Challenges oncologists face when caring for hispanics living in puerto rico with colorectal cancer and multiple chronic conditions
Background Colorectal cancer (CRC) is the leading cause of cancer-related death in Puerto Rico, posing significant challenges for patients with multiple chronic conditions (MCC). This qualitative study aimed to explore oncologists’ perspectives regarding the care of patients with CRC and MCC in Puer...
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| Vydáno v: | BMC cancer Ročník 25; číslo 1; s. 898 - 12 |
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| Hlavní autoři: | , , , , |
| Médium: | Journal Article |
| Jazyk: | angličtina |
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London
BioMed Central
20.05.2025
BioMed Central Ltd Springer Nature B.V BMC |
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| ISSN: | 1471-2407, 1471-2407 |
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| Abstract | Background
Colorectal cancer (CRC) is the leading cause of cancer-related death in Puerto Rico, posing significant challenges for patients with multiple chronic conditions (MCC). This qualitative study aimed to explore oncologists’ perspectives regarding the care of patients with CRC and MCC in Puerto Rico.
Methods
We conducted semi-structured interviews in Spanish with nine oncologists providing care for patients with CRC in Puerto Rico. We reached data saturation. We performed thematic analysis to identify key patterns and themes within the interview data. The coding scheme evolved through team discussions, with discrepancies addressed for consistency. Quotes were translated from Spanish to English.
Results
Five key themes were: (1) social determinants of health, (2) diagnosis pathways, (3) factors influencing treatment decisions, (4) survivorship and end-of-life care, and (5) care coordination and communication. Oncologists treating patients with CRC and MCC identified the lack of a social support network as a notable care coordination challenge. The health insurance system’s pre-authorization requirements for procedures and treatments further complicated care delivery, particularly for older adults, who faced challenges navigating these administrative processes without sufficient support. A lack of transportation and local specialized care services was a noted barrier to comprehensive patient care. Communication between patients, physician and caregivers proved challenging when multiple physicians and procedures were involved with patient’s care, often requiring patients to schedule appointments with different specialists themselves. Inter-provider communication primarily relied on phone calls or notes sent with the patient.
Conclusions
Oncologists caring for Hispanic older adults with CRC and MCC encounter complex challenges influenced by unmet social needs and the presence of comorbidities. Tailored approaches, culturally sensitive care, and improved coordination among physicians are vital to enhance the quality of care for this patient population. |
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| AbstractList | Background Colorectal cancer (CRC) is the leading cause of cancer-related death in Puerto Rico, posing significant challenges for patients with multiple chronic conditions (MCC). This qualitative study aimed to explore oncologists' perspectives regarding the care of patients with CRC and MCC in Puerto Rico. Methods We conducted semi-structured interviews in Spanish with nine oncologists providing care for patients with CRC in Puerto Rico. We reached data saturation. We performed thematic analysis to identify key patterns and themes within the interview data. The coding scheme evolved through team discussions, with discrepancies addressed for consistency. Quotes were translated from Spanish to English. Results Five key themes were: (1) social determinants of health, (2) diagnosis pathways, (3) factors influencing treatment decisions, (4) survivorship and end-of-life care, and (5) care coordination and communication. Oncologists treating patients with CRC and MCC identified the lack of a social support network as a notable care coordination challenge. The health insurance system's pre-authorization requirements for procedures and treatments further complicated care delivery, particularly for older adults, who faced challenges navigating these administrative processes without sufficient support. A lack of transportation and local specialized care services was a noted barrier to comprehensive patient care. Communication between patients, physician and caregivers proved challenging when multiple physicians and procedures were involved with patient's care, often requiring patients to schedule appointments with different specialists themselves. Inter-provider communication primarily relied on phone calls or notes sent with the patient. Conclusions Oncologists caring for Hispanic older adults with CRC and MCC encounter complex challenges influenced by unmet social needs and the presence of comorbidities. Tailored approaches, culturally sensitive care, and improved coordination among physicians are vital to enhance the quality of care for this patient population. Background Colorectal cancer (CRC) is the leading cause of cancer-related death in Puerto Rico, posing significant challenges for patients with multiple chronic conditions (MCC). This qualitative study aimed to explore oncologists’ perspectives regarding the care of patients with CRC and MCC in Puerto Rico. Methods We conducted semi-structured interviews in Spanish with nine oncologists providing care for patients with CRC in Puerto Rico. We reached data saturation. We performed thematic analysis to identify key patterns and themes within the interview data. The coding scheme evolved through team discussions, with discrepancies addressed for consistency. Quotes