Michel G, Gianinazzi M E, Eiser C, Bergstraesser E, Vetsch J, von der Weid N, Kuehni C E
Department of Health Sciences & Health Policy, University of Lucerne, Lucerne, Switzerland.
Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland.
Eur J Cancer Care (Engl). 2016 Nov;25(6):1024-1033. doi: 10.1111/ecc.12560. Epub 2016 Aug 23.
Follow-up care is important for childhood cancer survivors to facilitate early detection and treatment of late effects. We aimed to describe preferences for different organisational aspects and models of follow-up care among Swiss childhood cancer survivors, and characteristics associated with preferences for different models. We contacted 720 survivors aged 18+ years, diagnosed with cancer after 1990 (age 0-16 years), registered in the Swiss Childhood Cancer Registry (SCCR), and Swiss resident, who previously participated in a baseline survey. They received questionnaires to assess attendance and preferences for follow-up (rated on 4-point scales, 0-3). Clinical information was available from the SCCR. Survivors (n = 314: response rate 43.6%; 47.8% still attended follow-up) rated clinical reasons for follow-up higher than supportive reasons (p < .001). They rated checking for cancer recurrence (mean = 2.78, SD = 0.53) and knowing about risks for my children most important (mean = 2.22, SD = 0.83). They preferred to attend a children's hospital (mean = 1.94, SD = 1.11), adult hospital (mean = 1.86, SD = 0.98) or general practitioner (mean = 1.86, SD = 1.01) rather than a central specialised late effects clinic (mean = 1.25, SD = 1.06, p < .001), and be seen by paediatric (mean = 2.24, SD = 0.72) or medical oncologist (mean = 2.17, SD = 0.69). Survivors preferred decentralised clinic-based follow-up, rather than one central specialised late effects clinic. Survivors' preferences should be considered to ensure future attendance.
随访护理对于儿童癌症幸存者来说很重要，有助于对迟发效应进行早期检测和治疗。我们旨在描述瑞士儿童癌症幸存者对不同组织方面和随访护理模式的偏好，以及与不同模式偏好相关的特征。我们联系了720名18岁及以上的幸存者，他们于1990年以后（0至16岁）被诊断出患有癌症，登记在瑞士儿童癌症登记处（SCCR），并且是瑞士居民，他们之前参与过一项基线调查。他们收到问卷以评估随访的参与情况和偏好（按4分制评分，0至3分）。临床信息可从SCCR获得。幸存者（n = 314：回复率43.6%；47.8%仍在接受随访）对随访的临床原因的评分高于支持性原因（p <.001）。他们将检查癌症复发（平均值 = 2.78，标准差 = 0.53）和了解我的孩子的风险（平均值 = 2.22，标准差 = 0.83）评为最重要。他们更愿意前往儿童医院（平均值 = 1.94，标准差 = 1.11）、成人医院（平均值 = 1.86，标准差 = 0.98）或全科医生处（平均值 = 1.86，标准差 = 1.01），而不是中央专门的迟发效应诊所（平均值 = 1.25，标准差 = 1.06，p <.001），并且更希望由儿科医生（平均值 = 2.24，标准差 = 0.72）或医学肿瘤学家看病（平均值 = 2.17，标准差 = 0.69）。幸存者更喜欢基于诊所的分散式随访，而不是一个中央专门化迟发效应诊所。应考虑幸存者的偏好以确保未来的参与情况。
