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  • br Results br Referral Process

    2019-11-11


    Results
    Referral Process
    On reviewing the referral forms, it Norfloxacin was found that patients were referred for reflexology largely by their breast care nurse or their consultant; more specifically, 39% were referred by their breast care nurse, 30% by their consultant clinician, 12% by the family history nurse, and 19% by an unknown referrer. Referral forms were analyzed with correlating MYCaW forms to determine if the reason for referral to the service by the referrer matched the patient’s concern. It was found that of those referred, 32% were referred for a reason matching their concern at the outset of reflexology and 35% were not. The remaining 35% were unknown as it was not clearly indicated on the initial referral.
    ConcernsePatient Rationale for Attending
    On completing the MYCaW form, all patients had the oppor-tunity to highlight 1 or 2 concerns for which they were seeking varying degrees of alleviation. Patients chose to provide 1 or 2 concerns independently (Figure 3). Overall, 93 concerns were re-ported by 52 patients; 62 concerns across the BC group (30 pa-tients) and 31 from the NBC group (22 patients).
    Using the MYCaW guidelines, patient-reported concerns were sorted into 5 super categories. These were: (1) psychological and emotional concerns; (2) physical concerns; (3) hospital cancer treatment concerns; (4) concerns about well-being; and (5) practical concerns. The NBC group concerns fell into 2 of the super category groups, psychological and emotional concerns and physical concerns, as shown in Figure 3. The breast cancer group concerns fell into 4 of the super category groups: psychological and emotional concerns, physical concerns, hospital cancer treatment concerns, and concerns about well-being, as shown in Figure 4.
    The Impact of Reflexology on Breast Cancer Patients
    Figure 5 Overall Change in MYCaW Score (A), Well-being (B), and Total Concerns (C) for Both Patients With and Without Breast Cancer (n [ 52). There is a Significant Improvement of 42.4% in the MYCaW Score, 41.2% in Well-being and 44.2% in Total Concern (Lower Scores are Better). This is Statistically Significant When Performing Parametric Paired t tests Using Graphpad Prism Version 7 (P < .0001 for all Groups; **** in Graphs)
    Abbreviation: MYCaW ¼ Measure Yourself Concerns and Wellbeing.
    Overall Combined Outcomes
    Of the 52 patients who completed the MYCaW survey, 50 re-ported an improvement in their initial concerns (ie, 96% of the patients demonstrated via MYCaW antidiuretic hormone (ADH) reflexology was of benefit to them). There was an overall improvement of 42.4% in the pa-tients’ MYCaW score before and after intervention, which was statistically significant (P < .0001). There was an overall improvement of 41.2% in patient well-being and 44.2% change in patient concerns (P < .0001 for both) (Figure 5).
    Outcomes in Patients With Breast Cancer
    Concerns were graded by the individual at the beginning of the treatment and then regraded at the end of treatment. Within the breast cancer group, all patients reported an improvement in their MYCaW profile score. There was an improvement of 46.8% in the
    MYCaW score, a 43.4% change in well-being, and a 46.2% improvement in the initial concerns raised (P < .0001) (Figure 6). The improvements were further broken down into the 4 super categories as discussed above. The patient grading was converted into a percentage change in order to compare outcomes for each super category: a 42.4% improvement was reported for psycho-logical and emotional concerns and a 45.9% improvement in physical concerns. There was a further 41.2% improvement in concerns about hospital cancer treatment outcomes and a 35.7% improvement in concerns about well-being (Table 1).