Svrha: Svrha ove studije bila je istražiti kako onkolozi u Hrvatskoj koriste testove sekvenciranja sljedeće generacije (engl. next generation sequencing – NGS) za procjenu pacijenata oboljelih od ...raka. Metode: U razdoblju od 1. rujna do 2. listopada 2022. provedeno je istraživanje putem elektroničke anonimne Google form online ankete poslane na adrese elektroničke pošte onkologa iz baze podataka Hrvatskog društva za internističku onkologiju (N=120, stopa suradnje 62%). Cilj istraživanja bio je utvrditi koliko često koristimo NGS-testove u onkološkoj praksi u Hrvatskoj, u kojim indikacijama i za koju svrhu, imamo li problema s interpretacijom rezultata NGS-a te utječu li rezultati NGS-a na našu odluku o liječenju bolesnika. Zanimalo nas je i koliko smo zadovoljni uvjetima molekularnog testiranja u Hrvatskoj te koji su trenutačno najveći izazovi molekularnog testiranja u Hrvatskoj iz perspektive onkologa. Rezultati: Većina onkologa izjavila je da koriste NGS-testove u svojoj kliničkoj praksi (25% često, 60% ponekad). Testiranje uglavnom koriste kod bolesnika s rijetkim tumorima i uznapredovalom refraktornom malignom bolešću (57%) te tumorima nepoznatoga primarnog sijela (50%). Najčešći su razlozi za korištenje NGS-a: osiguravanje ciljane terapije odobrene od strane osiguravatelja (75%), liječenje putem milosrdne ili primjene lijeka off-label (69%) ili radi utvrđivanja prihvatljivosti za klinička ispitivanja (33%). Većina ispitanika ima problema s interpretacijom rezultata NGS-a (71% ponekad, 8% često) i rezultati NGS-a utječu na odluku o liječenju kod većine onkologa (29% često, 64% ponekad). Većina ispitanika nije zadovoljna trenutnim uvjetima molekularnog testiranja u Hrvatskoj (60% djelomično zadovoljno, 32% nezadovoljno). Najveći su izazovi molekularnog testiranja sljedeći: nemogućnost liječenja sukladno rezultatima ispitivanja (81%), vrijeme potrebno za dobivanje rezultata (52%), dodatni financijski izdatci (38%) te interpretacija rezultata testa (37%). Zaključak: Većina onkologa u Hrvatskoj koristi NGS-testove u svojoj kliničkoj praksi i rezultati NGS-a u znatnoj mjeri utječu na odluke o liječenju. Potrebno je poboljšati uvjete molekularnih ispitivanja u Hrvatskoj i pružiti podršku pri interpretaciji rezultata NGS-a.
Onkologija predstavlja važan segment sveukupnoga hrvatskoga zdravstvenog sustava. Sama onkologija
jedna je od trenutačno najpropulzivnijih medicinskih struka te smo svakodnevno svjedoci ekspanzivnog ...rasta
novih modaliteta onkološkog liječenja. Ove činjenice nameću imperativ stvaranja onkološke mreže koja bi kao
zadatak imala standardiziranje onkološkog liječenja i osiguravanje dostupnosti novih modaliteta liječenja za sve
oboljele od zloćudnih bolesti, neovisno o njihovom mjestu boravka.¹ Hrvatska već ima prepoznate i definirane
regionalne onkološke centre u sklopu kliničkih bolničkih centara u Zagrebu, Rijeci, Osijeku i Splitu. Nasreću, u
Hrvatskoj postoji tradicija, stara nekoliko desetljeća, razvoja onkoloških centara u općim i županijskim bolnicama.
Poimence, to su neklinički onkološki centri u Županijskoj bolnici Čakovec, Općoj bolnici Dubrovnik, Općoj bolnici
Karlovac, Općoj bolnici Koprivnica, Općoj bolnici Pula, Općoj bolnici Slavonski Brod, Općoj bolnici Šibenik, Općoj
bolnici Varaždin i Općoj bolnici Zadar. Svrha ovoga istraživanja, provedenog u svim nekliničkim onkološkim
centrima
Hrvatske te korištenjem podataka Državnog zavoda za statistiku i Hrvatskog zavoda za zdravstveno osiguranje,
bila je uvidjeti kako je trenutno organizirana onkološka skrb u Republici Hrvatskoj i koja je uloga nekliničkih
onkoloških centara u liječenju bolesnika sa zloćudnim bolestima u Republici Hrvatskoj.
The treatment of oncological patients must be based upon multidisciplinary approach, and takes place in specialized oncological centers. By the end of a specific oncological treatment further ...follow-up is being managed mostly by the oncologists, but the role of the general practitioners becomes more important every day and therefore should be precisely defined. Nowadays, most of the existing follow-up guidelines are not based on prospective studies, but on the experts opinion of individual oncological centers or specialists. The aim of the Croatian Society of Medical Oncology (CSMO) with these recommendations is to standardize and rationalize the diagnostic procedures algorithm in the follow-up of oncological patients after primary treatment, in patients with neuroendocrine neoplasms, hepatocellular carcinoma, pancreatic cancer and cancer of the bile ducts.
Purpose
Oncologists are predisposed to developing burnout syndrome. Like other health care professionals worldwide, oncologists have endured additional, extreme challenges during the Covid-19 ...pandemic. Psychological resilience presents a potential protective mechanism against burnout. This cross-sectional study examines whether psychological resilience eased burnout syndrome among Croatian oncologists during the pandemic.
