Developing High-Quality Cancer Rehabilitation Programs: A Timely Need.
Developing High-Quality Cancer Rehabilitation Programs: A Timely Need.
复制标题
DOI：
10.14694/edbk_156164
复制
发表时间：
2016-01-01
期刊：
影响因子：
--
通讯作者：
Mustian, Karen
中科院分区：
文献类型：
--
作者：
Alfano, Catherine M;Cheville, Andrea L;Mustian, Karen
随着癌症治疗的改善和人口老龄化，美国癌症幸存者的人数已经达到1450万人，而且还在不断增加。三分之二的癌症幸存者将超过65岁，他们可能会接受已经解除条件的癌症治疗，并患有多种合并症。癌症幸存者面临癌症治疗的许多不利后果，这些后果增加或加剧了现有共病的影响，并增加了功能衰退的风险。这些问题中的许多都可以接受康复干预，但转介给癌症康复专业人员并不是护理的标准部分。我们提出了一个使用多学科团队方法的监测、癌症康复评估和转诊工作的扩展的前瞻性模型。在这种模式中，癌症康复从癌症诊断时开始，一直持续到癌症治疗之后。评估和治疗身体障碍和心理社会症状，并提供生活方式和运动干预，以优化功能、健康和生活质量。我们提出了一个分级护理框架，以指导根据安全要求和需要，在何时、如何以及在哪里将幸存者转介给癌症康复专家的决定。这种模式有可能导致症状和损害的早期识别、适当的转诊和及时的治疗，反过来，将更好地解决和减少急性和长期癌症发病率。
The number of survivors of cancer in the United States, already 14.5 million, is growing with improved cancer treatment and aging of the population. Two-thirds of cancer survivors will be older than age 65 and are likely to enter cancer treatment already deconditioned and with multiple comorbidities. Survivors of cancer face numerous adverse consequences of cancer treatment that add to or exacerbate the effects of existing comorbidities and increase risk of functional decline. Many of these problems are amenable to rehabilitation interventions, but referral to cancer rehabilitation professionals is not a standard part of care. We present an expanded prospective model of surveillance, cancer rehabilitation assessment, and referral efforts using a multidisciplinary team approach. In this model, cancer rehabilitation begins at the time of cancer diagnosis and continues through and beyond cancer treatment. Physical impairments and psychosocial symptoms are assessed and treated, and lifestyle and exercise interventions are provided to optimize functioning, health, and quality of life. We present a stepped-care framework to guide decisions on when, how, and where to refer survivors to cancer rehabilitation specialists depending on safety requirements and needs. This model has the potential to result in early identification of symptoms and impairments, appropriate referral and timely treatment, and, in turn, will better address and minimize both acute and long-term cancer morbidity.