Boyajian Richard N, Grose Amy, Grenon Nina, Roper Kristin, Sommer Karen, Walsh Michele, Snavely Anna, Neary Susan, Partridge Ann, Nekhlyudov Larissa
Dana Farber Cancer Institute; Simmons College; Harvard Medical School; Harvard Vanguard Medical Associates, Boston, MA; and University of North Carolina, Chapel Hill, NC
Dana Farber Cancer Institute; Simmons College; Harvard Medical School; Harvard Vanguard Medical Associates, Boston, MA; and University of North Carolina, Chapel Hill, NC.
J Oncol Pract. 2014 Sep;10(5):e293-8. doi: 10.1200/JOP.2013.001192. Epub 2014 Jun 24.
Although survivorship care recommendations exist, there is limited evidence about current practices and patient preferences.
A cross-sectional survey was completed by survivors of lymphoma, head and neck, and gastrointestinal cancers at an academic cancer center. The survey was designed to capture patients' reports of receipt of survivorship care planning and their attitudes, preferences, and perceived needs regarding content and timing of cancer survivorship care information. Elements of survivorship care were based on the Institute of Medicine recommendations, literature review, and clinical experience.
Eighty-five survivors completed the survey (response rate, 81%). More than 75% reported receiving a follow-up plan or appointment schedule, a monitoring plan for scans and blood tests, information about short- and long-term adverse effects, and a detailed treatment summary. These elements were reported as desired by more than 90% of responders. Approximately 40% of these elements were only verbally provided. Although more than 70% described not receiving information about employment, smoking cessation, sexual health, genetic counseling, fertility, or financial resources, these elements were not reported as desired. However, "strategies to cope with the fear of recurrence" was most often omitted, yet desired by most respondents. Survivors' preferences regarding optimal timing for information varied depending on the element.
Our study suggests that cancer survivorship care planning is heterogeneous and may not need to be comprehensive, but rather tailored to individual survivors' needs. Providers must assess patient needs early and continue to revisit them during the cancer care continuum.
尽管存在癌症生存护理建议,但关于当前实践和患者偏好的证据有限。
在一家学术癌症中心,对淋巴瘤、头颈癌和胃肠道癌幸存者进行了一项横断面调查。该调查旨在获取患者关于接受癌症生存护理计划的报告,以及他们对癌症生存护理信息的内容和时机的态度、偏好和感知需求。生存护理的要素基于医学研究所的建议、文献综述和临床经验。
85名幸存者完成了调查(回复率为81%)。超过75%的受访者报告收到了后续计划或预约时间表、扫描和血液检查的监测计划、关于短期和长期不良反应的信息以及详细的治疗总结。超过90%的受访者表示希望获得这些要素。这些要素中约40%只是口头提供的。尽管超过70%的受访者表示未收到关于就业、戒烟、性健康、遗传咨询、生育或财务资源的信息,但他们并未表示希望获得这些要素。然而,“应对复发恐惧的策略”最常被遗漏,但大多数受访者都希望获得。幸存者对信息最佳时机的偏好因要素而异。
我们的研究表明,癌症生存护理计划是异质性的,可能无需全面,但应根据个体幸存者的需求进行调整。医疗服务提供者必须尽早评估患者需求,并在癌症护理连续过程中持续重新审视这些需求。