Peer support opportunities across the cancer care continuum: a systematic scoping review of recent peer-reviewed literature.

OBJECTIVE: Evidence suggests peer support (PS) is as an effective strategy for enhancing prevention and control of chronic and infectious diseases, including cancer. This systematic scoping review examines the range and variety of interventions on the use of PS across the cancer care continuum. METHOD: We used a broad definition of PS to capture a wide-range of interventions and characterize the current status of the field. Literature searches were conducted using PubMed, SCOPUS, and CINAHL to identify relevant articles published from January 2011 to June 2016. We screened the title and abstracts of 2087 articles, followed by full-text screening of 420 articles, resulting in a final sample of 242 articles of which the most recent 100 articles were reviewed (published June 2014 to May 2016). RESULTS: A number of the recent intervention studies focused on breast cancer (32%, breast cancer only) or multiple cancer sites (23%). Although the interventions spanned all phases of the cancer care continuum, only 2% targeted end-of-life care. Seventy-six percent focused on clinical outcomes (e.g., screening, treatment adherence) and 72% on reducing health disparities. Interventions were primarily phone-based (44%) or delivered in a clinic setting (44%). Only a few studies (22%) described the impact of providing PS on peer supporters. CONCLUSION: PS appears to be a widely used approach to address needs across the cancer care continuum, with many opportunities to expand its reach.

Influential factors on treatment decision making among patients with colorectal cancer: A scoping review.

PURPOSE: In recent years, a greater emphasis has been placed on shared decision-making (SDM) techniques between providers and patients with the goal of helping patients make informed decisions about their care and subsequently to improve patient health outcomes. Previous research has shown variability in treatment decision-making among patients with colorectal cancer (CRC), and there is little comprehensive information available to help explain this variability. Thus, the purpose of this study was to evaluate the current state of the literature on factors that are influential in treatment decision-making among patients with CRC. METHOD: A priori search terms using Boolean connectors were used to examine PubMed, PsycINFO, Web of Science, CINAHL, and MEDLINE for relevant studies. Eligibility criteria for inclusion in the study included patients with CRC and examination of influences on CRC treatment decision-making. All relevant data were extracted including, author, title and year, study methodology, and study results. RESULTS: Findings (n = 13) yielded influences in four areas: informational, patient treatment goals, patient role preferences, and relationship with provider. Quality of life and trust in physician were rated a high priority among patients when making decisions between different therapeutic options. Several studies found that patients wanted to be informed and involved but did not necessarily want to make autonomous treatment choices, with many preferring a more passive role. CONCLUSIONS: Providers who initiate a dialog to better understand their patients' treatment goals can establish rapport, increase patient understanding of treatment options, and help patients assume their desired role in their decision-making. Overall, there were a small number of studies that met all inclusion criteria with most used a cross-sectional design.

Emotions predictably modify response times in the initiation of human motor actions: A meta-analytic review.

Emotions motivate individuals to attain appetitive goals and avoid aversive consequences. Empirical investigations have detailed how broad approach and avoidance orientations are reflected in fundamental movement attributes such as the speed, accuracy, and variability of motor actions. Several theoretical perspectives propose explanations for how emotional states influence the speed with which goal directed movements are initiated. These perspectives include biological predisposition, muscle activation, distance regulation, cognitive evaluation, and evaluative response coding accounts. A comprehensive review of literature and meta-analysis were undertaken to quantify empirical support for these theoretical perspectives. The systematic review yielded 34 studies that contained 53 independent experiments producing 128 effect sizes used to evaluate the predictions of existing theories. The central tenets of the biological predisposition (Hedges' g = -0.356), distance regulation (g = -0.293; g = 0.243), and cognitive evaluation (g = -0.249; g = -0.405; g = -0.174) accounts were supported. Partial support was also identified for the evaluative response coding (g = -0.255) framework. Our findings provide quantitative evidence that substantiate existing theoretical perspectives, and provide potential direction for conceptual integration of these independent perspectives. Recommendations for future empirical work in this area are discussed.

Understanding time use, stress and recovery practices among early career physicians: an exploratory study.

Early career physicians (ECPs) work an average of 80 h per week, and at times may approach 24 continuous hours working. These hours, combined with a stressful work environment, and an inability to physically and psychologically detach from work make ECPs likely to experience burnout and other negative health-related consequences. This study provides insight into the stress and recovery challenges faced by ECPs in a typical hospital environment. Rich qualitative and quantitative data were gathered from participants regarding daily time usage, and recovery practices and needs. ECPs report longer working hours, less leisure time and shorter amounts of sleep than average working adults. ECPs do not participate in many resource-replenishing activities while at work, and when out of work, they tend to participate in more passive than active forms of recovery. Resource-draining activities were identified as requiring much of ECP's nonwork time, further limiting recovery. The prevention of burnout and other negative health consequences among ECPs requires the building of a workplace and educational culture that supports regular resource replenishment. This includes the need for a curriculum of medical education that teaches ECPs to identify the signs of stress and recovery needs, and how to effectively address these needs.

A patient-initiated voluntary online survey of adverse medical events: the perspective of 696 injured patients and families.

BACKGROUND: Preventable medical errors continue to be a major cause of death in the USA and throughout the world. Many patients have written about their experiences on websites and in published books. METHODS: As patients and family members who have experienced medical harm, we have created a nationwide voluntary survey in order to more broadly and systematically capture the perspective of patients and patient families experiencing adverse medical events and have used quantitative and qualitative analysis to summarise the responses of 696 patients and their families. RESULTS: Harm was most commonly associated with diagnostic and therapeutic errors, followed by surgical or procedural complications, hospital-associated infections and medication errors, and our quantitative results match those of previous provider-initiated patient surveys. Qualitative analysis of 450 narratives revealed a lack of perceived provider and system accountability, deficient and disrespectful communication and a failure of providers to listen as major themes. The consequences of adverse events included death, post-traumatic stress, financial hardship and permanent disability. These conditions and consequences led to a loss of patients' trust in both the health system and providers. Patients and family members offered suggestions for preventing future adverse events and emphasised the importance of shared decision-making. CONCLUSIONS: This large voluntary survey of medical harm highlights the potential efficacy of patient-initiated surveys for providing meaningful feedback and for guiding improvements in patient care.