دورية أكاديمية
Disparities Associated with Decision to Undergo Oncologic Surgery: A Prospective Mixed-Methods Analysis.
العنوان: | Disparities Associated with Decision to Undergo Oncologic Surgery: A Prospective Mixed-Methods Analysis. |
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المؤلفون: | Van Haren RM; University of Cincinnati Cancer Center, University of Cincinnati College of Medicine, Cincinnati, OH, USA. vanharrm@ucmail.uc.edu., Kovacic MB; University of Cincinnati Cancer Center, University of Cincinnati College of Medicine, Cincinnati, OH, USA.; Department of Rehabilitation, Exercise, and Nutrition Sciences, University of Cincinnati College of Allied Health Sciences, Cincinnati, OH, USA.; Department of Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, USA., Delman AM; University of Cincinnati Cancer Center, University of Cincinnati College of Medicine, Cincinnati, OH, USA., Pratt CG; University of Cincinnati Cancer Center, University of Cincinnati College of Medicine, Cincinnati, OH, USA., Griffith A; University of Cincinnati Cancer Center, University of Cincinnati College of Medicine, Cincinnati, OH, USA., Arbili L; University of Cincinnati Cancer Center, University of Cincinnati College of Medicine, Cincinnati, OH, USA., Harvey K; University of Cincinnati Cancer Center, University of Cincinnati College of Medicine, Cincinnati, OH, USA., Kohli E; University of Cincinnati Cancer Center, University of Cincinnati College of Medicine, Cincinnati, OH, USA., Pai A; Department of Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, USA., Topalian A; University of Cincinnati Cancer Center, University of Cincinnati College of Medicine, Cincinnati, OH, USA., Rai SN; University of Cincinnati Cancer Center, University of Cincinnati College of Medicine, Cincinnati, OH, USA., Shah SA; University of Cincinnati Cancer Center, University of Cincinnati College of Medicine, Cincinnati, OH, USA., Kues J; University of Cincinnati Cancer Center, University of Cincinnati College of Medicine, Cincinnati, OH, USA. |
المصدر: | Annals of surgical oncology [Ann Surg Oncol] 2024 Sep; Vol. 31 (9), pp. 5757-5764. Date of Electronic Publication: 2024 Jun 13. |
نوع المنشور: | Journal Article |
اللغة: | English |
بيانات الدورية: | Publisher: Springer Country of Publication: United States NLM ID: 9420840 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1534-4681 (Electronic) Linking ISSN: 10689265 NLM ISO Abbreviation: Ann Surg Oncol Subsets: MEDLINE |
أسماء مطبوعة: | Publication: 2005- : New York, NY : Springer Original Publication: New York, NY : Raven Press, c1994- |
مواضيع طبية MeSH: | Physician-Patient Relations* , Healthcare Disparities* , Decision Making* , Trust*, Humans ; Prospective Studies ; Middle Aged ; Male ; Female ; Aged ; Black or African American/statistics & numerical data ; Black or African American/psychology ; Prognosis ; Gastrointestinal Neoplasms/surgery ; Lung Neoplasms/surgery ; Follow-Up Studies ; Cultural Competency ; Communication ; White People/statistics & numerical data ; Minority Groups/statistics & numerical data ; Adult |
مستخلص: | Background: Underrepresented minority patients with surgical malignancies experience disparities in outcomes. The impact of provider-based factors, including communication, trust, and cultural competency, on outcomes is not well understood. This study examines modifiable provider-based barriers to care experienced by patients with surgical malignancies. Methods: A parallel, prospective, mixed-methods study enrolled patients with lung or gastrointestinal malignancies undergoing surgical consultation. Surveys assessed patients' social needs and patient-physician relationship. Semi-structured interviews ascertained patient experiences and were iteratively analyzed, identifying key themes. Results: The cohort included 24 patients (age 62 years; 63% White and 38% Black/African American). The most common cancers were lung (n = 18, 75%) and gastroesophageal (n = 3, 13%). Survey results indicated that food insecurity (n = 5, 21%), lack of reliable transportation (n = 4, 17%), and housing instability (n = 2, 8%) were common. Lack of trust in their physician (n = 3, 13%) and their physician's treatment recommendation (n = 3, 13%) were identified. Patients reported a lack of empathy (n = 3, 13%), lack of cultural competence (n = 3, 13%), and inadequate communication (n = 2, 8%) from physicians. Qualitative analysis identified five major themes regarding the decision to undergo surgery: communication, trust, health literacy, patient fears, and decision-making strategies. Five patients (21%) declined the recommended surgery and were more likely Black (100% vs. 21%), lower income (100% vs. 16%), and reported poor patient-physician relationship (40% vs. 5%; all p < 0.05). Conclusions: Factors associated with declining recommended cancer surgery were underrepresented minority race and poor patient-physician relationships. Interventions are needed to improve these barriers to care and racial disparities. (© 2024. This is a U.S. Government work and not under copyright protection in the US; foreign copyright protection may apply.) |
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فهرسة مساهمة: | Keywords: Cancer disparities; Complex surgical malignancies; Decision-making strategies; Modifiable provider-based barriers; Patient-physician relationships |
تواريخ الأحداث: | Date Created: 20240613 Date Completed: 20240808 Latest Revision: 20240815 |
رمز التحديث: | 20240815 |
مُعرف محوري في PubMed: | PMC11300547 |
DOI: | 10.1245/s10434-024-15610-4 |
PMID: | 38869765 |
قاعدة البيانات: | MEDLINE |
تدمد: | 1534-4681 |
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DOI: | 10.1245/s10434-024-15610-4 |