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韩国癌症幸存者的护理协调感知与健康结果的关系。

Association between perception of care coordination and health outcomes in Korean cancer survivors.

机构信息

Department of Family Medicine, Konkuk University Medical Center, Konkuk University School of Medicine, 120-1, Neungdong-ro, Gwangjin-gu, Seoul, 05030, South Korea.

Department of Family Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, South Korea.

出版信息

Health Qual Life Outcomes. 2020 Feb 4;18(1):21. doi: 10.1186/s12955-020-1279-6.

Abstract

BACKGROUND

To determine relationship between cancer survivors' perception of care coordination and their health outcomes.

METHODS

Study subjects were 1306 Korean adulthood cancer survivors who were enrolled in two academic hospital and completed a questionnaire consisting of questions asking two aspects of care coordination for cancer treatment they had received: 1) who played a main coordinator role and 2) whether care services had met their necessitated health concerns. We measured health outcomes including new comorbidity, number of clinic visits, health-related quality of life (HRQoL) and fear of cancer recurrence (FCR). Associations between the level of care coordination and health outcomes were evaluated by multiple logistic regression analysis after adjusting for covariates.

RESULTS

Survivors with uncoordinated care were more likely to have more new comorbidities after cancer diagnosis, visit clinic more frequently and have worse HRQoL and higher FCR. Females and unmarried survivors were more likely to have received uncoordinated care than males and ever married survivors. Uncoordinated care group had an increased the risk of new comorbidity (odds ratio 1.73, [95% confidence interval] 1.02-2.92), multiple clinic visits (1.69, 1.00-2.88), severe FCR (2.28, 1.33-3.93), low EuroQoL Visual Analogue Scale (1.82, 1.28-2.60), low global health status (1.51, 1.04-2.21), and poor physical (2.00, 1.31-3.04), role (2.46, 1.69-3.56) and emotional function (2.62, 1.81-3.78).

CONCLUSIONS

Coordinated care of Korean cancer survivors was associated with their health outcomes, including new comorbidity, clinic visits, HRQoL and FCR. Good care coordination may be reinforced to improve outcomes of survivorship care.

摘要

背景

为了确定癌症幸存者对护理协调的看法与他们健康结果之间的关系。

方法

研究对象为 1306 名韩国成年癌症幸存者,他们参加了两家学术医院的研究,并完成了一份问卷,其中包括两个方面的问题,询问他们接受的癌症治疗护理协调情况:1)谁担任主要协调员角色,2)护理服务是否满足他们的必要健康需求。我们测量了健康结果,包括新的合并症、就诊次数、健康相关生活质量(HRQoL)和对癌症复发的恐惧(FCR)。在调整了协变量后,通过多变量逻辑回归分析评估了护理协调水平与健康结果之间的关联。

结果

接受不协调护理的幸存者在癌症诊断后更有可能出现更多新的合并症,就诊更频繁,且 HRQoL 更差,FCR 更高。女性和未婚幸存者比男性和已婚幸存者更有可能接受不协调的护理。不协调护理组发生新合并症的风险增加(比值比 1.73,[95%置信区间] 1.02-2.92)、就诊次数增加(1.69,1.00-2.88)、严重 FCR(2.28,1.33-3.93)、低 EuroQoL 视觉模拟量表(1.82,1.28-2.60)、低总体健康状况(1.51,1.04-2.21)、差的身体(2.00,1.31-3.04)、角色(2.46,1.69-3.56)和情绪功能(2.62,1.81-3.78)。

结论

韩国癌症幸存者的协调护理与他们的健康结果有关,包括新的合并症、就诊次数、HRQoL 和 FCR。加强良好的护理协调可能会改善生存护理的结果。

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