RESUMO
PURPOSE: The LIFE Cancer Survivorship Program at NorthShore University HealthSystem provides risk-adapted visits (RAV) facilitated by an oncology nurse during which a survivorship care plan (SCP) is provided and discussed. In this report, we describe and evaluate RAV in promoting individualized health care and self-management during survivorship transition. METHODS: Patients complete a post-RAV questionnaire at their RAV and another ≥1 year after their RAV. RESULTS: One thousand seven hundred thirteen (1713) RAVs, majority for breast cancer, occurred from January 2007 to March 2014. One thousand six hundred fifteen (1615) "day-of" post-RAV questionnaires were completed. Respondents scaled statements as strongly agree/agree/disagree/strongly disagree. Combined strongly agree/agree ratings are 94 % felt more confident in communicating information about their treatments to other health care providers, 90 % felt more comfortable recognizing signs/symptoms to report to providers, and 98 % had a better appreciation for community programs/services. Of 488 respondents (RAV January 2007 to December 2012 n = 1366) to a questionnaire at least 1 year after the RAV, nearly 100 % found SCP useful to summarize medical information, 97 % to reinforce follow-up, 85 % to recognize symptoms of recurrence, 93 % to identify healthy lifestyle practices, 91 % to assist in identifying resources for support, 72 % discussed their SCP with their healthcare provider, and 97 % made at least one positive lifestyle change. CONCLUSIONS: Participation in LIFE RAV following treatment helps survivors to guide future self-care behavior. Data suggest that benefits may persist 1 year after the visit and support the feasibility of a nurse-led RAV to establish a SCP in cancer survivors. IMPLICATIONS FOR CANCER SURVIVORS: Combined provision and discussion of SCPs help survivors construct a useful understanding of their cancer experience and may promote long-term self-management.
Assuntos
Promoção da Saúde , Neoplasias/terapia , Planejamento de Assistência ao Paciente , Educação de Pacientes como Assunto , Assistência Centrada no Paciente , Autocuidado , Adulto , Idoso , Idoso de 80 Anos ou mais , Assistência Ambulatorial , Continuidade da Assistência ao Paciente , Feminino , Promoção da Saúde/métodos , Humanos , Masculino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/prevenção & controle , Neoplasias/mortalidade , Neoplasias/enfermagem , Educação de Pacientes como Assunto/métodos , Assistência Centrada no Paciente/métodos , Fatores de Risco , Inquéritos e Questionários , Sobreviventes/estatística & dados numéricos , Cuidado Transicional , Adulto JovemRESUMO
Endometrial cancer is a highly curable malignancy when it presents as uterine-confined disease, but the prognosis for metastatic or recurrent endometrial cancer is poor. The median survival of women enrolled in trials for recurrent or metastatic endometrial cancer is only approximately 12 months. Hormonal therapy, most commonly with progestins, benefits a small group of patients. Cytotoxic chemotherapy is indicated as frontline treatment for the majority of women with metastatic or recurrent disease. Anthracyclines, platinum compounds, and taxanes consistently achieve response rates greater than 20% in single-agent trials of chemotherapy-naive patients. Combination chemotherapy typically produces higher response rates, although combination regimens have not always improved survival historically. Doxorubicin plus cisplatin has been accepted as the Gynecologic Oncology Group (GOG) standard regimen based on phase III data. Recently, a COG randomized trial compared doxorubicin plus cisplatin to the triplet of doxorubicin, cisplatin, and paclitaxel, and it was found that the addition of paclitaxel significantly improved response rate, progression-free survival, and overall survival. Moreover, chemotherapy has been reported to improve survival when