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英国造血干细胞受者长期随访临床护理的真实体验:一项定性探索。

The lived experience of long-term follow-up clinical care for haematopoietic stem cell recipients in England: a qualitative exploration.

机构信息

Newcastle University, Newcastle Upon Tyne, UK.

出版信息

J Cancer Surviv. 2024 Oct;18(5):1590-1599. doi: 10.1007/s11764-023-01399-w. Epub 2023 May 16.

Abstract

PURPOSE

Despite a haematopoietic stem cell transplant (HSCT) being a potentially curative treatment option for malignant and non-malignant disorders, patients may develop complex physical and psychological post-transplant complications. Consequently, transplant centres remain responsible for patients' life-long monitoring and screening practices. We sought to describe how HSCT survivors experience long-term follow-up (LTFU) monitoring clinics in England.

METHOD

A qualitative approach was adopted with data collected from written accounts. Seventeen transplant recipients were recruited from across England, and the data was analysed using thematic analysis.

RESULTS

Data analysis elicited four themes: Transfer to LTFU care: 'will there be a change in my care, or will appointments just become less frequent?'; Care Coordination: 'it is good to know I am still in the system'; Relationship continuity: 'a good knowledge of me, my health and what is important to me'; and Late-effects Screening: 'there was not much information about what to expect or be aware of'.

CONCLUSIONS

HSCT survivors in England experience uncertainty and lack of information regarding the transfer from acute to long-term care and clinic screening practices. However, patients gain reassurance from remaining on a healthcare pathway and maintaining relationships with healthcare professionals.

IMPLICATIONS FOR CANCER SURVIVORS

HSCT recipients entering LTFU monitoring clinics are a growing population of cancer survivors. Understanding and acknowledging this cohort of patients' needs may inform the development of tailored support to help patients navigate the complicated healthcare pathway.

摘要

目的

尽管造血干细胞移植(HSCT)是治疗恶性和非恶性疾病的一种潜在治愈方法,但患者可能会出现复杂的身体和心理移植后并发症。因此,移植中心仍然负责患者的终身监测和筛查实践。我们旨在描述英国 HSCT 幸存者如何体验长期随访(LTFU)监测诊所。

方法

采用定性方法,从书面记录中收集数据。从英格兰各地招募了 17 名移植接受者,使用主题分析对数据进行分析。

结果

数据分析得出了四个主题:转移到 LTFU 护理:“我的护理会有变化,还是预约会变得不那么频繁?”;护理协调:“知道我还在系统中很好”;关系连续性:“对我、我的健康状况和对我重要的事情有很好的了解”;和晚期效应筛查:“关于预期或需要注意的事项,没有太多信息”。

结论

英国的 HSCT 幸存者在从急性护理到长期护理以及诊所筛查实践的转移方面感到不确定和缺乏信息。然而,患者从保持在医疗保健途径上并与医疗保健专业人员保持关系中获得了安心。

对癌症幸存者的影响

进入 LTFU 监测诊所的 HSCT 接受者是癌症幸存者中不断增长的人群。了解和承认这一患者群体的需求,可能有助于制定有针对性的支持措施,帮助患者驾驭复杂的医疗保健途径。

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