Drivers and barriers to health-seeking behaviors and interactions: a qualitative study of Black patients with lung cancer and with peripheral artery disease.

IF 2.4 4区 医学 Q1 MEDICINE, GENERAL & INTERNAL
Lisa Dwyer Orr, Kay Sadik, Kathleen Beusterien, Stephanie Loomer, Kristen King-Concialdi, Kathryn Krupsky, Elizabeth Brighton, Lee Kirksey, Narjust Florez
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Abstract

Objective: To identify factors that may influence health-seeking behaviors and health system interactions from the perspective of Black patients with lung cancer (LC) or peripheral artery disease (PAD).

Methods: Semi-structured interviews were conducted virtually with Black patients in the United States. Thematic analysis of interview transcripts was performed. The Sense-Think-ACT-Relate (STAR) behavioral framework was used to map emerging themes of drivers and barriers to health-seeking behaviors and health system interactions.

Results: Thirty Black patients with LC (n = 15) and PAD (n = 15) participated in this study. The mean age of participants was 53.4 years, 22 were female, and half lived in an urban area or large city. Factors that shape health-seeking behaviors spanned several framework domains including Trust, Rational and Emotional Associations, Cultural, and Situational. Having a provider who was friendly, knowledgeable, and understood the patient's lived experience was a key driver to seeking care. Barriers to care included patients not recognizing disease symptoms, reservations about seeking care, having previous negative interactions with healthcare systems, and feeling stigmatized or excluded. Situational influences, such as financial cost of accessing and receiving healthcare, also acted as barriers. Similar themes emerged for the LC versus PAD cohorts.

Conclusion: Multiple drivers and barriers to health-seeking behaviors exist for Black patients with LC versus PAD, including patients' perceptions of previous health system interactions. Because of known inequities experienced by Black patients, these results highlight the need for interventions that address more than just medical needs but that also encourage patients to seek care when they experience early symptoms and prioritize establishing patient-provider relationships built on trust, respect, and cultural understanding.

寻求健康行为和相互作用的驱动因素和障碍:肺癌和外周动脉疾病黑人患者的定性研究
目的:从黑人肺癌(LC)或外周动脉疾病(PAD)患者的角度探讨影响其就医行为和卫生系统相互作用的因素。方法:对美国黑人患者进行半结构化访谈。对访谈笔录进行专题分析。使用感知-思考-行动-关联(STAR)行为框架来绘制新出现的主题,即寻求健康行为和卫生系统互动的驱动因素和障碍。结果:30例黑人LC (n = 15)和PAD (n = 15)患者参与了本研究。参与者的平均年龄为53.4岁,22人是女性,一半居住在城市地区或大城市。塑造健康寻求行为的因素跨越了几个框架领域,包括信任、理性和情感联系、文化和情境。有一个友好、知识渊博、了解病人生活经历的提供者是寻求治疗的关键驱动力。治疗障碍包括患者不认识疾病症状,对寻求治疗持保留态度,以前与医疗保健系统有负面互动,感觉被污名化或被排斥。环境影响,如获得和接受医疗保健的财务成本,也成为障碍。LC组和PAD组也出现了类似的主题。结论:黑人LC与PAD患者的就医行为存在多种驱动因素和障碍,包括患者对以往卫生系统互动的看法。由于黑人患者所经历的不平等,这些结果强调了干预措施的必要性,不仅要解决医疗需求,还要鼓励患者在出现早期症状时寻求治疗,并优先建立建立在信任、尊重和文化理解基础上的医患关系。
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来源期刊
Current Medical Research and Opinion
Current Medical Research and Opinion 医学-医学:内科
CiteScore
4.40
自引率
4.30%
发文量
247
审稿时长
3-8 weeks
期刊介绍: Current Medical Research and Opinion is a MEDLINE-indexed, peer-reviewed, international journal for the rapid publication of original research on new and existing drugs and therapies, Phase II-IV studies, and post-marketing investigations. Equivalence, safety and efficacy/effectiveness studies are especially encouraged. Preclinical, Phase I, pharmacoeconomic, outcomes and quality of life studies may also be considered if there is clear clinical relevance
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