Improving Information Provision on Chemotherapy-Induced Alopecia and Scalp Cooling: A Comprehensive Approach Including A Website and Web-Based Decision Tool.

OBJECTIVE: Alopecia is a frequently occurring side effect of chemotherapy and has high impact on many patients. Currently, scalp cooling is the only method to prevent this chemotherapy-induced alopecia (CIA) and it is effective in about half of the patients. Since determinants of the success are largely unknown, all patients should be prepared for potential hair loss. The objective was to provide up-to-date online information about CIA and scalp cooling to support patients in coping with CIA and in their choice regarding scalp cooling. METHODS: Essential aspects of delivering information and lack of information were identified during focus groups, interviews, and a questionnaire survey among cancer patients, and in discussions with nurses. RESULTS: The obtained information was used to develop a website (www.scalpcooling.org) and a web-based tool. It combines scientific evidence and practical advice about CIA and regrowth of hair, scalp-cooling tolerance, efficacy and safety, as well as an overview of possible advantages and disadvantages. The web-based tool provides tailored information about the probability of CIA with and without scalp cooling in particular chemotherapy regimens. Besides, the tool offers patients' support in decision-making by allowing them to reflect and consider their values and opinions about scalp cooling. CONCLUSIONS: This comprehensive information is useful during nursing consultations.

Shared and individual medical appointments for children and adolescents with type 1 diabetes; differences in topics discussed?

OBJECTIVE: The purpose of this study was to examine differences in the type of topics discussed during shared medical appointments (SMAs) and traditional individual outpatient visits for children and adolescents with type 1 diabetes. In addition, differences between the conversational contributions of the participants were examined. METHODS: Videotapes of 42 individual outpatient visits and 5 SMAs with 31 children or adolescents were collected and observed using a checklist of topics adapted from the international consensus guideline for the management of type 1 diabetes in childhood and adolescents. Furthermore, patients reported about their experience with the information and support provided during an SMA. Data analysis was performed using one-way ANOVAs and univariate variance analysis. RESULTS: In SMAs, more diabetes-related topics were discussed. During SMAs, the conversational contributions of the different participants seemed to be more equally distributed than during traditional individual outpatient visits. Participants felt that they had learned most from the presence of other patients and their questions. CONCLUSION: More diabetes-related topics are covered in SMAs than in individual outpatient pediatric follow-up visits. PRACTICE IMPLICATION: SMAs seem to offer an appreciated variation on the regular diabetes care for children and adolescents.