Vuksanovic Dean, Sanmugarajah Jasotha, Lunn Dominic, Sawhney Raja, Eu Kelly, Liang Rhea
Gold Coast Hospital and Health Service, 1 Hospital Blvd, Parklands Drive, Southport, QLD, 4215, Australia.
ICON Cancer Centre, Gold Coast University Hospital, 1 Hospital Blvd, Southport, QLD, 4215, Australia.
Breast Cancer. 2021 Mar;28(2):289-297. doi: 10.1007/s12282-020-01156-2. Epub 2020 Sep 14.
The transition from a breast cancer patient to a survivor can be associated with significant physical, psychological, and social challenges. Development of multidisciplinary evidence-based care during the post-treatment period is a key area of cancer research. This study examined survivorship issues, unmet needs and perceptions about care among a cohort of breast cancer survivors.
Participants were 130 women diagnosed with breast cancer for at least one year, and attending a hospital breast or oncology outpatient clinic. They completed a series of self-report questionnaires assessing demographic and clinical characteristics, unmet needs, severity of survivorship issues, use of multidisciplinary services, clinical benchmarks, survivorship care satisfaction, and suggestions for service improvements.
There was an average of 4.9 unmet survivorship needs, with 67% of participants reporting at least one unmet need. Fear of cancer recurrence, stress, coordination of medical care and negative iatrogenic impacts of hormonal treatments were key concerns. The cancer support team typically consisted of medical and nursing staff, and family/friends, and most were satisfied with their survivorship care. There was minimal use of other multidisciplinary clinicians and support groups. Provision of additional dietary and cancer recurrence education, and a written treatment plan were identified as key areas of service improvement.
Despite high satisfaction ratings, survivorship issues and unmet needs were relatively common, particularly among younger participants. Use of multidisciplinary care was inconsistent and overall underutilised.
Ongoing specific evaluation and optimisation of existing models of multidisciplinary survivorship care are essential in meeting the complex needs of breast cancer survivors.
从乳腺癌患者转变为幸存者可能伴随着重大的身体、心理和社会挑战。在治疗后阶段开展多学科循证护理是癌症研究的一个关键领域。本研究调查了一组乳腺癌幸存者中的生存问题、未满足的需求以及对护理的看法。
参与者为130名被诊断患有乳腺癌至少一年且在医院乳腺或肿瘤门诊就诊的女性。她们完成了一系列自我报告问卷,评估人口统计学和临床特征、未满足的需求、生存问题的严重程度、多学科服务的使用情况、临床基准、生存护理满意度以及对服务改进的建议。
平均有4.9项未满足的生存需求,67%的参与者报告至少有一项未满足的需求。对癌症复发的恐惧、压力、医疗护理的协调以及激素治疗的负面医源性影响是主要关注点。癌症支持团队通常由医护人员以及家人/朋友组成,大多数人对他们的生存护理感到满意。对其他多学科临床医生和支持小组的利用很少。提供额外的饮食和癌症复发教育以及书面治疗计划被确定为服务改进的关键领域。
尽管满意度较高,但生存问题和未满足的需求相对普遍,尤其是在年轻参与者中。多学科护理的使用不一致且总体利用不足。
持续对现有的多学科生存护理模式进行具体评估和优化对于满足乳腺癌幸存者的复杂需求至关重要。