再参与：一个针对与癌症相关护理脱轨的儿童癌症幸存者的新型护士主导项目。
Re-Engage: A Novel Nurse-Led Program for Survivors of Childhood Cancer Who Are Disengaged From Cancer-Related Care.
机构信息
Kids Cancer Centre, Sydney Children's Hospital, Sydney, NSW, Australia.
School of Women's and Children's Health, UNSW Sydney, Sydney, NSW, Australia.
出版信息
J Natl Compr Canc Netw. 2020 Aug;18(8):1067-1074. doi: 10.6004/jnccn.2020.7552.
BACKGROUND
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.
METHODS
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.
RESULTS
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.
CONCLUSIONS
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.
TRIAL REGISTRATION
ACTRN12618000194268.
背景
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。
方法
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。
结果
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。
结论
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。
试验注册
ACTRN12618000194268。
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