Department of Otolaryngology-Head and Neck Surgery, UT Southwestern Medical Center, Dallas, TX, USA.
Department of Family and Community Medicine, UT Southwestern Medical Center, Dallas, TX, USA.
Ann Otol Rhinol Laryngol. 2023 Nov;132(11):1361-1372. doi: 10.1177/00034894231154182. Epub 2023 Mar 8.
To characterize the supportive care (SC) needs and receipt of SC services among head and neck cancer (HNC) patients prior to oncologic treatment and to explore the influence of social determinants of health on these outcomes.
Newly diagnosed HNC patients were surveyed via telephone prior to oncologic treatment between 10/2019 and 1/2021 using a prospective, cross-sectional, bi-institutional, pilot study design. The primary study outcome was unmet SC needs (Supportive Care Needs Survey-Short Form34 [SCNS-SF34]). Hospital type (university- vs county safety-net) was explored as an exposure. Descriptive statistics were performed using STATA16 (College Station, TX).
Among 158 potentially eligible patients, 129 were successfully contacted, 78 met the study criteria, and 50 completed the survey. The mean age was 61, 58% exhibited clinical stage III-IV disease, and 68% and 32% were treated at the university and county safety-net hospital, respectively. Patients were surveyed a median of 20 days after their first oncology visit and 17 days prior to initiation of oncology treatment. They had a median of 24 total needs (11 were met and 13 were unmet) and preferred to see a median of 4 SC services but received care from none. County safety-net patients had comparatively more unmet needs than university patients (14.5 vs 11.5, = .04).
Pretreatment HNC patients at a bi-institutional academic medical center report a high number of unmet SC needs with corollary poor receipt of available SC services. Novel interventions to address this significant gap in care are needed.
在肿瘤治疗前描述头颈部癌症（HNC）患者的支持性护理（SC）需求和 SC 服务的获得情况，并探讨健康社会决定因素对这些结果的影响。
2019 年 10 月至 2021 年 1 月，采用前瞻性、横断面、双机构、试点研究设计，通过电话对新诊断的 HNC 患者进行调查。主要研究结果为未满足的 SC 需求（支持性护理需求调查-短表 34 项 [SCNS-SF34]）。探讨了医院类型（大学医院与县保障网医院）作为暴露因素的影响。采用 STATA16（德克萨斯州学院站）进行描述性统计分析。
在 158 名符合条件的潜在患者中，成功联系了 129 名，符合研究标准的有 78 名，完成调查的有 50 名。患者的平均年龄为 61 岁，58%的患者表现为临床 III-IV 期疾病，68%和 32%的患者分别在大学医院和县保障网医院接受治疗。患者在首次肿瘤就诊后中位数 20 天和开始肿瘤治疗前中位数 17 天接受调查。他们的总需求中位数为 24 项（11 项得到满足，13 项未得到满足），并希望中位数接受 4 项 SC 服务，但没有得到任何服务。县保障网医院的患者未满足的需求比大学医院的患者多（14.5 比 11.5，=0.04）。
在一所双机构学术医疗中心，治疗前的 HNC 患者报告了大量未满足的 SC 需求，同时相应地获得了很少的可用 SC 服务。需要新的干预措施来解决这一严重的护理差距。
