Autore: RNCJPM20

  • Creazione di uno Sportello Linfologico a Reggio Emilia: un modello organizzativo integrato nella Rete Linfologica territoriale

    Implementation of a Lymphedema Counseling Service in Reggio Emilia: An Integrated Organizational Model within the Territorial Lymphedema Network

    Autori

    Dimatteo Mariangela (FT) – Medicina fisica e riabilitazione ASMN, AUSL-IRCCS di Reggio Emilia – Italia; Studente del master in Riabilitazione in linfologia clinica Universitaria La Sapienza di Roma

    Alice Pecorari (FT) Servizio RRF di Correggio, AUSL-IRCCS di Reggio Emilia, Italia; Studente del master in Riabilitazione in linfologia clinica Universitaria La Sapienza di Roma

    Bassoli Agnese (FT) Servizio NPIA, AUSL-IRCCS di Reggio Emilia, Italia; Laureanda magistrale in scienze riabilitative delle professioni sanitarie presso Univr – Università degli studi di Verona

    Piccinelli Barbara (Medico Fisiatra) Medicina fisica e riabilitazione ASMN, AUSL-IRCCS di Reggio Emilia, Italia

    Manfredi Nicoletta (FT) Medicina fisica e riabilitazione ASMN, AUSL-IRCCS di Reggio Emilia, Italia

    Giberti Tiziana (FT) Servizio RRF CNM, AUSL-IRCCS di Reggio Emilia, Italia

    Isabella Campanini, PhD LAM (Dip. Neuromotorio Riabilitativo) AUSL-IRCCS di Reggio Emilia

    Rancati Jacopo Matteo (Dirigente Professioni Sanitarie della Riabilitazione) Direzione Assistenziale, AUSL-IRCCS di Reggio Emilia, Italia

    Background and aims

    Lymphedema is a chronic, progressive, and disabling condition caused by impaired lymphatic transport, often resulting in substantial functional limitations and reduced autonomy.
    As with many chronic conditions, its management entails considerable healthcare expenditures. Current literature advocates for organizational models that enhance patient participation in the continuum of care.
    Institutional monitoring data indicate that, following completion of the physiotherapy cycle, patients frequently initiate informal contact with physiotherapists—typically in response to symptom recurrence or to request advice on newly arising concerns.

    Methods

    Within the existing territorial lymphedema rehabilitation network, a structured rehabilitative counseling service has been designed. The service is accessible via a secure digital platform, with the objective of formalizing, tracking, and expanding access to such informal consultations.
    This direct-access model aims to offer timely and appropriate responses to low-complexity rehabilitation needs. Each patient may access the service for up to two consultations—either in person or via telemedicine—allowing the physiotherapist to assess the case and propose suitable interventions. In cases requiring more comprehensive care, the physiotherapist may directly initiate referral for physiatric evaluation.

    Results

    The launch of the rehabilitative counseling service is scheduled for Autumn 2025, with an initial pilot phase involving two healthcare districts.
    Service requests will be managed through a secure online form, serving as the user interface for access. The structure of this form will be informed by observational data collected from patients who currently engage the service informally.
    Preliminary data suggest that the most frequently reported needs include: counseling on compression garments and bandaging techniques, verification of appropriate use of assistive devices, symptom self-management support, and lifestyle education.
    During the first year of implementation, the service is expected to handle approximately 100 requests, with over 50% of cases likely to be managed autonomously by physiotherapists, without requiring referral for physiatric consultation.
    In the long term, this model aims to reduce both the number of physiatric referrals and physiotherapy sessions for this patient population by approximately 10%.
    Additional indicators will be monitored to evaluate the model’s effectiveness, including: case typology, nature of the interventions provided, response times, and user satisfaction, leveraging data generated through the digital request platform.

    Conclusion

    The activation of a lymphedema counselling service represents an innovative model of care, based on therapeutic education, self-management and proximity of the intervention, accordig with DM 77/2022. The project enhances the physiotherapist as a territorial reference point within the lymphological network, helping to reduce inappropriate access to physiatric visits and repeated treatments.

