Patient advocates

患者倡导者
  • 文章类型: Journal Article
    目的:良好临床实践(GCP)对于以患者为中心的研究至关重要。强调“一刀切”方法的标准生物伦理学和GCP培训可能无法充分装备伦理委员会成员,尤其是外行和社会科学家成员,他们在审查临床试验和相关文件中的关键作用。这篇文章探讨了以患者为中心,患者倡导者驱动的培训计划,重点是提高患者对研究伦理和GCP的认识,倡导者和道德委员会成员。
    方法:一项名为“患者临床研究倡导者”(PACER)的患者倡导者驱动计划开展了以GCP为中心的患者研究培训。倡导者和道德委员会成员。研讨会前和研讨会后的问卷被用来评估参与者的GCP知识。
    结果:116名参与者参加了研讨会。在这91人同意参与评估参与者对伦理委员会(EC)功能的知识的问卷评估中,研究伦理和数据保密。讲习班前评价突出了知识差距。只有16.5%的人熟悉弱势群体的主要道德考虑因素,69.2%的人了解数据治理。研讨会后评估显示,总体反应显着改善了5.4%(?2=13.890;p<0.001)。对弱势群体道德考虑的理解增加了15.4%(p=0.007),数据隐私法规知识提高了11.0%(p=0.041)。
    结论:PACER倡议下的研讨会强调了在理解EC功能方面的知识差距,研究伦理和数据保密。研讨会有效地培养了参与者对道德研究实践的理解。
    OBJECTIVE: Good Clinical Practices (GCP) are essential for patient-centric research. The standard bioethics and GCP training emphasizing a \"one-size-fits-all\" approach may not adequately equip ethics committee members, especially the lay and social scientist members, towards their critical role in reviewing clinical trials and related documentation. This article explores a patient-centered, patient advocates-driven training program focused on raising awareness about research ethics and GCP among patients, advocates and ethics committee members.
    METHODS: A patient advocates-driven program called Patient Advocates for Clinical Research (PACER) conducted trainings focused on GCP for patient-centric research for patients, advocates and ethics committee members. Pre- and post-workshop questionnaires were used to assess the participants\' knowledge of GCP.
    RESULTS: The workshop was attended by 116 participants. Of these 91 consented to participate in questionnaire evaluation that assessed participants\' knowledge on ethics committee (EC) functionality, research ethics and data confidentiality. Pre-workshop evaluations highlighted knowledge gaps. Only 16.5% were familiar with the primary ethical consideration for vulnerable populations and 69.2% were knowledgeable about data governance. Post-workshop evaluations demonstrated significant overall response improvement of 5.4% (𝜒2=13.890; p<0.001). The understanding of ethical considerations for vulnerable populations rose by 15.4% (p=0.007), and knowledge of data privacy regulations improved by 11.0% (p=0.041).
    CONCLUSIONS: The workshop under PACER initiative highlighted the knowledge gaps in understanding the EC functionality, research ethics and data confidentiality. The workshop effectively fostered participants\' understanding of ethical research practices.
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  • 文章类型: Journal Article
    目的:多国癌症支持护理协会(MASCC)/欧洲肿瘤医学学会(ESMO)患者止吐指南委员会旨在(1)适应最新的循证,临床指南以患者为中心的止吐指南和(2)制定患者教育材料和声明。
    方法:止吐专家和患者倡导者通过将2023年MASCC/ESMO止吐指南纳入患者友好的语言来创建和审查MASCC2023年患者止吐指南。根据现有文献并利用专家修改的Delphi共识(≥75%的一致性)制定患者教育声明。患者倡导者/焦点小组的输入和患者调查结果进一步纳入以患者为中心的止吐指南和教育声明。
    结果:使用患者友好的语言和视觉幻灯片创建以患者为中心的止吐指南。还利用对患者友好的语言来传达教育声明。教育声明确定的主要内容类别包括:恶心/呕吐定义,原因,危险因素,类别,并发症,伴随症状,预防性止吐治疗,一般管理,什么时候打电话/问医疗团队什么,护理人员能做什么,和可用的资源。所有确定的内容都符合≥75%的专家协议阈值。十五(15)项表现出100%的协议,11项达成≥90%协议,三个内容项表现出80~82%的一致性。
    结论:首届MASCC2023患者止吐指南可以帮助患者和护理人员了解与癌症治疗相关的恶心和呕吐的预防。教育声明提供进一步的患者信息。教育患者如何使用指南止吐药和教育声明可以改善抗癌治疗相关的恶心和呕吐的控制。
    OBJECTIVE: The Multinational Association of Supportive Care in Cancer (MASCC)/European Society of Medical Oncology (ESMO) Patient Antiemetic Guideline Committee aimed to (1) adapt the updated evidence-based, clinical guidelines to patient-centered antiemetic guidelines and (2) develop patient education materials and statements.
