背景:推进癌症生存护理的大多数努力都发生在西方国家。为了全面了解亚太地区的生存护理服务,研究有限。本研究旨在建立对责任的看法,信心,以及肿瘤学从业人员的生存护理实践频率,并检查他们对阻碍高质量生存护理的因素的看法。
方法:在2015年5月至2016年10月期间,对10个亚太国家的医院肿瘤学从业人员进行了横断面调查。参与国包括澳大利亚,香港,中国,Japan,韩国,泰国,新加坡,印度,缅甸,和菲律宾。这项调查是通过癌症专科护理机构使用纸质或在线问卷进行的,教育会议,和专业组织。
结果:总计,1501名肿瘤学从业者参与了这项研究。当比较责任感知的分量表时,频率和置信度,澳洲执业人士的评分明显高于香港执业人士,Japan,泰国,和新加坡(所有p<0.05)。令人惊讶的是,在低收入和中等收入国家(LMICs)工作的从业者有更高的责任认知水平,与在高收入国家(HIC)工作的人相比,提供生存护理的信心和频率(p<0.001),除了护理协调的责任感外,没有观察到得分差异(p=0.83)。与护士和专职医疗专业人员相比,医生对提供大多数生存护理干预措施更有信心。在HIC和LMIC中,生存护理的感知障碍是相似的,对于所有从业者来说,评价最高的项目是缺乏时间,为患者和家庭成员提供专门的教育资源,和循证实践指南,告知生存护理。
结论:在HIC和LMIC之间观察到不同的生存实践,澳大利亚和其他国家之间的专业学科。未来的服务计划和研究工作应考虑到这些发现,并克服本研究中发现的障碍。
BACKGROUND: Most efforts to advance cancer survivorship care have occurred in Western countries. There has been limited research towards gaining a comprehensive understanding of survivorship care provision in the Asia-Pacific region. This study aimed to establish the perceptions of responsibility, confidence, and frequency of survivorship care practices of oncology practitioners and examine their perspectives on factors that impede quality survivorship care.
METHODS: A cross-sectional survey of hospital-based oncology practitioners in 10 Asia-Pacific countries was undertaken between May 2015-October 2016. The participating countries included Australia, Hong Kong,
China, Japan, South Korea, Thailand, Singapore, India, Myanmar, and The Philippines. The survey was administered using paper-based or online questionnaires via specialist cancer care settings, educational meetings, and professional organisations.
RESULTS: In total, 1501 oncology practitioners participated in the study. When comparing the subscales of responsibility perception, frequency and confidence, Australian practitioners had significantly higher ratings than practitioners in Hong Kong, Japan, Thailand, and Singapore (all p < 0.05). Surprisingly, practitioners working in Low- and Mid- Income Countries (LMICs) had higher levels of responsibility perception, confidence and frequencies of delivering survivorship care than those working in High-Income Countries (HICs) (p < 0.001), except for the responsibility perception of care coordination where no difference in scores was observed (p = 0.83). Physicians were more confident in delivering most of the survivorship care interventions compared to nurses and allied-health professionals. Perceived barriers to survivorship care were similar across the HICs and LMICs, with the most highly rated items for all practitioners being lack of time, dedicated educational resources for patients and family members, and evidence-based practice guidelines informing survivorship care.
CONCLUSIONS: Different survivorship practices have been observed between HICs and LMICs, Australia and other countries and between the professional disciplines. Future service planning and research efforts should take these findings into account and overcome barriers identified in this study.