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

基本信息

批准号：
8133263
负责人：
SHAWNA V. HUDSON
金额：
$ 8.85万
依托单位：
UNIV OF MED/DENT NJ-R W JOHNSON MED SCH
依托单位国家：
美国
项目类别：
财政年份：
2011
资助国家：
美国
起止时间：
2011-03-01 至 2013-02-28
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8133263
关键词：
Address Adult Affect Affective Age American Society of Clinical Oncology Attitude Behavior Belief Breast Cancer Survivor Caring Characteristics Clinical Cognitive Communities Community Hospitals Comprehensive Cancer Center Cross-Sectional Studies Data Data Reporting Decision Making Demographic Factors Development Diagnosis Education Emotional Ethnic Origin Family Physicians Foundations Future Goals Gynecologist Health Home environment Individual Internist Intervention Knowledge Late Effects Length Link Literature Malignant Neoplasms Malignant neoplasm of prostate Measures Mediating Mediator of activation protein Medical Medical Oncologist Medicare Motivation Nurse Practitioners Office Visits Oncologist Outcome Patient Care Patient Education Patient Preferences Patients Persons Physician Assistants Pilot Projects Population Primary Care Physician Primary Health Care Process Professional Education Prostate Provider Race Recurrence Reporting Research Role Screening for cancer Services Source Specialist Staging Survey Methodology Surveys Survivors Testing Toxic effect Treatment outcome Typology base cancer care cancer diagnosis cancer therapy care preference care seeking care systems community setting design evidence base experience follow-up information processing insight malignant breast neoplasm meetings oncology preference psychologic satisfaction social sound survivorship therapy design therapy development tumor willingness

项目摘要

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，预计癌症幸存者人数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要求。超过一半的已诊断患有癌症的人预计可以存活 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，肿瘤内科医生将出现短缺，因此需要采取多方面的策略来满足未来的癌症随访护理需求。因此，越来越多的初级保健提供者（PCP）被要求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，每年因癌症护理而前往医生办公室就诊的 3660 万人次中，有三分之一是针对 PCP 的。一项针对 SEER 相关医疗保险数据的研究报告称，与癌症和癌症相关专家相比，长期乳腺癌和前列腺癌幸存者（存活 5 年以上者中的 75%）接受初级保健提供者护理的比例更高。几项研究表明，同时就诊肿瘤科医生和初级保健医生的幸存者比只就诊其中之一的患者更有可能接受推荐的后续护理。然而，很少有研究探讨患者如何看待他们的护理选择、决策过程或这些因素对接受优质后续护理的影响。关于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，但目前的大部分生存研究来自于 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一项调查研究，评估和衡量他们的初级保健使用情况以及对后续癌症护理的态度； (2) 描述乳腺癌和前列腺癌幸存者的初级保健用于后续护理和复发监测的情况； (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、患者支持和人口统计因素。这项针对乳腺癌和前列腺癌幸存者 (n=400) 的描述性横断面研究将对在六家社区医院接受治疗的患者进行，这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提供坚实的经验基础，以加强幸存者护理计划并优化癌症幸存者群体的后续护理。