University of Michigan School of Social Work, Ann Arbor, USA.
Cancer. 2013 Jan 1;119(1):201-14. doi: 10.1002/cncr.27713. Epub 2012 Jun 28.
Adolescents and young adults (AYAs) with cancer demonstrate biomedical risks and psychosocial issues distinct from those of children or older adults. In this study, the authors examined and compared the extent to which AYAs treated in pediatric or adult oncology settings reported use of, and unmet need for, psychosocial support services.
Within 4 months of initial cancer diagnosis, 215 AYAs ages 14 to 39 years (99 from pediatric care settings and 116 from adult care settings; 75% response rate) were assessed for reporting use of information resources, emotional support services, and practical support services. Statistical analyses derived odds ratios and 95% confidence intervals for service use and unmet needs after controlling for race, employment/school status, sex, relationship status, severity of cancer, treatment, and treatment-related side effects.
AYAs ages 20 to 29 years were significantly less likely than teens and older patients ages 30 to 39 years to report using professional mental health services and were significantly more likely to report an unmet need with regard to cancer information, infertility information, and diet/nutrition information. Compared with teens who were treated in pediatric facilities, AYAs who were treated in adult facilities were more likely to report an unmet need for age-appropriate Internet sites, professional mental health services, camp/retreats programs, transportation assistance, and complementary and alternative health services.
Substantial proportions of AYAs are not getting their psychosocial care needs met. Bolstering psychosocial support staff and patient referral to community-based social service agencies and reputable Internet resources may enhance care and improve quality of life for AYAs.
与儿童或老年人相比,患有癌症的青少年和年轻人(AYAs)表现出独特的生物医学风险和心理社会问题。在这项研究中,作者检查并比较了在儿科或成人肿瘤学环境中接受治疗的 AYA 报告使用心理社会支持服务的程度以及未满足的需求。
在初次癌症诊断后的 4 个月内,对 215 名年龄在 14 至 39 岁的 AYA(99 名来自儿科护理环境,116 名来自成人护理环境;响应率为 75%)进行评估,以评估他们对信息资源、情感支持服务和实际支持服务的使用情况。在控制种族、就业/学校状况、性别、关系状况、癌症严重程度、治疗和与治疗相关的副作用后,统计分析得出服务使用和未满足需求的优势比和 95%置信区间。
20 至 29 岁的 AYA 报告使用专业心理健康服务的可能性明显低于青少年和 30 至 39 岁的年长患者,并且报告癌症信息、不孕信息和饮食/营养信息未得到满足的可能性明显更高。与在儿科设施中接受治疗的青少年相比,在成人设施中接受治疗的 AYA 更有可能报告需要年龄适当的互联网网站、专业心理健康服务、营地/静修计划、交通援助以及补充和替代健康服务。
相当一部分 AYA 的心理社会护理需求未得到满足。加强心理社会支持人员并将患者转介给社区社会服务机构和信誉良好的互联网资源,可能会增强对 AYA 的护理并提高他们的生活质量。