Race and Lung Cancer Surgery-A Qualitative Analysis of Relevant Beliefs and Management Preferences
Race and Lung Cancer Surgery-A Qualitative Analysis of Relevant Beliefs and Management Preferences
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DOI：
10.1188/10.onf.740-748
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发表时间：
2010-11-01
影响因子：
1.9
通讯作者：
Margolis, Mitchell L.
中科院分区：
文献类型：
--
作者：
George, Maureen;Margolis, Mitchell L.
目的/目标：为了更好地了解非裔美国人和白人成年人对肺癌切除手术的效用和肺癌管理偏好的信念。研究方法：定性。设置：费城退伍军人事务医疗中心。参与者：21名参与者（9名非裔美国人和12名高加索人; 11名患有慢性阻塞性肺病，10名患有肺癌）。进行了三个重点小组。成绩单和现场笔记进行编码，分组为主题类别，并探讨在以后的焦点groups.Main研究变量：信念肺癌切除手术和管理preferences.Findings：非洲裔美国人怀疑手术是必要的，质疑其疗效，并首选补充和替代医学（CAM）。非裔美国人和高加索人认为，在手术过程中暴露在空气中可能会导致肿瘤扩散，并怀疑吸烟会导致肺癌。因此，他们有一种治疗无效的感觉。相反，白种人对被迫等待手术不耐烦。两组都认为，如果现在的病人遇到过去的手术病人，获得第二意见，并有信任的病人-提供者relationships.Conclusions：怀疑外科医生的动机和认为无效的手术，以及支持CAM在非洲裔美国人，可能有助于关键的种族差异，在肺癌护理。解释：如果提供者更清楚地了解阻碍接受手术切除的信念和偏好，那么他们可以制定针对克服患者阻力的教育干预措施。这种个性化干预的临床效用可以在未来的研究中进行评估。
Purpose/Objectives: To gain a better understanding of beliefs about the utility of lung cancer resection surgery and preferences for lung cancer management among African American and Caucasian adults.Research Approach: Qualitative.Setting: The Philadelphia Veterans Affairs Medical Center.Participants: 21 participants (9 African Americans and 12 Caucasians; 11 with chronic obstructive pulmonary disease and 10 with lung-cancer).Methodologic Approach: Three focus groups were conducted. Transcripts and field notes were coded, grouped into thematic categories, and explored in later focus groups.Main Research Variables: Beliefs about lung cancer resection surgery and management preferences.Findings: African Americans doubted that surgery was needed, questioned its efficacy, and preferred complementary and alternative medicine (CAM). African Americans and Caucasians believed that exposure to air during surgery could cause tumor spread and were skeptical that smoking caused lung cancer. Therefore, they had a sense of treatment futility. Conversely, Caucasians were impatient with forced waiting for surgery. Both groups believed that surgery would be better accepted if current patients met past surgical patients, obtained second opinions, and had trusting patient-provider relationships.Conclusions: Suspicion about surgeons' motives and perceived ineffectiveness of surgery, as well as support for CAM among African Americans, may contribute to key racial disparities in lung cancer care.Interpretation: If providers understand more clearly the beliefs and preferences that impede acceptance of surgical resection, then they can formulate educational interventions directed at overcoming patient resistance. The clinical utility of such individualized interventions could be evaluated in future studies.