a Regional Cancer Centre, Stockholm-Gotland , Stockholm , Sweden.
b Department of Learning Informatics Management and Ethics , Karolinska Institutet , Stockholm , Sweden.
Acta Oncol. 2018 Oct;57(10):1303-1310. doi: 10.1080/0284186X.2018.1484157. Epub 2018 Jun 27.
Sweden's national cancer strategy points out several areas of cancer care that need improvements. Among them the need for supportive care resources to be accessible through the entire cancer trajectory and the reduction of socioeconomic inequalities. The aim of this study was to compare the patient-reported access to supportive care in the Stockholm-Gotland region between patients diagnosed in 2014 and 2016. The aim was also to describe how socioeconomic and other demographic factors impact access to supportive care.
All patients with gynaecological, head and neck, haematological and upper gastrointestinal cancers diagnosed in the Stockholm-Gotland regions were identified through the Swedish Cancer Registries. Data were collected via a questionnaire on demographic, socioeconomic factors and patients' perception (n = 1872) of access to supportive care. Data were summarized using descriptive statistics and logistic regression was used for relevant variables.
Access to some supportive care resources, such as contact nurses (CNs) and individual written care plans (IWCPs) had significantly improved from 2014 to 2016. The proportion of patients that had received information about patient advocacy groups (PAGs) had also improved but remained on a relatively low level (29 and 35%, respectively). The proportion of patients being refereed to palliative care (PC) did not change between 2014 and 2016. In total, 10% of the patients reported to having received information on second medical opinion (SMO). Patients that had undergone multimodality cancer treatment were more likely to report access to supportive care, and those with lower education levels were more likely to have access to CNs and IWCPs.
Access to some of the supportive care resources have shown improvements in the Stockholm-Gotland region but further efforts are required, especially regarding access to PC, information about PAGs and SMOs.
瑞典国家癌症战略指出了癌症护理领域需要改进的几个方面。其中包括通过整个癌症治疗过程提供支持性护理资源，并减少社会经济不平等。本研究的目的是比较 2014 年和 2016 年在斯德哥尔摩-哥塔兰地区诊断出的癌症患者在获得支持性护理方面的差异。同时，本研究还旨在描述社会经济和其他人口统计学因素如何影响获得支持性护理的机会。
通过瑞典癌症登记处确定了斯德哥尔摩-哥塔兰地区诊断出的妇科、头颈部、血液和上胃肠道癌症患者。通过问卷调查收集了人口统计学、社会经济学因素和患者对获得支持性护理的感知（n=1872）。数据采用描述性统计方法进行总结，并使用逻辑回归分析相关变量。
从 2014 年到 2016 年，一些支持性护理资源（如联系护士[CN]和个人书面护理计划[IWCP]）的获得情况有了显著改善。获得关于患者倡导团体（PAG）的信息的患者比例也有所提高，但仍处于相对较低的水平（分别为 29%和 35%）。2014 年至 2016 年间，被转诊至姑息治疗（PC）的患者比例没有变化。总体而言，10%的患者表示曾获得过第二医疗意见（SMO）的信息。接受多模式癌症治疗的患者更有可能获得支持性护理，而受教育程度较低的患者更有可能获得 CN 和 IWCP。
斯德哥尔摩-哥塔兰地区一些支持性护理资源的可及性有所改善，但仍需进一步努力，特别是在获得 PC、关于 PAG 和 SMO 的信息方面。
