Division of Hematology/Oncology, Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan, USA.
Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, Michigan, USA.
Cancer Med. 2021 Feb;10(4):1289-1296. doi: 10.1002/cam4.3725. Epub 2021 Jan 18.
Following treatment of Stage III colorectal cancer, guidelines recommend 3-5 years of surveillance for recurrence. However, over half of the 1.2 million U.S. survivors of colorectal cancer fail to receive guideline-concordant surveillance. In light of growing recognition that members of couples are interdependent and influence each other's health behaviors, we sought to describe, in their own words, the perspectives of spouses/partners on their engagement in patients' surveillance.
We conducted in-person, semi-structured interviews with 10 survivors of stage III colorectal cancer and their partners, together and separately. Interviews were transcribed verbatim, iteratively coded, and analyzed to identify emergent themes pertaining to partner engagement. Findings were validated through triangulation between study team members and triangulation between dyadic and individual interviews, and through an extensive search of transcripts for disconfirming evidence.
We identified three overarching domains of partner engagement in surveillance. First, psychosocial engagement included promoting patient participation in surveillance, showing care and concern, and attending to partner self-care. Second, information-seeking and dyadic communication focused on gathering information, staying informed about test results, and communicating about surveillance. Third, instrumental engagement referred to any explicit, objective activities such as scheduling appointments, attending appointments, and managing responsibilities at home. Participants shared strategies, examples, and in some cases unmet needs.
This study generated new, clinically meaningful knowledge about the ways in which partners engage in patients' surveillance. Opportunities to leverage partners as informal resources in surveillance include development of dyadic interventions to help partners engage most effectively.
在治疗 III 期结直肠癌后,指南建议对复发进行 3-5 年的监测。然而,超过 120 万美国结直肠癌幸存者中有一半以上未能接受符合指南的监测。鉴于越来越多的人认识到夫妻双方相互依存并影响彼此的健康行为,我们试图用配偶/伴侣自己的话来描述他们对参与患者监测的看法。
我们对 10 名 III 期结直肠癌幸存者及其伴侣进行了面对面的半结构化访谈,访谈内容包括患者和伴侣的单独访谈以及共同访谈。访谈内容逐字逐句记录下来,进行迭代编码,并进行分析以确定与伴侣参与相关的主题。通过研究小组成员之间的三角验证、对偶和个体访谈之间的三角验证以及对转录本的广泛搜索以寻找不一致的证据,对研究结果进行了验证。
我们确定了伴侣参与监测的三个总体领域。首先,心理社会参与包括促进患者参与监测、表达关心和关爱,以及关注伴侣的自我保健。其次,信息搜索和对偶沟通侧重于收集信息、了解测试结果,并就监测进行沟通。第三,工具性参与是指任何明确的、客观的活动,如安排预约、参加预约以及管理家庭责任。参与者分享了策略、例子,在某些情况下还分享了未满足的需求。
这项研究提供了关于伴侣参与患者监测的新的、具有临床意义的知识。利用伴侣作为监测中的非正式资源的机会包括开发对偶干预措施,以帮助伴侣最有效地参与。