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Multidisciplinary Endocrine Tumor Board: Assessment of the Patient Experience. 多学科内分泌肿瘤委员会:患者体验评估。
IF 1.5 Q3 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-02-04 eCollection Date: 2024-01-01 DOI: 10.1177/23743735241229383
Matthew A Gorris, McKenzie L Needham, Kayla C Finnegan, Corey S Obermiller, Lauren Witek, Reese W Randle, Cynthia A Burns

Research surrounding tumor boards has focused on patient outcomes and care coordination. Little is known about the patient experience with tumor boards. This survey examined aspects of the patient experience for patients presented at our multidisciplinary endocrine tumor board (ETB). A 15-item survey was distributed via the online patient portal to patients over the age of 18 whose case had been discussed at our ETB over an 18-month period. Descriptive statistics were reported, and a Fisher's exact test was used to examine relationships between variables. A total of 47 patients completed the survey (46%). A majority (72%) report their provider explained what the ETB is, and 77% report being informed their case would be discussed. Most patients were satisfied their case was being discussed (72%). A number of patients did report moderate or severe anxiety knowing their case was being discussed (15%). Sixty-four percent of patients report the ETB recommendations were clearly explained; however, satisfaction with the recommendations was slightly lower (53%). Despite the somewhat low satisfaction with the recommendations, 75% of patients felt more confident in their treatment plan knowing their case was discussed. Finally, if given the chance, 66% responded that they would have been interested in participating in their own ETB discussion. This study provides some insight into the patient experience surrounding tumor board discussions. Overall, patients are satisfied when their case is discussed at ETB. Patients can also experience anxiety about these discussions, and many patients desire to be present for their own discussions.

围绕肿瘤委员会的研究主要集中在患者疗效和护理协调方面。患者在肿瘤委员会的就医体验却鲜为人知。这项调查研究了在我们的多学科内分泌肿瘤委员会(ETB)上就诊的患者的各方面体验。在 18 个月的时间里,我们通过在线患者门户网站向 18 岁以上在 ETB 讨论过病例的患者发放了一份包含 15 个项目的调查问卷。调查报告采用描述性统计方法,并使用费雪精确检验来检验变量之间的关系。共有 47 名患者(46%)完成了调查。大多数患者(72%)称他们的医疗服务提供者向他们解释了 ETB 是什么,77% 的患者称他们被告知将讨论他们的病例。大多数患者对他们的病例得到讨论表示满意(72%)。一些患者在得知自己的病例被讨论后确实表示有中度或重度焦虑(15%)。64%的患者表示,ETB 的建议已得到清楚解释;但对建议的满意度略低(53%)。尽管对建议的满意度略低,但 75% 的患者在知道自己的病例被讨论后,对自己的治疗计划更有信心。最后,如果有机会,66% 的患者表示他们有兴趣参与自己的 ETB 讨论。这项研究为我们提供了一些有关肿瘤委员会讨论的患者体验。总体而言,患者对 ETB 讨论他们的病例感到满意。患者也会对这些讨论感到焦虑,许多患者希望自己能参加讨论。
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引用次数: 0
Shared Decision Making in Hallux Valgus Surgery: A Prospective Observational Study. 外翻手术中的共同决策:前瞻性观察研究
IF 1.5 Q3 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-02-01 eCollection Date: 2024-01-01 DOI: 10.1177/23743735241229376
Michael Bond, Mattheus Bicknell, Trafford Crump, Murray Penner, Andrea Veljkovic, Kevin Wing, Alastair Younger, Guiping Liu, Jason M Sutherland

Patient-physician communication has the potential to improve outcomes and satisfaction through the shared decision-making process (SDM). This study aims to assess the relationship between perception of SDM and demographic, clinical, and patient-reported outcomes in patients undergoing Hallux Valgus (HV) correction. A prospective analysis of 306 patients scheduled for HV surgery was completed. The CollaboRATE score was used to measure SDM. Multivariable linear regression model was used to assess whether SDM scores were associated with preoperative characteristics or postoperative outcome scores. The mean CollaboRATE score was 2.9 (SD 0.9) and did not differ by age, socioeconomic status, or sex. Lower CollaboRATE scores were associated with more symptoms of depression, lower socioeconomic status, and lower general health scores (p-value < 0.05). There was no association between SDM scores and postoperative outcome scores. In this study, patients with depressive symptoms and lower socioeconomic status had worse perceptions of SDM. There was no difference in postoperative outcomes among participants based on SDM scores. Level of Evidence: Level III, prospective observational study.

