Abstract：
OBJECTIVE: Integrative oncology (IO) provides complementary and integrative medicine within conventional supportive and palliative cancer care. The present study set out to identify barriers to attending an integrative physician (IP) consultation, provided without charge within an IO treatment program.
METHODS: Electronic files of adult oncology patients undergoing chemotherapy were studied. Patient-related characteristics were examined to identify factors associated with attendance at the IP consultation: socio-demographic (age, gender, country of birth, place of residence, primary language spoken); health- related (BMI, smoking, independent functioning); and cancer- related (primary tumor site, localized vs. metastatic).
RESULTS: Only 257 of the 1912 patients studied (13.4%) attended the IP consultation, with female patients more likely to attend (p < 0.001), as well as younger patients (p = 0.002); those residing outside the Jerusalem municipality (p = 0.008); and patients whose primary language was Hebrew (p < 0.001). Non-smokers and functionally independent patients were also more likely to attend (p = 0.007 and 0.008, respectively), as were those diagnosed with breast/gynecological (p = 0.005) or gastrointestinal tumors (p = 0.002). Multivariate analysis showed a significantly greater likelihood of attending the consultation among females (OR 1.619, 95% CI 1.065-2.460; p = 0.024); younger patients (OR 1.019, 95% CI 1.007-1.031; p = 0.001); non-Arabic speakers (OR 8.220, 95% CI 3.310-20.413; p < 0.001); and patients diagnosed with a tumor other than lung cancer (OR 2.954, 95% CI 1.259-6.933; p = 0.013).
CONCLUSIONS: Further prospective research addressing socio-demographic, personal health- and cancer-related characteristics of oncology patients is needed to address potential barriers to the provision of IO care within a diverse, equitable and inclusive setting of care.
METHODS: Electronic files of adult oncology patients undergoing chemotherapy were studied. Patient-related characteristics were examined to identify factors associated with attendance at the IP consultation: socio-demographic (age, gender, country of birth, place of residence, primary language spoken); health- related (BMI, smoking, independent functioning); and cancer- related (primary tumor site, localized vs. metastatic).
RESULTS: Only 257 of the 1912 patients studied (13.4%) attended the IP consultation, with female patients more likely to attend (p < 0.001), as well as younger patients (p = 0.002); those residing outside the Jerusalem municipality (p = 0.008); and patients whose primary language was Hebrew (p < 0.001). Non-smokers and functionally independent patients were also more likely to attend (p = 0.007 and 0.008, respectively), as were those diagnosed with breast/gynecological (p = 0.005) or gastrointestinal tumors (p = 0.002). Multivariate analysis showed a significantly greater likelihood of attending the consultation among females (OR 1.619, 95% CI 1.065-2.460; p = 0.024); younger patients (OR 1.019, 95% CI 1.007-1.031; p = 0.001); non-Arabic speakers (OR 8.220, 95% CI 3.310-20.413; p < 0.001); and patients diagnosed with a tumor other than lung cancer (OR 2.954, 95% CI 1.259-6.933; p = 0.013).
CONCLUSIONS: Further prospective research addressing socio-demographic, personal health- and cancer-related characteristics of oncology patients is needed to address potential barriers to the provision of IO care within a diverse, equitable and inclusive setting of care.
摘要：
目的：综合肿瘤学（IO）在常规支持和姑息癌症治疗中提供补充和综合医学。本研究旨在确定参加综合医师(IP)咨询的障碍，在IO处理程序中免费提供。
方法：研究成人肿瘤化疗患者的电子档案。检查患者相关特征，以确定与参加IP咨询相关的因素：社会人口统计（年龄，性别,出生国,居住地,主要语言)；健康相关(BMI，吸烟,独立功能)；和癌症相关(原发性肿瘤部位，局部与转移性）。
结果：研究的1912例患者中只有257例（13.4%）参加了IP会诊，女性患者更有可能参加（p<0.001），以及年轻患者（p=0.002）；居住在耶路撒冷市外的患者（p=0.008）；以及主要语言为希伯来语的患者（p<0.001）。非吸烟者和功能独立患者也更有可能参加（分别为p=0.007和0.008），诊断为乳腺/妇科肿瘤（p=0.005）或胃肠道肿瘤（p=0.002）的患者也是如此。多变量分析显示，女性参加咨询的可能性显着增加（OR1.619，95％CI1.065-2.460；p=0.024）；年轻患者（OR1.019，95％CI1.007-1.031；p=0.001）；非阿拉伯语使用者（OR8.220，95％CI3.310-20.413；p<0.001）；被诊断患有除肺癌以外的其他肿瘤的患者（OR2.954，95％CI1.259
结论：针对社会人口统计学的进一步前瞻性研究，需要肿瘤患者的个人健康和癌症相关特征，以解决在不同范围内提供IO护理的潜在障碍，公平和包容的护理设置。
方法：研究成人肿瘤化疗患者的电子档案。检查患者相关特征，以确定与参加IP咨询相关的因素：社会人口统计（年龄，性别,出生国,居住地,主要语言)；健康相关(BMI，吸烟,独立功能)；和癌症相关(原发性肿瘤部位，局部与转移性）。
结果：研究的1912例患者中只有257例（13.4%）参加了IP会诊，女性患者更有可能参加（p<0.001），以及年轻患者（p=0.002）；居住在耶路撒冷市外的患者（p=0.008）；以及主要语言为希伯来语的患者（p<0.001）。非吸烟者和功能独立患者也更有可能参加（分别为p=0.007和0.008），诊断为乳腺/妇科肿瘤（p=0.005）或胃肠道肿瘤（p=0.002）的患者也是如此。多变量分析显示，女性参加咨询的可能性显着增加（OR1.619，95％CI1.065-2.460；p=0.024）；年轻患者（OR1.019，95％CI1.007-1.031；p=0.001）；非阿拉伯语使用者（OR8.220，95％CI3.310-20.413；p<0.001）；被诊断患有除肺癌以外的其他肿瘤的患者（OR2.954，95％CI1.259
结论：针对社会人口统计学的进一步前瞻性研究，需要肿瘤患者的个人健康和癌症相关特征，以解决在不同范围内提供IO护理的潜在障碍，公平和包容的护理设置。
