A comparison of two models of follow-up care for adult survivors of childhood cancer.
Purpose: Few studies have compared follow-up-care models for adult survivors of childhood cancer (ASCCs), though choice of model could impact medical test adherence, and health-related quality of life (QOL). This study compared two follow-up-care models, cancer-center-based versus community-based, f...
| Publicado en: | Journal of Cancer Survivorship Vol. 13; no. 4; pp. 547 - 558 |
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| Autores principales: | , , , , , , , , , , |
| Formato: | research Journal Article |
| Publicado: |
Springer Nature
Aug2019
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=137870883&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 137870883 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 19322259 46CU jtl: Journal of Cancer Survivorship issn: 19322259 maglogo: N pubinfo: dt: Aug2019 vid: 13 iid: 4 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 137870883 137870883 NLM31250352 137870883 10.1007/s11764-019-00774-w NLM31250352 137870883 ppf: 547 ppct: 11 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: A comparison of two models of follow-up care for adult survivors of childhood cancer. aug: au: Reynolds, K. Spavor, M. Brandelli, Y. Kwok, C. Li, Y. Disciglio, M. Carlson, L. E. Schulte, F. Anderson, R. Grundy, P. Giese-Davis, J. affil: Long Term Survivor's Clinic, Alberta Children's Hospital, University of Calgary, 2888 Shaganappi Trail NW, T3B 6A8, Calgary, Alberta, Canada sug: subj: After Care Management Neoplasms Therapy Male Adolescence Middle Age Child, Preschool Child Neoplasms Pathology Canada After Care Standards Patient Compliance Female Prospective Studies Neoplasms Epidemiology Adult Human Quality of Life Validation Studies Comparative Studies Evaluation Research Multicenter Studies Scales Adolescent: 13-18 years Middle Aged: 45-64 years Child, Preschool: 2-5 years Child: 6-12 years Adult: 19-44 years Male Female ab: Purpose: Few studies have compared follow-up-care models for adult survivors of childhood cancer (ASCCs), though choice of model could impact medical test adherence, and health-related quality of life (QOL). This study compared two follow-up-care models, cancer-center-based versus community-based, for ASCCs in Alberta, Canada, to determine which model would demonstrate greater ASCC adherence to guideline-recommended medical screening tests for late effects, QOL, physical symptoms, and adherence to yearly follow-up.Methods: ASCC discharged to a community model (over 15 years) and those with comparable birth years (1973-1993) currently followed in a cancer center model were recruited via direct contact or multimedia campaign. Chart review identified chemotherapeutic and radiation exposures, and required medical late effect screening tests. ASCCs also completed questionnaires assessing QOL, physical symptoms, and follow-up behavior.Results: One hundred fifty-six survivors participated (community (n = 86); cancer center (n = 70)). Primary analysis indicated that cancer center ASCCs guideline-recommended total test adherence percentage (Mdn = 85.4%) was significantly higher than the community model (Mdn = 29.2%, U = 3996.50, p < 0.0001). There was no significant difference in QOL for cancer center ASCCs (M = 83.85, SD = 20.55 versus M = 77.50, SD = 23.94; t (154) = 1.77, p = 0.078) compared to community-based ASCCs. Cancer center-based ASCCs endorsed from 0.4-7.1% fewer physical symptom clusters, and higher adherence to follow-up behavior in comparisons using effect sizes without p values.Conclusion: This study highlights the cancer center model's superiority for adherence to exposure-based medical late effect screening guidelines, cancer-specific follow-up behaviors, and the reporting of fewer physical complaints in ASCCs.Implications For Cancer Survivors: ASCCs followed in a cancer center model likely benefit from earlier late-effects detection and opportunities for early intervention. pubtype: Academic Journal doctype: research Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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