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纳戈尔诺-卡拉巴赫共和国冲突影响地区患者获得癌症护理的障碍:一项定性研究。

Barriers to access to cancer care for patients from the conflict-affected region of the Nagorno-Karabakh Republic: A qualitative study.

作者信息

Hovhannisyan Alina, Philip Celene, Arakelyan Jemma, Tamamyan Gevorg, Arakelyan Stella

机构信息

Institute of Cancer and Crisis, Hematology Center After Prof. R. Yeolyan, Yerevan, Armenia.

Department of Chemistry, Hong Kong Special Administrative Region, City University of Hong Kong, Hong Kong, China.

出版信息

PLOS Glob Public Health. 2024 Jul 1;4(7):e0003243. doi: 10.1371/journal.pgph.0003243. eCollection 2024.

Abstract

Access to essential health services is a basic human right, yet many cancer patients living in conflict-affected regions face multiple obstacles to service use. The (former) Nagorno-Karabakh Republic was a conflict-affected region in the South Caucasus populated predominantly by ethnic Armenians. Multiple acute armed conflicts, the recent military occupation of the region, and the prolonged military blockade of the Lachin Corridor (a humanitarian corridor connecting Nagorno-Karabakh to Armenia) exacerbated existing social, health, economic, and political fragilities in this region. As a result, cancer services were disrupted, with limited clarity on how the ongoing military blockade of a humanitarian corridor affected cancer patients' experiences of accessing cancer care locally and in bordering Armenia. Our study aimed to describe the experiences of patients from Nagorno-Karabakh in accessing the cancer care services they needed. We conducted remote semi-structured interviews with adult (aged ≥18 years) cancer patients receiving cancer care from three university hospitals in Armenia and face-to-face interviews with cancer care professionals from these hospitals. Interviews were conducted during the blockade of the Lachin Corridor between March and May 2023. Data were analysed thematically using a deductive approach. Twelve adult cancer patients (9 women) and 12 cancer care professionals participated. A key barrier to accessing cancer services was attributed to the Azerbaijani military occupation of the region and the blockade of a major roadway connecting Nagorno-Karabakh to Armenia. Patients talked in length about the challenges of finding transport and travelling long distances to reach essential cancer services in Armenia. Policies of free anti-cancer medication provision and decentralised medication supply were paused because of the military occupation, affecting patients' timely access to anti-cancer medication. Out-of-pocket expenses for treatment, anti-cancer medication, travel, and temporary accommodation in Armenia placed a significant financial burden on cancer patients, exacerbated by the humanitarian crisis. Conflict-affected regions blockaded by military forces lack the capacity and targeted support to sustain their essential health services and provide care to those in need of life-saving treatments. Coordinated action from national and international organisations and governments is urgently needed to enhance humanitarian assistance and healthcare support to patients, their families and wider communities affected by military blockades and armed conflicts.

摘要

获得基本医疗服务是一项基本人权,但许多生活在受冲突影响地区的癌症患者在使用医疗服务时面临多重障碍。(前)纳戈尔诺-卡拉巴赫共和国是南高加索地区一个受冲突影响的地区,主要居住着亚美尼亚族。多次激烈的武装冲突、该地区最近的军事占领以及对拉钦走廊(连接纳戈尔诺-卡拉巴赫与亚美尼亚的人道主义走廊)的长期军事封锁加剧了该地区现有的社会、健康、经济和政治脆弱性。结果,癌症服务中断,目前尚不清楚对人道主义走廊的持续军事封锁如何影响癌症患者在当地和邻国亚美尼亚获得癌症治疗的经历。我们的研究旨在描述纳戈尔诺-卡拉巴赫患者在获得所需癌症护理服务方面的经历。我们对亚美尼亚三家大学医院接受癌症治疗的成年(年龄≥18岁)癌症患者进行了远程半结构化访谈,并对这些医院的癌症护理专业人员进行了面对面访谈。访谈于2023年3月至5月拉钦走廊被封锁期间进行。采用演绎法对数据进行了主题分析。12名成年癌症患者(9名女性)和12名癌症护理专业人员参与了研究。获得癌症服务的一个关键障碍归因于阿塞拜疆对该地区的军事占领以及连接纳戈尔诺-卡拉巴赫与亚美尼亚的一条主要道路的封锁。患者详细谈到了寻找交通工具以及长途跋涉前往亚美尼亚获得基本癌症服务的挑战。由于军事占领,免费提供抗癌药物和分散药物供应的政策暂停,影响了患者及时获得抗癌药物。在亚美尼亚,治疗、抗癌药物、交通和临时住宿的自付费用给癌症患者带来了沉重的经济负担,人道主义危机使这种负担更加严重。受军事力量封锁的受冲突影响地区缺乏维持其基本医疗服务并为需要救命治疗的人提供护理的能力和针对性支持。国家和国际组织及政府迫切需要采取协调行动,加强对受军事封锁和武装冲突影响的患者、其家人及更广泛社区的人道主义援助和医疗支持。

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6
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7
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8
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Soc Sci Med. 2021 Dec;291:114473. doi: 10.1016/j.socscimed.2021.114473. Epub 2021 Oct 9.

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