Szalda Dava, Pierce Lisa, Hobbie Wendy, Ginsberg Jill P, Brumley Lauren, Wasik Monika, Li Yimei, Schwartz Lisa A
The Children's Hospital of Philadelphia, CTRB 3-016, 3501 Civic Center Blvd, Philadelphia, PA, 19104, USA.
University of Pennsylvania, Philadelphia, PA, USA.
J Cancer Surviv. 2016 Apr;10(2):342-50. doi: 10.1007/s11764-015-0480-9. Epub 2015 Aug 25.
Young adult survivors (YAS) of childhood cancer require annual adult-focused, cancer-related follow-up given their risk for late effects of treatment. This study describes perception of and engagement with adult-focused, cancer-related follow-up care and general health care among YAS formally transferred to adult care from pediatric survivorship care.
YAS transferred from pediatric survivorship care in the prior 1-5 years completed measures indicating engagement with cancer-related follow-up care, other health care utilization, content of communication by providers, quality of cancer-related care, and satisfaction with health care in the prior year.
Eighty YAS (M age = 27.7 years, M time since diagnosis = 10.4 years) participated. Just over half of YAS surveyed (n = 44, 55%) endorsed continuing cancer-related follow-up care since transfer. Those with cancer-related follow-up endorsed seeing subspecialty survivorship providers (n = 16, 44%) and primary care providers (n = 22, 50%) or utilizing a shared care model (n = 6, 14%). About a third of YAS endorsed seeing subspecialists (n = 29, 36%) or using other support services (n = 22, 27%). YAS-perceived content of communication varied significantly depending on care model with less cancer-related content being discussed by primary care providers, though perceived quality of cancer-related care and satisfaction with health care was generally favorable.
YAS report less than optimal engagement in cancer-related follow-up care and communication in their health care encounters.
Young adult survivors should receive anticipatory guidance about expectations for delivery and content of adult-focused cancer-related follow-up care.
儿童癌症成年幸存者(YAS)由于存在治疗晚期效应的风险,需要每年接受以成年人为重点的癌症相关随访。本研究描述了从儿科幸存者护理正式转诊至成人护理的YAS对以成年人为重点的癌症相关随访护理和一般医疗保健的认知及参与情况。
在过去1至5年从儿科幸存者护理转诊的YAS完成了相关测评,这些测评表明了他们参与癌症相关随访护理的情况、其他医疗保健利用情况、提供者的沟通内容、癌症相关护理的质量以及对上一年医疗保健的满意度。
80名YAS(平均年龄 = 27.7岁,自诊断以来的平均时间 = 10.4年)参与了研究。接受调查的YAS中略超过一半(n = 44,55%)认可自转诊后继续接受癌症相关随访护理。那些接受癌症相关随访的人认可看专科幸存者护理提供者(n = 16,44%)和初级保健提供者(n = 22,50%)或采用共享护理模式(n = 6,14%)。约三分之一的YAS认可看专科医生(n = 29,36%)或使用其他支持服务(n = 22,27%)。YAS感知到的沟通内容因护理模式而异,初级保健提供者讨论的癌症相关内容较少,不过对癌症相关护理的感知质量和对医疗保健的满意度总体良好。
YAS报告称在癌症相关随访护理及医疗保健接触中的沟通方面参与度未达最佳水平。
成年幸存者应接受关于以成年人为重点的癌症相关随访护理的提供方式和内容期望的前瞻性指导。