Shen Abra H, Howell Doris, Edwards Elizabeth, Warde Padraig, Matthew Andrew, Jones Jennifer M
Cancer Rehabilitation and Survivorship Program, University Health Network, Toronto, Ontario, Canada.
Oncology Nursing, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada.
Urol Oncol. 2016 Apr;34(4):168.e11-20. doi: 10.1016/j.urolonc.2015.09.016. Epub 2015 Dec 18.
To gain a better understanding of the experiences of patients with early-stage testicular cancer during the transition from active cancer treatment to follow-up care.
Cross-sectional multimethod study (questionnaires, focus groups, and telephone interviews) to describe experiences of patients with testicular cancer transitioning to survivorship. Questionnaire package included standardized measures of survivorship knowledge, feeling of preparedness, health-related distress, and perspectives on care coordination. Standard descriptive statistics and Mann-Whitney tests to examine associations between all outcomes based on demographic and clinical variables were performed. Qualitative results (focus groups and interviews) were analyzed with qualitative content analysis.
Based on quantitative data (n = 90) and qualitative analyses (n = 13), participants had relatively high survivorship knowledge, most testicular cancer survivors were not provided with any formal transition planning or documentation, and a substantial minority felt unprepared to cope with the aftereffects of testicular cancer and the posttreatment survivorship phase. Younger men had lower survivorship knowledge, feelings of preparedness, and continuity of care scores and were less likely to report having received any self-management tools and education or information of patient resources. Participants reported that they did not know what to expect physically or emotionally after treatment ended and many continued to be frustrated and worried about their health problems. They expressed the need for reliable and personalized resources on what to expect after treatment and more formal transition care planning.
Patients with testicular cancer continue to struggle in their transition to posttreatment survivorship. Quality of care must emphasize a shift from a purely disease-focused approach to a wellness-centered approach that provides coordinated, patient-centered, and comprehensive care to optimize quality of life for these survivors.
为了更好地了解早期睾丸癌患者从积极的癌症治疗过渡到后续护理阶段的经历。
采用横断面多方法研究(问卷调查、焦点小组讨论和电话访谈)来描述睾丸癌患者向生存阶段过渡的经历。问卷包包括生存知识的标准化测量、准备程度、与健康相关的困扰以及对护理协调的看法。基于人口统计学和临床变量,进行标准描述性统计和曼-惠特尼检验以检查所有结果之间的关联。对定性结果(焦点小组讨论和访谈)进行定性内容分析。
基于定量数据(n = 90)和定性分析(n = 13),参与者的生存知识相对较高,大多数睾丸癌幸存者未得到任何正式的过渡计划或文件记录,相当一部分人觉得没有准备好应对睾丸癌的后遗症和治疗后的生存阶段。年轻男性的生存知识、准备程度和护理连续性得分较低,且不太可能报告收到任何自我管理工具以及患者资源的教育或信息。参与者表示,他们不知道治疗结束后在身体或情绪上会有什么预期,许多人仍对自己的健康问题感到沮丧和担忧。他们表达了对治疗后预期的可靠且个性化资源以及更正式的过渡护理计划的需求。
睾丸癌患者在向治疗后生存阶段的过渡中仍面临困难。护理质量必须强调从单纯以疾病为中心的方法转变为以健康为中心的方法,提供协调、以患者为中心的全面护理,以优化这些幸存者的生活质量。