scholarly journals A Pre-post Survey Analysis of Satisfaction with Health Care and Medical Mistrust after Patient Navigation for American Indian Cancer Patients

2011 ◽  
Vol 22 (4) ◽  
pp. 1331-1343 ◽  
Author(s):  
B. Ashleigh Guadagnolo ◽  
Kristin Cina ◽  
David Koop ◽  
Deborah Brunette ◽  
Daniel G. Petereit
Keyword(s):  
Health Care ◽  
American Indian ◽  
Cancer Patients ◽  
Patient Navigation ◽  
Medical Mistrust ◽  
Survey Analysis

A Comprehensive Program Enabling Effective Delivery of Regional Genetic Counseling

2018 ◽  
Vol 28 (5) ◽  
pp. 996-1002 ◽  
Author(s):  
Jubilee Brown ◽  
Aly Athens ◽  
David L. Tait ◽  
Erin K. Crane ◽  
Robert V. Higgins ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Ovarian Cancer ◽  
Health Care ◽  
Genetic Counseling ◽  
Cancer Patients ◽  
Health Care System ◽  
Patient Navigation ◽  
Counseling Services ◽  
Comprehensive Program ◽  
Genetic Counseling Services

ObjectivesThe aim of this study was to demonstrate the utility of a comprehensive program involving management-based evidence, telemedicine, and patient navigation to provide genetic counseling services for patients with ovarian and breast cancer across a geographically large health care system.MethodsWe identified all patients with newly diagnosed ovarian and breast cancer in our health care system from January 2013 to December 2015 through the cancer registry. Referral characteristics and testing outcomes were recorded for each year and compared using the χ2 or Fisher exact test.ResultsBecause the implementation of this program, the number of new ovarian cancer cases remained constant (109–112 cases/year) but patients referred for genetic counseling increased annually from 37% to 43% to 96% (P < 0.05). The percentage of ovarian cancer patients who underwent genetic testing increased annually from 24% to 27% to 53% (P < 0.05). The number of new breast cancer patients was constant (1543–1638 cases/year). The percentage of patients with triple negative breast cancer referred for genetic counseling rose from 69% in 2013 to 91% in 2015; the percentage of patients who underwent testing increased annually from 59% to 86% (P < 0.05). Of women with breast cancer diagnosed at less than 45 years of age, 78% to 85% were referred for genetic counseling across this period; the percentage of patients who underwent testing increased annually from 66% to 82% (P < 0.05). Patient navigation was initiated and was available to all patients in the system during this period. Telemedicine consults were performed in 118 breast/ovarian patients (6%) during this period.ConclusionsA comprehensive program may improve access to effective genetic counseling services in patients with ovarian and breast cancer despite geographic barriers.

Understanding Prostate Cancer Patients’ Support Needs: How Do They Manage Living With Cancer?

2018 ◽  
Vol 29 (1) ◽  
pp. 51-73
Author(s):  
Nandini Maharaj ◽  
Shimae Soheilipour ◽  
Jacqueline L. Bender ◽  
Arminée Kazanjian
Keyword(s):  
Prostate Cancer ◽  
Health Care ◽  
Cancer Patients ◽  
Health Care Professionals ◽  
Patient Navigation ◽  
Treatment Options ◽  
Support Needs ◽  
Psychosocial Needs ◽  
Prostate Cancer Survivors ◽  
Peer Navigation

