Singh-Carlson S, Wong F, Oshan G
School of Nursing, San Diego State University, San Diego, CA, U.S.A.
BC Cancer-Fraser Valley Centre, Surrey, BC.
Curr Oncol. 2018 Aug;25(4):e265-e274. doi: 10.3747/co.25.3734. Epub 2018 Aug 14.
This paper focuses on phase iii of a study evaluating the development and implementation of a survivorship care plan (scp) that could ultimately improve post-treatment quality of life for South Asian (sa) breast cancer survivors (bcss). Evaluating the utility of the scp was important to understand how sociocultural influences might affect uptake of the scp by sa bcss, especially as they transition from treatment to community care.
Post-treatment discharge planning using an individualized scp at discharge for sa female breast cancer patients with stage i or ii disease was offered as a pilot service to oncologists at BC Cancer's Fraser Valley and Abbotsford centres. A longitudinal study using a mixed-methods approach was used to evaluate the utility of that service at 1 year after discharge.
Participants ( = 16) completed a survey about their scp delivery experience, and a 1-year post implementation survey about the scp content and its utility. Most participants reported the discharge appointments to be extremely or very helpful with respect to post-treatment care questions. All have visited their family physicians for follow-up as recommended. The three major sources of support were family, faith, and family physician. Qualitative responses from the health care professionals who developed or implemented the scps identified two challenges in scp delivery: engaging patients or family members in relationship, and translating key information through interpreters.
It is important to evaluate the utility of scps for sa female survivors, who might differ from the general bcs population because of a different understanding of the disease; language barriers; strong influence of family members; societal stigmas; and personal, social, cultural, and religious beliefs and values. A formal nurse-led discharge appointment with discussions about follow-up care and an individualized scp outlining the short- and long-term effects of treatment are recommended. Particular attention has to be paid to the practical and psychosocial needs of sa bcss and their supporting family members.
本文聚焦于一项研究的第三阶段，该研究评估了一份生存护理计划（SCP）的制定与实施情况，该计划最终可能改善南亚（SA）乳腺癌幸存者（BCSS）治疗后的生活质量。评估SCP的效用对于理解社会文化影响如何可能影响SA BCSS对SCP的接受程度很重要，尤其是当她们从治疗过渡到社区护理时。
为不列颠哥伦比亚癌症协会弗雷泽谷和阿伯茨福德中心的肿瘤学家提供了一项试点服务，即针对患有I期或II期疾病的SA女性乳腺癌患者，在出院时使用个性化的SCP进行出院后计划安排。采用混合方法的纵向研究用于评估出院1年后该服务的效用。
参与者（n = 16）完成了一项关于其SCP提供体验的调查，以及一项关于SCP内容及其效用的实施后1年调查。大多数参与者报告称，出院预约对于治疗后护理问题非常有帮助。所有人都按照建议去看了家庭医生进行随访。三大支持来源是家人、信仰和家庭医生。制定或实施SCP的医疗保健专业人员的定性反馈确定了SCP提供中的两个挑战：让患者或家庭成员参与关系，以及通过口译员翻译关键信息。
评估SCP对SA女性幸存者的效用很重要，她们可能因对疾病的不同理解、语言障碍、家庭成员的强烈影响、社会耻辱以及个人、社会、文化和宗教信仰及价值观而与一般BCS人群不同。建议由护士主导进行正式的出院预约，讨论后续护理，并制定一份个性化的SCP，概述治疗的短期和长期影响。必须特别关注SA BCSS及其支持家庭成员的实际和心理社会需求。
