Guidry J J, Aday L A, Zhang D, Winn R J
Department of Health and Kinesiology, Texas A & M University, College Station 77843, USA.
Cancer Pract. 1997 Nov-Dec;5(6):361-6.
Patients with cancer must overcome many psychological, social, and economic barriers to obtain needed treatment. Because of the need for repeated visits for cancer treatment on either an outpatient or an inpatient basis, one of the major issues that patients with cancer must confront is that of arranging for transportation to care.
This study compares the distance and mode of transportation to radiotherapy and chemotherapy and perceptions of transportation as a barrier to care among white, black, and Hispanic cancer patients receiving treatment from a consortium of cancer treatment facilities in Texas. A mail questionnaire was developed to assess the perceived barriers to cancer treatment for patients who had been diagnosed clinically with breast, colon, cervical, or prostate cancer, or lymphoma between 1989 and 1993. A total of 910 surveys were mailed to prospective participants. Of the surveys mailed, 593 were returned, yielding a 65.2% response rate. By race, the respondents included whites (42%), blacks (40%), Hispanics (15%), and Asian-Pacific Islanders (3%). Two respondents were 17 years of age; the remaining respondents were 18 years or older.
This study shows that some patients may forgo needed treatment because of problems with transportation. This was perceived as an issue more for minority patients than for white patients. Black and Hispanic patients consistently reported that barriers such as distance, access to an automobile, and availability of someone to drive them to the treatment center were potential major problems. The distance to the facilities was farther for whites than for blacks and Hispanics. Patients generally had to travel farther for chemotherapy than for radiotherapy.
Patients, particularly minorities, may opt to forgo needed care in the absence of available and affordable means of transportation to treatment facilities. These findings demonstrate the need for healthcare providers to be aware of the transportation problems that patients with cancer experience in obtaining treatment. Healthcare providers must work with patients, their families, and volunteer agencies in the community to facilitate transportation to cancer treatment services.
癌症患者必须克服许多心理、社会和经济障碍才能获得所需治疗。由于癌症治疗需要患者门诊或住院反复就诊，因此癌症患者必须面对的一个主要问题是安排前往就医的交通。
本研究比较了得克萨斯州癌症治疗机构联盟中接受治疗的白人、黑人及西班牙裔癌症患者前往放疗和化疗地点的距离及交通方式，以及对交通作为就医障碍的看法。针对1989至1993年间临床诊断为乳腺癌、结肠癌、宫颈癌、前列腺癌或淋巴瘤的患者，设计了一份邮寄调查问卷，以评估其感知到的癌症治疗障碍。共向潜在参与者邮寄了910份调查问卷。在邮寄的调查问卷中，有593份被退回，回复率为65.2%。按种族划分，受访者包括白人（42%）、黑人（40%）、西班牙裔（15%）和亚太岛民（3%）。两名受访者为17岁；其余受访者均为18岁及以上。
本研究表明，一些患者可能因交通问题而放弃所需治疗。少数族裔患者比白人患者更认为这是一个问题。黑人和西班牙裔患者一直报告称，距离、能否使用汽车以及是否有人开车送他们去治疗中心等障碍可能是主要问题。白人前往治疗机构的距离比黑人和西班牙裔更远。患者前往化疗的路程通常比放疗更远。
如果没有可行且负担得起的前往治疗机构的交通方式，患者尤其是少数族裔患者可能会选择放弃所需治疗。这些发现表明医疗服务提供者需要意识到癌症患者在获得治疗过程中所面临的交通问题。医疗服务提供者必须与患者及其家人以及社区志愿机构合作，以便利患者前往接受癌症治疗服务。
