De Padova Silvia, Rosti Giovanni, Scarpi Emanuela, Salvioni Roberto, Amadori Dino, De Giorgi Ugo
Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori-IRST, Meldola (FC), Italy.
Tumori. 2011 May-Jun;97(3):367-73. doi: 10.1177/030089161109700319.
We compared expectations of testicular cancer survivors and their caregivers with those of healthcare providers for testicular cancer survivorship care and quality of life to identify experiences and potential expectations in which there was disagreement.
In a meeting with testicular cancer survivors, their caregivers, and care providers with an interest in testicular cancer, we distributed a structured questionnaire with 24 questions divided into 3 sections: personal information, information on the quality of life of survivors, information on the role of care providers, general practitioners and health-related internet sources in the expectations of survivors.
The overall response rate was 91% (29 of 32) for patients and 100% (14 of 14) for caregivers with all questionnaires evaluable, while among 60 care providers, 42 (70%) responded with 41 (68%) evaluable. Between patients/caregivers and care providers, expectations were most incongruent for the role of primary care physicians in testicular cancer follow-up: important/fundamental for 58% of patients/caregivers and 88% of care providers (P = 0.010). Comparing patients/caregivers with care providers in their views of the experience of testicular cancer survivorship, we found several discrepancies: the fear of recurrence was high/very high for 18 of 43 (42%) patients/caregivers and in the perception of 40 of 41 (98%) care providers (P <0.001), and psychological distress was considered as highly relevant by 35% of patients/caregivers and 93% of care providers (P <0.001).
Patients/caregivers and care providers have different perceptions of survivors' experiences and discordant expectations with respect to the roles of primary care providers in testicular cancer survivorship care. Uncertainties about the roles and responsibilities of physicians can lead to deficiencies in care, supporting the need to make survivorship care planning a standard component in cancer management.
我们比较了睾丸癌幸存者及其照料者与医疗服务提供者对睾丸癌生存护理及生活质量的期望,以确定存在分歧的经历和潜在期望。
在一次有睾丸癌幸存者、其照料者以及对睾丸癌感兴趣的护理提供者参加的会议上,我们分发了一份包含24个问题的结构化问卷,问卷分为三个部分:个人信息、幸存者生活质量信息、护理提供者、全科医生及健康相关互联网资源在幸存者期望中的作用信息。
患者的总体回复率为91%(32人中29人),照料者为100%(14人中14人),所有问卷均可评估,而在60名护理提供者中,42人(70%)回复,41人(68%)的问卷可评估。在患者/照料者与护理提供者之间,对于初级保健医生在睾丸癌随访中的作用,期望差异最大:58%的患者/照料者认为重要/根本,88%的护理提供者持此观点(P = 0.010)。比较患者/照料者与护理提供者对睾丸癌生存经历的看法,我们发现了一些差异:43名患者/照料者中有18人(42%)对复发的恐惧程度高/非常高,而41名护理提供者中有40人(98%)有此认知(P < 0.001),35%的患者/照料者和93%的护理提供者认为心理困扰高度相关(P < 0.001)。
患者/照料者与护理提供者对幸存者的经历有不同认知,且在初级保健提供者在睾丸癌生存护理中的作用方面期望不一致。医生角色和职责的不确定性可能导致护理不足,这支持了将生存护理计划作为癌症管理标准组成部分的必要性。