    REFERENCES

    • Gyawali B, Bowman M, Sharpe I, Jalink M, Srivastava S, Wijeratne DT. (2023) A systematic review of eHealth technologies for breast cancer supportive care. Cancer Treatment 2023; 114: 102519.
    • Henkin JS, Botton CE, Simon MS, et al. Telehealth multicomponent exercise and health education in breast cancer patients undergoing primary treatment: rationale and methodological protocol for a randomized clinical trial (ABRACE: Telehealth). Trials. 2023; 24: 42.
    • Hernandez Silva E, Lawler S, Langbecker D. The effectiveness of mHealth for self-management in improving pain, psychological distress, fatigue, and sleep in cancer survivors: a systematic review. Journal of Cancer Survivorship. 2019; 13: 97-107.
  • La definizione del setting riabilitativo in fase prechirurgica può migliorare l’appropriatezza nei percorsi PTA e PTG? Ruolo del Fisioterapista Gestore Percorsi

    La definizione del setting riabilitativo in fase prechirurgica può migliorare l’appropriatezza nei percorsi PTA e PTG? Ruolo del Fisioterapista Gestore Percorsi

    La definizione del setting riabilitativo in fase prechirurgica può migliorare l’appropriatezza nei percorsi PTA e PTG? Ruolo del Fisioterapista Gestore Percorsi

    Can the Definition of the Rehabilitation Setting in the Pre-Surgical Phase Improve Appropriateness in Hip and Knee Replacement Pathways? The Role of the Physiotherapist as Pathway Manager

    Autori

    CARETTA INGRID – (Physical Medicine and Rehabilitation Unit, Santa Maria Nuova Hospital – Reggio Emilia, Azienda Unità Sanitaria Locale – IRCCS di Reggio Emilia – Italy.)

    BENASSI MONICA – (Orthopedic Unit, Santa Maria Nuova Hospital – Reggio Emilia, Azienda Unità Sanitaria Locale – IRCCS di Reggio Emilia – Italy)

    MAZZOLA SONIA – (Orthopedic Unit, Santa Maria Nuova Hospital – Reggio Emilia, Azienda Unità Sanitaria Locale – IRCCS di Reggio Emilia – Italy)

    MANFREDI NICOLETTA – (Physical Medicine and Rehabilitation Unit, Santa Maria Nuova Hospital – Reggio Emilia, Azienda Unità Sanitaria Locale – IRCCS di Reggio Emilia – Italy.)

    FIOCCHI ALENA – (Physical Medicine and Rehabilitation Unit, Santa Maria Nuova Hospital – Reggio Emilia, Azienda Unità Sanitaria Locale – IRCCS di Reggio Emilia – Italy)

    RANCATI JACOPO MATTEO – (Care Management Unit, Azienda Unità Sanitaria Locale – IRCCS di Reggio Emilia – Italy)

    Introduction

    Since the second half of 2020, our institution has introduced a pre-surgical planning model for rehabilitation pathways regarding patients scheduled for hip and knee replacement. The model involves profiling cases using the BRASS scale and a socio-environmental assessment. Profiling is carried out by the nurses of the Pre-Hospitalization Service and determines the discharge setting, whether inpatient or outpatient rehabilitation. The discharge destination is negotiated with the patients and recorded on specific electronic forms. The Pathway Manager Physiotherapist (FGP) monitors the surgical room schedule and pre-activates the networked rehabilitation services that will take over the cases after discharge. In the orthopedic ward, rehabilitation is initiated directly by physiotherapists, who, in collaboration with nursing and medical staff, inform the FGP of any need to reassess the pathway. In this study we report results about first 4 years of production.

    Methods

    During the first year of implementing the new model, a monitoring of several process indicators related to user adherence and pathway safety was developed by a specific database. This monitoring allowed to collect data relating to user participation and safety of pathway.

    In the meanwhile of implementation we activated some adjustments to increase the timeliness and appropriateness of post-surgical interventions, including the activation of the medical staff in case of complications directly activated by the physiotherapist. Moreover, the workflows for sending outpatient cases (by FGP) were refined to improve rehabilitation continuity with direct access pathways, involving the rehabilitation team in case of emerging complexities, as reported by the physiotherapist.

