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Ansar A, Lewis V, McDonald CF, Liu C, Rahman MA. Factors influencing the timeliness of care for patients with lung cancer in Bangladesh. BMC Health Serv Res 2023; 23:261. [PMID: 36927788 PMCID: PMC10018894 DOI: 10.1186/s12913-023-09154-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 02/06/2023] [Indexed: 03/18/2023] Open
Abstract
BACKGROUND This study explored the factors associated with timeliness of care in the healthcare seeking pathway among patients with lung cancer in Bangladesh. METHODS A structured questionnaire was used for data collection from 418 patients with lung cancer through face-to-face interviews in three tertiary care hospitals. Log-rank tests were performed to test differences in the length of intervals between points in healthcare by socioeconomic characteristics and care seeking behaviours of the patients. Cox Proportional Hazard (PH) regression analysis was performed to identify the predictors of the intervals after adjustment for variations in other variables. RESULTS A higher education level was associated significantly (p < 0.05) with a shorter interval between first contact with a healthcare provider (HCP) and diagnosis (median 81 days) and initiation of treatment (median 101 days). Higher monthly household income was associated significantly with a shorter time from first contact and diagnosis (median 91 days), onset of symptom and diagnosis (median 99 days), onset of symptom and treatment (median 122 days), and first contact with any HCP to treatment (median 111 days). Consulting with additional HCPs prior to diagnosis was associated significantly with longer intervals from first contact with any HCP and diagnosis (median 127 days), onset of symptom and diagnosis (median 154 days), onset of symptom and treatment (median 205 days), and first contact with any HCP to treatment (median 174 days). Consulting with informal HCPs was associated significantly with a longer time interval from symptom to treatment (median 171 days). Having more than one triggering symptom was associated significantly with a shorter interval between onset of symptoms and first contact with any HCP. CONCLUSION The predictors for timeliness of lung cancer care used in this study affected different intervals in the care seeking pathway. Higher education and income predicted shorter intervals whereas consulting informal healthcare providers and multiple providers were associated with longer intervals.
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Affiliation(s)
- Adnan Ansar
- School of Nursing and Midwifery, College of Science Health and Engineering, La Trobe University, Kingsbury Drive, Bundoora, Melbourne, VIC, 3086, Australia. .,Institute for Breathing and Sleep (IBAS), Melbourne, Australia.
| | - Virginia Lewis
- School of Nursing and Midwifery, College of Science Health and Engineering, La Trobe University, Kingsbury Drive, Bundoora, Melbourne, VIC, 3086, Australia.,Australian Institute for Primary Care and Aging, La Trobe University, Melbourne, Australia
| | - Christine Faye McDonald
- Institute for Breathing and Sleep (IBAS), Melbourne, Australia.,Department of Respiratory & Sleep Medicine, Austin Health, Melbourne, Australia.,University of Melbourne, Melbourne, Australia
| | - Chaojie Liu
- School of Psychology and Public Health, La Trobe University, Melbourne, Australia
| | - Muhammad Aziz Rahman
- Institute for Breathing and Sleep (IBAS), Melbourne, Australia.,Australian Institute for Primary Care and Aging, La Trobe University, Melbourne, Australia.,School of Health, Federation University Australia, Berwick, Australia.,Department of Noncommunicable Diseases, Bangladesh University of Health Sciences (BUHS), Dhaka, Bangladesh.,Faculty of Public Health, Universitas Airlangga, Surabaya, Indonesia
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Ansar A, Lewis V, McDonald CF, Liu C, Rahman MA. Defining timeliness in care for patients with lung cancer: a scoping review. BMJ Open 2022; 12:e056895. [PMID: 35393318 PMCID: PMC8990712 DOI: 10.1136/bmjopen-2021-056895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES Early diagnosis and reducing the time taken to achieve each step of lung cancer care is essential. This scoping review aimed to examine time points and intervals used to measure timeliness and to critically assess how they are defined by existing studies of the care seeking pathway for lung cancer. METHODS This scoping review was guided by the methodological framework for scoping reviews by Arksey and O'Malley. MEDLINE, EMBASE, CINAHL and PsycINFO electronic databases were searched for articles published between 1999 and 2019. After duplicate removal, all publications went through title and abstract screening followed by full text review and inclusion of articles in the review against the selection criteria. A narrative synthesis describes the time points, intervals and measurement guidelines used by the included articles. RESULTS A total of 2113 articles were identified from the initial search. Finally, 68 articles were included for data charting process. Eight time points and 14 intervals were identified as the most common events researched by the articles. Eighteen different lung cancer care guidelines were used to benchmark intervals in the included articles; all were developed in Western countries. The British Thoracic Society guideline was the most frequently used guideline (20%). Western guidelines were used by the studies in Asian countries despite differences in the health system structure. CONCLUSION This review identified substantial variations in definitions of some of the intervals used to describe timeliness of care for lung cancer. The differences in healthcare delivery systems of Asian and Western countries, and between high-income countries and low-income-middle-income countries may suggest different sets of time points and intervals need to be developed.
