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倡导者-乳腺癌项目:倡导者与患者建议,到2025年改善乳腺癌护理服务、患者体验并推动以患者为中心的研究。

Advocate-BREAST: advocates and patients' advice to enhance breast cancer care delivery, patient experience and patient centered research by 2025.

作者信息

O'Sullivan Ciara C, Larson Nicole L, Vierkant Robert A, Smith Mary Lou, Chauhan Cynthia, Couch Fergus J, Olson Janet E, Loprinzi Charles L, Ruddy Kathryn J

机构信息

Department of Oncology, Mayo Clinic, 200 1st Street SW, Rochester, MN, 55905, USA.

Department of Quantitative Health Sciences, Mayo Clinic College of Medicine and Science, Mayo Clinic, Rochester, MN, USA.

出版信息

Arch Public Health. 2024 Aug 7;82(1):119. doi: 10.1186/s13690-024-01351-z.

Abstract

PURPOSE

The aims of the Advocate-BREAST project are to study and improve the breast cancer (BC) patient experience through education and patient-centered research.

METHODS

In December 2021, an electronic REDCap survey was circulated to 6,918 BC survivors (stage 0-4) enrolled in the Mayo Clinic Breast Disease Registry. The questionnaire asked about satisfaction with BC care delivery, and education and support receive(d) regarding BC linked concerns. Patients also ranked Quality Improvement (QI) proposals.

RESULTS

The survey received 2,437 responses. 18% had Ductal Carcinoma in Situ, 81% had early breast cancer (EBC), i.e. stage 1-3, and 2% had metastatic breast cancer (MBC). Mean age was 64 (SD 11.8), and mean time since diagnosis was 93 months (SD 70.2). 69.3% of patients received all care at Mayo Clinic. The overall experience of care was good (> 90%). The main severe symptoms recalled in year 1 were alopecia, eyebrow/eyelash thinning, hot flashes, sexual dysfunction, and cognitive issues. The main concerns recalled were fear of BC recurrence/spread; loved ones coping; fear of dying, and emotional health. Patients were most dissatisfied with information regarding sexual dysfunction, eyebrow/eyelash thinning, peripheral neuropathy, and on side effects of immunotherapy/targeted therapies. Top ranking QI projects were: i) Lifetime access to concise educational resources; ii) Holistic support programs for MBC and iii) Wellness Programs for EBC and MBC.

CONCLUSIONS

Patients with early and advanced BC desire psychological support, concise educational resources, and holistic care.

IMPLICATIONS

Focused research and QI initiatives in these areas will improve the BC patient experience.

摘要

目的

“倡导者 - 乳腺癌”项目的目标是通过教育和以患者为中心的研究来研究并改善乳腺癌(BC)患者的体验。

方法

2021年12月,一份电子REDCap调查问卷分发给了梅奥诊所乳腺疾病登记处登记的6918名BC幸存者(0 - 4期)。问卷询问了对BC护理服务的满意度,以及在与BC相关问题上获得的教育和支持情况。患者还对质量改进(QI)提案进行了排名。

结果

该调查共收到2437份回复。18%患有原位导管癌,81%患有早期乳腺癌(EBC),即1 - 3期,2%患有转移性乳腺癌(MBC)。平均年龄为64岁(标准差11.8),自诊断以来的平均时间为93个月(标准差70.2)。69.3%的患者在梅奥诊所接受了所有护理。总体护理体验良好(>90%)。第1年回忆起的主要严重症状有脱发、眉毛/睫毛稀疏、潮热、性功能障碍和认知问题。回忆起的主要担忧有担心BC复发/扩散;亲人的应对;对死亡的恐惧以及情绪健康。患者对有关性功能障碍、眉毛/睫毛稀疏、周围神经病变以及免疫疗法/靶向疗法副作用的信息最不满意。排名靠前的QI项目有:i)终身获取简明教育资源;ii)针对MBC的整体支持项目;iii)针对EBC和MBC的健康项目。

结论

早期和晚期BC患者需要心理支持、简明教育资源和整体护理。

启示

在这些领域开展有针对性的研究和QI举措将改善BC患者的体验。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/495c/11308547/c6a0cb55d3a1/13690_2024_1351_Fig1_HTML.jpg

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