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      Providing supportive care to cancer patients: a study on inter-organizational relationships

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          Abstract

          Background

          Supportive cancer care (SCC) has historically been provided by organizations that work independently and possess limited inter-organizational coordination. Despite the recognition that SCC services must be better coordinated, little research has been done to examine inter-organizational relationships that would enable this goal.

          Objective

          The purpose of this study was to describe relationships among programs that support those affected by cancer. Through this description the study objective was to identify the optimal approach to coordinating SCC in the community.

          Methods

          Senior administrators in programs that provided care to persons and their families living with or affected by cancer participated in a personal interview. Setting: South-central Ontario, Canada. Study population: administrators from 43 (97%) eligible programs consented to participate in the study.

          Results

          Network analysis revealed a diffuse system where centralization was greater in operational than administrative activities. A greater number of provider cliques were present at the operational level than the administrative level. Respondents identified several priorities to improve the coordination of cancer care in the community including: improving standards of care; establishing a regional coordinating body; increasing resources; and improving communication between programs.

          Conclusion

          Our results point to the importance of developing a better understanding on the types of relationships that exist among service programs if effective integrated models of care are to be developed.

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          Most cited references32

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          Social network analysis: a handbook

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            The unmet supportive care needs of patients with cancer. Supportive Care Review Group.

            The aim of this study was to determine the prevalence and predictors of the perceived unmet needs of cancer patients undergoing treatment for their disease at public treatment centers. A total of 1,492 consecutive patients attending the surgical, radiation, or medical oncology departments of 9 major public cancer treatment centers in New South Wales, Australia, were asked to participate. Of the 1,370 eligible patients, 1,354 (99%) consented to participate and 888 (65%) returned completed surveys. Eligible consenting patients were given a Supportive Care Needs Survey to complete at home and return by mail within 7 days. Patients' perceived needs were assessed across the following five areas: psychologic, health system and information, physical and daily living, patient care and support, and sexuality. Patients' perceived needs were highest in the psychologic, health system and information, and physical and daily living domains. Logistic regression modeling revealed subgroups of patients with different types of needs. The significant predictors of reporting some unmet need for help varied according to the domain examined. This statewide study shows that cancer patients experience high levels of unmet needs across the range of domains examined. The study provides information that may be valuable in identifying areas where interventions could be tested and evaluated in an attempt to address the unmet needs of people living with cancer. Copyright 2000 American Cancer Society.
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              Practical Sampling

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                Author and article information

                Contributors
                St. Joseph's Health System Research Network, Supportive Care Research Unit, Juravinski Cancer Centre, Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada
                Supportive Cancer Care Research Unit, Juravinski Cancer Centre, Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada
                Supportive Cancer Care Research Unit, Juravinski Cancer Centre, Department of Oncology, McMaster University, Hamilton, ON, Canada
                Supportive Cancer Care Research Unit, Juravinski Cancer Centre, Department of Oncology, McMaster University, Hamilton, ON, Canada
                Supportive Cancer Care Research Unit, Juravinski Cancer Centre, School of Rehabilitation Science, McMaster University, ON, Canada
                Supportive Cancer Care Research Unit, Juravinski Cancer Center, Hamilton, ON, Canada
                Journal
                Int J Integr Care
                IJIC
                International Journal of Integrated Care
                Igitur, Utrecht Publishing & Archiving (Utrecht, The Netherlands )
                1568-4156
                Jan-Mar 2008
                11 February 2008
                : 8
                : e01
                Affiliations
                St. Joseph's Health System Research Network, Supportive Care Research Unit, Juravinski Cancer Centre, Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada
                Supportive Cancer Care Research Unit, Juravinski Cancer Centre, Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada
                Supportive Cancer Care Research Unit, Juravinski Cancer Centre, Department of Oncology, McMaster University, Hamilton, ON, Canada
                Supportive Cancer Care Research Unit, Juravinski Cancer Centre, Department of Oncology, McMaster University, Hamilton, ON, Canada
                Supportive Cancer Care Research Unit, Juravinski Cancer Centre, School of Rehabilitation Science, McMaster University, ON, Canada
                Supportive Cancer Care Research Unit, Juravinski Cancer Center, Hamilton, ON, Canada
                Author notes
                Correspondence to: Kevin Brazil, St. Joseph's Health System Research Network, 105 Main St. E., Level P1, Hamilton, Ontario, Canada L8N 1G6, Phone: +905-522-1155 Ext. 35154, Fax: +905-521-6010, E-mail: brazilk@ 123456mcmaster.ca
                Article
                ijic200801
                2254486
                18317559
                d7cb4f43-1d25-4e50-98f5-103fab405ca8
                Copyright 2008, International Journal of Integrated Care (IJIC)
                History
                : 9 November 2006
                : 30 October 2007
                : 22 November 2007
                Categories
                Research and Theory

                Health & Social care
                supportive cancer care,service networks,inter-organizational relationships,collaboration

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