Emotional support to cancer patients regarding psycho-oncology

Andrés Fontalba
 

In my first post, “When it’s our turn?”, I addressed the need to promote shared clinical decision in mental disorders, from now on I will focus my interest in commenting on having emotional support in the diagnosis and cancer treatment.

The clinical dialogue between the doctor and the patient on the prognosis and care of cancer in advanced stages significantly influences how it tests both the benefits and the side effects of the treatment. It also affects how the time in which his life ends and how family members adapt to the patient's illness and death. It’s very important to detect personal differences regarding the need to receive information. Aside from a small percentage of patients who prefer not to be informed, most consider all the information they receive related to their prognosis and treatment to be precious. The exchange of information occurs in a sensitive relationship between the professional and the patient, in which they have to deal with highly emotionally charged communication and in which we must guarantee the information to be fully understandable. It’s clear that the patient, with great frequency, is anxious, among many other factors, because of the doubts about his prognosis, the family burden caused by the disease or the results of the tests. And these top levels of anxiety affect both the interpersonal relationship and the processing of information and the decisions made. It’s for all these reasons that research in psycho-oncology provides us with different tools to favour both the therapeutic link and the understanding of the patient's disease, as this review collects.

Reducing Overprescription with Psychology based Interventions

Pedro Rey

There exits consensus about drug overprescription having become a significant public health problem, both for its health effects and for its budgetary repercussions. The case of the opioid "epidemic" in the United States frequently comes under scrutiny. We must not forget the abuse of benzodiazepines (especially) during hospital treatment or the loss of efficacy of antibiotics due to the development and selection of bacteria that developed resistance due to improper and excessive use. Traditional methods of combating these problems have been to try to educate both the medical profession and patients, to train prescribers or to review prescribing practices and create automated alert systems. However, although in some cases these measures have been relatively successful in the short term, they have also been shown to be not cost-effective, to lose efficacy in the medium term, and to be challenging to transfer to significant interventions.

The patient's experience is key, but ... what about the professionals?

Anna Sant

Undoubtedly today we notice the relationship between the patient's experience and that of the professional. Although we often pay more attention to the former, both are equally important, and their improvement is essential to achieve satisfactory results.

This reflection is more pertinent because we work in healthcare organizations that aim to improve and/or reorganize the way they relate to their patients. Although we have long talked about the evolution of the Triple Aim concept of healthcare (better health outcomes, lower costs, better patient care) to that of the Quadruple Aim, adding the fourth dimension of the professional experience, we continue in operating patient experience and professional experience programs independently. Normally, the first led by the patient care area and the second by human resources or medical and nursing management.

From the humanisation of medicine to the dehumanisation of professionals

Gustavo Tolchinsky

The well-being of doctors is an issue that has a direct impact on the quality and quantity of care that healthcare systems can deliver to society. You only need review several of the entries of recent months and certain articles that even quantify the cost and waste that burnout implies for healthcare organisations. As has been shown in these articles, organisational factors, workloads, alienation from the values of organisations and professionals, the autonomy of professionals to manage their work, and even the type of clinical information management programs and their usability affect professional well-being.

The same challenge in Sao Paulo, Dallas and Phoenix: how to reduce unwarranted clinical variability?

David Font

Triple Aim, Right Care, Less is More, Nothing with Me without Me, Lean are concepts, principles and methodological approaches that are increasingly present in healthcare institutions and which we frequently discuss in the posts on Advances in Clinical Management. All of them aim to make better use of resources and allocate them to what adds value to the patient, thereby advancing sustainability, quality and safety. While it is clear that this is the way, the real challenge is how to put it into practice in each of our institutions. And so it is essential to read and travel to learn from other institutions.