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Rural US Latina breast cancer patients experience language barriers, health literacy issues, and limited access to health care resources that negatively impact survivorship care. This study explored the challenges to survivorship care for rural Latina breast cancer (BC) patients and approaches to supporting survivorship care plans (SCP) from the stakeholders' perspectives. Data were collected via eight focus groups (n = 40) and individual interviews (n = 4) with Latina BC patients, family caregivers, and health care professionals in a rural US-Mexico Border region. Interviews were audio-taped, transcribed, translated, and analyzed using thematic analysis. Themes related to the patient's SCP challenges included: (1) lack of knowledge of treatment information, (2) lack of proactive health behavior, (3) gaps in information for care coordination, (4) psychological distress, and (5) difficulty retaining health information. Respondents expressed that the SCP document could fill patient information gaps as well as support patient communication with their clinicians and family. Rural BC patients demonstrated an acute need for information and active engagement in their survivorship care. The findings indicate the importance of addressing challenges for survivorship care on multiple dimensions: Cognitive, behavioral, social, and structural. Developing a culturally tailored SCP intervention will be imperative to support survivorship care.

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Objective: Coping with cancer is central to patients' cancer recovery and quality of life, yet little is known about cancer experiences and coping from the perspective of binational cancer patients. This brief report provides an exploration of experiences relating to cancer diagnosis/treatment and coping among Latino cancer patients living in the U.S.-Mexico border regionDesign: We conducted secondary data analysis of qualitative dataParticipants and methods: We conducted in-depth of interviews with 22 patients from a rural cancer care organization. Thematic analysis was used to analyze the data.Findings: Three themes emerged: 1) changes in sexual functioning, 2) navigating cancer in the U.S. and between Mexican border communities, and 3) social support.Conclusion: Rural Latino cancer patients face multiple challenges in accessing cancer treatments. Social support fills the gaps for their continuum of care.Implication: Promoting culturally-relevant coping and resilience in clinical practice.

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Access to quality cancer care for cancer patients living in the rural U.S.-Mexico border region is complex due to common binational health care-seeking behaviors and regional socio-economic and cultural characteristics. But little is known about the challenges border dwelling residents face when navigating their cancer care systems. In-depth interviews were conducted with 22 cancer patients in Southern California. Thematic analysis was applied to identify patterns of meaning in the data. Emerging themes were: (1) delays in cancer care coordination: (a) poor coordination of cancer care (b) U.S. and cross-border discordance in cancer diagnosis; (2) regional shortage of cancer specialists; and (3) financial hardship. Findings revealed that care needs distinctly involved care coordination in/outside of the patient's community and bi-national care coordination. In addition to local solutions to improve cancer coordination through community-based partnerships, efforts to bridge care in a two-nation context are also imperative.

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Quality of clinician-patient cancer communication is vital to cancer care and survivorship. Racial/ethnic minority patients in rural regions may have unique characteristics including cultural beliefs, language barriers, and low health literacy which require effective cross-cultural cancer communication. Despite the growing US population of racial/ethnic minorities and widespread emphasis on culturally appropriate health communication, little is known about challenges and facilitators of cancer communication among underserved rural Latino cancer patients in the US-Mexico border region. This study conducted secondary data analysis of interview data collected from 22 individual cancer patients living on the US side of the US-Mexico border. Thematic analysis was conducted to explore a priori questions regarding patient experiences with cancer care communication with their providers. Emerging themes included lack of language concordance, patient perspectives on clarity and accuracy of information provided, patient perceptions on provider sensitivity in giving cancer diagnosis, and improving the clinical interpersonal relationship. Practice guidelines are suggested and discussed. These findings illuminate the importance of advancing improvement of cancer communication between clinicians and Spanish language-dominant Latinos.

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Patient navigation is a widely used approach to minimize health disparities among socioeconomically marginalized cancer patients. Although patient navigation is widely used, there is a dearth of studies exploring patient experience with navigators among rural cancer patients. This qualitative study explores the challenges and barriers to cancer care faced by cancer patients living in a US/Mexico border region in Southern California. We individually interviewed 22 cancer patients, most of whom were Latino. Data were analyzed using constant comparison with a reiterative analysis method. The main themes relating to barriers to care and experiences with patient navigators include the following: (1) removing financial barriers, (2) coordinating services, and (3) providing therapeutic interventions. The cancer patients highly valued the navigators for their knowledge about community resources, support, and advocacy. This study suggests that it is imperative that navigators know the regional and binational health care utilization issues that impact patients' access to cancer care.

