Exploring Cancer Treatment Experiences for Patients With Preexisting Mobility Disability.
Exploring Cancer Treatment Experiences for Patients With Preexisting Mobility Disability.
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DOI：
10.1097/phm.0000000000001622
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发表时间：
2021-02-01
影响因子：
3
通讯作者：
Iezzoni LI
中科院分区：
文献类型：
--
作者：
Agaronnik ND;El-Jawahri A;Kirschner K;Iezzoni LI
我们探讨了癌症护理的过程中预先存在的行动不便的患者，专注于治疗决策和经验。我们招募了20名参与者，他们既有行动障碍，需要使用辅助设备或协助日常生活活动，随后被诊断患有癌症（不包括皮肤癌）。我们进行了开放式的个人访谈，达到数据饱和，逐字转录传统的内容分析。关注点集中在4个主题上：与残疾相关的医疗经历影响癌症治疗决策;对癌症治疗恶化功能障碍的担忧;获取障碍;以及对治疗残疾人的有限提供者意识和偏见。对先前医疗干预的残余恐惧和对加重功能障碍的担忧影响了癌症治疗偏好。与会者还提出了他们的潜在残疾可能被用来证明不那么积极的治疗的担忧。然而，癌症治疗确实加剧了一些参与者的行动困难。无法进入的医院病房、缺乏无障碍医疗设备以及态度障碍使治疗复杂化。先前存在行动不便的人在癌症治疗中遇到障碍，影响护理质量和潜在结果。在癌症治疗和康复过程中，有必要进行进一步的培训和积极的规划，以适应残疾。
We explored the process of cancer care for patients with pre-existing mobility disability, focusing on treatment decisions and experiences. We recruited 20 participants with pre-existing mobility disability, requiring use of an assistive device or assistance with activities of daily living, subsequently diagnosed with cancer (excluding skin cancers). We conducted open-ended individual interviews, which reached data saturation and were transcribed verbatim for conventional content analysis. Concerns coalesced around 4 themes: disability-related healthcare experiences affect cancer treatment decisions; concerns about cancer treatment worsening functional impairments; access barriers; and limited provider awareness and biases about treating people with disability. Residual fear from previous medical interventions and concerns about exacerbating functional impairments influenced cancer treatment preferences. Participants also raised concerns that their underlying disability may be used to justify less aggressive treatment. Nevertheless, cancer treatment did exacerbate mobility difficulties for some participants. Inaccessible hospital rooms, lack of accessible medical equipment, and attitudinal barriers complicated treatments. People with pre-existing mobility disability experience barriers to cancer treatment, compromising quality of care and potentially outcomes. Further training and proactive planning for accommodating disability during cancer treatment and rehabilitation are warranted.