通过共同决策过程(SDM),医患沟通有可能提高治疗效果和满意度。本研究旨在评估接受外翻矫正术(HV)的患者对 SDM 的认知与人口统计学、临床和患者报告结果之间的关系。研究对 306 名计划接受 HV 手术的患者进行了前瞻性分析。采用 CollaboRATE 评分来衡量 SDM。采用多变量线性回归模型评估SDM评分是否与术前特征或术后结果评分相关。CollaboRATE 评分的平均值为 2.9(SD 0.9),与年龄、社会经济地位或性别无关。较低的 CollaboRATE 得分与较多的抑郁症状、较低的社会经济地位和较低的一般健康评分有关(p 值,证据等级 III 级,前瞻性观察研究):证据等级:三级,前瞻性观察研究。
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引用次数: 0
Patients' Experiences of a Precision Medicine Clinic. 患者对精准医疗诊所的体验。
IF 1.5 Q3 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-02-01 eCollection Date: 2024-01-01 DOI: 10.1177/23743735241229384
David Barrett, Jovana Sibalija, Richard B Kim

The purpose of this study is to provide an overview of patients' experiences using a precision medicine (PM) clinic that conducts pharmacogenomics-based (PGx) testing for adverse drug reactions. The study aimed to identify the features of the clinic valued most by patients and areas for improvement. A paper survey was used to collect data. Survey questions focused on patients' perceptions of the PM testing and the overall clinic experience. Sixty-seven patients completed the survey. Quantitative data were analyzed using SPSS and frequencies were reported. Open-ended responses were coded and organized thematically. Patients reported that the clinic services increased confidence in their medication usage. Feeling respected by staff, receiving education, and quick appointments were highly valued by patients. Suggested areas for improvement included better communication from the clinic to patients, expansion of clinic services, and education for other healthcare providers. The findings demonstrate that patient experience goes beyond the clinical care provided. Current and potential future providers of PM should invest the time and energy to configure their care delivery system to enhance the patient experience.

本研究旨在概述患者使用精准医疗(PM)诊所的经历,该诊所开展基于药物基因组学的药物不良反应(PGx)检测。研究旨在确定患者最看重的诊所特点以及需要改进的地方。研究采用纸质调查的方式收集数据。调查问题主要涉及患者对 PM 检测的看法以及诊所的整体体验。67 名患者完成了调查。使用 SPSS 对定量数据进行了分析,并报告了频率。对开放式回答进行了编码,并按主题进行了整理。患者表示,门诊服务增强了他们用药的信心。患者对工作人员的尊重感、接受教育和快速预约给予了高度评价。建议改进的方面包括加强诊所与患者之间的沟通、扩大诊所服务范围以及对其他医疗服务提供者进行教育。研究结果表明,患者体验不仅仅局限于所提供的临床护理。目前和未来潜在的 PM 提供者应投入时间和精力来配置其医疗服务系统,以提升患者体验。
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引用次数: 0
From Monologue to Dialogue: The Pursuit of Relationship Centered Communication Across a Large, Integrated Healthcare System. 从独白到对话:在大型综合医疗保健系统中追求以关系为中心的沟通。
IF 1.5 Q3 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-01-15 eCollection Date: 2024-01-01 DOI: 10.1177/23743735241226507
Agnes Barden, Jill Kalman, Sven Gierlinger, Daniel Baker, Nicole Giammarinaro, Natalie Rousseau

By listening to the "voice" of patients, Northwell Health, New York's largest healthcare organization, took an evidence-based approach to empowering physicians and advanced care providers. The Relationship Centered Communication course utilizes experiential learning to strengthen patient-centered communication and empathy skills to elicit provider-patient relationships grounded in partnership. This case study highlights (1) The pragmatic cultural journey requiring visionary leadership, strong collaborations, and an evolving educational strategy. (2) Over the course of 6 years, 3300+ providers were educated in this evidence-based communication course. (3) As a result, Northwell's Hospital Consumer Assessment of Healthcare Providers and Systems "Communication with Doctors" domain has increased by 22 percentile rank points, when compared nationally to peers, in addition to other notable patient experience metric improvements within ambulatory medical practice.

