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在 COVID-19 期间,护理中断的差异及其对癌症幸存者身心健康的影响。

Disparities in the Care Disruption During COVID-19 and in its Impacts on the Mental and Physical Well-Being of Cancer Survivors.

机构信息

School of Nursing, Department of Research and Scholarship, Columbia University, New York City, NY, USA.

出版信息

Am J Health Promot. 2024 Nov;38(8):1188-1198. doi: 10.1177/08901171241262224. Epub 2024 Jun 15.

Abstract

PURPOSE

Our study explores cancer care disruption among different demographic subgroups. It also investigates these disruptions' impacts on cancer survivors' mental and physical well-being.

DESIGN

Pooled cross-sectional survey data.

SETTING

Health Information Trends Survey for Surveillance Epidemiology and End Results, HINTS-SEER.

PARTICIPATION

n = 1234 cancer survivors participated in the study and completed the survey

MEASURES

Outcome variables were treatment disruption in cancer care, mental health and physical health perceptions, age, race, education, income, and sexual orientation.

ANALYSIS

Multiple imputations were used to address missing data. Descriptive statistics were conducted to understand the perceptions of care disruption. Partial least squares structural equation models were employed for data analysis, adjusted for socio-demographics.

RESULTS

COVID-19 impacted cancer treatment and follow-up appointments (69.45%), routine cancer screening (60.70%), and treatment plans (73.58%), especially among elderly patients. It changed the interactions with health care providers (HCP) for 28.03% of the participants. Older adults were 2.33 times more likely to experience treatment appointment disruptions. People who thought their contact with their doctors changed during COVID-19 were more likely to be older adults (65 or more) (OR = 3.85, = .011), white (OR >1, = .002), and with higher income (OR = 1.81, = .002). The changes to cancer treatment and follow-up medical appointments negatively impacted the well-being of the patients (mental: β = -.006, = .043; physical: β = -.001, = .006), routine screening and preventative care visits (mental: β = -.029, = .031; physical: β = -.003, = .008), and cancer treatment plans (mental: β = -.044, = .024; physical: β = -.021, = .040).

CONCLUSIONS

Our findings underscore the crucial requirement for implementing focused interventions aimed at alleviating the discrepancies in the accessibility of cancer care across diverse demographic groups, particularly during times of emergency, in order to mitigate any potential disruptions in care.

摘要

目的

本研究探讨了不同人口统计学亚组中癌症护理的中断情况。还调查了这些中断对癌症幸存者身心健康的影响。

设计

汇总的横断面调查数据。

设置

健康信息趋势调查监测流行病学和结局,HINTS-SEER。

参与者

1234 名癌症幸存者参加了这项研究,并完成了调查。

措施

结果变量是癌症护理中断、心理健康和身体健康感知、年龄、种族、教育、收入和性取向。

分析

使用多重插补处理缺失数据。进行描述性统计以了解护理中断的感知。使用偏最小二乘结构方程模型进行数据分析,根据社会人口统计学进行调整。

结果

COVID-19 影响了癌症治疗和随访预约(69.45%)、常规癌症筛查(60.70%)和治疗计划(73.58%),尤其是老年患者。它改变了 28.03%的参与者与医疗保健提供者的互动。年龄较大的人经历治疗预约中断的可能性高 2.33 倍。认为在 COVID-19 期间与医生的接触发生变化的人更有可能是老年人(65 岁或以上)(OR=3.85, =.011)、白人(OR>1, =.002)和高收入者(OR=1.81, =.002)。癌症治疗和随访医疗预约的变化对患者的健康产生了负面影响(心理:β=-.006, =.043;身体:β=-.001, =.006)、常规筛查和预防保健就诊(心理:β=-.029, =.031;身体:β=-.003, =.008)和癌症治疗计划(心理:β=-.044, =.024;身体:β=-.021, =.040)。

结论

我们的研究结果强调了在紧急情况下,需要实施有针对性的干预措施,以缓解不同人口统计学群体之间癌症护理可及性方面的差异,以减轻护理中断的任何潜在影响。

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