Woersching Joanna, Van Cleave Janet H, Haber Judith, Chyun Deborah
New York University.
University of Connecticut.
Oncol Nurs Forum. 2019 May 1;46(3):365-383. doi: 10.1188/19.ONF.365-383.
The impact of mental health disorders (MHDs) and substance use disorders (SUDs) on healthcare utilization (HCU) in patients with cancer is an understudied phenomenon.
A literature search of studies published prior to January 2018 that examined HCU in patients with preexisting MHDs or SUDs diagnosed with cancer was conducted.
The research team evaluated 22 studies for scientific rigor and examined significant trends in HCU, as well as types of the MHD, SUD, and cancer studied.
The heterogeneity of HCU outcome measures, MHD, SUD, sample sizes, and study settings contributed to inconsistent study findings. However, study trends indicated higher rates of HCU by patients with depression and lower rates of HCU by patients with schizophrenia. In addition, the concept of HCU measures is evolving, addressing not only volume of health services, but also quality and efficacy.
Oncology nurses are essential to improving HCU in patients with MHDs and SUDs because of their close connections with patients throughout the stages of cancer care. Additional prospective studies are needed to examine specific MHDs and different types of SUDs beyond alcohol use, improving cancer care and the effectiveness of HCU in this vulnerable population.
心理健康障碍（MHDs）和物质使用障碍（SUDs）对癌症患者医疗保健利用（HCU）的影响是一个研究不足的现象。
对2018年1月之前发表的研究进行了文献检索，这些研究考察了已诊断患有MHDs或SUDs且又被诊断患有癌症的患者的医疗保健利用情况。
研究团队评估了22项研究的科学严谨性，并研究了医疗保健利用方面的显著趋势，以及所研究的MHD、SUD和癌症的类型。
医疗保健利用结果测量、MHD、SUD、样本量和研究环境的异质性导致研究结果不一致。然而，研究趋势表明，抑郁症患者的医疗保健利用率较高，而精神分裂症患者的医疗保健利用率较低。此外，医疗保健利用测量的概念正在不断发展，不仅涉及卫生服务的数量，还涉及质量和效果。
肿瘤护理人员对于改善患有MHDs和SUDs的患者的医疗保健利用至关重要，因为他们在癌症护理的各个阶段都与患者密切联系。需要进行更多的前瞻性研究，以研究除酒精使用之外的特定MHDs和不同类型的SUDs，改善癌症护理以及这一弱势群体的医疗保健利用效果。