通过倾听患者的 "心声",纽约最大的医疗保健机构诺斯韦尔医疗保健公司(Northwell Health)采用循证方法来增强医生和高级护理提供者的能力。以关系为中心的沟通 "课程利用体验式学习来加强以患者为中心的沟通和移情技能,从而建立起以伙伴关系为基础的医疗服务提供者与患者之间的关系。本案例研究强调:(1)务实的文化之旅需要有远见的领导、强有力的合作和不断发展的教育战略。(2) 在 6 年的时间里,3300 多名医疗服务提供者接受了这一循证沟通课程的教育。(3)因此,诺斯韦尔医院的医疗保健提供者和系统消费者评估 "与医生沟通 "领域与全国同行相比提高了 22 个百分点,此外,非住院医疗实践中的其他患者体验指标也有显著改善。
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引用次数: 0
The Feasibility of Using Point of Care Ultrasound as a Visual Substitute for Physical Examination During Telehealth Visits: A Pilot Project 在远程医疗就诊过程中使用护理点超声波作为可视化体格检查替代物的可行性:试点项目
IF 1.5 Q3 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-01-10 DOI: 10.1177/23743735231224516
Vida C. Passero, Nicole Conley, Erin P. Finley, Christopher Kevin Schott
Telehealth provides greater opportunity for specialty access but lacks components of the physical exam. Point-of-care ultrasound (POCUS) may assist telehealth as a visual substitute for the provision of palpation. We conducted a prospective observational pilot project to survey oncologists about (1) their expectations of POCUS, (2) their use of POCUS in oncology telehealth visits, and (3) post-project assessment of their experiences. The results of the pre-assessment survey showed an interest among the oncologists in the ability to evaluate structures remotely via POCUS. POCUS was utilized in 6.4% of visits, most commonly for lymph node assessment (60% of use). POCUS was not utilized most often due to not being applicable to the patient's visit. There were 14 instances of technical issues limiting views of the relevant anatomy reported. Oncologists rated the use of POCUS as very satisfied or satisfied in the vast number of recorded responses. This pilot study suggests POCUS can be integrated into oncology telehealth visits for specific applications such as lymph node assessment. The surveys indicated a potential interest and positive responses that provide for the foundation of expansion to subspecialty care access for patients with telehealth supported by POCUS.
远程保健为专科就诊提供了更多机会,但缺乏体检的组成部分。床旁超声(POCUS)可协助远程医疗,作为触诊的视觉替代。我们开展了一项前瞻性观察试点项目,对肿瘤专家进行了以下方面的调查:(1)他们对 POCUS 的期望;(2)他们在肿瘤远程医疗就诊中使用 POCUS 的情况;以及(3)项目结束后对其经验的评估。评估前调查结果显示,肿瘤专家对通过 POCUS 远程评估结构的能力很感兴趣。在 6.4% 的就诊中使用了 POCUS,最常用于淋巴结评估(使用率为 60%)。未使用 POCUS 的最常见原因是不适用于患者的就诊。据报告,有 14 例因技术问题而限制了对相关解剖结构的观察。在大量记录的回复中,肿瘤学家对 POCUS 的使用评价为 "非常满意 "或 "满意"。这项试点研究表明,可以将 POCUS 整合到肿瘤远程医疗就诊中,用于淋巴结评估等特定应用。调查显示了潜在的兴趣和积极的回应,为通过 POCUS 支持的远程医疗为患者提供亚专科护理服务奠定了基础。
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引用次数: 0
Reducing Preoperative Caregiver Anxiety With Virtual Reality: A Pragmatic, Randomized Controlled Study. 用虚拟现实技术减轻术前护理人员的焦虑:一项务实的随机对照研究。
IF 1.5 Q3 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-01-05 eCollection Date: 2024-01-01 DOI: 10.1177/23743735231220190
Ahtziri Fonseca, Daniel Qian, Ty Forbes, Brian S-K Li, Charles Lee, Kylie Burdsall, Samuel Rodriguez, Christian Jackson, Ellen Y Wang, Thomas J Caruso

