Barnes Elizabeth A, Fan Grace, Harris Kristin, Doyle Meagan, Librach Lawrence S, Chow Edward, Barbera Lisa, Tsao May, Lam Kelvin, Danjoux Cyril
Department of Radiation Oncology, Toronto Sunnybrook Regional Cancer Centre, 2075 Bayview Ave, Toronto, Ontario, Canada, M4N 3M5.
J Clin Oncol. 2007 Dec 20;25(36):5758-62. doi: 10.1200/JCO.2007.13.3082.
It is important for cancer patients to maintain continuity of care with their family physician (FP) while being followed at the cancer center. The primary objective of this study was to determine the perception of patients seen in the palliative Rapid Response Radiotherapy Program (RRRP) on FP involvement in their cancer care. Secondary objectives were to identify factors predicting for perceived FP involvement in patient cancer care.
Consecutive patients were approached for study enrollment at the time of RRRP visit and asked to complete a 15-item survey.
Three hundred sixty-five patients were accrued over 15 months. Ninety-eight percent had an FP, and 43% felt their FP was involved in their cancer care. Eighty percent of patients were satisfied with the overall medical care provided by their FP, and 71% had been with their FP for > or = 5 years. The most common reason patients gave for perceiving limited FP involvement was the medical oncologist looking after all of their cancer needs. Multivariate analysis found that satisfaction with overall medical care provided by the FP, shorter time since last FP visit, seeing the FP since cancer diagnosis, and FP providing on-call service for after-hour emergencies all significantly predicted for patients perceiving FP involvement in their cancer care.
Less than half of patients surveyed perceived their FP as involved in their cancer care. Encouraging continuity of care between patients and FPs may allow for easier transition of care back to the FP once palliative treatment at the cancer center has finished and help facilitate end-of-life planning.
癌症患者在癌症中心接受随访期间，与家庭医生保持连续的医疗护理至关重要。本研究的主要目的是确定在姑息性快速反应放射治疗计划（RRRP）中接受治疗的患者对家庭医生参与其癌症护理的看法。次要目的是确定预测家庭医生参与患者癌症护理的因素。
在RRRP就诊时连续招募患者进行研究，并要求他们完成一项包含15个项目的调查。
在15个月内共招募了365名患者。98%的患者有家庭医生，43%的患者认为其家庭医生参与了他们的癌症护理。80%的患者对家庭医生提供的整体医疗护理感到满意，71%的患者与家庭医生的合作时间≥5年。患者认为家庭医生参与有限的最常见原因是肿瘤内科医生满足了他们所有的癌症护理需求。多变量分析发现，对家庭医生提供的整体医疗护理的满意度、自上次看家庭医生以来的时间较短、自癌症诊断后看过家庭医生以及家庭医生提供夜间紧急情况的随叫随到服务，均显著预测患者认为家庭医生参与了他们的癌症护理。
接受调查的患者中，不到一半的人认为其家庭医生参与了他们的癌症护理。鼓励患者与家庭医生之间保持连续的医疗护理，可能有助于在癌症中心的姑息治疗结束后，更顺利地将护理转回到家庭医生手中，并有助于推动临终规划。
