Prostate Cancer Foundation of Australia, Sydney, NSW, Australia.
Division of Research and Innovation, University of Southern Queensland, Springfield, Qld, Australia.
BJU Int. 2021 Dec;128 Suppl 3(Suppl 3):18-29. doi: 10.1111/bju.15159. Epub 2020 Aug 18.
To develop contemporary and inclusive prostate cancer survivorship guidelines for the Australian setting.
A four-round iterative policy Delphi was used, with a 47-member expert panel that included leaders from key Australian and New Zealand clinical and community groups and consumers from diverse backgrounds, including LGBTQIA people and those from regional, rural and urban settings. The first three rounds were undertaken using an online survey (94-96% response) followed by a fourth final face-to-face panel meeting. Descriptors for men's current prostate cancer survivorship experience were generated, along with survivorship elements that were assessed for importance and feasibility. From these, survivorship domains were generated for consideration.
Six key descriptors for men's current prostate cancer survivorship experience that emerged were: dealing with side effects; challenging; medically focused; uncoordinated; unmet needs; and anxious. In all, 26 survivorship elements were identified within six domains: health promotion and advocacy; shared management; vigilance; personal agency; care coordination; and evidence-based survivorship interventions. Consensus was high for all domains as being essential. All elements were rated high on importance but consensus was mixed for feasibility. Seven priorities were derived for immediate action.
The policy Delphi allowed a uniquely inclusive expert clinical and community group to develop prostate cancer survivorship domains that extend beyond traditional healthcare parameters. These domains provide guidance for policymakers, clinicians, community and consumers on what is essential for step change in prostate cancer survivorship outcomes.
为澳大利亚制定当代且具包容性的前列腺癌生存指南。
采用四轮迭代政策 Delphi 方法，由 47 名专家组成，包括来自澳大利亚和新西兰主要临床和社区团体的领导人，以及来自不同背景的消费者，包括 LGBTQIA 人群以及来自地区、农村和城市环境的人群。前三轮采用在线调查（响应率为 94-96%）进行，然后进行第四轮面对面最终小组会议。生成了男性当前前列腺癌生存体验的描述符，以及评估重要性和可行性的生存元素。在此基础上，生成了生存领域以供考虑。
出现了男性当前前列腺癌生存体验的六个关键描述符：应对副作用；具有挑战性；以医学为重点；不协调；未满足的需求；焦虑。总共确定了六个领域中的 26 个生存元素：健康促进和宣传；共同管理；警惕；个人代理；护理协调；以及基于证据的生存干预措施。所有领域都被认为是必不可少的，共识度很高。所有元素的重要性都很高，但可行性的共识存在分歧。得出了 7 项优先事项，以供立即采取行动。
政策 Delphi 允许具有独特包容性的专家临床和社区团体制定超出传统医疗保健参数的前列腺癌生存领域。这些领域为政策制定者、临床医生、社区和消费者提供了指导，以实现前列腺癌生存结果的重大改善。
