AIM:To assess the reasons for,and factors associated with,patient-initiated changes in treating specialist in inflammatory bowel diseases(IBD).METHODS:Prospectively identified IBD patients(n = 256) with ≥ 1 encounter...AIM:To assess the reasons for,and factors associated with,patient-initiated changes in treating specialist in inflammatory bowel diseases(IBD).METHODS:Prospectively identified IBD patients(n = 256) with ≥ 1 encounter at a metropolitan hospital were surveyed,including whether they had changed treating specialist and why.Negative reasons included loss of confidence,disagreement,and/or personality clash with the specialist.RESULTS:Of 162 respondents,70(43%) had ever changed specialists;30/70(43%) for negative reasons,52/70(74%) in the preceding year.Patients with negative reasons for changing(n = 30) were younger(median,35.2 years vs 45.3 years),had higher IBD knowledge(median,5.0 years vs 4.0 years),yet had lower medication adherence and satisfaction scores(median,19.0 years vs 22.0 years,14.0 years vs 16.0 years respectively,Mann-Whitney tests,all P < 0.05),compared to all other responders(n = 132).Patients with a recent change(for any reason) were more likely to have Crohn's disease,currently active disease,previous bowel resection and recent hospitalization [OR 2.6,95% CI(1.3-5.4),2.2(1.0-4.7),5.56(1.92-16.67),2.0(1.3-3.0),eachP < 0.05].CONCLUSION:Changing specialist appears associated with patient-related(age,nonadherence) and contemporaneous disease-related factors(recent relapse) which,where modifiable,may enhance patient-doctor relationships and therefore quality of care.展开更多
This review is intended to describe the features of colorectal cancer both in terms of pathophysiology and clinical features of the pathology. It also describes the anatomical and clinical features of different primar...This review is intended to describe the features of colorectal cancer both in terms of pathophysiology and clinical features of the pathology. It also describes the anatomical and clinical features of different primary tumor locations in colorectal cancer. It is also to note how relevant it is to identify rectal cancer and colon cancer as different pathologies due to the clinical, pathophysiological and immuno-oncological features of rectal cancer compared to the ones of colon cancer while remarking the importance of medical doctors in the interaction with oncological patients. Background: Colorectal Cancer (CRC) is a major public health problem, representing the third most commonly diagnosed cancer in males and the second in females and it is fundamental to note and discuss doctor-patient interaction, fundamental for proper adherence and psychological status of the oncological patient, when discussing such important and impactful pathologies. Conclusions: This review highlights the possibility of an update in the terminology of Colorectal Cancer (CRC) into different clinically relevant pathologies within the umbrella term colorectal cancer (for instance rectal and colon cancer as different tumors). It also remarks on the importance of medical doctors in the interaction with oncological patients.展开更多
文摘AIM:To assess the reasons for,and factors associated with,patient-initiated changes in treating specialist in inflammatory bowel diseases(IBD).METHODS:Prospectively identified IBD patients(n = 256) with ≥ 1 encounter at a metropolitan hospital were surveyed,including whether they had changed treating specialist and why.Negative reasons included loss of confidence,disagreement,and/or personality clash with the specialist.RESULTS:Of 162 respondents,70(43%) had ever changed specialists;30/70(43%) for negative reasons,52/70(74%) in the preceding year.Patients with negative reasons for changing(n = 30) were younger(median,35.2 years vs 45.3 years),had higher IBD knowledge(median,5.0 years vs 4.0 years),yet had lower medication adherence and satisfaction scores(median,19.0 years vs 22.0 years,14.0 years vs 16.0 years respectively,Mann-Whitney tests,all P < 0.05),compared to all other responders(n = 132).Patients with a recent change(for any reason) were more likely to have Crohn's disease,currently active disease,previous bowel resection and recent hospitalization [OR 2.6,95% CI(1.3-5.4),2.2(1.0-4.7),5.56(1.92-16.67),2.0(1.3-3.0),eachP < 0.05].CONCLUSION:Changing specialist appears associated with patient-related(age,nonadherence) and contemporaneous disease-related factors(recent relapse) which,where modifiable,may enhance patient-doctor relationships and therefore quality of care.
文摘This review is intended to describe the features of colorectal cancer both in terms of pathophysiology and clinical features of the pathology. It also describes the anatomical and clinical features of different primary tumor locations in colorectal cancer. It is also to note how relevant it is to identify rectal cancer and colon cancer as different pathologies due to the clinical, pathophysiological and immuno-oncological features of rectal cancer compared to the ones of colon cancer while remarking the importance of medical doctors in the interaction with oncological patients. Background: Colorectal Cancer (CRC) is a major public health problem, representing the third most commonly diagnosed cancer in males and the second in females and it is fundamental to note and discuss doctor-patient interaction, fundamental for proper adherence and psychological status of the oncological patient, when discussing such important and impactful pathologies. Conclusions: This review highlights the possibility of an update in the terminology of Colorectal Cancer (CRC) into different clinically relevant pathologies within the umbrella term colorectal cancer (for instance rectal and colon cancer as different tumors). It also remarks on the importance of medical doctors in the interaction with oncological patients.
