Faculty of Nursing, University Health Network (Princess Margaret Hospital), 610 University Ave, Toronto, ON, Canada.
J Cancer Surviv. 2012 Dec;6(4):359-71. doi: 10.1007/s11764-012-0232-z. Epub 2012 Jul 10.
The impact of cancer and cancer treatment on the long-term health and quality of life of survivors is substantial, leading to questions about the most appropriate configuration of services and models of care for follow-up of post-primary treatment survivors.
A systematic review and quality appraisal of the health literature for structure of services and models of follow-up care for post-treatment survivors was identified through a search of guideline sources and empirical databases including MEDLINE, EMBASE, PsycINFO, the Cochrane Library, CINAHL, and EBSCO from 1999 through December 2009.
Ten practice guidelines and nine randomized controlled trials comprised the evidence base for models of care for adult cancer survivors. Although the evidence base was rated as low quality, nurse-led and primary care physician models of follow-up care were equivalent for detecting recurrence. Consensus also suggests that cancer survivors may benefit from coordinated transition planning that includes the provision of survivorship care plans as part of standard care.
Realignment of models of care is identified as a health system priority to meet the supportive care and surveillance needs of a burgeoning survivor population. Further research is needed to evaluate the efficacy of models of care in a broader population of cancer survivors with differing needs and risks. While the evidence is limited, there is research that may be used to guide the configuration of health care services and planning.
癌症及其治疗对幸存者长期健康和生活质量的影响是巨大的，这就引发了关于为癌症治疗后幸存者提供后续服务的最适当的服务结构和护理模式的问题。
通过对指南来源和实证数据库（包括 1999 年至 2009 年 12 月期间的 MEDLINE、EMBASE、PsycINFO、Cochrane 图书馆、CINAHL 和 EBSCO）的搜索，确定了对癌症治疗后幸存者的服务结构和后续护理模式进行系统回顾和健康文献质量评估。
10 项实践指南和 9 项随机对照试验构成了成人癌症幸存者护理模式的证据基础。尽管证据基础的质量被评为低质量，但护士主导和初级保健医生主导的后续护理模式在检测复发方面是等效的。共识还表明，癌症幸存者可能受益于协调的过渡计划，包括作为标准护理一部分提供生存护理计划。
重新调整护理模式被确定为卫生系统的优先事项，以满足不断增加的幸存者群体的支持性护理和监测需求。需要进一步研究来评估更广泛的癌症幸存者群体中不同需求和风险的护理模式的疗效。虽然证据有限，但有一些研究可以用来指导医疗服务的配置和规划。
