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农村初级保健诊所与癌症幸存者护理:癌症幸存者护理轨迹的一部分

Rural Primary Care Offices and Cancer Survivorship Care: Part of the Care Trajectory for Cancer Survivors.

作者信息

Berry-Stoelzle Maresi, Parang Kim, Daly Jeanette

机构信息

Department of Family Medicine, University of Iowa, Iowa City, IA, USA.

出版信息

Health Serv Res Manag Epidemiol. 2019 Jan 25;6:2333392818822914. doi: 10.1177/2333392818822914. eCollection 2019 Jan-Dec.

Abstract

BACKGROUND

A cancer diagnosis is a monumental event in a patient's life and with the number of cancer survivors increasing; most of these patients will be taken care of by a primary care provider at some point after their cancer therapy. The purpose of this study is to identify primary care physician's needs to care for a patient who has had cancer.

METHODS

A cross-sectional survey of the physician members of the Iowa Research Network was conducted. The survey was designed to measure physician confidence in cancer survivor's care, office strategies regarding cancer survivorship care, and resources available for patients with cancer. Two hundred seventy-four Iowa Research Network members were invited to participate in this survey.

RESULTS

Eighty-two physicians (30%) completed the questionnaire with 96% reporting that they are aware of their patient's cancer survivorship status. Seventy-one physicians reported they were aware of cancer survivorship status by an oncologist sending a note to the office, 68 being diagnosed in their office, 61 by the patient keeping the office apprised, and 15 receiving a survivorship care plan. Physicians reported the top changes in a cancer survivor's physical health as fatigue (81%) and pain (59%). Sixty-two physicians reported not feeling confident for managing chemobrain, cardiotoxicity (71%), and skin changes (35%). Male physicians were significantly more confident managing patients' skin changes ( = .049) and musculoskeletal disturbances than female physicians ( = .027), while female physicians were significantly more confident managing early-onset menopause than male physicians ( = .027).

CONCLUSION

Most respondents are aware of their patients who are cancer survivors and are mostly confident in the care they provide for them related to long-term effects and side effects of cancer therapies with limited receipt of cancer survivorship care plans.

摘要

背景

癌症诊断是患者生命中的重大事件,随着癌症幸存者数量的增加,这些患者中的大多数在癌症治疗后的某个阶段将由初级保健提供者进行护理。本研究的目的是确定初级保健医生对癌症患者护理的需求。

方法

对爱荷华研究网络的医生成员进行了横断面调查。该调查旨在衡量医生对癌症幸存者护理的信心、关于癌症幸存者护理的办公室策略以及为癌症患者提供的资源。邀请了274名爱荷华研究网络成员参与这项调查。

结果

82名医生(30%)完成了问卷,96%的医生报告称他们了解患者的癌症生存状况。71名医生报告称他们通过肿瘤学家给办公室发送便条了解到癌症生存状况,68名是在他们的办公室被诊断出来的,61名是患者告知办公室的,15名收到了生存护理计划。医生们报告说癌症幸存者身体健康方面最常见的变化是疲劳(81%)和疼痛(59%)。62名医生报告称对管理化疗脑、心脏毒性(71%)和皮肤变化(35%)没有信心。男性医生在管理患者皮肤变化(P = 0.049)和肌肉骨骼紊乱方面比女性医生更有信心(P = 0.027),而女性医生在管理早发性更年期方面比男性医生更有信心(P = 0.027)。

结论

大多数受访者了解他们的癌症幸存者患者,并且大多对他们为患者提供的与癌症治疗的长期影响和副作用相关的护理有信心,但收到的癌症生存护理计划有限。

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"Lost to Follow-up" Among Adult Cancer Survivors.成年癌症幸存者中的“失访”情况
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