Satisfaction Of Survivors Research Articles

Depression and life satisfaction after Kahramanmaraş earthquakes: The serial mediation roles of life meaning and coping with earthquake stress.

This study aims to examine the meaning of life, and the mediating effect of strategies for coping with earthquake stress in the relationship between depression, and life satisfaction in survivors of the 2023 Kahramanmaraş centered earthquakes. The participants of this study were 472 adults (31.1% male, 68.9% female; Mage = 24.52) who were affected by earthquakes. The data of the study were tested with the bootstrapping-based PROCESS macro program (Model-81). The results showed that depression negatively predicted life satisfaction. Meaning of life mediated the relationship between depression and life satisfaction. However, problem solving and cognitive avoidance coping strategies reduced the effects of depression and the meaning of life on life satisfaction. These results can be a resource for mental health services for earthquake victims. At the same time, the study provides evidence that protecting personal resources in disaster situations positively affects life satisfaction in terms of conservation of resources theory (COR).

Overall Satisfaction with Cancer Care Among Sexual and Gender Minority People and Their Utilization of Identity-Tailored Health Education Materials.

Purpose: This study was conducted to understand whether health education materials made specifically for members of sexual and gender minority (SGM) groups play a pivotal role in SGM cancer survivors' care satisfaction and experiences. Methods: We identified 2250 SGM cancer survivors who completed the "OUT: National Cancer Survey," conducted by the National LGBT Cancer Network in 2020-2021, and classified participants by their self-reported satisfaction with overall cancer care. We examined care satisfaction in relation to use of SGM-tailored health education resources and factors surrounding their SGM identities, which may influence their satisfaction, including feelings of safety with care teams. Results: Regardless of satisfaction with overall care, substantial proportions of survivors reported lacking vital health education resources specific to their SGM identities in areas of mental health (69%), physical activity (91%), tobacco use cessation (89%), and alcohol consumption (86%), despite attributing value to these materials. Contextualizing SGM survivor satisfaction with care, it was notable that among SGM survivors who felt safe with members of their care team knowing their SGM identity, only 3% were less than satisfied with their overall cancer care, compared to 38% who felt unsafe. Conclusion: SGM survivors value tailored information and health education resources that incorporate their intersectional identities. More research must be done to elucidate why SGM survivors do not receive these materials, while creating spaces where they feel safe receiving care. Increased delivery of SGM-tailored materials and prioritization of SGM safety in health care may have implications for overall cancer care satisfaction among SGM survivors.

Health-related quality of life, psychological issues and concerns among sarcoma survivors: a mixed method study.

We aimed to explore the health-related quality of life (HRQoL), psychological issues and concerns among sarcoma survivors in India and assess their satisfaction with nursing care. This study employed a sequential mixed-methods design, enrolling 100 sarcoma survivors from July to December 2021, with data collected using standardised questionnaires for HRQoL, depression, anxiety, stress, cognitive impairment and self-structured satisfaction with nursing care. Qualitative data were gathered through focused group discussions. The mean global health score among sarcoma survivors was 79.48 ± 16.26. A significant number of survivors had symptoms of mild-to-moderate depression (30%), severe anxiety (12%), stress (16%) and mild cognitive impairment (5%). Significant mean rank differences were observed between anxiety and financial difficulty (p < 0.05), emotional functioning (p < 0.001), cognitive functioning (p < 0.001), pain (<0.05), insomnia (p < 0.001), fatigue (p < 0.001), anorexia (p < 0.05) and nausea/vomiting (p < 0.001). Educational qualification had a significant association with depression and anxiety while family history of cancer emerged as a significant factor associated with anxiety and stress among survivors. Qualitative analysis revealed themes related to body image, societal discrimination, socio-economic impact, marriage concerns and fertility issues. Survivor satisfaction with nursing care was good. A substantial number of sarcoma survivors had an average HRQoL and experienced depression, anxiety and stress. Our study emphasizes the importance of holistic survivorship care, involving nurses in post-treatment support, and addressing societal discrimination and psychosocial concerns to enhance their quality of life. Our study calls for a holistic approach to sarcoma survivor care and emphasizes the importance of personalised survivorship care plans led by nurses to address the diverse needs of sarcoma survivors in India. Such plans should encompass strategies for managing depression, anxiety and stress, along with addressing body image concerns and social support.

