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与乳腺癌重建术社会经济差异相关的因素:威斯康星州外科医生的观点。

Factors Associated With Socioeconomic Disparities in Breast Reconstruction: Perspectives of Wisconsin Surgeons.

机构信息

Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, WI.

Institute for Clinical and Translational Research and School of Nursing, University of Wisconsin-Madison, Madison, WI.

出版信息

Clin Breast Cancer. 2023 Jun;23(4):461-467. doi: 10.1016/j.clbc.2023.03.010. Epub 2023 Mar 28.

Abstract

INTRODUCTION

The objective is to expand our understanding of the factors associated with receipt of breast reconstruction for socioeconomically disadvantaged women within Wisconsin.

METHODS

A purposeful sample of general/breast and plastic surgeons were identified. One-on-one interviews were conducted, audio-recorded, and transcribed in full (n = 15). Conventional content analysis was performed to identify themes.

RESULTS

Both general/breast and plastic surgeons perceived that general/breast surgeons served as gatekeepers to which patients are offered a referral for reconstruction. Given the additional recovery time, frequent clinic visits, and potential for complications associated with reconstruction, general/breast surgeons perceived that not all women prioritize it. Surgeons perceived this to be especially true for socioeconomically disadvantaged women. Surgeons identified time off work, travel for visits, and out-of-pocket costs as specific challenges to reconstruction experienced by socioeconomically disadvantaged women. Surgeons perceived that early education, incorporating financial considerations into discussions, and reducing travel burden may help to improve access to reconstruction.

CONCLUSION

Wisconsin surgeons described factors they perceived contributed to lower rates of reconstruction for socioeconomically disadvantaged women and described ways to increase reconstruction access.

摘要

简介

本研究旨在深入了解与威斯康星州经济弱势群体女性接受乳房重建相关的因素。

方法

确定了有目的的普通/乳房和整形外科医生样本。对 15 名医生进行了一对一的访谈,全程录音并完整转录。采用常规内容分析法识别主题。

结果

普通/乳房和整形外科医生均认为普通/乳房外科医生是向患者提供重建转介的把关人。鉴于重建相关的额外恢复期、频繁的就诊次数和潜在并发症,普通/乳房外科医生认为并非所有女性都将其视为优先事项。外科医生认为,这对经济弱势群体的女性来说尤其如此。外科医生确定了工作时间、就诊旅行和自付费用等是经济弱势群体在重建方面面临的具体挑战。外科医生认为,早期教育、将经济因素纳入讨论以及减轻旅行负担可能有助于改善重建的可及性。

结论

威斯康星州的外科医生描述了他们认为导致经济弱势群体女性乳房重建率较低的因素,并描述了增加重建机会的方法。

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