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澳大利亚地区头颈癌幸存者的医疗保健利用情况及未满足的需求:一项横断面调查。

Health Care Utilisation and Unmet Needs in Survivors of Head and Neck Cancer in Regional Australia: A Cross-Sectional Survey.

作者信息

Pradhan Poorva, Sharman Ashleigh R, Lacey Judith, Dwyer Patrick, Hill Jacques, Davis Kimberley J, Craig Steven, Wu Raymond, Ashford Bruce, Mitchell Jenny, Clark Jonathan R, Elliott Michael S, Palme Carsten E, Venchiarutti Rebecca L

机构信息

Department of Head and Neck Surgery, Chris O'Brien Lifehouse, Camperdown, Australia.

Department of Supportive Care and Integrative Oncology, Chris O'Brien Lifehouse, Camperdown, Australia.

出版信息

Psychooncology. 2025 Jan;34(1):e70056. doi: 10.1002/pon.70056.

Abstract

BACKGROUND

The post-treatment survivorship period marks the transition away from acute care and poses distinct challenges for individuals with head and neck cancer (HNC). This can be especially challenging for people in regional areas who travel long distances to access care and experience unique challenges in accessing health services.

AIM

To investigate unmet needs and healthcare utilisation of survivors of HNC in regional areas.

METHODS

Invitations were sent to 619 survivors of HNC living in rural New South Wales, Australia, who were 1-15 years post-treatment. Participants self-reported unmet survivorship needs and the strength of these needs using the Cancer Survivors' Unmet Needs Measure. Health care utilisation over the preceding 12 months was collected using an investigator-designed questionnaire.

RESULTS

One hundred and seventeen responses were received (19% response rate). Participants were predominantly male (65%), had oropharynx cancer (52%), with mean age of 70.2 years. Some 54% of participants reported at least one unmet need, and 40% rated these unmet needs as 'strong'. Top unmet needs included concern about recurrence (24%), access to local services (15%), and financial support (15%). 94% of participants reported seeing their GP, while 62% visited a dental clinic; only 10% sought professional psychosocial support despite prevalent unmet needs.

CONCLUSION

Rural survivors of HNC in Australia have substantial unmet psychosocial needs yet demonstrate low utilisation of professional psychosocial support. This may reflect the limited availability or accessibility of services for this population, which could be addressed with shared models of care utilising both GP-led and telehealth services.

摘要

背景

治疗后的生存期标志着从急性护理的过渡,给头颈癌(HNC)患者带来了独特的挑战。对于居住在偏远地区、需要长途跋涉就医且在获取医疗服务方面面临特殊挑战的人来说,这可能尤其具有挑战性。

目的

调查偏远地区HNC幸存者未满足的需求和医疗服务利用情况。

方法

向居住在澳大利亚新南威尔士州农村、治疗后1至15年的619名HNC幸存者发出邀请。参与者使用癌症幸存者未满足需求量表自行报告未满足的生存需求及其强度。使用研究者设计的问卷收集过去12个月的医疗服务利用情况。

结果

共收到117份回复(回复率为19%)。参与者主要为男性(65%),患有口咽癌(52%),平均年龄为70.2岁。约54%的参与者报告至少有一项未满足的需求,40%将这些未满足的需求评为“强烈”。未满足的主要需求包括对复发的担忧(24%)、获得当地服务(15%)和经济支持(15%)。94%的参与者报告看过全科医生,62%去过牙科诊所;尽管存在普遍未满足的需求,但只有10%的人寻求专业的心理社会支持。

结论

澳大利亚农村地区的HNC幸存者有大量未满足的心理社会需求,但专业心理社会支持的利用率较低。这可能反映了该人群服务的可获得性或可及性有限,可通过利用全科医生主导和远程医疗服务的共享护理模式来解决。

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