Manne Sharon L, Hudson Shawna V, O'Malley Dena, Devine Katie A, Matasar Matthew, Peram Jacintha, Solleder Justin, Handorf Elizabeth, Evens Andrew M
Rutgers Cancer Institute of New Jersey, 120 Albany Street, Tower 2 Floor 8, New Brunswick, NJ, 08901, USA.
Dept Family Medicine and Community Health, Rutgers RWJ Medical School, 303 George Street, Rm 309, New Brunswick, NJ, 08901, USA.
J Cancer Surviv. 2024 Aug 27. doi: 10.1007/s11764-024-01664-6.
Taking an active role in managing post-treatment care has emerged as a key aspect of promoting a successful transition into survivorship and is associated with better patient outcomes. In this study, we focus on two key aspects of active self-management, activation and preparedness. Activation was defined as understanding one's role in the care process and having the knowledge, skill, and confidence to take on a role in managing self-care. Preparedness was defined as the extent to which individuals perceived they had sufficient information about what to expect after cancer treatments are completed. The study goal was to characterize survivorship preparedness and activation among lymphoma survivors within 5 years of treatment completion in New Jersey and examine the association of sociodemographic, medical, care transition experiences, practical concerns, and psychosocial factors with activation and preparedness.
One hundred and one Hodgkin lymphoma or non-Hodgkin lymphoma survivors who had completed treatment within 5 years completed a survey of survivorship care experiences (response rate = 34.12%).
Approximately 60% of survivors reported high activation, with similar percentages for higher preparedness. Less activated survivors were significantly (p < .05) younger, married, resided in a more deprived geographic area, and reported more fatigue and information needs. Less activated survivors reported recalling that their providers were significantly (p < .05) less likely to discuss long-term side effects, psychosocial needs, risk-reducing lifestyle recommendations, and how to manage other medical concerns. Fewer care transition practices were most strongly associated with lower preparedness.
A significant proportion were not activated for survivorship, and both activation and preparedness were strongly associated with providers' survivorship transition practices.
Implementing programs to foster more activation and preparedness for lymphoma survivorship care would benefit from education about recommended follow-up care and healthy lifestyle practices. Providers should routinely ask about their patients' confidence and preparedness for survivorship and provide referrals for appropriate care as needed.
积极参与治疗后护理管理已成为促进成功过渡到癌症生存阶段的一个关键方面，并且与更好的患者预后相关。在本研究中，我们关注积极自我管理的两个关键方面，即积极性和准备程度。积极性被定义为理解自己在护理过程中的角色，并具备在自我护理管理中发挥作用的知识、技能和信心。准备程度被定义为个体认为自己对癌症治疗完成后将会发生什么有足够信息的程度。研究目标是描述新泽西州治疗完成后5年内淋巴瘤幸存者的生存准备程度和积极性，并研究社会人口学、医疗、护理过渡经历、实际问题以及心理社会因素与积极性和准备程度之间的关联。
101名在5年内完成治疗的霍奇金淋巴瘤或非霍奇金淋巴瘤幸存者完成了一项生存护理经历调查（回复率 = 34.12%）。
约60%的幸存者报告积极性较高，准备程度较高的比例与之相似。积极性较低的幸存者明显（p < 0.05）更年轻、已婚、居住在更贫困的地理区域，并且报告有更多疲劳和信息需求。积极性较低的幸存者报告称，他们回忆起其医疗服务提供者明显（p < 0.05）不太可能讨论长期副作用、心理社会需求、降低风险的生活方式建议以及如何处理其他医疗问题。较少的护理过渡实践与较低的准备程度关联最为紧密。
很大一部分人在癌症生存方面没有被激发积极性，积极性和准备程度都与医疗服务提供者的生存过渡实践密切相关。
实施促进淋巴瘤生存护理更多积极性和准备程度的项目将受益于关于推荐的后续护理和健康生活方式实践的教育。医疗服务提供者应常规询问患者对生存的信心和准备程度，并根据需要提供适当护理的转诊服务。
