Jacobsen Paul B
Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, Florida 33612, USA.
Cancer. 2009 Sep 15;115(18 Suppl):4419-29. doi: 10.1002/cncr.24589.
Upon completion of their primary treatment, many cancer survivors become "lost in transition," and receive inadequate or, at best, poorly coordinated follow-up care. Unmet psychosocial and educational needs figure prominently among the concerns identified by survivors of adult-onset cancers in the post-treatment period. This article focuses on the role clinical practice guidelines could play in improving the quality of psychosocial care provided to these post-treatment survivors. After defining clinical practice guidelines and describing their development, the article provides an overview of existing clinical practice guidelines for the psychosocial care of cancer patients and identifies their strengths and weaknesses. A major weakness relevant to this article is that none of the existing guidelines focus on the post-treatment period. Two recent efforts in the field of cancer survivorship are identified that should stimulate and inform the development of guidelines for psychosocial care in the post-treatment period. One effort is the growing movement to implement survivorship care planning at the end of primary treatment. Assessing and addressing unmet and anticipated psychosocial needs have been identified as major components of survivorship care planning. The other effort is the release by the Children's Oncology Group of Long-term Follow-up Guidelines for Survivors of Childhood, Adolescent, and Young Adult Cancers. These guidelines provide a useful model of how guidelines for the psychosocial care of survivors of adult-onset cancers might be developed, organized, and implemented.
在完成初始治疗后,许多癌症幸存者会“在过渡阶段迷失”,接受的后续护理不足,或者充其量只是协调不佳。未满足的心理社会和教育需求在成年期癌症幸存者治疗后所确定的担忧中显得尤为突出。本文重点关注临床实践指南在改善为这些治疗后幸存者提供的心理社会护理质量方面可能发挥的作用。在界定了临床实践指南并描述了其制定过程后,本文概述了现有的癌症患者心理社会护理临床实践指南,并指出了它们的优点和缺点。与本文相关的一个主要缺点是,现有的指南均未关注治疗后阶段。本文确定了癌症幸存者领域最近的两项工作,它们应能推动并为治疗后阶段心理社会护理指南的制定提供参考。一项工作是在初始治疗结束时实施幸存者护理计划的运动日益兴起。评估和解决未满足的以及预期的心理社会需求已被确定为幸存者护理计划的主要组成部分。另一项工作是儿童肿瘤学组发布了《儿童、青少年和青年癌症幸存者长期随访指南》。这些指南为如何制定、组织和实施成年期癌症幸存者心理社会护理指南提供了一个有用的范例。