Survivorship concerns are common after prostate cancer with many survivors experiencing long-term and late effects of treatment. Patient navigation has been promoted to improve continuity of care. While many studies have examined the potential benefits of patient navigation by health-care professionals for the screening and diagnostic phase, few are focused on peer navigation for prostate cancer patients in the treatment and posttreatment survivorship phase. The purpose of this qualitative descriptive study was to explore the perceptions of men with prostate cancer and the partners of such men regarding their support needs and experiences. In depth, semistructured interviews were conducted with 20 men who were prostate cancer survivors and 4 partners. Qualitative thematic analysis was used to identify themes and patterns across the interviews. According to the results, participants had experienced uncertainty regarding their test results and treatment options. Many participants had dealt with these challenges by researching information and seeking support from health-care professionals, family members, and fellow prostate cancer patients. Four themes are highlighted: (a) dealing with the unknown, (b) everyone is different, (c) keep looking forward, and (d) getting on with it. Overall participants held favorable views of peer support. Sharing one’s experiences with an empathic peer who has completed treatment can reassure the patient that he is not alone. Knowing what to expect empowers men and their partners to manage the illness and effects of treatment. This research provides insights into the scope of patients’ and partners’ informational and psychosocial needs and preferred coping strategies.

scholarly journals The Patient Navigation Project for Socially Vulnerable Cancer Patients Improves Quality of Life and Health Literacy

2018 ◽  
Vol 4 (Supplement 2) ◽  
pp. 110s-110s
Author(s):  
S. Scheuer
Keyword(s):  
Quality Of Life ◽  
Health Care ◽  
Health Literacy ◽  
Cancer Patients ◽  
Patient Navigation ◽  
Cancer Survival ◽  
Well Being ◽  
Distress Level

Background: Social inequality in cancer survival and rehabilitation is a major problem. Patient navigation has shown to empower cancer patients to take part in their health care and help them navigate through an increasingly complex health care system. These promising results makes it relevant to explore whether patient navigation can improve the lives of vulnerable cancer patients. Aim: The aim of this study is to examine whether the Danish Cancer Society's nation-wide Patient Navigation Project improves quality of life and health literacy among socially vulnerable cancer patients. Methods: Socially vulnerable cancer patients were included in the project and matched with a navigator (volunteer). The navigators, who had a background in social welfare or health care, supported the patients during a 6-month period. The navigators participated in health care visits, helped the patients to keep track of their disease and treatment, and gave the patients emotional support. The support was based on the patients' needs and the navigators focused on empowering the patients. The patients completed a baseline questionnaire and a 6-month follow-up questionnaire. The questionnaires focused on quality of life (WHO-5 Well-being Index and distress thermometer) and health literacy. Results: Of the 268 participants enrolled in the project, 45 were still enrolled when data were collected and 110 did not complete the 6-month navigation period, due to death or disease worsening. Of the 113 participants who completed the 6-month navigation period, 97 participants filled out the 6-month follow-up questionnaire (86%). The participants were predominantly on retirement benefit (61%), 19% were unemployed and 56% had no or a short education. At baseline, the mean distress level was 8.1, and 64% had a low well-being score and were therefore at risk for depression/long term stress. 6 month after enrolment, the distress level had decreased to 6.7 ( P < 0.001) and 28% had a low well-being score ( P < 0.001). When it comes to health literacy, 60% of the participants stated that they had become better at finding information about their disease 6 month after enrolment, and 74% had become better at asking questions at meetings at the hospital. Conclusion: The socially vulnerable cancer patients enrolled in the Patient Navigation Project experienced increased well-being, a lower distress level and improved health literacy 6 months after enrollment. The findings of the study suggests that patient navigation can improve quality of life and health literacy for socially vulnerable cancer patients.

Cancer Patients' and Health Care Providers' Perspectives on Smoking Relapse

2008 ◽  
Author(s):  
Vani N. Simmons ◽  
Erika B. Litvin ◽  
Riddhi Patel ◽  
Paul B. Jacobsen ◽  
Judith McCaffrey ◽  
...  
Keyword(s):  
Health Care ◽  
Cancer Patients ◽  
Health Care Providers ◽  
Care Providers ◽  
Smoking Relapse

scholarly journals Changing Trends in Viral Hepatitis-Associated Hospitalizations in the American Indian/Alaska Native Population, 1995–2007

