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癌症诊断、治疗和护理:对罗姆人、吉普赛人和游民的经历和卫生服务利用情况的定性研究。

Cancer diagnosis, treatment and care: A qualitative study of the experiences and health service use of Roma, Gypsies and Travellers.

机构信息

College of Human and Health Sciences, Swansea University, Wales, UK.

Roma peer researcher.

出版信息

Eur J Cancer Care (Engl). 2021 Sep;30(5):e13439. doi: 10.1111/ecc.13439. Epub 2021 May 6.

Abstract

BACKGROUND

Early diagnosis and treatment are key to reducing deaths from cancer, but people from Black and Minority Ethnic (BME) groups are more likely to encounter delays in entering the cancer care system. Roma, Gypsies and Travellers are ethnic minorities who experience extreme health inequalities.

OBJECTIVE

To explore the experiences of cancer diagnosis, treatment and care among people who self-identify as Roma or Gypsies and Travellers.

METHODS

A participatory qualitative approach was taken. Peer researchers conducted semi-structured interviews (n = 37) and one focus group (n = 4) with community members in Wales and England, UK.

RESULTS

Cancer fatalism is declining, but Roma, Gypsies and Travellers experience barriers to cancer healthcare at service user, service provider and organisational levels. Communication was problematic for all groups, and Roma participants reported lack of access to interpreters within primary care. Clear communication and trusting relationships with health professionals are highly valued and most frequently found in tertiary care.

CONCLUSION

This study suggests that Roma, Gypsies and Travellers are motivated to access health care for cancer diagnosis and treatment, but barriers experienced in primary care can prevent or delay access to diagnostic and treatment services. Organisational changes, plus increased cultural competence among health professionals, have the potential to reduce inequalities in early detection of cancer.

摘要

背景

早期诊断和治疗是降低癌症死亡率的关键,但来自黑人和少数族裔(BME)群体的人更有可能在进入癌症护理系统时遇到延迟。罗姆人、吉普赛人和游民是少数民族,他们经历着极端的健康不平等。

目的

探索自认为是罗姆人或吉普赛人和游民的人在癌症诊断、治疗和护理方面的经历。

方法

采用参与式定性方法。在英国威尔士和英格兰,同行研究人员对社区成员进行了半结构化访谈(n=37)和一次焦点小组(n=4)。

结果

癌症宿命论正在减少,但罗姆人、吉普赛人和游民在服务使用者、服务提供者和组织层面上都面临着癌症医疗保健的障碍。所有群体的沟通都存在问题,罗姆族参与者报告在初级保健中无法获得口译员。与卫生专业人员的清晰沟通和信任关系受到高度重视,并且在三级保健中最常发现。

结论

本研究表明,罗姆人、吉普赛人和游民有动机寻求癌症诊断和治疗的医疗保健,但在初级保健中遇到的障碍可能会阻止或延迟获得诊断和治疗服务。组织变革,加上卫生专业人员文化能力的提高,有可能减少癌症早期检测方面的不平等。

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