Worrall Sharyn F, Dwyer Andrea J, Garcia Reese M, McAbee Keavy E, Davis Anjelica Q
1Fight Colorectal Cancer, Springfield, Missouri; and.
2University of Colorado Cancer Center, Colorado School of Public Health, Aurora, Colorado.
J Natl Compr Canc Netw. 2021 Feb 19;19(6):693-699. doi: 10.6004/jnccn.2020.7655.
Colorectal cancer (CRC) is the third most common cancer among men and women in the United States. Patients and survivors experience a range of challenges, including anxiety, financial issues, long-term adverse effects, and more. The intent of this project was to assess the needs of the CRC community directly from survivors and their caregivers and to lay a foundation for ongoing support.
Twelve nominal group technique sessions were facilitated. Participants were randomized and presented with the following questions: "What information do you wish you had at the time of diagnosis?" and "What information do you need now as a survivor?" After the nominal group technique process, each statement's score was divided by the number of people in the session, providing the average to identify the top-ranked statements. Themes and subthemes were applied to statements. Results were compared between coders.
There was a total of 79 participants, 49 of whom self-identified as a patient with or survivor of cancer. Patient/survivor demographics were as follows: stage IV disease (n=20), stage III disease (n=22), stage II disease (n=5), stage I disease (n=2), caregiver/family member (n=30), male (n=16), female (n=63), White (n=50), Native Hawaiian/Pacific Islander (n=1), Hispanic/Latino (n=13), Black/African American (n=11), Asian (n=1), and more than one race/ethnicity (n=3). The most frequent themes among responses to the first question were communication and coordination with care team and access to CRC resources. The most frequent themes among responses to the second question were psychosocial support and family/caregiver support. Frequent themes among responses across both questions were understanding treatment options and adverse effects.
These findings highlight gaps in support for individuals affected by CRC, and lay a foundation for ongoing assistance. Future studies exploring differences based on disease stage, race/ethnicity, age, gender identity, geographic location, and tumor location are needed to further tailor support for those experiencing CRC. Themes identified in this project require a multidisciplinary approach to ensure that the unmet needs of survivors are addressed.
结直肠癌(CRC)是美国男性和女性中第三大常见癌症。患者和幸存者面临一系列挑战,包括焦虑、财务问题、长期不良反应等等。本项目的目的是直接从幸存者及其护理人员那里评估CRC群体的需求,并为持续的支持奠定基础。
组织了12次名义群体技术会议。参与者被随机分组,并被问到以下问题:“你希望在诊断时获得哪些信息?”以及“作为幸存者,你现在需要哪些信息?”在名义群体技术过程之后,每个陈述的得分除以会议中的人数,得出平均分以确定排名靠前的陈述。主题和子主题被应用于陈述。对编码人员之间的结果进行了比较。
共有79名参与者,其中49人自我认定为癌症患者或幸存者。患者/幸存者的人口统计学特征如下:IV期疾病(n = 20)、III期疾病(n = 22)、II期疾病(n = 5)、I期疾病(n = 2)、护理人员/家庭成员(n = 30)、男性(n = 16)、女性(n = 63)、白人(n = 50)、夏威夷原住民/太平洋岛民(n = 1)、西班牙裔/拉丁裔(n = 13)、黑人/非裔美国人(n = 11)、亚裔(n = 1)以及多种族/族裔(n = 3)。对第一个问题的回答中最常见的主题是与护理团队的沟通与协调以及获取CRC资源。对第二个问题的回答中最常见的主题是心理社会支持和家庭/护理人员支持。两个问题的回答中常见的主题是了解治疗选择和不良反应。
这些发现凸显了对受CRC影响的个体支持方面的差距,并为持续援助奠定了基础。未来需要开展基于疾病阶段、种族/族裔、年龄、性别认同、地理位置和肿瘤位置的差异研究,以进一步为CRC患者量身定制支持。本项目中确定的主题需要多学科方法来确保幸存者未得到满足的需求得到解决。