1 Memorial Sloan Kettering Cancer Center, New York, NY.
2 Netherlands Cancer Institute-Antoni van Leeuwenhoek, Amsterdam, the Netherlands.
J Oncol Pract. 2019 Mar;15(3):e230-e237. doi: 10.1200/JOP.18.00359. Epub 2019 Jan 7.
As the number of cancer survivors grows, new models of survivorship care are being implemented, but there is limited evaluation to date. This retrospective review assesses the concordance of care provided to adult-onset cancer survivors by advanced practice providers (nurse practitioners and physician assistants) with Institute of Medicine guidelines for survivorship care.
Records from three survivorship clinics at a single institution were reviewed for frequency of recurrence surveillance, screening for second cancers, symptom management (physical, psychological), health promotion education (alcohol, tobacco, cholesterol, and bone density screenings; diet/exercise discussion), care coordination, and provision of care plan. Data were characterized using descriptive statistics.
Over 2 years, 9,052 unique survivorship visits occurred; 210 breast, 208 prostate, and 204 colorectal visits were randomly selected for review. All patients with breast cancer underwent surveillance for recurrence; 99% were screened for new cancers. Discussion of health promotion activities ranged from 83% to 100%; 91% of patients were reviewed for physical symptoms, and 93% were reviewed for psychological symptoms. All patients with prostate cancer underwent recurrence surveillance; 97% were screened for new primaries. Health promotion activities ranged from 70% to 97%, and symptoms were discussed in 89% of visits. All patients with colorectal cancer underwent a surveillance colonoscopy for recurrence; 97% had a carcinoembryonic antigen test. Among women, 97% had mammograms, and 96% had a Papanicolaou test; 83% of men had a prostate-specific antigen test. Health promotion activities ranged from 69% to 100%, and symptoms were discussed in 93% to 97% of visits.
Findings suggest that advanced practice providers can provide survivorship care in accordance with Institute of Medicine standards, which provide a normative standard. This assessment is an important step in evaluating survivorship outcomes.
随着癌症幸存者人数的增加，新的生存护理模式正在实施，但迄今为止评估有限。这项回顾性研究评估了由高级执业护士（护士和医师助理）提供的成年癌症幸存者的护理与医学研究所生存护理指南的一致性。
对一家机构的三个生存诊所的记录进行了回顾，以评估复发监测的频率、筛查第二癌、症状管理（身体、心理）、健康促进教育（酒精、烟草、胆固醇和骨密度筛查；饮食/运动讨论）、护理协调和护理计划的提供。使用描述性统计数据对数据进行了描述。
在 2 年期间，发生了 9052 次独特的生存随访；随机选择了 210 例乳腺癌、208 例前列腺癌和 204 例结直肠癌进行回顾。所有乳腺癌患者均进行了复发监测；99%的患者接受了新癌症筛查。健康促进活动的讨论范围从 83%到 100%；91%的患者接受了身体症状的检查，93%的患者接受了心理症状的检查。所有前列腺癌患者均进行了复发监测；97%的患者接受了新原发性肿瘤筛查。健康促进活动的范围从 70%到 97%，89%的就诊时讨论了症状。所有结直肠癌患者均进行了复发监测结肠镜检查；97%的患者进行了癌胚抗原检测。在女性中，97%的患者进行了乳房 X 光检查，96%的患者进行了巴氏涂片检查；83%的男性进行了前列腺特异性抗原检测。健康促进活动的范围从 69%到 100%，93%到 97%的就诊时讨论了症状。
研究结果表明，高级执业护士可以根据医学研究所的标准提供生存护理，这为生存护理提供了一个规范标准。这项评估是评估生存结果的重要步骤。
