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患者体验,按就诊地点分类,青少年和青年癌症患者。

Care Experience, by Site of Care, for Adolescents and Young Adults With Cancer.

机构信息

MultiCare Health System, Tacoma, WA.

Seattle Children's Hospital, Seattle, WA.

出版信息

JCO Oncol Pract. 2021 Jun;17(6):e817-e826. doi: 10.1200/OP.20.00840. Epub 2021 Feb 10.

Abstract

PURPOSE

Most of the 77,000 adolescents and young adults (AYAs) 15-39 years of age diagnosed with cancer annually in the United States are treated at community rather than academic centers. Little is known about their healthcare experience.

METHODS

A cross-sectional, anonymous, online survey was conducted with a convenience sample of AYAs treated for cancer at US academic (n = 112) or community centers (n = 64).

RESULTS

Clinical trials were offered more frequently to respondents treated at academic centers (26.8% 7.8%; = .005). Eighty percent of all those offered a clinical trial chose to enroll. Over three-fourths reported awareness of community-based or online AYA oncology support services; however, significantly more respondents from academic centers reported awareness of services provided by the institution itself (40.2% 7.8%; < .001). Significantly more respondents from academic centers reported receiving information relevant to their age group (41.1% 15.6%; < .001). Respondents treated at academic centers were significantly more satisfied with support, communication, and overall treatment. Odds of respondents treated at an academic center reporting that their healthcare team knew enough about AYAs were 3.12-fold higher than those treated at community centers (95% CI, 1.6 to 6.4; = .002). Odds of overall satisfaction were significantly higher for respondents who reported that their healthcare team "knew enough about AYAs" (aOR, 9.7, 95% CI, 2.4 to 53.9; = .003).

CONCLUSION

Cancer treatment for AYAs at both academic and community centers can be optimized by improving healthcare providers' understanding of the key issues facing AYAs with cancer and by increasing AYA-specific institutional resources and support services.

摘要

目的

每年,美国约有 77000 名 15-39 岁的青少年和年轻人(AYAs)被诊断患有癌症,其中大多数在社区而不是学术中心接受治疗。对于他们的医疗体验,人们知之甚少。

方法

使用美国学术(n=112)或社区中心(n=64)治疗癌症的 AYA 便利样本,进行了一项横断面、匿名、在线调查。

结果

向学术中心治疗的患者提供临床试验的频率更高(26.8% 比 7.8%;.005)。所有提供临床试验的患者中,80%选择入组。超过四分之三的患者报告意识到社区或在线 AYA 肿瘤支持服务;然而,来自学术中心的患者明显更多地意识到机构本身提供的服务(40.2% 比 7.8%;.001)。来自学术中心的患者明显更多地报告意识到与他们年龄组相关的信息(41.1% 比 15.6%;.001)。来自学术中心的患者对支持、沟通和整体治疗的满意度明显更高。与在社区中心接受治疗的患者相比,在学术中心接受治疗的患者报告其医疗团队对 AYA 的了解程度足够的患者,其报告医疗团队“足够了解 AYA”的可能性是 3.12 倍(95%CI,1.6 至 6.4;.002)。报告医疗团队“足够了解 AYA”的患者,其总体满意度的可能性显著更高(aOR,9.7,95%CI,2.4 至 53.9;.003)。

结论

通过提高医疗服务提供者对 AYA 癌症患者面临的关键问题的理解,并增加针对 AYA 的机构资源和支持服务,可以优化学术和社区中心的 AYA 癌症治疗。

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