PO.SHP01.02 · 科学与健康政策
肺癌患者及照护者的认知与挑战的年龄相关差异:2025
Age-related differences in lung cancer patients' and caregivers' perceptions and challenges: 2025
作者与单位 Authors & Affiliations
摘要 Abstract
中文摘要
背景 已有研究考察了肺癌患者体验的各个方面,但缺乏对美国患者所面临的挑战如何因年龄而异的全面评估。该项目由 LungCAN 组织内的研究团队开展。LungCAN 是一个由肺癌倡导组织组成的协作团体,共同致力于提高公众对肺癌现实状况的认识。
方法 共发出 2055 份调查问卷,回收率为 46%(患者占 63.39%,照护者占 45.09%)。该队列按年龄分层(44 岁及以下 vs. 45 岁及以上),以确定年龄是否影响人们对罹患肺癌或照护肺癌患者的恐惧或担忧,以及在医疗诊疗或治疗中所面临的挑战的看法。采用卡方独立性检验来识别各年龄组之间在恐惧、担忧和挑战方面的显著差异。
结果 统计分析表明,两个队列之间在肺癌相关恐惧方面存在显著差异(p 值 = 1.24e-09)。较年轻队列(≤44 岁)的主要担忧是心理社会和情感影响(19.2%)及社会污名(4.4%)。较年长队列(≥45 岁)则专注于临床和实际问题,包括疾病进展和复发(24.3%)以及信息和支持不足(11.3%)。
在医疗诊疗和治疗所面临的挑战方面观察到显著的年龄差异(p 值 < 2.2e-16)。诊疗费用是所有参与者的首要担忧,但在 44 岁及以下参与者中的患病率(67.3%)显著高于较年长组(46.9%)。较年轻队列将交通视为挑战的频率显著更高(41.5% vs. 30.5%),而工作相关问题在较年长队列中更为突出(16.9% vs. 9.1%)。
结论 年龄揭示了患者和照护者在感知肺癌相关挑战方面的差异。有必要采取对年龄敏感的支持策略。
罹患肺癌或照护肺癌患者所面临的恐惧与挑战。总计 N (%) N (%) N (%) 总计 842*(%)44 岁及以下 364(%)45 岁及以上 478(%)恐惧 疾病进展与复发 149(17.7%) 33(9.1%) 116(24.3%) 死亡 193(22.9%) 98(26.9%) 95(19.9%) 身体症状、副作用和生活质量 177(21.0%) 79(21.7%) 98(20.5%) 情感与心理影响 128(15.2%) 70(19.2%) 58(12.1%) 对家庭的经济与情感影响 155(18.4%) 70(19.2%) 85(17.8%) 信息不足与缺乏支持系统 69(8.2%) 15(4.1%) 54(11.3%) 社会污名与孤立 30(3.6%) 16(4.4%) 14(2.9%) 挑战 往返就诊的交通 297(35.3%) 151(41.5%) 146(30.5%) 诊疗费用与支付 469(55.7%) 245(67.3%) 224(46.9%) 排期问题 270(32.1%) 117(32.1%) 153(32.0%) 获取试验或替代疗法的机会 293(34.8%) 132(36.3%) 161(33.7%) 语言障碍 76(9.0%) 50(13.7%) 26(5.4%) 我所在地区治疗的可及性 168(20.0%) 79(21.7%) 89(18.6%) 工作相关问题 114(13.5%) 33(9.1%) 81(16.9%) 其他 112(13.3%) 6(1.6%) 106(22.2%) *参与者包括患者、其近亲和远亲家属以及医疗服务提供方的工作人员。
查看英文原文 English abstract
Background Studies have been conducted looking at aspects of patient experiences with lung cancer, but a comprehensive assessment of how challenges may differ by age of US patients is missing. The Research team within the LungCAN organization conducted this project. LungCAN is a collaborative group of lung cancer advocacy organizations that work together to raise public awareness about the realities of lung cancer.
Methods 2055 surveys were sent out with 46% returned (63.39% patients, 45.09% caregivers). The cohort was stratified by age (44 and under vs. 45 and over) to determine if age influenced perspectives in fears or concerns about living with or supporting someone with lung cancer, and challenges faced with medical care or treatment. Chi-square test of independence was used to identify significant differences in fears, concerns, and challenges between age groups.
Results Statistical analysis suggested a significant disparity in fears concerning lung cancer between the two cohorts (p-value = 1.24e-09). Major concerns of the younger cohort (≤44) were psychosocial and emotional impact (19.2%) and social stigma (4.4%). The older cohort (≥45) was preoccupied with clinical and practical issues including disease progression and recurrence (24.3%) and insufficient information and support (11.3%).
Significant age-based divergence was observed in the challenges faced with medical care and treatment (p-value < 2.2e-16). The cost of care was the predominant concern across participants, but prevalence was substantially higher among participants aged 44 and below (67.3%) compared to the older group (46.9%). The younger cohort viewed transportation as a challenge with significantly greater frequency (41.5% vs. 30.5%) while job related issues were more prominent among the elder cohort (16.9% vs. 9.1%).
Conclusions Age reveals differences in how patients and caregivers perceive the challenges associated with lung cancer. Age-sensitive approach to support strategies are warranted.
Fears and Challenges faced with living with or supporting someone with lung cancer. Total N (%) N (%) N (%) Total 842* (%) 44 and under 364 (%) 45 and over 478 (%) Fears Disease progression & recurrence 149(17.7%) 33(9.1%) 116(24.3%) Death 193(22.9%) 98(26.9%) 95(19.9%) Physical Symptoms, Side Effects, and QOL 177(21.0%) 79(21.7%) 98(20.5%) Emotional & Psychological Impact 128(15.2%) 70(19.2%) 58(12.1%) Financial & Emotional Impact on Family 155(18.4%) 70(19.2%) 85(17.8%) Inadequate Information and Lack of Support Systems 69(8.2%) 15(4.1%) 54(11.3%) Social Stigma & Isolation 30(3.6%) 16(4.4%) 14(2.9%) Challenges Transportation to and from appointments 297(35.3%) 151(41.5%) 146(30.5%) Cost of care and payment 469(55.7%) 245(67.3%) 224(46.9%) Scheduling issues 270(32.1%) 117(32.1%) 153(32.0%) Access to trials or alternative therapies 293(34.8%) 132(36.3%) 161(33.7%) Language Barriers 76(9.0%) 50(13.7%) 26(5.4%) Availability of treatments in my geographic area 168(20.0%) 79(21.7%) 89(18.6%) Job related issues 114(13.5%) 33(9.1%) 81(16.9%) Other 112(13.3%) 6(1.6%) 106(22.2%) *The participants include patients, their close and extended family members, and staff from health care providers.
利益披露 Disclosure
J. Schiller, None..
D. Deb, None..
A. Reuben, None..
P. Jiang, None..
A. Cipau, None..
M. Muskavitch, None..
S. Patton, None..
M. Spain, None.