谁为早期乳腺癌患者提供后续护理？
Who provides follow-up care for patients with early breast cancer?
作者信息
Worster A, Wood M L, McWhinney I R, Bass M J
机构信息
Victoria Family Medical Centre, London.
出版信息
Can Fam Physician. 1995 Aug;41:1314-20.
OBJECTIVE
To assess how often family physicians are involved in posttreatment care of their stage I breast cancer patients and to identify factors associated with family physicians providing follow-up care.
DESIGN
A retrospective cohort study with a 5-year follow up by chart review.
PARTICIPANTS
All cases of breast cancer seen at the London Regional Cancer Centre between 1982 and 1987 were reviewed to identify 183 stage I cancer patients alive at 5 years.
MAIN OUTCOME MEASURES
Whether a physician (other than an oncologist) was involved in the follow-up care of patients, and whether the physician was a family physician or a surgeon.
RESULTS
Follow-up care during the 5-year postoperative period was provided in most cases by oncologists alone (66.7%); family physicians and surgeons were involved in 17.5% and 15.8% of cases, respectively. Surgeons became involved in follow-up care much earlier (12 months) than family physicians did (23 months) (P = 0.01) and were more likely to provide care for patients who received radiation treatment (P = 0.04) and for patients who lived in London (P = 0.004). Most malignant breast lesions (77.5%) were discovered by patients themselves (P = 0.0001).
CONCLUSIONS
Currently, family physicians are infrequently involved in follow-up care of their patients with early breast cancer.
目的
评估家庭医生参与其I期乳腺癌患者治疗后护理的频率，并确定与家庭医生提供后续护理相关的因素。
设计
一项回顾性队列研究，通过病历审查进行5年随访。
参与者
对1982年至1987年期间在伦敦地区癌症中心就诊的所有乳腺癌病例进行审查，以确定183名5年后仍存活的I期癌症患者。
主要观察指标
是否有医生（肿瘤学家除外）参与患者的后续护理，以及该医生是家庭医生还是外科医生。
结果
在大多数情况下，术后5年的后续护理仅由肿瘤学家提供（66.7%）；家庭医生和外科医生分别参与了17.5%和15.8%的病例。外科医生比家庭医生更早（12个月）参与后续护理（23个月）（P = 0.01），并且更有可能为接受放射治疗的患者（P = 0.04）和居住在伦敦的患者（P = 0.004）提供护理。大多数乳腺恶性病变（77.5%）是由患者自己发现的（P = 0.0001）。
结论
目前，家庭医生很少参与其早期乳腺癌患者的后续护理。
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