Clinical update: survivorship care--models and programs.
ABSTRACT To provide a clinical update of models of care for adult cancer survivors and the challenges in program development.
Review of the literature.
In the 4 years since the publication of the original article, survivorship is becoming a distinct phase of cancer care that includes surveillance for recurrence, evaluation of and treatment for medical and psychosocial consequences of treatment, recommendations for screening for new primary cancers, health promotion recommendations, and provision of a written treatment summary and care plan to the patient and other health professionals.
Implementing comprehensive services and evaluating care models continue to pose significant challenges for cancer care providers across the country; however, oncology nurses are uniquely positioned to take the lead in the care of cancer survivors of all ages and their role in the care of survivors is gaining recognition nationally and internationally.
SourceAvailable from: Tamar Nijsten[Show abstract] [Hide abstract]
ABSTRACT: BACKGROUND: Keratinocyte cancer is the most common cancer among Caucasians. OBJECTIVE: We sought to study time trends of the burden of disease attributable to keratinocyte cancer in The Netherlands. METHODS: Data of all patients with newly diagnosed keratinocyte cancer (ie, squamous cell carcinoma and basal cell carcinoma) were obtained from the population-based Netherlands Cancer Registry and the Eindhoven Cancer Registry (1989-2008). Population structure, mortality data, and life expectancy data were extracted from Statistics Netherlands. The disability-adjusted life-years (DALY) was the sum of the years of life lived with disability and the years of life lost. RESULTS: The world standardized rate of keratinocyte cancer has doubled and was 103 and 94 per 100,000 person-years for males and females in 2004 to 2008, respectively. DALYs as a result of basal cell carcinoma increased by 124% and DALYs as a result of squamous cell carcinoma increased by 66% from 1989 to 1993. Keratinocyte cancer accounted for a total loss of 19,913 DALYs (15,369 years of life lived with disability and 4544 years of life lost) between 2004 and 2008. LIMITATIONS: Only the first keratinocyte cancer was included in this study. CONCLUSION: Keratinocyte cancer is a large burden to the Dutch society. Because incidence rates of keratinocyte cancer continue to increase, the management becomes even more challenging.Journal of the American Academy of Dermatology 09/2014; DOI:10.1016/j.jaad.2014.07.003 · 5.00 Impact Factor
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ABSTRACT: Background. Recent advances have improved the likelihood of long-term survival for patients with lung cancer. However, little attention has been given to the growing need for dedicated survivorship care for these patients. To address this unmet need, we developed a unique follow-up care model. Methods. In 2006, we convened a multidisciplinary working group to design a thoracic survivorship program (TSP) that provides follow-up by a nurse practitioner (NP) trained in survivorship care. Patients with early-stage lung cancer who were disease free for at least 1 year after resection were eligible for the program, which incorporates a standardized approach to cancer surveillance. Data on symptoms and outcomes were prospectively collected. Real-time electronic medical documentation was developed to optimize communication with primary physicians. Results. Data were analyzed for the initial phase of the program, which comprised 655 patients. Ninety-two percent of eligible survivors who remained disease free chose to continue their care in the TSP, rather than receive follow-up with their thoracic surgeon. Clinically significant posttreatment symptoms were common, including fatigue (46%), anxiety (32%), chronic pain (25%), dyspnea (14%), and depression (12%). The majority of recurrences (72%) and second primary cancers (91%) in this cohort were identified by scheduled chest computed tomography at TSP visits. Conclusions. Survivorship care for patients with lung cancer, delivered in our NP-led TSP, is feasible, effective, and well accepted by patients. Through the implementation of a uniform self-sustaining patient-centered system, the TSP model improves on the variation of physician-led follow-up care. (C) 2014 by The Society of Thoracic SurgeonsThe Annals of Thoracic Surgery 07/2014; 98(3). DOI:10.1016/j.athoracsur.2014.05.020 · 3.63 Impact Factor
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ABSTRACT: The terms "model of health care," "service model." and "nursing model of practice" are often used interchangeably in practice, policy, and research, despite differences in definitions. This article considers these terms in the context of consumer-centred recovery and its implementation into a publicly-funded health service organization in Australia. Findings of a case study analysis are used to inform the discussion, which considers the diverse models of health care employed by health professionals; together with the implications for organizations worldwide that are responsible for operationalizing recovery approaches to health care. As part of the discussion, it is suggested that the advent of recovery-oriented services, rather than recovery models of health care, presents challenges for the evaluation of the outcomes of these services. At the same time, this situation provides opportunities for mental health nurses to lead the way, by developing rigorous models of practice that support consumers who have acute, chronic, or severe mental illness on their recovery journey; and generate positive, measureable outcomes.Issues in Mental Health Nursing 03/2014; 35(3):156-64. DOI:10.3109/01612840.2013.855281