Pediatric patients and their caregivers often experience perioperative anxiety. Interventions reduce caregiver anxiety improve cooperation and contribute to an improved patient experience. This study seeks to evaluate the efficacy of virtual reality (VR)-assisted mindfulness on perioperative caregiver anxiety. Participants were randomized into a standard of care (SOC) group, which included snacks but no technology-based distractions, or a VR group, which included snacks and a VR-guided meditation. Caregiver anxiety was measured before and after the intervention using the Visual Analogue Scale for Anxiety (VAS-A). Secondary aims explored participants' baseline anxiety with the State-Trait Anxiety Inventory (STAI). VR group participants completed a satisfaction survey. Linear regression models of VAS-A and STAI were used to compare group differences. Satisfaction survey results were reported with descriptive statistics. 26 participants were included, with 12 randomized to the SOC group and 14 to the VR group. VAS-A scores in the VR group were lower than those in the SOC group (p = .002). The STAI found no change in participants' state of anxiety in the SOC group (p = .7108), compared to a significant reduction (p = .014) in the VR group when controlling for anxiety traits. 12 of 14 caregivers in the VR group expressed satisfaction or strong satisfaction. This study supports the implementation of VR mindfulness as a method to reduce caregiver anxiety. VR use in the pediatric healthcare setting is safe and inexpensive, and the intervention had a high degree of participant satisfaction.

儿科患者及其护理人员经常会在围手术期感到焦虑。减少护理人员焦虑的干预措施可提高合作性,有助于改善患者体验。本研究旨在评估虚拟现实(VR)辅助正念对围术期护理人员焦虑的疗效。参与者被随机分为标准护理(SOC)组和虚拟现实(VR)组,前者包括零食,但不使用技术分散注意力;后者包括零食和 VR 引导的冥想。干预前后使用焦虑视觉模拟量表(VAS-A)测量照顾者的焦虑程度。次要目的是通过状态-特质焦虑量表(STAI)了解参与者的基线焦虑。VR 小组参与者完成了满意度调查。VAS-A 和 STAI 的线性回归模型用于比较组间差异。满意度调查结果通过描述性统计进行报告。共纳入了 26 名参与者,其中 12 人被随机分配到 SOC 组,14 人被随机分配到 VR 组。VR 组的 VAS-A 评分低于 SOC 组(P = .002)。STAI 发现,SOC 组参与者的焦虑状态没有变化(p = .7108),而 VR 组在控制焦虑特质后显著降低(p = .014)。在 VR 组的 14 位照顾者中,有 12 位表示满意或非常满意。这项研究支持将 VR 正念作为减少护理人员焦虑的一种方法。在儿科医疗环境中使用 VR 既安全又便宜,而且干预措施的参与者满意度很高。
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引用次数: 0
What's in This For You? What's in This For Me?: A Win-Win Perspective of Involving Study Advisory Committee Members in Palliative Care Research. 这对你有什么好处?这对我有什么好处?让研究咨询委员会成员参与姑息关怀研究的双赢视角》。
IF 1.5 Q3 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-01-02 eCollection Date: 2024-01-01 DOI: 10.1177/23743735231224562
Juanita Booker-Vaughns, Dawn Rosini, Romilla Batra, Garrett K Chan, Patrick Dunn, Robert Galvin, Ernest Hopkins, Eric Isaacs, Constance L Kizzie-Gillett, Margaret Maguire, Martha Navarro, Neha Reddy Pidatala, William Vaughan, Sally Welsh, Pluscedia Williams, Angela Young-Brinn, Kaitlyn Van Allen, Allison M Cuthel, Rebecca Liddicoat Yamarik, Mara Flannery, Keith S Goldfeld, Corita R Grudzen

Study advisory committees (SACs) provide critical value to clinical trials by providing unique perspectives that pull from personal and professional experiences related to the trial's healthcare topic. The Emergency Medicine Palliative Care Access (EMPallA) study had the privilege of convening a 16-person SAC from the project's inception to completion. The study team wanted to understand the impact this project had on the SAC members. In this narrative, we use reflective dialogue to share SAC members' lived experiences and the impact the EMPallA study has had on members both personally and professionally. We detail the (1) benefits SAC members, specifically patients, and caregivers, have had through working on this project. (2) The importance of recruiting diverse SAC members with different lived experiences and leveraging their feedback in clinical research. (3) Value of community capacity building to ensure the common vision of the clinical trial is promoted.