Methods
An anonymized self-reporting questionnaire was electronically distributed by the Croatian Society for Medical Oncology to 130 specialist and resident oncologists working in hospitals. Available for completion from September 6–24, 2021, the survey comprised demographic questions; the Oldenburg Burnout Inventory (OLBI), covering exhaustion and disengagement; and the Brief Resilience Scale (BRS). The response rate was 57.7%.
Results
Burnout was moderate or high for 86% of respondents, while 77% had moderate or high psychological resilience. Psychological resilience was significantly negatively correlated with the OLBI exhaustion subscale (
r
= − .54;
p
< 0.001) and the overall OLBI score (
r
= − .46;
p
< 0.001). Scheffe’s post hoc test showed that oncologists with high resilience scored significantly lower on the overall OLBI (
M
= 2.89; SD = 0.487) compared to oncologists with low resilience (
M
= 2.52; SD = 0.493).
Conclusion
The findings thus indicate that oncologists with high psychological resilience are at significantly lower risk of developing burnout syndrome. Accordingly, convenient measures to encourage psychological resilience in oncologists should be identified and implemented.
Confronting a breast cancer diagnosis, along with complex and challenging treatment procedures, is an extremely stressful experience. Psychological resilience is the ability to maintain or restore ...normal functioning while facing adversity. We aimed to explore the impact of an early breast cancer diagnosis on psychological resilience, distress, and perception of health. A cross-sectional study was conducted, including 50 patients newly diagnosed with early breast cancer and 67 healthy women with screening mammograms graded 1 or 2 using a Breast Imaging Reporting and Data System. The levels of distress, perception of health, and psychological resilience were assessed using the depression, anxiety, and stress scale, the SF 36-Item Health Survey 1.0, and the Connor–Davidson RISC-25 scale. Differences between variables were examined using the t-test and chi-square test for interval and categorial variables. The surveys were conducted within four weeks of a breast cancer diagnosis. Patients with breast cancer reported a deterioration of their health relative to the previous year and significantly higher levels of psychological resilience, while there was no significant difference between the groups in levels of stress, anxiety, or depression. The process of diagnosis with early breast cancer may activate psychological dynamic processes which are involved in the effective adaptation to acute stress, leading to higher resilience levels in breast cancer patients compared to healthy controls.
Information on the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), later termed coronavirus disease (COVID-19), first emerged by the end of 2019. As the pandemic spread, cancer patients ...were immediately recognized as a high-risk population with regard to COVID-19 infection. Moreover, epidemiological measures, like social distancing and lockdowns, additionally burdened patients with cancer. Even outside pandemic breast cancer patients are prone to psychological distress with prevalence ranging approximately 20-40%. This multicentric study aimed to examine the impact of COVID-19 pandemic on the level of distress among breast cancer patients in Croatia while the first wave of COVID-19 pandemic.
Fife hundred forty-five breast cancer patients were offered to participate in the study. A total of two hundred and one patient, with disease stages ranging I-IV, completed the questionnaire. The questionnaire consisted of disease and socio-demographic characteristics followed by the Distress Thermometer and a problem list. The cut off value of 4 was used to define the high level of distress within Distress Thermometer.
High distress level was reported in 54.2% of patients. The most significant problems reported by the participants of our study affected emotions, causing worry, sadness, depression, fear, and nervousness. Additionally, specific practical problems emerged (e.g., child care, housing, and work/school), most probably partly due to the lockdowns and social distancing. Interestingly enough, none of the socio-demographic or disease characteristics were linked to the level of distress.
During first wave of COVID-19 pandemic more than half of breast cancer patients, undergoing active oncologic treatment, experienced a high level of distress. Therefore, distress driven by the COVID-19 pandemic should be promptly addressed and additional psychological and social support, targeting specific practical and emotional problems, should be provided for those patients. All the more so as global COVID-19 pandemic far exceeded the duration of the first wave.
The coronavirus disease (COVID-19) pandemic has greatly affected the oncology community worldwide. Lockdowns, an epidemiological measure, have made it difficult for oncologists to provide care. In ...this study, we analysed the impact of the COVID-19 pandemic on Croatian cancer care.
This was a multicentre cross-sectional observational study of 422 patients who received systemic oncology therapy during the pandemic. The patients completed a survey to capture their views on the impact of the COVID-19 pandemic on their cancer care. Univariate descriptive and bivariate analyses were performed to analyse the relationship between the patients' perspective on the impact of the COVID-19 pandemic on cancer care and the quality of Croatian cancer care and their clinical and sociodemographic data.
Discontinuation or change in cancer treatment during the COVID-19 pandemic was observed in 10.2% of cases. Most did not change their place of treatment owing to the lockdown (97.6%). 14.7% of the patients felt that the quality of cancer care received had changed during the pandemic.
In the first few months of the pandemic, Croatia had a favourable epidemiological situation. However, 25% of patients with cancer reported that the pandemic affected cancer treatment and the quality of cancer care.
Liječenje onkoloških bolesnika mora se temeljiti na multidisciplinarnom pristupu, a provodi se u specijaliziranim onkološkim centrima. Nakon završetka specifičnog onkološkog liječenja daljnje ...praćenje uglavnom provode onkolozi, ali je uloga liječnika primarne zdravstvene zaštite (PZZ) sve važnija i potrebno ju je jasno definirati. Trenutačno se većina preporuka za praćenje ne temelji na prospektivnim studijama, već se zasniva na stručnim mišljenjima pojedinih onkoloških centara ili specijalista. Hrvatsko društvo za internističku onkologiju (HDIO) ovim preporukama želi standardizirati i racionalizirati dijagnostičke postupke u praćenju onkoloških bolesnika, nakon završetka primarnog liječenja, u bolesnika s neuroendokrinim neoplazmama, hepatocelularnim karcinomom, rakom gušterače i rakom žučnih vodova.
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