Richter Franziska, Kronziel Lea Louisa, König Inke, Langer Thorsten, Gebauer Judith
Department of Pediatric Oncology and Hematology, University Medical Center Schleswig-Holstein, Lübeck, Germany.
Institute of Medical Biometry and Statistics, University of Luebeck, Lübeck, Germany.
JMIR Cancer. 2024 Dec 26;10:e59614. doi: 10.2196/59614.
Many childhood cancer survivors (CCS) develop treatment-related late effects, including an increased risk of obesity and metabolic syndrome. A healthy lifestyle can reduce the risk of associated comorbidities. Therefore, at-risk CCS could benefit from lifestyle counseling during regular long-term follow-up (LTFU).
We implemented a new form of care to decrease the long-term morbidity among CCS and to gain new insights into the lifestyle of those patients.
Over a 1-year study period, lifestyle counseling was integrated into LTFU care. Metabolic disorders, including hypercholesterolemia, diabetes mellitus, overweight or underweight, and low activity levels, were assessed as screening parameters for various risk groups. The perspectives of CCS, physicians, and sports scientists were compared to identify those with the highest needs. Each lifestyle counseling included general recommendations for physical activity, as well as an assessment of individual preferences for and barriers to the implementation of a healthy lifestyle. A follow-up appointment after 1 month was performed.
Of the 155 CCS aged 18 to 63 years (n=100, 65% female and n=55, 35% male), 112 (72%) had an indication for lifestyle counseling, identified by physicians, sports scientists, or the CCS themselves. Metabolic disorders affected 45% (n=70) of these CCS, and 46% (n=72) did not meet recommended activity levels. A total of 120 (77%) CCS received lifestyle counseling, including 8 initially uninterested individuals who became open to recommendations. Those with intensive cancer treatment history showed the greatest need. A total of 65 (54%) CCS were advised to change their lifestyle in both areas (diet and exercise) while 51 (43%) CCS received recommendations for only exercise (n=43 CCS, 36%) or diet (n=8 CCS, 7%). A total of 4 (3%) CCS, although interested in counseling, received no advice, as they already met the recommendations. Follow-up revealed high adherence to recommendations and successful integration into daily lives. In total, 97% (n=150) of survivors indicated that the provision of lifestyle counseling during LTFU would be generally beneficial.
Incorporating specialized health care professionals such as sports scientists into survivorship care enhances the multidisciplinary approach of LTFU care. Promoting a healthy lifestyle by offering guideline-based lifestyle counseling is broadly accepted among CCS and may reduce long-term morbidity.
许多儿童癌症幸存者（CCS）会出现与治疗相关的晚期效应，包括肥胖和代谢综合征风险增加。健康的生活方式可以降低相关合并症的风险。因此，有风险的CCS在定期长期随访（LTFU）期间可从生活方式咨询中受益。
我们实施了一种新的护理形式，以降低CCS的长期发病率，并深入了解这些患者的生活方式。
在为期1年的研究期间，将生活方式咨询纳入LTFU护理。评估代谢紊乱，包括高胆固醇血症、糖尿病、超重或体重不足以及低活动水平，作为各种风险组的筛查参数。比较CCS、医生和运动科学家的观点，以确定需求最高的人群。每次生活方式咨询都包括体育活动的一般建议，以及对实施健康生活方式的个人偏好和障碍的评估。1个月后进行随访预约。
在155名年龄在18至63岁的CCS中（n = 100，65%为女性，n = 55，35%为男性），112名（72%）有生活方式咨询的指征，由医生、运动科学家或CCS自己确定。代谢紊乱影响了这些CCS中的45%（n = 70），46%（n = 72）未达到推荐的活动水平。共有120名（77%）CCS接受了生活方式咨询，包括8名最初不感兴趣但后来对建议持开放态度的个体。有强化癌症治疗史的人需求最大。共有65名（54%）CCS被建议在饮食和运动两个方面改变生活方式，而51名（43%）CCS仅接受了运动（n = 43名CCS，36%）或饮食（n = 8名CCS，7%）方面的建议。共有4名（3%）CCS虽然对咨询感兴趣，但未得到建议，因为他们已经符合推荐标准。随访显示对建议的高度依从性以及成功融入日常生活。总体而言，97%（n = 150）的幸存者表示在LTFU期间提供生活方式咨询通常是有益的。
将运动科学家等专业医疗保健人员纳入幸存者护理可增强LTFU护理的多学科方法。通过提供基于指南的生活方式咨询来促进健康的生活方式在CCS中得到广泛认可，并可能降低长期发病率。