Stroke Survivor's Satisfaction and Experience with Rehabilitation Services: A Qualitative Systematic Review.

Research in healthcare is increasingly focused on quality assurance and continuous quality improvement aiming to promote service quality. Satisfaction is a key endpoint in outcomes research and service benchmarking, along with "traditional" clinical outcomes. What controls stroke survivors' satisfaction differs among qualitative studies' conclusions, but there is general consensus on the importance of communication, improvement in activity, and engagement in goal setting. This review aims to collect and synthesise studies of the satisfaction of stroke survivors with rehabilitation services. A systematic search was conducted in seven electronic databases, including CINAHL, OVID, Pedro, Scopus Midline, Web of Science, and PubMed. The database search yielded 1339 studies, while one additional work was identified through hand searching. After removing duplicates, 74 studies were read in full, and after resultant exclusions, 12 qualitative studies were systematically reviewed, extracted, and appraised by two reviewers independently (HAS and RT) and the third reviewer (CS) was available for any disagreement. Five analytical themes were identified: Healthcare Professional-Patient Relationship (HCP), Delivery Service, Perceived Patient Autonomy (PPA), Expectations Shape Satisfaction, and Culture Influences Satisfaction. The studies of survivors' satisfaction, experiences, and their rehabilitative needs with the services they receive have provided different factors that influence their satisfaction during rehabilitation in different countries worldwide. However, the context in which the studies were conducted is quite limited, and more detailed studies are required for many underexplored contexts.

Tsunami Resettlement Program and Survivor Satisfaction Fifteen Years After the 2004 Tsunami in Aceh, Indonesia

Fifteen years after the Aceh tsunami, the housing for the tsunami survivors has undergone material changes and shifts in ownership. This study analyzed the survivors’ satisfaction with the housing aid and examined the decision-making mechanisms that occurred during the rehabilitation-reconstruction period for housing construction in the relocation and non-relocation areas. This study used qualitative-descriptive methods. Interviews and focus group discussions were used to collect the data and respondents were selected by purposive sampling. The findings indicated that the decision-making in the relocation and non-relocation areas for housing reconstruction was partially top-down. There were four aspects of this decision-making: (1) choice of location; (2) quality and materials of the house; (3) house construction; and (4) supervision of house construction. However, the survivors in both the relocation and non-relocation areas were only involved in the house construction and supervision of house construction elements. The survivors’ satisfaction criteria differed between those in the relocation vs. non-relocation areas. The satisfaction of survivors in the relocation areas was based on the distance and quality of the houses and access to public facilities. For the non-relocation area survivors, house quality was the only significant factor.&#x0D; Keywords: life satisfaction, survivors’ satisfaction, housing, relocation, decision-making

Hip Arthroscopy in the Presence of Advanced Osteoarthritis Results in 57% Survivorship, With 78% Survivor Satisfaction, at 10 Years. A Matched-Control Study

To (1) determine the 10-year survivorship (avoidance of total hip arthroplasty, THA) for patients with advanced osteoarthritis (OA) undergoing hip arthroscopy for femoroacetabular impingement, and (2) compare survivorship and patient-reported outcomes (PROs) with a matched-control group without OA. Advanced OA hips (Tönnis ≥2) were matched in a 1:1 ratio (age ± 5 years, sex) to hips with preoperative Tönnis grade ≤1. Exclusion criteria was dysplasia, age <18 years, previous hip conditions/surgeries, and bilaterally operated patients with OA on one side only. Survival was estimated by Kaplan-Meier analysis for levels of sex, age groups and Tönnis. Cox proportional hazards model estimated hazard ratios (HR) of undergoing THA conversion. Where THA was avoided, outcomes and proportion of cases achieving patient acceptable symptomatic state was determined RESULTS: 53 OA hips were matched with 53 control hips. Survival distributions were significantly different for: (1) Group: OA 57.1%, control 87.0% (P= .001); (2) Tönnis grade: Tönnis 0, 89.2%; Tönnis 1, 77.8%; Tönnis 2, 67.6%; Tönnis 3, 25.0% (P < .001); and (3) age: (OA: 75.0% vs 44.8%, control: 100%, vs 75.0%, for <35 and >35 years respectively) (P= .002). Conversion to THA was greater for increasing Tönnis: HR 1.9 (P= .450), 3.5 (P= .032), and 11.0 (P < .001) for Tönnis 1, 2, and 3 respectively, relative to no OA (Tönnis 0) and >35 years: HR 4.3 (95% confidence interval 1.6-11.3, P= .003). Patient acceptable symptomatic state achievement was similar for both groups (78% OA vs 91% control, P= .167). modified Harris Hip Score and Short Form-36 significantly improved within both groups from baseline to 10 years CONCLUSIONS: Arthroscopic correction of femoroacetabular impingement, in the presence of advanced OA results in 57% survivorship at 10 years (68% Tönnis 2, 25% Tönnis 3). Where THA was avoided, 78% considered their 10-year post-HA state to be satisfactory, with patient-reported outcomes similar to a matched non-OA cohort. Tönnis 2 in particular should be considered for arthroscopic hip preservation to avoid the need to prematurely replace the hip joint. IV, case series.

