial (N498)
  • University of Washington with three sites
    Medical College of Georgia (Dr. Martha Terris),
    University of Texas Health Science Center, Fox
    Chase Cancer Center (Philadelphia, PA)
  • Study participants are men with localized
    prostate cancer making decisions regarding
    treatment
  • Compares decisional conflict and satisfaction in
    men receiving the web-based P4 intervention to
    those receiving traditional patient education

21
The Personal Patient Profile-Prostate (P4)
22
Enhancing Communication with African American
Cancer Survivors Through Cultural Competence
23
Managing Prostate Cancer Burden in African
Americans
  • Randomized pilot clinical trial for African
    American men and their partners (N9 dyads)
    funded by Georgia Cancer Coalition
  • Goal of establishing the feasibility of providing
    telephone interpersonal counseling (TIP-C) to
    African American men with advanced PCa on ADT
    their partners
  • TIP-C seeks to improve health-related quality of
    life (HRQOL) and decrease depressive symptoms

24
Telephone Interpersonal Counseling
  • Our Current focus for TIP-C Research
  • Prostate Cancer research
  • African American men with prostate cancer
  • Receiving Hormone Therapy
  • Their partners
  • Culturally matched symptom management information
    and brief interpersonal counseling

25
(No Transcript)
26
Evaluation Questions
  • How effective is the culturally competent
    research protocol in increasing access
    enrollment of African American men their
    partners?
  • To what extent is the culturally competent
    approach to TIP counseling effective in
    addressing culturally pertinent areas?
  • To what extent do participants adhere to the
    protocol?
  • Are participants satisfied with their experience?

27
Suhs Model of Cultural Competence Applied to
TIP-C Study with African Americans
28
African American Cultural Competence Program Plan
  • Cognitive Cultural concordance for data
    collection TIP counseling to enhance awareness
    knowledge of African American culture
  • Affective Demonstrate respect acceptance of
    the values beliefs of African Americans
  • Environment Network with physicians seeing
    African Americans with prostate cancer
  • Behavioral Tailor assessments interventions
    specific to African American culture

29
(No Transcript)
30
Procedures
  • Tracked network indicators including of
    contacts to providers, responses, referral
    rates
  • Audio taped all TIP sessions, panel of African
    Americans with expertise in health disparities
    reviewed culturally pertinent interactions
  • Tracked adherence to the three data collection
    for all participants, 6 TIP sessions for men 3
    TIP session for women receiving the intervention
  • Compiled responses to satisfaction questionnaire
    given at the program conclusion

31
Access Enrollment - Question 1
  • Poor response rate (15.4) of 39 physician
    contacts with in five metropolitan areas in the
    region
  • 6 written agreements to participate in the
    referral network 4 in the authors academic
    health sciences center 2 in outside
    metropolitan area

32
Culturally Sensitive TIP Counseling - Question 2
  • Panel review identified several culturally
    pertinent areas
  • Diet, limited knowledge of prostate cancer,
    understanding of mental health terms,
    spirituality/religion
  • Panel concluded counselor was able to attend to
    culturally pertinent concerns

33
Adherence to Program Protocol - Question 3
  • Average counseling call duration was 30 minutes
  • 100 adherence to data collection
  • 100 adherence with counseling calls

34
Satisfaction with Participation - Question 4
  • Satisfaction questions posed by a data collector,
    not the telephone counselor
  • All participants expressed satisfaction but
    questions need to be posed in more open-ended
    manner
  • Even control participants found the program
    experience to be helpful in provoking thought
    about their condition seeking out additional
    information

35
Satisfaction (cont)
  • Satisfaction high - Comments
  • the more African Americans are involved the
    better, we are usually the last to know
  • this was the first time something like this was
    brought to my attention, and we are left in
    the dark
  • it made me look for more information

36
Cultural Competence in P4 Study
  • Augusta site is a major recruitment region for
    African American participants
  • The Web-based treatment decision making support
    program is designed to be culturally sensitive to
    various ethnic groups
  • African American men are volunteering to
    participate and are going online

37
(No Transcript)
38
(No Transcript)
39
Conclusions
  • Traditional and new channels for patient-
    provider communication are critical in the quest
    for excellence in cancer care.
  • Telephone counseling and computerbased
    communications are the most promising
    innovations.
  • Cultural competence is a necessary element in
    effective patient-provider communication.

40
Questions Discussion
gbennett_at_mcg.edu rosjones_at_mcg.edu
About PowerShow.com