“你首先得去看医生”：儿童癌症幸存者的过渡期望与经历

"You First Have to Check Out the Doctors": Transition Expectations and Experiences of Survivors After Pediatric Cancer.

作者信息

Aleshchenko Ekaterina, Langer Thorsten, Calaminus Gabriele, Glogner Juliane, Haugke Henrike, Trocchi Pietro, Swart Enno, Baust Katja

机构信息

Institute of Social Medicine and Health Systems Research, Faculty of Medicine, Otto von Guericke University, Magdeburg, Germany.

University Hospital of Schleswig-Holstein, Campus Luebeck, Luebeck, Germany.

出版信息

Cancer Med. 2024 Dec;13(23):e70455. doi: 10.1002/cam4.70455.

DOI:10.1002/cam4.70455

PMID:39655443

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11629024/

Abstract

PURPOSE

The shift from child-centered to adult-focused healthcare presents social and psychological challenges for adolescents and young adults with chronic conditions, which can affect their participation in follow-up care. This study aims to investigate the factors that influence patient-driven motivations for adhering to follow-up recommendations, while also exploring the barriers and supports that impact the transition process for pediatric cancer survivors.

METHODS

We developed interview guidelines grounded in the Theory of Planned Behavior (TPB) and the stereotype priming model (SPM). We conducted 10 episodic narrative interviews with pediatric cancer survivors during their transition phase. The interview transcripts were analyzed through qualitative thematic content analysis, followed by quantitative analysis using multiple regression models. This research is a part of the broader VersKiK study, which aims to propose enhancements to the organization of (long-term) follow-up care after cancer in childhood and adolescence in Germany.

RESULTS

In this study, pediatric cancer survivors transitioning to adult healthcare showed varied motivations for follow-up care. Positive attitudes, driven by understanding the benefits, improved engagement, while anxiety and fear of losing familiar care created barriers. Family and peer support played a key role in encouraging adherence. Perceived control over healthcare management, supported by organizational help, was crucial, but logistical and financial challenges often undermined this control.

CONCLUSIONS

Several motives underlying pediatric cancer survivors' behavior significantly influence their transition experiences. Enhancing positive attitudes, strengthening social support, and improving perceived control through targeted interventions may support smoother transitions to adult healthcare facilities.

TRIAL REGISTRATION

Registered at German Clinical Trial Register (IDs: DRKS00025960 and DRKS00026092).

摘要

目的

从以儿童为中心的医疗保健向以成人为重点的医疗保健的转变，给患有慢性病的青少年和年轻人带来了社会和心理挑战，这可能会影响他们参与后续护理。本研究旨在调查影响患者遵循后续建议的自主动机的因素，同时探讨影响儿科癌症幸存者过渡过程的障碍和支持因素。

方法

我们以计划行为理论（TPB）和刻板印象启动模型（SPM）为基础制定了访谈指南。我们在儿科癌症幸存者的过渡阶段对他们进行了10次情景叙事访谈。访谈记录通过定性主题内容分析进行分析，然后使用多元回归模型进行定量分析。这项研究是更广泛的VersKiK研究的一部分，该研究旨在提出改进德国儿童和青少年癌症（长期）后续护理组织的建议。