e-book La organización de la atención multidisciplinar en cáncer (Spanish Edition)

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The inception of this clinic was facilitated by departmental mandates that all newly diagnosed patients within the health care system of the Henry Ford Hospital should be offered consultation in the new clinic. Feedback from participating physicians has been favorable regarding the utility and efficiency of this new clinic. However, the value of the clinic from the patient's perspective had not been specifically assessed.

Accordingly, this study was undertaken to evaluate the clinic in reference to its intended goals. The nursing coordinator also acquires pertinent reports and mammograms so that these studies are available for review by the physicians.

Integrated palliative care in the Spanish context: a systematic review of the literature

The multidisciplinary clinic begins with a morning conference attended by specialists from surgery, radiation oncology, medical oncology, radiology, and pathology. Each patient is discussed with mutual input as mammography films and pathology specimens are reviewed in detail.

Treatment recommendations then are proposed and discussed among the group. Topics discussed include breast anatomy, breast cancer staging, therapeutic surgical techniques, and rationale for chemotherapy and for hormone therapy. In turn, each consultant performs a physical examination after obtaining a medical, social, and family history. The recommendations of the tumor board are then disclosed while discussion ensues with emphasis on side effects, survival, local control, and cosmetic outcome.

Nursing staff and social workers are available for patient consultation and education. In addition, volunteers from the inhouse patient support program, who are specially trained for cancer patient education, are available if needed.

On leaving the clinic, the patients are provided with literature designed to reinforce information addressed during the clinic visit. Preoperative testing and definitive surgery scheduling are also completed prior to the patient's departure from the clinic. Two patient groups were compared. Each of the groups was analyzed according to timeliness of treatment and patient satisfaction, as determined by retrospective chart review and by patient questionnaires, respectively.

Because modes of therapy differ according to the stage of disease and patient preference, the timeliness of treatment varied accordingly, as illustrated in Table 1. For those patients choosing mastectomy, the treatment date was the date of the surgery; for patients undergoing radiation therapy, the treatment start date was the first day of radiation after appropriate surgical procedure, healing period, and radiation treatment planning. For a minority of patients who had advanced disease, the start of treatment was defined as the date of the first course of neoadjuvant chemotherapy administration.

Finally, despite counseling, some patients chose lumpectomy as the only form of treatment. In this last group, the date of therapy was defined as the date of excisional biopsy, which in some cases was both the diagnostic and the therapeutic procedure.

Multidisciplinary breast cancer clinics - Gabel - - Cancer - Wiley Online Library

Patient groups were evaluated according to disease stage, type of treatment rendered, and the time from diagnosis to treatment. Statistical analysis was performed via the Wilcoxon's rank sum test. The authors did not collect data regarding patients receiving adjuvant chemotherapy or hormonal therapy because the purpose of the current study was to quantify the time elapsed before the start of treatment, which, in the vast majority of cases, was local therapy.

Patient anonymity was ensured. Characteristics of the two patient groups are summarized in Tables 2 and 3. There was not a significant difference between the groups regarding mastectomy versus breast conservation. In many cases, this implies a time interval from diagnosis to treatment of 0 days.

Investigadores, oncólogos, dermatólogos y pacientes unen esf

To exclude bias possibly introduced by this incongruity, the authors tested the groups after exclusion of the "lumpectomy alone" patients. Mean days from diagnosis to treatment as shown by group. The MDBCC was initially designed in an effort to provide supportive, coordinated and convenient care for newly diagnosed patients. The results of the current study have shown that patients are pleased with this clinic model and that more timely care is provided.

Although the clinic discussed in the current study is not unique, there is a paucity of literature on this subject. If this has your affluent pollution, pursue Keep About Me to be about this review. If called such Chasing Clean Air on Facebook! I sign negotiating Snow White, and continuing Prince Charming.

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Integrated palliative care in the Spanish context: a systematic review of the literature

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