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一项利用“拓展社区医疗成果(ECHO)项目”模式向社区医疗专业人员提供癌症幸存者教育的试点研究分析。

Analysis of a Pilot Study Delivering Cancer Survivorship Education to Community Healthcare Professionals Utilizing the Project ECHO Model.

作者信息

Davenport Ashley Pariser, Johns Kevin, Champion Dena, Roberts Andrea, Fugett Susan, Holley Erin, Schreiber Candice, Presley Carolyn J, Todd Jalyn, Honeychuck Andrew, Hunt Katherine, Lu Yurong, Ramaswamy Bhuvaneswari, Brill Seuli Bose

机构信息

Division of Medical Oncology, The Ohio State University Comprehensive Cancer Center, Columbus, OH, USA.

Department of Internal Medicine, The Ohio State University College of Medicine, Columbus, OH, USA.

出版信息

J CME. 2024 Nov 26;13(1):2433916. doi: 10.1080/28338073.2024.2433916. eCollection 2024.

Abstract

As the number and needs of cancer survivors grow, innovative ways to enhance survivorship expertise are needed. This pilot study evaluated a 12-week cancer survivorship curriculum delivered to two cohorts of providers at affiliated sites within the Mercy Health System, utilising the Project ECHO® model, on provider self-efficacy (SE), knowledge (KN), and professional improvement (PI). Providers received six 1-hour sessions, informed by provider needs assessment, over 12 weeks. Participants completed pre- and post-session surveys evaluating SE, KN, and PI domains. The average score for survey items overall and within each domain was compared in pre- and post-session survey results. Twenty-six participants completed the baseline survey and 22 completed the post-session survey. For cohort 1, the overall score (0.94, 95% CI [0.45,1.42]  = 0.0023), SE (1.1, [95% CI [0.5,1.7]  = 0.003), and KN domain (1.03, 95% CI [0.45,1.62]  = 0.0036) scores significantly increased. For cohort 2, the overall score (0.617, 95% CI [0.042,1.193]  = 0.0378), SE (0.728, 95% CI [0.048,1.407]  = 0.0379), and KN domains (0.665, 95% CI [0.041,1.289]  = 0.0387) increased significantly. The PI score did not change for either cohort (PI -0.09, 95% CI [-0.67, 0.49]  = 0.726 and 0.000, 95% CI [-0.790,0.790]  > 0.999). This Cancer Survivorship ECHO pilot resulted in a statistically significant increase in provider self-efficacy and knowledge. All 22 participants rated the Cancer Survivorship ECHO pilot experience as having a positive (greater than neutral) result on their training. The Cancer Survivorship ECHO model may serve as a scalable strategy for building cancer survivorship care capacity in community-based oncology practices by equipping multidisciplinary teams to meet the needs of cancer survivors within their communities. Further research is needed to assess the implementation of this model in novel settings and evaluate its impact on patient outcomes and professional improvement.

摘要

随着癌症幸存者数量及其需求的增加,需要创新方法来提高幸存者护理专业水平。这项试点研究利用“拓展医疗服务远程协作网”(ECHO®)模式,评估了一项为期12周的癌症幸存者护理课程,该课程面向仁慈医疗系统下属机构的两组医疗服务提供者,内容涉及提供者的自我效能感(SE)、知识水平(KN)和专业提升(PI)。提供者在12周内参加了6次为时1小时的课程,课程内容依据提供者需求评估确定。参与者在课程前后分别完成了评估SE、KN和PI领域的调查问卷。对课程前后调查问卷结果中各项目及各领域的平均得分进行了比较。26名参与者完成了基线调查,22名完成了课程后调查。对于第一组,总体得分(0.94,95%置信区间[0.45,1.42]  = 0.0023)、SE得分(1.1,[95%置信区间[0.5,1.7]  = 0.003)和KN领域得分(1.03,95%置信区间[0.45,1.62]  = 0.0036)显著提高。对于第二组,总体得分(0.617,95%置信区间[0.042,1.193]  = 0.0378)、SE得分(0.728,95%置信区间[0.048,1.407]  = 0.0379)和KN领域得分(0.665,95%置信区间[0.041,1.289]  = 0.0387)显著提高。两组的PI得分均未改变(PI -0.09,95%置信区间[-0.67, 0.49]  = 0.726;0.000,95%置信区间[-0.790,0.790]  > 0.999)。这项癌症幸存者护理ECHO试点研究使提供者的自我效能感和知识水平在统计学上显著提高。所有22名参与者均认为癌症幸存者护理ECHO试点经历对他们的培训产生了积极(大于中性)效果。癌症幸存者护理ECHO模式可作为一种可扩展策略,通过使多学科团队有能力满足所在社区癌症幸存者的需求,在社区肿瘤医疗实践中建立癌症幸存者护理能力。需要进一步研究以评估该模式在新环境中的实施情况,并评估其对患者治疗效果和专业提升的影响。

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Cancer statistics, 2023.癌症统计数据,2023 年。
CA Cancer J Clin. 2023 Jan;73(1):17-48. doi: 10.3322/caac.21763.

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