Recommended
More Related Content
What's hot
What's hot (20)
Similar to Multidisciplinary care is essential in the recovery of the oncological patient during and after treatment
Similar to Multidisciplinary care is essential in the recovery of the oncological patient during and after treatment (20)
More from Nata Chalanskaya
More from Nata Chalanskaya (17)
Recently uploaded
Recently uploaded (20)
Multidisciplinary care is essential in the recovery of the oncological patient during and after treatment
- 1. Multidisciplinary care is essential in the recovery of the oncological patient during and after treatment Jette Vibe-Petersen, Director, MD Copenhagen Centre for Cancer and Health kraeftcenter-kbh.dk
- 2. Division of responsibility for health in Denmark (1) The State/national level • Ministry of Health and National Board of Health • Regulation, legislation, quality standards Regional level • Hospital service – somatic and psychiatric • General practitioners, various specialists kraeftcenter-kbh.dk
- 3. Division of responsibility for health in Denmark (2) Municipality level – City of Copenhagen, The Health and Care Administration: • Health-promotion and disease-prevention • Rehabilitation of the chronically ill citizens • Physical training and rehabilitation for all citizens • Elderly care kraeftcenter-kbh.dk
- 4. Chronic Care Programs Early intervention Follow up after dis- charge from hospital Rehabilitation of chronic care Coordinated programs for patients with chronic conditions Preventive health Palliative care Cancer, Heart-disease, Diabetes, COPD, Dementia Hospital MunicipalityGP kraeftcenter-kbh.dk
- 5. Patients with cancer City of Copenhagen 2016 • Around 2.700 new cancer patients per year • 24.000 cancer survivors Users of the centre 2016 • 1100 patients referred kraeftcenter-kbh.dk
- 6. National survey of Danish cancer patients’ needs and experiences • Survey in 2012 • 6900 cancer patients partcipated • Mean age: 65 years • Women: 52%, Men: 48% kraeftcenter-kbh.dk
- 7. Aim • To ensure knowledge about Danish cancer patients’ experiences in the cancer pathway, with a special focus on experienced needs and problems in relation to patient’s health kraeftcenter-kbh.dk
- 8. Short and long term effects of cancer kraeftcenter-kbh.dk 28% 39% 42% 45% 47% 50% 57% 58% 32% 21% 21% 30% 29% 26% 21% 22% 40% 43% 38% 25% 24% 24% 22% 21% Fatique Reduction of sexual activity Reduced sexual drive Reduced muscle power Difficulty sleeping Muscle/joint pain Dry mucous membranes Tingling or lack of sensation in fingers/feets Not at all A little Some/a lot
- 9. Short and long term effects of cancer kraeftcenter-kbh.dk ”I am sad that my sexual life is ruined. I am wondering whether it could be any different” ”I had not at all expected those late effects. I was not told about them. I almost had to tap them on the shoulder and ask ”can it really be true that…”
- 10. Rehabilitation needs kraeftcenter-kbh.dk Need for help and support in relation to: • Emotional reactions 45 % • Sexual problems 36 % • Physical problems 49 %
- 11. Rehabilitation needs kraeftcenter-kbh.dk 32.8% 18.7% 19.6% 36.9% 19.6% 29.2% 30.3% 61.7% 51.2% Physical problems (n=1952) Sexual problems (n=1.352) Emotional reactions (n=1.777) To a great extent To some extent To a lesser extent/not at all “Have you received the help and support you needed in relation to”
- 12. Cancer patients with comorbidty kraeftcenter-kbh.dk + Comorbidity ÷ Comorbidity Quality of life scores (EORTCT-QLQ-30) 67,2 (66.0-68,3) 80,9 (80.1-81,8) Need for help: Emotional issues 56,7 % 37,3 % Sexual issues 40,7 % 31,2 % Physical issues 63,1 % 41,3 % Life style changes 34,5 % 24,3 %
- 13. Key messages • Need for help and support in relation to physical, emotional, social and sexual issues • Need to focus on the entire health- and life situation of the patient • Need to think beyond the walls of the individual institution and make bridges between different phases of care kraeftcenter-kbh.dk
- 14. Rehabilitation in Denmark • According to The Health Act from 2007 the responsibility is divided between the municipalities and the hospitals • Hospitals are responsible for interventions if the patient is in need of efforts that requires medical specialists kraeftcenter-kbh.dk
- 15. The aim of rehabilitation The desired result for the cancer patient is to experience an active everyday life - the best life possible with or after a cancer disease and treatment • Essential terms • Right after diagnosis • Based on life situation • In parallel with treatment kraeftcenter-kbh.dk
- 16. A unique partnership • Rehabilitation - Municipality of Copenhagen • Counselling - The Danish Cancer Society – a non-profit patient organization Joint offices and facilities Joint and separate programs kraeftcenter-kbh.dk
