Reed Sarah C, Walker Rod, Ziebell Rebecca, Rabin Borsika, Nutt Stephanie, Chubak Jessica, Nekhlyudov Larissa
Jane Addams College of Social Work, University of Illinois at Chicago, 1040 West Harrison Street, Chicago, IL, 60607-7134, USA.
Kaiser Permanente Health Research Institute, Seattle, WA, USA.
J Cancer Educ. 2018 Dec;33(6):1181-1188. doi: 10.1007/s13187-017-1228-1.
Prior studies reveal gaps in cancer survivors' discussions with health care providers about follow-up care and receipt of care plans; however, whether survivorship care planning may vary by cancer type is not known. We surveyed 615 survivors of breast, colorectal, prostate, lung cancer, and melanoma enrolled in three health plans to examine cancer survivors' self-reported discussions of follow-up care, including the need for surveillance, late and long-term effects, emotional needs, and health behaviors. We assessed whether cancer survivors received a written treatment summary and post-treatment care instructions. Most (92%) survivors reported having a discussion about the need for surveillance; 75%, late and long-term effects; 69%, lifestyle and health behaviors; and 53%, emotional and social needs. Most (88%) reported receiving post-treatment care instructions and 47%, a treatment summary. While there was little difference among survivors' receipt of surveillance or health behavior recommendations by cancer type (p = 0.85 and p = 0.66, respectively), discussions of late and long-term effects occurred among 82% of prostate, 78% of breast, 73% of melanoma, 72% of colorectal, and 67% of lung survivors (p = 0.06). Approximately half of survivors reported discussions of emotional needs, with modest differences by cancer type (p = 0.08). Our findings indicate that most patient-provider discussions cover information on surveillance, with less emphasis on late and long-term effects, lifestyle and health behaviors, and substantially less focusing on emotional and social needs. No or modest differences in discussions occurred by cancer type. Whether tailoring information to individual cancer survivor needs is beneficial should be examined.
先前的研究揭示了癌症幸存者与医疗服务提供者在后续护理及护理计划接收方面的讨论存在差距;然而,生存护理计划是否会因癌症类型而异尚不清楚。我们对参加三项健康计划的615名乳腺癌、结直肠癌、前列腺癌、肺癌和黑色素瘤幸存者进行了调查,以研究癌症幸存者自我报告的后续护理讨论情况,包括监测需求、晚期和长期影响、情感需求以及健康行为。我们评估了癌症幸存者是否收到了书面治疗总结和治疗后护理说明。大多数(92%)幸存者报告曾讨论过监测需求;75%讨论过晚期和长期影响;69%讨论过生活方式和健康行为;53%讨论过情感和社会需求。大多数(88%)报告收到了治疗后护理说明,47%收到了治疗总结。虽然不同癌症类型的幸存者在接受监测或健康行为建议方面差异不大(p值分别为0.85和0.66),但82%的前列腺癌幸存者、78%的乳腺癌幸存者、73%的黑色素瘤幸存者、72%的结直肠癌幸存者和67%的肺癌幸存者讨论过晚期和长期影响(p值为0.06)。约一半的幸存者报告讨论过情感需求,不同癌症类型之间存在适度差异(p值为0.08)。我们的研究结果表明,大多数医患讨论涵盖了监测信息,对晚期和长期影响、生活方式和健康行为的关注较少,对情感和社会需求的关注则少得多。不同癌症类型在讨论方面没有或仅有适度差异。是否根据个体癌症幸存者的需求调整信息是否有益值得研究。