Gezondheidsproblemen bij patiënten met borstkanker.

Schotsman, M. (Marjolein) (2014) Gezondheidsproblemen bij patiënten met borstkanker. thesis, Medicine.

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Abstract

Aim: Breast cancer is known to be one of the most frequent diseases with an increasing incidence and decreasing mortality. This results in more female breast cancer survivors who have to deal with the health problems of this disease and its treatment. To provide better future care for the growing group of cancer survivors, a research was conducted concerning the highly-relevant health problems for women with breast cancer, one year since diagnosis. In addition, this research attempted to reach a consensus between the experts panels on colorectal, lung and breast cancer about the health problems of the three types of cancer together. Material and method: Using the Delphi method, an attempt at consensus was investigated between the 3 panels of breast cancer expert on the health problems, more than one year since the diagnosis of breast cancer. The expert panels consisted of: experts by experience, non-medical experts and medical professionals on health problems of breast cancer patients. The International Classification of Functioning, Disability and Health (ICF), at 3 digit level, was used to achieve consensus in two rounds between the three expert panels. The question in the first Delphi-round dealt with the extent at which the experts thought each of the 265 ICF-items was relevant for survivors of breast cancer, more than 1 year since diagnosis. After analysis, in which median scores of each ICF-items were determined, questionnaires for the second Delphi-round were composed from ‘highly relevant’ and ‘relevant’ health problems. With help of five researchers, consensus rules were devised to reach consensus between the expert panels of colorectal, lung, and breast cancer. These added extra items to the questionnaire. The second round of the Delphi study was intended to test whether the experts agreed that the ‘highly relevant’ items were to be added to the breast cancer consensus list and the ‘relevant’ items were to be dropped. Consensus rates of 80% from the 3 breast cancer experts panels and of 70% from the colorectal-, lung-, and breast cancer experts were required to make a selection of the final ICF-items. Results: In the first Delphi-round a panel of 53 experts agreed to participate. 39 of these experts completed the questionnaire and selected 12 ‘highly relevant’ and 108 ‘relevant’ ICF-items. A questionnaire with a total of 166 ICF-items was made using the consensus rules and presented again to the breast cancer experts. A total of 30 breast cancer experts selected 20 ‘highly relevant’ health problems from this questionnaire, for women with breast cancer, more than one year after their diagnosis. At the same time, a consensus list of 26 ICF-items, created with the help of 76 experts in the field of colorectal, lung, and breast cancer was provided which contained health problems these patient groups showed after more than one year since diagnosis. Conclusions: that can be drawn is that more than one year since the diagnosis of breast cancer, patients are still suffering from various health problems. This research provided a practical consensus list with ‘highly relevant’ health problems. At the same time, consensus between experts on the subject of colorectal, lung, and breast cancer provided a consensus list with health problems of patients with these 3 types of cancer, more than one year since diagnosis. The consensus lists are a good supplement to the existing screening tools and to the existing theoretical framework. Further research can be done concerning the implementation and validation of these consensus lists.

Item Type:	Thesis (Thesis)
Supervisor name:	Berendsen, Dr. A.J. and Wynia, Dr. K.
Faculty:	Medical Sciences
Date Deposited:	25 Jun 2020 10:43
Last Modified:	25 Jun 2020 10:43
URI:	https://umcg.studenttheses.ub.rug.nl/id/eprint/434

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