Publications by authors named "Janet M de Groot"

6 Publications

  • Page 1 of 1

Missing in Action: Reports of Interdisciplinary Integration in Canadian Palliative Care.

Curr Oncol 2021 07 16;28(4):2699-2707. Epub 2021 Jul 16.

Tom Baker Cancer Centre, Alberta Health Services, Calgary, AB T2N 4N2, Canada.

Palliative care has an interdisciplinary tradition and Canada is a leader in its research and practice. Yet even in Canada, a full interdisciplinary complement is often lacking, with psychosocial presence ranging from 0-67.4% depending on the discipline and region. We sought to examine the most notable gaps in care from the perspective of Canadian palliative professionals. Canadian directors of palliative care programs were surveyed with respect to interdisciplinary integration. Participants responded in writing or by phone interview. We operationalized reports of interdisciplinary professions as either "present" or "under/not-represented". The Vaismoradi, Turunen, and Bondas' procedure was used for content analysis. Our 14 participants consisted of physicians (85.7%), nurses (14.3%), and a social worker (7.1%) from Ontario (35.7%), British Columbia (14.3%), Alberta (14.3%), Quebec (14.3%), Nova Scotia (14.3%), and New Brunswick (7.1%). Psychology and social work were equally and most frequently reported as "under/not represented" (5/14, each). All participants reported the presence of medical professionals (physicians and nurses) and these groups were not reported as under/not represented. Spiritual care and others (e.g., rehabilitation and volunteers) were infrequently reported as "under/not represented". Qualitative themes included Commonly Represented Disciplines, Quality of Multidisciplinary Collaboration, Commonly Under-Represented Disciplines, and Special Concern: Psychosocial Care. Similar to previous reports, we found that (1) psychology was under-represented yet highly valued and (2) despite social work's relative high presence in care, our participants reported a higher need for more. These finding highlight those psychosocial gaps in care are most frequently noted by palliative care professionals, especially psychology and social work. We speculate on barriers and enablers to addressing this need.
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http://dx.doi.org/10.3390/curroncol28040235DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8293061PMC
July 2021

Reflecting on Palliative Care Integration in Canada: A Qualitative Report.

Curr Oncol 2021 07 19;28(4):2753-2762. Epub 2021 Jul 19.

Tom Baker Cancer Centre, Alberta Health Services, Calgary, AB T2N 4N2, Canada.

Studies have identified integrated interdisciplinary care as a hallmark of effective palliative care. Although models attempt to show how integration may function, there is little literature available that practically explores how integration is fostered and maintained. In this study we asked palliative care clinicians across Canada to comment on how services are integrated across the healthcare system. This is an analysis of qualitative data from a larger study, wherein clinicians provided written responses regarding their experiences. Content analysis was used to identify response categories. Clinicians ( = 14) included physicians, a nurse and a social worker from six provinces. They identified the benefits of formalized relationships and collaboration pathways with other services to streamline referral and consultation. Clinicians perceived a need for better training of residents and primary care physicians in the community and more acceptance, shared understanding, and referrals. Clinicians also described integrating well with oncology departments. Lastly, clinicians considered integration a complex process with departmental, provincial, and national involvement. The needs and strengths identified by the clinicians mirror the qualities of successfully integrated palliative care programs globally and highlight specific areas in policy, education, practice, and research that could benefit those in Canada.
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http://dx.doi.org/10.3390/curroncol28040240DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8293234PMC
July 2021

Living in two worlds: Becoming and being a doctor among those who identify with "not from an advantaged background".

Curr Probl Pediatr Adolesc Health Care 2019 04 3;49(4):92-101. Epub 2019 May 3.

Staff Psychiatrist, Foothills Medical Centre, Calgary, AB, Canada; Staff Psychiatrist, Tom Baker Cancer Centre, Calgary, AB, Canada; Associate Professor, Cumming School of Medicine, University of Calgary, AB, Canada. Electronic address:

