在美国监狱中提供癌症护理的障碍和促进者
Christopher R Manz1,2, Brett Nava-Coulter1, Emma Voligny1
1Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts.
JAMA network open
|October 15, 2025
概括
美国监狱癌症护理的障碍包括患者接纳,护理协调,沟通和运输. 应对这些挑战对于改善被监禁人口的癌症结果至关重要.
科学领域:
- 在瘤学瘤学.
- 公共卫生 公共卫生
- 医疗保健服务研究 医疗服务研究
背景情况:
- 癌症是美国监狱中囚犯死亡的主要原因.
- 监狱癌症患者的死亡率高于普通人群.
- 对于监狱内的癌症护理障碍和促进因素的了解有限.
研究的目的:
- 确定和描述影响美国监狱癌症护理服务的障碍和促进因素.
- 涵盖癌症护理的连续性,从查和诊断到终身护理.
主要方法:
- 在16个美国监狱系统中,与32名临床医生 (医疗主任,初级保健医生,瘤学家) 进行了半结构化的定性访谈.
- 采用混合的诱导和演主题内容分析,用于采访成绩单.
- 进行了22名参与者的成员检查焦点小组,以验证发现.
主要成果:
- 确定了7个关键障碍:患者接受,人口健康,护理协调,沟通,症状管理,运输和护理中的人性.
- 突出跨领域主题:人力不足,安全优先于健康,缺乏透明度.
- 指出2个促进因素:为服务不足的人提供更多的医疗保健,克服健康的社会决定因素.
结论:
- 临床医生发现了在美国监狱内提供癌症护理的重大障碍.
- 这些已识别的障碍为开发有针对性的干预提供了机会.
- 改善监狱中的癌症护理服务对于改善患者治疗结果至关重要.
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