School of Industrial Engineering, Purdue University, West Lafayette, IN, United States of America.
Independent Scholar, Bremerton, WA, United States of America.
PLoS One. 2024 Oct 24;19(10):e0312547. doi: 10.1371/journal.pone.0312547. eCollection 2024.
Despite improvements in early detection and therapeutic interventions, the mortality rate for Black breast cancer patients is still significantly higher than that of White breast cancer patients. This study seeks to understand differences in the patient experience that lead to this disparity. Semi-structured interviews were conducted to understand the breast cancer treatment process and patient experiences. This study collected health services and timeline data from medical records. Based on these two data sources, the patient's journey in breast cancer treatment was mapped and a thematic analysis was conducted to identify challenges and barriers in the process. The cancer care continuum consists of four stages-diagnosis, surgery, chemotherapy/radiation, and follow-up care. The themes contributing to patient experiences and challenges were identified and compared in each stage for both Black and White patients. Both Black and White participants faced challenges related to financial constraints, treatment changes, lack of autonomy, and insufficient emotional support. However, Black participants additionally faced significant barriers in terms of cultural concordance, effective patient-provider communication, and delay in diagnosis. This study highlights the importance of incorporating effective provider-patient communication, navigation, and emotional support, especially for Black breast cancer patients throughout the cancer care continuum to address healthcare disparities.
尽管早期检测和治疗干预有所改善，但黑人乳腺癌患者的死亡率仍然明显高于白人乳腺癌患者。本研究旨在了解导致这种差异的患者体验差异。进行了半结构化访谈，以了解乳腺癌治疗过程和患者体验。本研究从病历中收集了卫生服务和时间线数据。基于这两个数据源，绘制了患者在乳腺癌治疗中的旅程，并进行了主题分析，以确定过程中的挑战和障碍。癌症护理连续体包括四个阶段——诊断、手术、化疗/放疗和随访护理。确定了导致患者体验和挑战的主题，并在每个阶段对黑人和白人患者进行了比较。黑人和白人参与者都面临与经济限制、治疗变化、缺乏自主权和情感支持不足相关的挑战。然而，黑人参与者还面临着文化一致性、有效医患沟通和诊断延迟方面的重大障碍。本研究强调了在癌症护理连续体中为黑人乳腺癌患者提供有效医患沟通、导航和情感支持的重要性，以解决医疗保健差距问题。
