Department of Psychology, University of Sheffield, Western Bank, Sheffield, UK.
Psychooncology. 2011 Aug;20(8):813-22. doi: 10.1002/pon.1783. Epub 2010 May 26.
Given increased survival rates and treatment-related late effects, follow-up for cancer survivors is increasingly recommended. However, information about adverse events (e.g. possibility of late effects) may be distressing for the cancer survivor and lead to poor clinic attendance. Survivor satisfaction with appointments and the information provided are important. The Monitoring Process Model provides a theoretical framework to understand how survivors cope with threatening information, and consequences for follow-up care. Our aims were to describe satisfaction with routine follow-up and association between monitoring/blunting and satisfaction with care.
Three hundred and forty-nine patients [aged 18-45 years with a history of haematological, germ cell, breast or childhood cancer, >5 years from diagnosis without relapse (>2 years for germ cell survivors) and with a follow-up appointment during the study period] were identified from hospital databases. Participants completed questionnaires before (T1) and after a routine appointment (T2).
Two hundred and seventy-nine (79.9%) questionnaires were completed at T1 and 198 (56.7%) at T2. Clinic satisfaction was higher with shorter waiting time, longer consultation and more topics discussed, but not associated with monitoring. High monitors reported more psychological problems, more importance of clinic attendance and greater value of support groups and professional counselling.
Satisfaction with follow-up is high among young adult cancer survivors. Follow-up was rated more highly by higher monitors, supporting previous findings that monitors seek out health care information. Provision of additional support services might increase satisfaction among survivors with psychological and social problems.
鉴于癌症患者生存率的提高和治疗相关的晚期效应,越来越多的人建议对癌症幸存者进行随访。然而,有关不良事件(例如晚期效应的可能性)的信息可能会令癌症幸存者感到痛苦,并导致其就诊率下降。癌症幸存者对预约和提供的信息的满意度非常重要。监测过程模型为理解幸存者如何应对威胁性信息以及对后续护理的影响提供了理论框架。我们的目的是描述对常规随访的满意度,并探讨监测/缓冲与护理满意度之间的关系。
从医院数据库中确定了 349 名患者(年龄 18-45 岁,有血液系统、生殖细胞、乳腺或儿童期癌症病史,距诊断时间>5 年且无复发(生殖细胞幸存者>2 年),且在研究期间有随访预约)。参与者在常规预约前(T1)和预约后(T2)完成了问卷。
在 T1 时完成了 279 份(79.9%)问卷,在 T2 时完成了 198 份(56.7%)。就诊满意度与等待时间较短、咨询时间较长和讨论的话题较多有关,但与监测无关。高监测者报告了更多的心理问题、对就诊的重视程度更高,并且认为支持小组和专业咨询更有价值。
年轻成年癌症幸存者对随访的满意度较高。较高的监测者对随访的评价更高,这支持了之前的研究结果,即监测者会主动寻求健康信息。提供额外的支持服务可能会提高有心理和社会问题的幸存者的满意度。