Evaluation of Patient Needs and Patient Navigator Communication About Cervical Cancer Prevention in Appalachian Kentucky
Evaluation of Patient Needs and Patient Navigator Communication About Cervical Cancer Prevention in Appalachian Kentucky
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DOI：
10.1111/jcom.12002
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发表时间：
2013-02-01
影响因子：
7.9
通讯作者：
Dignan, Mark B.
中科院分区：
文献类型：
--
作者：
Cohen, Elisia L.;Scott, Allison M.;Dignan, Mark B.
很少有研究描述患者导航过程可能解决医疗服务不足人群的治疗和随访护理差异的方式。使用社会生态学框架，我们分析了在阿巴拉契亚肯塔基州完成随机导航试验的519例患者的调查评估，以检查患者报告的后续宫颈癌护理障碍。我们还分析了试验中4名非专业患者导航员的深入访谈记录，以确定后续护理的其他障碍，并了解导航员使用哪些沟通策略成功（或不成功）帮助患者绕过这些障碍。我们的分析提供了深入了解患者导航如何通过辅助不确定性管理来提高对随访护理的依从性。我们还讨论了改善导航员培训的机会，以解决临床结果的差异。
Few studies describe the way patient navigation processes may address disparities in treatment and follow-up care for medically underserved populations. Using a social ecological framework, we analyzed survey assessments of 519 patients completing a randomized navigation trial in Appalachia Kentucky to examine patient-reported barriers to follow-up cervical cancer care. We also analyzed in-depth interview transcripts with 4 lay patient navigators in the trial to identify additional barriers to follow-up care and to learn what communication strategies navigators use to successfully (or unsuccessfully) help patients navigate around those barriers. Our analysis provides insight into how patient navigation may improve adherence to follow-up care through assisted uncertainty management. We also discuss opportunities for improving navigator training to address disparities in clinical outcomes.