Huibertse Lotte J, van Eenbergen Mies, de Rooij Belle H, Bastiaens Maarten T, Fossion Laurent M C L, de la Fuente Rob B, Kil Paul J M, Koldewijn Evert L, Meier A H P, Mommers Roland J M, Niemer A Q, Oddens Jorg R, Oomens Eric H G M, Prins Mandy, de Roos Kees-Peter, Thissen Monique R T M, Timmermans Martine W H, Wijsman Bart P, van de Poll-Franse Lonneke V, Ezendam Nicole P M
a Department of Research , Netherlands Comprehensive Cancer Organization , Utrecht , The Netherlands.
b CoRPS - Center of Research on Psychology in Somatic Diseases, Department of Medical and Clinical Psychology , Tilburg University , Tilburg , The Netherlands.
Acta Oncol. 2017 Feb;56(2):278-287. doi: 10.1080/0284186X.2016.1267398. Epub 2017 Jan 9.
The best practice for the organization of follow-up care in oncology is under debate, due to growing numbers of cancer survivors. Understanding survivors' preferences for follow-up care is elementary for designing patient-centred care. Based on data from prostate cancer and melanoma survivors, this study aims to identify: 1) preferences for follow-up care providers, for instance the medical specialist, the oncology nurse or the general practitioner; 2) characteristics associated with these preferences and 3) the preferred care provider to discuss cancer-related problems.
Survivors diagnosed with prostate cancer (N = 535) and melanoma (N = 232) between 2007 and 2013 as registered in The Netherlands Cancer Registry returned a questionnaire (response rate was 71% and 69%, respectively). A latent class cluster model analysis was used to define preferences and a multinomial logistic regression analysis was used to identify survivor-related characteristics associated with these preferences.
Of all survivors, 29% reported no preference, 40% reported a preference for the medical specialist, 20% reported a preference for both the medical specialist and the general practitioner and 11% reported a preference for both the medical specialist and the oncology nurse. Survivors who were older, lower/intermediate educated and women were more likely to have a preference for the medical specialist. Lower educated survivors were less likely to have a preference for both the medical specialist and the general practitioner. Overall, survivors prefer to discuss diet, physical fitness and fatigue with the general practitioner, and hereditary and recurrence with the medical specialist. Only a small minority favored to discuss cancer-related problems with the oncology nurse.
Survivors reported different preferences for follow-up care providers based on age, education level, gender and satisfaction with the general practitioner, showing a need for tailored follow-up care in oncology. The results indicate an urgency to educate patients about transitions in follow-up care.
由于癌症幸存者数量不断增加，肿瘤学后续护理的最佳组织方式仍存在争议。了解幸存者对后续护理的偏好是设计以患者为中心的护理的基础。基于前列腺癌和黑色素瘤幸存者的数据，本研究旨在确定：1）对后续护理提供者的偏好，例如医学专家、肿瘤护士或全科医生；2）与这些偏好相关的特征；3）讨论癌症相关问题的首选护理提供者。
在荷兰癌症登记处登记的2007年至2013年间被诊断为前列腺癌（N = 535）和黑色素瘤（N = 232）的幸存者回复了一份问卷（回复率分别为71%和69%）。使用潜在类别聚类模型分析来定义偏好，并使用多项逻辑回归分析来确定与这些偏好相关的幸存者特征。
在所有幸存者中，29%表示没有偏好，40%表示偏好医学专家，20%表示偏好医学专家和全科医生两者，11%表示偏好医学专家和肿瘤护士两者。年龄较大、受教育程度较低/中等以及女性幸存者更有可能偏好医学专家。受教育程度较低的幸存者不太可能同时偏好医学专家和全科医生。总体而言，幸存者更喜欢与全科医生讨论饮食、身体健康和疲劳问题，与医学专家讨论遗传和复发问题。只有一小部分人倾向于与肿瘤护士讨论癌症相关问题。
幸存者根据年龄、教育水平、性别和对全科医生的满意度，对后续护理提供者表现出不同的偏好，这表明肿瘤学中需要量身定制的后续护理。结果表明迫切需要对患者进行后续护理过渡方面的教育。
