ABSTRACT
OBJECTIVE: The aim of this study was to analyze the relationships between the characteristics of the management of oncohematology services and the psychosocial determinants of caregivers' health at work including social support, stress, and coping strategies. DESIGN: Investigation using questionnaires was carried out about nurses and nurse aides in hematology and oncology services. SETTING: All hematology and oncology services of Western France were requested. Five questionnaires concerning sociodemographic characteristics, measurements of quality of work life, of social support, of perceived stress, and of coping strategies and quality of work life were delivered among health professionals. PARTICIPANTS: Five hundred seventy-four questionnaires from 53 different services were analyzed. There were 57.4% nurses and 42.6% nurse aides. Some 94.1% were female and 33.5% were older than 40 years. RESULTS: Several characteristics of oncohematology services were significantly linked to health indicators, as the need for time and recognition, the importance of training (in palliative care, pain management, and help relationship), the care of patients and their families, the interdisciplinary efficiency, and external interventions (psychologists and volunteers). We showed that participative management which includes implementation of service projects and of multidisciplinary staff influence the quality of work life of health professionals. We showed also how much the characteristics of services organized around an effective social support (need for recognition) favor a better quality of work life among caregivers, influencing their perceived stress and their coping strategies. CONCLUSION: To our knowledge, it is the first study showing a relationship between participative management (including multidisciplinary staffs, approach with a service project, and internal training) and the quality of work life in the domain of health care. The implementation of this model should be promoted in health care services.
Subject(s)
Caregivers/psychology , Medical Oncology/organization & administration , Nurses/psychology , Nursing Assistants/psychology , Palliative Care/organization & administration , Quality of Life , Adaptation, Psychological , Adult , Female , France , Humans , Job Satisfaction , Male , Nurses/statistics & numerical data , Nursing Assistants/statistics & numerical data , Population Surveillance , Quality Indicators, Health Care/statistics & numerical data , Social Support , Stress, Psychological/psychology , Surveys and QuestionnairesABSTRACT
Deferoxamine (DFO) is an iron chelator used to treat iron overload in patients receiving chronic blood transfusions, and is usually administered as overnight subcutaneous infusions. ISOSFER was a prospective, observational, cross-sectional study conducted in metropolitan France that evaluated patient characteristics, quality of life (QoL), compliance and patient satisfaction with DFO monotherapy. Of 70 patients with either thalassemia, sickle cell disease or myelodysplastic syndromes, 30% were 'satisfied' or 'very satisfied' with DFO. Patients' SF-36 scores were lower than those of the general French population, and lower among patients with comorbidities and those dissatisfied with treatment. Although 72% of patients had good compliance to DFO, 57% reported missing at least one infusion in the previous month, and 82% of patients expressed a preference for oral therapy. These results suggest that QoL is severely compromised in patients receiving DFO, and that compliance is not optimal.
Subject(s)
Chelation Therapy/psychology , Deferoxamine/therapeutic use , Iron Overload/psychology , Quality of Life , Siderophores/therapeutic use , Adult , Aged , Aged, 80 and over , Blood Transfusion/psychology , Chelation Therapy/adverse effects , Child , Cross-Sectional Studies , Deferoxamine/adverse effects , Female , France , Hematologic Diseases/psychology , Hematologic Diseases/therapy , Humans , Iron Overload/drug therapy , Male , Middle Aged , Patient Compliance , Prospective Studies , Siderophores/adverse effects , Transfusion ReactionABSTRACT
The JAK2(V617F) mutation does not elucidate the phenotypic variability observed in myeloproliferative neoplasm (MPN) families. A putative tumor suppressor gene, TET2, was recently implicated in MPN and myelodysplastic syndromes through the identification of acquired mutations affecting hematopoietic stem cells. The present study analyzed the TET2 gene in 61 MPN cases from 42 families. Fifteen distinct mutations were identified in 12 (20%) JAK2(V617F)-positive or -negative patients. In a patient with 2 TET2 mutations, the analysis of 5 blood samples at different phases of her disease showed the sequential occurrence of JAK2(V617F) and TET2 mutations concomitantly to the disease evolution. Analysis of familial segregation confirmed that TET2 mutations were not inherited but somatically acquired. TET2 mutations were mainly observed (10 of 12) in patients with primary myelofibrosis or patients with polycythemia vera or essential thrombocythemia who secondarily evolved toward myelofibrosis or acute myeloid leukemia.
