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- Johansson, Birgitta, et al.
(författare)
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Hemsjukvård för äldre cancerpatienter : Utökad uppföljning och stöd i hemmet minskar behov av specialistsjukvård
- 2003
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Ingår i: Läkartidningen. - 0023-7205 .- 1652-7518. ; 100:17, s. 1524-1531
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- The effects of intensified primary health care were examined in the »Support-Care-Rehabilitation« project conducted in Uppsala county 1993-1997. Intensified primary health care was one part of an individual support intervention and comprised extended information about patients from the specialist clinics, and education and supervision in cancer care for GPs and home care nurses. The aim was to improve the ability of general practitioners and home care nurses to monitor and support cancer patients. A total of 485 newly diagnosed cancer patients were randomized to intensified primary health care or to a control group (standard care). The intervention group showed a marked increase in follow-up contacts. About 90% of intensified primary health care patients reported such contacts, compared to 26% of control patients. The number of days of hospitalization at the specialist clinics for elderly patients (Ž70 yr.) randomized to the intervention group were 393 less than for elderly controls three months after diagnosis. The conclusion is that intensified primary health care constitutes a cost-effective strategy for enhancing co-operation between home care, primary health care and specialist clinics.
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- Johansson, Birgitta, et al.
(författare)
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Reduced utilisation of specialist care among elderly cancer patients : a randomised study of a primary healthcare intervention
- 2001
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Ingår i: European Journal of Cancer. - 0959-8049 .- 1879-0852. ; 37:17, s. 2161-2168
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to evaluate the effect of an individual support (IS) intervention including intensified primary healthcare on the utilisation of specialist care among cancer patients, and to investigate if such an effect was modified by the patient's age (less than 70 years or 70 years and more). Newly diagnosed cancer patients (n=416) were randomised between the intervention and a control condition, and data were collected on the utilisation of specialist care within 3 months from inclusion. Intensified primary healthcare comprised extended information from the specialist clinics, and education and supervision in cancer care for general practitioners (GPs) and home-care nurses. The support given also included interventions designed to diminish problems of weight loss and psychological distress. The intervention reduced the number of admissions (NoA) and the days of hospitalisation (DoH) after adjustment for weight loss and psychological distress, but only for older patients. Older patients randomised to the intervention (n=82) experienced 393 fewer DoH than the older control patients (n=79). In addition, the proportion of older patients in the IS group who utilised acute specialist care was smaller compared with older control patients group. The conclusion is that older cancer patients' utilisation of specialist care may be reduced by intensified primary healthcare services.
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| 6. |
- Johansson, Birgitta, et al.
(författare)
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The role on the general practitioner in cancer care and the effect of an extended information routine
- 2000
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Ingår i: Scandinavian Journal of Primary Health Care. - : Informa UK Limited. - 0281-3432 .- 1502-7724. ; 18:3, s. 143-148
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To describe the role of the General Practitioner (GP) in the care of one specified cancer patient per GP, and to explore the GP's knowledge about that patient's disease and treatments, and what information she/he wanted versus received from the specialist clinic. A further aim was to evaluate the effects of an Extended Information Routine (EIR), including increased information from the specialist clinic to the GP.DESIGN:Semi-structured interviews with GPs about a patient randomised between an extended information routine and standard information from the specialist clinics.SETTINGS:Primary Health Care.SUBJECTS:20 GPs, 10 who received extended information about the specified patient and 10 who did not.MAIN OUTCOME MEASURES:The extent of GPs' contact with the patient, GPs' potential or actual possibilities to support the patient, desired and received information from the specialist clinic.RESULTS AND CONCLUSIONS: GPs are commonly involved in the care of cancer patients, particularly in the diagnostics of the disease but also during the periods of treatment and follow-up. The information from the specialist clinic to the GP is insufficient in standard care. The extended information routine increased the GPs' knowledge of the disease and treatments, and facilitated their possibilities to determine patients' need for support.
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| 7. |
- Johansson, Birgitta, et al.
(författare)
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Uppsalastudie av 20 husläkares roll i vården av cancerpatienter : Lättare att bedöma behovet av stöd om utförlig specialistinformation ges
- 2002
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Ingår i: Läkartidningen. - 0023-7205 .- 1652-7518. ; 99:8, s. 771-773
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- The aim of this study is to describe the role of the GP in the care of one specified cancer patient per GP and to explore the GP’s knowledge about that patient’s disease and treatments. A further aim was to evaluate the effects of an extended information routine, including increased information from the specialist clinic to the GP. Twenty GPs were selected for a semi-structured interview about a patient randomised either to an extended GP information routine or to standard information. The results suggest that GPs are commonly involved in the care of cancer patients, particularly in the diagnosis of the disease but also during the period of treatments and follow-up. The information from the specialist clinic to the GP is insufficient in standard care. The extended information routine increased the GPs’ knowledge about the disease and treatments and facilitated their possibilities to determine patients’ need for support. However, this did not affect the extent of contacts with the patient.
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| 9. |
- Persson, C, et al.
(författare)
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A randomized study of nutritional support in patients with colorectal and gastric cancer
- 2002
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Ingår i: Nutrition and Cancer. - 0163-5581 .- 1532-7914. ; 42:1, s. 48-58
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Tidskriftsartikel (refereegranskat)abstract
- Involuntary weight loss is often seen among patients with gastrointestinal (GI) cancer. Weight loss may influence quality of life (QoL) and is a predictor of survival. The present study is an attempt to improve body weight development in GI cancer patients by individual support (IS), including nutritional measures. Patients were randomized in a 2 x 2 design between 1) IS, including nutritional support, 2) group rehabilitation (GR), 3) IS + GR (ISGR), or 4) standard care (SC). Data concerning dietary intake (24-h recalls), body weight, and QoL (EORTC-QLQ C-30) were collected over 2 yr for 67 patients with colorectal or gastric cancer, randomized to IS or ISGR. Data on weight and QoL were collected for 70 patients with the same diagnoses randomized to GR or SC. Despite a tendency to greater weight loss at inclusion, the IS + ISGR group managed to gain weight significantly more rapidly and to a greater extent than the GR + SC group. The differences became statistically significant at 12 and 24 mo (P < 0.05). Patients with weight loss at baseline increased their energy intake and weight more than those without weight loss. No differences were seen in QoL ratings between randomization groups, but there was a positive correlation between weight development and QoL and a negative correlation between fatigue and weight development. There was a numerical difference, not statistically significant (P = 0.3), indicating a shorter time of survival in patients in the GR + SC group. IS, including nutritional support, leads to more rapid weight gain than SC in patients with newly diagnosed GI cancer.
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