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造血干细胞移植幸存者和临床医生使用生存护理计划的障碍和促进因素。

Barriers and facilitators to the use of survivorship care plans by hematopoietic stem cell transplant survivors and clinicians.

机构信息

University of Wisconsin, Madison, WI, USA.

Carbone Cancer Center, University of Wisconsin, Madison, WI, USA.

出版信息

Support Care Cancer. 2022 Feb;30(2):1323-1330. doi: 10.1007/s00520-021-06492-3. Epub 2021 Sep 5.

Abstract

PURPOSE

Survivors of hematopoietic stem cell transplants (HSCT) have complex care needs for the remainder of their lives, known as the survivorship period. Survivorship care plans (SCPs) have been proposed to improve care coordination and ultimately survivorship outcomes. We explored the barriers and facilitators of SCP use among HSCT survivors and their clinicians in order to develop more useful SCPs for the HSCT context.

METHODS

Analogous surveys regarding perceived barriers to and facilitators of SCP use based on a sample SCP for a female allogenic HSCT survivor were administered to HSCT survivors and non-transplant oncology and primary care clinicians.

RESULTS

Twenty-seven HSCT survivors and 18 clinicians completed the survey. The main barriers to SCP use were lack of awareness of SCP existence, uncertainty regarding where to find SCP, unclear roles and responsibilities among healthcare teams, length of SCP, and difficultly understanding SCPs. The facilitators of SCP use were increased understanding of survivorship care needs, clarified roles and responsibilities of survivors and clinicians, SCPs that are readily available and searchable in electronic health record, increased awareness of SCP existence and provision to all survivors, and if the SCP is survivor-specific and up-to-date.

CONCLUSIONS

Much of the work regarding SCPs has looked at barriers to creation and provision; however, our study examines factors influencing use of SCPs. By determining the barriers and facilitators surrounding SCP use for HSCT survivors and their clinicians, we can create SCP templates and clinical workflows to optimize SCP use, ideally leading to better outcomes for HSCT survivors.

摘要

目的

造血干细胞移植(HSCT)幸存者在其余生中都有复杂的护理需求,这被称为生存期间。生存护理计划(SCP)的提出是为了改善护理协调,最终改善生存结果。我们旨在探索 HSCT 幸存者及其临床医生使用 SCP 的障碍和促进因素,以便为 HSCT 环境开发更有用的 SCP。

方法

根据女性异基因 HSCT 幸存者的样本 SCP,对 HSCT 幸存者和非移植肿瘤学和初级保健临床医生进行了类似的关于使用 SCP 的感知障碍和促进因素的调查。

结果

27 名 HSCT 幸存者和 18 名临床医生完成了调查。使用 SCP 的主要障碍是缺乏对 SCP 存在的认识、对在哪里找到 SCP 的不确定性、医疗团队之间角色和责任不明确、SCP 长度以及难以理解 SCP。使用 SCP 的促进因素包括对生存护理需求的理解增加、幸存者和临床医生的角色和责任明确、SCP 易于在电子健康记录中搜索和获取、对 SCP 存在和向所有幸存者提供的意识提高、以及 SCP 是否针对幸存者且是最新的。

结论

关于 SCP 的大部分工作都集中在创建和提供的障碍上;然而,我们的研究考察了影响 SCP 使用的因素。通过确定 HSCT 幸存者及其临床医生使用 SCP 的障碍和促进因素,我们可以创建 SCP 模板和临床工作流程,以优化 SCP 的使用,理想情况下为 HSCT 幸存者带来更好的结果。

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