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The purpose of this study was to identify and describe the domains that define a good death from the perspectives of healthy Mexican American older adults. Qualitative data from face-to-face interviews with 18 participants residing in Southern California were analyzed. Five categories regarding the concepts of good and bad death include no suffering, living life with faith, having time for closure with family, dying at home, and a natural death. Understanding the meaning of good and bad death within specific cultural contexts is integral to promoting cultural sensitivity when working with older adults, especially in end-of-life care.

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OBJETIVOS: Determinar que el valor creatinina es útil como un método de diagnóstico para la Rotura Prematura de Membranas en el Hospital Nacional Arzobispo Loayza durante Agosto 2012 - Febrero 2013. METODOLOGIA: Estudio Observacional, de tipo analítico-comparativo prospectivo. Se trabajó con un total de 90 pacientes que se atendieron en los consultorios de Obstetricia que acuden al Hospital Nacional Arzobispo Loayza durante Agosto 2012 - Febrero 2013. Para ello se dividieron en dos grupos: 26 pacientes con diagnóstico de RPM y 64 pacientes sin diagnóstico de RPM a las cuales se midió el valor de la creatinina. Se estimaron las frecuencias absolutas y relativas y medidas de tendencia central y de dispersión. Se utilizó la prueba Chi cuadrado y t-Student, toda interpretación estadística se realizó con un nivel de significancia del 95 por ciento. RESULTADOS: La edad de las pacientes estuvo entre los rangos: 19 a 34 años (70 por ciento) y en menor porcentaje las menores de 19 años (4.4 por ciento). El 57.8 por ciento eran Solteras y el 1.1 por ciento Separadas. El nivel de instrucción de las participantes fue en el 60 por ciento nivel Secundario y el 12.2 por ciento Técnica. La edad materna en el grupo caso más frecuente fue 19 a 34 años (42.3 por ciento) y las mayores de 35 años (42.3 por ciento) muy diferente al grupo control donde priorizó los rangos de edad entre 19-34 años (81.2 por ciento), encontrándose diferencias significativas en ambas variables (p<0.001). El estado civil Soltera en ambos grupos fue similar (p=0.101), siendo en el grupo de pacientes sin RPM 69.2 por ciento y en el grupo sin RPM 53.1 por ciento. El 96.2 por ciento de los pacientes del grupo caso tuvo nivel de instrucción primaria y el 45.3 por ciento del grupo control tuvo nivel de instrucción Secundario, encontrándose estadísticas porcentuales significativas (p<0.001). En gran parte de gestantes del grupo caso (53.8 por ciento) tuvo una edad gestacional entre 37 a 40 semanas muy similar...

OBJECTIVE: Determine the creatinine value is useful as a diagnostic method for Premature Rupture of Membranes at National Hospital Arzobispo Loayza during August 2012 - February 2013. METHODOLOGY: Observational study of prospective comparative-analytical type. We worked with a total of 90 patients seen in the clinics of Obstetrics attending at National Hospital Arzobispo Loayza during August 2012 - February 2013. For this purpose, the groups were divided into two groups: 26 patients diagnosed with RPM and 64 patients without RPM which a value was measured by creatinine. We estimated absolute and relative frequencies and measures of central tendency and dispersion. We used the chi-square test and t-Student, all statistical interpretation was performed with a significance level of 95 per cent. RESULTS: The age of patients was found between the ranges: 19-34 years (70 per cent) and minority women less than 19 years (4.4 per cent). The singles were 57.8 per cent and separate were 1.1 per cent. The education level of the participants was: 60 per cent Secondary and 12.2 per cent Technical. Maternal age in the group case with the most frequent is between 19-34 years (42.3 per cent) and those older than 35 years (42.3 per cent) very different to the control group where prioritized age ranges between 19-34 years (81.2 per cent), with differences significant in both variables (p<0.001). Marital status was similar in both groups (p=0.101), being in the group of patients without RPM: 69.2 per cent and 53.1 per cent group without RPM. The 96.2 per cent of patients in the case group had primary level of education and 45.3 per cent of the control group had Secondary education level, being statistical significant both percentages (p<0.001). In much of pregnant women in the case group (53.8 per cent) had a gestational age from 37 to 40 weeks very similar to the control group (57.8 per cent) being statistically similar (p=0.731). With respect to parity: The 69.2 per cent...

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