Centre of Global Intercultural Health (CeSGI) ICIM, Universidad del Desarrollo, Santiago, Chile.
Programa de Doctorado en Ciencias e Innovación en Medicina (DCIM), Universidad del Desarrollo, Santiago, Chile.
Front Public Health. 2023 Aug 16;11:1228304. doi: 10.3389/fpubh.2023.1228304. eCollection 2023.
Globally, it has been reported that different social determinants of health affect health outcomes in lung cancer (LC). Research on the therapeutic trajectories of patients (TTP) is a novel field for identifying barriers and facilitators in health. The objective of this study was to reveal perceived differences in TTP with LC in Chile according to selected social determinants of health (SDH) and the experiences of patients, health professionals, and civil society leaders.
This is a qualitative paradigm, one case-study design. Online semi-structured interviews were conducted with patients with LC, health professionals, and civil society leaders. The strategies for the recruitment process included social networks, civil society organizations, health professionals, and the snowball technique. A thematic analysis was carried out.
Selected SDH impact LC's TTP in Chile, particularly concerning health system access, health services, information, and patient navigation experiences. The analysis of the experiences of the participants allowed us to identify barriers related to the selected SDH in three stages of the TTP: initiation, examinations, and diagnosis and treatment. Individuals with limited education, those residing outside the capital, women, and those in the public health system encountered more barriers throughout their TTP.
Study findings suggest that being a woman with low education, from the public health system, and not from the capital might represent one of the most powerful intersections for experiencing barriers to effective healthcare in LC in Chile. It is necessary to monitor the TTP from an SDH perspective to guarantee the rights of access, opportunity, quality, and financial protection.
据全球报道,不同的健康社会决定因素会影响肺癌(LC)的健康结果。对患者治疗轨迹(TTP)的研究是一个新领域,可以发现健康方面的障碍和促进因素。本研究的目的是根据选定的健康社会决定因素(SDH)和患者、卫生专业人员和民间社会领导人的经验,揭示智利 LC 患者 TTP 中感知到的差异。
这是一个定性范式,一个案例研究设计。对 LC 患者、卫生专业人员和民间社会领导人进行了在线半结构化访谈。招聘过程的策略包括社交网络、民间社会组织、卫生专业人员和滚雪球技术。进行了主题分析。
选定的 SDH 影响智利 LC 的 TTP,特别是在卫生系统获取、卫生服务、信息和患者导航方面。参与者经验的分析使我们能够在 TTP 的三个阶段识别与选定 SDH 相关的障碍:启动、检查和诊断以及治疗。受教育程度较低的个体、居住在首都以外的个体、女性以及公共卫生系统中的个体在整个 TTP 中遇到了更多的障碍。
研究结果表明,作为一名受教育程度较低的女性,来自公共卫生系统且不是来自首都的人,可能代表在智利 LC 中体验有效医疗保健障碍的最有力交叉点之一。有必要从 SDH 的角度监测 TTP,以保障获得、机会、质量和财务保护的权利。