Meeting the needs of cancer patients: is there a need for an organizational change?

As stated in the literature the most important needs of cancer patients are not adequately meet. Improving information, communication and education provided have not led to incisive changes in the organizational model of the oncology departments. The study contributes to this direction, by planning an "Integrated Operating Point" (I.O.P.) dedicated to cancer patients and their relatives in Italy. 42 Some professionals, patients and relatives were involved and 42 of them participated in focus group/or interviews. Results of thematic content analysis allow us to sketch out some key elements that I.O.P. should have in order to support cancer patients and their families. Integration of services, continuity of care, and cooperation between professionals involved are key elements that might qualify such organizational development.

Meeting the needs of cancer patients: identifying patients', relatives' and professionals' representations.

BACKGROUND AND AIM: The literature on cancer patients agrees that most of the cancer patients' needs often remain unmet. How are these different needs perceived by patients, relatives and professionals? The present research has tried to make a contribution by analysing evidences of the needs, especially unmet, that different actors attribute to a cancer patient. METHOD: A total of 42 Italian participants (76.2% women) took part in the study. Patients, relatives, physicians, nurses, social care assistants and volunteers participated separately in six focus groups. Three face-to-face interviews were conducted with psychologist, general practitioner and social worker. All focus groups/interviews were processed through an analysis of thematic content. RESULTS: The results showed a priority given to the need for information, and also the importance of psychological and social support needs, confirming that they remain unmet. Differences between participants are visible by looking at the needs cited more frequently. For example, the oncologists are more sensitive to information needs related to the illness and its treatment, while the social worker cited the need for social, economic and legal assistance more frequently. The nurses highlighted the need for continuity of care, and the psychologists underlined the importance of psychological support, while the relatives cited the need of support both from and for families. CONCLUSIONS: RESULTS suggested that a comprehensive approach that addresses medical and psychosocial factors is needed. Cancer patients must be provided with a multidisciplinary survivorship care plan that addresses information related to their long-term care and identifies available psychological and social services.

[The path of continuity of care between hospital and territory in patients with severe brain injury. The expectations of caregivers and professionals]. / Il percorso di continuità assistenziale ospedale-territorio nei pazienti con gravi cerebrolesioni acquisite. Le aspettative dei caregiver e dei professionisti.

The present study analyses how continuity of care is perceived by health professionals and GRACER (Gravi Cerebrolesioni Acquisite Emilia Romagna) patients' caregivers, in order to investigate where the gap between expectations and reality is more heavily felt and which dimension of the continuity of care is the most important both for health professionals and GRACER patients' caregivers. The study has been developed following the Gap Analysis theoretical model. A questionnaire, based on ServQual model, was used to collect data about the three dimensions of the construct of continuity of care related to information, management and relation, declined along the lines of expectations and perception of reality. The questionnaire was administered to health professionals and caregivers of GRACER patients (12-36 months after the event) inside 4 healthcare institutes in Emilia Romagna. The PAI (Piano Assistenziale Individuale) approach was the methodology applied in these 4 sites. To both groups the relational continuity was the most important dimension, followed at a long distance by the informational and the management ones. It has also been noted that to professionals reality is always worse than expectations, with the exception of only two items in the dimension of management continuity. To caregivers reality is worse than expectations in some items in the dimensions of information and management The study has shown that the relational dimension of continuity of care should be more investigated, as confirmed by literature. More research is needed about the professionals' dissatisfaction generated by the negative balance between expectations and perception of reality.