Purpose: Conceptual models provide frameworks to illustrate relationships among patient-, provider-, system-, and community-level factors that inform care delivery and research. Existing models of cancer survivorship care focus largely on pediatric or adult populations whose needs differ from adolescents and young adults (AYAs). We developed a patient-centered conceptual model of AYA survivorship care.Methods:We conducted a narrative literature review of current conceptual and theoretical models of care. We engaged AYA cancer survivors (n = 25) in semi-structured one-hour telephone interviews. Most participants were in their 20s and 30s, and the majority (84%) were women. Recruitment was stratified by age and time since cancer diagnosis. We conducted a thematic analysis of interview transcripts to identify themes that exemplified patient-centered care.Results: Most participants identified as white and female. Leukemia and breast cancer were the most common cancer types. Main themes included the need for (1) care coordination, (2) ongoing mental health support, (3) connection to AYA peer support, (4) support during fertility preservation efforts, (5) support with financial burden, (6) support for quality of life, (7) information about and support with side effects and late effects, and (8) attention to the unique needs of young adults.Conclusions:We present a patient-centered conceptual model of AYA survivorship care needs that can inform future cancer care delivery and research.
目的：概念模型为阐明影响医疗服务提供与研究的患者、医护人员、系统及社区层面因素之间的关系提供了框架。现有癌症生存照护模型主要关注需求与青少年及年轻成人（AYA）群体存在差异的儿科或成人患者。本研究构建了一个以患者为中心的AYA生存照护概念模型。 方法：通过叙事性文献综述梳理现有照护概念与理论模型。对25名AYA癌症幸存者进行半结构化电话访谈，每次访谈持续一小时。多数参与者年龄在20-39岁之间，其中女性占84%。根据年龄和确诊后时间进行分层抽样。采用主题分析法对访谈转录文本进行编码，识别体现以患者为中心照护的核心主题。 结果：参与者以白人女性为主。白血病和乳腺癌是最常见的癌症类型。主要主题包括：（1）照护协调需求；（2）持续心理健康支持；（3）AYA同伴支持网络连接；（4）生育力保存过程中的支持；（5）经济负担支持；（6）生活质量支持；（7）副作用与远期效应相关信息及支持；（8）对年轻成人特殊需求的关注。 结论：本研究提出的以患者为中心的AYA生存照护需求概念模型，可为未来癌症照护服务提供与研究方向提供参考依据。
肿瘤(癌症)患者之家