Perspectives and Experiences of Healthcare Professionals Involved in a Community Nurse-Delivered Shared Care Model Intervention Designed to Support Outpatients Receiving Chemotherapy: A Qualitative Study Using Interviews
Bora KimChantale BoustanyLouise AcretJodi McLeodNatalie CookHeather McKenzieLillian HayesJudith FethneyJudy M. SimpsonSimon WillcockKate White
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Background. Chemotherapy can cause a range of side effects including nausea, vomiting, diarrhea, and infection, which can have a significant impact on an individual’s quality of life. Survival outcomes can be impacted when side effects are poorly managed, leading to failure to complete the defined dose of treatment. Objective. This study presents clinicians’ experiences with a shared care model involving home-based community nurse (CN) support to improve side-effect management of individuals receiving chemotherapy as an outpatient. Methods. A qualitative study was conducted with CNs, cancer nurses, medical oncologists, and a general practitioner involved in the CN intervention delivered as part of a randomized controlled trial (RCT) aimed at reducing unplanned presentations to hospital of cancer patients receiving outpatient chemotherapy. Semistructured individual and focus group interviews were conducted. Key themes were identified using thematic analysis. Findings. Twenty-three healthcare professionals were interviewed. Three themes were identified: (1) being able to enhance patient-centered care and clinical practice during chemotherapy; (2) importance of effective communication and collaborative relationships between different care settings; and (3) ways to adapt the intervention for implementation in routine clinical practice. Participants reported that it was feasible for CNs to care for this patient group, and their home visits enabled preemptive symptom management. Suggestions to improve and modify the intervention to implement this care model within existing clinical care included a flexible approach, such as a blended delivery with face-to-face visits and telephone calls; a risk- or needs-based approach to prioritize patient groups more likely to benefit from the intervention; and sharing of electronic medical records for more effective collaboration and communication. Conclusions. A CN-delivered shared care model provided a feasible approach to the provision of individualized support for outpatients receiving chemotherapy. This study suggests ways to adapt this care model into existing clinical workflow and structures. This trial is registered with ACTRN12614001113640.Keywords:
Health Professionals
In this paper, problems connected to the adaptation of EU cereal intervention in Hungary are discussed. Statistical evidence is provided about the two record years of intervention in Hungary proving that farmers did not take part in intervention though the system was sought to be tailored to farmers' needs. Intervention purchases took place at the wholesale level and traders were the most active participants in both intervention periods. This dynamic intervention activity of traders will significantly alter the Hungarian trade sector by bringing it closer to the physical processes of the cereal chain. As to the size of intervention, the great volume of the purchase of maize has resulted in an exceptionally severe problem considering the large surplus of Hungarian cereals. Recently, the Commission hampered maize intervention in Hungary by excluding this crop from cereals eligible for intervention. This measure is criticised in the paper, as we deem it unnecessary in recent market conditions, and in our view it doesn't make up the compulsory need for a complex reconsideration of recent EU cereal policy on the long term.
European commission
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In this paper, problems connected to the adaptation of EU cereal intervention in Hungary are discussed. Statistical evidence is provided about the two record years of intervention in Hungary proving that farmers did not take part in intervention though the system was sought to be tailored to farmers' needs. Intervention purchases took place at the wholesale level and traders were the most active participants in both intervention periods. This dynamic intervention activity of traders will significantly alter the Hungarian trade sector by bringing it closer to the physical processes of the cereal chain. As to the size of intervention, the great volume of the purchase of maize has resulted in an exceptionally severe problem considering the large surplus of Hungarian cereals. Recently, the Commission hampered maize intervention in Hungary by excluding this crop from cereals eligible for intervention. This measure is criticised in the paper, as we deem it unnecessary in recent market conditions, and in our view it doesn't make up the compulsory need for a complex reconsideration of recent EU cereal policy on the long term.
