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医疗服务不足的头颈癌和肺癌患者特征与护理人员参与临床试验有关。

Underserved head-and-neck and lung cancer patient characteristics are associated with caregiver participation in a clinical trial.

作者信息

Ulrich Gillian R, Ranby Krista W, Borrayo Evelinn

机构信息

Department of Psychology, University of Colorado Denver, Denver, CO, USA.

Department of Community & Behavioral Health, University of Colorado School of Public Health, Aurora, CO, USA.

出版信息

Contemp Clin Trials Commun. 2023 Aug 2;35:101195. doi: 10.1016/j.conctc.2023.101195. eCollection 2023 Oct.

Abstract

BACKGROUND

Patient-caregiver relationships affect cancer outcomes, yet factors related to joint enrollment in cancer research trials are unclear. This work examined associations between cancer patients' sociodemographic and health factors and their caregivers' trial participation.

METHODS

Baseline data were drawn from a parent trial testing psychosocial interventions delivered to medically underserved head-and-neck cancer (HNC) and lung cancer (LC) patients (N = 274) and caregivers (N = 210). Logistic regression evaluated whether patient characteristics were associated with participating alone versus with a caregiver(s) and type of caregiver.

RESULTS

Many patients (65.0%) had a caregiver in the study, which was more common for married (OR = 2.05, p < .01) and retired patients (OR = 1.95, p < .05). Patients who indicated Hispanic (OR = 2.31, p < .05), Medicaid insurance (OR = 4.12, p < .001), monthly income <$4000 (OR = 3.04, p < .01), and smoked (OR = 2.87, p < .01) were more likely to enroll with a non-spouse/partner caregiver versus a spouse/partner. Participation was unrelated to distress.

CONCLUSIONS

Patient characteristics highlight caregiver relationships, informing trial design and recruitment for medically underserved cancer populations. Psychosocial interventions targeting underserved patients and their informal caregivers, those most in need of intervention support, should consider the inclusion of non-spousal cancer caregivers. Understanding how patient factors may be associated with caregiver involvement informs recruitment strategies and increases the utility of psychosocial interventions.

摘要

背景

患者与照顾者的关系会影响癌症治疗结果,但与共同参与癌症研究试验相关的因素尚不清楚。这项研究探讨了癌症患者的社会人口统计学和健康因素与其照顾者参与试验之间的关联。

方法

基线数据来自一项针对医疗服务不足的头颈癌(HNC)和肺癌(LC)患者(N = 274)及其照顾者(N = 210)的心理社会干预试验。逻辑回归分析评估患者特征是否与独自参与试验、与照顾者一起参与试验以及照顾者类型有关。

结果

许多患者(65.0%)在研究中有照顾者,这在已婚患者(OR = 2.05,p <.01)和退休患者中更为常见(OR = 1.95,p <.05)。表明自己是西班牙裔(OR = 2.31,p <.05)、参加医疗补助保险(OR = 4.12,p <.001)、月收入低于4000美元(OR = 3.04,p <.01)以及吸烟的患者(OR = 2.87,p <.01)与非配偶/伴侣照顾者一起参与试验的可能性高于与配偶/伴侣一起参与试验的可能性。参与试验与痛苦程度无关。

结论

患者特征凸显了照顾者关系,为医疗服务不足的癌症患者群体的试验设计和招募提供了参考。针对服务不足的患者及其非正式照顾者(最需要干预支持的人群)的心理社会干预应考虑纳入非配偶癌症照顾者。了解患者因素与照顾者参与之间的关联有助于制定招募策略,并提高心理社会干预的效用。

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