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乳腺癌幸存者对不同提供者在随访护理中所扮演角色的看法。

Breast cancer survivor's perspectives on the role different providers play in follow-up care.

机构信息

Wisconsin Surgical Outcomes Research Program, Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.

School of Nursing, Institute for Clinical and Translational Research, University of Wisconsin-Madison, Madison, WI, USA.

出版信息

Support Care Cancer. 2018 Jun;26(6):2015-2022. doi: 10.1007/s00520-018-4042-3. Epub 2018 Jan 13.

Abstract

IMPORTANCE

Significant variation in the number and types of oncologists that provide breast cancer follow-up exists. However, there is limited understanding regarding breast cancer survivors' preferences for who provides their follow-up. Our objective was to explore breast cancer survivors' perspectives on the goals of breast cancer follow-up, the preferred role for primary care providers, and the perceived roles of different types of oncologists during follow-up.

METHODS

A convenience sample of stage 0-III breast cancer survivors was identified and in-depth one-on-one interviews conducted. Data were analyzed using inductive content analysis.

RESULTS

Survivors cited a strong preference for oncology-based follow-up within the first 5 years after diagnosis, driven by their need for reassurance that cancer had not recurred. Survivors also thought that their primary care provider needed to be involved. Survivors assumed that oncology follow-up was directed by a standard protocol that included streamlining the follow-up team. Survivors recognized that patients with more complex cancers or challenging treatment courses may require more intensive follow-up and deviate from the standard protocol. Most survivors were comfortable deferring decisions regarding who participated in follow-up to the oncology team.

CONCLUSIONS

Most patients think a streamlined approach to oncology-based breast cancer follow-up already occurs, driven by a standard protocol. The use of a standard protocol to provide guidance for which types of oncology providers should participate in breast cancer follow-up will streamline care and represents a significant opportunity to reduce unnecessary variation. This approach is especially critical given patients' strong preferences for oncology-based follow-up.

摘要

重要性

提供乳腺癌随访的肿瘤学家的数量和类型存在显著差异。然而,对于乳腺癌幸存者对谁来提供随访的偏好,人们的了解有限。我们的目的是探讨乳腺癌幸存者对乳腺癌随访目标的看法、初级保健提供者的首选角色,以及在随访期间不同类型肿瘤学家的感知角色。

方法

通过便利抽样,确定了 0-III 期乳腺癌幸存者,并进行了深入的一对一访谈。使用归纳内容分析对数据进行分析。

结果

幸存者强烈倾向于在诊断后的头 5 年内进行基于肿瘤学的随访,这是因为他们需要确认癌症没有复发。幸存者还认为他们的初级保健提供者需要参与。幸存者假设肿瘤学随访是由包括简化随访团队的标准协议指导的。幸存者认识到,患有更复杂癌症或治疗过程具有挑战性的患者可能需要更密集的随访,并偏离标准协议。大多数幸存者愿意将谁参与随访的决策交给肿瘤学团队。

结论

大多数患者认为,已经存在一种基于肿瘤学的简化乳腺癌随访方法,这是由标准协议驱动的。使用标准协议来指导哪些类型的肿瘤学提供者应参与乳腺癌随访,将简化护理,并为减少不必要的差异提供重要机会。考虑到患者对基于肿瘤学的随访的强烈偏好,这种方法尤其关键。

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