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Affiliation(s)
- Adnan Ansar
- School of Nursing and Midwifery, College of Science Health and Engineering, La Trobe University, Melbourne, Victoria, Australia
- Institute for Breathing and Sleep (IBAS), Melbourne, Victoria, Australia
| | - Virginia Lewis
- School of Nursing and Midwifery, College of Science Health and Engineering, La Trobe University, Melbourne, Victoria, Australia
- Australian Institute for Primary Care and Aging, La Trobe University, Bundoora, Victoria, Australia
| | - Christine Faye McDonald
- Institute for Breathing and Sleep (IBAS), Melbourne, Victoria, Australia
- Department of Respiratory and Sleep Medicine, Austin Health, Heidelberg, Victoria, Australia
- University of Melbourne, Melbourne, Victoria, Australia
| | - Chaojie Liu
- School of Psychology and Public Health, La Trobe University, Bundoora, Victoria, Australia
| | - Muhammad Aziz Rahman
- Institute for Breathing and Sleep (IBAS), Melbourne, Victoria, Australia
- Australian Institute for Primary Care and Aging, La Trobe University, Bundoora, Victoria, Australia
- School of Health, Federation University Australia, Berwick, Victoria, Australia
- Department of Noncommunicable Diseases, Bangladesh University of Health Sciences (BUHS), Dhaka, Bangladesh
- Faculty of Public Health, Universitas Airlangga, Surabaya, Indonesia
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Zhang J, Oberoi J, Karnchanachari N, IJzerman MJ, Bergin RJ, Druce P, Franchini F, Emery JD. A systematic overview on risk factors and effective interventions to reduce time to diagnosis and treatment in lung cancer. Lung Cancer 2022; 166:27-39. [DOI: 10.1016/j.lungcan.2022.01.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Revised: 01/12/2022] [Accepted: 01/20/2022] [Indexed: 11/25/2022]
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Nwagbara UI, Ginindza TG, Hlongwana KW. Health systems influence on the pathways of care for lung cancer in low- and middle-income countries: a scoping review. Global Health 2020; 16:23. [PMID: 32188467 PMCID: PMC7081618 DOI: 10.1186/s12992-020-00553-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2020] [Accepted: 03/03/2020] [Indexed: 01/01/2023] Open
Abstract
Background Globally, lung cancer is the most common cancer and cause of cancer-related deaths, responsible for nearly one in five deaths. Many health systems in low- and middle-income countries, including sub-Saharan Africa have weak organizational structure, which results in delayed lead time for lung cancer patient care continuum from diagnosis to palliative care. Aim To map evidence on the health systems issues impacting on the delays in timely lung cancer care continuum from diagnosis to palliative care in LMICs, including sub-Saharan Africa. Methods A scoping review was performed following the method of Arksey and O’Malley. Systematic searches were performed using EBSCOhost platform, a keyword search from the following electronic databases were conducted: PubMed/MEDLINE, Google Scholar, Science Direct, World Health Organization (WHO) library, and grey literature. The screening was guided by the inclusion and exclusion criteria. The quality of the included studies was determined by Mixed Method Appraisal Tool (MMAT). Results A total of 2886 articles were screened, and 236 met the eligibility criteria for this scoping review study. Furthermore, 155 articles were also excluded following abstract screening. Eighty-one articles were selected for full-article screening by two researchers with 10 being selected for independent detailed data extraction for synthesis. These studies were also subjected to methodological quality assessment. All included studies were conducted in LMICs mostly Asia, the Middle East, and Latin America and published between January 2008 and June 2018. The ten included studies described at least one interval in lung cancer care. Conclusions Reducing wait time across this care continuum is needed to improve easy access to healthcare, quality care, survival and patient outcomes, as many patients still face longer wait times for diagnosis and treatment of lung cancer than recommended in several healthcare settings. A multidisciplinary team approach will help to reduce wait time and ensure that all patients receive appropriate care. Interventions are needed to address delays in lung cancer care in LMICs. Health-care providers at all levels of care should be educated and equipped with skills to identify lung cancer symptoms and perform or refer for appropriate diagnostic tests.
