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应对从癌症护理到初级护理的过渡:生存护理计划的协助

Navigating the Transition From Cancer Care to Primary Care: Assistance of a Survivorship Care Plan.

作者信息

Brant Jeannine M, Blaseg Karyl, Aders Kathy, Oliver Dona, Gray Evan, Dudley William N

机构信息

Billings Clinic Hospital.

Billings Clinic.

出版信息

Oncol Nurs Forum. 2016 Nov 1;43(6):710-719. doi: 10.1188/16.ONF.710-719.

Abstract

PURPOSE/OBJECTIVES: To examine symptom and quality-of-life (QOL) trajectories in breast cancer and lymphoma survivors enrolled in a survivorship navigation intervention and to explore patient, caregiver, and primary care provider (PCP) satisfaction with receipt of a survivorship care plan (SCP). 
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DESIGN: Prospective, cohort, longitudinal.
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SETTING: The Billings Clinic, an integrated cancer center in Montana. 
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SAMPLE: 67 patients with breast cancer or lymphoma who recently completed cancer treatment, along with 39 of their caregivers and 23 PCPs. 
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METHODS: Data collection at one, three, and six months by the Functional Assessment of Cancer Therapy-General and satisfaction surveys.
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MAIN RESEARCH VARIABLES: Symptoms, QOL, and satisfaction with the survivorship navigator and the SCP.
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FINDINGS: Symptoms persisted six months following treatment. Symptoms and QOL indicators with worst intensity were energy, sleep, coping, and satisfaction with sex life. Patients with more comorbidities reported worse QOL, telephoned the survivorship navigator more often, and were more satisfied with the SCP. Patients with lymphoma reported higher QOL, but it was not significantly different from patients with breast cancer. Patients were significantly more satisfied than caregivers with the SCP at time 1. PCPs were highly satisfied with the SCP.
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CONCLUSIONS: Some symptoms persist, even when cancer treatment has ended. Patients with comorbidities are at higher risk for more severe symptoms and worse QOL and may benefit from ongoing support. SCPs can facilitate patients' transition to primary care following cancer treatment. 
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IMPLICATIONS FOR NURSING

Healthcare professionals who care for breast cancer survivors need to routinely assess them for the presence of comorbid conditions. Obese breast cancer survivors may benefit from weight reduction interventions to possibly decrease their risk of developing lymphedema and improve their overall health status.

摘要

目的/目标:研究参加生存导航干预的乳腺癌和淋巴瘤幸存者的症状及生活质量(QOL)轨迹,并探讨患者、护理人员和初级保健提供者(PCP)对收到生存护理计划(SCP)的满意度。

设计

前瞻性队列纵向研究。

地点

位于蒙大拿州的综合癌症中心比林斯诊所。

样本

67例近期完成癌症治疗的乳腺癌或淋巴瘤患者,以及39名他们的护理人员和23名初级保健提供者。

方法

通过癌症治疗功能评估通用版和满意度调查在1个月、3个月和6个月时收集数据。

主要研究变量

症状、生活质量以及对生存导航员和生存护理计划的满意度。

研究结果

治疗后症状持续了6个月。强度最差的症状和生活质量指标是精力、睡眠、应对能力和对性生活的满意度。合并症更多的患者生活质量更差,更频繁地致电生存导航员,并且对生存护理计划更满意。淋巴瘤患者报告的生活质量更高,但与乳腺癌患者相比无显著差异。在第1次时,患者对生存护理计划的满意度明显高于护理人员。初级保健提供者对生存护理计划高度满意。

结论

即使癌症治疗已经结束,一些症状仍然存在。合并症患者出现更严重症状和更差生活质量的风险更高,可能受益于持续的支持。生存护理计划可以促进患者在癌症治疗后向初级保健的过渡。

对护理的启示

照顾乳腺癌幸存者的医护人员需要定期评估他们是否存在合并症。肥胖的乳腺癌幸存者可能从减重干预中受益,这可能会降低他们发生淋巴水肿的风险并改善他们的整体健康状况。

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