Thomas-Purcell Kamilah B, Tarver Will L, Richards Christine, Primus-Joseph Marva
Master of Public Health Program, College of Osteopathic Medicine, Nova Southeastern University, 3301 South University Drive Ft., Lauderdale, FL, 3328, USA.
HSR&D Center for Health Information and Communication, Richard L. Roudebush VA Medical Center, 1481 West 10th Street (11-H), Indianapolis, IN, 46202, USA.
Cancer Causes Control. 2017 Nov;28(11):1195-1206. doi: 10.1007/s10552-017-0925-8. Epub 2017 Jul 21.
Although extensive screening services for breast and cervical cancers are available in the Caribbean, these cancers continue to be the leading causes of cancer death among women in this region. The purpose of this study was to determine the quality and availability of breast and cervical cancer treatment care and support services from the perspective of the gatekeepers who provide care for the patients in the Windward Islands of Dominica, Grenada, St Lucia, and St. Vincent.
A qualitative research design using semi-structured, in-depth interviews was used to gather data from gatekeepers who provided oncology prevention and care services to patients for at least one year. Data were collected on availability and quality of cancer care and treatment services and coded using the themes obtained via thematic analysis of the data.
Twenty-three current providers participated in the study (Dominica, 5; Grenada, 7; St. Lucia, 5; St. Vincent and the Grenadines, 6). The participants' years of work experience ranged from 2 to 45 years. The codes encompassed a range of social ecological factors that influence breast and cervical cancer screening and treatment in the Windward Islands. The emergent themes were availability of resources, cost of care, and social support.
The findings of this study emphasize the varying social determinants of health that affect breast and cervical cancer prevention and treatment. It also highlights the disparities in availability of treatment within the wider Caribbean. It is necessary to broaden the perspective on health from a purely biomedical paradigm to a social perspective.
尽管加勒比地区提供了广泛的乳腺癌和宫颈癌筛查服务，但这些癌症仍然是该地区女性癌症死亡的主要原因。本研究的目的是从多米尼克、格林纳达、圣卢西亚和圣文森特等向风群岛为患者提供护理的守门人的角度，确定乳腺癌和宫颈癌治疗护理及支持服务的质量和可及性。
采用定性研究设计，通过半结构化深度访谈从为肿瘤预防和护理服务提供至少一年的守门人那里收集数据。收集了癌症护理和治疗服务的可及性和质量数据，并使用通过对数据进行主题分析获得的主题进行编码。
23名现任提供者参与了该研究（多米尼克5名；格林纳达7名；圣卢西亚5名；圣文森特和格林纳丁斯6名）。参与者的工作年限从2年到45年不等。编码涵盖了一系列影响向风群岛乳腺癌和宫颈癌筛查及治疗的社会生态因素。新出现的主题是资源可及性、护理成本和社会支持。
本研究结果强调了影响乳腺癌和宫颈癌预防及治疗的不同社会健康决定因素。它还突出了整个加勒比地区治疗可及性方面的差异。有必要将健康视角从纯粹的生物医学范式拓宽到社会视角。