We aim to deepen understanding of the experiences of becoming and being a physician among those in medicine who are 'not from advantaged backgrounds'. Despite modest success with institutional efforts to increase the diversity of medical school students, individuals with this less visible dimension of diversity remain under-represented across North America and the UK. Further, little is known about their experiences and contributions following medical school entry. In-depth interviews were carried out with twelve participants, including eight medical students, a resident and three physicians to explore experiences in medicine among those who self-identify with 'not from an advantaged background'. Reflection on the meaning of those experiences was encouraged. Intersectional identifications were common in relation to 'not from an advantaged background'. For some, the latter was background to identification with upbringings that were rural, influence by ethnicity, personal or parental immigration, and parents who were single or had limited education. Themes that arose in relation to being and becoming a doctor for these participants included: (1) the hidden curriculum's contribution to silencing markers of socioeconomic under-privilege; (2) limited formal curriculum opportunities to discuss socio-economic difference; (3) professional identity construction including empathy for the varied challenges of low-income patients in clinical situations and (4) living in two worlds: with a tension between the medical world and one's original world of socializing with friends and family from a non-advantaged upbringing. This study offered a unique, welcome opportunity to reflect on professional identity development in relation to one's family's socio-economic status. Safe, inclusive pedagogical opportunities to discuss socio-economic status and its intersectional elements, may support professional identity development that includes empathy and responsiveness to health inequities. The open dialogue, although perhaps uncomfortable, may be valuable to enhance cultural humility among medical students. The assessment of such initiatives in relation to professional identity formation is an important next step.
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http://dx.doi.org/10.1016/j.cppeds.2019.03.006DOI Listing
April 2019

An Axiological Analysis of One Medical School's Admissions Process: Exploring Individual Values and Value Systems.

Acad Med 2019 08;94(8):1229-1236

R.H. Ellaway is professor, Department of Community Health Sciences, and director, Office of Health and Medical Education Scholarship, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada. R.L. Malhi is research associate, Distributed Learning and Rural Initiatives, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada. W. Woloschuk is program evaluation consultant, Undergraduate Medical Education, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada. J.M. de Groot is associate professor, Departments of Psychiatry and Oncology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada. C.J. Doig is professor, Departments of Critical Care Medicine and Community Health Sciences, and current chair, Admissions Committee, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada. D. Myhre is professor, Department of Family Medicine, and associate dean, Distributed Learning and Rural Initiatives, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.

Purpose: Values and value systems are fundamental to medical school admissions processes. An axiological analysis was carried out to explore the individual values and value systems found within the University of Calgary's Cumming School of Medicine's undergraduate admissions process.

Method: A mixed-methods case study methodology was developed with a focus on applicant characteristics viewed as desirable, the relative value ascribed to applicant characteristics, the values that participants in admissions processes brought to bear, the values that were reflected in the artifacts and procedures used in support of admissions processes, and the values that were expressed at a system, program, or institutional level. The study employed a descriptive audit of admissions processes, a stakeholder survey, stakeholder interviews, and a discourse analysis of admissions materials (all carried out between June and September 2017).

Results: The study found that, despite a general sense of satisfaction with the rigor of the admissions process, there was less satisfaction with the final selection it produced. Participants wanted to see more attention paid to responsibilities to patients and society than to gender and ethnic balance.

Conclusions: Those involved with medical school admissions need to be mindful of their value systems and use them to align intent with process and outcomes in selecting tomorrow's physicians. Axiological analysis of medical education processes can play a central role in reviewing and refocusing efforts on meeting an institution's social mission and medical education's social contract.
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http://dx.doi.org/10.1097/ACM.0000000000002698DOI Listing
August 2019

Do single and partnered women with gynecologic cancer differ in types and intensities of illness- and treatment-related psychosocial concerns? A pilot study.

J Psychosom Res 2007 Sep 2;63(3):241-5. Epub 2007 Aug 2.

Department of Psychiatry, Foothills Medical Centre, Calgary, Alberta, Canada.

Objective: We compared the psychosocial and psychosexual concerns of single and partnered women with gynecologic cancer, since relationship status and psychosocial context are known to affect sexuality, a life domain commonly affected by this cancer.

Method: A cross-sectional convenience sample of 49 women (68% response), with ovarian (n=31), endometrial (n=12), and cervical (n=6) cancer, responded to a 72-item self-report Cancer Concerns Questionnaire and additional psychosocial questionnaires.

Results: Single (n=13) and partnered women (n=36) similarly reported prognosis as their highest concern, but single women (26% of the sample) reported that communication with the treatment team, treatment side effects, and prognosis were of greater salience to them than did partnered women. The latter group had greater sexuality and partner relationship concerns.

Conclusion: These preliminary findings suggest that relationship status, whether partnered or single, influences current psychosocial concerns among women with gynecologic cancer, despite similar levels of illness- and treatment-related intrusions on important life domains.
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http://dx.doi.org/10.1016/j.jpsychores.2007.02.011DOI Listing
September 2007
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