了解意大利癌症差异的原因:癌症患者和医疗保健提供者障碍和需求的定性研究。

Understanding Reasons for Cancer Disparities in Italy: A Qualitative Study of Barriers and Needs of Cancer Patients and Healthcare Providers.

机构信息

Applied Research Division for Cognitive and Psychological Science, IEO, European Institute of Oncology IRCCS, Milan, Italy.

Laboratory of Behavioral Observation and Research on Human Development, Department of Psychology, Educational Science and Human Movement, University of Palermo, Palermo, Italy.

出版信息

Cancer Control. 2024 Jan-Dec;31:10732748241258589. doi: 10.1177/10732748241258589.

Abstract

BACKGROUND

The second leading cause of death in Italy is cancer. Substantial disparities persist in the level of care and outcomes for cancer patients across various communities, hospitals, and regions in Italy. While substantial progress has been made in medical research and treatment options, these advancements tend to disproportionately benefit the wealthier, better-educated, and more privileged areas and portions of the population. Therefore, the primary aim of the current study is to explore possible reasons for inequalities in access to and utilisation of care from the perspective of cancer patients, who are recipients of these treatments, and healthcare providers, who are responsible for their administration.

METHODS

After being recruited through social media platforms, patients' organisations, and hospital websites, cancer patients (n = 22) and healthcare providers (n = 16) from various Italian regions participated in online focus group discussions on disparities in access to and provision of care. Video and audio recordings of the interviews were analysed using Thematic analysis.

RESULTS

Among cancer patients, 7 themes were identified, while 6 themes emerged from the healthcare providers highlighting encountered barriers and unmet needs in cancer care. Most of these emerging themes are common to both groups, such as geographical disparities, information deficiencies, and the importance of psycho-oncological support. However, several themes are specific to each group, for instance, cancer patients highlight the financial burden and the poor interactions with healthcare providers, while healthcare providers emphasise the necessity of establishing a stronger specialists' network and integrating clinical practice and research.

CONCLUSION

Current findings reveal persistent challenges in cancer care, including long waiting lists and regional disparities, highlighting the need for inclusive healthcare strategies. The value of psycho-oncological support is underscored, as well as the potential of the Internet's use for informational needs, emphasising the imperative for improved awareness and communication to overcome disparities in cancer care.

摘要

背景

意大利的第二大死亡原因是癌症。在意大利的各个社区、医院和地区,癌症患者的护理水平和治疗效果存在着显著的差异。尽管在医学研究和治疗方案方面取得了重大进展,但这些进展往往更有利于富裕、受教育程度更高和更有特权的地区和人群。因此,目前的研究主要目的是从接受这些治疗的癌症患者和负责治疗的医疗保健提供者的角度,探讨获得和利用医疗服务方面不平等的可能原因。

方法

通过社交媒体平台、患者组织和医院网站招募后,来自意大利不同地区的癌症患者(n=22)和医疗保健提供者(n=16)参加了关于获得和提供医疗服务方面差异的在线焦点小组讨论。使用主题分析对访谈的视频和音频记录进行分析。

结果

在癌症患者中,确定了 7 个主题,而医疗保健提供者则确定了 6 个主题,突出了癌症护理中遇到的障碍和未满足的需求。这些新出现的主题中,大多数在两组中都很常见,如地理差异、信息不足和心理肿瘤支持的重要性。然而,有几个主题是每个组特有的,例如,癌症患者强调财务负担和与医疗保健提供者的不良互动,而医疗保健提供者则强调建立更强的专家网络和整合临床实践和研究的必要性。

结论

目前的研究结果揭示了癌症护理中存在的持续挑战,包括漫长的等候名单和地区差异,这突显了需要采取包容性的医疗保健策略。强调了心理肿瘤支持的价值,以及互联网在满足信息需求方面的潜力,强调了提高认识和沟通以克服癌症护理差距的必要性。

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