Faculty of Health Science, Universidad Europea de Valencia, Valencia, Spain.
Departament d'Epidemiologia i Metodologia de Les Ciències Socials I de La Salut d'Umanresa, Universitat de Vic-Universitat Central de Catalunya, Manresa, Catalonia, Spain.
Breast Cancer Res Treat. 2024 Apr;204(2):377-387. doi: 10.1007/s10549-023-07191-9. Epub 2023 Dec 28.
This study aimed to analyze social inequalities in the use and access of physiotherapy service and its clinical and socio-economic determinants in women diagnosed with breast cancer in the hospital network of Barcelona.
Data from 2235 women belonging to the mixed (prospective and retrospective) DAMA Cohort were analyzed, including demographic, socio-economic, clinical, and breast cancer treatment outcomes. To determine the influence of such variables on access to physiotherapy, different Poisson regression models with robust variance (obtaining Prevalence Ratios and confidence intervals) were estimated.
Although when experiencing different chronic and acute symptoms, only between 20 and 35% of women visited physiotherapist. Two out of 3 women reported to have received insufficient information about medical care and rehabilitation. Age of women, job occupation, education level, having a mutual or private insurance, as well as outcomes related to breast cancer, appear to be factors influencing the access to physiotherapy.
Social and economic inequalities exist on the access to physiotherapy by women diagnosed with breast cancer, which is generally low, and may clearly impact on their functional recovery. Promoting strategies to reduce social bias, as well as improve communication and patient information regarding physiotherapy may be of interest for a better health care in breast cancer diagnosed women.
本研究旨在分析巴塞罗那医院网络中被诊断患有乳腺癌的女性在使用和获得物理治疗服务方面的社会不平等现象，以及其临床和社会经济决定因素。
分析了属于混合（前瞻性和回顾性）DAMA 队列的 2235 名女性的数据，包括人口统计学、社会经济、临床和乳腺癌治疗结果。为了确定这些变量对获得物理治疗的影响，使用了不同的稳健方差泊松回归模型（得出患病率比和置信区间）。
尽管在经历不同的慢性和急性症状时，只有 20%至 35%的女性会去看物理治疗师。三分之二的女性报告说，她们获得的关于医疗和康复的信息不足。女性的年龄、职业、教育水平、是否有共同或私人保险，以及与乳腺癌相关的结果，似乎是影响获得物理治疗的因素。
被诊断患有乳腺癌的女性在获得物理治疗方面存在社会和经济不平等现象，而且这种治疗的可及性普遍较低，这可能会对她们的功能恢复产生明显影响。为了改善乳腺癌诊断女性的医疗服务，可能有必要采取促进减少社会偏见的策略，以及改善与物理治疗相关的沟通和患者信息。