- 17. A multidisciplinary team is essential kraeftcenter-kbh.dk Rehabilitation unit • Jette Vibe-Petersen Head of Centre (medical doctor) • Nurses • Physiotherapists • Occupational therapists • Dieticians • Social workers • Academics • Administrative staff members Counselling unit Marie Lawætz Head of counselling (psychologist) Psychologists Psychotherapist Social worker Administrative staff member 80 volunteers - Professionals - Former patients
- 18. Fysioterapeuternes arbejde i CKSK • Varetagelse af holdtræning • Kontaktperson funktion • Individuelle rådgivninger, vejledninger og behandlinger • Deltage i tværfaglig undervisning, balance i hverdagen, undervisning på temaaftener mv. • Varetagelse af andre fysiske aktiviteter • Forskning og udvikling kraeftcenter-kbh.dk Diagnosis Follow-up Course of disease Cancer Treatment Contact person A physiotherapist, nurse or dietician is assigned to each patient throughout the programme Assessment interview An individualised rehabilitation programme is planned by patient and contact person Last follow-up interview Focus on transition from/completion of the programme Referral Discharge Rehabilitation programme at Copenhagen Centre for Cancer and Health Multidisciplinary intervention programmeAssessment Physical activity Strength and cardio- vascular training, stability training, outdoor activities, yoga Patient Education Physical, psychological, social and existential issues Other options Smoking cessation, meetings for relatives, counselling, activities provided by the Danish Cancer Society REHABILITATION FOR PATIENTS WITH CANCER Follow-up interviews Adjustment of rehabilitation programme involving everyday life and disease status Completion interview Focus on adherence to lifestyle changes Social counselling Individual counselling, return to work Dietary guidance Individual - and group counselling, cooking classes kraeftcenter-kbh.dk
- 19. Rehabilitation Progress in the centre (1) Being referred ... • A contact person makes an appointment within 2 days – nurse, physiotherapist, occupational therapist or dietician • During that first contact the patients resources and other relevant factors are identified • Comorbidity (60 % of all patients) kraeftcenter-kbh.dk
- 20. Rehabilitation progress in the centre (2) • Plan of action, including o Goal setting o Intervention plan What to do for the patient him- or herself At the Rehabilitation unit At the Counselling unit • Evaluation continuously • Final interview including plan for action after rehabilitation course kraeftcenter-kbh.dk
- 21. Physical activity during and after cancer treatment – an evidence based intervention kraeftcenter-kbh.dk
- 22. Physical activity – why? • Maintain or improve physical functioning during and after treatment • Counteract some of the side effects from treatment • Mental wellbeing • Social networking kraeftcenter-kbh.dk
- 23. Physical activity at Copenhagen Centre for Cancer and Health • During the assessment interview the contact person and the patient identify the needs and motivation for physical activity • Goal setting • Introduction to training (individual or group) • Approx. 1100 referrals per year • Approx. 45% participate in physical activity kraeftcenter-kbh.dk
- 25. Individual restrictions • Bone metastases • Myelomatosis • Lymphoedema • Brain metastases kraeftcenter-kbh.dk
- 26. Physical activity – other interventions • Exercise ”light” and exercise class for patients with limited mobility • Core stability • Yoga • Body Bike • Outdoor training • Post surgery breast cancer (www.brystrehab.dk) • Exercise classes for men kraeftcenter-kbh.dk
- 27. Psycho-social aspects of rehabilitation • Focus on both psychical AND social conditions • Holistic view on both patient and relatives • Coordination of offers • Group based activities: Networking and exchange of experience kraeftcenter-kbh.dk
- 28. Health educational approach How can we help you? What concerns you the most? What can you do yourself? • We offer knowledge about cancer • We offer an opportunity to work with attitudes and emotions kraeftcenter-kbh.dk
- 29. ” Getting diagnosed with cancer overnight is like skydiving without a parachute. The health care centre provides me with the parachute” Statement from a woman with breast cancer kraeftcenter-kbh.dk
- 30. O g ”Give a man a fish and you feed him for a day … – show him how to catch a fish and you feed him for a lifetime... ” Chinese Proverb kraeftcenter-kbh.dk
- 31. Our experiences • Age 18-85 years • 60% of the patients are curable and 40% are in a palliative phase • Increasing proportion of men (33% - 41%) predominantly exercise and cooking classes • 98% are satisfied or very satisfied with our program kraeftcenter-kbh.dk
- 32. Our experiences • Rehabilitation programs at Copenhagen Centre for Cancer and Health offered to a broad range of cancer patients is feasible and safe • Ongoing process to ensure that hospital or GP refers to rehabilitation kraeftcenter-kbh.dk