Occupational Participation, Performance, and Satisfaction in Survivors of Human Trafficking

Abstract Date Presented 04/02/2022 The purpose of the study is to identify occupational performance problems self-identified by survivors of human trafficking to further understand the occupational needs of this population. Social and emotional health promotion and maintenance, leisure exploration and participation, sleep preparation and participation, financial management, and symptom and condition management were the most commonly identified occupational performance problems. Primary Author and Speaker: Rebecca Marie Wangberg Additional Authors and Speakers: Shana Cerny

Life Satisfaction of Holocaust Survivors

Objective: Find out the impact of the Holocaust trauma on life satisfaction of alive Czech survivors, and to compare it with a control group of respondents. Design: Prospective study Participants: The total number of respondents in the study was 130. The exposed group consisted of 65 Czech Holocaust survivors (average age 88.5 years), control group of 65 Czech seniors (average age 88 years). Methods: The article presents a quantitative research assessing the life satisfaction of survivors using the standardized Life Satisfaction Questionnaire by Fahrenberg et al. (1986) on a main group, and compares it with a control group. A nonparametric test for two selections (Mann – Whitney) at a significance level of 0.05 was used to test the hypotheses. Results: In spite of wide spectrum of the Holocaust effects, the exposed group shows higher or the same satisfactionin the most of the monitored areas compared to the control group (Health Me 4 vs. 3, p – 0.000; Workand employment Me 6 vs. 5, p – 0.000; Financial situation Me 6 vs. 4, p – 0.000; Leisure time Me 4 vs. 4, p – 0.002; Marriage and partnership Me 2 vs. 0, p – 0.284; Own self Me 4 vs. 3, p – 0.000; Sexuality Me 3 vs. 3, p – 0.879; Friends and acquaintances Me 5 vs. 4, p – 0.002; Housing Me 5 vs. 4, p – 0.000; Overall life satisfaction Me 5 vs. 4, p – 0.001). On the contrary, they are less satisfied in the area Children (Me 4 vs. 5, p – 0.016). Conclusions: The research displays integration of hardiness and vulnerability, lust for life and the ability of man to live and survive in extreme conditions and still feel a joy of life.

Protocol paper: Multi-site, cluster-randomized clinical trial for optimizing functional outcomes of older cancer survivors after chemotherapy

BackgroundCancer survivors over the age of 65 have unique needs due to the higher prevalence of functional and cognitive impairment, comorbidities, geriatric syndromes, and greater need for social support after chemotherapy. In this study, we will evaluate whether a Geriatric Evaluation and Management-Survivorship (GEMS) intervention improves functional outcomes important to older cancer survivors following chemotherapy. MethodsA cluster-randomized trial will be conducted in approximately 30 community oncology practices affiliated with the University of Rochester Cancer Center (URCC) National Cancer Institute Community Oncology Research Program (NCORP) Research Base. Participating sites will be randomized to the GEMS intervention, which includes Advanced Practice Practitioner (APP)-directed geriatric evaluation and management (GEM), and Survivorship Health Education (SHE) that is combined with Exercise for Cancer Patients (EXCAP©®), or usual care. Cancer survivors will be recruited from community oncology practices (of participating oncology physicians and APPs) after the enrolled clinicians have consented and completed a baseline survey. We will enroll 780 cancer survivors aged 65 years and older who have completed curative-intent chemotherapy for a solid tumor malignancy within four weeks of study enrollment. Cancer survivors will be asked to choose one caregiver to also participate for a total up to 780 caregivers. The primary aim is to compare the effectiveness of GEMS for improving patient-reported physical function at six months. The secondary aim is to compare effectiveness of GEMS for improving patient-reported cognitive function at six months. Tertiary aims include comparing the effectiveness of GEMS for improving: 1) Patient-reported physical function at twelve months; 2) objectively assessed physical function at six and twelve months; and 3) patient-reported cognitive function at twelve months and objectively assessed cognitive function at six and twelve months. Exploratory health care aims include: 1) Survivor satisfaction with care, 2) APP communication with primary care physicians (PCPs), 3) completion of referral appointments, and 4) hospitalizations at six and twelve months. Exploratory caregiver aims include: 1) Caregiver distress; 2) caregiver quality of life; 3) caregiver burden; and 4) satisfaction with patient care at six and twelve months. DiscussionIf successful, GEMS would be an option for a standardized APP-led survivorship care intervention. Trial RegistrationClinicalTrials.govNCT05006482, registered on August 9, 2021.

