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家长照顾者对目前提供的儿童癌症生存者照护的偏好和满意度。

Parent caregivers' preferences and satisfaction with currently provided childhood cancer survivorship care.

机构信息

Department of Family Medicine, CHA Gumi Medical Center, CHA University, Gumi, Republic of Korea.

Department of Family Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-Ro, Gangnam-Gu, Seoul, 06351, Republic of Korea.

出版信息

J Cancer Surviv. 2024 Apr;18(2):617-630. doi: 10.1007/s11764-022-01287-9. Epub 2022 Nov 18.

Abstract

PURPOSE

The aim of this study was to investigate the level of satisfaction of parent caregivers of childhood cancer survivors (CCSs) with currently provided survivorship care and their preferences for survivorship care provider.

METHODS

Study subjects were parent caregivers recruited at three hospitals in Korea. Study data were collected from self-administered questionnaires and medical records. We assessed parent caregivers' levels of satisfaction with specific survivorship care contents and preferred types of survivorship care provider among oncologists, primary care physicians (PCPs), and institutional general physicians (IGPs). Factors associated with parent caregivers' preferences for survivorship care provider were evaluated by multiple logistic regression analysis.

RESULTS

680 parent caregivers (mother 62.1% and father 37.9%) of 487 CCSs (mean age at diagnosis: 6.9 ± 5.1 years; mean time since treatment completion 5.4 ± 4.4 years) were included. Parent caregivers' dissatisfaction was the highest with screening for second primary cancer, followed by psychosocial problem management. Higher educational level of parent caregiver, parent caregiver's higher level of dissatisfaction with currently provided care, higher age of CCSs at cancer diagnosis, history of receiving hematopoietic stem cell transplant, and longer time lapse after cancer treatment were significantly associated with parent caregivers' higher preference for PCPs or IGPs than oncologists. Parent caregiver's multiple comorbidities and higher fear of cancer recurrence were associated with parent caregivers' higher preference for oncologists than PCPs or IGPs. Around 80% of parent caregivers recognized that a shared care system was helpful for promoting the health of CCSs.

CONCLUSION

Parent caregivers were substantially dissatisfied with currently provided care, especially regarding the health issues not directly associated with the primary cancer. Parent caregivers' preferences for survivorship care provider is influenced by multiple factors, including age and survival time of CCSs, characteristics of parent caregivers, satisfaction level with care, and specific survivorship care contents.

IMPLICATIONS FOR CANCER SURVIVORS

The findings of our study suggest that shared survivorship care for CCSs with consideration of specific care contents can complement the current oncologist-led survivorship care system.

摘要

目的

本研究旨在调查儿童癌症幸存者(CCS)的家长照护者对目前提供的生存护理的满意度水平及其对生存护理提供者的偏好。

方法

研究对象为在韩国三家医院招募的家长照护者。研究数据来自于自我管理问卷和病历。我们评估了家长照护者对特定生存护理内容的满意度水平,以及他们对肿瘤医生、初级保健医生(PCP)和机构全科医生(IGP)的生存护理提供者的偏好类型。通过多因素逻辑回归分析评估了与家长照护者对生存护理提供者的偏好相关的因素。

结果

共纳入 487 例 CCS 的 680 名家长照护者(母亲占 62.1%,父亲占 37.9%)(诊断时平均年龄:6.9±5.1 岁;治疗完成后平均时间:5.4±4.4 年)。家长照护者对筛查第二原发癌的不满意程度最高,其次是心理社会问题管理。家长照护者的教育水平较高、对目前提供的护理不满意程度较高、CCS 诊断时年龄较大、曾接受造血干细胞移植、癌症治疗后时间较长与家长照护者更倾向于选择 PCP 或 IGP 而不是肿瘤医生显著相关。家长照护者的多种合并症和对癌症复发的恐惧程度较高与家长照护者更倾向于选择肿瘤医生而不是 PCP 或 IGP 相关。约 80%的家长照护者认为共享护理系统有助于促进 CCS 的健康。

结论

家长照护者对目前提供的护理不满意程度较大,尤其是对与原发性癌症无直接关联的健康问题。家长照护者对生存护理提供者的偏好受多种因素影响,包括 CCS 的年龄和生存时间、家长照护者的特征、对护理的满意度水平以及特定的生存护理内容。

对癌症幸存者的意义

本研究的结果表明,考虑到特定的护理内容,对 CCS 进行共享的生存护理可以补充目前以肿瘤医生为主导的生存护理系统。

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