Kids Cancer Centre, Sydney Children's Hospital, Sydney, NSW, Australia.
School of Women's and Children's Health, UNSW Sydney, Sydney, NSW, Australia.
J Natl Compr Canc Netw. 2020 Aug;18(8):1067-1074. doi: 10.6004/jnccn.2020.7552.
Survivors of childhood cancer often experience treatment-related chronic health conditions. Survivorship care improves survivors' physical and mental health, yet many are disengaged from care. Innovative models of care are necessary to overcome patient-reported barriers to accessing survivorship care and to maximize survivors' health.
We piloted a novel survivorship program, called "Re-engage," a distance-delivered, nurse-led intervention aiming to engage, educate, and empower survivors not receiving any cancer-related care. Re-engage involves a nurse-led consultation delivered via telephone/online to establish survivors' medical history and needs. Participants completed questionnaires at baseline, 1 month postintervention, and 6-month follow-up.
A total of 27 survivors who had not accessed survivorship care in the last 2 years participated (median age, 31 years; interquartile range [IQR], 27-39 years); of which, 82% were at high-risk for treatment-related complications. Participation in Re-engage was high (75%) and there was no attrition once survivors enrolled. At 1 month postintervention, 92% of survivors reported that Re-engage was "beneficial," which all survivors reported at 6-month follow-up. Survivors' overall satisfaction with their care increased from 52% before Re-engage to 84% at 1 month postintervention. Survivors' mean self-efficacy scores remained similar from baseline to 1 month postintervention (b = -0.33, 95% CI, -1.31 to 0.65), but increased significantly from baseline to 6-month follow-up (b = 1.64, 95% CI, 0.28-3.00). At 6-month follow-up, 73% of survivors showed an increase in health-related self-efficacy compared with baseline.
Re-engage is a highly acceptable and feasible intervention and promotes health-related self-efficacy, which is integral to survivors being advocates for their own health. Further empirical work is needed to evaluate the long-term efficacy of Re-engage.
ACTRN12618000194268.
儿童癌症幸存者常经历与治疗相关的慢性健康问题。生存护理可改善幸存者的身心健康，但许多人无法获得护理。需要创新的护理模式来克服患者报告的获取生存护理的障碍，并最大限度地提高幸存者的健康水平。
我们试点了一种新的生存者方案，称为“重新参与”，这是一种远程提供的、由护士主导的干预措施，旨在使未接受任何癌症相关护理的生存者参与、教育和赋权。重新参与涉及通过电话/在线进行的护士主导的咨询，以确定生存者的病史和需求。参与者在基线、干预后 1 个月和 6 个月随访时完成了问卷调查。
共有 27 名在过去 2 年内未接受生存护理的幸存者参与（中位年龄 31 岁；四分位距 [IQR] 27-39 岁）；其中 82%存在治疗相关并发症的高风险。重新参与的参与率很高（75%），一旦幸存者入组，就没有流失。在干预后 1 个月时，92%的幸存者报告称重新参与“有益”，所有幸存者在 6 个月随访时都报告了这一点。幸存者对护理的总体满意度从重新参与前的 52%增加到 1 个月后的 84%。幸存者的自我效能评分从基线到干预后 1 个月基本保持不变（b = -0.33，95%CI，-1.31 至 0.65），但从基线到 6 个月随访时显著增加（b = 1.64，95%CI，0.28-3.00）。在 6 个月随访时，与基线相比，73%的幸存者表现出健康相关自我效能的提高。
重新参与是一种高度可接受且可行的干预措施，并促进了健康相关的自我效能，这对于幸存者倡导自己的健康至关重要。需要进一步的实证研究来评估重新参与的长期疗效。
ACTRN12618000194268。
