Amanda E Janitz, Amber S Anderson-Buettner, Stefani D Madison, Mark P Doescher, Ryan Nipp, Sheryl Buckner, Dorothy A Rhoades
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To evaluate the implementation, we conducted interviews with patients and clinical staff who participated in the screening process. We thematically analyzed interview transcriptions using inductive and deductive coding to identify themes.</p><p><strong>Results: </strong>Of 42 patients completing FHS, 76.2% reported moderate/severe hardship. Ten patients and four clinical staff (1 physician, 3 NA navigation staff) completed interviews. We identified three themes: (1) FHS perceptions and intervention experiences, (2) FHS efficacy and opportunities for expansion, and (3) nuances for NA patients and patient-related factors. Patients expressed positive experiences with FHS, including identifying financial challenges, but preferences regarding timing varied. Staff reported logistic and sustainability challenges in implementing FHS. However, clinic staff reported positive experiences with the tool, interactions with patients, and the resulting supportive care referrals.</p><p><strong>Conclusion: </strong>Implementation of FHS for NA patients with cancer was well received by patients and staff and was perceived by both groups as facilitating efforts to address financial hardship. Measures to improve staffing and sustainability are needed to enable broader implementation.</p>","PeriodicalId":22046,"journal":{"name":"Supportive Care in Cancer","volume":"32 12","pages":"792"},"PeriodicalIF":2.8000,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Pilot implementation and qualitative evaluation of a financial hardship screening among Native American patients with cancer.\",\"authors\":\"Amanda E Janitz, Amber S Anderson-Buettner, Stefani D Madison, Mark P Doescher, Ryan Nipp, Sheryl Buckner, Dorothy A Rhoades\",\"doi\":\"10.1007/s00520-024-08995-1\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>Native American (NA) patients with cancer are at increased risk of financial hardship due to lack of private health insurance coverage, medical comorbidities, and higher poverty rates. 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引用次数: 0
摘要
目的：由于缺乏私人医疗保险、合并症和较高的贫困率，美国原住民癌症患者面临经济困难的风险增加。我们的目标是在美国原住民癌症患者中实施并评估一项经济困难筛查（FHS）试点计划：2022年，我们使用经济毒性综合评分--慢性病治疗功能评估（COST-FACIT）工具，在由NA特定医疗机构转诊至NCI指定癌症中心的成年NA癌症患者中试行经济困难筛查。我们将 COST-FACIT 分数分为轻度/无困难（26-44 分）和中度/严重困难（≤ 25 分）。为了评估实施情况，我们对参与筛查过程的患者和临床工作人员进行了访谈。我们采用归纳和演绎编码法对访谈记录进行了专题分析，以确定主题：在完成家庭健康调查的 42 名患者中，76.2% 的患者表示有中度/重度困难。10 名患者和 4 名临床工作人员（1 名医生、3 名 NA 导航人员）完成了访谈。我们确定了三个主题：(1) 家庭健康服务的认知和干预经验；(2) 家庭健康服务的功效和扩展机会；(3) NA 患者的细微差别和患者相关因素。患者对家庭健康服务表示了积极的体验，包括发现了财务方面的挑战，但对时间的偏好各不相同。工作人员报告了实施家庭健康服务在后勤和可持续性方面的挑战。不过，诊所工作人员在使用该工具、与患者互动以及由此产生的支持性护理转介方面都有积极的体验：结论：为新来乍到的癌症患者实施家庭健康服务受到了患者和医务人员的欢迎，他们都认为该服务有助于解决经济困难问题。需要采取措施改善人员配备和可持续性，以便更广泛地实施。
Pilot implementation and qualitative evaluation of a financial hardship screening among Native American patients with cancer.
Purpose: Native American (NA) patients with cancer are at increased risk of financial hardship due to lack of private health insurance coverage, medical comorbidities, and higher poverty rates. We aimed to implement and evaluate a pilot financial hardship screening (FHS) program among NA patients with cancer.
Methods: In 2022, we piloted the implementation of FHS among adult NA patients with cancer referred by NA-specific health facilities to an NCI-designated cancer center using the COmprehensive Score for financial Toxicity-Functional Assessment of Chronic Illness Therapy (COST-FACIT) tool. We dichotomized COST-FACIT scores as mild/no hardship (26-44) and moderate/severe hardship (≤ 25). To evaluate the implementation, we conducted interviews with patients and clinical staff who participated in the screening process. We thematically analyzed interview transcriptions using inductive and deductive coding to identify themes.
Results: Of 42 patients completing FHS, 76.2% reported moderate/severe hardship. Ten patients and four clinical staff (1 physician, 3 NA navigation staff) completed interviews. We identified three themes: (1) FHS perceptions and intervention experiences, (2) FHS efficacy and opportunities for expansion, and (3) nuances for NA patients and patient-related factors. Patients expressed positive experiences with FHS, including identifying financial challenges, but preferences regarding timing varied. Staff reported logistic and sustainability challenges in implementing FHS. However, clinic staff reported positive experiences with the tool, interactions with patients, and the resulting supportive care referrals.
Conclusion: Implementation of FHS for NA patients with cancer was well received by patients and staff and was perceived by both groups as facilitating efforts to address financial hardship. Measures to improve staffing and sustainability are needed to enable broader implementation.
期刊介绍：
Supportive Care in Cancer provides members of the Multinational Association of Supportive Care in Cancer (MASCC) and all other interested individuals, groups and institutions with the most recent scientific and social information on all aspects of supportive care in cancer patients. It covers primarily medical, technical and surgical topics concerning supportive therapy and care which may supplement or substitute basic cancer treatment at all stages of the disease.
Nursing, rehabilitative, psychosocial and spiritual issues of support are also included.
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