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探讨心理社会关怀在基于价值的肿瘤学中的作用:来自对 3000 名癌症患者和幸存者的调查结果。

Exploring the role of psychosocial care in value-based oncology: Results from a survey of 3000 cancer patients and survivors.

机构信息

a Graduate Center of the City University of New York , New York , NY , USA.

b CancerCare , New York , NY , USA.

出版信息

J Psychosoc Oncol. 2019 Jul-Aug;37(4):441-455. doi: 10.1080/07347332.2018.1504851. Epub 2018 Nov 19.

Abstract

PURPOSE

To explore the psychosocial needs of cancer patients and survivors across the United States and their implications for value-based oncology.

DESIGN

A secondary analysis of findings from a cross-sectional national online survey.

SAMPLE

Respondents were sampled and stratified by cancer type and geographic region to approximate the cancer-affected population of the United States. Breast, prostate, and colorectal were the most common cancers reported. Across surveys, the majority of respondents were female (57%), over 55 (60%), and white (70%) and had at least some college (36%).

METHODS

Six online surveys were administered to cohorts of approximately 500 unique cancer patients and survivors. Survey topics included: (1) diagnosis, (2) treatment planning, (3) communication with providers, (4) insurance and financial concerns, (5) quality of life, side effects, and symptoms, and (6) survivorship and end-of-life. Descriptive analyses were used to explore psychosocial needs and experiences across three domains of patient-centered value in oncology.

FINDINGS

Each survey received 500-527 responses. Respondents most commonly reported needing more information regarding their insurance coverage and out-of-pocket costs (65%), access to clinical trials (89%), and support organizations (45%). Forty-one percent were very or extremely distressed about cancer's impact on their ability to work and over 25% reported high-levels of cancer-related financial hardship.

CONCLUSIONS

Patients and survivors reported significant unmet informational needs, financial hardship, distress, and symptoms or treatment side effects that interfered with daily life. Implications for Psychosocial Providers or Policy: Providers and payment reform advocates can improve value in oncology by ensuring access to comprehensive psychosocial care and informational support.

摘要

目的

探索美国癌症患者和幸存者的心理社会需求及其对基于价值的肿瘤学的意义。

设计

对横断面全国在线调查结果的二次分析。

样本

按癌症类型和地理位置对受访者进行抽样和分层,以近似美国受癌症影响的人群。报告的最常见癌症是乳腺癌、前列腺癌和结直肠癌。在所有调查中,大多数受访者为女性(57%)、55 岁以上(60%)和白人(70%),且至少有一些大学学历(36%)。

方法

对约 500 名独特的癌症患者和幸存者进行了六次在线调查。调查主题包括:(1)诊断,(2)治疗计划,(3)与提供者的沟通,(4)保险和财务问题,(5)生活质量、副作用和症状,以及(6)生存和临终关怀。使用描述性分析来探讨肿瘤学中三个以患者为中心的价值领域的心理社会需求和体验。

发现

每次调查收到 500-527 份回复。受访者最常报告需要更多关于保险覆盖范围和自付费用(65%)、临床试验(89%)和支持组织(45%)的信息。41%的人对癌症对其工作能力的影响感到非常或极度困扰,超过 25%的人报告存在高水平的癌症相关经济困难。

结论

患者和幸存者报告了重大的未满足的信息需求、经济困难、困扰以及影响日常生活的症状或治疗副作用。对心理社会服务提供者或政策的影响:提供者和支付改革倡导者可以通过确保获得全面的心理社会护理和信息支持来提高肿瘤学的价值。

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