目的:我们的目标是为癌症生存服务的组织和结构制定基于证据的建议,和最佳护理实践,以优化初级治疗后幸存者的健康和福祉。这篇综述旨在确定癌症生存服务的最佳组织和护理交付结构。以及具体的临床实践和干预措施,可以改善或最大限度地提高成年癌症幸存者的心理社会健康和总体福祉。
方法:我们对加拿大抗癌伙伴关系的癌症指南清单进行了系统的搜索,美国国家准则信息交换所,加拿大医学协会信息库,medline(Ovid:1999年至2009年11月),Embase(Ovid:1999年至2009年11月),Psychinfo(Ovid:1999年至2009年11月),Cochrane图书馆(Ovid;2009年第1期),和cinahl(ebsco:1999年至2009年12月)。扫描了相关论文的参考列表和最近的评论文章,以获取其他引用。
方法:如果报告了癌症幸存者的组织系统组件,则选择了文章作为系统综述的证据,或关于心理社会或支持性护理干预措施HOWELL等人。为癌症幸存者设计的。如果文章仅关注儿科癌症幸存者人群或从儿科癌症过渡到成人服务的人群,则将其排除在系统评价之外;如果它们仅涉及药物干预或诊断测试以及癌症幸存者的随访;如果它们是方法描述不足的系统评价;如果它们是定性或描述性研究;如果它们是意见文件,信件,或社论。
方法:癌症之旅幸存者专家小组的三名成员选择并审查了证据(SM,TC,TKO)。由此产生的证据摘要得到了进一步的指导,并由癌症之旅幸存者专家小组的成员进行了审查。十四条实践准则,八个系统审查,60项随机对照试验构成了本指导文件的证据基础.这些出版物表明,幸存者受益于协调的治疗后护理,包括解决特定社会心理的干预措施,支持性护理,和康复问题。
结论:持续的高质量研究对于优化癌症幸存者的服务至关重要。促进健康生活方式行为或解决心理社会问题和痛苦的干预措施似乎可以改善身体功能,社会心理健康,以及幸存者的生活质量。
OBJECTIVE: Our goal was to develop evidence-based recommendations for the organization and structure of cancer survivorship services, and best-care practices to optimize the health and well-being of post-primary treatment survivors. This review sought to determine the optimal organization and care delivery structure for cancer survivorship services, and the specific clinical practices and interventions that would improve or maximize the psychosocial health and overall well-being of adult cancer survivors.
METHODS: We conducted a systematic search of the Inventory of Cancer
Guidelines at the Canadian Partnership Against Cancer, the U.S. National
Guideline Clearinghouse, the Canadian Medical Association InfoBase, medline (ovid: 1999 through November 2009), embase (ovid: 1999 through November 2009), Psychinfo (ovid: 1999 through November 2009), the Cochrane Library (ovid; Issue 1, 2009), and cinahl (ebsco: 1999 through December 2009). Reference lists of related papers and recent review articles were scanned for additional citations.
METHODS: Articles were selected for inclusion as evidence in the systematic review if they reported on organizational system components for survivors of cancer, or on psychosocial or supportive care interventions HOWELL et al. designed for survivors of cancer. Articles were excluded from the systematic review if they focused only on pediatric cancer survivor populations or on populations that transitioned from pediatric cancer to adult services; if they addressed only pharmacologic interventions or diagnostic testing and follow-up of cancer survivors; if they were systematic reviews with inadequately described methods; if they were qualitative or descriptive studies; and if they were opinion papers, letters, or editorials.
METHODS: Evidence was selected and reviewed by three members of the Cancer Journey Survivorship Expert Panel (SM, TC, TKO). The resulting summary of the evidence was guided further and reviewed by the members of Cancer Journey Survivorship Expert Panel. Fourteen practice
guidelines, eight systematic reviews, and sixty-thee randomized controlled trials form the evidence base for this guidance document. These publications demonstrate that survivors benefit from coordinated post-treatment care, including interventions to address specific psychosocial, supportive care, and rehabilitative concerns.
CONCLUSIONS: Ongoing high-quality research is essential to optimize services for cancer survivors. Interventions that promote healthy lifestyle behaviours or that address psychosocial concerns and distress appear to improve physical functioning, psychosocial well-being, and quality of life for survivors.