Assessment of 5-year outcomes of life satisfaction in survivors after rehabilitation programs: a multicenter clinical trial

Using a rehabilitation program for the survivors of acute respiratory distress syndrome (ARDS) could be one of the important and fundamental steps to improve the pulmonary function and health-related quality of life (HRQoL) of patients. This study was carried out to evaluate the effect of two rehabilitation techniques (Family-Based Empowerment Model (FECM)/Continuing Care Model (CCM), or both of them) on pulmonary function, and HRQoL in ARDS survivors. From December 2009 to June 2016, ARDS survivors from mixed medical-surgical ICUs at four academic teaching hospitals in Tehran, Iran, were randomly assigned to one of three intervention groups (A, B, or C) or a control group (D). Pre- and post-interventions, pulmonary functions and HRQoL status of patients in all groups were collected 48 times via clinical measurements and various questionnaires during 5 years of follow-up. Significantly improvement was seen in the intervention groups compared to the control group, and the greatest benefit was observed in patients who received mixed of FCEM and CCM rehabilitation techniques. Co-administration of FCEM and CCM can improve pulmonary function as well as the life satisfaction of ARDS survivors. As a result, the execution of the empowerment model by nurses is recommended for ARDS survivors and the participation of their families at the same time.Trial registration: NCT02787720 (ClinicalTrial.gov, 24/05/2016).

Systematic Review of Research on Co-Location Models for Serving Intimate Partner and Sexual Violence Survivors

Co-located models to address intimate partner violence and sexual violence, such as Family Justice Centers (FJC) and Multi-Agency Model Centers (MAMC), have emerged as promising practices to meet the needs of survivors. Although implementation of FJCs and MAMCs is widespread and supported by a recent increase in funding, little is known about the effectiveness of these models. This systematic review synthesizes and critically analyzes the peer-reviewed and grey literature focused on evaluating FJCs and MAMCs in the United States. A systematic search of terms pertaining to intimate partner violence, sexual violence, and co-located models was conducted using 11 computerized article databases and 15 center and organization websites. Thirteen studies were included in the final sample, most of which were government or agency-initiated reports. Over half of the studies were process evaluations and four were outcome evaluations. Of the outcome evaluations, none included a comparison group and two used a longitudinal design. Overall, the studies largely focused on organizational outcomes as opposed to survivor outcomes. Despite the lack of information pertaining to survivor outcomes, study findings indicated a high degree of provider and survivor satisfaction with co-located models. Although the research on co-located models – such as FJCs and MAMCs – is growing, evidence about the models’ impact on survivor outcomes related to safety and well-being is inconclusive. Using methodologically rigorous approaches to evaluation design and data analysis, future research should focus on exploring the relationship between coordination, collaboration, and survivor outcomes.