    In the long term, the analysis was conducted based on the discharge form (SDO) flows on an annual basis, monitoring indicators related to average length of stay and the percentage of discharge to other care settings.

    Results

    In the first year of implementation, 292 cases were profiled, and the user adherence rate to the proposed rehabilitation pathways was 88.7%. Factors that facilitated adherence to the outpatient pathway included the continuity of rehabilitation services offered and the fear of infectious risks associated with hospital stays (also due to the COVID-19 pandemic context). Obstacles included the absence of adequate family support and the presence of architectural barriers. No significant adverse events were recorded in the sample.

    The need to revise planned pathways due to the emergence of complications affected 13 cases out of the 280 actually undergoing surgical intervention.

    The SDO flows monitored annually from 2020 to 2023 highlighted a steady decline in cases managed in inpatient settings (from 50% to 30%), improving the appropriateness of settings, with no significant variations in the average length of stay (more detail in the attached images)

    Discussion and Conclusion

    The implemented model highlights that rehabilitation pathway planning for the examined cases can be standardized and defined in the pre-surgical phase without compromising patient safety. The intervention of the medical staff is necessary if the predetermined pathway exhibits complications and can be directly activated by the physiotherapist within the rehabilitation team.

    The model contributes to facilitating pathways in terms of intervention timeliness and rehabilitation continuity, concurrently improving appropriateness in the choice of care setting and resource utilization.

    The role of a Pathway Manager Physiotherapist (FGP) is functional in governing patient flows within the service network in collaboration with other involved professionals. The model is potentially exportable and replicable; it requires the establishment of an interconnected network of rehabilitation services, a structured rehabilitation team, and can contribute to cost containment.

    REFERENCES

    1. Gkagkalis, G., et al. (2019). “Are the cumulated ambulation score and risk assessment and prediction tool useful for predicting discharge destination and length of stay following total knee arthroplasty?” Eur J Phys Rehabil Med.
    2. Li, G., et al. (2019). “Factors associated with the length of stay in total knee arthroplasty patients with the enhanced recovery after surgery model.” J Orthop Surg Res 14(1): 343.
    3. Roger, C., et al. (2019). “Factors associated with hospital stay length, discharge destination, and 30-day readmission rate after primary hip or knee arthroplasty: Retrospective Cohort Study.” Orthop Traumatol Surg Res 105(5): 949-955.
    4. Shah, A., et al. (2019). “Preoperative Patient Factors Affecting Length of Stay following Total Knee Arthroplasty: A Systematic Review and Meta-Analysis.” J Arthroplasty 34(9): 2124-2165.e2121.
    5. Nuti, Vainieri, Bonini (2010). “Disinvestment for re-allocation: a process to identify priorities in healthecare.” Health Policy 95(2-3):137-43
  • Dall’implementazione della cartella riabilitativa basata sul modello tassonomico ICF, alla realizzazione di strumenti di valutazione della performance dei professionisti

    Dall’implementazione della cartella riabilitativa basata sul modello tassonomico ICF, alla realizzazione di strumenti di valutazione della performance dei professionisti

    Dall’implementazione della cartella riabilitativa basata sul modello tassonomico ICF, alla realizzazione di strumenti di valutazione della performance dei professionisti

    From the implementation of the rehabilitation record based on the ICF taxonomic model to the implementation of performance evaluation tools for healthcare professionals

    Autori

    RANCATI JACOPO MATTEO – (Care Management Unit, Azienda Unità Sanitaria Locale – IRCCS di Reggio Emilia – Italy)

    MONTECCHI MARIA GIULIA – (Neuro-Rehabilitation Unit, S. Sebastiano Hospital – Correggio, Azienda Unità Sanitaria Locale – IRCCS di Reggio Emilia – Italy)

    REVERBERI CRISTINA – (Care Management Unit, Azienda Unità Sanitaria Locale – IRCCS di Reggio Emilia – Italy)

