Absolom K, Eiser C, Michel G, Walters S J, Hancock B W, Coleman R E, Snowden J A, Greenfield D M
Department of Psychology, University of Sheffield, Sheffield S10 2SJ, UK.
Br J Cancer. 2009 Aug 18;101(4):561-7. doi: 10.1038/sj.bjc.6605213. Epub 2009 Jul 28.
Since the launch of the National Cancer Survivorship Initiative, there has been a surge of interest surrounding the value and organisation of long-term follow-up care after cancer treatment. We report the views of 309 adult cancer survivors (aged 18-45 years) on provision of follow-up and preferences for care.
A total of 207 survivors completed questionnaires before and after routine consultant-led follow-up appointments and 102 were recruited by post. Measures of health status (including late effects, perceived vulnerability to late effects and quality of life), reasons for attending follow-up (clinical and supportive), issues to be discussed at follow-up and preferences for different models of care were assessed.
In all, 59% of the survivors reported experiencing one or more cancer-related health problems. Survivors rated clinical reasons for attending follow-up more highly than supportive reasons (P<0.001), although nutritional advice and counselling were considered useful (60 and 47%, respectively). Those still receiving scheduled follow-up appointments did not discuss the range of issues intended with 'late effects' and 'fertility', which were particularly under-discussed. Hospital rather than GP follow-up was more highly rated.
Survivors value the clinical reassurance currently provided by consultant-led care. However, supportive needs are not systematically addressed. Multi-disciplinary services are recommended to meet supportive needs in addition to clinical care.
自国家癌症幸存者倡议启动以来，围绕癌症治疗后长期随访护理的价值和组织，人们的兴趣激增。我们报告了309名成年癌症幸存者（年龄在18 - 45岁之间）对随访服务提供情况及护理偏好的看法。
共有207名幸存者在常规由顾问主导的随访预约前后完成了问卷调查，102名通过邮寄方式招募。评估了健康状况指标（包括远期效应、对远期效应的感知易感性和生活质量）、参加随访的原因（临床和支持性）、随访中要讨论的问题以及对不同护理模式的偏好。
总体而言，59%的幸存者报告经历了一种或多种与癌症相关的健康问题。幸存者对参加随访的临床原因的评分高于支持性原因（P<0.001），尽管营养建议和咨询被认为是有用的（分别为60%和47%）。那些仍在接受定期随访预约的人没有讨论“远期效应”和“生育能力”等一系列预期问题，这些问题尤其未得到充分讨论。医院随访而非全科医生随访的评分更高。
幸存者重视目前由顾问主导的护理所提供的临床安心感。然而，支持性需求未得到系统解决。除临床护理外，建议提供多学科服务以满足支持性需求。