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Affiliation(s)
- Ugochinyere I Nwagbara
- Discipline of Public Health Medicine, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, 4041, South Africa.
| | - Themba G Ginindza
- Discipline of Public Health Medicine, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, 4041, South Africa
| | - Khumbulani W Hlongwana
- Discipline of Public Health Medicine, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, 4041, South Africa
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Shin DW, Cho J, Yang HK, Kim SY, Lee S, Nam EJ, Chung JS, Im JS, Park K, Park JH. Physicians' attitudes towards the media and peer-review selection of the 'best cancer doctor': comparison of two different selection methods. BMJ Open 2018; 8:e019067. [PMID: 29764870 PMCID: PMC5961570 DOI: 10.1136/bmjopen-2017-019067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2017] [Revised: 11/30/2017] [Accepted: 01/19/2018] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES The choice of doctor is an important issue for patients with cancer, and the reputation of the doctor is the single most important factor for patients to choose a doctor. Media are providing information about the 'best cancer doctor', but they vary widely in their selection methodology. We investigated cancer physicians' attitudes towards the selection of the 'best cancer doctor' by the media, by comparing two different selection methodologies: selection by media personnel or selection through peer-review system. DESIGN Nationwide, cross-sectional survey. SETTING National Cancer Center and 12 Regional Cancer Centers across Korea. PARTICIPANTS A total of 680 cancer care physicians participated in the survey (75.5% participation rate), and two were excluded due to incomplete response. MAIN OUTCOME MEASURES Physicians' opinions on the credibility, fairness, validity, helpfulness to patients, their intention to use the information and helpfulness to improve the quality of cancer care of the two different methods. RESULTS Only a few physicians believed that the selection method of the 'best cancer doctor' by the media personnel was credible (9.1%), fair (6.1%) or valid (10.0%). In contrast, the majority agreed that the peer-selection method of the 'best doctor' is credible (74.7%), fair (64.7%) and valid (67.4%). More physicians believed the latter methods would be useful for patients when selecting their doctor (38.5% vs 82.2%) and may lead to improvement of the quality of cancer care from the perspective of the healthcare system (12.6% vs 59.8%). The need for ensuring objectiveness and transparency was also raised. CONCLUSION Physicians showed different attitudes towards two different selection methods. Regulations or guidelines for selecting the 'best cancer doctor' and for disclosing the information should be considered in order to control the quality of the information and to protect the customers.
