Abstract：
Purpose: Improvements in outcomes for adolescent and young adult (AYA) oncology patients have lagged behind those of other age-specific cancer populations. Research has indicated that low availability of clinical trials, biological differences of this age-group, and several psychosocial factors including higher emotional distress impact outcomes. To improve care and survival rates for these patients, hospitals have implemented AYA oncology programs. The current study evaluated documentation of care in an AYA program housed in an academic medical center based on three areas emphasized in the National Comprehensive Cancer Network\'s Clinical Practice Guidelines in Oncology for AYAs: clinical trial enrollment, fertility, and psychosocial care. Methods: Retrospective chart reviews were conducted for 45 patients treated before the start of the AYA oncology program and 45 patients treated after program initiation. Patients aged 15-39 years with a diagnosis of a malignant tumor were included. Variables evaluated included documentation of clinical trial enrollment, fertility preservation and sexual health considerations, and behavioral health referrals. Results: Documentation of most clinical trial and fertility variables did not significantly improve from pre- to post-program, although a higher number of patients had these variables documented post-program. Behavioral health referrals increased significantly from 52.8% pre-program to 95.4% post-program. Conclusion: Access to behavioral health care improved the most following implementation of our AYA program, which is likely because of the integration of a dedicated psychologist for AYAs when the program began. The practice of guideline-based care for this population can be better assessed and improved with designated behavioral health providers and more systematic documentation processes.
摘要：
目的：青少年和年轻成人（AYA）肿瘤患者的预后改善落后于其他特定年龄的癌症人群。研究表明，临床试验的可用性低，这个年龄组的生物学差异，和一些心理社会因素，包括较高的情绪困扰影响结果。为了提高这些患者的护理和生存率，医院已经实施了AYA肿瘤学计划。目前的研究评估了在一个学术医学中心的AYA计划中的护理文件，该计划基于国家综合癌症网络的AYA肿瘤学临床实践指南中强调的三个领域：临床试验注册，生育力,和心理社会护理。方法：对AYA肿瘤学项目开始前治疗的45例患者和项目开始后治疗的45例患者进行回顾性图表回顾。包括诊断为恶性肿瘤的15-39岁患者。评估的变量包括临床试验登记的文件，生育能力保护和性健康考虑，和行为健康推荐。结果：大多数临床试验和生育变量的文档从计划前到计划后都没有显着改善，尽管更多的患者在项目后记录了这些变量.行为健康推荐从计划前的52.8％显着增加到计划后的95.4％。结论：获得行为保健改善了我们AYA计划的最以下实施，这可能是因为该计划开始时，AYAs的专门心理学家的整合。通过指定的行为健康提供者和更系统的文档流程，可以更好地评估和改进针对该人群的基于指南的护理实践。
