Division of Radiation Oncology, Department of Surgery, Faculty of Medicine, University of British Columbia, Vancouver, and BC Cancer Agency-Vancouver Island Centre, Victoria, BC.
Curr Oncol. 2011 Oct;18(5):e218-26. doi: 10.3747/co.v18i5.793.
Increasing numbers of women are surviving breast cancer, and survivorship care is becoming more complex. Primary care physicians provide care for most survivors of breast cancer in the Canadian province of British Columbia. The present study offers insight into the confidence of primary care physicians in their abilities to provide such care. It also explores potential ways to assist those providers in enhancing this aspect of their practice.
A questionnaire was mailed to 1000 primary care physicians caring for survivors of breast cancer. The questionnaire explored the perspectives of the responding physicians on their ability to manage various aspects of survivorship care for breast cancer patients, identified preferences for the content and format of communication from oncologists at the time of transition from active oncology treatment to survivorship, and determined the means most commonly used to obtain knowledge about breast cancer. This 1-page, 31-item checkbox and open-answer questionnaire assessed the perceptions of primary care physicians about the care of breast cancer survivors after completion of active treatment and their personal preferences for resources providing information about breast cancer.
The questionnaire response rate was 59%. Primary care physicians reported being most confident in screening for recurrence and managing patient anxiety; they were least confident in managing lymphedema and providing psychosocial counselling. Compared with physicians following fewer survivors of breast cancer, those who followed more breast cancer survivors had higher confidence in managing the biomedical aspects of follow-up and in providing counselling about nutrition and exercise. Most physicians found discharge letters from oncologists to be useful. Point-form discharge information was preferred by 43%; detailed description, by 19%; and both formats, by 38%. The most useful information items identified for inclusion in a discharge letter were a diagnosis and treatment summary and the recommended surveillance and endocrine therapy. Continuing medical education events and online resources were the means most commonly used to obtain knowledge about breast cancer.
Primary care physicians who provide follow-up for survivors of breast cancer report that they are confident in managing care and satisfied with discharge letters containing a diagnosis and treatment summary, and recommendations for surveillance and endocrine treatment. At the time of patient discharge, additional information about common medical and psychosocial issues in this patient population would be useful to primary care physicians. Preferred means to access current breast cancer information include continuing medical education events and online resources.
越来越多的女性乳腺癌幸存者，生存护理变得更加复杂。在加拿大不列颠哥伦比亚省，初级保健医生为大多数乳腺癌幸存者提供护理。本研究深入了解初级保健医生对提供此类护理能力的信心。它还探讨了协助这些提供者增强实践这一方面的潜在方法。
向 1000 名照顾乳腺癌幸存者的初级保健医生邮寄了一份问卷。问卷探讨了答复医生对管理乳腺癌患者生存护理各个方面的能力的看法，确定了在从积极肿瘤治疗过渡到生存护理时从肿瘤医生那里获得沟通的内容和格式的偏好，并确定了获得乳腺癌知识的最常用方法。这份 1 页 31 项复选框和开放式答案的问卷评估了初级保健医生对完成积极治疗后乳腺癌幸存者护理的看法，以及他们对提供乳腺癌信息资源的个人偏好。
问卷回复率为 59%。初级保健医生报告说，他们在筛查复发和管理患者焦虑方面最有信心；在管理淋巴水肿和提供心理社会咨询方面最没有信心。与随访较少乳腺癌幸存者的医生相比，随访较多乳腺癌幸存者的医生在管理随访的生物医学方面和提供有关营养和运动的咨询方面更有信心。大多数医生发现肿瘤医生的出院信很有用。43%的人更喜欢重点信息；19%的人更喜欢详细描述；38%的人更喜欢两者。出院信中最有用的信息项目包括诊断和治疗总结以及推荐的监测和内分泌治疗。继续医学教育活动和在线资源是获得乳腺癌知识最常用的方法。
为乳腺癌幸存者提供随访的初级保健医生报告说，他们对管理护理有信心，并对出院信中包含诊断和治疗总结以及监测和内分泌治疗建议感到满意。在患者出院时，为初级保健医生提供有关该患者人群常见医学和心理社会问题的额外信息将是有用的。获取当前乳腺癌信息的首选方法包括继续医学教育活动和在线资源。
