Survivorship care in breast cancer
Identifieur interne : 000E43 ( Pmc/Checkpoint ); précédent : 000E42; suivant : 000E44Survivorship care in breast cancer
Auteurs : Sally L. SmithSource :
- Canadian Family Physician [ 0008-350X ] ; 2015.
Abstract
To compare the perceptions of breast cancer survivors and primary care physicians (PCPs) about PCPs’ ability to deliver survivorship care in breast cancer.
Mailed survey.
British Columbia.
A total of 1065 breast cancer survivors who had completed treatment of nonmetastatic breast cancer within the previous year, and 587 PCPs who had patients with nonmetastatic breast cancer discharged to their care within the preceding 18 months.
Breast cancer survivors’ and PCPs’ confidence ratings of PCPs’ ability to deliver the following aspects of care: screening for recurrence; managing osteoporosis, lymphedema, endocrine therapy, menopausal symptoms, and anxiety about or fear of recurrence; and providing nutrition and exercise counseling, sex and body image counseling, and family counseling. Response options for each question included low, adequate, or good. Responses were summarized as frequencies and compared using χ2 tests.
Response rates for breast cancer survivors and PCPs were 47% and 59%, respectively. Responses were statistically different in all categories (
Breast cancer survivors and PCPs are reasonably confident in a PCP-based model of survivorship care. Primary care physicians are confident in their ability to manage physical effects related to breast cancer, with the exception of lymphedema. Low confidence ratings among both groups in psychosocial aspects of care suggest an area for improvement.
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PubMed Central: 4463912
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Survivorship care in breast cancer</title><author><name sortKey="Smith, Sally L" sort="Smith, Sally L" uniqKey="Smith S" first="Sally L." last="Smith">Sally L. Smith</name></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmc">4463912</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4463912</idno><idno type="RBID">PMC:4463912</idno><idno type="pmid">NONE</idno><date when="2015">2015</date><idno type="wicri:Area/Pmc/Corpus">000258</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000258</idno><idno type="wicri:Area/Pmc/Curation">000258</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">000258</idno><idno type="wicri:Area/Pmc/Checkpoint">000E43</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Checkpoint">000E43</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Survivorship care in breast cancer</title><author><name sortKey="Smith, Sally L" sort="Smith, Sally L" uniqKey="Smith S" first="Sally L." last="Smith">Sally L. Smith</name></author></analytic><series><title level="j">Canadian Family Physician</title><idno type="ISSN">0008-350X</idno><idno type="eISSN">1715-5258</idno><imprint><date when="2015">2015</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><title>Abstract</title><sec><title>Objective</title><p>To compare the perceptions of breast cancer survivors and primary care physicians (PCPs) about PCPs’ ability to deliver survivorship care in breast cancer.</p></sec><sec><title>Design</title><p>Mailed survey.</p></sec><sec><title>Setting</title><p>British Columbia.</p></sec><sec><title>Participants</title><p>A total of 1065 breast cancer survivors who had completed treatment of nonmetastatic breast cancer within the previous year, and 587 PCPs who had patients with nonmetastatic breast cancer discharged to their care within the preceding 18 months.</p></sec><sec><title>Main outcome measures</title><p>Breast cancer survivors’ and PCPs’ confidence ratings of PCPs’ ability to deliver the following aspects of care: screening for recurrence; managing osteoporosis, lymphedema, endocrine therapy, menopausal symptoms, and anxiety about or fear of recurrence; and providing nutrition and exercise counseling, sex and body image counseling, and family counseling. Response options for each question included low, adequate, or good. Responses were summarized as frequencies and compared using χ<sup>2</sup> tests.</p></sec><sec><title>Results</title><p>Response rates for breast cancer survivors and PCPs were 47% and 59%, respectively. Responses were statistically different in all categories (<italic>P</italic> < .05). Both groups were most confident in the ability of PCPs to screen for recurrence, but breast cancer survivors were 10 times as likely to indicate low confidence (10% of breast cancer survivors vs 1% of PCPs) in this aspect of care. More breast cancer survivors (23%) expressed low confidence in PCPs’ ability to provide counseling about fear of recurrence compared with PCPs (3%). Aspects of care in which both breast cancer survivors and PCPs were most likely to express low confidence included sex and body image counseling (35% of breast cancer survivors vs 26% of PCPs) and family counseling (33% of breast cancer survivors vs 24% of PCPs). Primary care physicians (24%) described low confidence in their ability to manage lymphedema.