Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, New York.
Cancer. 2014 Mar 1;120(5):722-30. doi: 10.1002/cncr.28472. Epub 2013 Dec 10.
The Institute of Medicine recommended that survivors of cancer and their primary care providers receive survivorship care plans (SCPs) to summarize cancer treatment and plan ongoing care. However, the use of SCPs remains limited.
Oncology providers at 14 National Cancer Institute Community Cancer Centers Program hospitals completed a survey regarding their perceptions of SCPs, including barriers to implementation, strategies for implementation, the role of oncology providers, and the importance of topics in SCPs (diagnosis, treatment, recommended ongoing care, and the aspects of ongoing care that the oncology practice will provide).
Among 245 providers (response rate of 70%), 52% reported ever providing any component of an SCP to patients. The most widely reported barriers were lack of personnel and time to create SCPs (69% and 64% of respondents, respectively). The most widely endorsed strategy among those using SCPs was the use of a template with prespecified fields; 94% of those who used templates found them helpful. For each topic of an SCP, although 87% to 89% of oncology providers believed it was very important for primary care providers to receive the information, only 58% to 65% of respondents believed it was very important for patients to receive the information. Furthermore, 33% to 38% of respondents reported mixed feelings regarding whether it was the responsibility of oncology providers to provide SCPs.
Practices need additional resources to overcome barriers to implementing SCPs. We found resistance toward SCPs, particularly the perceived value for the survivor and the idea that oncology providers are responsible for SCP dissemination.
美国医学研究所建议癌症幸存者及其初级保健提供者接受生存护理计划(SCP),以总结癌症治疗并计划持续护理。然而,SCP 的使用仍然有限。
14 家美国国家癌症研究所社区癌症中心计划医院的肿瘤学提供者完成了一项关于他们对 SCP 的看法的调查,包括实施障碍、实施策略、肿瘤学提供者的作用以及 SCP 中重要主题(诊断、治疗、推荐的持续护理以及肿瘤学实践将提供的持续护理方面)。
在 245 名提供者(回应率为 70%)中,有 52%的人报告曾向患者提供 SCP 的任何部分。报告最多的障碍是缺乏人员和时间来创建 SCP(分别有 69%和 64%的受访者)。在使用 SCP 的人中,最广泛认可的策略是使用带有预定义字段的模板;使用模板的人中,有 94%的人认为它们很有帮助。对于 SCP 的每个主题,尽管 87%至 89%的肿瘤学提供者认为初级保健提供者获得信息非常重要,但只有 58%至 65%的受访者认为患者获得信息非常重要。此外,33%至 38%的受访者对肿瘤学提供者是否有责任提供 SCP 表示感到矛盾。
实践需要额外的资源来克服实施 SCP 的障碍。我们发现对 SCP 的抵制,特别是对幸存者的价值和肿瘤学提供者负责传播 SCP 的想法的抵制。