A review of pro-arrest, pro-charge, and pro-prosecution policies as a response to domestic violence

Summary The focus of this scoping review was to understand the overall state of research activity related to pro-arrest, pro-charge, and pro-prosecution policies in Canada. The review identified 295 articles, academic (47.5%) and gray literature (52.5%) published between 1983 and 2018 that reported on these policies as a response to domestic violence in Canada. Findings The findings acknowledged growing concerns over the ineffectiveness of these policies as a response to domestic violence. In fact, over half of the articles (57.6%) either failed to support these policies or recommended significant revisions; only a small number of articles (1.0%) favored these policies in their current form. Themes related to the effectiveness of these policies included criminalization and public awareness, survivor satisfaction, standardized police response, removal of burden from survivor to charge, and better than nothing. Themes related to the ineffectiveness included disconnect between policy and practice, revictimizes survivors, one-size fits all approach, have not adequately reduced domestic violence in Canada, lack of understanding training and education for all, failure to address structural and systemic factors, lack of trust in the criminal justice system, and success has been difficult to measure. Applications The deconstruction of these policies in this review points to the need for future research to address identified gaps in the literature and to explore alternatives that serve their intended emancipatory effect.

Social capital, policy fairness, and subjective life satisfaction of earthquake survivors in Wenchuan, China: a longitudinal study based on post-earthquake survey data

BackgroundExisting research has rarely examined an earthquake’s sustained impact and the trajectory of the earthquake survivors’ life satisfaction over time. This study aims to analyze longitudinal changes in life satisfaction of Wenchuan earthquake survivors and the impact of social capital and government relief policy.MethodsThis research applied a hierarchical linear model to longitudinal survey data collected after the earthquake. The survey was divided into three waves and was collected from Deyang City and Mianyang City of Sichuan Province. A random sampling method was used; a sample of 225 participants had valid responses over three waves of the survey.ResultsThis study found that a survivor’s social capital and the perception of the fairness of government relief policy have a significant effect on the trajectory of life satisfaction post-disaster. First, the initial life satisfaction of those with high social capital was significantly higher than of those with low social capital, whilst survivors with high social capital had a lower rate of change in life satisfaction. Second, one year after the earthquake, those who felt government policy was unfair had a lower life satisfaction than those who felt it was fair. However, from the first year to the fourth year after the disaster, survivors who believed that the government policy was unfair experienced a higher rate of change in life satisfaction than those who did not. Third, the fairness of government relief policy moderates the relationship between survivors’ social capital and changes in life satisfaction. A fair policy of relief can reduce the negative impact of the lack of individual social capital on life satisfaction.ConclusionsSurvivors reconstruct life satisfaction through their social network and the perception of the fairness of the government’s post-disaster relief policy. Therefore, to promote the improvement of life satisfaction of survivors, it is necessary to cultivate social capital and ensure fairness of the relief policy.

Impacts of Structural Social Capital and Cognitive Social Capital on the Psychological Status of Survivors of the Yaan Earthquake

The Yaan earthquake occurred in April 2013, which measured 7.0 on the Richter scale, caused 196 people died, 11,470 injured and USD 6.9 billion economic loss. The Yaan area were also severely affected by the Wenchuan earthquake in 2008. This research examined the impacts of structural social capital (social association) and cognitive social capital on the psychological status (depression, life satisfaction) of survivors of the Yaan earthquake. Based on a survey of 495 respondents, structural equation models were constructed to test the mediation effects of cognitive social capital on the relationships between structural social capital, depression, and life satisfaction of respondents with disaster impact as a control variable. This study also examined the paths of impact of the three components of cognitive social capital (sense of community, trust, and social connectedness) on survivors’ psychological status. The findings indicated the following. 1) The disaster impact had negative effect on cognitive social capital (β = −.15, p < 0.05), but no effect on structural capital (β = −.06, n.s.); disaster impact also had positive effect on depression (β = .16, p < 0.01) and negative effect on life satisfaction (β = −.13, p < 0.05). 2) Structural social capital had positive effect on cognitive social capital (β = −.35, p < 0.001) and cognitive social capital had negative effect on depression (β = −.44, p < 0.001). Structural social capital had indirect effect but no direct effect on depression. The impact of structural social capital on depression was fully mediated by cognitive social capital. 3) Cognitive social capital had positive effect on life satisfaction (β = .44, p < 0.001). Structural social capital had indirect effect but no direct effect on life satisfaction. The impact of structural social capital on life satisfaction was fully mediated by cognitive social capital. 4) Sense of community has a positive effect on life satisfaction (β = .72, p < 0.05), but no effect on depression. 5) Trust has a negative effect on depression (β = −.41, p < 0.05), but no effect on life satisfaction. 6) Social connectedness has a negative effect on depression (β = −.16, p < 0.05), but no effect on life satisfaction. The research highlighted the importance of building and maintaining cognitive social capital in a community affected by disaster. It also makes recommendations for social workers to improve trust and social connectedness in the pre-disaster and disaster relief phases to buffer depression. After a disaster, it is recommended to facilitate a sense of community to improve the life satisfaction of survivors.