    METHODS: The MASCC 2023 Patient Antiemetic Guidelines were created and reviewed by antiemetic experts and patient advocates by incorporating the 2023 MASCC/ESMO antiemetic guidelines into patient-friendly language. Patient Education Statements were developed based on current literature and by utilizing an expert modified Delphi consensus (≥ 75% agreement). Patient advocate/focus group input and patient survey results were further integrated into Patient-Centered Antiemetic Guidelines and Education Statements.
    RESULTS: Patient-Centered Antiemetic Guidelines were created using patient-friendly language and visual slides. Patient-friendly language was also utilized to communicate the Educational Statements. Key content categories identified for the Educational Statements included the following: nausea/vomiting definitions, causes, risk factors, categories, complications, accompanying symptoms, prophylactic antiemetic treatment, general management, when to call/what to ask the healthcare team, what caregivers can do, and available resources. All identified content met the ≥ 75% expert agreement threshold. Fifteen (15) items demonstrated 100% agreement, 11 items achieved ≥ 90% agreement, and three content items demonstrated 80 ~ 82% agreement.
    CONCLUSIONS: The inaugural MASCC 2023 Patient Antiemetic Guidelines can help patients and caregivers understand the prevention of nausea and vomiting related to their cancer treatment. Educational Statements provide further patient information. Educating patients on how to utilize guideline antiemetics and the education statements can contribute improvements in the control of anticancer treatment-related nausea and vomiting.
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  • 文章类型: Journal Article
    引出持续疼痛患者的观点,了解他们作为患者倡导者与疼痛管理专业人员和服务合作的经历,并考虑对当前患者参与服务开发和研究模式的影响。
    从批判的现实主义角度进行反身性主题分析。
    对10名在持续性疼痛领域担任患者倡导者的参与者进行了单独的在线访谈。参与者是通过有目的和滚雪球抽样招募的。对数据进行了分析并组织成主题,并以描述性方式呈现。
    患者倡导者与他们所帮助的组织之间的关系被概念化为“不平等的伙伴关系”。参与者描述了与个别卫生专业人员和研究团队的积极和肯定的经验(尊重)。这通常发生在不灵活的组织政策的背景下,这些政策给参与带来了障碍,包括缺乏经济补偿和期望在不灵活的期限内工作。因此,患者倡导者可能会体验到缺乏归因于他们的经验和声音的价值(来自机构的未满足的需求)。
    具有参与持续疼痛服务的个人经验的人处于有利地位,可以为服务改进做出贡献。虽然这种贡献被认为是有价值的,它似乎因组织障碍而贬值。围绕支付的组织政策可能会导致那些经历更高水平的劣势的人缺乏代表性。因此,服务和政策制定者可能会错过对服务发展可能很重要的见解。
    UNASSIGNED: To elicit perspectives of people with persistent pain about their experiences working with pain management professionals and services as patient advocates and to consider implications for current models of involving patients in service development and research.
    UNASSIGNED: reflexive thematic analysis from a critical realist perspective.
    UNASSIGNED: Online interviews were conducted individually with 10 participants who had acted as patient advocates in the field of persistent pain. Participants were recruited through purposive and snowball sampling. Data were analysed and organised into themes and are presented descriptively.
    UNASSIGNED: The relationship between patient advocates and the organisations they help is conceptualised as \'an unequal partnership\'. Participants described positive and affirming experiences with individual health professionals and research teams (Respect). This often occurred within a context of inflexible organisational policies that presented barriers to participation including a lack of financial compensation and expectation to work to inflexible deadlines. As a result, patient advocates could experience a lack of value attributed to their experiences and voices (unmet needs from institutions).
    UNASSIGNED: People with personal experience of engaging with services for persistent pain are in a strong position to contribute to service improvement. Although this contribution is recognised as valuable, it appears to be devalued by organisational barriers. Organisational policies around payment may lead to a lack of representation of those experiencing higher levels of disadvantage. As a result, services and policy makers may be missing out on insights that could be important for service development.
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  • 文章类型: Journal Article
    上皮样血管内皮瘤(EHE)是一种非常罕见的,血管肉瘤,临床表现从惰性到侵袭性。超过50%的患者出现转移性疾病,需要全身治疗,尽管没有专门批准用于EHE的全身疗法。回顾性证据支持mTOR抑制剂(例如西罗莫司)的活性,虽然仅在标签外可用。因此,EHE患者和倡导者正在努力通过收集患者观点和经验的数据来支持有效治疗的批准。
    2023年2月,EHE罕见癌症慈善机构(英国)和EHE基金会(美国),与其他倡导者,对EHE患者关于西罗莫司的使用和可及性的观点和经验进行了调查。调查由20个问题组成,这些问题是为接受治疗的个人设计的,那些接受治疗的人,或者从未接受过药物治疗。在患者社区中广泛推广,在线调查将患者分为三个队列进行分析:肝移植患者,曾服用西罗莫司的非移植患者和未服用西罗莫司的非移植患者.
