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评估与癌症幸存者及医疗质量相关的健康社会决定因素。

Evaluating Social Determinants of Health Related to Cancer Survivorship and Quality of Care.

作者信息

Somayaji Darryl, Mohedat Heba, Li Chin-Shang

机构信息

Author Affiliations: School of Nursing, University at Buffalo (Dr Somayaji and Mrs Mohedat), New York; and Division of Supportive Care in Cancer, Department of Surgery, University of Rochester Medical Center (Dr Li), Rochester, New York.

出版信息

Cancer Nurs. 2025;48(5):370-377. doi: 10.1097/NCC.0000000000001327. Epub 2024 Feb 26.

Abstract

BACKGROUND

Social determinants of health posit that negative outcomes are influenced by individuals living in underserved and underresourced neighborhoods.

OBJECTIVE

This study examines a cancer diagnosis, race/ethnicity, age, geographic location (residence), education, and social economic status factors at disease onset and treatment.

METHODS

A multivariable PO regression analysis was run for quality of care at testing or diagnosis, and quality of care at treatment and the quality of received care compared with another person.

RESULTS

Participants are representative of the Southern Community Cohort Study (SCCS) of adults diagnosed with breast (n = 263), prostate (n = 195), lung (n = 46), colorectal (n = 105), or other cancers (n = 526). This study includes cancer survivors who completed the SCCS Baseline and Cancer Navigation Surveys in urban (73.13%) and rural (26.87%) areas. White participants reported a higher quality of received care for testing or diagnosis and care for treatment compared with Black participants. Participants with high school or equivalent education (odds ratio, 1.662; 95% confidence interval, 1.172-2.356; P = .0044) or some college or junior college education (odds ratio, 1.970; 95% confidence interval, 1.348-2.879; P = .0005) were more likely to report a better level of quality of received care for treatment.

CONCLUSIONS

The SCCS represents individuals who are historically underrepresented in cancer research. The results of this study will have broad implications across diverse communities to reduce disparities and inform models of care.

IMPLICATIONS FOR PRACTICE

Nurses are positioned to evaluate the quality of population health and design and lead interventions that will benefit underserved and underresourced communities.

摘要

背景

健康的社会决定因素认为,负面结果受到生活在服务不足和资源匮乏社区的个人的影响。

目的

本研究调查了疾病发作和治疗时的癌症诊断、种族/族裔、年龄、地理位置(居住地)、教育程度和社会经济地位因素。

方法

对检测或诊断时的护理质量、治疗时的护理质量以及与他人相比所接受护理的质量进行多变量泊松回归分析。

结果

参与者代表了南方社区队列研究(SCCS)中被诊断患有乳腺癌(n = 263)、前列腺癌(n = 195)、肺癌(n = 46)、结直肠癌(n = 105)或其他癌症(n = 526)的成年人。本研究包括在城市(73.13%)和农村(26.87%)地区完成SCCS基线和癌症导航调查的癌症幸存者。与黑人参与者相比,白人参与者报告在检测或诊断以及治疗护理方面所接受护理的质量更高。接受过高中或同等教育的参与者(优势比,1.662;95%置信区间,1.172 - 2.356;P = .0044)或接受过一些大学或大专教育的参与者(优势比,1.970;95%置信区间,1.348 - 2.879;P = .0005)更有可能报告在治疗护理方面所接受护理的质量更高。

结论

SCCS代表了在癌症研究中历史上代表性不足的人群。本研究结果将对不同社区产生广泛影响,以减少差异并为护理模式提供信息。

对实践的启示

护士有能力评估人群健康质量,并设计和领导有益于服务不足和资源匮乏社区的干预措施。

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