    GUARESCHI ERIKA – (Information Technology Unit, Azienda Unità Sanitaria Locale – IRCCS di Reggio Emilia – Italy)

    ZEULI GIUSEPPE – (Information Technology Unit, Azienda Unità Sanitaria Locale – IRCCS di Reggio Emilia – Italy

    RICCO’ ROBERTA – (Care Management Unit, Azienda Unità Sanitaria Locale – IRCCS di Reggio Emilia – Italy)

    BOCCIA ZOBOLI ANTONIO – (Care Management Unit, Azienda Unità Sanitaria Locale – IRCCS di Reggio Emilia – Italy)

    Introduction

    The progressive digitization of healthcare documentation is compelling health professionals to change their operational habits related to record-keeping. The configuration of electronic health record (CCE) templates is strategically significant for service managers, both to facilitate this transition and to guide and monitor the professional behaviour of their collaborators.

    Based on taxonomic models from relevant literature in the rehabilitation field (International Classification of Functioning – ICF), our institution has configured a rehabilitative electronic health record template (CCE-R) along with a reporting system. The purpose of the present work is to present its contents in various application settings. Some of the indicators and standards outlined have been proposed for monitoring physiotherapists’ performance, especially in the context of specific diagnostic-therapeutic care pathways (PDTA).

    Methods

    The ICF references were used both in the development of rehabilitative assessment in inpatient and outpatient settings and in the configuration of the physiotherapist’s log in a consultancy context. The templates were prepared in macro-sections containing lists of descriptors (related to functions being assessed or activities performed) selectable with a dichotomous approach (0-1), followed by an analytical field to complete the description of the item in qualitative and quantitative terms. The choice of terminology was subject to interprofessional analysis to clear out any interpretative differences and standardize the semantics. The use of pre-configured closed fields and a single format of the CCE-R facilitated the preparation of reports with a transversal and overarching approach to the setting and disciplinary field of use.

    Results

    Structured reports return performance indicators for approximately 130 physiotherapists, distributed across 6 hospitals, based on the use of configured electronic forms.

    In both outpatient and inpatient settings, performance is evaluated based on the percentage of patients admitted through the completion of the initial, intermediate, and final assessment forms, the verification form of rehabilitation goals, and the discharge report.

    In both settings, performance was above 90% for the certification of the initial assessment and the verification form of rehabilitative goals. The same level of performance was observed for the final assessment and discharge letter, but only for the inpatient setting. Other indicators show performance that is not yet adequately structured, especially in the outpatient context (figure 2). In the consulting field, the disparity is even more pronounced, particularly when comparing hospitals with very different activity volumes and turnover rates (figure 1).

    Discussion and Conclusion

    The configuration of the CCE-R templates based on the ICF taxonomic model, through the direct involvement of representatives from professional groups, allowed for the creation of working tools. The aggregated data from the associated reporting provides an essential view of the professional behaviours of individual workgroups concerning record-keeping. The transversal and overarching approach to individual services or operational settings ensures comparability. Initial analyses showed that local practices were not always uniform across different contexts. The realignment of these discrepancies towards expected standards can be defined as work objectives to be assigned to the unit manager or professional group, for the purpose of performance evaluation and potentially the attribution of performance-based pay, with an objective and measured approach.

    REFERENCES

    1. Odone A, Buttigieg S, Ricciardi W, Azzopardi-Muscat N, Staines A. Public health digitalization in Europe. Eur J Public Health. 2019 Oct 1;29(Supplement_3):28-35.
    2. Kruse CS, Kristof C, Jones B, Mitchell E, Martinez A. Barriers to Electronic Health Record Adoption: a Systematic Literature Review. J Med Syst. 2016 Dec;40(12):252.
    3. Riferimenti normativi: D.Lgs.vo 150/09; D.Lgs.vo 75/2017; Delibera 5/2017 OIV-SSR.

     

  • Educazione terapeutica nella preparazione alla chirurgia protesica di anca e ginocchio: realizzazione di un supporto informativo audio-visivo.

