Leeds Institute of Medical Research at St James's, University of Leeds, Leeds, UK.
Leeds Teaching Hospitals NHS Trust, Leeds, UK.
Support Care Cancer. 2021 Nov;29(11):6315-6324. doi: 10.1007/s00520-021-06193-x. Epub 2021 Apr 16.
Teenage and young adult (TYA) survivors of childhood brain tumours and their family caregivers can experience many late effects of treatment that can hamper the transition to living independent lives. Yet, their long-term supportive care needs are largely unknown. We investigated the supportive care needs of TYA survivors and their caregivers and explored the role and perceived use of support.
Face-to-face semi-structured interviews were conducted with survivors aged 16-30 (n = 11) who were ≥ 5 years after diagnosis and caregivers (n = 11). Interviews were recorded and transcriptions thematically analysed.
Four themes emerged: (1) preferences for support and support services (unmet needs). Concerns regarding mental health, employment and financial uncertainty, the desire to live independently, and lack of support were emphasised. (2) Decline in support. Caregivers noted a drop-off in support available when transitioning to adult services. (3) Reasons for not obtaining adequate support. Several barriers to accessing support were raised, including distance and aging out of services. (4) The role of long-term hospital-based follow-up care. Participants highlighted the importance of, and reassurance from, long-term follow-up care but noted a more all-inclusive approach is required.
Even many years after diagnosis, TYA childhood brain tumour survivors and their caregivers continue to have unmet supportive care needs. Both TYA survivors and their caregivers can benefit from support to meet their unique needs and improve long-term quality of life. Understanding unmet needs and recognising what services are required due to the late effects of treatment is critical to improving long-term quality of survival.
青少年和年轻成人(TYA)是儿童脑肿瘤的幸存者,他们及其家庭照顾者可能会经历许多治疗的晚期影响,这些影响可能会阻碍他们过渡到独立生活。然而,他们的长期支持性护理需求在很大程度上尚未可知。我们调查了 TYA 幸存者及其照顾者的支持性护理需求,并探讨了支持的作用和感知用途。
对年龄在 16-30 岁(n=11)、诊断后≥5 年的幸存者和照顾者(n=11)进行了面对面的半结构化访谈。访谈进行了录音,并对转录内容进行了主题分析。
出现了四个主题:(1)对支持和支持服务的偏好(未满足的需求)。强调了对心理健康、就业和财务不确定性、独立生活的愿望以及缺乏支持的关注。(2)支持减少。照顾者注意到,在过渡到成人服务时,可获得的支持减少了。(3)无法获得足够支持的原因。提出了一些获得支持的障碍,包括距离和服务年龄限制。(4)长期基于医院的随访护理的作用。参与者强调了长期随访护理的重要性和从中获得的安心,但指出需要采取更全面的方法。
即使在诊断多年后,TYA 儿童脑肿瘤幸存者及其照顾者仍有未满足的支持性护理需求。TYA 幸存者及其照顾者都可以从支持中受益,以满足他们的独特需求并提高长期生活质量。了解未满足的需求,并认识到由于治疗的晚期影响而需要哪些服务,对于提高长期生存质量至关重要。