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“有备无患”:儿童癌症长期幸存者及其父母的信息需求以及对幸存者护理模式的影响

"Forewarned and forearmed": Long-term childhood cancer survivors' and parents' information needs and implications for survivorship models of care.

作者信息

Vetsch Janine, Fardell Joanna E, Wakefield Claire E, Signorelli Christina, Michel Gisela, McLoone Jordana K, Walwyn Thomas, Tapp Heather, Truscott Jo, Cohn Richard J

机构信息

University of Lucerne, Department of Health Sciences and Health Policy, Lucerne, Switzerland; Discipline of Paediatrics, School of Women's and Children's Health, UNSW Medicine, University of New South Wales, Kensington, NSW, 2031, Australia; Kids Cancer Centre, Sydney Children's Hospital, Randwick, NSW, 2031, Australia.

Discipline of Paediatrics, School of Women's and Children's Health, UNSW Medicine, University of New South Wales, Kensington, NSW, 2031, Australia; Kids Cancer Centre, Sydney Children's Hospital, Randwick, NSW, 2031, Australia.

出版信息

Patient Educ Couns. 2017 Feb;100(2):355-363. doi: 10.1016/j.pec.2016.09.013. Epub 2016 Sep 22.

Abstract

OBJECTIVE

This mixed-method study assessed 1) survivors' and parents' information needs; and 2) associations between unmet information needs and clinical and socio-demographic characteristics.

METHODS

Stage 1: CCS and parents of CCS, >5years post-diagnosis completed a questionnaire on information needs, overall health and perceived risk. Predictors for unmet information needs were assessed by multivariable regression. Stage 2: participants were interviewed in-depth on these topics.

RESULTS

Questionnaires were completed by 485 participants comprising 322 survivors (mean age: 26.7years, SD=7.9; time since diagnosis: 19.7years, SD=8.8) and 163 parents (child age: 12.9years, SD=2.4; time since diagnosis: 9.7years, SD=2.3), and complemented by 70 interviews. Survivors reported unmet information needs about late effects (57.5%) and parents for fertility issues (62.5%). Survivors had more unmet needs for medical information whereas parents had significantly more regarding sexual issues and lifestyle. Being a parent (p=0.001), dissatisfaction with follow-up care (p=0.003), lower overall health (p=0.014), higher perceived risk of late effects (p<0.001), and greater anxiety/depression (p<0.001) were significantly associated with more unmet needs.

CONCLUSION

Unmet information needs were common for survivors and parents of CCS.

PRACTICE IMPLICATIONS

Future efforts towards tailoring information on potential late effects, healthy lifestyles and follow-up care may help to address unmet information needs.

摘要

目的

本混合方法研究评估了1)幸存者及其父母的信息需求;以及2)未满足的信息需求与临床和社会人口学特征之间的关联。

方法

第一阶段:确诊后超过5年的慢性疾病幸存者(CCS)及其父母完成了一份关于信息需求、总体健康状况和感知风险的问卷。通过多变量回归评估未满足信息需求的预测因素。第二阶段:就这些主题对参与者进行深入访谈。

结果

485名参与者完成了问卷,其中包括322名幸存者(平均年龄:26.7岁,标准差=7.9;确诊后时间:19.7年,标准差=8.8)和163名父母(孩子年龄:12.9岁,标准差=2.4;确诊后时间:9.7年,标准差=2.3),并辅以70次访谈。幸存者报告称,关于迟发效应的信息需求未得到满足(57.5%),而父母关于生育问题的信息需求未得到满足(62.5%)。幸存者对医疗信息的未满足需求更多,而父母在性问题和生活方式方面的未满足需求明显更多。作为父母(p=0.001)、对后续护理不满意(p=0.003)、总体健康状况较差(p=0.014)、对迟发效应的感知风险较高(p<0.001)以及焦虑/抑郁程度较高(p<0.001)与更多未满足需求显著相关。

结论

慢性疾病幸存者及其父母未满足信息需求的情况很常见。

实践意义

未来在提供关于潜在迟发效应、健康生活方式和后续护理信息方面的努力可能有助于满足未满足的信息需求。

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