Lee-Miller Cathy, Montgomery Kathleen E, Evered Jane, Phelps Kat, Norslien Kirsten, Parkes Amanda, Kwekkeboom Kristine
Division of Pediatric Hematology/Oncology, Department of Pediatrics, University of Wisconsin-Madison School of Medicine and Public Health, Madison, Wisconsin, USA.
University of Wisconsin-Madison School of Nursing, Madison, Wisconsin, USA.
J Adolesc Young Adult Oncol. 2024 Feb;13(1):123-131. doi: 10.1089/jayao.2023.0062. Epub 2023 Aug 11.
Over 87,000 adolescents and young adults (AYAs) are diagnosed with cancer in the United States each year. Improvement in outcomes in the AYA population has lagged that of both younger and older patients. This decrement may be attributable to several factors, including insufficient supportive care services. Our team modified the Needs Assessment & Service Bridge (NA-SB) tool, utilizing an iterative approach with patient and clinician stakeholders to meet the needs of the AYA population at a large Midwestern Cancer Center. We recruited a 10-member AYA Advisory Board (AB) from our Cancer Center patients, and met five times over 9 months to discuss supportive care and the NA-SB. We recruited a multidisciplinary group of oncology clinicians to assess content validity and conducted interviews with nine clinician stakeholders to discuss implementation. The AB generated a 59-item-modified NA-SB, retaining most of the original NA-SB items and adding several more. Five items with concerns for relevance and/or clarity were revised to create the final 58-item-modified NA-SB. Priorities for implementation were identified by AB and clinician stakeholders. The modified NA-SB thoroughly reflects supportive care needs of our Midwestern AYA cancer survivors. When implemented, the tool may facilitate patient-care team communication and provide data to prioritize development of new supportive care resources. AYA cancer survivors have unique supportive care needs that are insufficiently addressed by current care models; using the modified NA-SB may help address those needs, leading to improved AYA outcomes.
在美国,每年有超过87,000名青少年及年轻成人(AYA)被诊断患有癌症。AYA人群治疗结果的改善滞后于较年轻和较年长的患者。这种差距可能归因于多种因素,包括支持性护理服务不足。我们的团队修改了需求评估与服务桥梁(NA-SB)工具,采用迭代方法与患者和临床医生利益相关者合作,以满足中西部一家大型癌症中心AYA人群的需求。我们从癌症中心的患者中招募了一个由10名成员组成的AYA咨询委员会(AB),并在9个月内召开了5次会议,讨论支持性护理和NA-SB。我们招募了一组多学科肿瘤临床医生来评估内容效度,并与9名临床医生利益相关者进行访谈以讨论实施情况。AB生成了一个有59个条目的修改版NA-SB,保留了大部分原始NA-SB条目并增加了一些。对5个有关相关性和/或清晰度存疑的条目进行了修订,以创建最终的58个条目的修改版NA-SB。AB和临床医生利益相关者确定了实施的优先事项。修改后的NA-SB充分反映了我们中西部AYA癌症幸存者的支持性护理需求。该工具在实施时可能会促进患者护理团队之间的沟通,并提供数据以确定新的支持性护理资源开发的优先级。AYA癌症幸存者有独特的支持性护理需求,而当前的护理模式并未充分满足这些需求;使用修改后的NA-SB可能有助于满足这些需求,从而改善AYA的治疗结果。