Improving healthcare empowerment through breast cancer patient navigation: a mixed methods evaluation in a safety-net setting.
Improving healthcare empowerment through breast cancer patient navigation: a mixed methods evaluation in a safety-net setting.
复制标题
通过乳腺癌患者导航改善赋予医疗保健能力：安全网络中的混合方法评估。
DOI：
10.1186/1472-6963-14-407
复制
发表时间：
2014-09-19
影响因子：
2.8
通讯作者：
Burke NJ
中科院分区：
文献类型：
--
作者：
Gabitova G;Burke NJ
美国的乳腺癌死亡率仍然相对较高，特别是在少数族裔和低收入人群中。获得优质护理的机会不平等，随访率较低，治疗依从性差，导致这些群体之间的差距不断扩大。医疗保健授权（HCE）理论上是通过与提供者合作，提高对治疗的理解和依从性来改善患者的治疗效果。患者导航是一种医疗保健组织干预，通过提供信息，情感和心理支持，从根本上提高了医疗保健能力。患者导航员通过多语言协调治疗和将社区服务，支持和教育纳入癌症护理的连续性来解决护理障碍。利用调查和定性方法，我们评估了患者导航计划在北方加州安全网医院乳腺诊所，通过评估其对患者的癌症护理经验和供应商的观点的程序的影响。我们对16名患者和4名服务提供者进行了定性访谈，进行了约66小时的临床观察，并通过自填式调查从66名患者那里获得了反馈。乳腺诊所患者导航员的作用包括提供行政协助、心理社会支持、增进知识、更好地了解治疗过程，并确保患者与提供者之间更好地沟通。因此，患者导航器促进了患者和提供者之间的合作，以及对跨学科护理过程的理解。调查结果表明，所有种族背景和年龄组的大多数患者对该计划非常满意，并对其导航员有积极的看法。与患者和提供者的访谈强调了导航员在确保护理连续性、提高治疗完成率以及减少提供者工作量和等待时间方面的作用。导航员在患者中的角色不确定是该计划的一个弱点。乳腺诊所的患者导航对患者的护理和医疗保健授权体验产生了积极影响。澄清导航员作用的不确定性将有助于取得成功。
Breast cancer mortality rates in the U.S. remain relatively high, particularly among ethnic minorities and low-income populations. Unequal access to quality care, lower follow up rates, and poor treatment adherence contribute to rising disparities among these groups. Healthcare empowerment (HCE) is theorized to improve patient outcomes through collaboration with providers and improving understanding of and compliance with treatment. Patient navigation is a health care organizational intervention that essentially improves healthcare empowerment by providing informational, emotional, and psychosocial support. Patient navigators address barriers to care through multilingual coordination of treatment and incorporation of access to community services, support, and education into the continuum of cancer care. Utilizing survey and qualitative methods, we evaluated the patient navigation program in a Northern California safety-net hospital Breast Clinic by assessing its impact on patients’ experiences with cancer care and providers’ perspectives on the program. We conducted qualitative interviews with 16 patients and 4 service providers, conducted approximately 66 hours of clinic observations, and received feedback through the self-administered survey from 66 patients. The role of the patient navigator at the Breast Clinic included providing administrative assistance, psychosocial support, improved knowledge, better understanding of treatment process, and ensuring better communication between patients and providers. As such, patient navigators facilitated improved collaboration between patients and providers and understanding of interdisciplinary care processes. The survey results suggested that the majority of patients across all ethnic backgrounds and age groups were highly satisfied with the program and had a positive perception of their navigator. Interviews with patients and providers highlighted the roles of a navigator in ensuring continuity of care, improving treatment completion rates, and reducing providers’ workload and waiting time. Uncertainty about the navigator’s role among the patients was a weakness of the program. Patient navigation in the Breast Clinic had a positive impact on patients’ experiences with care and healthcare empowerment. Clarifying uncertainties about the navigators’ role would aid successful outcomes.
登录
查看更多内容
影响因子：
1.1
作者：
Koh, Catherine;Nelson, Joan M.;Cook, Paul F.
通讯作者：
Cook, Paul F.
DOI：
10.1158/1055-9965.epi-12-0532
发表时间：
2012-10
期刊：
Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology
影响因子：
--
作者：
Battaglia TA;Bak SM;Heeren T;Chen CA;Kalish R;Tringale S;Taylor JO;Lottero B;Egan AP;Thakrar N;Freund KM
通讯作者：
Freund KM
影响因子：
1.9
作者：
Campbell, Cheryl;Craig, Janet;Bailey-Dorton, Chasse
通讯作者：
Bailey-Dorton, Chasse
影响因子：
6.2
作者：
Jean-Pierre, Pascal;Fiscella, Kevin;Winters, Paul C.
通讯作者：
Winters, Paul C.
影响因子：
6.2
作者：
Ghebre, Rahel G.;Jones, Lovell A.;Wenzel, Jennifer A.;Martin, Michelle Y.;Durant, Raegan W.;Ford, Jean G.
通讯作者：
Ford, Jean G.