印度 COVID-19 封锁期间癌症患者就医面临的挑战:叙事回顾

Abhipsa Tripathy, Prem Shankar Mishra
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摘要

在 COVID-19 封锁期间,为癌症患者提供医疗保健服务面临诸多挑战;然而,由于缺乏报告和相关审查,因此必须了解全国癌症患者的细微叙述。COVID-19 大流行严重影响了癌症患者在持续护理过程中的整体状况。为此,本文旨在调查在印度 COVID-19 封锁期间,由于管理不善和缺乏医疗系统规划,癌症患者所面临的挑战和困难。在 2020 年 3 月 24 日至 2020 年 7 月印度封锁期间,我们共收集了 46 篇报纸文章,其中包含不同类型癌症患者的不同病例。我们采用归纳法分析了在国家封锁期间癌症患者面临常规服务和治疗挑战的在线新闻报道和文章。我们进行了内容分析,选择了各邦/中央直辖区的网络新闻文章,从而为我们的文章创建了一个概念图。在所有文章中,大多数文章从供应方的问题出发,报道了癌症患者管理不善(63%)和缺乏及时治疗(37%)等挑战,而从需求方的限制因素出发,报道了对传播的恐惧(10%)、经济问题(10%)和住宿问题(5%)。内容分析得出的广泛主题类别包括:以病人为中心的相关因素、医疗管理相关因素或供应方因素,以及因癌症病人管理不善而造成的封锁的不利影响。此外,研究结果显示,在印度 COVID-19 封锁的关键时期,不同的叙述涉及一系列多重因素,如服务中断、延误、筛查模式改变、诊断和治疗以及后续治疗和姑息治疗。由于卫生管理不善、卫生工作者短缺、基础设施缺陷以及对 COVID-19 感染的恐惧,服务提供机制中断,这给全国癌症患者寻求医疗服务带来了前所未有的挑战。因此,政府必须经常保持警惕,并在这些紧急情况下给予优先考虑。不过,印度政府新近推出的 "国家数字健康计划"(NDHM)可能会起到催化剂的作用,即使在未来发生这种大流行病肆虐之后,也能为该国数字健康基础设施的整合提供必要的支持。
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Challenges for Cancer Patients Seeking Medical Care During COVID-19 Lockdown in India: A Narrative Review
Delivering healthcare services to cancer patients during COVID-19 lockdown posed several challenges; however, lack of reporting and concerned reviews made it imperative to understand the nuance of narratives among cancer patients across country. The COVID-19 pandemic has had a severe effect on the entirety among cancer patients in the continuum of care. In this regard, this article aims to investigate the challenges and hard times faced by cancer patients due to mismanagement and lack of health system planning during COVID-19 lockdown in India. A total of 46 newspaper articles with distinct cases of patients suffering from different types of cancer were collected between 24 March 2020 and July 2020 lockdowns in India. We analyse the online news reports and articles of cancer patients facing regular services and treatment challenges during the country’s lockdown following an inductive approach. We conducted the content analysis that chose online news articles across states/union territories, leading to the creation of a conceptual diagram for our article. From all the articles, most articles reported challenges like poor governance of cancer patients (63%) and lack of timely treatment (37%) from the supply-side issues, whereas from the demand-side constraints, such as fear of transmission (10%), financial issues (10%) and accommodation problems (5%), were reported. The broad thematic categories that evolved from our content analysis are patient-centred related factors, healthcare management-related factors or supply-side factors and detrimental impacts of lockdown with the poor governance of cancer patients. Further, the findings revealed through different sets of narratives that involved a range of multiple factors such as service interruption, delays and altered modes of screening, diagnosis and treatment as well as follow-up and palliative care during the critical time of COVID-19 lockdowns in India. The interruption of service delivery mechanisms due to poor health management, deficits of health workforce, infrastructural lacunae and fear of COVID-19 infection placed unprecedented challenges to cancer patients across the country in seeking healthcare services. Therefore, the government must be regularly vigilant and give priority under these emergency circumstances. However, the newly introduced National Digital Health Mission (NDHM) by the Government of India might be a catalyser that provides the necessary support for the integration of digital health infrastructure in the country even after such a pandemic havoc in the future.
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