RTI International, Washington, DC, and Research Triangle Park, NC; and University of North Carolina-Chapel Hill, Chapel Hill, NC
RTI International, Washington, DC, and Research Triangle Park, NC; and University of North Carolina-Chapel Hill, Chapel Hill, NC.
J Oncol Pract. 2015 Jan;11(1):e19-27. doi: 10.1200/JOP.2014.001403. Epub 2014 Sep 9.
This article, derived from a Technical Brief prepared for the Agency for Healthcare Research and Quality, presents an overview on current models of care for survivors of adult-onset cancer who have completed active treatment.
This article integrates reviewed literature on background, context, research gaps, and future research directions for survivorship care models. We also conducted a systematic literature review of current evidence from studies of survivorship care models.
Our systematic review identified nine empirical studies of survivorship care models, covering multiple models types and illustrating the heterogeneity in this field. The literature review indicated considerable heterogeneity in models of survivorship care, components of models, survivor populations, and target outcomes. Models of survivorship care are highly individualized to the institution or setting where they are provided. "Usual care" is often uncoordinated and highly varied across cancer survivors and within cancer programs. Anticipated shortages in the oncology workforce may require the expanded use of nurse practitioners and physician assistants and shared care with primary care providers to deliver survivorship care to the growing number of survivors. Concerns associated with survivorship care models include payment considerations, adequacy of training, and the potential for lack of coordination and fragmented care.
There is substantial variation in survivorship care models. The optimal nature, timing, intensity, format, and outcomes of survivorship care models are uncertain and require further research. Specific research questions need to be addressed by the survivorship community to better understand the advantages and limitations of survivorship models.
本文源自为美国医疗保健研究与质量署准备的一份技术简报，概述了已完成积极治疗的成年癌症幸存者的现有照护模式。
本文整合了对照护模式背景、环境、研究空白和未来研究方向的文献综述。我们还对现有的照护模式研究进行了系统文献回顾。
我们的系统评价确定了 9 项关于照护模式的实证研究，涵盖了多种模式类型，并说明了该领域的异质性。文献综述表明，照护模式的异质性体现在多个方面，包括模式类型、模式组成部分、幸存者人群和目标结果。照护模式高度个体化，适用于提供服务的机构或环境。“常规照护”通常在癌症幸存者之间以及癌症项目内缺乏协调且差异很大。肿瘤学劳动力的预期短缺可能需要扩大使用执业护士和医师助理，并与初级保健提供者共享照护，为不断增加的幸存者提供照护。与照护模式相关的问题包括支付考虑、培训的充分性，以及协调和碎片化照护的潜在缺乏。
照护模式存在很大差异。照护模式的最佳性质、时间、强度、格式和结果尚不确定，需要进一步研究。幸存者社区需要解决具体的研究问题，以更好地了解照护模式的优势和局限性。
