Transportation - A Vehicle or Roadblock to Cancer Care for VA Patients With Colorectal Cancer?
Transportation - A Vehicle or Roadblock to Cancer Care for VA Patients With Colorectal Cancer?
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DOI：
10.1016/j.clcc.2011.05.001
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发表时间：
2012-03-01
影响因子：
3.4
通讯作者：
van Ryn, Michelle
中科院分区：
文献类型：
--
作者：
Zullig, Leah L.;Jackson, George L.;van Ryn, Michelle
患者必须有交通工具才能获得适当的癌症护理。癌症护理评估和反应性评估研究 (C-CARES) 调查问卷对整个 VA 医疗系统中 2008 年诊断出的结直肠癌患者进行了调查。少数（19%）受访者表示存在交通障碍。经历疼痛且报告没有主要社会支持（OR 6.13，95% CI 3.10，12.14）或非配偶支持（OR 2.00，95% CI 1.40，2.87）的患者更有可能遇到交通障碍。背景：患者必须先有交通才能到达治疗地点，然后才能获得适当的癌症护理。本文描述了与因交通相关障碍而无法获得癌症护理的患者相关的因素。患者和方法：癌症护理评估和反应性评估研究 (C-CARES) 调查问卷于 2009 年秋季邮寄给退伍军人事务部 (VA) 患有结直肠癌 (CRC) 的患者。符合条件的患者于 2008 年在任何 VA 机构进行诊断，他们是男性，在邮寄时还活着。总共返回 1409 份调查（回复率约 67%）。为了评估交通障碍，患者被询问往返治疗的交通困难的频率。使用经过验证的患者报告结果测量信息系统 (PROMIS) 量表对疲劳、疼痛和抑郁症状进行评估。使用多元逻辑回归来研究交通障碍的决定因素。结果：少数受访者 (19%) 报告了交通障碍。经历疼痛的患者（OR，1.04；95% Cl，1.02-1.06）比没有这种症状的患者出现交通障碍的可能性更大。报告没有主要社会支持（OR，6.13；95% CI，3.10-12.14）或非配偶支持（OR，2.00；95% CI，1.40-2.87）的患者比配偶提供社会支持的患者更有可能遇到交通障碍。讨论：疼痛不受控制或社会支持较少的患者出现交通障碍的可能性更大。该数据无法确定社会支持、症状和交通之间的定向关联。结论：询问无障碍交通应成为癌症护理的常规部分，特别是对于已知危险因素的患者。
Patients must have transportation before they can access appropriate cancer care. The Cancer Care Assessment & Responsive Evaluation Studies (C-CARES) questionnaire surveyed colorectal cancer patients diagnosed in 2008 throughout the VA healthcare system. A minority (19%) of respondents reported transportation barriers. Patients experiencing pain and who reported no primary social support (OR 6.13, 95% CI 3.10, 12.14) or non-spousal support (OR 2.00, 95% CI 1.40, 2.87) were more likely to experience transportation barriers.Background: Patients must have transportation to the treatment site before they can access appropriate cancer care. This article describes factors associated with patients experiencing transportation-related barriers to accessing cancer care. Patients and Methods: The Cancer Care Assessment & Responsive Evaluation Studies (C-CARES) questionnaire was mailed to Veterans Affairs (VA) patients with colorectal cancer (CRC) during the fall of 2009. Eligible patients were diagnosed at any VA facility in 2008, they were men, and alive at the time of the mailing. A total of 1409 surveys were returned (approximately 67% response rate). To assess transportation barriers, patients were asked how often it was difficult to get transportation to or from treatment. Symptoms were assessed using validated Patient-Reported Outcomes Measurement Information System (PROMIS) scales for fatigue, pain, and depression. Multivariate logistic regression was used to examine determinants of transportation barriers. Results: A minority of respondents (19%) reported transportation barriers. Patients experiencing pain (OR, 1.04; 95% Cl, 1.02-1.06) had greater odds of transportation barriers than patients without this symptom. Patients who reported no primary social support (OR, 6.13; 95% CI, 3.10-12.14) or nonspousal support (OR, 2.00; 95% CI, 1.40-2.87) were more likely to experience transportation barriers than patients whose spouses provided social support. Discussion: Patients with uncontrolled pain or less social support have greater odds of transportation barriers. The directional association between social support, symptoms, and transportation cannot be determined in this data. Conclusion: Inquiring about accessible transportation should become a routine part of cancer care, particularly for patients with known risk factors.