Attendance at a survivorship clinic: impact on knowledge and psychosocial adjustment
Attendance at a survivorship clinic: impact on knowledge and psychosocial adjustment
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DOI：
10.1007/s11764-013-0291-9
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发表时间：
2013-12-01
影响因子：
3.7
通讯作者：
Sklar, Charles A.
中科院分区：
文献类型：
--
作者：
Ford, Jennifer S.;Chou, Joanne F.;Sklar, Charles A.
由于发生迟发不良后果的风险较高，建议儿童癌症幸存者在专门的幸存者诊所接受后续护理。然而，很少有人知道到这些诊所就诊对心理社会适应、知识和发病率的影响。本研究评估了参加幸存者诊所和未参加幸存者诊所的患者在知识、风险感知和心理社会适应方面的差异。我们评估了102名参加长期随访（LTFU）诊所的幸存者和71名从未在专业诊所（非LTFU）看过的幸存者。参与者在评估前至少5年被诊断，年龄至少20岁，没有活动性疾病的证据。各组按性别、癌症诊断时的年龄、诊断结果和种族进行匹配。参与者目前的平均年龄为30岁，在12岁左右被诊断出患有癌症。非ltfu幸存者不去诊所的最常见原因是“不知道”（71%）或“不感兴趣”（16%）。每一组的幸存者都能够准确地报告他们的癌症诊断，但很少有人知道具体的治疗信息。幸存者对未来健康问题风险的认知没有显著差异，两组相似地低估了他们的风险。每组中都有少数人报告有心理或情绪问题（16- 18%），创伤后应激障碍（4.2- 6.9%）和/或心理困扰（7.8- 19.7%）。幸存者需要继续接受教育，了解他们的具体癌症治疗方法、建议的随访做法、幸存者护理的重要性以及他们对晚期影响的具体风险。在那些参加幸存者诊所的儿童癌症幸存者中，大多数人需要继续接受有关他们具体的癌症治疗、建议的后续实践和晚期影响风险的教育。由于许多儿童癌症幸存者似乎不知道幸存者诊所的存在，因此需要改进治疗完成后幸存者过渡的方法。
Due to their heightened risk of developing late-occurring adverse outcomes, pediatric cancer survivors are advised to receive follow-up care in specialized Survivor Clinics. However, little is known about the impact of attending such clinics on psychosocial adjustment, knowledge, and morbidity. This study assesses the differences between those who attended a Survivorship Clinic and those who did not on knowledge, perception of risk, and psychosocial adjustment.We assessed 102 survivors who attended our Long-Term Follow-Up (LTFU) Clinic and 71 survivors never seen in a specialized clinic (non-LTFU). Participants were diagnosed at least 5 years prior to the assessment, were at least 20 years old, and had no evidence of active disease. Groups were matched on gender, age at cancer diagnosis, diagnosis, and race.On average, participants were currently 30 years of age and had been diagnosed with cancer around age 12. Most common reasons that non-LTFU survivors did not attend the clinic were "not aware" (71 %) or "not interested" (16 %). Survivors in each group were able to accurately report their cancer diagnosis, but few knew specific treatment information. There were no significant differences regarding survivors' perceptions of risk of future health problems with both groups similarly underestimating their risks. A significant minority in each group reported psychological or emotional problems (16-18 %), post-traumatic stress disorder (4.2-6.9 %), and/or psychological distress (7.8-19.7 %).Survivors are in need of continued education about their specific cancer treatments, recommended follow-up practices, the importance of survivorship care, and their specific risks for late effects.Among those childhood cancer survivors who do attend a Survivor clinic, a majority are in need of continued education about their specific cancer treatments, recommended follow-up practices, and risk of late effects. As many survivors of pediatric cancer appear to be unaware of the existence of Survivor clinics, improved methods of transitioning survivors after completion of treatment are needed.