At the heart of the COVID-19 crisis: Perceived concerns of changes in long-term cancer care in French women with cancer.

OBJECTIVE: In the COVID-19 crisis context, the main objective of the study is to investigate factors associated with perceived concerns of change in long-term cancer care in patients currently under treatment. METHODS: A French population-based cross-sectional study was performed using an online questionnaire in April 2020. All persons currently receiving cancer treatment and belonging to the Seintinelles Association (https://www.seintinelles.com) were included in this present analysis. Individual sociodemographic characteristics, medical status and information regarding cancer care were collected. Multivariate binomial logistic regression analysis was performed. RESULTS: We included 298 women in the analysis. Younger participants (OR = 0.96 [0.94-0.99]), the need to visit healthcare facilities to receive treatment (OR = 2.93 [1.16-8.52]), deterioration in the quality of communication with the medical team since the beginning of the COVID-19 crisis (OR = 3.24 [1.61-7.02]) and being cared for by a university hospital or a public hospital (OR = 2.19 [1.16-4.23] versus comprehensive cancer centre) were associated with a perceived fear of change in long-term cancer care. CONCLUSION: To address patients' concerns regarding changes in their long-term cancer care, medical teams should consider the patients' own perceptions of the situation and provide clear, appropriate, precise information on cancer care, especially in the centres mostly affected by the COVID-19 crisis.

Representations of Research among Newly Graduated Paramedical Professionals: A Qualitative Study.

Despite a keen interest in clinical research, most paramedical professionals are unwilling to play an active role. Our objective was to explore paramedical professionals' representations of research. Using an existing database of final year paramedical students (speech therapy, occupational therapy, psychomotricity, audiometry, physiotherapy, orthoptics), we deployed a qualitative approach composed of two successive steps: (1) a free word association task, and (2) semi-structured individual interviews. Out of the 54 students who agreed to be contacted, we received 21 responses to the free word association questionnaire, and 11 interviews were conducted. The hierarchical evocation matrix revealed that the scientific representation of research is based on words defining the research and the purpose of the research. "Collaboration" was identified as being an essential part of the research process. The central core of the representation is coherent with all its components perceived as positive. The content analysis of the interviews showed a polarization around two key points: (1) participants are interested in accessing and using evidence in their practice (2) but feel less confident about and/or motivated to generate evidence themselves. This study highlights the need to develop more research-friendly environments, especially in training institutions.

Cultural and Ethical Barriers to Cancer Treatment in Nursing Homes and Educational Strategies: A Scoping Review.

(1) Background: The aging of the population, the increase in the incidence of cancer with age, and effective chronic oncological treatments all lead to an increased prevalence of cancer in nursing homes. The aim of the present study was to map the cultural and ethical barriers associated with the treatment of cancer and educational strategies in this setting. (2) Methods: A systematic scoping review was conducted until April 2021 in MEDLINE, Embase, and CINAHL. All articles assessing continuum of care, paramedical education, and continuing education in the context of older cancer patients in nursing homes were reviewed. (3) Results: A total of 666 articles were analyzed, of which 65 studies were included. Many factors interfering with the decision to investigate and treat, leading to late- or unstaged disease, palliative-oriented care instead of curative, and a higher risk of unjustified transfers to acute care settings, were identified. The educational strategies explored in this context were generally based on training programs. (4) Conclusions: These results will allow the co-construction of educational tools intended to develop knowledge and skills to improve diagnostic and therapeutic decision-making, the consistency of care, and, ultimately, the quality of life of older cancer patients in nursing homes.

Risk target: an interactive context factor in risk perception.

The effect of specification of the target on risk evaluation was examined. A whole set of hazards, covering most of the domains, were considered: common individual hazards, outdoor activities, medical care, public transportation, energy production, pollutants, sex, deviance, and addictions. Three human targets were introduced: personal health risk (including personal risk of death), health risk for people in the country, and health risk for people in the world. The basic design was a between-subjects design. The first hypothesis was that risk judgments made in the "world" condition should be higher than risk judgments made in the "country" condition, and risk judgments made in this condition should be higher than risk judgments made in the "personal" condition. This is what was observed. The second hypothesis was that the target effect should differ as a function of the kind of hazards considered. This also is what was observed. In two domains--pollutants, and deviance, sex, and addictions--the target effect was important. It corresponded to about one-tenth of the response scale. In the four remaining domains, the target effect was unimportant or absent.