Frej Khaoula Ben Haj, Hardy Nicole, Whitcomb Bradford
University of Connecticut School of Medicine, 263 Farmington Ave, Farmington, CT, 06030, USA.
Division of Gynecologic Oncology, John Dempsey Hospital, Farmington, CT, USA.
J Cancer Educ. 2025 Apr;40(2):280-289. doi: 10.1007/s13187-024-02510-0. Epub 2024 Sep 24.
Obstetrics and Gynecology (Ob/Gyn) residents will encounter, screen for, and diagnose gynecologic malignancies. This survey assessed residents' confidence in providing NCCN Guidelines-based care to Gynecologic Oncology patients of differing racial/ethnic backgrounds and insurance statuses while accounting for residents' backgrounds. An anonymous, novel Qualtrics survey was disseminated to current US Ob/Gyn residents, with multiple-choice questions about subject demographics and Likert scale questions about their readiness to care for diverse patients. Differences in responses between racial groups were analyzed using the Kruskal-Wallis Rank Sum test. Differences in responses between ethnic groups were evaluated using the Wilcoxon Rank Sum test. Regardless of their backgrounds, residents feel "somewhat prepared" to care for diverse patients. There was no statistical between ethnic groups regarding confidence in caring for racial minorities or insurance types. Similarly, there was no statistical difference between racial groups regarding caring for racial minorities, but a difference did exist for insurance types (p = 0.027). No significant racial/ethnic differences were found in opinions on trial enrollment or chemotherapy delays, though most residents agreed that racial/ethnic minorities face delays in chemotherapy. Finally, resident ethnicity and race both impacted resident perceptions of difficulties for Medicaid and minority patients in obtaining non-operative gynecologic care (p = 0.044; p = 0.017) and scheduling outpatient appointments (p = 0.016; p = 0.032). Ob/Gyn residents feel prepared to provide NCCN Guidelines-based care to socioeconomically diverse patients with gynecologic malignancies, though differences exist when accounting for residents' racial/ethnic backgrounds. These results reflect the importance of emphasizing on culturally competent care in residency, particularly for patients with cancer.
妇产科住院医师会遇到、筛查并诊断妇科恶性肿瘤。这项调查评估了住院医师在为不同种族/族裔背景和保险状况的妇科肿瘤患者提供基于美国国立综合癌症网络（NCCN）指南的治疗时的信心，同时考虑了住院医师的背景。一项匿名的新型Qualtrics调查被分发给了美国目前的妇产科住院医师，其中包括关于受试者人口统计学的多项选择题以及关于他们照顾不同患者准备情况的李克特量表问题。使用Kruskal-Wallis秩和检验分析种族群体之间的回答差异。使用Wilcoxon秩和检验评估族裔群体之间的回答差异。无论背景如何，住院医师都觉得自己“有点准备好”照顾不同的患者。在照顾少数族裔或保险类型方面，族裔群体之间没有统计学差异。同样，在照顾少数族裔方面，种族群体之间没有统计学差异，但在保险类型方面存在差异（p = 0.027）。在试验入组或化疗延迟的意见方面未发现显著的种族/族裔差异，不过大多数住院医师同意少数族裔在化疗方面面临延迟。最后，住院医师的族裔和种族都影响了他们对医疗补助患者和少数族裔患者在获得非手术妇科护理方面的困难的看法（p = 0.044；p = 0.017）以及安排门诊预约方面的困难的看法（p = 0.016；p = 0.032）。妇产科住院医师觉得自己有准备为社会经济背景不同的妇科恶性肿瘤患者提供基于NCCN指南的治疗，不过在考虑住院医师的种族/族裔背景时存在差异。这些结果反映了在住院医师培训中强调文化胜任力护理的重要性，尤其是对于癌症患者。
