Delivery of Survivorship Care by Primary Care Physicians: The Perspective of Breast Cancer Patients
Delivery of Survivorship Care by Primary Care Physicians: The Perspective of Breast Cancer Patients
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DOI：
10.1200/jco.2008.18.0679
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发表时间：
2009-02-20
影响因子：
45.3
通讯作者：
Armstrong, Katrina
中科院分区：
文献类型：
--
作者：
Mao, Jun J.;Bowman, Marjorie A.;Armstrong, Katrina
今年在美国被诊断出患有乳腺癌的182,460名妇女将成为长期幸存者。帮助这些妇女从主动治疗转变为生存是一项挑战，涉及肿瘤学家和初级保健医生（PCP）。这项研究旨在描述绝经后乳腺癌幸存者（BCS）对PCP相关生存护理的看法。患者和Methodswe对在一家大型大学医院的门诊乳腺癌诊所中看到的300 bcss进行了横断面调查。主要结果度量是对感知的生存护理的七项自我报告措施（Cronbach的alpha = .89）。多元回归分析用于识别与感知的护理交付相关的因素。ResultSoverall，BCSS评级与PCP相关的生存护理为100中的65个（标准偏差= 17）。最有PCP相关的护理领域最受认可的是普通护理（78％），社会心理支持（73％）和健康促进（73％）。 BCSS较少，将其PCP视为癌症随访（50％），癌症治疗的后期影响（59％）或治疗与癌症或癌症疗法有关的症状（41％）的知识渊博（41％）。只有28％的人认为他们的PCP和肿瘤学家沟通良好。在多元回归分析中，非白人种族和PCP的信任水平与较高感知到的与PCP相关的生存护理水平显着相关（两者的P = .001）。结论性的BCSS所认为的高质量的普通护理，其PCP提供了高质量的通用，他们对PCP提供特定于癌症的生存护理的能力并不充满信心。需要对干预措施进行测试，以改善肿瘤学主要护理沟通和PCP知识对癌症特异性生存护理的了解。
PurposeMost of the 182,460 women diagnosed with breast cancer in the United States this year will become long-term survivors. Helping these women transition from active treatment to survivorship is a challenge that involves both oncologists and primary care physicians (PCPs). This study aims to describe postmenopausal breast cancer survivors' (BCS) perceptions of PCP-related survivorship care.Patients and MethodsWe conducted a cross-sectional survey of 300 BCSs seen in an outpatient breast oncology clinic at a large university hospital. The primary outcome measure was a seven-item self-reported measure on perceived survivorship care (Cronbach's alpha = .89). Multivariate regression analyses were used to identify factors associated with perceived care delivery.ResultsOverall, BCSs rated PCP-related survivorship care as 65 out of 100 (standard deviation = 17). The areas of PCP-related care most strongly endorsed were general care (78%), psychosocial support (73%), and health promotion (73%). Fewer BCSs perceived their PCPs as knowledgeable about cancer follow-up (50%), late effects of cancer therapies (59%), or treating symptoms related to cancer or cancer therapies (41%). Only 28% felt that their PCPs and oncologists communicated well. In a multivariate regression analysis, nonwhite race and level of trust in the PCP were significantly associated with higher perceived level of PCP-related survivorship care (P = .001 for both).ConclusionAlthough BCSs perceived high quality of general care provided by their PCPs, they were not as confident with their PCPs' ability to deliver cancer-specific survivorship care. Interventions need to be tested to improve oncology-primary care communication and PCP knowledge of cancer-specific survivorship care.