Delays, fragmentation, and desire for alternatives: A qualitative study of the patient experience through diagnosis and treatment of endometrial cancer

IF 4.1 2区 医学 Q1 OBSTETRICS & GYNECOLOGY
Bria Johnson , Arianna Milicia , Jennifer Hicks , Ebony Hoskins , Lucile Adams-Campbell , Charlotte Gamble
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引用次数: 0

Abstract

Background

Black patients in the United States have twice the mortality rate from endometrial cancer as their White peers. Washington D.C. has the highest endometrial cancer mortality rate in the nation. The study objective was to assess barriers and facilitators of care in the context of Black patients' experiences during diagnosis, referral, and management of endometrial cancer in Washington D.C.

Methods

Black patients with an endometrial cancer diagnosis who had completed surgery and adjuvant chemotherapy and/or radiation therapy were recruited over a 16-month period. Hour-long semi-structured interviews were conducted, recorded and transcribed. Qualitative analysis of the transcripts was performed and themes distilled from patient experience.

Results

There were 22 patient transcripts that were included in the qualitative analysis. Three core themes related to barriers included: delays to accessing care, fragmentation in the delivery of healthcare, and desire for alternatives to standard of care hysterectomy. Three core themes related to facilitators included: positive role of nurse navigators, streamlined referral process, thorough counseling from surgeon.

Conclusion

Barriers and facilitators to care impact the experience of Black patients undergoing care for endometrial cancer, which may contribute to disparities in outcomes. Future research can leverage patient-identified facilitators to address inequities in endometrial cancer outcomes.
延迟,碎片化和对替代方案的渴望:通过诊断和治疗子宫内膜癌患者经验的定性研究
背景:在美国,黑人患子宫内膜癌的死亡率是白人的两倍。华盛顿特区的子宫内膜癌死亡率是全国最高的。研究目的是评估华盛顿特区黑人患者在诊断、转诊和处理子宫内膜癌过程中的护理障碍和促进因素。方法招募已完成手术和辅助化疗和/或放射治疗的子宫内膜癌诊断的黑人患者,为期16个月。进行了长达一小时的半结构化访谈,并进行了录音和转录。对转录本进行定性分析,并从患者经验中提取主题。结果22份患者转录本被纳入定性分析。与障碍相关的三个核心主题包括:获得护理的延迟、提供保健的碎片化以及对标准护理子宫切除术的替代方案的渴望。与辅导员相关的三个核心主题包括:护士导航员的积极作用,简化的转诊流程,外科医生的彻底咨询。结论护理障碍和辅助因素影响黑人子宫内膜癌患者的护理体验,可能导致预后差异。未来的研究可以利用患者确定的促进因素来解决子宫内膜癌结果的不公平问题。
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来源期刊
Gynecologic oncology
Gynecologic oncology 医学-妇产科学
CiteScore
8.60
自引率
6.40%
发文量
1062
审稿时长
37 days
期刊介绍: Gynecologic Oncology, an international journal, is devoted to the publication of clinical and investigative articles that concern tumors of the female reproductive tract. Investigations relating to the etiology, diagnosis, and treatment of female cancers, as well as research from any of the disciplines related to this field of interest, are published. Research Areas Include: • Cell and molecular biology • Chemotherapy • Cytology • Endocrinology • Epidemiology • Genetics • Gynecologic surgery • Immunology • Pathology • Radiotherapy
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