Social determinants of health and lung cancer surgery: a qualitative study.
Social determinants of health and lung cancer surgery: a qualitative study.
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DOI：
10.3389/fpubh.2023.1285419
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发表时间：
2023
影响因子：
5.2
通讯作者：
Sun, Virginia
中科院分区：
文献类型：
--
作者：
Teteh, Dede K.;Ferrell, Betty;Okunowo, Oluwatimilehin;Downie, Aidea;Erhunmwunsee, Loretta;Montgomery, Susanne B.;Raz, Dan;Kittles, Rick;Kim, Jae Y.;Sun, Virginia
关键词：
健康社会决定因素（SDOH）是可能影响癌症患者预后的非临床因素。本研究旨在探讨SDOH因素对肺癌手术患者生活质量（QOL）相关结局的影响。13名患者被邀请参加一项二元自我管理干预的随机试验，并同意在研究结束时（出院后3个月）参加半结构化的关键信息访谈。使用传统的内容分析方法来确定从访谈中得出的代码和主题。独立调查人员对定性数据进行编码，随后由第二组独立调查人员加以确认。最后确定了主题，审查和解决了差异。出现了六个主题，每个主题又有几个副主题。总体而言，大多数参与者了解SDOH的概念，并认为提供者对SDOH信息的认识对于提供全面的外科护理很重要。一些参与者描述了治疗期间的财务挑战，这些挑战因癌症诊断而加剧，导致压力和糟糕的生活质量。人们对教育的感知影响各不相同，包括其在医疗保健系统导航、健康行为决策和更多经济流动性机会方面的重要性。由于保险范围、旅行负担以及担心因退休而失去高质量保险，一些与会者在获得医疗保健方面遇到了障碍。邻里和建筑环境因素，如安全、空气质量、获得绿色空间和其他环境因素被认为对生活质量很重要。来自家庭/朋友和精神/宗教团体的社会支持被认为对术后恢复很重要。在肺癌手术患者中，SDOH因素可以影响患者的生活质量和生存历程。重要的是，应该对SDOH进行常规评估，以确定五个领域中未满足需求的患者。需要sdoh驱动的干预措施来解决这些未满足的需求，并改善肺癌手术患者的生活质量和护理质量。
Social determinants of health (SDOH) are non-clinical factors that may affect the outcomes of cancer patients. The purpose of this study was to describe the influence of SDOH factors on quality of life (QOL)-related outcomes for lung cancer surgery patients. Thirteen patients enrolled in a randomized trial of a dyadic self-management intervention were invited and agreed to participate in semi-structured key informant interviews at study completion (3 months post-discharge). A conventional content analysis approach was used to identify codes and themes that were derived from the interviews. Independent investigators coded the qualitative data, which were subsequently confirmed by a second group of independent investigators. Themes were finalized, and discrepancies were reviewed and resolved. Six themes, each with several subthemes, emerged. Overall, most participants were knowledgeable about the concept of SDOH and perceived that provider awareness of SDOH information was important for the delivery of comprehensive care in surgery. Some participants described financial challenges during treatment that were exacerbated by their cancer diagnosis and resulted in stress and poor QOL. The perceived impact of education varied and included its importance in navigating the healthcare system, decision-making on health behaviors, and more economic mobility opportunities. Some participants experienced barriers to accessing healthcare due to insurance coverage, travel burden, and the fear of losing quality insurance coverage due to retirement. Neighborhood and built environment factors such as safety, air quality, access to green space, and other environmental factors were perceived as important to QOL. Social support through families/friends and spiritual/religious communities was perceived as important to postoperative recovery. Among lung cancer surgery patients, SDOH factors can impact QOL and the patient’s survivorship journey. Importantly, SDOH should be assessed routinely to identify patients with unmet needs across the five domains. SDOH-driven interventions are needed to address these unmet needs and to improve the QOL and quality of care for lung cancer surgery patients.
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影响因子：
3.7
作者：
Hovanec J;Siemiatycki J;Conway DI;Olsson A;Stücker I;Guida F;Jöckel KH;Pohlabeln H;Ahrens W;Brüske I;Wichmann HE;Gustavsson P;Consonni D;Merletti F;Richiardi L;Simonato L;Fortes C;Parent ME;McLaughlin J;Demers P;Landi MT;Caporaso N;Tardón A;Zaridze D;Szeszenia-Dabrowska N;Rudnai P;Lissowska J;Fabianova E;Field J;Dumitru RS;Bencko V;Foretova L;Janout V;Kromhout H;Vermeulen R;Boffetta P;Straif K;Schüz J;Kendzia B;Pesch B;Brüning T;Behrens T
通讯作者：
Behrens T
影响因子：
3.2
作者：
Hsieh, HF;Shannon, SE
通讯作者：
Shannon, SE
影响因子：
2.5
作者：
Teteh, Dede;Love, Madeleine;Ericson, Marissa;Chan, Marissa;Phillips, Tanyanika;Toor, Aroona;Ferrell, Betty;Erhunmwunsee, Loretta;Montgomery, Susanne B.;Sun, Virginia;Kim, Jae Y.
通讯作者：
Kim, Jae Y.
影响因子：
2.9
作者：
Shi Y;Gu F;Hou LL;Hu YQ
通讯作者：
Hu YQ
影响因子：
2.2
作者：
Ermers, Daisy J. M.;van Bussel, Karin J. H.;Schers, Henk J.
通讯作者：
Schers, Henk J.