Safari Day Unit, 156793Lincoln County Hospital, Lincoln, UK.
Faculty of Health and Life Sciences, 5995Northumbria University, Newcastle upon Tyne, UK.
J Pediatr Oncol Nurs. 2021 May-Jun;38(3):190-204. doi: 10.1177/1043454221992302. Epub 2021 Mar 26.
This systematic appraisal explores the literature surrounding treatment adherence in teenagers and young adults (TYAs) with cancer, with the aim of identifying influential factors that could affect adherence rates. This area is particularly important due to the increased risk of relapse and death associated with nonadherent behavior. In addition, TYAs are found to be the age group least likely to adhere to medical regimes. A comprehensive review of the literature was conducted and seven studies met the inclusion criteria, the articles were then critiqued using a data extraction form and eight themes were generated and discussed. This review highlights the complexities and difficulties in measuring adherence, as well as the key factors affecting adherence, before identifying implications for practice. Good communication and relationships are crucial between all parties involved in TYAs' care including the patients, professionals, parents, and peers. A model of adherence was adapted on the basis of the result of the systematic review, other literature pertaining to adherence in TYAs, and the clinical experience of the authors. Personal factors and external factors, along with treatment factors and interactions with the system all have an effect on the patient's response or ability to adhere. It is apparent that there is a need for more high-quality qualitative and quantitative research in this area, with an emphasis on finding interventions that directly improve adherence specific to this age group.
本系统评价探讨了青少年和青年癌症患者（TYAs）治疗依从性的文献，旨在确定可能影响依从率的影响因素。由于不依从行为与复发和死亡风险增加相关，因此该领域尤为重要。此外，TYAs 被发现是最不可能遵守医疗方案的年龄组。对文献进行了全面审查，有 7 项研究符合纳入标准，然后使用数据提取表对这些文章进行了评估，并生成了 8 个主题进行讨论。本综述强调了测量依从性的复杂性和困难，以及影响依从性的关键因素，最后确定了对实践的影响。在 TYAs 护理中，包括患者、专业人员、父母和同龄人在内的所有相关方之间的良好沟通和关系至关重要。在系统评价的结果、其他关于 TYAs 依从性的文献以及作者的临床经验的基础上，改编了依从性模型。个人因素和外部因素，以及治疗因素和与系统的相互作用，都会对患者的反应或遵医能力产生影响。显然，需要在这一领域进行更多高质量的定性和定量研究，重点是找到专门针对这一年龄组的直接提高依从性的干预措施。
