Tanner Lynn R, Sencer Susan, Gossai Nathan, Watson David, Hooke Mary C
Physical Medicine & Rehabilitation, Children's Minnesota, Minneapolis, Minnesota, USA.
Cancer & Blood Disorders Program, Children's Minnesota, Minneapolis, Minnesota, USA.
Pediatr Blood Cancer. 2022 Nov;69(11):e29912. doi: 10.1002/pbc.29912. Epub 2022 Aug 20.
Cancer and its treatment can lead to functional limitations affecting ongoing development in children and adolescents. We developed a pediatric cancer rehabilitation program that integrates evidence-based rehabilitative care into cancer treatment. The program utilizes the CREATE (collaboration, rehabilitation/research, education, assessment, treatment, evaluation) Childhood Cancer Rehabilitation model. We aim to describe the structural and process components of our rehabilitation program and provide an access and utilization analysis.
To evaluate the rehabilitation program, we identified new patients with oncologic diagnoses from 2002 to 2019 using our database. To evaluate rehabilitative care, descriptive data, including the timing and type of rehabilitation services utilized within 5 years of a child's diagnosis, were collected and reviewed. Statistical analysis focused on change over time.
Among 1974 children assessed, 1580 (80.0%) received care from at least one rehabilitation service. Between 2002 and 2018, the percentage of children receiving rehabilitation services grew significantly throughout all disciplines, except for outpatient speech-language pathology. Utilization differed by age and diagnosis. Integrating therapists in the clinic improved patient access, reduced the time to access outpatient services, and increased the number of attended visits. Additional factors supporting program growth included: identifying leaders, using a prospective surveillance model, education, and program evaluation.
A multimodal interprofessional approach, such as the CREATE model, improves access to and the efficiency of evidence-based rehabilitation services promoting recovery, ongoing development, and quality of life.
癌症及其治疗可能导致功能受限，影响儿童和青少年的持续发育。我们制定了一项儿科癌症康复计划，将循证康复护理纳入癌症治疗中。该计划采用了CREATE（协作、康复/研究、教育、评估、治疗、评价）儿童癌症康复模式。我们旨在描述我们康复计划的结构和流程组成部分，并进行可及性和利用情况分析。
为了评估该康复计划，我们使用数据库确定了2002年至2019年新诊断为肿瘤的患者。为了评估康复护理，收集并审查了描述性数据，包括儿童诊断后5年内使用的康复服务的时间和类型。统计分析侧重于随时间的变化。
在评估的1974名儿童中，1580名（80.0%）接受了至少一项康复服务。2002年至2018年期间，除门诊言语病理学外，所有学科接受康复服务的儿童比例均显著增长。利用率因年龄和诊断而异。在诊所配备治疗师改善了患者的可及性，减少了获得门诊服务的时间，并增加了就诊次数。支持项目发展的其他因素包括：确定负责人、采用前瞻性监测模式、教育和项目评估。
多模式跨专业方法，如CREATE模式，可提高循证康复服务的可及性和效率，促进康复、持续发育和生活质量。
