Handberg Charlotte, Jensen Charlotte Maria, Maribo Thomas
Department of Public Health, Section for Clinical Social Medicine and Rehabilitation, Faculty of Health, Aarhus University, Denmark.
DEFACTUM, Central Denmark Region, Denmark.
J Clin Med Res. 2017 Oct;9(10):864-871. doi: 10.14740/jocmr3160w. Epub 2017 Sep 1.
Formalized and systematic assessment of survivorship care and rehabilitation needs is prerequisite for ensuring cancer patients sufficient help and support through their cancer trajectory. Patients are often uncertain as to how to express and address their survivorship care and rehabilitation needs, and little is known about specific, unmet needs and the plans necessary to meet them. There is a call for both ensuring survivorship care and rehabilitation for cancer patients in need and further for documenting the specific needs related to the cancer disease and its treatment. Thus the aim of this study was to describe specific survivorship care and rehabilitation needs and plans as stated by patients with cancer at hospitals when diagnosed and when primary care survivorship care and rehabilitation begins.
Needs assessment forms from cancer patients at two hospitals and two primary care settings were analyzed. The forms included stated needs and survivorship care and rehabilitation plans. All data were categorized using the International Classification of Functioning, Disability and Health (ICF).
Eighty-nine patients at hospitals and 99 in primary care, stated their needs. Around 50% of the patients completed a survivorship care and rehabilitation plan. In total, 666 (mean 7.5) needs were stated by hospital patients and 836 (mean 8.0) by those in primary care. The needs stated were primarily within the ICF component "body functions and structure", and the most frequent needs were (hospitals/primary care) fatigue (57%/67%), reduced muscle strength (55%/67%) and being worried (37%/36%).
The results underpin an urgent need for a systematic procedure to assess needs in clinical practice where cancer patients are being left without survivorship care and rehabilitation needs assessment. Gaining knowledge on needs assessment and the detailed description of needs and plans can facilitate targeted interventions. The findings indicate an urgent need to change the practice culture to be systematic in addressing and identifying survivorship care needs among patients with cancer. Further the findings call for considering the development of a new needs assessment form with involvement of both patients and healthcare professionals.
对癌症生存护理和康复需求进行规范化、系统化评估是确保癌症患者在其癌症治疗过程中获得充分帮助和支持的前提条件。患者往往不确定如何表达和提出他们的癌症生存护理和康复需求，对于具体的未满足需求以及满足这些需求所需的计划知之甚少。目前既需要确保为有需要的癌症患者提供生存护理和康复服务，也需要记录与癌症疾病及其治疗相关的具体需求。因此，本研究的目的是描述癌症患者在医院确诊时以及初级保健癌症生存护理和康复开始时所陈述的具体癌症生存护理和康复需求及计划。
对两家医院和两个初级保健机构的癌症患者需求评估表进行了分析。这些表格包括所陈述的需求以及癌症生存护理和康复计划。所有数据均使用《国际功能、残疾和健康分类》（ICF）进行分类。
医院的89名患者和初级保健机构的99名患者陈述了他们的需求。约50%的患者完成了癌症生存护理和康复计划。医院患者共陈述了666项（平均7.5项）需求，初级保健机构的患者陈述了836项（平均8.0项）需求。所陈述的需求主要在ICF的“身体功能和结构”部分，最常见的需求是（医院/初级保健机构）疲劳（57%/67%）、肌肉力量下降（55%/67%）和焦虑（37%/36%）。
研究结果表明迫切需要一种系统程序来评估临床实践中癌症患者的需求，因为目前癌症患者得不到癌症生存护理和康复需求评估。了解需求评估以及对需求和计划的详细描述有助于开展有针对性的干预措施。研究结果表明迫切需要改变实践文化，以便系统地关注和识别癌症患者的癌症生存护理需求。此外，研究结果呼吁考虑在患者和医疗专业人员的参与下开发一种新的需求评估表。
