Predictors of Follow-Up Care Seeking Among Breast and Prostate Cancer Survivors

乳腺癌和前列腺癌幸存者寻求后续护理的预测因素

• 批准号: 8700941
• 负责人: SHAWNA V. HUDSON
• 金额: $ 5.47万
• 依托单位: RBHS-ROBERT WOOD JOHNSON MEDICAL SCHOOL
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-03-01 至 2014-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8700941
• 关键词: Predictors; Follow; Up; Care; Seeking

DESCRIPTION (provided by applicant): Predictors of Follow-Up Care Seeking Among Breast and Prostate Cancer Survivors By 2050 the estimated number of cancer survivors will surpass new cancer cases, putting great demands on service providers and systems of care. More than half of individuals already diagnosed with cancer are expected to survive for more than 5 years. For breast and prostate cancers survival exceeds 88%. The American Society of Clinical Oncology projects a medical oncologist shortage by 2020 that will necessitate a multifaceted strategy to meet future cancer follow-up care demands. Therefore, primary care providers (PCPs) are increasingly being called upon to provide a "medical home" (i.e., usual source of care) for cancer survivors who have completed treatment. Currently one third of the 36.6 million physician office visits made for cancer care annually are made to PCPs. A study of SEER linked Medicare data reports that greater proportions of long-term breast and prostate cancer survivors (75% of those surviving 5+ yrs) receive care from primary care providers than cancer and cancer related specialists. Several studies suggest that survivors who see both oncologists and primary care physicians are more likely to receive recommended follow-up care than patients who see one or the other. Yet, there is little research that examines how patients think about their options for care, their decision making processes or the impact of these factors on receiving quality follow-up care. There is also limited research on cancer survivors who receive their treatment in community settings. While most adult cancer survivors in the US are treated for their cancers in community settings, much of the current survivorship research comes from patients treated at NCI designated comprehensive cancer centers. We address these important knowledge gaps in the proposed study. Specific aims of the study are to: (1) implement a survey study of adult cancer survivors treated in community settings that assesses and measures their primary care use and attitudes regarding their follow-up cancer care; (2) describe primary care usage of breast and prostate cancer survivors for follow-up care and recurrence surveillance; and, (3) assess cognitive- affective, patient support and demographic factors that affect how survivors use oncology specialists and PCPs for follow-up care. This descriptive, cross-sectional study of breast and prostate cancer survivors (n=400) will be conducted with patients treated at six community hospitals reflective of the diversity of community cancer treatment experiences in the state of NJ. Study results will provide a sound empirical basis for the development of interventions that enhance survivor care plans and optimize follow-up care in cancer survivor populations.

描述（由申请人提供）：乳腺癌和前列腺癌幸存者寻求后续护理的预测因素到2050年，癌症幸存者的估计数量将超过新发癌症病例，这对服务提供者和护理系统提出了巨大的要求。超过一半已经被诊断出患有癌症的人预计能存活5年以上。乳腺癌和前列腺癌的存活率超过88%。美国临床肿瘤学会预计，到2020年，医学肿瘤学家将出现短缺，这将需要一个多方面的战略来满足未来癌症后续护理的需求。因此，越来越多的人要求初级保健提供者（pcp）为完成治疗的癌症幸存者提供“医疗之家”（即通常的护理来源）。目前，每年因癌症治疗而就诊的3660万名医生中，有三分之一是到pcp就诊的。一项与SEER相关的医疗保险数据研究报告称，长期乳腺癌和前列腺癌幸存者（占存活5年以上患者的75%）接受初级保健提供者护理的比例高于癌症和癌症相关专家。几项研究表明，同时看肿瘤学家和初级保健医生的幸存者比只看其中之一的患者更有可能接受推荐的后续护理。然而，很少有研究调查患者如何考虑他们的护理选择，他们的决策过程或这些因素对接受高质量后续护理的影响。对在社区环境中接受治疗的癌症幸存者的研究也很有限。虽然美国大多数成年癌症幸存者在社区环境中接受癌症治疗，但目前大部分幸存者研究来自NCI指定的综合癌症中心接受治疗的患者。我们在拟议的研究中解决了这些重要的知识差距。该研究的具体目的是：(1)对在社区环境中接受治疗的成年癌症幸存者进行调查研究，评估和测量他们对初级保健的使用情况和对后续癌症护理的态度；(2)描述乳腺癌和前列腺癌幸存者在随访护理和复发监测方面的初级保健使用情况；(3)评估影响幸存者如何使用肿瘤专家和pcp进行后续护理的认知-情感、患者支持和人口因素。这项对乳腺癌和前列腺癌幸存者（n=400）的描述性横断面研究将与在六家社区医院接受治疗的患者一起进行，反映了新泽西州社区癌症治疗经验的多样性。研究结果将为制定干预措施，加强幸存者护理计划和优化癌症幸存者人群的随访护理提供良好的经验基础。