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Affiliation(s)
- Dong Wook Shin
- Department of Family Medicine, Samsung Medical Center, Seoul, South Korea
- Supportive Care Center, Samsung Comprehensive Cancer Center, Seoul, South Korea
- Department of Digital Health, SAIHST, Sungkyunkwan University, Seoul, South Korea
| | - Juhee Cho
- Department of Health, Behavior and Society & Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
- Cancer Education Center, Samsung Comprehensive Cancer Center, SAHIST and School of Medicine, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Hyung Kook Yang
- Division of Health Policy and Management, National Cancer Control Institute, National Cancer Center, Goyang, South Korea
| | - So Young Kim
- Division of Health Policy and Management, National Cancer Control Institute, National Cancer Center, Goyang, South Korea
- Department of Public Health and Preventive Medicine, Chungbuk National University Hospital, Cheongju, South Korea
| | - Soohyeon Lee
- Division of medical oncology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea
| | - Eun Joo Nam
- Division of Health Policy and Management, National Cancer Control Institute, National Cancer Center, Goyang, South Korea
| | - Joo Seop Chung
- Department of Hemato-Oncology, Pusan National University Hospital, Busan, South Korea
| | - Jeong-Soo Im
- Department of Preventive Medicine, Gachon Medical School, Incheon, South Korea
| | - Keeho Park
- Division of Health Policy and Management, National Cancer Control Institute, National Cancer Center, Goyang, South Korea
| | - Jong Hyock Park
- Division of Health Policy and Management, National Cancer Control Institute, National Cancer Center, Goyang, South Korea
- College of Medicine/Graduate School of Health Science Business Convergence, Chungbuk National University, Cheongju, South Korea
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Timeliness of access to lung cancer diagnosis and treatment: A scoping literature review. Lung Cancer 2017; 112:156-164. [DOI: 10.1016/j.lungcan.2017.08.011] [Citation(s) in RCA: 93] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2017] [Revised: 08/02/2017] [Accepted: 08/09/2017] [Indexed: 11/18/2022]
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Kwas H, Guermazi E, Khattab A, Hrizi C, Zendah I, Ghédira H. [Prognostic factors of advanced stage non-small-cell lung cancer]. REVUE DE PNEUMOLOGIE CLINIQUE 2017; 73:180-187. [PMID: 28756002 DOI: 10.1016/j.pneumo.2017.05.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/09/2017] [Revised: 04/07/2017] [Accepted: 05/03/2017] [Indexed: 06/07/2023]
Abstract
INTRODUCTION Primary lung cancer is the leading cause of cancer death in men in the world. Although the introduction of new drugs, new therapeutic strategies and despite therapeutic advances, the prognosis is relatively improved during the last years. AIM To evaluate the prognosis of patients with locally advanced or metastatic non-small-cell lung cancer (NSCLC) and to identify prognostic factors at these stages. METHODS A retrospective study, including 140 cases of locally advanced or metastatic NSCLC diagnosed in our department between 2003 and 2013. RESULTS The average age was 61±10 years (35 to 90 years). Sex ratio was 18. The delays management were 80±25 days for presentation, 45±20 days for the diagnostic, while the treatment delay was 8±2.33 days. The cancer was at stage IIIA in 14%, IIIB in 27% and IV in 59%. Six months and one-year survival was between 50 and 74% and between 9 and 25%, respectively. Better survival was observed in patients with NSCLC on stage III, having better performance status, having comorbid conditions, with prolonged delays management, a short therapeutic delay and patients who received specific antitumor treatment. CONCLUSION The prognostic factors in locally advanced and metastatic NSCLC in our patients were: stage of cancer, performance status, comorbid conditions, delay of management and specific antitumoral treatment. These factors should be considered in the management of patients with advanced NSCLC.
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Affiliation(s)
- H Kwas
- Service de pneumologie I, hôpital Abderrahmane-Mami-de-l'Ariana, faculté de médecine de Tunis, université El-Manar de Tunis, 2080 Tunis, Tunisie.
