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癌症幸存者护理计划的应用及其对初级保健门诊临床决策的影响:一项关于幸存者健康的工程、初级保健与肿瘤协作研究的结果

Cancer Survivorship Care Plan Utilization and Impact on Clinical Decision-Making at Point-of-Care Visits with Primary Care: Results from an Engineering, Primary Care, and Oncology Collaborative for Survivorship Health.

作者信息

Donohue SarahMaria, Haine James E, Li Zhanhai, Feldstein David A, Micek Mark, Trowbridge Elizabeth R, Kamnetz Sandra A, Sosman James M, Wilke Lee G, Sesto Mary E, Tevaarwerk Amye J

机构信息

University of Wisconsin, Madison, WI, USA.

Department of Medicine, Division of Internal Medicine, University of Wisconsin, Madison, WI, USA.

出版信息

J Cancer Educ. 2019 Apr;34(2):252-258. doi: 10.1007/s13187-017-1295-3.

Abstract

Every cancer survivor and his/her primary care provider should receive an individualized survivorship care plan (SCP) following curative treatment. Little is known regarding point-of-care utilization at primary care visits. We assessed SCP utilization in the clinical context of primary care visits. Primary care physicians and advanced practice providers (APPs) who had seen survivors following provision of an SCP were identified. Eligible primary care physicians and APPs were sent an online survey, evaluating SCP utilization and influence on decision-making at the point-of-care, accompanied by copies of the survivor's SCP and the clinic note. Eighty-eight primary care physicians and APPs were surveyed November 2016, with 40 (45%) responding. Most respondents (60%) reported discussing cancer or related issues during the visit. Information needed included treatment (66%) and follow-up visits, and the cancer team was responsible for (58%) vs primary care (58%). Respondents acquired this information by asking the patient (79%), checking oncology notes (75%), the SCP (17%), or online resources (8%). Barriers to SCP use included being unaware of the SCP (73%), difficulty locating it (30%), and finding needed information faster via another mechanism (15%). Despite largely not using the SCP for the visit (90%), most respondents (61%) believed one would be quite or very helpful for future visits. Most primary care visits included discussion of cancer or cancer-related issues. SCPs may provide the information necessary to deliver optimal survivor care but efforts are needed to reduce barriers and design SCPs for primary care use.

摘要

每位癌症幸存者及其初级保健提供者在接受根治性治疗后都应收到一份个性化的癌症生存护理计划(SCP)。关于初级保健就诊时即时护理的利用情况,目前所知甚少。我们评估了初级保健就诊临床环境中SCP的利用情况。确定了在提供SCP后见过幸存者的初级保健医生和高级执业提供者(APP)。符合条件的初级保健医生和APP收到了一份在线调查问卷,评估SCP的利用情况及其对即时护理决策的影响,并附上幸存者的SCP副本和临床记录。2016年11月对88名初级保健医生和APP进行了调查,40人(45%)回复。大多数受访者(60%)报告在就诊期间讨论了癌症或相关问题。所需信息包括治疗(66%)和随访就诊,癌症治疗团队负责(58%),而初级保健负责(58%)。受访者通过询问患者(79%)、查看肿瘤学记录(75%)、SCP(17%)或在线资源(8%)获取这些信息。SCP使用的障碍包括不知道有SCP(73%)、难以找到它(30%)以及通过其他方式能更快找到所需信息(15%)。尽管在很大程度上就诊时未使用SCP(90%),但大多数受访者(61%)认为SCP对未来就诊会非常或相当有帮助。大多数初级保健就诊都包括对癌症或癌症相关问题的讨论。SCP可能提供提供最佳幸存者护理所需的信息,但需要努力减少障碍并设计适用于初级保健使用的SCP。

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Survivorship care plans: prevalence and barriers to use.生存护理计划:使用情况及障碍
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