    该调查评估了来自21个国家/地区的129名患者的反应数据,主要来自美国,英国,澳大利亚,加拿大(70%)。肝脏移植,西罗莫司和非西罗莫司队列为16%,25%和59%,分别。在西罗莫司组中,66%报告治疗持续时间超过一年,16%的人超过五年,说明药物的功效。在非西罗莫司组中,42%的药物未获得,11%的西罗莫司可获得,但由于其超标签状态,未选择用于治疗.总的来说,在所有队列中,87%的患者表示药物的可用性非常重要或非常重要。
    调查答复强调了西罗莫司对EHE的活性,以及确保药物标签扩展的重要性,从而为患者提供公平的治疗机会。
    UNASSIGNED: Epithelioid hemangioendothelioma (EHE) is an ultra-rare, vascular sarcoma with clinical presentation ranging from an indolent to an aggressive form. Over 50% of patients present with metastatic disease, requiring systemic therapy, although no systemic therapies are specifically approved for EHE. Retrospective evidence supports the activity of mTOR inhibitors (e.g. sirolimus), although available only off-label. EHE patients and advocates are therefore working to support approval of effective treatments by collecting data on patient perspectives and experiences.
    UNASSIGNED: In February 2023, the EHE Rare Cancer Charity (UK) and The EHE Foundation (US), with other advocates, conducted a survey of perspectives and experiences of EHE patients regarding the use and accessibility of sirolimus. The survey consisted of 20 questions designed for individuals undergoing treatment, those who had been treated, or had never been treated with the drug. Widely promoted within the patient community, the online survey categorized patients into three cohorts for the analysis: liver transplant patients, non-transplant patients who had ever taken sirolimus and sirolimus-naïve non-transplant patients.
    UNASSIGNED: The survey evaluated data from 129 patient responses from 21 countries, mostly from USA, UK, Australia, and Canada (70%). The liver transplant, sirolimus and non-sirolimus cohorts were 16%, 25% and 59%, respectively. In the sirolimus group 66% reported treatment durations exceeding one year, with 16% exceeding five years, indicating the drug\'s efficacy. In the non-sirolimus group, the drug was not available for 42% and for 11% sirolimus was available but not selected for treatment because of its off-label status. Overall, 87% of all patients across all cohorts expressed the importance of the drug\'s availability as hugely or very important.
    UNASSIGNED: The survey responses highlight the activity of sirolimus for EHE and the importance of securing a label extension for the drug delivering equitable access to this treatment for patients.
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  • 文章类型: Journal Article
    早发性结直肠癌(年龄在50岁以下)(EOCRC)是一个不可否认的重要实体,都是因为它的发病率越来越高,以及它影响的人口。其他当前的评论强调了有关其分子基础的临床管理和知识的要点。然而,我们打算更进一步。随着患者参与和疾病体验的重要性增加,我们整合了病人的声音来展示弱点和需求,以及促进EOCRC知识和管理的下一步。对不同观点的综合回顾,临床,研究和病人自己,因此可以定义为综合需求评估。因此,这可能是朝着定义和行动的基本同质性努力的第一步。
    Early-onset colorectal cancer (age under 50 years) (EOCRC) is an entity of undeniable importance, both because of its growing incidence, and the population it affects. Other current reviews emphasize the essential points regarding the clinical management and knowledge of its molecular bases. However, we intend to go one step further. With the increased significance of patient participation and disease experience in mind, we have integrated the voice of the patient to show the weaknesses and the needs, and next steps in the advancement of knowledge and management of EOCRC. This integrative review of the different perspectives, clinical, research and the patients themselves, can therefore be defined as an integrative needs assessment. Hence, this may be a first step in working towards an essential homogeneity of definitions and action.
