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造血干细胞移植患者生存者和临床医生对生存者护理计划的评估:一个针对生存者健康的工程学、初级保健和肿瘤学协作。

Survivor and Clinician Assessment of Survivorship Care Plans for Hematopoietic Stem Cell Transplantation Patients: An Engineering, Primary Care, and Oncology Collaborative for Survivorship Health.

机构信息

Division of Hematology/Oncology, Department of Medicine, University of Wisconsin, Madison, Wisconsin.

Division of Hematology/Oncology, Department of Medicine, University of Wisconsin, Madison, Wisconsin; Carbone Cancer Center, University of Wisconsin, Madison, Wisconsin.

出版信息

Biol Blood Marrow Transplant. 2019 Jun;25(6):1240-1246. doi: 10.1016/j.bbmt.2019.02.003. Epub 2019 Feb 11.

Abstract

The long-term care of hematopoietic stem cell transplantation (HSCT) survivors poses special challenges owing to a myriad of possible chronic and/or late complications. Survivorship care plans (SCPs) have been proposed as tools to communicate information on the late effects of treatment and recommended follow-up care to clinicians and survivors. The primary aims of this study were to determine SCP content and format, as well as to assess the preferred timing of SCP provision following HSCT. HSCT survivors and nontransplantation clinicians (oncologists and primary care physicians) were invited to participate in a survey evaluating the usefulness and utility of a sample HSCT-specific SCP with a treatment summary generated by autopopulation from an electronic health record (EHR). All participating HSCT survivors (n = 29) and clinicians (n = 18) indicated a desire to receive an SCP. More than 85% of the participants perceived information about treatments received, recommended follow-up and health maintenance including vaccinations, survivor and clinician resources, and graft-versus-host disease and other late/chronic side effects to be useful. The majority of survivors also believed that care team contact information was useful. In addition, >85% of survivors and clinicians agreed that the SCP increased their understanding of treatments and chronic/late side effects, improved health care provided, and were satisfied with the SCP and found it understandable and easy to use. The majority of survivors indicated that additional information should be added to the SCP, whereas some clinicians deemed the SCP too long. Survivors preferred to receive the SCP as a paper document at the end of a regular follow-up visit and review it with a cancer clinician, whereas clinicians preferred to receive the SCP through the EHR. These findings will help improve the design of future SCPs for use by HSCT survivors and clinicians. Future work will include leveraging the EHR to ease the burden of creating user-centered documents.

摘要

造血干细胞移植(HSCT)幸存者的长期护理由于存在多种可能的慢性和/或晚期并发症而带来特殊挑战。生存护理计划(SCP)已被提议作为向临床医生和幸存者传达治疗后晚期影响信息和建议后续护理的工具。本研究的主要目的是确定 SCP 的内容和格式,并评估 HSCT 后提供 SCP 的首选时机。邀请 HSCT 幸存者和非移植临床医生(肿瘤学家和初级保健医生)参与评估一份样本 HSCT 特定 SCP 的有用性和实用性的调查,该 SCP 的治疗总结由电子健康记录(EHR)自动填充生成。所有参与的 HSCT 幸存者(n=29)和临床医生(n=18)均表示希望收到 SCP。超过 85%的参与者认为有关接受的治疗、推荐的随访和健康维护(包括疫苗接种)、幸存者和临床医生资源以及移植物抗宿主病和其他晚期/慢性副作用的信息有用。大多数幸存者还认为护理团队的联系信息有用。此外,超过 85%的幸存者和临床医生同意 SCP 提高了他们对治疗和慢性/晚期副作用的理解,改善了所提供的医疗保健,并对 SCP 感到满意,认为它易于理解且易于使用。大多数幸存者表示,应在 SCP 中添加其他信息,而一些临床医生则认为 SCP 太长。幸存者希望在定期随访结束时收到纸质 SCP 并与癌症临床医生一起查看,而临床医生则希望通过 EHR 接收 SCP。这些发现将有助于改进 HSCT 幸存者和临床医生使用的未来 SCP 设计。未来的工作将包括利用 EHR 减轻创建以用户为中心的文档的负担。

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