    Educazione terapeutica nella preparazione alla chirurgia protesica di anca e ginocchio: realizzazione di un supporto informativo audio-visivo.

    Educazione terapeutica nella preparazione alla chirurgia protesica di anca e ginocchio: realizzazione di un supporto informativo audio-visivo.

    Therapeutic Education in Preparing for Hip and Knee Prosthetic Surgery: Development of an Audiovisual Informational Support

    Autori

    CASALINI GIULIA – ( Care Management Unit, Azienda Unità Sanitaria Locale – IRCCS di Reggio Emilia – Italy)

    MAGNANINI FRANCESCA – ( Care Management Unit, Azienda Unità Sanitaria Locale – IRCCS di Reggio Emilia – Italy)

    DE SANTIS ANNAMARIA – (Bachelor Degree in Digital Education – Modena and Reggio Emilia University – Italy)

    TEDESCHI CINZIA – (Bachelor Degree in Digital Education – Modena and Reggio Emilia University – Italy)

    PINNA VANESSA – (Bachelor Degree in Digital Education – Modena and Reggio Emilia University – Italy)

    FRANCESCA CIPOLLI – (Bachelor Degree in Physiotherapy – Modena and Reggio Emilia University – Italy)

    RANCATI JACOPO MATTEO – ( Care Management Unit, Azienda Unità Sanitaria Locale – IRCCS di Reggio Emilia – Italy)

    Introduction

    Therapeutic education processes in the perioperative phases are fundamental for patient engagement in developing self-care approaches aimed at improving rehabilitation outcomes. Literature shows that patients’ conscious participation in their therapeutic journey reduces recovery times, the risk of complications, and the use of healthcare resources. In our institution, the preparation of patients scheduled for hip and knee replacement surgery includes the use of numerous printed informational materials and varying approaches across different surgical facilities within the organization. The purpose of this study is to analyze the informational needs of patients, update and digitize the already available materials, and organize them on a single computerized platform. This platform will integrate audiovisual informational support to facilitate the therapeutic education process and an informed choice of post-surgical rehabilitation pathways.

    Methods

    For the reorganisation of the existing informational material, a collection and review of the contents available was carried out at the various hospital facilities involved in the surgical line. For the informative needs analysis, a questionnaire was prepared with the involvement of experienced digital health professionals. The questionnaire will be administered over a period of 2 months anonymously to a sample of patients undergoing rehabilitation treatment following surgery, with adherence on a voluntary basis. The data emerged will be processed with descriptive statistical analysis, in order to identify the prevalent and most significant needs.

    In parallel, semi-structured interviews will be conducted with some professionals involved in the programme, which will be analysed using qualitative analysis methodologies. The contents that emerged from both sources will be compared and used to create a story-board as the basis for the audio-visual, that will be realised with the technical, technological and methodological support of experienced professionals.

    Results

    The digital platform for organizing the existing informational supports has already been created and made available online. The content has been reviewed and updated thanks to the direct participation of the professionals involved in patient care throughout the various phases of the therapeutic process. The results of the questionnaires and interviews will be available by summer 2024. The storyboard will be created with the intent to align the communication needs of professionals with the patients’ informational needs. The audiovisual material is expected to be completed by the end of 2024. The digitization of informational supports is part of a general review of care pathways, with the long-term objective of reducing the average length of hospital stays and increasing discharges to home (with the simultaneous activation of outpatient rehabilitation pathways). Both indicators will be monitored using data generated from the hospital discharge form (SDO).

    Discussion and Conclusion

    Collaboration with experts in digital education is strategic in analyzing the communication needs within healthcare pathways to align the needs of professionals with those of patients, and in creating more effective tools and informational supports.

    The digitization of informational supports and their availability on a single electronic platform aligns with the PNRR processes impacting the healthcare system, facilitating accessibility and usability at every stage of the pathway, while reducing indirect logistical costs (printing, storage, distribution) and environmental impact.

