Vilchis Hugo, Onstad Lynn E, Benavidez Rachel, Castillo Rebecca, Bush Nigel, Sanchez Janet, O'Connell Mary, Thompson Beti, Moinpour Carol M
Burrell Institute of Health Policy Research, Burrell College of Osteopathic Medicine, New Mexico State University, Las Cruces, NM, USA.
Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA.
J Cancer Educ. 2019 Feb;34(1):173-179. doi: 10.1007/s13187-017-1283-7.
We conducted a pilot test of a patient navigation intervention (Una Mano Amiga) to address cancer health disparities in three rural counties in southwest New Mexico. We trained two bilingual lay health workers (promotoras) as patient navigators (PNs) to help adult cancer patients and their participating families in Grant, Luna, and Hidalgo counties "navigate" the health care system, including appropriate access to social and financial services. Our hypothesized outcome was a reduction in time from diagnosis to treatment initiation compared to the average time without PNs in each of the three counties (2000-2009). We enrolled 85 eligible patients and 43 eligible family members who had completed psychosocial and demographic forms in this PN intervention. Mean time from cancer diagnosis to treatment initiation among 41 study patients was 59.6 days across the three counties. Mean time from non-intervention comparison data was 47.1 days. In the intervention group, on a 0-10 satisfaction scale (higher = more), patient mean scores for three items ranged from 9.3 to 9.6, family members, 8.9-9.3. Caregiver stress as measured by a Caregiver Self-Assessment score ≥ 10 (highest stress = 16) decreased from 23.8% of caregivers at study entry to 14.3% at follow-up (not statistically significantly different). Although the PN intervention did not decrease time from diagnosis to treatment initiation compared to three comparison counties, positive reactions of patients and family members support further research with larger samples.
我们开展了一项患者导航干预措施（Una Mano Amiga）的试点测试，以解决新墨西哥州西南部三个农村县的癌症健康差异问题。我们培训了两名双语基层卫生工作者（健康促进员）作为患者导航员，帮助格兰特县、卢纳县和希达尔戈县的成年癌症患者及其参与的家庭“导航”医疗保健系统，包括适当获取社会和金融服务。我们假设的结果是，与这三个县（2000 - 2009年）没有患者导航员时的平均时间相比，从诊断到开始治疗的时间会缩短。我们招募了85名符合条件的患者和43名符合条件的家庭成员，他们在这项患者导航干预中完成了心理社会和人口统计学表格。在这三个县的41名研究患者中，从癌症诊断到开始治疗的平均时间为59.6天。非干预比较数据的平均时间为47.1天。在干预组中，在0 - 10的满意度量表上（分数越高表示越满意），患者对三个项目的平均得分在9.3至9.6之间，家庭成员的平均得分在8.9至9.3之间。通过照顾者自我评估得分≥10（最高压力 = 16）衡量的照顾者压力，从研究开始时23.8%的照顾者降至随访时的14.3%（无统计学显著差异）。尽管与三个对照县相比，患者导航干预并未缩短从诊断到开始治疗的时间，但患者和家庭成员的积极反应支持进行更大样本的进一步研究。