</p></sec><sec><title>Conclusion</title><p>Breast cancer survivors and PCPs are reasonably confident in a PCP-based model of survivorship care. Primary care physicians are confident in their ability to manage physical effects related to breast cancer, with the exception of lymphedema. Low confidence ratings among both groups in psychosocial aspects of care suggest an area for improvement.</p></sec></div></front></TEI><pmc article-type="research-article"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<front><journal-meta><journal-id journal-id-type="nlm-ta">Can Fam Physician</journal-id><journal-id journal-id-type="iso-abbrev">Can Fam Physician</journal-id><journal-id journal-id-type="hwp">cfp</journal-id><journal-id journal-id-type="publisher-id">CFP</journal-id><journal-title-group><journal-title>Canadian Family Physician</journal-title></journal-title-group><issn pub-type="ppub">0008-350X</issn><issn pub-type="epub">1715-5258</issn><publisher><publisher-name>College of Family Physicians of Canada</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="pmc">4463912</article-id><article-id pub-id-type="publisher-id">e277</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research</subject></subj-group></article-categories><title-group><article-title>Survivorship care in breast cancer</article-title><subtitle>Perceptions of patients and primary care physicians</subtitle><trans-title-group xml:lang="fr"><trans-title>Les soins aux survivantes du cancer du sein</trans-title><trans-subtitle>Les soins aux survivantes du cancer du sein</trans-subtitle></trans-title-group></title-group><contrib-group><contrib contrib-type="author"><name><surname>Smith</surname><given-names>Sally L.</given-names></name><degrees>MD FRCP</degrees><xref rid="c1-061e277" ref-type="corresp"></xref></contrib><aff id="af1-061e277">Radiation oncologist at the British Columbia Cancer Agency, Vancouver Island Centre (VIC), and Clinical Associate Professor in the Department of Surgery at the University of British Columbia (UBC) in Vancouver.</aff></contrib-group><contrib-group><contrib contrib-type="author"><name><surname>Murchison</surname><given-names>Sonja</given-names></name><degrees>MD</degrees></contrib><aff id="af2-061e277">Graduate of the Island Medical Program at UBC.</aff></contrib-group><contrib-group><contrib contrib-type="author"><name><surname>Singh-Carlson</surname><given-names>Savitri</given-names></name><degrees>RN PhD APHN</degrees></contrib><aff id="af3-061e277">Assistant Director of the Graduate Program and Associate Professor in the School of Nursing at California State University in Long Beach.</aff></contrib-group><contrib-group><contrib contrib-type="author"><name><surname>Alexander</surname><given-names>Cheryl</given-names></name></contrib><aff id="af4-061e277">Data coordinator at the BC Cancer Agency, VIC.</aff></contrib-group><contrib-group><contrib contrib-type="author"><name><surname>Wai</surname><given-names>Elaine S.</given-names></name><degrees>MSc MD FRCPC</degrees></contrib><aff id="af5-061e277">Radiation oncologist at the BC Cancer Agency, VIC, and Clinical Associate Professor in the Department of Surgery at UBC.</aff></contrib-group><author-notes><corresp id="c1-061e277">Correspondence: <bold>Dr Sally L. Smith</bold>; e-mail <email>ssmith11@bccancer.bc.ca</email></corresp></author-notes><pub-date pub-type="ppub"><month>6</month><year>2015</year></pub-date><volume>61</volume><issue>6</issue><fpage>e277</fpage><lpage>e283</lpage><permissions><copyright-statement>Copyright© the College of Family Physicians of Canada</copyright-statement><copyright-year>2015</copyright-year></permissions><self-uri content-type="pdf" xlink:type="simple" xlink:href="e277.pdf"></self-uri><abstract><title>Abstract</title><sec><title>Objective</title><p>To compare the perceptions of breast cancer survivors and primary care physicians (PCPs) about PCPs’ ability to deliver survivorship care in breast cancer.</p></sec><sec><title>Design</title><p>Mailed survey.</p></sec><sec><title>Setting</title><p>British Columbia.</p></sec><sec><title>Participants</title><p>A total of 1065 breast cancer survivors who had completed treatment of nonmetastatic breast cancer within the previous year, and 587 PCPs who had patients with nonmetastatic breast cancer discharged to their care within the preceding 18 months.