Cancer and Palliative Care Outcomes Centre, Queensland University of Technology Faculty of Health, Kelvin Grove, Queensland, Australia
Deakin Health Economics, Institute for Health Transformation, Deakin University Faculty of Health, Geelong, Victoria, Australia.
BMJ Open. 2022 Feb 2;12(2):e049802. doi: 10.1136/bmjopen-2021-049802.
To evaluate the implementation of a multicomponent survivorship programme for men with prostate cancer and their carers.
A single cohort study, guided by the RE-AIM framework.
Multiple health services in Australia.
Men with prostate cancer and their carers, and health professionals.
A 12-month telehealth programme that provided centralised and coordinated decision and information support, exercise and nutrition management, specialised clinical support and practical support to men and their carers.
Multiple sources of data including participant-reported health outcomes and experience of care, qualitative interviews, records of the programme were collected at different time points.
Of 394 eligible men at various stages of survivorship, 142 consented (36% consent rate) and 136 (96%) completed the programme. All men participated in general care coordination and more than half participated in exercise and/or nutrition management interventions. Participation in the specialised support component (ie, psychosocial and sexual health support, continence management) was low despite the high level of need reported by men. Overall, the men reported improvements in their experience of care. Factors such as addressing service gaps, provision of specialised services, care coordination, adoption of needs-based and telehealth-based approaches were identified as enablers to the successful implementation of the programme. Issues such as insufficient integration with existing services, lack of resources and high caseload of the intervention team, men's reluctance to discuss needs and lack of confidence with technology were barriers in implementing the programme.
Survivorship interventions are relevant to men regardless of the stage of their disease and treatments undertaken. It is possible to provide access to a comprehensive model of survivorship care to promote the health and quality of life for men with prostate cancer.
This study was registered with the Australian and New Zealand Clinical Trials Registry (ACTRN12617000174381).
评估针对前列腺癌男性及其照护者的多组分生存随访计划的实施情况。
基于 RE-AIM 框架的单队列研究。
澳大利亚的多个卫生服务机构。
前列腺癌男性及其照护者，以及卫生专业人员。
为期 12 个月的远程医疗计划，为男性及其照护者提供集中和协调的决策及信息支持、运动和营养管理、专门的临床支持和实际支持。
在不同时间点，从多个来源收集数据，包括参与者报告的健康结果和护理体验、定性访谈、计划记录。
在处于不同生存随访阶段的 394 名符合条件的男性中，有 142 名（36%的同意率）同意参与，136 名（96%）完成了该计划。所有男性都参与了常规护理协调，超过一半的男性参与了运动和/或营养管理干预。尽管男性报告的需求很高，但参与专门支持部分（即心理社会和性健康支持、控尿管理）的比例较低。总体而言，男性报告称他们的护理体验得到了改善。确定了一些因素，例如解决服务差距、提供专门服务、护理协调、采用基于需求和远程医疗的方法，这些因素是该计划成功实施的促成因素。一些问题，如与现有服务整合不足、资源匮乏、干预团队的病例量高、男性不愿讨论需求以及对技术缺乏信心，这些是实施该计划的障碍。
生存随访干预措施与男性相关，无论其疾病阶段和接受的治疗如何。为促进前列腺癌男性的健康和生活质量，提供全面的生存随访护理模式是可行的。
本研究在澳大利亚和新西兰临床试验注册中心（ACTRN12617000174381）注册。
