Glynne-Jones R, Chait I, Thomas S F
The Wellhouse NHS Trust, Barnet, UK.
Clin Oncol (R Coll Radiol). 1997;9(1):25-9. doi: 10.1016/s0936-6555(97)80055-6.
This study aimed to examine a formal planned system of discharge from the oncology clinic of a district general hospital for long term cancer survivors. The mainstay of this system lay in a written contract between the doctor and the patient, which accepted continuing responsibility after discharge. During a 6-month period, 65 consecutive cancer patients who were in long-standing remission were interviewed and offered discharge according to the terms of the contract. Of these, 41 accepted and signed the contract. At 4 months postdischarge, patients were visited in their homes and their views sought on the effectiveness of the contract in terms of reassurance and their experience of being discharged after so many years of follow-up care. At a median interval of 13 months (range 6-18), six patients have returned to the clinic. The remaining 35 patients appeared to be successfully rehabilitated to primary care. Anxiety and fear that recurrence would not be detected were the major factors associated with refusal to accept the discharge contract.
本研究旨在探讨一家地区综合医院肿瘤门诊针对长期癌症幸存者的正式计划出院系统。该系统的核心在于医生与患者之间的书面合同，合同规定出院后仍承担持续责任。在6个月的时间里，连续对65名处于长期缓解期的癌症患者进行了访谈，并根据合同条款提议让他们出院。其中，41名患者接受并签署了合同。出院4个月后，对患者进行了家访，询问他们关于合同在提供安心感方面的有效性以及在多年随访治疗后出院的体验。在中位间隔时间为13个月（范围6 - 18个月）时，有6名患者返回了诊所。其余35名患者似乎已成功康复并回归初级保健。担心复发未被察觉的焦虑和恐惧是与拒绝接受出院合同相关的主要因素。
