Browsing by Author "Gillis, Chelsia"

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    ERAS From the Patient Perspective
    (2016-10-08) Gill, Marlyn; Zelinsky, Sandra; Gillis, Chelsia; Nguyen, Susan
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    Feasibility of a multimodal exercise, nutrition, and palliative care intervention in advanced lung cancer
    (2021-02-13) Ester, Manuel; Culos-Reed, S. N; Abdul-Razzak, Amane; Daun, Julia T; Duchek, Delaney; Francis, George; Bebb, Gwyn; Black, Jennifer; Arlain, Audra; Gillis, Chelsia; Galloway, Lyle; Capozzi, Lauren C
    Abstract Background Advanced lung cancer patients face significant physical and psychological burden leading to reduced physical function and quality of life. Separately, physical activity, nutrition, and palliative symptom management interventions have been shown to improve functioning in this population, however no study has combined all three in a multimodal intervention. Therefore, we assessed the feasibility of a multimodal physical activity, nutrition, and palliative symptom management intervention in advanced lung cancer. Methods Participants received an individually tailored 12-week intervention featuring in-person group-based exercise classes, at-home physical activity prescription, behaviour change education, and nutrition and palliative care consultations. Patients reported symptom burden, energy, and fatigue before and after each class. At baseline and post-intervention, symptom burden, quality of life, fatigue, physical activity, dietary intake, and physical function were assessed. Post-intervention interviews examined participant perspectives. Results The multimodal program was feasible, with 44% (10/23) recruitment, 75% (75/100) class attendance, 89% (8/9) nutrition and palliative consult attendance, and 85% (17/20) assessment completion. Of ten participants, 70% (7/10) completed the post-intervention follow-up. Participants perceived the intervention as feasible and valuable. Physical activity, symptom burden, and quality of life were maintained, while tiredness decreased significantly. Exercise classes prompted acute clinically meaningful reductions in fatigue, tiredness, depression, pain, and increases in energy and well-being. Conclusion A multimodal physical activity, nutrition, and palliative symptom management intervention is feasible and shows potential benefits on quality of life that warrant further investigation in a larger cohort trial. Trial registration NCT04575831 , Registered 05 October 2020 – Retrospectively registered.
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    Prehabilitation for Enhanced Recovery After Colorectal Surgery
    (2020-06-08) Gillis, Chelsia; Fenton, Tanis R.; Gramlich, Leah M.; Culos-Reed, Susan Nicole; Sajobi, Tolulope T.
    Background: Postoperative morbidity is largely the product of the preoperative condition of the patient, the quality of surgical care provided, and the degree of surgical stress elicited. Enhanced Recovery After Surgery (ERAS) minimizes surgical stress with standardized evidence-based perioperative care; yet the ERAS care elements focus mainly on the intra- and postoperative periods, which may not sufficiently enhance recovery if preoperative patient-related factors have not been modified before surgery. Prehabilitation programs aim to enhance recovery by targeting the preoperative condition of the patient.Methods: This dissertation includes four manuscripts that broadly contribute to the evidence that supports the hypothesis that the patient’s preoperative status modifies outcomes in colorectal surgery. Results: First, intermediately frail and frail patients with poor functional walking capacity before surgery suffer more postoperative complications than patients with better functional walking capacity. Second, nutrition prehabilitation, with and without exercise, reduces mean length of hospital stay by two days. Third, patient interviews suggest that patients support the idea of using prehabilitation to enhance their preoperative condition. Finally, the last manuscript offers methodological suggestions to measure and analyze external variables as a means of advancing the prehabilitation literature and further enhancing patient outcomes. Conclusion: The findings of this doctoral dissertation add to the growing body of evidence that the process of surgical recovery begins before surgery. Prehabilitation interventions can be applied to support better postoperative recoveries.
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    Stillbirth, still life: A qualitative patient-led study on parents’ unsilenced stories of stillbirth
    (2017) Roland, Brenda; Wheatley, Venesa; Jones, Ashley; Gillis, Chelsia
    Objective: Explore parents’ experiences of stillbirth using a patient-led qualitative approach. Methods: Parents who had experienced stillbirth in the previous 5 years were recruited through posters and snowball sampling, each participating in one or more data collection event. We conducted a co-design focus group to set the direction of our research, narrative interviews, and a reflect focus group to engage parents in finalizing the analysis and findings. Data were analysed iteratively using a participatory grounded theory approach. Results: Parents’ (n=11) experiences tended to be expressed in the form of two narratives: clinical and personal; the historical silent discourse permeated both narratives. The clinical experience, Abandoned in silence, was sub-divided into three categories: 1) Lead me through the decision with one sub-category: Recognize that I am having a birth and death experience; 2) I need specialized care now; and 3) I need specialized care later. The personal experience, Shrouded in silence, was sub-divided into three categories: 1) I survived the space between; 2) I am learning to forge a new path; and 3) My daughter’s name is Charlotte. Stillbirth is a story of death, but it is also a story of life. In stillbirth, parents require the space to experience both the birth and death elements of the story; yet, one or both elements are often silenced. Stillbirth, still Life was the core concept that emerged from parents’ stories of their stillborn babies. Conclusion: Parents’ narratives are driven by the need to honour their babies’ lives. They are learning to be unsilenced.
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    Surgical frailty assessment: a missed opportunity
    (2017-07-24) Eamer, Gilgamesh; Gibson, Jennifer A; Gillis, Chelsia; Hsu, Amy T; Krawczyk, Marian; MacDonald, Emily; Whitlock, Reid; Khadaroo, Rachel G
    Abstract Background Preoperative frailty predicts adverse postoperative outcomes. Despite the advantages of incorporating frailty assessment into surgical settings, there is limited research on surgical healthcare professionals’ use of frailty assessment for perioperative care. Methods Healthcare professionals caring for patients enrolled at a Canadian teaching hospital were surveyed to assess their perceptions of frailty, as well as attitudes towards and practices for frail patients. The survey contained open-ended and 5-point Likert scale questions. Responses were compared across professions using independent sample t-tests and correlations between survey items were analyzed. Results Nurses and allied health professionals were more likely than surgeons to think frailty should play a role in planning a patient’s care (nurses vs. surgeons p = 0.008, allied health vs. surgeons p = 0.014). Very few respondents (17.5%) reported that they ‘always used’ a frailty assessment tool. Results from qualitative data analysis identified four main barriers to frailty assessment: institutional, healthcare system, professional knowledge, and patient/family barriers. Conclusion Across all disciplines, the lack of knowledge about frailty issues was a prominent barrier to the use of frailty assessments in practice, despite clinicians’ understanding that frailty affects their patients’ outcomes. Confidence in frailty assessment tool use through education and addressing barriers to implementation may increase use and improve patient care. Healthcare professionals agree that frailty assessments should play a role in perioperative care. However, few perform them in practice. Lack of knowledge about frailty is a key barrier in the use of frailty assessments and the majority of respondents agreed that they would benefit from further training.