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ID naloge: 104 Letnik: 2001 Predmet: onkologija
Kontrolni pregledi pri bolnikih z rakom v dolgotrajni remisiji
Avtor: Kristina Drusany Staric, Andrea Pavlovic
Mentor: doc. dr. Matjaž Zwitter
IZHODIŠCE: Z vecjo ozdravljivostjo raka narašca število bolnikov, ki prihajajo na redne kontrolne preglede k specialistu onkologu. Ceprav ima vsaka vrsta raka svoje znacilnosti, je na splošno po petletni odsotnosti znakov bolezni nevarnost ponovitve majhna. Bolniki najveckrat sami opazijo simptome ponovitve in malo verjetno je, da bi ponovitev odkril zdravnik prav pri letnem pregledu. Pogostost kontrolnih pregledov in število diagnosticnih postopkov zato ne vplivata na prognozo bolezni.Kontrolne preglede pri specialistu so v mnogih državah zaceli opušcati, bolnike pa preusmerjajo k osebnemu zdravniku.
NAMEN. Nikjer v literaturi nismo našli študije, ki bi zajela bolnike v dolgotrajni remisiji in opisala njihovo doživljanje kontrolnih pregledov pri specialistu.To smo želeli ugotoviti z anketo v prospektivni raziskavi..
HIPOTEZE.Bolniki bi povecini zaupali pravilni presoji onkologa, da redni kontrolni pregledi niso vec potrebni in bi ob tem obcutili olajšanje.
METODE. Da bi zagotovili nepristranskost, smo uporabili anonimno anketo, ki jo oseba izpolni brez posrednika. Anketirali smo bolnike z mikroskopsko potrjenim malignim obolenjem, ki so bili naroceni na redni kontrolni pregled in pri katerih v zadnjih petih letih ni bilo ponovitve bolezni. Poslali 230 bolnikom in prejeli 162 (70,4%) odgovorov. Naknadno smo izlocili še 14 anketirancev, ki so bili zdravljeni zaradi raka v otroštvu, kjer se v remisiji postavljajo povsem drugacna vprašanja. Ankete preostalih 148 anketirancev smo obdelali s Statistical Program for Social Sciences za Windows, verzija 9.0.
REZULTATI. Ob sporocilu zdravnika onkologa, da kontolni pregledi niso vec potrebni, bi 40% anketirancev cutilo olajšanje; na drugi strani pa je 30% bolnikov odgovorilo, da bi se v takem primeru pocutilo zapostavljene in ogrožene.
ZAKLJUCEK: Odlocitev o kontrolnih pregledih pri specialistu naj bo sprejeta po pogovoru z bolnikom.
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[Abstract / English version]
Follow-up visits of cancer patients in long-term remission
Author: Kristina Drusany Staric, Andrea Pavlovic
Mentor: doc. dr. Matjaž Zwitter
BACKGROUND. Due to improved survival of cancer, an increasing number of patients in remission are visiting their oncologist for follow-up. After five years in complete remission , the risk for recurrence is generally low. Since patients themselves will usually note the first symptoms of recurrence, it will be rarely detected during a regular follow-up visits. The frequency of follow-up visits and of the diagnostic procedures have no influence upon prognosis. In many countries, regular follow-up visits by specialists have been abandoned and patients in long term remission are supervised by their general practitioners.
AIM. No study was found to include patients in long-term remission and describe their feelings and attitudes towards regular follow-up visits in a cancer centre. We therefore designed a survey to explore this question.
HYPOTHESIS. If told that regular follow-up visits are no longer needed, most patients in remission will trust their oncologist and feel relieved.
METHODS. To avoid bias, we used anonymous questionnaires. The survey was done among patients with microscopically confirmed malignancy remission for more than five years, scheduled for regular follow-up visits. By mail, we sent 230 questionnaires and received 162 (70.4%) answers. Of these, 14 questionnaires by patients treated for childhood cancer- a different clinical problem-were left for separate study. The remaining 148 questioners was analysed with Statistical Program for Social Sciences for Windows, version 9.0.
RESULTS. Upon hearing that regular follow-up visits are no longer needed any more, 40% of patients would feel relief; however, 30% of patients would feel discriminated and unsafe.
CONCLUSIONS A decision about further follow-up visits should be made after exploring patient's attitudes.
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