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Exploring transitions in care among patients with head and neck CANCER: a multimethod study.
Kersen, Jaling; Roach, Pamela; Chandarana, Shamir; Ronksley, Paul; Sauro, Khara.
Afiliación
  • Kersen J; Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada.
  • Roach P; Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada.
  • Chandarana S; O'Brien Institute of Public Health, University of Calgary, Calgary, AB, Canada.
  • Ronksley P; Department of Family Medicine, University of Calgary, Calgary, AB, Canada.
  • Sauro K; Department of Surgery, Division of Otolaryngology, Head and Neck Surgery, Calgary, AB, Canada.
BMC Cancer ; 24(1): 1108, 2024 Sep 05.
Article en En | MEDLINE | ID: mdl-39237932
ABSTRACT

BACKGROUND:

Patients with head and neck cancers (HNC) experience many transitions in care (TiC), occurring when patients are transferred between healthcare providers and/or settings. TiC can compromise patient safety, decrease patient satisfaction, and increase healthcare costs. The evidence around TiC among patients with HNC is sparse. The objective of this study was to improve our understanding of TiC among patients with HNC to identify ways to improve care.

METHODS:

This multimethod study consisted of two phases Phase I (retrospective population-based cohort study) characterized the number and type of TiC that patients with HNC experienced using deterministically linked, population-based administrative health data in Alberta, Canada (January 1, 2012, to September 1, 2020), and Phase II (qualitative descriptive study) used semi-structured interviews to explore the lived experiences of patients with HNC and their healthcare providers during TiC.

RESULTS:

There were 3,752 patients with HNC; most were male (70.8%) with a mean age at diagnosis of 63.3 years (SD 13.1). Patients underwent an average of 1.6 (SD 0.7) treatments, commonly transitioning from surgery to radiotherapy (21.2%). Many patients with HNC were admitted to the hospital during the study period, averaging 3.3 (SD 3.0) hospital admissions and 7.8 (SD 12.6) emergency department visits per patient over the study period. Visits to healthcare providers were also frequent, with the highest number of physician visits being to general practitioners (average = 70.51 per patient). Analysis of sixteen semi-structured interviews (ten patients with HNC and six healthcare providers) revealed three themes (1) Navigating the healthcare system including challenges with the complexity of HNC care amongst healthcare system pressures, (2) Relational head and neck cancer care which encompasses patient expectations and relationships, and (3) System and individual impact of transitions in care.

CONCLUSIONS:

This study identified challenges faced by both patients with HNC and their healthcare providers amidst the frequent TiC within cancer care, which was perceived to have an impact on quality of care. These findings provide crucial insights that can inform and guide future research or the development of health interventions aiming to improve the quality of TiC within this patient population.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias de Cabeza y Cuello Límite: Aged / Female / Humans / Male / Middle aged País/Región como asunto: America do norte Idioma: En Revista: BMC Cancer Asunto de la revista: NEOPLASIAS Año: 2024 Tipo del documento: Article País de afiliación: Canadá Pais de publicación: Reino Unido

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias de Cabeza y Cuello Límite: Aged / Female / Humans / Male / Middle aged País/Región como asunto: America do norte Idioma: En Revista: BMC Cancer Asunto de la revista: NEOPLASIAS Año: 2024 Tipo del documento: Article País de afiliación: Canadá Pais de publicación: Reino Unido