Department of Psychiatry and Behavioral Health, Pennsylvania State University College of Medicine, 500 University Drive, Hershey, PA 17033, USA.
Department of Psychiatry and Behavioral Health, Pennsylvania State University College of Medicine, 500 University Drive, Hershey, PA 17033, USA; Penn State Cancer Institute, 500 University Drive, Hershey, PA 17033, USA; Department of Medicine, Pennsylvania State University College of Medicine, 500 University Drive, Hershey, PA 17033, USA.
J Cancer Policy. 2024 Dec;42:100508. doi: 10.1016/j.jcpo.2024.100508. Epub 2024 Sep 30.
The study aimed to gain insight into the experiences of patients with cancer and survivors regarding the integration of social needs assessment into their care, while also gathering perspectives from patient navigators on the barriers to obtaining and utilizing social needs information during cancer care, which taken together may influence cancer care policies. By comparing the perspectives of patients and navigators, the study sought to inform best practices for integrating, identifying, and addressing social needs to improve patient experiences and outcomes.
We conducted qualitative interviews and self-report surveys involving patients with cancer, providers, and patient navigators or care coordinators, seeking their insights and firsthand experiences related to health-related social needs in cancer care. Interviews were transcribed, separated into memos of main themes based on deductive coding, and further analyzed for new emergent themes using inductive coding.
The present analysis focuses solely on the perspectives of 20 patient navigators and 21 patients. Qualitative analyses revealed two overarching themes: Theme 1: Personal and health system-related factors may create barriers for patients to disclose health-related social needs information during cancer care; and Theme 2: When social needs are identified, it is best practice to acknowledge and address social needs through referrals, resources, timely follow-up, and continued care coordination. Key barriers include individual beliefs and attitudes, concerns regarding privacy and sensitivity of questions, uncertainties about the outcomes of disclosing information, and patient-provider relationships and trust.
Drawing upon the perspectives of patients and patient navigators provided valuable insight into the challenges associated with acquiring information on social needs. Their viewpoints presented feasible solutions to overcome barriers through early acknowledgment of patient needs, timely resource provision, and maintaining consistent follow-up actions. Additionally, it enhanced understanding of the pivotal role patient navigators play in oncology, serving as crucial links between screening for health-related social needs and addressing individual patient requirements.
The policies and policy improvements our paper seeks to impact include: inequalities in cancer care and health-related social needs of cancer.
本研究旨在深入了解癌症患者和幸存者在将社会需求评估纳入其治疗过程中的体验，同时收集患者导航员在癌症护理过程中获取和利用社会需求信息方面所面临的障碍的观点，这些信息可能共同影响癌症护理政策。通过比较患者和导航员的观点，本研究旨在为整合、识别和解决社会需求提供最佳实践，以改善患者体验和结果。
我们进行了定性访谈和自我报告调查，涉及癌症患者、提供者以及患者导航员或护理协调员，以了解他们在癌症护理中与健康相关的社会需求方面的见解和第一手经验。访谈记录被转录，并根据演绎编码分为主要主题的备忘录，然后使用归纳编码进一步分析新出现的主题。
本分析仅侧重于 20 名患者导航员和 21 名患者的观点。定性分析揭示了两个总体主题：主题 1：个人和医疗系统相关因素可能会导致患者在癌症护理过程中难以披露与健康相关的社会需求信息；主题 2：当识别出社会需求时，最佳实践是通过转介、资源、及时的后续行动和持续的护理协调来承认和解决社会需求。主要障碍包括个人信念和态度、对问题的隐私和敏感性的担忧、对披露信息结果的不确定性，以及患者与提供者的关系和信任。
借鉴患者和患者导航员的观点，深入了解了获取社会需求信息所面临的挑战。他们的观点提出了通过早期承认患者的需求、及时提供资源以及保持持续的后续行动来克服障碍的可行解决方案。此外，它增强了对患者导航员在肿瘤学中所扮演的关键角色的理解，他们是筛查与健康相关的社会需求和满足个体患者需求之间的重要纽带。
本文旨在影响的政策和政策改进包括：癌症护理中的不平等和癌症患者的健康相关社会需求。
