改善儿童癌症成年幸存者的医疗保健：健康政策专家德尔菲小组的建议
Improving health care for adult survivors of childhood cancer: recommendations from a delphi panel of health policy experts.
作者信息
Mertens Ann C, Cotter Kelly L, Foster Barbara M, Zebrack Brad J, Hudson Melissa M, Eshelman Debra, Loftis Lauren, Sozio Margaret, Oeffinger Kevin C
机构信息
Division of Pediatric Epidemiology and Clinical Research, 420 Delaware St. SE, MMC 715, Minneapolis, MN 55455, USA.
出版信息
Health Policy. 2004 Aug;69(2):169-78. doi: 10.1016/j.healthpol.2003.12.008.
OBJECTIVES
To identify barriers to, models of care for, and initiatives to improve health care of adult survivors of childhood cancer.
METHODS
Seventeen health care policy experts were asked to respond to the three objectives through a three-iterative Delphi process.
RESULTS
Key barriers identified were that primary care physicians are unfamiliar with the health problems of survivors and survivors are often unaware of their risks. The recommended model of care would incorporate the chronic disease management model. Highest priority initiatives recommended were targeted education of primary care physicians and survivors, development and evaluation of standards of survivorship care, and a national web-based information center.
CONCLUSIONS
The insights and recommendations of the panel provide a foundation intended to improve health care of cancer survivors.
目标
确定成年期儿童癌症幸存者医疗保健的障碍、护理模式及改善措施。
方法
通过三轮德尔菲法，邀请17位医疗保健政策专家针对上述三个目标做出回应。
结果
确定的主要障碍是初级保健医生不熟悉幸存者的健康问题，且幸存者往往未意识到自身风险。推荐的护理模式应纳入慢性病管理模式。推荐的首要举措是对初级保健医生和幸存者进行针对性教育、制定和评估幸存者护理标准，以及建立一个全国性的网络信息中心。
结论
专家小组的见解和建议为改善癌症幸存者的医疗保健奠定了基础。
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