European commission
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Timing of intervention is crucial, and different timings of intervention may lead to diametrically opposite outcomes. This chapter describes the relationship between disease risk, intervener, and interventions and the timing of intervention. The relationship between disease risk and intervention timing is to explain how to grasp the timing of intervention according to the disease risk through different stages of the development of the same disease. In the section of interveners and intervention timing, two examples are used to elaborate how interveners influence intervention timing. In the section of intervention means and intervention timing, two examples are also used to illustrate the importance of choosing intervention timing according to the fit of interveners and interventions.
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Preface Acknowledgments Introduction: Attitudes, Assumptions, and Caveats The Urge to Synthesize Conceiving the Qualitative Research Synthesis Study Searching For and Retrieving Qualitative Research Reports Appraising Reports of Qualitative Studies Classifying the Findings in Qualitative Research Reports Synthesizing Qualitative Research Findings: Qualitative Metasummary Synthesizing Qualitative Research Findings: Qualitative Metasynthesis Optimizing the Validity of Qualitative Research Synthesis Studies Presenting Syntheses of Qualitative Research Findings Appendix: Reports in the Qualitative Metasynthesis Project Index
Qualitative analysis
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This is a protocol for a Cochrane Review (Intervention). The objectives are as follows: To determine the effectiveness of various interventions to improve the adoption of SDM by healthcare professionals. To address this objective, four comparisons are planned: 1.Single intervention specifically designed to improve the adoption of SDM by healthcare professionals in healthcare settings compared to no intervention. 2.Single intervention specifically designed to improve the adoption of SDM by healthcare professionals in healthcare settings compared to any other single intervention. 3.Multifaceted intervention specifically designed to improve the adoption of SDM by healthcare professionals in healthcare settings compared to no intervention. 4.Multifaceted intervention specifically designed to improve the adoption of SDM by healthcare professionals in healthcare settings compared to any other single intervention.
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Several studies have shown that healthcare professionals are at greater risk than the rest of the population of having certain health problems due to the specificity of their workplace and the physical and psychological demands of their work. Additionally, healthcare professionals seem to behave differently when seeking health care. Several studies also indicate that the health of healthcare professionals has an impact on the performance of services and on the health of the population. The present paper analyzes morbidity patterns, health behaviors and lifestyles, self-perceived health status and health service utilization among healthcare professionals, by using the Portuguese 1999 National Health Survey. Results differ from those found in international studies. Portuguese healthcare professionals did not suffer more from some health problems than non-healthcare professionals. Healthcare professionals tended to assess their health as good and better as that of other workers. They also reported healthier behaviors (smoked less, drank less and practiced exercise more often) and missed fewer workdays due to sickness. The percentage of healthcare professionals suffering from back pain was lower than the percentage of other workers but they started to complain earlier.
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Illustrations Acknowledgments Introduction: Intervention Centrality: An Argument Global Structure and American Intervention World Perspectives and American Intervention Policy Perspectives on American Intervention Foreign Policy Doctrines on American Intervention American Intervention: Post-Cold War Cases American Intervention: Evolving Opportunities American Intervention: Evolving Trends Intervention Impact: An Assessment Bibliography Index
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This article has discussed the problem behavior concept and its several classified methods,and it has clarified about the definition and the type of problem behavior,and described in detail the three common problem behavior intervention method: The behavior intervention,the cognition intervention and the sensory integrative training method.It proposed some concrete suggestion about how to use them.
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Intervention is a fully widespread phenomenon from ancient to modern time on international relationship field. The debate on this conception among scholars has been seen all the time. People are getting closer to a common sense of intervention by generation effort. But scholars still pursue a more strict, scientific and specific definition of intervention. For a better discussion on international structure and form at present, a more clear\|out conception of intervention is needed. This paper try to review the literature about the intervention study and try to inspect the definition about it as well. This paper also attempt to analyze the main actor, the subject aim of the intervention, the punishment and coerce effect of the intervention, and its characteristics to damage certain sovereignty.
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Humanitarian Intervention
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