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癌症患者症状背景下的患者赋权与寻求帮助之间的关系。

The relationship between patient enablement and help-seeking in the context of blood cancer symptoms.

机构信息

School of Health Sciences, University of Surrey, Surrey, UK.

Department of Applied Health Research, UCL, London, UK.

出版信息

Psychooncology. 2023 Aug;32(8):1223-1230. doi: 10.1002/pon.6170. Epub 2023 May 18.

Abstract

OBJECTIVE

Approaches to improve earlier diagnosis of cancer often focus on symptom awareness as a key driver of help-seeking behaviour and other psychological influences are less well understood. This is the first study to explore the role of patient enablement on help-seeking for people experiencing potential blood cancer symptoms.

METHODS

A cross-sectional, nationally representative survey was completed by 434 respondents (>18 years). Questions asked about symptom experiences, medical help-seeking and re-consultation. Existing patient enablement items were included in the newly developed Blood Cancer Awareness Measure. We collected data on patient socio-demographic characteristics.

RESULTS

Of those responding to the survey 224/434 (51.6%) reported experiencing at least one potential blood cancer symptom. Half of those experiencing symptoms (112/224) had sought medical help. Results from logistic regression analysis showed that higher scores on patient enablement were associated with being less likely to seek help (Odds Ratio [OR] 0.89, Confidence Interval [CI] 0.81-0.98) after controlling for socio-demographics. Separate analyses showed that higher enablement was associated with being more comfortable to re-consult if symptoms didn't go away or got worse (OR 1.31, CI 1.16-1.48); after a test result suggested there was nothing to worry about, but symptoms persisted (OR 1.23, CI 1.12-1.34) or to request further tests, scans or investigations (OR 1.31, CI 1.19-1.44).

CONCLUSIONS

Contrary to our hypotheses, patient enablement was associated with lower likelihood of help-seeking for potential blood cancer symptoms. Yet enablement appears to play an important role in likelihood of re-consulting when symptoms persist, get worse or need further investigation.

摘要

目的

提高癌症早期诊断的方法通常侧重于症状意识,将其作为寻求帮助行为的关键驱动因素,而其他心理影响则了解较少。这是第一项研究,旨在探索患者赋权在出现潜在血液癌症状的人群中寻求帮助的作用。

方法

通过全国代表性的横断面调查,由 434 名(>18 岁)受访者完成。问题涉及症状体验、医疗求助和再次就诊。新开发的血液癌意识量表中包含了现有的患者赋权项目。我们收集了患者社会人口统计学特征的数据。

结果

在回应调查的 434 人中,有 224/434(51.6%)报告至少出现过一种潜在的血液癌症状。有症状的人中,有一半(112/224)寻求了医疗帮助。逻辑回归分析的结果表明,在控制了社会人口统计学因素后,患者赋权得分越高,寻求帮助的可能性越低(优势比 [OR] 0.89,置信区间 [CI] 0.81-0.98)。单独的分析表明,更高的赋权与如果症状没有消失或恶化时更愿意再次就诊有关(OR 1.31,CI 1.16-1.48);在测试结果表明没有什么可担心的,但症状持续存在时(OR 1.23,CI 1.12-1.34),或者要求进行进一步的测试、扫描或调查时(OR 1.31,CI 1.19-1.44)。

结论

与我们的假设相反,患者赋权与潜在血液癌症状的求助可能性较低有关。然而,当症状持续存在、恶化或需要进一步调查时,赋权似乎在再次就诊的可能性方面发挥了重要作用。

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