Identifying barriers to cancer survivors sharing their survivorship care plans with their healthcare provider.

To understand what factors influence whether a cancer survivor will share their survivorship care plan (SCP) with their healthcare provider (HCP). We used data from 3231 cancer survivors who utilized the OncoLink SCP resource between 2009 and 2016. Random forest and stepwise regression were used to identify predictors of SCP satisfaction and barriers to survivors sharing their care plans with their HCPs. Eighty-seven percent of users rated their satisfaction with their SCP as good or better; however, only 70% of survivors planned to share their SCP with their HCP. The most commonly reported reason for not sharing was a feeling that their HCP would not care. Self-reported satisfaction with their SCP was strongest predictor of whether a survivor would share their SCP. Gender, cancer status, number of chemotherapies received, and who was managing their healthcare were all associated with self-reported survivor satisfaction with their SCP. Survivor satisfaction with SCPs was high, but there was a disconnect in the number of satisfied survivors and the number of survivors planning to share their SCP with their HCP. To bridge this gap, additional prompts that HCPs are expecting this information should be added to the care plans. One of the primary functions of survivorship care plans is to improve communication between survivor and healthcare provider. While survivors are overwhelmingly satisfied with their SCP, additional steps are necessary to get survivors to share their SCP with their HCP.

Abstract T P286: Telephone Support Program Promotes Stroke Survivor Knowledge, Self-Care, and Satisfaction

Background and Issues: Stroke is the fourth leading cause of death, and the leading cause of disability. Aside from physically disablement, stroke survivors often experience difficulty coping with life post-discharge. Knowledge of stroke symptoms is often low, even in patients who have suffered stroke. Programs designed to provide support and education to stroke survivors can be effective at promoting stroke knowledge and improving patient satisfaction. Purpose: To evaluate the effectiveness of a telephone support program at promoting stroke knowledge, coping and self-care in stroke survivors. Methods: The Rush Stroke Buddy Program was developed in 2011 to provide support for patients with ischemic and hemorrhagic stroke after discharge from Rush University Medical Center. The telephone program consists of monthly calls to patients who voluntarily enlist in the program. Each phone call has two facilitators, a nursing student (“Buddy”) and a stroke survivor (“Ambassador”), who are undergo intensive training including lectures given by a rehab physician, a behavioral psychologist, a spiritual care worker, a social worker, and a nurse educator. Each phone call follows protocol: the Buddy is responsible for discussing aspects of stroke symptom education, personal medical risk factor reduction, and reviewing medications; the Ambassador provides emotional support for the stroke survivor. Results: Of 34 active participants since program inception, 17 (50%) agreed to be surveyed. 15 subjects (88%) felt the program empowered them to manage their health, addressed concerns, and helped them cope (94%). 13 subjects (76%) stated the program helped them overcome difficulties. All participants could name at least one stroke symptom; 14 subjects (82%) could name two or more. 13 subjects (76%) felt they better understood their medicines; 16 subjects (94%) felt they understood when to seek urgent medical attention. Sixteen subjects (94%) stated they would recommend the program to others. Conclusions: The Rush Stroke Buddy Program provides stroke survivor satisfaction, reinforces stroke symptom knowledge, and provides emotional support. Although further research is needed on stroke support, this program overall improves patient coping, self-care and education.

In Our Voice: Survivors’ Recommendations for Change

Seven focus groups with a diverse group of intimate partner violence (IPV) survivors (n = 39) explored how to improve survivor satisfaction, empowerment, and safety related to their court-based experiences. These occurred in three jurisdictions which all supported community coordinated responses to IPV. This paper contributes to the literature by asking survivors about existing service gaps and how helping professionals might enhance court operations. Analysis was conducted using a framework approach based on the socio-ecological model. Findings suggest four areas worthy of improvement: Logistics, Emotional Enhancements, Society’s Perception of IPV, and Court Procedures. The recommendations for change are neither expensive nor complicated; rather, modest changes may result in greater victim satisfaction with the courts.

Survivorship care plans in cancer: a systematic review of care plan outcomes.