    The implementation of therapeutic education processes promotes the proactive involvement of patients in their own care pathway, increasing their empowerment and adherence to self-care processes. These strategies help improve the appropriateness of the use of rehabilitation settings, promote outpatient trajectories, and reduce the overall economic impact of the care pathway.

    REFERENCES

    • Abu Abed Manar, Himmel Wolfgang, Vormfelde Stefan, Koschack Janka. Video-assisted patient education to modify behavior: a systematic review. Patient Education Counseling. 2014;97(1):16-22
    • McDonald Steve, Page Matthew J, Beringer Katherine, Wasiak Jason, Sprowson Andrew. Preoperative education for hip or knee replacement. Cochrane Database Systematic Reviews. 2014; 13(5)
    • Tom Kathleen, Phang Terry P. Effectiveness of the video medium to supplement preoperative patient education: A systematic review of the literature. Patient Education Counseling. 2022;105(7):1878-1887
    • Wainwright Thomas W, Gill Mike, McDonald David A, Middleton Robert G, Reed Mike, Sahota Opinder, Yates Piers, Ljungqvist Olle. Consensus statement for perioperative care in total hip replacement and total knee replacement surgery: Enhanced Recovery After Surgery (ERAS®) Society recommendations. Acta Orthopaedica. 2020; 91(1):3-19

  • Proposta di due indicatori percentuali per misurare la libertà di movimento articolare e segmentale utili ai fini gestionali

    Proposal of two percentage indices to measure overall joint mobility and segmental mobility useful for managerial purposes

    Introduction

    Outcome measures used in physiotherapy are typically intended and validated for a particular disease, joint or setting [ 1 ]. For clinical purposes, this is the correct approach. However, functional recovery cannot be compared between different anatomical districts or among different diseases. Such a comparison would be extremely useful at the management level to monitor the overall effectiveness of the physiotherapy interventions.

    To address this issue, we developed and tested two indices of joint mobility and segmental mobility that can be used for all joints and with a 0-100 scoring system. Joint mobility depends on the anatomical structural constraints of the joint. Segmental mobility is also affected by other non-anatomical variables, such as pain and muscle strength.

    Methods

    The joint mobility index (JMI) was computed for each joint as follows: 1) the ROM measurement methodology was standardized according to available literature [ 2 ]; 2) joint maximum excursion in each direction was measured and expressed as a percentage of its normative reference value [ 2 ], leading to a 0-100 grading; and 3) the mean value among all possible joint movements (e.g., flexion, extension, abduction, etc.) was computed. JMI was computed for the following joints: shoulder, elbow, wrist, hip, knee, and ankle (non-axial joints).

    With the same approach, the segmental mobility index (SMI) was also computed. This is a multi-dimensional index that takes into account JMI (as computed above), pain at rest, pain during movement, and strength. Pain was assessed using the verbal numeric rating scale [ 3 ]. Muscle strength was measured with the appropriate Manual Muscle Test. Variables were expressed as a percentage of the corresponding normative value and averaged to produce SMI.

    Results

    A form for JMI computation has been created and added to the electronic medical record of our institution. (Figure 1a). It allows for JMI computation for both the affected and contralateral side (when needed), during active and passive movements, and in subsequent assessment (e.g., admission, hospital stay, discharge). An example of its use is presented for the shoulder joint in Figure 1b, where the increase in SMI (last column) can be seen. An example of the use of SMI is presented in Figure 1c. The increase in both numerical values and plot area is clearly visible.

    Discussion and Conclusion

    We developed two indices that can be used to follow the recovery in joint mobility and segmental mobility in patients with different diseases and in different settings. Their feasibility and usefulness are currently under test at our institution.

    ROM measurements and clinical scales remain key in clinical practice and at the single-patient level. The two proposed indices, one unidimensional and one multidimensional, could be useful at the organizational and managerial level thus providing a broad overview of patients’ recovery following physiotherapy interventions in a ward, a unit, or a hospital.

    Further improvements can be added to the current indices, such as the use of age- and gender-matched normative values and the inclusion of other disorders that could hinder segmental mobility (e.g., lymphedema, scar tissue complications, etc.).