2011 ◽  
Vol 126 (6) ◽  
pp. 816-825 ◽  
Author(s):  
Kathy K. Byrd ◽  
John T. Redd ◽  
Robert C. Holman ◽  
Dana L. Haberling ◽  
James E. Cheek
Keyword(s):  
Health Care ◽  
Hepatitis C ◽  
Hepatitis B ◽  
American Indian ◽  
Viral Hepatitis ◽  
Alaska Native ◽  
Hepatitis A ◽  
Hospitalization Rate ◽  
Time Periods ◽  
Significant Change

Objective. We described the changing epidemiology of viral hepatitis among the American Indian/Alaska Native (AI/AN) population that uses Indian Health Service (IHS) health care. Methods. We used hospital discharge data from the IHS National Patient Information Reporting System to determine rates of hepatitis A-, B-, and C-associated hospitalization among AI/ANs using IHS health care from 1995–2007 and summary periods 1995–1997 and 2005–2007. Results. Hepatitis A-associated hospitalization rates among AI/AN people decreased from 4.9 per 100,000 population during 1995–1997 to 0.8 per 100,000 population during 2005–2007 (risk ratio [RR] = 0.2, 95% confidence interval [CI] 0.1, 0.2). While there was no significant change in the overall hepatitis B-associated hospitalization rate between time periods, the average annual rate in people aged 45–64 years increased by 109% (RR=2.1, 95% CI 1.4, 3.2). Between the two time periods, the hepatitis C-associated hospitalization rate rose from 13.0 to 55.0 per 100,000 population (RR=4.2, 95% CI 3.8, 4.7), an increase of 323%. The hepatitis C-associated hospitalization rate was highest among people aged 45–64 years, males, and those in the Alaska region. Conclusions. Hepatitis A has decreased to near-eradication levels among the AI/AN population using IHS health care. Hepatitis C-associated hospitalizations increased significantly; however, there was no significant change in hepatitis B-associated hospitalizations. Emphasis should be placed on continued universal childhood and adolescent hepatitis B vaccination and improved vaccination of high-risk adults. Prevention and education efforts should focus on decreasing hepatitis C risk behaviors and identifying people with hepatitis C infection so they may be referred for treatment.

Patient-reported unfair treatment within the health care system.

2021 ◽  
Vol 39 (28_suppl) ◽  
pp. 115-115
Author(s):  
Nicole E. Caston ◽  
Courtney Williams ◽  
Kathleen D. Gallagher ◽  
Rebekah Angove ◽  
Eric Anderson ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care System ◽  
Categorical Variables ◽  
Medical Mistrust ◽  
Insurance Company ◽  
Medical Providers ◽  
Unfair Treatment ◽  
Patient Reported ◽  
Race Ethnicity ◽  
Care System

