Class of 2016 Abstract / Objectives: To identify common and serious drug-drug interactions involving novel anticoagulant drugs in cancer patients. Subjects: 60 patients who were treated at the Banner University of Arizona Cancer Center between November 1, 2013 and April 1, 2015 with rivaroxaban, dabigatran, or apixaban. Methods: A retrospective chart review was performed for patients who received a NOAC (novel oral anticoagulant) to determine if a medication regimen contained a drug-drug interaction involving the NOAC. Results: When analyzing the DDIs involving rivaroxaban, dabigatran, and apixaban, Micromedex® detected a total of 123 interactions, compared to Lexicomp®, which detected 111 interactions. When using Lexicomp®, there were 59 (32%) instances of no detected interactions, 19 (10%) moderate interactions, 27 (15%) major interactions, and 65 (36%) contraindicated DDIs with rivaroxaban. When using Micromedex®, there were 47 (26%) instances where no interaction was detected, 4 (2%) moderate interactions, and 119 (65%) major interactions, and no interactions were classified as contraindicated with rivaroxaban. Lexicomp® detected 3 (50%) interactions as major, and found no DDIs in 3 (50%) instances for dabigatran, and detected 1 (7%) moderate, 2 (14%) major and 6 (43%) contraindicated interactions for apixaban. Micromedex® detected 3 (50%) interactions as major, and found no DDIs in 3 (50%) instances for dabigatran, and detected 12 (86%) of interactions as major and found no DDIs in 2 (14%) instances for apixaban. Conclusions: There was significant variation in DDI detection between current literature4,5 and the drug information databases, Lexicomp® and Micromedex®, however most interactions detected were major or contraindicated.

Cancer diagnoses affect millions of people in the United States each year. Today, cancer patients face many challenges when trying to navigate the complex healthcare system. Patient navigation programs were developed to address and overcome barriers patients may face as they make their way through the healthcare system. The purpose of this project was to provide an analysis and discussion of the current published literature to provide evidence for improving care coordination and patient satisfaction in the oncology clinical setting with a patient navigator program. The practice-focused question for this project asked if a patient navigator program for adult cancer patients improved patient outcomes. The systematic review, guided by Watson's theory of caring, included 11 studies published between 2010 and 2017 identified through Cochrane Library, CINAHL, ProQuest, PubMed, and Joanna Briggs Institute. Initially a total of 679 articles were identified; however the number reduced by removing duplicates and after review of titles and abstracts. The remaining articles were then evaluated by the level of evidence based on the Manly and Fineout-Overholt's guide on hierarchy of evidence. The results identified in this systematic review showed patient navigation can improve care coordination and patient satisfaction. This review offers findings on the impact of cancer care coordination and patient satisfaction, which may be used by healthcare leaders when determining how to improve cancer care and as a result may provide positive social change. If the organization implements a patient navigator program, it is expected that this change would benefit patients, families, healthcare providers and the organization.

ANOTATION Bc. Michaela Petráková, The quality of life in oncology patients. Hussite Faculty of Theology, Charles University, Prague. The dissertation topic is based on quality of life in oncology patients. Various factors of quality of life in general and particularly in oncology patients, issues of neoplastic diseases, branch of oncology, dialogue with patients, and palliative care as well are described in the theoretical part of thesis. The practical part of thesis deals with a level of patients' educaction, initial perception of their disease, subsequent course and more, changes in personal, family, social and professional life in connection with oncology disease and the treatment process. Corresponding research was performed among the patients in Na Pleši hospital, s.r.o. Obtained results has revealed the oncology disease decisively influenced an impact on life as well as on quality of life in diseased humans. There is a considerably hard for patients to cope with such a state of the life. Patients' families and friends play a significant role in oncology patients and they both have an important influence on the particular course of disease. Described scope of family and friends has been regarded as a support, and moreover some source of safety for the patient. Key words: Oncology, quality of life in...

