Dittus Kim L, Sprague Brian L, Pace Claire M, Dulko Dorothy A, Pollack Lori A, Hawkins Nikki A, Geller Berta M
Hematology/Oncology Division, University of Vermont, College of Medicine, Burlington, USA.
Department of Surgery and Office of Health Promotion Research, University of Vermont, Burlington, USA.
J Gen Pract (Los Angel). 2014 Jul;2(4):163. doi: 10.4172/2329-9126.1000163. Epub 2014 May 26.
Survivorship care plans (SCP), which describe a cancer survivor's diagnosis, treatment and follow-up, are recommended. The study objective was to evaluate primary care providers' (PCP) responses to SCPs developed for breast and colorectal cancer survivors in their practice and to determine whether PCP response to the SCPs varied according to characteristics of the practitioner and their practice.
SCPs were created using the Journey Forward® Care Plan for breast and colorectal cancer patients in rural and urban settings. The SCP and a survey were sent to PCPs.
Primary care physicians.
Attitudes regarding survivorship care plans.
Thirty-nine (70.9% response rate) surveys were completed. Most felt the SCP was useful (90%), that it enhanced understanding (75%) and that detail was sufficient (>80%). However, 15% disagreed that the care plan helped them understand their role, a perception especially prevalent among PCPs in the rural setting. Among PCPs with ≤ 18 years in practice, 95% agreed that the SCP would improve communication with patients, contrasted with 60% of those with >21 years in practice. The most common barrier to providing follow-up care was limited access to survivors.
While SCPs appear to improve PCPs understanding of a cancer diagnosis and treatment, clear delineation of each provider's role in follow-up care is needed. Additional detail on which tests are needed and education on late and long term effects of cancer may improve coordination of care.
推荐使用描述癌症幸存者诊断、治疗及随访情况的生存护理计划(SCP)。本研究的目的是评估初级保健提供者(PCP)对其执业过程中为乳腺癌和结直肠癌幸存者制定的SCP的反应,并确定PCP对SCP的反应是否因从业者及其执业情况的特征而异。
使用“向前迈进”®护理计划为农村和城市环境中的乳腺癌和结直肠癌患者制定SCP。将SCP和一份调查问卷发送给PCP。
初级保健医生。
对生存护理计划的态度。
共完成39份调查问卷(回复率为70.9%)。大多数人认为SCP有用(90%),能增强理解(75%)且细节充分(>80%)。然而,15%的人不同意护理计划有助于他们理解自己的角色,这种看法在农村地区的PCP中尤为普遍。在执业年限≤18年的PCP中,95%的人同意SCP会改善与患者的沟通,而执业年限>21年的PCP中这一比例为60%。提供后续护理最常见的障碍是接触幸存者的机会有限。
虽然SCP似乎能提高PCP对癌症诊断和治疗的理解,但在后续护理中需要明确界定每个提供者的角色。关于所需检查的更多细节以及癌症晚期和长期影响的教育可能会改善护理协调。