    REFERENCES

    1. Haigh R, Tennant A, Biering-Sørensen F, Grimby G, Marincek C, Phillips S, Ring H, Tesio L, Thonnard JL. The use of outcome measures in physical medicine and rehabilitation within Europe. J Rehabil Med. Novembre 2001; 33(6):273-8.
    2. Clarkson HM, Gilewich GB. Valutazione cinesiologica. Esame della mobilità articolare e della forza muscolare. 2° Ed. Milano: Edi.Ermes; 2002. 432 p.

  • Educazione terapeutica in seguito a chirurgia al seno. Sviluppo di supporto informativo audiovisivo.

    Therapeutic education after breast surgery: implementation of audio-visual informational support.

    Introduction

    Therapeutic education is an essential element in all peri-operative stages and are key for patient engagement when administering self-care programs. Existing literature clearly states that an informed participation on behalf of patients during the course of treatment reduces the risk of complications, shortens recovery time, and consequently optimizes the use of healthcare resources [1,2].

    At Azienda USL-IRCCS of Reggio Emilia, the “Breast-PDTA” (Therapeutic Diagnostic Care Path) involves structured therapeutic educational interventions led by both nursing staff and physiotherapists. This is often done both verbally, by giving routine notions on standard care, and with pamphlets and brochures.

    PDTA monitoring data has on average 450 cases/year. Unfortunately, less than 65% of patients participate in therapeutic education group sessions led by PTs. Based on patients’ feedback, we created an audiovisual support to facilitate the therapeutic and educational process.

    Methods

    At first, we collected and reviewed the material already available at the services involved in the Breast-PDTA of our Institution and on The Web. Then, we conducted a focus group involving women previously treated for breast cancer according to the Breast-PDTA. The sample was recruited voluntarily by local patient associations. Data collection and analysis was conducted according to the methodology for qualitative studies. Based on the information on patient needs gathered via the focus group, a multi-professional group created the storyboard of the audiovisual material. This was created to be also used at other institutions in Emilia-Romagna for the years to come.

    Results

    The qualitative survey highlighted the users’ needs for additional information and more practical suggestions on how to become more self-sufficient including everyday activities especially in the immediate postoperative period, when exercising and during job-related activities. Users stated they would prefer to receive this information during the pre-surgical stage, rather than after surgery when issues related to surgical wound management and drainage may arise.

    An in-depth analysis of available materials revealed a large but haphazard informational support available in PDF format. However, this information is difficult to access for both professionals and patients alike. All available information was now reordered onto a single internet page that can be reached by a link or a QR-Code (See Figure). The storyboard has been created and the audiovisual support is scheduled to be published in the fall of 2023 on the same webpage.

    Discussion and Conclusion

    The focus group revealed a partial discrepancy between the content put forward by the healthcare professionals and the real informational needs of the users, who were primarily interested in being self-sufficient in their ADLs, addressing the potential need for assistance, and wished to resume physical exercise and job-related activities.

    The new audiovisual support does not replace the role of health professionals in the educational process. On the contrary, it can empower the professionals’ role by freeing up time to devote to listening to patients. This may help women become more aware and prepared to face the therapeutic process, right from the pre-surgical stages.

    The reorganization and improvement of the existing information on a single webpage is consistent with the user-friendly digitization process the healthcare system is currently undergoing. The reorganization of material and audiovisual publication will be the subject of future analysis as part of PDTA monitoring.

    REFERENCES

    1. Gyawali B, Bowman M, Sharpe I, Jalink M, Srivastava S, Wijeratne DT. (2023) A systematic review of eHealth technologies for breast cancer supportive care. Cancer Treatment Reviews. 2023; 114: 102519
    2. Singleton AC, Raeside R, Hyun KK, Partridge SR, Di Tanna GL, Hafiz N, Tu Q, Tat-Ko J, Sum SCM, Sherman KA, Elder E, Redfern J. Electronic Health Interventions for Patients with Breast Cancer: Systematic Review and Meta-Analyses. Journal of Clinical Oncology. 2022; 40: 2257-2270.