Step-by-step: A clinical pathway for stepped care management of fear of cancer recurrence-results of a three-round online delphi consensus process with Australian health professionals and researchers.

Autor: Smith A'; The Daffodil Centre, The University of Sydney, A Joint Venture with Cancer Council NSW, Sydney, NSW, Australia. ben.a.smith@sydney.edu.au.; South West Sydney Clinical Campuses, UNSW Medicine & Health, UNSW Sydney, Liverpool, NSW, Australia. ben.a.smith@sydney.edu.au., Girgis A; South West Sydney Clinical Campuses, UNSW Medicine & Health, UNSW Sydney, Liverpool, NSW, Australia., Taylor N; School of Population Health, UNSW Sydney, Sydney, NSW, Australia., Pearce A; The Daffodil Centre, The University of Sydney, A Joint Venture with Cancer Council NSW, Sydney, NSW, Australia.; Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia., Liu J; St Vincent's Hospital, Sydney, NSW, Australia.; UNSW Medicine & Health, UNSW Sydney, Sydney, NSW, Australia.; Garvan Institute of Medical Research, Sydney, NSW, Australia., Shepherd HL; Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia., Wu VS; The Daffodil Centre, The University of Sydney, A Joint Venture with Cancer Council NSW, Sydney, NSW, Australia.; South West Sydney Clinical Campuses, UNSW Medicine & Health, UNSW Sydney, Liverpool, NSW, Australia., Garvey G; The School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia., Kirsten L; Nepean Cancer Services, Nepean Blue Mountains Local Health District, Penrith, NSW, Australia.; School of Psychology, Psycho-Oncology Cooperative Research Group, The University of Sydney, Sydney, NSW, Australia., Zakhary I; Multicultural Services, South Western Sydney Local Health District, Liverpool, NSW, Australia., Ee C; Caring Futures Institute, Flinders University, Bedford Park, SA, Australia.; NICM Health Research Institute, Western Sydney University, Penrith, NSW, Australia., Ewald D; Lennox Head Medical Centre, Lennox Head, NSW, Australia.; Bullinah Aboriginal Health Service, Ballina, NSW, Australia.; Sydney University Medical School, Northern Rivers University Centre for Rural Health, Lismore, NSW, Australia., Miller A; Cancer Council NSW, Woolloomooloo, NSW, Australia., Shaw J; School of Psychology, Psycho-Oncology Cooperative Research Group, The University of Sydney, Sydney, NSW, Australia.
Jazyk: angličtina
Zdroj: Journal of cancer survivorship : research and practice [J Cancer Surviv] 2024 Oct 07. Date of Electronic Publication: 2024 Oct 07.
DOI: 10.1007/s11764-024-01685-1
Abstrakt: Purpose: Fear of cancer recurrence (FCR) is not routinely addressed in clinical practice, meaning many cancer survivors forego effective interventions. We established expert consensus on a clinical pathway to help health professionals identify and manage FCR in early-stage cancer survivors.
Methods: Australian health professionals and researchers working with adult cancer survivors participated in a three-round Delphi study promoted via oncology professional bodies and social media. The Round 1 online survey presented 38 items regarding FCR screening, triage, assessment, referral, and stepped care, based on a literature review, related pathways/guidelines, and expert input. Participants rated how representative of best-practice items were on a 5-point scale (strongly disagree-strongly agree), with optional qualitative feedback. Consensus was defined as ≥ 80% of participants strongly/agreeing with items. Items not reaching consensus were re-presented to Round 1 participants in two subsequent rounds with new items, derived from content analysis of qualitative feedback.
Results: From 94 participants in Round 1 (89% health professionals), 26/38 (68%) items reached consensus. By round 3, 35/38 (92%) items, including 8 new items, reached consensus. Routine FCR screening and triage conversations and stepped care management (i.e. tailored and staged treatment) were endorsed. However, the timing of FCR screening/triage did not reach consensus.
Conclusions: This world-first FCR clinical pathway incorporating contemporary evidence and expert opinion recommends routine screening and triage to stepped care management of FCR. Some pathway components, such as screening or triage timing, may need tailoring for different contexts.
Implications for Cancer Survivors: Implementation of the pathway could aid routine identification and management of FCR, reducing its burden on cancer survivors and the healthcare system.
(© 2024. The Author(s).)
Databáze: MEDLINE
Externí odkaz: