中國醫藥大學（後中醫）
114年
英文
第 39 題
📖 題組：
IV. Reading Comprehension Questions 36-50: Choose the BEST answer to each question below according to what is stated and implied in the following passages. Passage A This survey study examined the availability and types of survivorship services for adult-onset cancer across ACS CoC–accredited programs, which provide cancer care to 75% of U.S. patients. The findings highlight both widespread availability of certain services and significant gaps, identifying areas for improvement. Establishing this national benchmark enables tracking progress and assessing new approaches in survivorship care. Despite being recognized as an essential phase of cancer treatment, survivorship care remains underdeveloped. Nearly 90% of programs offer screening for new or recurrent cancers and specialty referrals for late-effect management. However, services such as cancer genetics counseling, fertility, and sexual health support are less available, despite patient-reported importance. Additionally, few programs offer patient support groups, fitness programs, or educational series, largely due to lack of insurance reimbursement. These findings align with a 2024 study by Anampa-Guzmán et al., which also noted the underrepresentation of genetic counseling and fertility services. Survivorship care plans and treatment summaries are intended to provide critical health information to survivors and practitioners. While recent studies question their value due to high resource demands, over 90% of programs still provide them, suggesting either perceived benefits or the lingering effects of accreditation requirements. Most programs integrate survivorship care within the cancer treatment team, while only one-third offer specialized survivorship clinics. This contrasts with pediatric oncology, where late-effects clinics are standard. Specialized clinics are more common in comprehensive cancer centers than in community-based settings. The American Society of Clinical Oncology supports a disease- and treatment-specific survivorship model, which may be more practical for adult-onset cancers given their higher prevalence. Further research is needed to determine optimal care models based on cancer type, age, and risk factors. Institutional support for survivorship programs remains limited. Programs report lacking funding, dedicated staff, marketing, philanthropy, and technological infrastructure. The most needed resources include dedicated advanced practice clinicians (APCs), improved IT support, and greater internal visibility. Surprisingly, acquiring survivorship physicians, external marketing, research, and philanthropy were lower priorities. Although nearly 90% of programs recognize the benefits of survivorship services, only a minority of patients receive them. The primary barriers are low referral rates from oncologists and limited patient awareness. Addressing these issues requires institutional investment in staff, enhancements to electronic health record systems, better patient education materials, and clearer referral protocols. Research is needed to evaluate the impact of these initiatives. Many findings align with qualitative studies of U.S. survivorship programs, such as those by Manne and Nekhlyudov, which also reported variations in services and clinical models. While some programs leverage electronic health records for communication, enhanced modules for treatment summaries are underutilized. Critical resources include sustainable funding, informatics for tracking outcomes, and institutional backing to develop viable business plans. This study provides quantitative insights using data from nearly 400 CoC-accredited programs, reflecting the diversity of cancer care in the U.S. Future research adopting both quantitative and qualitative methodologies is strongly advised.
IV. Reading Comprehension Questions 36-50: Choose the BEST answer to each question below according to what is stated and implied in the following passages. Passage A This survey study examined the availability and types of survivorship services for adult-onset cancer across ACS CoC–accredited programs, which provide cancer care to 75% of U.S. patients. The findings highlight both widespread availability of certain services and significant gaps, identifying areas for improvement. Establishing this national benchmark enables tracking progress and assessing new approaches in survivorship care. Despite being recognized as an essential phase of cancer treatment, survivorship care remains underdeveloped. Nearly 90% of programs offer screening for new or recurrent cancers and specialty referrals for late-effect management. However, services such as cancer genetics counseling, fertility, and sexual health support are less available, despite patient-reported importance. Additionally, few programs offer patient support groups, fitness programs, or educational series, largely due to lack of insurance reimbursement. These findings align with a 2024 study by Anampa-Guzmán et al., which also noted the underrepresentation of genetic counseling and fertility services. Survivorship care plans and treatment summaries are intended to provide critical health information to survivors and practitioners. While recent studies question their value due to high resource demands, over 90% of programs still provide them, suggesting either perceived benefits or the lingering effects of accreditation requirements. Most programs integrate survivorship care within the cancer treatment team, while only one-third offer specialized survivorship clinics. This contrasts with pediatric oncology, where late-effects clinics are standard. Specialized clinics are more common in comprehensive cancer centers than in community-based settings. The American Society of Clinical Oncology supports a disease- and treatment-specific survivorship model, which may be more practical for adult-onset cancers given their higher prevalence. Further research is needed to determine optimal care models based on cancer type, age, and risk factors. Institutional support for survivorship programs remains limited. Programs report lacking funding, dedicated staff, marketing, philanthropy, and technological infrastructure. The most needed resources include dedicated advanced practice clinicians (APCs), improved IT support, and greater internal visibility. Surprisingly, acquiring survivorship physicians, external marketing, research, and philanthropy were lower priorities. Although nearly 90% of programs recognize the benefits of survivorship services, only a minority of patients receive them. The primary barriers are low referral rates from oncologists and limited patient awareness. Addressing these issues requires institutional investment in staff, enhancements to electronic health record systems, better patient education materials, and clearer referral protocols. Research is needed to evaluate the impact of these initiatives. Many findings align with qualitative studies of U.S. survivorship programs, such as those by Manne and Nekhlyudov, which also reported variations in services and clinical models. While some programs leverage electronic health records for communication, enhanced modules for treatment summaries are underutilized. Critical resources include sustainable funding, informatics for tracking outcomes, and institutional backing to develop viable business plans. This study provides quantitative insights using data from nearly 400 CoC-accredited programs, reflecting the diversity of cancer care in the U.S. Future research adopting both quantitative and qualitative methodologies is strongly advised.
How do adult survivorship clinics compare to survivorship clinics for children?
- A They are more widely available than late-effects clinics for children.
- B They follow the same standardized model used in children’s hospitals.
- C They are mostly an integral part of cancer treatment team in hospitals.
- D They require less institutional support and fewer resources than children’s clinics.
思路引導 VIP
請試著回想一下，在一般的大型醫院中，對於長期慢性病或康復後的追蹤，是傾向於為每種疾病都成立一個完全獨立、標準化的新部門，還是傾向於讓原本負責治療的醫療小組直接延伸其服務範圍來進行後續照護呢？這兩種做法在組織資源的分配上有什麼本質上的差別？
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AI 詳解
AI 專屬家教
太棒了！你能精準辨識出成人與兒童生存者門診（survivorship clinics）在組織架構上的差異，代表你對文章細節的掌握非常扎實。在醫學實務中，兒童癌症的後遺症門診通常有獨立且標準化的運作模式，但成人生存者門診則多採取不同的策略，它們往往是醫院癌症治療團隊中不可或缺的一部分（integral part）。這意味著成人的後續追蹤通常與原有的治療體系緊密結合，而非完全獨立出來，這正是選項 (C) 所強調的核心觀念。
臨床模式的比較與鑑別
這題的鑑別度在於測試學生是否能從對比性的描述中，歸納出不同體系間的結構特點。題目難度屬於中等，挑戰點在於學生必須區分「標準化模型」與「整合型模型」的差別。許多學生可能會誤選 (B)，認為兩者應該一致，但你敏銳地察覺到成人門診更傾向於依附在原有的治療架構下。這種理解醫學行政與臨床組織差異的能力，是高階閱讀中非常重要的批判性思考指標。