In attempting to give more years of life to cancer patients, their Quality of Life (QoL) during this time has frequently been compromised. Assessment of patients’ QoL provide nurses with an opportunity to know about the whole range of patients’ needs and desires. These information would be potentially very useful for health care professionals particularly nurses for planning, conducting and evaluating the nursing care of cancer patients. Questionnaire survey research carried out in countries other than Australia identified a varied amount of agreement between cancer patients and nurses about cancer patients’ QoL. However, based on the literature review, no research study has been found in Australia that provides a detailed understanding of how nurses and cancer patients are similar or different in their perceptions of cancer patients’ QoL. A research study, therefore, was conducted to answer the following key questions: (a) what differences and/or similarities are there between patients’ and nurses’ perceptions of cancer patients’ QoL; (b) why do these differences and/or similarities exist? A research study with a mixed approach was undertaken to answer the research questions. In the first phase, a survey by questionnaire was conducted. The main aims were to identify: (a) the level of agreement between cancer patients’ and nurses’ scores on the World Health Organisation’s Quality of Life Brief questionnaire (WHOQoL-BREF); and (b) variables that may influence the level of agreement between them. Each patient and nurse was invited to complete the WHOQoL-BREF questionnaire, which was considered as an appropriate tool for evaluating cancer patients’ QoL. This questionnaire considers QoL across four domains or dimensions: physical, psychological, social relationship and environmental. In the first phase of the study, 166 cancer patients and 95 nurses were recruited from three major hospitals in Adelaide, South Australia. The patients had a range of cancer diagnoses with breast cancer being the most prevalent. Most patients were being treated as inpatients with chemotherapy being their primary treatment. The mean age of nurses was approximately 37 years and their clinical experience with cancer patients averaged approximately eight years. Intraclass Correlation Coefficient (ICC) between patients’ and nurses’ scores ranged from ‘poor’ in the social relationship and psychological domains up to ‘moderate’ in the physical domain indicating that generally nurses were different in their perceptions from those of cancer patients. Another major finding of this phase was that nurses underestimated cancer patients’ QoL in the social relationship and environmental aspects, which consisted of more personal and private issues. Having finished the first phase, the second phase was conducted based on the principles of a classical version or mode of grounded theory. The aim here was to include an interpretive perspective and explore the reasons why nurses may differ in their perceptions about cancer patients’ QoL in comparison to cancer patients. In this phase, three cancer patients and 10 nurses took part in semi-structured interviews. Participants were selected from different inpatient and outpatient oncology services and a palliative setting. Differences in patients’ and nurses’ perceptions about cancer patients’ QoL and their implications for nursing clinical practice were discussed further in the light of six important categories found in the second phase including: QoL meanings, QoL aspects, Cues-based QoL assessment; Purpose-based QoL assessment; Facilitators of QoL assessment; and Barriers to QoL assessment. It emerged that QoL has individualised meanings and nurses generally have difficulties understanding their patients’ personal perspective or definition of QoL. Another interpretive outcome that may explain why nurses differed in their perceptions when compared with cancer patients is that nurses’ assessment of cancer patients’ QoL in oncology wards is mainly made during their interaction with patients when providing care. Such an assessment has a focus on physical cues and may not facilitate nurses developing a more holistic picture of cancer patients’ QoL. Participants in the interpretive phase indicated that time limitations, focus on care tasks, and discontinuity of care, all work against nurses developing a more accurate understanding of cancer patients’ QoL. Conversely, it was found that building a relationship and stronger rapport with patients is the main facilitator in improving nurses’ understanding of cancer patients’ QoL.

Thesis (MCur)--Stellenbosch University, 2000. / ENGLISH ABSTRACT: Against the background of the approach to make the follow up care to oncology patients more accessible and with the emphasis on quality care, it was indicated that this service needs to be evaluated. A study based on a combination of qualitative and quantitative methods (also called triangulation) was conducted to formulate structure, process and outcome standards for a comprehensive follow up care for the oncology patients and to evaluate this service according these standards. The most important results are: • The quality of care relating to the structure standards was optimal regarding the organization of the patient's visits, follow up treatment and referrals. A suboptimal standard was found regarding the general management system. • In the process standards focusing on the physical and psychosocial needs of the patient, a suboptimal standard was found regarding all aspects. Nursing practice leading to subobtimal care of patients is a major cause for concern. • With the outcome standards reflecting in patient satisfaction, positive as well as negative opinions and perceptions were found. Recommendations include: • Upgrading of management systems • Empowerment of the nurses with knowledge and scientific competencies • Attention to the opinions and perceptions of the patients to completely involve the patient in the service and treatment process. Keywords: Oncology follow up service I formulation of structure, process and outcome standards. / AFRIKAANSE OPSOMMING: Teen die agtergrond van die benadering om opvolgdienste meer toegangklik te maak vir onkologiese pasiënte, met die beklemtoning van gehaltesorg, is dit aangedui dat hierdie diens geëvalueer moes word. 'n Studie gebaseer op 'n kombinasie van kwalitatiewe en kwantitatiewe metodes (genoem triangulasie) is uitgevoer om struktuur, proses en uitkomsstandaarde vir 'n omvattende opvolgdiens aan onkologiepasiënte te formuleer en die diens aan die hand daarvan te evalueer. Die belangrikste resultate is: • Die gehalte van sorg wat verband hou met die struktuurstandaarde was net optimaal ten opsigte van die organisasie van die pasiënt se besoeke, opvolgbehandeling en verwysings. 'n Suboptimale standaard is gevind ten opsigte van die algemene bestuurstelsel. • In die prosesstandaarde wat fokus op die fisiese en psigososiale behoeftes van die pasiënt, is 'n suboptimale standaard in alle aspekte gevind. Verpleegpraktyk wat lei tot suboptimale sorg van pasiënte is 'n groot bron van kommer. • Met die uitkomsstandaarde wat reflekteer in pasiënttevredenheid is positiewe maar ook negatiewe opinies en persepsies gevind. Aanbevelings sluit in: • Verbetering van bestuurstelsels • Bemagtiging van die verpleegkundige met kennis en wetenskaplike vaardighede • Aandag aan pasiënte se opinies en persepsies ten einde die pasiënt ten volle te betrek by die hele diens en behandelingsproses. Sleutelwoorde : Onkologiese opvolgdiens / formulering van struktuurproses en uitkomsstandaarde.