Ahmadi Hamed, Jewett Michael A S, Shore Neal D, Alkazaz Nour, Almatar Ashraf, Latini David M, Legere Laura, Messing Ed, Thrasher J Brantley, Lee Cheryl T
Oregon Health and Science University, Portland, Oregon.
University of Toronto, Toronto, Ontario, Canada.
Urol Pract. 2016 Jan;3(1):62-69. doi: 10.1016/j.urpr.2015.01.003. Epub 2015 Oct 13.
A quarter of American cancer survivors have genitourinary malignancies that are largely managed by urologists. We explored urologist perceptions about survivorship care for genitourinary malignancies.
A total of 701 SUO (Society of Urologic Oncology) and 1,746 LUGPA (Large Urology Group Practice Association) members were invited to complete a web based survey composed of 5 domains, including 1) demographics, 2) current survivorship care practices, 3) perceived barriers, 4) accessibility to survivorship resources and 5) perceptions of advocacy groups.
Of 191 respondents 137 (72%) had no training in survivorship care. Of the 174 respondents 129 (74%) practiced shared care models while 45 (26%) preferred pure specialized followup care. Only 39 of 129 respondents (30%) with a shared care model always provided a written care plan. These plans infrequently included information on lifestyle modifications and educational resources. Routine patient referral to advocacy organizations was highest for prostate cancer at 40% followed by bladder, testicular and kidney cancers at 17%, 10% and 8%, respectively. Lack of time/resources and practice guidelines were considered the 2 most important barriers to survivorship care by 31% and 30% of participants, respectively. Web based information on advocacy groups and best practice guidelines were selected as the most important initiatives to promote survivorship care.
Despite the low response rate this study highlights important practice gaps in survivorship care for patients with genitourinary malignancies. In collaboration with advocacy organizations professional societies should initiate programs to better educate and train their members in survivorship care guidelines and consensus best practices.
四分之一的美国癌症幸存者患有泌尿生殖系统恶性肿瘤,这些患者大多由泌尿科医生负责治疗。我们探讨了泌尿科医生对泌尿生殖系统恶性肿瘤幸存者护理的看法。
共邀请了701名泌尿肿瘤学会(SUO)成员和1746名大型泌尿外科集团执业协会(LUGPA)成员完成一项基于网络的调查,该调查由5个领域组成,包括1)人口统计学,2)当前的幸存者护理实践,3)感知到的障碍,4)获得幸存者资源的机会,以及5)对倡导组织的看法。
在191名受访者中,137名(72%)没有接受过幸存者护理方面的培训。在174名受访者中,129名(74%)采用共享护理模式,而45名(26%)更喜欢纯粹的专科后续护理。在采用共享护理模式的129名受访者中,只有39名(30%)总是提供书面护理计划。这些计划很少包含生活方式调整和教育资源方面的信息。前列腺癌患者转诊至倡导组织的比例最高,为40%,其次是膀胱癌、睾丸癌和肾癌,分别为17%、10%和8%。分别有31%和30%的参与者认为时间/资源不足和缺乏实践指南是幸存者护理的两个最重要障碍。基于网络的倡导组织信息和最佳实践指南被选为促进幸存者护理的最重要举措。
尽管回复率较低,但本研究凸显了泌尿生殖系统恶性肿瘤患者幸存者护理方面的重要实践差距。专业协会应与倡导组织合作,启动相关项目,以便更好地对其成员进行幸存者护理指南和共识最佳实践方面的教育和培训。