Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois.
Department of Obstetrics and Gynecology, The University of Chicago Medicine, Chicago, Illinois.
Cancer Res Commun. 2023 Apr 3;3(4):521-531. doi: 10.1158/2767-9764.CRC-22-0283. eCollection 2023 Apr.
Cancer treatment can trigger or exacerbate health-related socioeconomic risks (HRSR; food/housing insecurity, transportation/utilities difficulties, and interpersonal violence). The American Cancer Society and National Cancer Institute recommend HRSR screening and referral, but little research has examined the perceptions of patients with cancer on the appropriateness of HRSR screening in healthcare settings. We examined whether HRSR status, desire for assistance with HRSRs, and sociodemographic and health care-related factors were associated with perceived appropriateness of HRSR screening in health care settings and comfort with HRSR documentation in electronic health records (EHR). A convenience sample of adult patients with cancer at two outpatient clinics completed self-administered surveys. We used and Fisher exact tests to test for significant associations. The sample included 154 patients (72% female, 90% ages 45 years or older). Thirty-six percent reported ≥1 HRSRs and 27% desired assistance with HRSRs. Overall, 80% thought it was appropriate to assess for HRSRs in health care settings. The distributions of HRSR status and sociodemographic characteristics were similar among people who perceived screening to be appropriate and those who did not. Participants who perceived screening as appropriate were three times as likely to report prior experience with HRSR screening (31% vs. 10%, = 0.01). Moreover, 60% felt comfortable having HRSRs documented in the EHR. Comfort with EHR documentation of HRSRs was significantly higher among patients desiring assistance with HRSRs (78%) compared with those who did not (53%, < 0.01). While initiatives for HRSR screening are likely to be seen by patients with cancer as appropriate, concerns may remain over electronic documentation of HRSRs.
National organizations recommend addressing HRSRs such as food/housing insecurity, transportation/utilities difficulties, and interpersonal violence among patients with cancer. In our study, most patients with cancer perceived screening for HRSRs in clinical settings as appropriate. Meanwhile, concerns may remain over the documentation of HRSRs in EHRs.
癌症治疗可能引发或加剧与健康相关的社会经济风险（HRSR；食品/住房无保障、交通/公用事业困难和人际暴力）。美国癌症协会和美国国家癌症研究所建议进行 HRSR 筛查和转介，但几乎没有研究探讨癌症患者对 HRSR 筛查在医疗保健环境中的适宜性的看法。我们研究了 HRSR 状况、对 HRSR 援助的渴望，以及社会人口统计学和医疗保健相关因素是否与对 HRSR 筛查在医疗保健环境中的适宜性的看法以及对电子健康记录（EHR）中 HRSR 记录的舒适度相关。我们在两个门诊诊所便利抽样了 154 名成年癌症患者，完成了自我管理的调查。我们使用 和 Fisher 精确检验来检验显著关联。样本包括 154 名患者（72%为女性，90%年龄在 45 岁或以上）。36%的患者报告有≥1 项 HRSR，27%的患者希望获得 HRSR 援助。总体而言，80%的人认为在医疗保健环境中评估 HRSR 是合适的。在认为筛查合适的人和认为不合适的人之间，HRSR 状况和社会人口统计学特征的分布相似。认为筛查合适的参与者报告之前有 HRSR 筛查经验的可能性是三倍（31%比 10%， = 0.01）。此外，60%的人觉得在 EHR 中记录 HRSR 是舒适的。与没有 HRSR 援助需求的患者（53%， < 0.01）相比，希望获得 HRSR 援助的患者（78%）对在 EHR 中记录 HRSR 的舒适度明显更高。虽然癌症患者可能认为 HRSR 筛查等举措是合适的，但他们可能仍然对 HRSR 在电子病历中的记录表示担忧。
国家组织建议在癌症患者中解决 HRSR，例如食品/住房无保障、交通/公用事业困难和人际暴力。在我们的研究中，大多数癌症患者认为在临床环境中筛查 HRSR 是合适的。同时，人们可能仍然对 EHR 中 HRSR 的记录表示担忧。
