Milken Institute School of Public Health, George Washington University, 950 New Hampshire Ave., Washington, DC, 20052, USA.
L. Douglas Wilder School of Government and Public Affairs, Virginia Commonwealth University, 1001 W. Franklin St., Richmond, VA, 23284, USA.
J Cancer Surviv. 2020 Dec;14(6):939-958. doi: 10.1007/s11764-020-00905-8. Epub 2020 Jun 30.
This study explored cancer survivors' experiences with and priorities for cancer survivorship care to describe a patient-centered approach to quality survivorship care.
We conducted 22 focus groups with 170 adult survivors of breast, prostate, and colorectal cancer from six cities across the country and online. We used thematic analysis to identify participants' principles and priorities for quality survivorship care.
Based on our analysis of a limited group of cancer survivors, we identified two core principles that underlie participants' expectations for survivorship care and 11 practice priorities that reflect opportunities to improve patient-centeredness at the individual, interpersonal, and organizational levels. The principles reflect participants' desire to be better prepared for and equipped to accept and manage their chronic care needs post-cancer treatment. The priorities reflect practices that patients, providers, and cancer centers can engage in to ensure survivors' goals for post-treatment care are met.
Results from the study suggest the need to expand conceptualization of high-quality survivorship care. The survivor principles and practice priorities identified in this study challenge the field to organize a more patient-centered survivorship care system that empowers and respects patients and provides a holistic approach to survivors' chronic and long-term needs.
Quality cancer survivorship care must reflect patients' priorities. The findings from this study can be used to develop a patient-centered framework for survivorship care that can be used in conjunction with quality guidelines to ensure survivorship care is organized to achieve both clinical and patient-centered outcomes.
本研究探讨了癌症幸存者对癌症生存护理的体验和优先事项,以描述一种以患者为中心的优质生存护理方法。
我们在全国六个城市和网上进行了 22 个焦点小组,共有 170 名乳腺癌、前列腺癌和结直肠癌的成年幸存者参加。我们使用主题分析来确定参与者对优质生存护理的原则和优先事项。
基于对有限数量的癌症幸存者的分析,我们确定了两个核心原则,这些原则是参与者对生存护理期望的基础,以及 11 个反映在个人、人际和组织层面上提高以患者为中心程度的实践优先事项。这些原则反映了参与者希望更好地为癌症治疗后慢性护理需求做好准备,并具备接受和管理这些需求的能力。这些优先事项反映了患者、提供者和癌症中心可以采取的措施,以确保满足幸存者对治疗后护理的目标。
研究结果表明,需要扩大对高质量生存护理的概念化。本研究确定的幸存者原则和实践优先事项挑战了该领域,要求建立一个更加以患者为中心的生存护理系统,赋予患者权力并尊重患者,为幸存者的慢性和长期需求提供整体方法。
高质量的癌症生存护理必须反映患者的优先事项。本研究的结果可用于制定以患者为中心的生存护理框架,该框架可与质量指南结合使用,以确保生存护理的组织能够实现临床和以患者为中心的结果。