Keller Mary Conway, Needham Andrew, Holden Elizabeth, Engelke Karina, Foy Kelly, Hart Leigh, Hinderer Katherine
Division of Hematology/Oncology, Connecticut Children's, Hartford, CT, USA.
Center for Cancer and Blood Disorders, Connecticut Children's, Hartford, CT, USA.
J Pediatr Hematol Oncol Nurs. 2024 Mar-Apr;41(2):96-106. doi: 10.1177/27527530231194598. Epub 2024 Jan 18.
Increased childhood cancer survival rates have spurred a new body of research pertaining to the cancer-survivorship continuum. Literature suggests a lack of research and guidelines for care at the end of treatment (EOT). To improve the transition to survivorship and determine any posttreatment challenges, this study explored the experiences of childhood cancer survivors (CCSs), parents/caregivers, and pediatric oncology health care professionals (HCPs) at EOT. This study employed a mixed methods design. EOT Questionnaires were completed by CCSs and parents/caregivers within 6 months of completing treatment, and by pediatric oncology HCPs. A total of 75 CCSs and parents/caregivers and 21 HCPs completed the study. The majority of parents/caregivers (78%) and older CCSs (94%) recalled having an EOT "meeting." Most were satisfied with the meeting, but described unexpected worries/problems following EOT. Family members stating they were "very satisfied" with the EOT meeting increased significantly relative to the number of EOT topics addressed. In contrast, the omission of certain psychosocial discussion topics negatively correlated with satisfaction. Oncologists provided the majority of EOT services, with infrequent provision by other HCPs. Less than 20% of HCPs characterized families as "very satisfied" with EOT services and suggested improvements to meet families' needs. This study found unmet psychosocial and anticipatory guidance needs, indicating a lack of preparedness. The results suggest that end of cancer treatment requires a more standardized, comprehensive, and multidisciplinary approach. Enhanced education and support services are needed to promote the successful navigation of all families through this period of transition.
儿童癌症存活率的提高催生了一批关于癌症幸存者连续统一体的新研究。文献表明,在治疗结束(EOT)时缺乏相关研究和护理指南。为了改善向幸存者阶段的过渡并确定任何治疗后挑战,本研究探讨了儿童癌症幸存者(CCSs)、父母/照顾者以及儿科肿瘤医疗保健专业人员(HCPs)在治疗结束时的经历。本研究采用了混合方法设计。治疗结束调查问卷由CCSs和父母/照顾者在完成治疗后的6个月内填写,儿科肿瘤HCPs也参与了填写。共有75名CCSs和父母/照顾者以及21名HCPs完成了该研究。大多数父母/照顾者(78%)和年龄较大的CCSs(94%)回忆起有过一次治疗结束“会议”。大多数人对这次会议感到满意,但描述了治疗结束后出现的意外担忧/问题。表示对治疗结束会议“非常满意”的家庭成员数量相对于所讨论的治疗结束主题数量显著增加。相比之下,某些心理社会讨论主题的遗漏与满意度呈负相关。肿瘤学家提供了大部分治疗结束服务,其他HCPs提供的较少。不到20%的HCPs认为家庭对治疗结束服务“非常满意”,并建议做出改进以满足家庭需求。本研究发现心理社会和预期指导需求未得到满足,表明缺乏准备。结果表明,癌症治疗结束需要一种更标准化、全面和多学科的方法。需要加强教育和支持服务,以促进所有家庭在这一过渡时期成功过渡。