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澳大利亚常规癌症支持性护理服务:全国服务映射研究(CIA 研究)。

Conventional supportive cancer care services in Australia: A national service mapping study (The CIA study).

机构信息

Physiotherapy Department and Division of Cancer Services, Princess Alexandra Hospital, Metro South Health, Brisbane, Queensland, Australia.

Cancer and Palliative Care Outcomes Centre, School of Nursing, Queensland University of Technology, Brisbane, Queensland, Australia.

出版信息

Asia Pac J Clin Oncol. 2022 Jun;18(3):191-200. doi: 10.1111/ajco.13575. Epub 2021 Mar 13.

Abstract

AIM

Cancer and its treatment produce significant acute and long-term adverse effects in cancer survivors, resulting in a range of supportive cancer care needs across the disease trajectory. To enhance supportive cancer care in Australia, this study sought to understand and describe conventional services offered nationwide, specific to their structure (ownership, setting, duration), process (participants, delivery mode, referral pathways), and outcomes (evaluation).

METHODS

A survey canvassing 13 conventional supportive cancer care interventions was electronically distributed to 265 cancer organizations in all Australian states and territories over 2019 and 2020. Cancer organizations were invited to participate if they provided at least one cancer-directed treatment (ie, surgery, radiation therapy, or systemic therapies); or clinical cancer care to adults, adolescents, or children; or conventional supportive care interventions to cancer survivors.

RESULTS

A response rate of 46% (n = 123/265) was achieved, with 72% of cancer organizations (n = 88) delivering at least one intervention. Most were provided as outpatient or inpatient services, with few at home (<13%) or via telehealth (<10%). Psychological therapy (90%), self-care (82%), exercise (77%), healthy eating (69%), and lymphedema (69%) services were most common. Fatigue management (51%) and pelvic health (32%) were less common. Services offering massage, return-to-work, cognitive therapy, sleep hygiene, and leisure were underrepresented (<31%).

CONCLUSION

Provision of conventional supportive cancer care services continues to evolve in Australia. Multiple areas of care require development of dedicated services to address supportive cancer care intervention shortfalls across the country. Online resources and telemedicine are currently underutilized modalities that are available for further development.

摘要

目的

癌症及其治疗会给癌症幸存者带来重大的急性和长期不良影响,导致癌症患者在整个疾病过程中产生各种支持性的医疗需求。为了加强澳大利亚的支持性癌症护理,本研究旨在了解和描述全国范围内常规提供的服务,这些服务在结构(所有权、设置、持续时间)、过程(参与者、提供模式、转介途径)和结果(评估)方面各有特点。

方法

通过电子邮件在 2019 年和 2020 年向澳大利亚所有州和地区的 265 家癌症组织分发了一份电子调查问卷,调查了 13 种常规支持性癌症护理干预措施。如果癌症组织提供了至少一种癌症靶向治疗(即手术、放射治疗或系统治疗);或为成人、青少年或儿童提供临床癌症护理;或为癌症幸存者提供常规支持性护理干预,则邀请其参与。

结果

共收到 265 家癌症组织中的 46%(n=123)的回复,其中 72%(n=88)的癌症组织提供了至少一种干预措施。大多数服务都是作为门诊或住院服务提供的,仅有不到 13%(<13%)的服务是在家庭中提供的,不到 10%(<10%)的服务是通过远程医疗提供的。最常见的服务是心理治疗(90%)、自我护理(82%)、运动(77%)、健康饮食(69%)和淋巴水肿(69%)。疲劳管理(51%)和骨盆健康(32%)则较少见。提供按摩、重返工作、认知疗法、睡眠卫生和休闲的服务则更少(<31%)。

结论

在澳大利亚,常规支持性癌症护理服务的提供仍在不断发展。许多领域的护理需要开发专门的服务,以解决全国范围内支持性癌症护理干预措施的不足。在线资源和远程医疗目前利用不足,有进一步发展的空间。

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