Improving the cancer adult patient support network (iCAN): a pilot study on a communication model and modified focus group.

Background: Many consider that cancer has the greatest impact of any disease in the world, and it can drastically limit patients' quality of life. Combating such a life-threatening disease can pose many challenges to daily life, highlighted by demonstrating the need to discuss one's health status within a focus group and encourage treatment compliance. Aim: the purposes of this study were to share the authors' experience of a modified focus group in an Oral Medicine Unit, termed "Improving Cancer Adult Patients Support Network" (iCAN), and to evaluate how effective communication could improve patients' quality of life and empower them by virtue of enhanced knowledge and an awareness of cancer management. Methods: the paper adhered to the COREQ checklist regarding its reporting procedures. The iCAN format was precisely reproduced four times with four groups, consisting of 12 adult male and female patients with solid cancers. They discussed several main topics relating to cancer treatment, as chosen by a majority of the participants. Four specialists were involved in the discussion of the selected topics The iCAN format was faithfully reproduced during each meeting, with the participants in the roles of moderator and health specialists. Finally, a satisfaction questionnaire was administered. Results: the most reliable results demonstrated a marked change in lifestyle and eating habits in more than 50% of participants. More than 80% were unaware of the side effects of cancer treatments in general and the oral mucosa in particular. Each meeting reported a maximum degree of satisfaction experienced by the participants. Conclusion: iCAN focus group meetings appear to have facilitated a process of narrative interviewing, thereby improving the doctor-patient relationship underlying the humanization of the care process.

Reducing the anxiety of patients undergoing an oral biopsy by means of graphic novels: an open-label randomized clinical trial

Background: The use of graphic novels is a trending topic in health communication as a new form of visual storytelling which explores narratives of health care, cancer, healing, and disability. The objective of the present study was to evaluate - for the first time in the literature - the effect of graphic novels in reducing the anxiety of patients waiting for an incisional biopsy in an oral oncology setting. Material and Methods: This open-label randomized clinical trial comprised 50 patients with a clinical suspicion of oral potentially malignant disorders. Twenty-five patients were randomly allocated to the test group, and a colourful graphic novel was provided. Subsequently, the Beck Depression Inventory and the Depression Anxiety Stress Scales-21 were administered to all 50 recruited patients, after which a biopsy was performed on each patient. Results: No statistically significant difference was observed between the test and control groups for the variables regarding the demographic data (p>0.2). There was a significant difference after the introduction of the graphic novel, regardless of which questionnaire was used. The graphic novel demonstrated an improvement in the ability of the test group to tolerate anxiety while waiting for an oral biopsy in both psychological tests (p<0.05). Conclusions: In light of these initial positive results, the authors of this study would like to suggest the use of graphic novels in oral oncology, dentistry, and medicine with the aim of reducing patient anxiety. (AU)

Diagnostic delay of oral squamous cell carcinoma and the fear of diagnosis: A scoping review.

The mortality rate of patients affected with oral squamous cell carcinoma (OSCC) has been stable in recent decades due to several factors, especially diagnostic delay, which is often associated with a late stage diagnosis and poor prognosis. The aims of this paper were to: analyze diagnostic delay in OSCC and to discuss the various psychological factors of patients with OSCC, with particular attention to the patient's fear of receiving news regarding their health; and the professional dynamics related to the decision-making processes in cases of suspected OSCC. A preliminary review of literature focusing on OSCC diagnostic delay was performed. Seven articles were included with the diagnostic delay ranging from 45 days to approximately 6 months. Patients' fears and, to a lesser degree, the concerns of dentists, were found to be still poorly investigated. On the basis of the authors' professional experience, the development of oral lesions of unknown origin may generate different behaviors in the decision-making processes by patients and clinicians, and fear may play a key role in the distinct steps of this process. It is crucial to increase awareness and inform patients about the onset of OSCC, and contemporaneously encourage experimental studies on patients' fear and professional behaviors with respect to communication regarding OSCC.

The patient-doctor relationship: new insights in light of the current Ministerial recommendations regarding Phase 2 of the COVID-19 pandemic.

Following the publication of the Italian Ministerial recommendations relating to dentistry in Phase 2 of the COVID-19 pandemic (focusing on operational protocols for all dental staff), we believe that the patient/dentist relationship should increasingly take into account the heightened fears and anxious thoughts of patients. This particularly regards patients who are about to undergo dental work. Moreover, dentists should also pay close attention to recent events, which have determined the new recommendations regarding SARS-COV-2 biocontainment. Furthermore, the authors of this paper consider it appropriate to make suggestions and develop interventionist techniques regarding the interface with the patient starting from the initial consultation. The latter is invariably determinant in establishing clear communication of the Ministerial recommendations in encouraging a relaxed atmosphere with the patient. This interface is also a decisive factor in promoting patient empowerment, including specifying the time period envisaged for treatment in the new COVID-19 era in as calm a manner as possible. Such an approach will have a positive impact on the dentistry team.