Liska Carrie M, Morash Robin, Paquet Lise, Stacey Dawn
The Ottawa Hospital, Ottawa, ON.
Carleton University, Ottawa, ON.
Can Oncol Nurs J. 2018 Apr 1;28(2):76-81. doi: 10.5737/236880762827681. eCollection 2018 Spring.
Our Wellness Beyond Cancer Survivorship Program was established and evaluated as a quality improvement project. Individualized survivorship care plans for survivors and primary care providers included cancer surveillance recommendations and survivors' self-reported physical and psychosocial needs. At the discharge visit, an oncology nurse reviewed the care plan and symptom management strategies with survivors. We assessed the physical and psychosocial needs and feelings of empowerment of 70 breast and 53 colorectal cancer survivors on entry into the program and one year after discharge to primary care. Survivors were months to 10 or more years since the end of active treatment, with colorectal cancer survivors referred sooner (average 1.2 years). At baseline, colorectal cancer survivors reported little concern about their needs (scores <1.0 out of 5.0) and breast cancer survivors reported some concern about sleep disturbances, weight changes, memory/concentration changes, and fear of recurrence (scores 1.0 to 1.5 out of 5.0). All survivors reported feeling empowered (>3.0 out of 4.0). Needs and empowerment levels were mostly unchanged one year later. Colorectal cancer survivors showed a statistically significantly increased fear of recurrence at one year. In summary, cancer survivors with a survivorship care plan continued to feel empowered one year following discharge.
我们的“癌症幸存者之后的健康计划”是作为一个质量改进项目设立并进行评估的。为幸存者和初级保健提供者制定的个性化生存护理计划包括癌症监测建议以及幸存者自我报告的身体和心理社会需求。在出院访视时,一名肿瘤学护士与幸存者一起回顾了护理计划和症状管理策略。我们评估了70名乳腺癌幸存者和53名结直肠癌幸存者在进入该计划时以及出院回到初级保健机构一年后的身体和心理社会需求以及赋权感受。幸存者在积极治疗结束后已有数月至10年或更长时间,结直肠癌幸存者转诊时间更早(平均1.2年)。在基线时,结直肠癌幸存者对自身需求几乎没有担忧(评分<5.0分中的1.0分),乳腺癌幸存者对睡眠障碍、体重变化、记忆/注意力变化以及复发恐惧有些担忧(评分5.0分中的1.0至1.5分)。所有幸存者均表示有赋权感(>4.0分中的3.0分)。一年后,需求和赋权水平大多没有变化。结直肠癌幸存者在一年时复发恐惧在统计学上显著增加。总之,有生存护理计划的癌症幸存者在出院一年后仍感到有赋权感。