Comprehensive long-term follow-up programs for pediatric cancer survivors
Comprehensive long-term follow-up programs for pediatric cancer survivors
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DOI：
10.1002/cncr.22096
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发表时间：
2006-08-15
期刊：
影响因子：
6.2
通讯作者：
Turoff, Alicia J.
中科院分区：
文献类型：
--
作者：
Aziz, Noreen M.;Oeffinger, Kevin C.;Turoff, Alicia J.
背景本研究的目的是提供一个详细的描述，全面的长期随访（LTFU）计划的儿童癌症幸存者。来自美国和加拿大的24个综合LTFU项目的项目主管完成了一份6页的调查，提供了5个类别的详细信息：项目描述，项目的感知益处和优势，项目开发和使用的障碍，改进项目的方法，以及儿科癌症幸存者的理想护理模式。参与者确定了通过LTFU计划向幸存者提供医疗保健的以下主要好处：由熟悉幸存者长期风险的临床医生提供医疗保健，提供基于风险的筛查和晚期效应监测，以及针对降低风险和健康生活方式的有针对性的教育。LTFU项目运作的主要障碍包括系统驱动和患者/生存者驱动因素。系统驱动的因素包括资源和资金不足，以维持方案，对提供幸存者护理的机构承诺低，缺乏照顾不断增长的幸存者人口的能力，以及与社区医生进行沟通的困难。幸存者驱动的障碍包括缺乏兴趣和缺乏对癌症相关风险的认识。本报告描述了儿科综合LTFU计划提供的随访护理的频率、内容和设置。随着生存护理的发展，关键的挑战将包括整合一个结构化的程序评估和护理能力建设。
BACKGROUND. The objective of this study was to provide a detailed description of comprehensive long-term follow-up (LTFU) programs for pediatric cancer survivors.METHODS. Program directors from 24 comprehensive LTFU programs in the U.S. and Canada completed a 6-page survey that provided details in 5 categories: description of the program, perceived benefits and strengths of the program, barriers to the development and use of the program, methods to improve the program, and an ideal model of care for pediatric cancer survivors.RESULTS. Participants identified the following primary benefits to health care delivered to survivors through LTFU programs: health care delivered by clinicians familiar with long-term risks of survivors, provision of risk-based screening and surveillance for late effects, and targeted education for risk reduction and healthy lifestyles. Key barriers to the functioning of LTFU programs included system-driven and patient/survivor-driven factors. System-driven factors included inadequate resources and finances to sustain programs, low institutional commitment toward the provision of survivorship care, lack of capacity to care for the growing population of survivors, and difficulties with ongoing communication with community physicians. Survivor-driven barriers included lack of interest and lack of awareness of cancer-related risks.CONCLUSIONS. This report describes the frequency, content, and setting of follow-up care delivered by pediatric comprehensive LTFU programs. Critical challenges as survivorship care evolves will include integrating a structured process of program evaluation and building capacity for care.