Caregivers of Patients with Hematological Malignancies within Home Care: A Phenomenological Study.

The role of caregivers in homecare settings is relevant to the patient's wellbeing and quality of life. This phenomenon is well described in the literature for the oncological setting but not specifically for that of hematological malignancies. The aim of this study was to explore the experience of primary caregivers of patients with hematological malignancies within home care. We conducted a phenomenological study based on interviews with 17 primary caregivers of hematological patients. Analysis of the contents led to the identification of five main themes. Perhaps, the innovative aspects of this study can be summarized in three points: This service was demonstrated to fulfil the ethical aspects of providing the patient with a dignified accompaniment to the end of life. Secondly, the efficiency of the service and the benefit are directly dependent on the caregivers' wellbeing, so knowledge of the dynamics and emotions involved can lead to the development and implementation of programs for hematological malignancies. Lastly, a collaborative caregivers-professionals relationship can improve a sense of accomplishment for all parties involved, lessening the family's frustration related to not having done their best. Home care brings significant benefits for both the patient and the caregivers and fulfils the ethical obligation of providing the patient dignified end-of-life care.

Composition and emission of VOC from biogas produced by illegally managed waste landfills in Giugliano (Campania, Italy) and potential impact on the local population.

The composition in Volatile Organic Compounds (VOC) of the biogas produced by seven landfills of Giugliano (Naples, Campania, Italy) was determined and VOC emission rates assessed to verify if these compounds represent a potential threat to the population living nearby. VOC composition in the biogas could not be predicted, as heterogeneous waste was dumped from the late 1980s to the early 2000s and then underwent biological degradation. No data are available on the amount and composition of VOC in the biogas before the landfills closure as no operational biogas collection system was present. In this study, VOC composition was determined by gas chromatography-mass spectrometry (GC-MS), after collecting samples from collection pipes and from soil fractures in cover soil or capping. Individual VOC were quantified and data compared with those collected at two landfills in Latium, when they were still in operation. Relevant differences were observed, mainly due to waste aging, but no specific VOC revealing toxic waste dumping was found, although the concurrent presence of certain compounds suggested that dumping of industrial wastes might have occurred. The average VOC emission was assessed and a dispersion model was run to find out if the emitted plume could affect the health of population. The results suggested that fugitive emissions did not represent a serious danger, since the concentrations simulated at the neighboring cities were below the threshold limits for acute and chronic diseases. However, VOC plume could cause annoyance at night when the steady state conditions of the atmosphere enhance pollutants accumulation in the lower layers. In addition, some of the emitted VOC, such as alkylbenzenes and monoterpenes, can contribute to tropospheric ozone formation.

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 degree of coincidence between the needs of cancer patients and the answers in the statutes of associations and dedicated health services]. / I bisogni del paziente con patologia oncologica e le risposte negli statuti di servizi sanitari dedicati e associazioni.

AIMS: The research took place in the northern area of Emilia Romagna, and aimed at investigating the needs expressed by cancer patients and those included in the goals of health services and associations dedicated to cancer disease. METHOD: The study involved 22 cancer patients (12 females and 10 males, mean age 55.36 +/- 10.7) through a semi-structured interview. Twenty-five Organizational Regulations and 17 Health Card Services of institutions dedicated to cancer disease were also analyzed. RESULTS: The basic needs of cancer patients are rarely economic, legal, material and more often medical and psychological (e.g. psychological support, medical care and equal treatment, continuity of care in hospital and at home and information about diagnosis and treatment). The health services focus on the fulfillment of the needs of self-determination, dignity and respect for people, information on diagnosis and treatments, and of psychological support. The associations provide help through activities geared towards ensuring socialization opportunities (need for aggregation and company), support patients and their family and aim to be a connection in the continuity of care between hospital and home. CONCLUSIONS: While the aims of health services and associations are oriented to respond to many basic needs, some remain still unmet and others are not adequately considered (eg. need to return to daily lives). The offer, aimed to fulfill these need, could be enhanced through a network of synergistic partnerships between health services, citizenship and associations.