| | - E Guermazi
- Service de pneumologie I, hôpital Abderrahmane-Mami-de-l'Ariana, faculté de médecine de Tunis, université El-Manar de Tunis, 2080 Tunis, Tunisie
| | - A Khattab
- Service de pneumologie I, hôpital Abderrahmane-Mami-de-l'Ariana, faculté de médecine de Tunis, université El-Manar de Tunis, 2080 Tunis, Tunisie
| | - C Hrizi
- Service d'épidémiologie, hôpital Abderrahmane-Mami-de-l'Ariana, faculté de médecine de Tunis, université E-Manar de Tunis, 2080 Tunis, Tunisie
| | - I Zendah
- Service de pneumologie I, hôpital Abderrahmane-Mami-de-l'Ariana, faculté de médecine de Tunis, université El-Manar de Tunis, 2080 Tunis, Tunisie
| | - H Ghédira
- Service de pneumologie I, hôpital Abderrahmane-Mami-de-l'Ariana, faculté de médecine de Tunis, université El-Manar de Tunis, 2080 Tunis, Tunisie
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Iachina M, Jakobsen E, Fallesen AK, Green A. Transfer between hospitals as a predictor of delay in diagnosis and treatment of patients with Non-Small Cell Lung Cancer - a register based cohort-study. BMC Health Serv Res 2017; 17:267. [PMID: 28403839 PMCID: PMC5389102 DOI: 10.1186/s12913-017-2230-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2016] [Accepted: 04/05/2017] [Indexed: 12/04/2022] Open
Abstract
Background Lung cancer is the second most frequent cancer diagnosis in Denmark. Although improved during the last decade, the prognosis of lung cancer is still poor with an overall 5-year survival rate of approximately 12%. Delay in diagnosis and treatment of lung cancer has been suggested as a potential cause of the poor prognosis and as consequence, fast track cancer care pathways were implemented describing maximum acceptable time thresholds from referral to treatment. In Denmark, patients with lung cancer are often transferred between hospitals with diagnostic facilities to hospitals with treatment facilities during the care pathway. We wanted to investigate whether this organizational set-up influenced the time that patients wait for the diagnosis and treatment. Therefore, the objective of this study was to uncover the impact of transfer between hospitals on the delay in the diagnosis and treatment of Non-Small Cell Lung Cancer (NSCLC). Methods We performed a historical prospective cohort study using data from the Danish Lung Cancer Registry (DLCR). All patients diagnosed with primary NSCLC from January 1st 2008 to December 31st 2012 were included. Patients with unresolved pathology and incomplete data on the dates of referral, diagnosis and treatment were excluded. Results A total of 11 273 patients were included for further analyses. Transfer patients waited longer for treatment after the diagnosis, (Hazard ratio (HR) 0.81 (0.68–0.96)) and in total time from referral to treatment (HR 0.84 (0.77–0.92)), than no-transfer patients. Transfer patients had lower odds of being diagnosed (Odds Ratio (OR) 0.82 (0.74–0.94) and treated (OR 0.66 (0.61–0.72) within the acceptable time thresholds described in the care pathway. Conclusion Fast track cancer care pathways were implemented to unify and accelerate the diagnosis and treatment of cancer. We found that the transfer between hospitals during the care pathway might cause delay from diagnosis to treatment as well as in the total time from referral to treatment in patients with Non Small-Cell Lung Cancer. The difference between no-transfer and transfer patients persists after adjusting for known predictors of delay.
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Affiliation(s)
- Maria Iachina
- Center for Clinical Epidemiology and Research Unit of Clinical Epidemiology, Odense University Hospital, University of Southern Denmark, Sdr. Boulevard 29, Entrance 216, ground floor East, DK-5000, Odense C, Denmark.
| | - Erik Jakobsen
- OPEN, Odense Patient data Exploratory Network, Odense University Hospital/Department of Clinical Research, University of Southern Denmark, Odense, Denmark.,The Danish Lung Cancer Registry, Department of Thoracic Surgery, Odense University Hospital, Odense, Denmark
| | - Anne Kudsk Fallesen
- OPEN, Odense Patient data Exploratory Network, Odense University Hospital/Department of Clinical Research, University of Southern Denmark, Odense, Denmark.,QuintilesIMS, Copenhagen, Denmark
| | - Anders Green
- OPEN, Odense Patient data Exploratory Network, Odense University Hospital/Department of Clinical Research, University of Southern Denmark, Odense, Denmark
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Shieh SH, Hsieh VCR, Liu SH, Chien CR, Lin CC, Wu TN. Delayed time from first medical visit to diagnosis for breast cancer patients in Taiwan. J Formos Med Assoc 2014; 113:696-703. [DOI: 10.1016/j.jfma.2012.12.003] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2012] [Revised: 11/29/2012] [Accepted: 12/11/2012] [Indexed: 10/27/2022] Open
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Feng R, Wang DB, Chai J, Cheng J, Li HP. Total delay for treatment among cancer patients: a theory-guided survey in China. Asian Pac J Cancer Prev 2014; 15:4339-47. [PMID: 24935394 DOI: 10.7314/apjcp.2014.15.10.4339] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