研究咨询委员会(SAC)通过提供与试验的医疗保健主题相关的个人和专业经验所产生的独特观点,为临床试验提供了重要价值。急诊医学姑息治疗方案(EMPallA)研究从项目开始到结束,有幸召集了一个由 16 人组成的 SAC。研究小组希望了解该项目对 SAC 成员的影响。在本叙述中,我们通过反思性对话来分享 SAC 成员的亲身经历以及 EMPallA 研究对成员个人和职业产生的影响。我们详细介绍了 (1) SAC 成员(特别是患者和护理人员)通过参与该项目获得的益处。(2) 招募具有不同生活经历的 SAC 成员并利用他们在临床研究中的反馈意见的重要性。(3) 社区能力建设的价值,以确保促进临床试验的共同愿景。
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引用次数: 0
“Here, I am More than Just Symptoms Combined”: Mental Health Services from the Perspective of Community Rehabilitation Groups "在这里,我不仅仅是症状的组合":从社区康复团体的角度看心理健康服务
IF 1.5 Q3 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-01-01 DOI: 10.1177/23743735231224266
Felipe Agudelo Hernández, Daniela Rojas Loaiza, Eduardo Marulanda
In response to the rise in mental disorders, psychosocial and community approaches have been proposed, complementing traditional clinical services. The present research aimed to understand the perception of individuals attending community-based strategies regarding mental health services as part of the approach to mental disorders in Colombia. Two workshops were conducted with 30 individuals with mental disorders (depression, anxiety and bipolar disorder), who were members of community strategies. A thematic analysis was conducted. The theme resulting from the analysis shows Community mental health within the healthcare system, which consisted of categories such as Group Amplifying Actions for Health and Groups as Complementary to Other Forms of Care. It is emphasized that the healthcare system should establish bridges with community mental health strategies and actively engage in their strengthening processes to enhance the outcomes of pharmacological interventions and even psychotherapeutic interventions. Bidirectional learning approach is proposed between community-based mental health services and clinical settings within the healthcare system. Community strategies can make an important contribution to complex processes in the health system.
为了应对精神障碍的增加,人们提出了社会心理和社区方法,作为对传统临床服务的补充。本研究旨在了解参加以社区为基础的战略的个人对作为哥伦比亚精神障碍治疗方法一部分的精神健康服务的看法。研究人员与 30 名精神障碍患者(抑郁症、焦虑症和躁郁症)以及社区战略成员举行了两次研讨会。进行了主题分析。分析得出的主题显示了医疗保健系统中的社区心理健康,其中包括 "群体放大健康行动 "和 "群体作为其他护理形式的补充 "等类别。分析强调,医疗保健系统应与社区心理健康战略建立联系,并积极参与其强化过程,以提高药物干预甚至心理治疗干预的效果。建议在社区心理健康服务和医疗系统的临床环境之间采取双向学习的方法。社区战略可以为医疗系统的复杂过程做出重要贡献。
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引用次数: 0
Meaningful Engagement of People Living With Noncommunicable Diseases: Challenges and Opportunities 非传染性疾病患者的有意义参与:挑战与机遇
IF 1.5 Q3 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-01-01 DOI: 10.1177/23743735231224560
Mark Thomaz Ugliara Barone, E. Klatman
Meaningful engagement of people living with health conditions means actively incorporating them in all stages of health decision-making. Despite efforts by global health agencies and governments towards meaningful engagement of people living with noncommunicable diseases (PLWNCDs), many opportunities for participation are tokenistic. PLWNCDs often report feeling excluded from technical discussions and outnumbered by other stakeholders. Participation in decision-making is a human right, and PLWNCDs must continue advocating for a “nothing about us without us” approach. They should be respected as decision-makers with voice, agency, voting power, rights, and duties. This article highlights four key themes: (1) both tokenistic participation and exclusion of PLWNCDs from technical discussions are still common; (2) the “patient” label implies passivity and can perpetuate limited participation, whereas the identifier of PLWNCDs connotes valuable knowledge associated with lived experience; (3) meaningful participation of PLWNCDs in health decision-making processes should be considered a human right; (4) PLWNCD should be empowered to continue to advocate for inclusion and be respected as decision-makers.
让非传染性疾病患者有意义地参与,意味着让他们积极参与卫生决策的各个阶段。尽管全球卫生机构和各国政府都在努力争取非传染性疾病患者(PLWNCDs)的有意义参与,但许多参与机会都是象征性的。非传染性疾病 PLWNCD 常常表示,他们感觉自己被排除在技术讨论之外,而且人数比其他利益相关者少。参与决策是一项人权,PLWNCD 必须继续倡导 "没有我们,就没有我们 "的方法。他们作为拥有发言权、代理权、投票权、权利和义务的决策者,应该得到尊重。本文强调了四个关键主题:(1) 象征性的参与和将 PLWNCDs 排除在技术讨论之外的情况仍很普遍;(2) "患者 "标签意味着被动性,可能会使有限的参与永久化,而 PLWNCDs 的标识则意味着与生活经验相关的宝贵知识;(3) PLWNCDs 有意义地参与健康决策过程应被视为一项人权;(4) 应赋予 PLWNCDs 权力,使其能够继续倡导包容,并作为决策者受到尊重。
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引用次数: 0
Patient Perceptions of the Impact of the COVID Pandemic on the Quality of Their Gastrointestinal Cancer Care. 患者对 COVID 大流行对胃肠道癌症护理质量影响的看法。
IF 1.5 Q3 HEALTH CARE SCIENCES & SERVICES Pub Date : 2023-12-29 eCollection Date: 2023-01-01 DOI: 10.1177/23743735231223849
Melanie Powis, Rinku Sutradhar, Saidah Hack, Shabbir M H Alibhai, Alejandro Berlin, Simron Singh, Monika K Krzyzanowska