115 Background: Patients with cancer who perceive discrimination and unfair treatment from the health care system are at risk for lower health-related quality of life. This study seeks to better understand the characteristics of under-resourced patients who report unfair treatment from the health care system and providers. Methods: This cross-sectional analysis used data from a nationwide survey distributed in December 2020 by Patient Advocate Foundation (PAF), a US non-profit organization providing case management and financial aid to individuals with chronic illness. The survey was fielded via email to those who received PAF services from July 2019-April 2020. Inclusion criteria included a valid e-mail address, aged ≥ 19, and either current or previous cancer treatment. Respondents reported unfair treatment in connection to their health care. Age, sex, race/ethnicity, and annual household income were abstracted from the PAF database. The validated Group-Based Medical Mistrust Scale was used to assess respondents’ level of mistrust in medical providers as it relates to their ethnic group. Scores range from 12-60 and were categorized based on tertiles as high mistrust (scores ≥ 29), neutral (21-28), and low mistrust (≤ 20). Frequencies and percentages were calculated for categorical variables. Results: There were a total of 429 survey respondents with cancer. Most respondents were female (73%) and aged 56-75 (57%); 31% were Black, Indigenous, or Persons of Color (BIPOC). The most common cancer types were hematologic (33%) and breast (33%). Overall, 20% (n = 86) of respondents reported having received unfair treatment. Of those reporting unfair treatment, 56% reported receipt from their doctor, nurse, or health care provider, 51% insurance company, 38% the health care system, and 14% pharmacist. When asked why they felt unfairly treated, the most common responses were related to insurance status (51%), disease or condition (45%), and income (35%). Notably, unfair treatment due to race/ethnicity (6%), sex (9%), and sexual orientation/gender expression (3%) were uncommon. When compared to those who reported objective treatment, respondents reporting unfair treatment were more often unemployed/other (28% vs 11%), privately insured (38% vs 27%), having income < $23,000 (40% vs 25%), having 3+ comorbidities (40% vs 23%) and reporting more mistrust in medical providers (53% vs 27%). There did not appear to be a difference in reporting of unfair treatment by race/ethnicity. Of BIPOC respondents, 51% reported high mistrust in medical providers. Conclusions: This under-resourced population of respondents with cancer reported unfair treatment related to their finances, insurance, and disease status. Our data suggest health care-associated discrimination may occur based on socioeconomic resources. This work identifies a novel equity consideration warranting further evaluation.

Impact of medical mistrust (MM) on perceptions of tumor genomic profiling (TGP) among African American (AA) cancer patients: Application of perceptual mapping (PM).

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e22527-e22527
Author(s):  
Michael J. Hall ◽  
Paul D'Avanzo ◽  
Yana Chertock ◽  
Jesse A Brajuha ◽  
Sarah Bauerle Bass
Keyword(s):  
Cancer Patients ◽  
Test Performance ◽  
Information Needs ◽  
University Hospital ◽  
Urban Site ◽  
Cancer Center ◽  
Medical Mistrust ◽  
Chi Square ◽  
Perceptual Mapping ◽  
Chi Square Analysis

e22527 Background: TGP is widely used to identify targetable mutations for precision cancer treatment and clinical trials. Many patients have poor understanding of TGP and are unaware of possible secondary hereditary risks. Lack of clarity regarding the relevance of informed consent and genetic counseling further magnify risks for patients. AA patients have lower genetic knowledge and health literacy and higher MM than Caucasian patients, making them especially vulnerable in the clinical setting. Perceptions of TGP in AA cancer patients have not been well-characterized. Methods: 120 AA pts from 1 suburban and 1 urban site (Fox Chase Cancer Center[FCCC] and Temple University Hospital[TUH]) were surveyed. A k-means cluster analysis using a modified MM scale was conducted; chi-square analysis assessed demographic differences. Perceptual mapping (PM)/multidimensional scaling and vector modeling was used to create 3-dimensional maps to study how TGP barriers/facilitators differed by MM group and how message strategies for communicating about TGP may also differ. Results: Data from 112 analyzable patients from FCCC (55%) and TUH (45%) were parsed into less MM (MM-L, n = 42, 37.5%) and more MM (MM-H, n = 70, 72.5%) clusters. MM-L and MM-H clusters were demographically indistinct with no significant associations by sex (p = 0.49), education (p = 0.3), income (p = 0.65), or location (p = 0.43); only age was significant (older = higher MM, p = 0.006). Patients in the MM-H cluster reported higher concerns about TGP, including cost (p < 0.001), insurance discrimination (p < 0.001), privacy breaches (p = 0.001), test performance/accuracy (p = 0.001), secondary gain by providers (p < 0.001) and provider ability to explain results (p = 0.04). Perceptual mapping identified both shared and contrasting barriers between MM clusters (Table). Conclusions: More than 2/3 of AA patients comprised a MM-H cluster. Communication strategies should focus on concerns about family and how to discuss TGP with an oncologist. PM can identify distinct and shared information needs of vulnerable populations undergoing TGP. [Table: see text]

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