Department of Psychiatry and Behavioral Sciences, Memorial Sloan-Kettering Cancer Center, 641 Lexington Avenue, 7th Floor, New York, NY, 10022, USA,
J Cancer Surviv. 2013 Dec;7(4):535-43. doi: 10.1007/s11764-013-0291-9. Epub 2013 Jun 22.
Due to their heightened risk of developing late-occurring adverse outcomes, pediatric cancer survivors are advised to receive follow-up care in specialized Survivor Clinics. However, little is known about the impact of attending such clinics on psychosocial adjustment, knowledge, and morbidity. This study assesses the differences between those who attended a Survivorship Clinic and those who did not on knowledge, perception of risk, and psychosocial adjustment.
We assessed 102 survivors who attended our Long-Term Follow-Up (LTFU) Clinic and 71 survivors never seen in a specialized clinic (non-LTFU). Participants were diagnosed at least 5 years prior to the assessment, were at least 20 years old, and had no evidence of active disease. Groups were matched on gender, age at cancer diagnosis, diagnosis, and race.
On average, participants were currently 30 years of age and had been diagnosed with cancer around age 12. Most common reasons that non-LTFU survivors did not attend the clinic were "not aware" (71 %) or "not interested" (16 %). Survivors in each group were able to accurately report their cancer diagnosis, but few knew specific treatment information. There were no significant differences regarding survivors' perceptions of risk of future health problems with both groups similarly underestimating their risks. A significant minority in each group reported psychological or emotional problems (16-18 %), post-traumatic stress disorder (4.2-6.9 %), and/or psychological distress (7.8-19.7 %).
Survivors are in need of continued education about their specific cancer treatments, recommended follow-up practices, the importance of survivorship care, and their specific risks for late effects.
Among those childhood cancer survivors who do attend a Survivor clinic, a majority are in need of continued education about their specific cancer treatments, recommended follow-up practices, and risk of late effects. As many survivors of pediatric cancer appear to be unaware of the existence of Survivor clinics, improved methods of transitioning survivors after completion of treatment are needed.
由于儿科癌症幸存者发生晚期不良后果的风险较高，建议他们在专门的生存者诊所接受后续护理。然而，对于参加此类诊所对心理社会适应、知识和发病率的影响知之甚少。本研究评估了参加生存者诊所和未参加专门诊所的患者在知识、风险认知和心理社会适应方面的差异。
我们评估了 102 名参加我们的长期随访 (LTFU) 诊所的幸存者和 71 名从未在专门诊所就诊的幸存者 (非 LTFU)。参与者在评估前至少 5 年被诊断出患有癌症，年龄至少 20 岁，且无活动性疾病的证据。两组在性别、癌症诊断时的年龄、诊断和种族上相匹配。
平均而言，参与者目前的年龄为 30 岁，诊断出癌症的年龄约为 12 岁。非 LTFU 幸存者不参加诊所的主要原因是“不知道”(71%)或“不感兴趣”(16%)。每组幸存者都能够准确报告自己的癌症诊断，但很少有人知道具体的治疗信息。两组幸存者对未来健康问题的风险认知没有显著差异，两组都低估了自己的风险。少数幸存者报告了心理或情绪问题(16-18%)、创伤后应激障碍(4.2-6.9%)和/或心理困扰(7.8-19.7%)。
幸存者需要继续接受有关其特定癌症治疗、推荐的随访实践、生存者护理的重要性以及他们特定晚期效应风险的教育。
在那些确实参加生存者诊所的儿童癌症幸存者中，大多数人需要继续接受有关其特定癌症治疗、推荐的随访实践和晚期效应风险的教育。由于许多儿科癌症幸存者似乎不知道生存者诊所的存在，因此需要改进治疗完成后过渡幸存者的方法。