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  • 文章类型: Journal Article
    肌肉骨骼肉瘤是罕见的癌症,因为整个肉瘤家族在不同的层面上提出了一些挑战,从医学知识到临床研究和决策。应对这些挑战,必然要求将患者观点纳入有助于改善治疗的每个领域的决策过程,从医疗机构提供优质服务到研究问题。没有患者提供的输入来告知决策,当前的以患者为中心的护理模式没有任何意义,听起来至少是不合理的,即使不是不道德的。将PROM放在癌症研究和护理的“中心阶段”,可以允许建立一个真正的循证倡导(EBA),从而授权循证医学(EBM)。
    Musculoskeletal sarcomas are rare cancers that as the whole family of sarcomas pose several challenges at different levels, ranging from medical knowledge to clinical research and policymaking. Addressing these challenges, necessarily calls for the inclusion of patient perspective inside the decision-making processes of every area that contributes to treatment improvement, from the provision of high-quality services by healthcare organisations to research issues. Without patient-provided inputs to inform decisions, the current paradigm of patient-centred care makes no sense and sounds at the least irrational if not unethical. Putting PROMs on \"centre stage\" in cancer research and care, could allow to build a truly Evidence Based Advocacy (EBA) and therefore to empower Evidence Based Medicine (EBM).
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  • 文章类型: Journal Article
    The drug development process is a long and arduous one, especially for rare diseases. Patient and patient representatives can and should be involved in this process from an early stage, since they have the perspective of living with a disease on a daily basis and can best identify which symptoms are the largest burden and which benefits would be more important to them. In this perspective, we outline how patients can be involved optimally in drug development. We outline success factors such as finding the right partners, bilateral education, having realistic expectations, and an open and honest dialog with all stakeholders.
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  • 文章类型: Journal Article
    简介:迫切需要研究怀孕期间使用阿片类药物对胎儿和儿童发育的影响,以更好地为医疗实践和政策提供信息。健康大脑和儿童发育研究将检查从出生到生命的第一个十年的大脑和行为发育。由于该计划的范围大且预期复杂,在全国28个地点实施了18个月的规划阶段。第一阶段倡议的一个核心要素涉及利益相关者咨询委员会的发展,以告知该倡议的下一阶段。方法:第一阶段利益相关者会议在俄勒冈健康与科学大学举行,纽约大学Langone医学中心,匹兹堡大学,和佛蒙特大学更好地理解观点并为即将到来的研究提供信息。尽管不同地点的利益相关者会议的结构不同,会议的总体目标包括建立关系,收集输入,和学习研究参与。审查了每次会议的文件的位置,持续时间,与会者,共同的研究主题,以及改进研究方法的相关建议。结果:所有利益相关者都对患有物质使用障碍的孕妇的研究感兴趣,并同意研究重点,包括合作,连接,通信,和支持。不同的利益相关者对研究设计的各个方面以及通过会议出现的主题提供了独特的观点。讨论:总的来说,对这项研究感到兴奋,特别是有机会包括有生活经验的人的声音;提供者之间的合作,同行支持专家,病人,和其他人;以及为研究做出贡献的兴奋,这些研究可以阐明成瘾医学和儿童发育领域的新的和相关的发现。网站还发现,有物质使用障碍的人和医疗系统之间存在不信任,这可以通过将有生活经验的人纳入研究团队来解决,形成连接,沟通清楚,在隐性偏见中训练研究团队,并实施创伤护理。总之,这些利益相关者会议为组织即将进行的研究提供了宝贵的信息;然而,研究人员将受益于更多的时间和更多的面对面联系的机会。
    Introduction: There is a dire need for research regarding the implications of opioid use during pregnancy on fetal and childhood development to better inform both medical practice and policy. The Healthy Brain and Child Development Study will examine brain and behavioral development from birth through the first decade of life. Due to large scope and anticipated complexity of this initiative, an 18-month planning phase was implemented across 28 sites across the nation. A core element of the Phase I initiative involved the development of Stakeholder Advisory Committees to inform the next phase of the initiative. Methods: Phase I stakeholder meetings were conducted at Oregon Health and Science University, New York University Langone Medical Center, the University of Pittsburgh, and the University of Vermont to better understand perspectives and inform upcoming research. Despite differences in the structure of the stakeholder meetings by site, the overarching goals for the meetings included establishing relationships, gathering input, and learning about research engagement. Documents from each meeting were reviewed for location, duration, attendees, common research themes, and pertinent suggestions for improving research approaches. Results: All stakeholders had high levels of interest in research for pregnant people with substance use disorders and agreed on research priorities including collaboration, connection, communication, and support. Different stakeholders offered unique perspectives on various aspects of study design and themes that emerged through meetings. Discussion: Overall, there was excitement about the research, especially the opportunity to include the voices of people with lived experience; collaboration between providers, peer support specialists, patients, and others; and excitement around contributing to research that could elucidate new and pertinent findings in the realm of addiction medicine and child development. Sites also found that there is mistrust between people with substance use disorder and the medical system, and this could be addressed by including people with lived experience on the research team, forming connections, communicating clearly, training the research team in implicit bias, and practicing trauma-informed care. In conclusion, these stakeholder meetings provided valuable information for structuring upcoming studies; however, researchers would have benefitted from more time and more opportunities for in-person connection.
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  • 文章类型: Journal Article
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