</p></sec><sec><title>Main outcome measures</title><p>Breast cancer survivors’ and PCPs’ confidence ratings of PCPs’ ability to deliver the following aspects of care: screening for recurrence; managing osteoporosis, lymphedema, endocrine therapy, menopausal symptoms, and anxiety about or fear of recurrence; and providing nutrition and exercise counseling, sex and body image counseling, and family counseling. Response options for each question included low, adequate, or good. Responses were summarized as frequencies and compared using χ<sup>2</sup> tests.</p></sec><sec><title>Results</title><p>Response rates for breast cancer survivors and PCPs were 47% and 59%, respectively. Responses were statistically different in all categories (<italic>P</italic> < .05). Both groups were most confident in the ability of PCPs to screen for recurrence, but breast cancer survivors were 10 times as likely to indicate low confidence (10% of breast cancer survivors vs 1% of PCPs) in this aspect of care. More breast cancer survivors (23%) expressed low confidence in PCPs’ ability to provide counseling about fear of recurrence compared with PCPs (3%). Aspects of care in which both breast cancer survivors and PCPs were most likely to express low confidence included sex and body image counseling (35% of breast cancer survivors vs 26% of PCPs) and family counseling (33% of breast cancer survivors vs 24% of PCPs). Primary care physicians (24%) described low confidence in their ability to manage lymphedema.</p></sec><sec><title>Conclusion</title><p>Breast cancer survivors and PCPs are reasonably confident in a PCP-based model of survivorship care. Primary care physicians are confident in their ability to manage physical effects related to breast cancer, with the exception of lymphedema. Low confidence ratings among both groups in psychosocial aspects of care suggest an area for improvement.</p></sec></abstract><trans-abstract xml:lang="fr"><title>Résumé</title><sec><title>Objectif</title><p>Comparer l’opinion des médecins de première ligne (MPL) et des survivantes du cancer du sein au sujet de la capacité des MPL de traiter ces survivantes.</p></sec><sec><title>Type d’étude</title><p>Enquête postale.</p></sec><sec><title>Contexte</title><p>La Colombie-Britannique.</p></sec><sec><title>Participants</title><p>Un total de 1065 survivantes du cancer du sein qui avaient complété leur traitement pour un cancer du sein non métastatique au cours de l’année précédente et de 587 MPL qui avaient des patientes avec un cancer du sein non métastatique confiées à leurs soins depuis 18 mois.</p></sec><sec><title>Principaux paramètres à l’étude</title><p>Niveaux de confiance des survivantes du cancer et des MPL concernant la capacité des MPL de fournir les type de soins suivants: dépistage des récidives; traitement de l’ostéoporose et du lymphœdème, thérapie hormonale, symptômes de ménopause, et anxiété ou craintes à l’égard des récidives; et l’offre de conseils sur la nutrition et l’exercice, sur l’activité sexuelle et sur l’image corporelle. Il y avait 3 choix de réponses pour chaque question: faible, adéquat et bon. Les réponses ont été rapportées sous forme de fréquence et comparées à l’aide de tests de χ<sup>2</sup>.</p></sec><sec><title>Résultats</title><p>Les taux de réponse pour les survivantes du cancer et pour les MPL étaient de 47 % et 59 % respectivement. On notait des différences significatives entre les réponses dans toutes les catégories (<italic>p</italic> > ,05). Les deux groupes avaient davantage confiance en la capacité des MPL pour dépister les récidives, mais les survivantes étaient 10 fois plus susceptibles d’indiquer un manque de confiance quant à cet aspect des soins (10 % des survivantes du cancer contre 1 % des MPL). Parmi les survivantes du cancer du sein, 23 % se disaient peu certaines que les MPL étaient capables de donner des conseils sur la crainte des récidives, comparativement à 3 % des MPL. Les types de soins où les deux groupes étaient le plus susceptibles d’exprimer de l’inquiétude étaient le counseling sur l’activité sexuelle et sur l’image corporelle (35 % chez les survivantes du cancer contre 26 % chez les MPL) et le counseling de la famille (33 % chez les survivantes contre 24 % chez les MPL). Vingt-quatre pour cent des MPL se disaient peu confiants en leur capacité de traiter le lymphœdème.</p></sec><sec><title>Conclusion</title><p>Les survivantes du cancer du sein et les MPL étaient plutôt d’accord avec un modèle de soins de survie fondé sur les MPL. Les MPL avaient confiance en leur capacité de traiter les effets physiques liés au cancer du sein, à l’exception du lymphœdème. Les deux groupes exprimaient un faible niveau de confiance concernant les aspects psychosociaux des soins, ce qui suggère une possibilité d’amélioration.</p></sec></trans-abstract></article-meta></front></pmc><affiliations><list></list><tree><noCountry><name sortKey="Smith, Sally L" sort="Smith, Sally L" uniqKey="Smith S" first="Sally L." last="Smith">Sally L. Smith</name></noCountry></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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