Patientoriented Algorithm for the X-ray Therapy Cabinet of Oncology Dispensary
Abstract and keywords
Abstract (English):
Results: IIntroduction: Superficial X-ray therapy is a common treatment of non-melanoma skin cancer with a high incidence worldwide. Interrupting the course of radiation therapy can negatively affect patient survival and treatment results. Low treatment adherence may be associated with a lack of a patient-centered approach and ineffective communications. The original study shows that patients undergoing X-ray therapy for cancer may have different needs. Based on the study results an algorithm for a patient-oriented approach has been developed for the X-ray cabinets. Purpose: To develop a patient-oriented algorithm of the X-ray therapy room to address the issues of increasing patient satisfaction and forming their adherence to treatment. The objectives of the study included studying and detailing the needs of the patients who passed the X-ray therapy and to develop the patient-oriented algorithm for the X-ray therapy room. Material and methods: The study of the patient's values was carried out from 2019 to 2020 by interviewing using open-ended questions to find out the deep motives and beliefs of patients. The study was based on Milton Rokich’s (2005) model of value orientations, which was adapted to the objectives of the study. Results: The study included 116 patients undergoing treatment with the X-ray therapy at the City Clinical Oncology Dispensary. As a result of the study, the following patient needs were identified: clinical outcome of the procedure 111 (96 %), safety of treatment and adverse reactions 106 (91 %), cosmetic outcome 53 (46 %), convenience of the treatment schedule 42 (36 %), painlessness of the procedure 39 (34 %), the ability to lead a normal lifestyle 27 (23 %), comfortable conditions for the procedure 16 (14 %), financial costs associated with treatment 10 (9 %), preservation of organ function 4 (3 %). On the basis of the data obtained, a patient-oriented algorithm for the X-ray therapy was developed, including a communication plan with the patient. The study results clearly demonstrate that even with the same disease and condition, patients may have different priorities hat need to be considered to improve patient experience and adherence to treatment. Conclusion: Radiation treatment decision-making based on the patients values is important for the development of the patient-centered management in oncology since this directly affects patients’ adherence to treatment. Exploring the values and needs of patients is an opportunity to influence and improve the metrics of the patient experience. Due to the mass incidence of non-melanoma skin cancer, the introduction of patient-centered approaches is an important part of patient satisfaction and increase of patients adherence to the treatment.

Keywords:
quality of medical care, value-based healthcare, X-ray therapy, skin cancer
References

1. Sostoyanie onkologicheskoy pomoschi naseleniyu Rossii v 2019 godu /Pod red. Kaprina A.D., Starinskogo V.V., Shahzadovoy A.O. M., 2020g.

2. Klinicheskie rekomendacii «Bazal'nokletochnyy rak kozhi» ID:KR467 http://cr.rosminzdrav.ru/#!/recomend/981 (Data obrascheniya 15.01.2021).

3. Klinicheskie rekomendacii «Ploskokletochnyy rak kozhi» ID:KR476 http://cr.rosminzdrav.ru/#!/recomend/984 (Data obrascheniya 15.01.2021)

4. Suwinski R, Sowa A, Rutkowski T, Wydmanski J, Tarnawski R, Maciejewski B, et al. Time factor in postoperative radiotherapy: A multivariate locoregional control analysis in 868 patients // Int J Radiat Oncol Biol Phys. 2003. Vol. 56. P. 399-412 DOI:https://doi.org/10.1016/S0360-3016(02)04469-3

5. Tarnawski R, Fowler J, Skladowski K, Swierniak A, Suwiński R, Maciejewski B, et al. How fast is repopulation of tumor cells during the treatment gap ?// Int J Radiat Oncol Biol Phys. 2002. Vol. 54. P. 229-36. DOI:https://doi.org/10.1016/S0360-3016(02)02936-X

6. Dale RG, Hendry JH, Jones B, Robertson AG, Deehan C, Sinclair JA, et al. Practical methods for compensating for missed treatment days in radiotherapy, with particular reference to head and neck schedules // Clin Oncol (R Coll Radiol). 2002. Vol. 14. P. 382-93. DOI:https://doi.org/10.1053/clon.2002.0111

7. Martens RM, Koopman T, Noij DP, de Bree R, Vergeer MR, Zwezerijnen G, Leemans CR, de Graaf P, Boellaard R, Castelijns JA. Adherence to pretreatment and intratreatment imaging of head and neck squamous cell carcinoma patients undergoing (chemo) radiotherapy in a research setting // Clinical Imaging, 2021. Vol. P. 82-90. DOIhttps://doi.org/10.1016/j.clinimag.2020.06.047

8. Rangarajan, R, & Jayaraman, K (2017). Barriers affecting adherence to radiation treatment and strategies to overcome those barriers. Indian Journal of Cancer. 2017. Vol 54. P 458. DOIhttps://doi.org/10.4103/ijc.ijc_260_17

9. Goldsworthy S, Palmer S, Latour JM, McNair H, Cramp M. A systematic review of effectiveness of interventions applicable to radiotherapy that are administered to improve patient comfort, increase patient compliance, and reduce patient distress or anxiety // Radiography [Internet]. Elsevier BV. 2020. Vol. 26. No 4. P. 314-24. http://dx.doi.org/10.1016/j.radi.2020.03.002

10. Epstein N. Multidisciplinary in-hospital teams improve patient outcomes: A review // Surgical Neurology International [Internet]. Scientific Scholar. 2014. Vol. 5. No 8. P. 295. Available from: http://dx.doi.org/10.4103/2152-7806.139612

11. Avisar N, Heller Y, Weil C, Ben-Baruch A, Potesman-Yona S, Oren R, et al. Multi-disciplinary patient-centered model for the expedited provision of costly therapies in community settings: the case of new medication for hepatitis C // Israel Journal of Health Policy Research [Internet]. Springer Science and Business Media LLC; 2017. Vol. 28. No 6 (1). http://dx.doi.org/10.1186 /s13584-017-0172-1

12. Taber JM, Leyva B, Persoskie A. Why do People Avoid Medical Care? A Qualitative Study Using National Data. // Journal of General Internal Medicine [Internet]. Springer Science and Business Media LLC; 2014. Vol. 12. No 30 (3). P. 290-7. http://dx.doi.org/https://doi.org/10.1007/s11606-014-3089-1

13. Rokich M. Priroda chelovecheskih cennostey M Rokich M., 2005 s.56.

14. Belanovskiy S.A. Glubokoe interv'yu /Uchebnoe posobie. M.: Nikkolo-Media, 2001.

15. Kempbell D. Modeli eksperimentov v social'noy psihologii i prikladnyh issledovaniyah. Per. s angl. M.: Progress, 1980.

16. Malkey M. Nauka i sociologiya znaniya. Per. s angl. M.: Progress, 1983

17. Greenbuam TL The Practical Handbook and Guide to Focus Group Research. Lexington, MA: Lexington Books, 1987

18. Hal'fin R.A., Syrcova D.P., L'vova E.E., Kobyackaya E.E. Pacientorientirovannyy podhod: bazovye ponyatiya // Problema standartizacii v zdravoohranenii. 2017. № 1-2. S. 9-13.

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