We surveyed patients who had a received care for a gastrointestinal cancer between 03/2020 and 05/2021 to understand their perceptions of the impact of the Covid pandemic on cancer care delivery and quality of care. Three-hundred fifty-eight respondents provided evaluable responses (response rate: 17.3%). Approximately half of respondents (46.4%) perceived that they had experienced a pandemic-related cancer care modification; most changes were initiated by a clinician or the cancer center (44.6%). Relative to White patients those from Racialized Groups (OR: 1.91, 95% CI: 1.03-3.54) were more likely to report a cancer treatment change. Additionally, relative to patients in follow-up, those who were newly diagnosed (OR: 2.39; 95% CI: 1.21-4.71) were more likely to report a change. Compared to White patients, patients from Racialized Groups were approximately twice as likely to report perceiving that virtual visits during Covid negatively impacted the quality of their care (OR: 2.21; 95% CI: 0.96-5.08). These findings potentially reflect pre-existing systemic disparities in quality of and access to care, as well as differences in how care is experienced by patients from Racialized Groups.

我们对 2020 年 3 月至 2021 年 5 月期间接受过胃肠道癌症治疗的患者进行了调查,以了解他们对 Covid 大流行对癌症治疗服务和护理质量的影响的看法。358 名受访者提供了可评估的答复(答复率:17.3%)。大约一半的受访者(46.4%)认为他们经历过与大流行相关的癌症护理调整;大多数调整是由临床医生或癌症中心发起的(44.6%)。与白人患者相比,来自种族化群体的患者(OR:1.91,95% CI:1.03-3.54)更有可能报告癌症治疗方法的改变。此外,与随访患者相比,新确诊患者(OR:2.39;95% CI:1.21-4.71)更有可能报告改变治疗方案。与白人患者相比,种族化群体患者报告认为 Covid 期间的虚拟访问对其护理质量产生负面影响的可能性约为白人患者的两倍(OR:2.21;95% CI:0.96-5.08)。这些发现可能反映了医疗质量和获取医疗服务方面预先存在的系统性差异,以及种族化群体患者在体验医疗服务方面的差异。
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引用次数: 0
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