Neuroethics Canada, Division of Neurology, Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.
Faculty of Medicine, Division of Neurosurgery, Department of Surgery, University of British Columbia, Vancouver, British Columbia, Canada.
Can J Neurol Sci. 2023 Jun;50(s1):s17-s25. doi: 10.1017/cjn.2023.18. Epub 2023 May 10.
Geographic, social, political, and economic factors shape access to advanced neurotechnologies, yet little previous research has explored the barriers, enablers, and areas of opportunity for equitable and meaningful access for diverse patient communities across Canada. We applied a mixed-mode approach involving semi-structured interviews and rating scale questions to consult with 24 medical experts who are involved in the care of patients who undergo functional neurosurgery targeting the brain. Seven major themes emerged from the qualitative analysis: , , , , , , and . Descriptive statistics of the Likert-scale responses suggest that interviewees perceive a disparity between the imperative of access to advanced neurotechnologies for people living in rural and remote areas and the likelihood of achieving such access. The results depict a complex picture of access to functional neurosurgery in Canada with pockets of excellence and a motivation to improve the availability of care for vulnerable populations through the expansion of distributed care models, improved health care system efficiencies, increasing funding and support for patient travel, and increasing awareness about and advocacy for advanced neurotechnologies.
地理、社会、政治和经济因素影响着先进神经技术的可及性，尽管此前很少有研究探讨加拿大不同患者群体获得公平和有意义的先进神经技术的障碍、促进因素和机会领域。我们采用了一种混合模式方法，包括半结构化访谈和李克特量表问题，咨询了 24 名参与针对大脑进行功能神经外科手术的患者护理的医学专家。从定性分析中出现了七个主要主题： ， ， ， ， ， ， 。李克特量表反应的描述性统计数据表明，受访者认为农村和偏远地区的人们获得先进神经技术的必要性与实现这种获得的可能性之间存在差距。结果描绘了加拿大功能神经外科手术的一个复杂图景，其中有一些卓越的领域，并通过扩大分布式护理模式、提高医疗保健系统效率、增加患者旅行的资金和支持，以及提高对先进神经技术的认识和倡导，来改善弱势群体的护理供应。