PURPOSE This study aimed at exploring treatment delay (TD) among cancer patients in China with an attempt to develop a practical methodology facilitating frontline Chinese clinicians in promoting earlier cancer diagnosis and treatment. MATERIALS AND METHODS The study comprised framework development, qualitative interviews and paired factor rating. Framework development utilized systematic literature review, soft systems thinking and consensus groups. Qualitative interviews employed a checklist of open questions soliciting information about all the domains included the framework from cancer patients drawn via stratified randomized sampling of inpatients at 10 hospitals in Hefei, China. Paired factor rating used a self-developed computer aid and the interviewed patients as referring cases to weigh the relative importance of the factors listed in the framework in terms of their contributions to specific components of total delay (TD). RESULTS a) A conceptual framework was proposed consisting of a 6-step path to TD and 36 category determinants. b) A total of 227 patients were interviewed; their TD was 267.3 mean or 108 median days ranging from 0 to 2475 days; average appraisal, illness, behavioral, preparation and treatment delay accounted for 52.1%, 9.4%, 0.30%, 8.8% and 29.4% of the TD respectively. Individual side factors were rated substantially more important than environmental side factors (60% vs. 40%); most influential TD factors included cancer symptoms, overall health, family relations and knowledge about cancer and health. CONCLUSIONS The framework proposed together with the interviewing and rating approaches used provide a potential new methodology for understanding cancer patients' TD and promoting earlier cancer treatment.
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Affiliation(s)
- Rui Feng
- Library Department of Literature Retrieval and Analysis, 2School of Health Services Management, 3School of Nursing, Anhui Medical University, Hefei, China E-mail :
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Gonzalez-Barcala FJ, Falagan JA, Garcia-Prim JM, Valdes L, Carreira JM, Puga A, Martín-Lancharro P, Garcia-Sanz MT, Anton-Sanmartin D, Canive-Gomez JC, Pose-Reino A, Lopez-Lopez R. Timeliness of care and prognosis in patients with lung cancer. Ir J Med Sci 2013; 183:383-90. [PMID: 24091615 DOI: 10.1007/s11845-013-1025-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2013] [Accepted: 09/21/2013] [Indexed: 12/26/2022]
Abstract
BACKGROUND Timeliness of care is an important dimension of health care quality. The determining factors of less timely care and their influence on the survival of patients with lung cancer (LC) remain uncertain. AIMS To analyse the delays in the diagnosis and treatment of LC in our health area, the factors associated with the timeliness of care and their possible relationship with the survival of these patients. METHODS A retrospective study was conducted on all patients with a cytohistologically confirmed diagnosis of LC between 1 June 2005 and 31 May 2008. The time delays for consultation (specialist delay), diagnosis (diagnosis delay), and treatment (treatment delay), were analysed, as well as the factors associated with these delays and the influence of the timeliness of care on survival. RESULTS A total of 307 cases were included (87 % males). The mean specialist delay was 53.6 days (median 35 days), diagnosis delay 31.5 days (median 18 days), treatment delay 23.5 days (median 14 days). The greater age of the patient and a more advanced stage were associated with a shorter specialist delay. Male sex, a more advanced stage, and poor general status were associated with a shorter treatment delay. The survival is longer in patients with a longer treatment delay. CONCLUSIONS The delay in the diagnosis in our population seems to be excessively long. The greater the age, a more advanced tumour stage, male sex, and poor general health status are associated with shorter delays. A longer treatment delay is associated with a longer survival.
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Affiliation(s)
- F J Gonzalez-Barcala
- Servicio de Neumología, Hospital Clínico-Universitario, C/Choupana SN, 15706, Santiago de Compostela, Spain,
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Bütof R, Baumann M. Time in radiation oncology – Keep it short! Radiother Oncol 2013; 106:271-5. [DOI: 10.1016/j.radonc.2013.03.007] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2013] [Accepted: 03/04/2013] [Indexed: 12/25/2022]
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Sihoe AD, Hiranandani R, Wong H, Yeung ES. Operating on a suspicious lung mass without a preoperative tissue diagnosis: pros and cons†. Eur J Cardiothorac Surg 2013; 44:231-7; discussion 237. [DOI: 10.1093/ejcts/ezs671] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
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