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头颈部癌症早期诊断和治疗的促进因素和障碍的定性研究:患者和照顾者的看法。

A qualitative exploration of the facilitators and barriers to early diagnosis and treatment of head and neck cancer: Perceptions of patients and carers.

机构信息

Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales, Australia.

Department of Head and Neck Surgery, Chris O'Brien Lifehouse, Camperdown, New South Wales, Australia.

出版信息

Eur J Cancer Care (Engl). 2022 Nov;31(6):e13718. doi: 10.1111/ecc.13718. Epub 2022 Sep 30.

Abstract

OBJECTIVE

The objective of this study to explore experiences of patients and carers of the pathway to diagnosis and treatment of head and neck cancer (HNC), focusing on differences based on remoteness of residence.

METHODS

Patients ≥6 months post-treatment completion, and their carers, were recruited. Semi-structured interviews, guided by the Model of Pathways to Treatment as the theoretical framework, were conducted to examine pathways to treatment of HNC and facilitators and barriers to early diagnosis and treatment. Thematic analysis with an iterative and data-driven approach was used to identify themes.

RESULTS

A total of 39 patients and 17 carers participated in the interviews. Facilitators of timely diagnosis and treatment included a sense of urgency from health care professionals (HCPs), advocacy by the HCP or carers, and leveraging social capital. Distance to services, financial costs, and a perceived lack of emotional investment by HCPs arose as barriers to timely diagnosis and treatment. Participants were often able to rationalise that not all delays were negative, depending causes and expected impact on cancer management.

CONCLUSION

The findings highlight the complex nature of factors facilitating and impeding early HNC diagnosis and treatment that may be targeted in interventions to support patients and meet important benchmarks for high-quality cancer care.

摘要

目的

本研究旨在探讨头颈部癌症(HNC)患者及其照顾者在诊断和治疗途径方面的体验,重点关注居住地点偏远程度的差异。

方法

招募了治疗完成后≥6 个月的患者及其照顾者。采用路径治疗模型作为理论框架,进行半结构化访谈,以探讨 HNC 的治疗途径以及早期诊断和治疗的促进因素和障碍。采用迭代和数据驱动的主题分析方法来确定主题。

结果

共有 39 名患者和 17 名照顾者参与了访谈。及时诊断和治疗的促进因素包括医疗保健专业人员(HCP)的紧迫感、HCP 或照顾者的倡导以及利用社会资本。距离服务、经济成本以及 HCP 缺乏情感投入被认为是及时诊断和治疗的障碍。参与者通常能够根据原因和对癌症管理的预期影响,将并非所有的延迟都是负面的合理化。

结论

研究结果强调了促进和阻碍早期 HNC 诊断和治疗的因素的复杂性,这些因素可能成为干预措施的目标,以支持患者并满足高质量癌症护理的重要基准。

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