Medical Radiology and Radiation Safety. 2021. Vol. 66. № 5. P. 45–49

Patientoriented Algorithm for the X-ray Therapy Cabinet of Oncology Dispensary

J.A. Zuenkova1, D.I. Kicha1, A.Yu. Abramov1, Y.G. Buynova2, L.M. Klisova2

1Peoples Friendship University of Russia, Moscow, Russia

2City Clinical Oncology Dispensary, Saint-Petersburg, Russia

Contact person: Zuenkova Yuliya Aleksandrovna: This email address is being protected from spambots. You need JavaScript enabled to view it.

ABSTRACT

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.

Key words: quality of medical care, value-based healthcare, X-ray therapy, skin cancer

For citation: Zuenkova JA, Kicha DI, Abramov AYu., Buynova YG, Klisova LM. Patientoriented Algorithm for the X-ray Therapy Cabinet of Oncology Dispensary. Medical Radiology and Radiation Safety. 2021;66(5):45-49.

DOI: 10.12737/1024-6177-2021-66-5-45-49

References

1. Sostoyanie Oncologicheskoy Pomoshchi Naseleniu v Rossii in 2019. Ed. Kaprin AD, Starinsky ММ, Shahzadova AO. Moscow Publ., 2020 (In Russian).

2. Clinical Guidelines Basal Cell Carcinoma. http://cr.rosminzdrav.ru /#!/recomend/981 ID:КР467. 

3. Clinical Guidelines Squamous Cell Carcinoma. ID:КР476. http://cr.rosminzdrav.ru/#!/recomend/984. (In Russian).

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;56:399-412. 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;54:229-36. 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;14:382-93. 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;69;82–90. DOI:10.1016/j.clinimag.2020.06.047.

8. Rangarajan R & Jayaraman K. Barriers Affecting Adherence to Radiation Treatment and Strategies to Overcome Those Barriers. Indian Journal of Cancer. 2017;54;2:458. DOI:10.4103/ijc.ijc_260_17.

9. Goldsworthy S, Palmer  S, Latour JM, McNair H,  Cramp MA 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;26;4:314–24. 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;5;8:295. 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;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;30(3):290–7. http://dx.doi.org/10.1007/ s11606-014-3089-1.

13. Rokich M. Priroda Chelovecheskih Tzennostey. Mockow Publ., 2005. P.56 (In Russian).

14. Belanovsky SA. In-Depth Interview: Tutorial. Moscow, Nikkolo-Medical Publ., 2001 (In Russian).

15. Kempbel D. Experimental Models in Social Psychology and Applied Research. Progress Publ., 1980 (In Russian). 

16. Mulkay M J Science and the Sociology of Knowledge. Moscow, Progress Publ., 1983.

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

18. Halfin RA, Syrtsova DP, Lvova DP, Kobatskaya EE. A Patient-Centered Approach: Basic Concepts. Problems of Standartisation in Russia. 2017;1-2: 9-13 (In Russian).

 PDF (RUS) Full-text article (in Russian)

 

Conflict of interest. The author declare no conflict of interest.

Financing. The study had no sponsorship.

Contribution. Article was prepared with equal participation of the authors

Article received: 14.04.2021. 

Accepted for publication: 27.05.2021.