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加拿大前列腺癌治疗的等待时间及患者对医疗服务的看法:一份混合方法报告。

Wait times for prostate cancer treatment and patient perceptions of care in Canada: a mixed-methods report.

作者信息

Tran K, Sandoval C, Rahal R, Porter G, Siemens R, Hernandez J, Fung S, Louzado C, Liu J, Bryant H

机构信息

Canadian Partnership Against Cancer, Toronto, ON;

Canadian Partnership Against Cancer, Toronto, ON; ; Faculty of Medicine, Dalhousie University, Halifax, NS;

出版信息

Curr Oncol. 2015 Oct;22(5):361-4. doi: 10.3747/co.22.2795.

Abstract

BACKGROUND

Access to cancer care is a significant concern for Canadians. Prolonged delays between cancer diagnosis and treatment have been associated with anxiety, stress, and perceived powerlessness for patients and their family members. Longer wait times can also be associated with poorer prognosis, although the evidence is inconclusive. Here, we report national wait times for radiation therapy and surgery for localized prostate cancer (pca) and the effect of wait time on patient perceptions of their care.

RESULTS

Treatment wait times showed substantial interprovincial variation. The longest 90th percentile wait times for radiation therapy and surgery were, respectively, 40 days and 105 days. In all provinces, waits for radiation therapy were longer for pca patients than for patients with breast, colorectal, or lung cancer. In the focus groups and interviews conducted with 47 men treated for pca, many participants did not perceive that wait times for treatment were prolonged. Those who experienced delays between diagnosis and treatment voiced issues with a lack of communication about when they would receive treatment and a lack of support or information to make an informed decision about treatment. Minimizing treatment delays was an aspect of the cancer journey that participants would like to change because of the stress it caused.

CONCLUSIONS

Although wait time statistics are useful, a review of cancer control in Canada cannot be considered complete unless an effort is made to give voice to the experiences of individuals with cancer. The findings presented here are intended to provide a snapshot of national care delivery for localized pca and to identify opportunities for improvement in clinical practice.

摘要

背景

获得癌症治疗是加拿大人极为关注的问题。癌症诊断与治疗之间的长期延误与患者及其家属的焦虑、压力和无助感相关。尽管证据尚无定论,但较长的等待时间也可能与较差的预后相关。在此,我们报告了局部前列腺癌(pca)放射治疗和手术的全国等待时间,以及等待时间对患者护理认知的影响。

结果

治疗等待时间在各省之间存在显著差异。放射治疗和手术最长的第90百分位数等待时间分别为40天和105天。在所有省份,pca患者等待放射治疗的时间比乳腺癌、结直肠癌或肺癌患者更长。在对47名接受pca治疗的男性进行的焦点小组讨论和访谈中,许多参与者并未觉得治疗等待时间过长。那些在诊断和治疗之间经历延误的人表示,在何时接受治疗方面缺乏沟通,并且在做出关于治疗的明智决定时缺乏支持或信息。由于治疗延误带来的压力,尽量减少治疗延误是参与者希望改变的癌症治疗过程中的一个方面。

结论

尽管等待时间统计数据很有用,但除非努力听取癌症患者的经历,否则对加拿大癌症控制的审查就不能被认为是完整的。此处呈现的研究结果旨在提供局部pca全国护理服务的概况,并确定临床实践中有待改进的机会。

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