头颈部伴神经周围浸润的皮肤鳞状细胞癌诊断和治疗途径的定性探索。
A qualitative exploration of the pathway to diagnosis and treatment of cutaneous squamous cell carcinoma of the head and neck with perineural spread.
机构信息
Department of Head and Neck Surgery, Chris O'Brien Lifehouse, Camperdown, New South Wales, Australia.
Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia.
出版信息
Cancer Med. 2024 Aug;13(16):e70118. doi: 10.1002/cam4.70118.
BACKGROUND
Perineural spread (PNS) is associated with a poor prognosis in cutaneous squamous cell carcinoma of the head and neck (cSCCHN). Hence, investigating facilitators and barriers of early diagnosis and treatment of PNS in cSCCHN may improve outcomes.
METHODS
Patients were recruited from an institutional database. Semi-structured interviews were conducted according to the Model of Pathways to Treatment. Thematic analysis was based on the four main intervals in the framework using a data-driven analytical method.
RESULTS
Seventeen participants were interviewed. Facilitators included patients' past experiences, symptom progression, trust in healthcare professionals (HCPs), and capacity to leverage relationships. Barriers included difficult diagnoses, limited access to cancer services, lack of care coordination, and lack of awareness of PNS among primary health care providers.
CONCLUSION
These findings emphasise the complexity early diagnosis and treatment of PNS. Interventions like clinical practice guidelines, education for HCPs, and telehealth could facilitate timely detection and management.
背景
神经周围扩散（PNS）与头颈部皮肤鳞状细胞癌（cSCCHN）的预后不良相关。因此，研究 cSCCHN 中 PNS 的早期诊断和治疗的促进因素和障碍因素可能会改善预后。
方法
患者从机构数据库中招募。根据治疗途径模型进行半结构化访谈。使用数据驱动的分析方法，基于框架中的四个主要间隔进行主题分析。
结果
对 17 名参与者进行了访谈。促进因素包括患者的既往经历、症状进展、对医疗保健专业人员（HCPs）的信任以及利用关系的能力。障碍包括诊断困难、癌症服务机会有限、缺乏护理协调以及初级保健提供者对 PNS 的认识不足。
结论
这些发现强调了早期诊断和治疗 PNS 的复杂性。临床实践指南、HCP 教育和远程医疗等干预措施可以促进及时发现和管理。
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