Young cancer survivors’ expectations of physicians for issues of mental health, interpersonal relationships, and reintegration to society.
Bibliographic record
Abstract
208 Background: As patients transition from cancer treatment to survivorship, issues surrounding the social and mental health impacts of survivorship gain increased importance. In this study, we examined young cancer survivors’ expectations of their physicians with respect to mental health, interpersonal relationships, and reintegration back to work and school. We also explored factors associated with these expectations. Methods: We surveyed patients aged 20 to 39 years who were diagnosed with solid tumors, evaluated at any 1 of 5 regional cancer centers in British Columbia, and alive at 2 or more years after their diagnosis. We explored the relationship between patient factors and expectations, adjusting for confounders through the use of multivariate regression models. Results: With a survey response rate of 57%, a total of 447 patients were analyzed: median age was 35 years (IQR 31-38), 30% were men, and 89% had ECOG 0. Tumor sites included breast (222; 50%), testicular (126; 28%), gynecological (76; 17%), and colorectal (23; 5%). Decreasing levels of expectations of cancer specialist (CS) were seen with 72%, 48%, and 28% of patients indicating that their CS should have some to full responsibility on issues related to mental health, social counselling, and reintegration, respectively. Compared to CS, patients held much higher expectations of their primary care physician (PCP) taking some to full responsibility for these same issues (see Table). Expectations of their PCP were further increased when there was frequent contact between patient and PCP. Conclusions: The majority of young cancer survivors in our survey expected their PCP more than their CS to have a significant degree of responsibility for mental, interpersonal, and social issues arising from their cancer or treatment. Early integration of PCP into survivorship care models may augment the work provided by the psychosocial cancer team and ease the transition to survivorship for patients. [Table: see text]
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".