探讨青少年癌症幸存者对随访护理的看法及其对过渡过程的担忧——一项定性内容分析。
Exploring the perspective of adolescent childhood cancer survivors on follow-up care and their concerns regarding the transition process-A qualitative content analysis.
机构信息
Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Department of Pediatric Hematology and Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
出版信息
Cancer Med. 2024 May;13(10):e7234. doi: 10.1002/cam4.7234.
PURPOSE
In Germany, children diagnosed with cancer survive their initial disease in more than 80%, and the majority will become long-term survivors. Around the age of 18, survivors are transferred to adult healthcare. The transition can be a critical period in the process of care at which many childhood cancer survivors discontinue to participate in regular follow-up care. Hence, the objective of the paper was to explore (a) survivors' attitudes towards pediatric follow-up care and (b) their concerns regarding the transition process to draw conclusions for optimizing pediatric care and transition processes.
METHODS
We conducted semi-structured interviews with 21 adolescent childhood cancer survivors between the ages of 14 and 20. The survivors were recruited via a pediatric oncology department of a university hospital in Germany. Based on the principles of qualitative content analysis, a deductive-inductive method according to Kuckartz was applied.
RESULTS
Based on the interview guide and derived from the exploratory research questions, two key categories were generated: (a) Survivors' attitudes towards pediatric follow-up care, which encompasses all formal and emotional aspects of survivors regarding follow-up care, and (b) their concerns regarding transition from pediatric to adult healthcare, where hindering and facilitating factors for a successful transition occur. Our results show high satisfaction among survivors with follow-up care. Nevertheless, they wish to be more integrated into processes and the organization of their follow-up care. Most adolescent survivors do not feel ready for transition.
CONCLUSION
The integration of survivors into the organization processes and routines, and the promotion of emotional detachment from pediatric health care professionals (HCPs) are important to reduce concerns and uncertainties of adolescent survivors regarding the transition process and to promote subjective readiness for transition. To gain confidence in the adult healthcare, it is crucial to provide tailored education depending on individual requirements and needs and to build trusting relationships between survivors and adult HCPs.
目的
在德国，被诊断患有癌症的儿童中有超过 80%能够存活下来，且大多数会成为长期幸存者。在 18 岁左右，这些幸存者会被转移到成人保健机构。这个过渡时期可能是治疗过程中的一个关键阶段，在此期间，许多儿童癌症幸存者会停止参加定期的随访护理。因此，本文的目的是探讨（a）幸存者对儿科随访护理的态度，以及（b）他们对过渡过程的关注，从而为优化儿科护理和过渡过程提供结论。
方法
我们对 21 名年龄在 14 至 20 岁之间的青少年癌症幸存者进行了半结构化访谈。这些幸存者是通过德国一所大学医院的儿科肿瘤病房招募的。根据定性内容分析的原则，采用了一种根据 Kuckartz 的演绎归纳方法。
结果
根据访谈指南和探索性研究问题，生成了两个关键类别：（a）幸存者对儿科随访护理的态度，其中包括幸存者对随访护理的所有正式和情感方面，以及（b）他们对从儿科到成人保健过渡的关注，其中存在阻碍和促进成功过渡的因素。我们的研究结果表明，幸存者对随访护理的满意度很高。然而，他们希望能够更深入地参与到随访护理的组织和流程中。大多数青少年幸存者还没有为过渡做好准备。
结论
将幸存者融入组织流程和常规工作中，促进与儿科保健专业人员（HCPs）的情感分离，对于减少青少年幸存者对过渡过程的担忧和不确定性，以及促进他们对过渡的主观准备是很重要的。为了获得对成人保健的信心，根据个人需求和需求提供量身定制的教育，以及建立幸存者与成人 HCPs 之间的信任关系是至关重要的。
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