PDF(Pubmed)
Abstract：
BACKGROUND: Patients with fewer socioeconomic and health literacy resources are disadvantaged in their access and use of healthcare, which may give rise to worse experiences with care and thus inequalities in patient experiences. However, only a limited number of studies have examined how socioeconomic and health literacy factors shape inequalities in patients\' experiences with cancer care.
OBJECTIVE: To examine whether patients\' experiences with cancer care differ according to their economic status and health literacy.
METHODS: Secondary analysis of data on 2789 adult patients diagnosed with cancer from the Swiss Cancer Patient Experiences-2 (SCAPE-2) study, a cross-sectional survey conducted in eight hospitals across Switzerland from September 2021 to February 2022. Regression analysis was applied to examine the independent effect of patients\' economic status and health literacy on various outcomes of experiences with cancer care, covering eight different dimensions of patient-centred care, controlling for confounding factors.
RESULTS: Adjusted regression analysis showed that patients with lower economic status reported significantly worse experiences with cancer care in 12 out of 29 specific care experiences, especially in the dimensions of \'respect for patients\' preferences\' and \'physical comfort\' where all items of experiences were associated with economic status. Additionally, lower health literacy was associated with worse patient experiences in 23 specific care experiences. All items in the dimensions of \'respect for patients\' preferences\', \'physical comfort\' and \'emotional support\' were associated with health literacy.
CONCLUSIONS: This study revealed significant inequalities in experiences with cancer care shaped by the economic status and health literacy of patients across different dimensions of patient-centred care. It is essential to address the needs of more disadvantaged patients who face obstacles in their access and use of the healthcare system, not only to mitigate inequalities in cancer care but also to avoid inequalities in health outcomes.
OBJECTIVE: To examine whether patients\' experiences with cancer care differ according to their economic status and health literacy.
METHODS: Secondary analysis of data on 2789 adult patients diagnosed with cancer from the Swiss Cancer Patient Experiences-2 (SCAPE-2) study, a cross-sectional survey conducted in eight hospitals across Switzerland from September 2021 to February 2022. Regression analysis was applied to examine the independent effect of patients\' economic status and health literacy on various outcomes of experiences with cancer care, covering eight different dimensions of patient-centred care, controlling for confounding factors.
RESULTS: Adjusted regression analysis showed that patients with lower economic status reported significantly worse experiences with cancer care in 12 out of 29 specific care experiences, especially in the dimensions of \'respect for patients\' preferences\' and \'physical comfort\' where all items of experiences were associated with economic status. Additionally, lower health literacy was associated with worse patient experiences in 23 specific care experiences. All items in the dimensions of \'respect for patients\' preferences\', \'physical comfort\' and \'emotional support\' were associated with health literacy.
CONCLUSIONS: This study revealed significant inequalities in experiences with cancer care shaped by the economic status and health literacy of patients across different dimensions of patient-centred care. It is essential to address the needs of more disadvantaged patients who face obstacles in their access and use of the healthcare system, not only to mitigate inequalities in cancer care but also to avoid inequalities in health outcomes.
摘要：
背景：社会经济和健康素养资源较少的患者在获得和使用医疗保健方面处于不利地位，这可能会导致更糟糕的护理体验，从而导致患者体验的不平等。然而,只有有限数量的研究研究了社会经济和健康素养因素如何影响癌症治疗患者的不平等。
目的：根据患者的经济状况和健康素养，检查患者的癌症治疗经历是否不同。
方法：对来自瑞士癌症患者经历-2（SCAPE-2）研究的2789名被诊断患有癌症的成年患者的数据进行二次分析，一项从2021年9月至2022年2月在瑞士八家医院进行的横断面调查.回归分析用于检查患者的经济状况和健康素养对癌症护理经验的各种结果的独立影响。涵盖以患者为中心的护理的八个不同维度，控制混杂因素。
结果：调整后的回归分析显示，经济状况较低的患者在29种特定护理经历中有12种癌症护理经历明显恶化，特别是在“尊重患者”和“身体舒适”的维度上，所有的经历项目都与经济地位有关。此外,在23次特定护理体验中,较低的健康素养与较差的患者体验相关.\'尊重患者\'偏好\'维度中的所有项目，“身体舒适”和“情感支持”与健康素养有关。
结论：这项研究揭示了在以患者为中心的护理的不同方面，患者的经济状况和健康素养形成了癌症护理经验的显著不平等。必须解决在获得和使用医疗保健系统方面面临障碍的更弱势患者的需求，不仅要减轻癌症治疗中的不平等，还要避免健康结果中的不平等。
目的：根据患者的经济状况和健康素养，检查患者的癌症治疗经历是否不同。
方法：对来自瑞士癌症患者经历-2（SCAPE-2）研究的2789名被诊断患有癌症的成年患者的数据进行二次分析，一项从2021年9月至2022年2月在瑞士八家医院进行的横断面调查.回归分析用于检查患者的经济状况和健康素养对癌症护理经验的各种结果的独立影响。涵盖以患者为中心的护理的八个不同维度，控制混杂因素。
结果：调整后的回归分析显示，经济状况较低的患者在29种特定护理经历中有12种癌症护理经历明显恶化，特别是在“尊重患者”和“身体舒适”的维度上，所有的经历项目都与经济地位有关。此外,在23次特定护理体验中,较低的健康素养与较差的患者体验相关.\'尊重患者\'偏好\'维度中的所有项目，“身体舒适”和“情感支持”与健康素养有关。
结论：这项研究揭示了在以患者为中心的护理的不同方面，患者的经济状况和健康素养形成了癌症护理经验的显著不平等。必须解决在获得和使用医疗保健系统方面面临障碍的更弱势患者的需求，不仅要减轻癌症治疗中的不平等，还要避免健康结果中的不平等。
