Gynecologic cancer survivor preferences for long-term surveillance.
Gynecologic cancer survivor preferences for long-term surveillance.
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DOI：
10.1186/s12885-018-4313-x
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发表时间：
2018-04-03
期刊：
影响因子：
3.8
通讯作者：
Bodurka D
中科院分区：
文献类型：
--
作者：
Schlumbrecht M;Sun C;Huang M;Milbourne A;Bodurka D
随着医疗保健改革的进行和肿瘤学家数量的减少，妇科癌症幸存者护理的适当分类至关重要。患者的参与是这项工作的必要组成部分。本研究的目的是评估妇科癌症幸存者在完成治疗后对监测的偏好。与妇女癌症基金会一起制定并发布了一份38项调查表。所有在FWC登记为妇科癌症幸存者的妇女都被邀请参加。患者被问及医生对多种症状和诊断的偏好，以及他们何时感到舒适地将护理转移出肿瘤学家的办公室。采用卡方检验和logistic回归进行分析。624名患者完成了问卷调查。66%的人患有卵巢癌，86%的人主要由妇科肿瘤科医生治疗。57%的受访者表示，他们不愿意在任何时候去看肿瘤科医生以外的医生进行生存护理。与年轻女性相比，年龄> 60岁的女性在任何时候都不太愿意离开肿瘤学家接受生存护理（OR 1.53 [95% CI 1.03-2.27]，p = 0.03）。与子宫癌幸存者相比，卵巢癌幸存者也更有可能报告留在肿瘤学家那里的愿望（p < 0.001）。除了少数例外，受访者更喜欢由他们的肿瘤学家管理非肿瘤医学问题。妇科癌症幸存者更希望他们的肿瘤学家继续积极参与生存护理。随着幸存者人口的持续增长，协调患者需求与医生和经济限制将是一项挑战。
With ongoing healthcare reform and shrinking numbers of oncologists, appropriate triaging of gynecologic cancer survivor care is crucial. Input from patients is a necessary part of this task. The objective of this study was to assess the preferences of gynecologic cancer survivors for surveillance after the completion of treatment. A 38-item questionnaire was developed and launched in conjunction with the Foundation for Women’s Cancer (FWC). All women who registered as gynecologic cancer survivors with the FWC were invited to participate. Patients were asked about physician preferences for multiple symptoms and diagnoses, and when they felt comfortable transferring care out of their oncologists’ offices. Analyses were performed with chi-square and logistic regression. Six hundred twenty four patients completed the questionnaire. Sixty six percent had ovarian cancer, and 86% were primarily treated by a gynecologic oncologist. Fifty seven percent of the respondents reported being unwilling to see a physician other than their oncologist for survivorship care at any time. Women age > 60 years were less willing to leave their oncologists for survivorship care at any time compared to younger women (OR 1.53 [95% CI 1.03–2.27], p = 0.03). Ovarian cancer survivors were also more likely to report a desire to stay with their oncologists compared with uterine cancer survivors (p < 0.001). With few exceptions, respondents preferred management of non-oncologic medical problems by their oncologists. Gynecologic cancer survivors prefer that their oncologists remain heavily involved in survivorship care. Reconciling patient needs with physician and financial constraints will be a challenge as the survivor population continues to grow.
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