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癌症治疗过程中症状管理体验的种族差异。

Racial differences in symptom management experiences during breast cancer treatment.

机构信息

Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 1105F McGavran-Greenberg Hall, CB#7411, Chapel Hill, NC, 27599-7411, USA.

Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, 450 West Drive, Chapel Hill, NC, 27599, USA.

出版信息

Support Care Cancer. 2018 May;26(5):1425-1435. doi: 10.1007/s00520-017-3965-4. Epub 2017 Nov 18.

Abstract

PURPOSE

Racial disparities in cancer treatment-related symptom burden are well documented and linked to worse treatment outcomes. Yet, little is known about racial differences in patients' treatment-related symptom management experiences. Such understanding can help identify modifiable drivers of symptom burden inequities. As part of the Cancer Health Accountability for Managing Pain and Symptoms (CHAMPS) study, we examined racial differences in symptom management experiences among Black and White breast cancer survivors (BCS).

METHODS

We conducted six focus groups (n = 3 Black BCS groups; n = 3 White BCS groups) with 22 stages I-IV BCS at two cancer centers. Focus groups were audio-recorded and transcribed verbatim. Based on key community-based participatory research principles, our community/academic/medical partner team facilitated focus groups and conducted qualitative analyses.

RESULTS

All BCS described positive symptom management experiences, including clinician attentiveness to symptom concerns and clinician recommendations for pre-emptively managing symptoms. Black BCS commonly reported having to advocate for themselves to get information about treatment-related symptoms, and indicated dissatisfaction regarding clinicians' failure to disclose potential treatment-related symptoms or provide medications to address symptoms. White BCS often described dissatisfaction regarding inadequate information on symptom origins and clinicians' failure to offer reassurance.

CONCLUSIONS

This study elucidates opportunities for future research aimed at improving equity for cancer treatment-related symptom management. For Black women, warnings about anticipated symptoms and treatment for ongoing symptoms were particular areas of concern. Routine symptom assessment for all women, as well as clinicians' management of symptoms for racially diverse cancer patients, need to be more thoroughly studied and addressed.

摘要

目的

癌症治疗相关症状负担的种族差异已有充分记录,并与更差的治疗结果相关。然而,对于患者在治疗相关症状管理方面的种族差异知之甚少。这种理解有助于确定症状负担不平等的可改变驱动因素。作为癌症管理疼痛和症状的健康问责制(CHAMPS)研究的一部分,我们检查了黑人和白人乳腺癌幸存者(BCS)之间在症状管理方面的种族差异。

方法

我们在两家癌症中心进行了六组焦点小组(n = 3 组黑人 BCS;n = 3 组白人 BCS),共有 22 名 I-IV 期 BCS 患者参与。焦点小组进行了录音并逐字记录。基于关键的社区参与式研究原则,我们的社区/学术/医疗合作伙伴团队主持了焦点小组并进行了定性分析。

结果

所有 BCS 都描述了积极的症状管理体验,包括临床医生对症状关注和对预先管理症状的建议。黑人 BCS 通常报告说,他们必须为自己争取有关治疗相关症状的信息,并对临床医生未能披露潜在治疗相关症状或提供药物来解决症状表示不满。白人 BCS 经常对症状来源的信息不足和临床医生未能提供安慰表示不满。

结论

本研究阐明了未来旨在改善癌症治疗相关症状管理公平性的研究机会。对于黑人女性来说,对预期症状和正在进行的症状的治疗的警告是特别关注的领域。需要更全面地研究和解决所有女性的常规症状评估,以及临床医生对不同种族癌症患者的症状管理。

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Racial differences in symptom management experiences during breast cancer treatment.癌症治疗过程中症状管理体验的种族差异。
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