Background:Eight years after the Institute of Medicine recommended survivorship care plans (SCPs) for all cancer survivors, this study systematically reviewed the evidence for their use.Methods:Studies evaluating outcomes after implementation of SCPs for cancer survivors were identified by searching databases (MEDLINE, EMBASE and Cochrane). Data were extracted and summarised.Results:Ten prospective studies (2286 survivors) met inclusion criteria (5 randomised controlled trials (RCTs)). Study populations included survivors of breast, gynaecological, colorectal and childhood cancer. Several models of SCP were evaluated (paper based/on-line, oncologist/nurse/primary-care physician-delivered and different templates). No significant effect of SCPs was found on survivor distress, satisfaction with care, cancer-care coordination or oncological outcomes in RCTs. Breast cancer survivors with SCPs were better able to correctly identify the clinician responsible for their follow-up care. One study suggested a positive impact on reducing unmet needs. Levels of survivor satisfaction with, and self-reported understanding of, their SCP were very high. Feasibility was raised by health professionals as a significant barrier, as SCPs took 1–4 h of their time to develop.Conclusions:Emerging evidence shows very few measurable benefits of SCPs. Survivors reported high levels of satisfaction with SCPs. Resource issues were identified as a significant barrier to implementation.

Seeking to Reduce Nonbeneficial Treatment in the ICU

To investigate whether the proactive intervention of a clinical ethicist in cases of prolonged lengths of stay in a critical care setting reduces nonbeneficial treatment while increasing perceived patient/surrogate and provider satisfaction and reducing associated costs. Nonbeneficial treatment is defined here as the use of life-sustaining treatments delivered to patients who had been in the ICU for 5 days and did not survive to discharge. Prospective randomized exploratory trial from October 2007 to February 2010 in the adult ICU of a large, urban, not-for-profit community hospital. Medical/surgical ICU of California Pacific Medical Center, a large tertiary not-for-profit hospital in San Francisco, CA. Three hundred eighty-four patients with ICU lengths of stay of five days or greater. Patients were randomized to either an intervention arm (Proactive Ethics Intervention) (n = 174) or control arm (n = 210). There were 56 patients in the intervention arm and 52 patients in the control arm who did not survive to discharge. Proactive ethics intervention involves a trained bioethicist in the care of all ICU patients with a length of stay greater than or equal to 5 days. The intervention used a nine step process model designed to look for manifest or latent ethics conflicts and address them. The primary outcome measures were days in the ICU; overall length of hospital stay; mortality; nonbeneficial treatments, for example, provision of nutritional support; surrogate and survivor satisfaction, and cost. The intervention and control arms showed no significant difference in mortality. Proactive Ethics Intervention, at the 95% CI, was not associated with reductions of overall length of stay (23 d for intervention and 21 d for control, p = 0.74), ICU days (11 in each arm, p = 0.91), life-sustaining treatments (days on ventilator: intervention, 14.6; control, 13.7; p = 0.74; days receiving artificial nutrition and hydration: intervention, 16.5; control, 15.9; p = 0.85), or cost ($167,350.00 for intervention and $164,670.00 for control, p =0.92) in patients who did not survive to discharge. Perceptions of quality of care by patients and providers showed no difference between intervention and control arms. Our study finds that Proactive Ethics Intervention, provided to all patients in a critical care setting for 5 days, and before an ethical conflict has been recognized, is ineffective in reducing overall length of hospital stay, ICU days, nonbeneficial treatments, or hospital costs. It is also not effective in increasing perceptions of quality of care by patients or providers.

Physical Health Problem Intrusion Linking Religious Attributions to Marital Satisfaction in Survivors of the 2004 Tsunami

The impact of the 2004 tsunami that struck East Asia on Buddhist, Sri Lankan mothers was investigated in this study. More specifically, the relationship between attributing the 2004 tsunami to Karma and marital satisfaction was examined in a sample of 163 women, 3 years after the Disaster. Mediation by persisting physical health problems, on the relationship between attributing the tsunami to Karma and martial satisfaction, after controlling for mental health status and income before the tsunami was also tested. Karma attributions were not directly associated with marital satisfaction. However, an indirect path positively linking Karma attributions with persistent physical health challenges, and negatively linking physical health challenges to marital satisfaction was observed. Using Hobfoll’s (1989) conservation of resources (COR) model, implications of physical health challenges for disaster survivors and attributions endorsing an external locus of control are discussed.