Transition and transfer of childhood cancer survivors to adult care: A national survey of pediatric oncologists.
Pediatr Blood Cancer
; 64(2): 346-352, 2017 02.
Article
em En
| MEDLINE
| ID: mdl-27463688
ABSTRACT
BACKGROUND:
Pediatric oncologists are responsible for ensuring that adolescent and young adult (AYA) childhood cancer survivors have the knowledge and skills necessary to manage their follow-up care in adult healthcare systems. PROCEDURES To describe transition practices and barriers to transfer, we electronically surveyed U.S. Children's Oncology Group members 507/1449 responded (35%) and 347/507 (68%) met eligibility criteria.RESULTS:
Of 347 respondents, 50% are male, median years in practice 10 (range 5-22), 37% practice in freestanding children's hospitals. Almost all care for survivors up to age 21 years (96%), 42% care for survivors over age 25 years, and only 16% over age 30 years. While 66% of oncologists reported providing transition education to their patients, very few (8%) reported using standardized transition assessments. The most frequent barriers to transfer were perceived attachment to provider (91%), lack of adult providers with cancer survivor expertise (86%), patient's cognitive delay (81%), or unstable social situation (80%). Oncologists who continue to care for patients older than 25 years are more likely to perceive parents' attachment to provider (P = 0.037) and patients' social situation as barriers to transfer (P = 0.044). Four themes emerged from a content analysis of 75 respondents to the open-ended question inviting comments on transition/transfer practices desire for flexible transfer criteria; providers as barriers; provider lack of transition knowledge, skills, and resources; and desire for collaboration.CONCLUSIONS:
Although most pediatric oncologists reported transferring AYA cancer survivors to adult care and providing some transition education, they endorse deficits in transition skills, emotional readiness, and institutional resources.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Planejamento de Assistência ao Paciente
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Padrões de Prática Médica
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Sobreviventes
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Continuidade da Assistência ao Paciente
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Transição para Assistência do Adulto
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Oncologistas
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Neoplasias
Tipo de estudo:
Observational_studies
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Prognostic_studies
Limite:
Adolescent
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Adult
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Female
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Humans
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Male
Idioma:
En
Revista:
Pediatr Blood Cancer
Assunto da revista:
HEMATOLOGIA
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NEOPLASIAS
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PEDIATRIA
Ano de publicação:
2017
Tipo de documento:
Article