Breast Cancer Survivors' Perceptions of Survivorship Care Options
Breast Cancer Survivors' Perceptions of Survivorship Care Options
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DOI：
10.1200/jco.2011.36.9264
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发表时间：
2012-01-10
影响因子：
45.3
通讯作者：
Earle, Craig C.
中科院分区：
文献类型：
--
作者：
Mayer, Erica L.;Gropper, Adrienne B.;Earle, Craig C.
目的随着乳腺癌幸存者数量的增加，需要一种持久的综合幸存者护理模式，包括肿瘤科内外的提供者和/或探视类型。本研究的目的是探讨幸存者对不同临床医生类型或通过电话/互联网的虚拟访问作为生存护理的组成部分的舒适度。方法参加一般生存调查的乳腺癌幸存者完成了一份额外的针对乳腺癌的问卷，评估对不同临床医生类型的随访或虚拟访问对患者生存、担忧和压力的自我感知影响。在减少对癌症的担忧(优势比[OR]，2.21；P<；.001)、减少就诊前后的压力(OR，1.40；P<；.002)以及提高癌症存活率(OR，2.38；P<；.001)方面，最受欢迎的肿瘤内科医生随访访问比那些接受初级保健医生(PCP)或护士从业者(NP)的人更受欢迎。然而，大多数人也对同一领域的PCP和NP表现出相当大的舒适感。与面对面就诊相比，患者对虚拟就诊对癌症存活率和癌症相关担忧的影响较小。结论乳腺癌幸存者对提供后续护理的PCP和NPS都感到满意，尽管他们表示更喜欢内科肿瘤学家。鉴于患者对虚拟访问的负面印象，需要增加对这一新兴概念的熟悉和研究。NP主导的生存诊所模式，增加了对PCP的指导，为提高幸存者护理的质量和满意度提供了一条有希望的途径。J Clin Oncol30：158-163。(C)2011年美国临床肿瘤学会
PurposeAs the number of breast cancer survivors increases, a durable model of comprehensive survivor care is needed, incorporating providers and/or visit types both within and outside of oncology. The objective of this study was to explore survivors' comfort with different clinician types or with a telephone/Internet-based virtual visit as components of survivorship care.MethodsBreast cancer survivors participating in a general survivorship survey completed an additional breast cancer-specific questionnaire evaluating the self-perceived impact of follow-up visits to various clinician types, or follow-up by a virtual visit, on survival, worrying, and stress related to cancer.ResultsA total of 218 breast cancer survivors completed the questionnaire. Most favored medical oncologist follow-up visits over those with primary care physicians (PCPs) or nurse practitioners (NPs) in terms of reduced worrying about cancer (odds ratio [OR], 2.21; P < .001), reduced stress around the visit (OR, 1.40; P < .002), and improved effect on cancer survival (OR, 2.38; P < .001). However, the majority also displayed substantial comfort with both PCPs and NPs in the same domains. Patients rated a virtual visit as having a less favorable impact on cancer survival and cancer-related worrying compared with in-person visits with clinicians.ConclusionBreast cancer survivors are comfortable with both PCPs and NPs providing follow-up care, although they indicate a preference for medical oncologists. Given patients' negative impressions of a virtual visit, increased familiarity with and research investigating this emerging concept are needed. The NP-led survivorship clinic model, with increased guidance for PCPs, offers a promising route for improving quality of and satisfaction with survivor care. J Clin Oncol 30:158-163. (C) 2011 by American Society of Clinical Oncology