were translated from Spanish to English. Results Five key themes were: (1) social determinants of health, (2) diagnosis pathways, (3) factors influencing treatment decisions, (4) survivorship and end-of-life care, and (5) care coordination and communication. Oncologists treating patients with CRC and MCC identified the lack of a social support network as a notable care coordination challenge. The health insurance system’s pre-authorization requirements for procedures and treatments further complicated care delivery, particularly for older adults, who faced challenges navigating these administrative processes without sufficient support. A lack of transportation and local specialized care services was a noted barrier to comprehensive patient care. Communication between patients, physician and caregivers proved challenging when multiple physicians and procedures were involved with patient’s care, often requiring patients to schedule appointments with different specialists themselves. Inter-provider communication primarily relied on phone calls or notes sent with the patient. Conclusions Oncologists caring for Hispanic older adults with CRC and MCC encounter complex challenges influenced by unmet social needs and the presence of comorbidities. Tailored approaches, culturally sensitive care, and improved coordination among physicians are vital to enhance the quality of care for this patient population. Colorectal cancer (CRC) is the leading cause of cancer-related death in Puerto Rico, posing significant challenges for patients with multiple chronic conditions (MCC). This qualitative study aimed to explore oncologists' perspectives regarding the care of patients with CRC and MCC in Puerto Rico.BACKGROUNDColorectal cancer (CRC) is the leading cause of cancer-related death in Puerto Rico, posing significant challenges for patients with multiple chronic conditions (MCC). This qualitative study aimed to explore oncologists' perspectives regarding the care of patients with CRC and MCC in Puerto Rico.We conducted semi-structured interviews in Spanish with nine oncologists providing care for patients with CRC in Puerto Rico. We reached data saturation. We performed thematic analysis to identify key patterns and themes within the interview data. The coding scheme evolved through team discussions, with discrepancies addressed for consistency. Quotes were translated from Spanish to English.METHODSWe conducted semi-structured interviews in Spanish with nine oncologists providing care for patients with CRC in Puerto Rico. We reached data saturation. We performed thematic analysis to identify key patterns and themes within the interview data. The coding scheme evolved through team discussions, with discrepancies addressed for consistency. Quotes were translated from Spanish to English.Five key themes were: (1) social determinants of health, (2) diagnosis pathways, (3) factors influencing treatment decisions, (4) survivorship and end-of-life care, and (5) care coordination and communication. Oncologists treating patients with CRC and MCC identified the lack of a social support network as a notable care coordination challenge. The health insurance system's pre-authorization requirements for procedures and treatments further complicated care delivery, particularly for older adults, who faced challenges navigating these administrative processes without sufficient support. A lack of transportation and local specialized care services was a noted barrier to comprehensive patient care. Communication between patients, physician and caregivers proved challenging when multiple physicians and procedures were involved with patient's care, often requiring patients to schedule appointments with different specialists themselves. Inter-provider communication primarily relied on phone calls or notes sent with the patient.RESULTSFive key themes were: (1) social determinants of health, (2) diagnosis pathways, (3) factors influencing treatment decisions, (4) survivorship and end-of-life care, and (5) care coordination and communication. Oncologists treating patients with CRC and MCC identified the lack of a social support network as a notable care coordination challenge. The health insurance system's pre-authorization requirements for procedures and treatments further complicated care delivery, particularly for older adults, who faced challenges navigating these administrative processes without sufficient support. A lack of transportation and local specialized care services was a noted barrier to comprehensive patient care. Communication between patients, physician and caregivers proved challenging when multiple physicians and procedures were involved with patient's care, often requiring patients to schedule appointments with different specialists themselves. Inter-provider communication primarily relied on phone calls or notes sent with the patient.Oncologists caring for Hispanic older adults with CRC and MCC encounter complex challenges influenced by unmet social needs and the presence of comorbidities. Tailored approaches, culturally sensitive care, and improved coordination among physicians are vital to enhance the quality of care for this patient population.CONCLUSIONSOncologists caring for Hispanic older adults with CRC and MCC encounter complex challenges influenced by unmet social needs and the presence of comorbidities. Tailored approaches, culturally sensitive care, and improved coordination among physicians are vital to enhance the quality of care for this patient population. BackgroundColorectal cancer (CRC) is the leading cause of cancer-related death in Puerto Rico, posing significant challenges for patients with multiple chronic conditions (MCC). This qualitative study aimed to explore oncologists’ perspectives regarding the care of patients with CRC and MCC in Puerto Rico.MethodsWe conducted semi-structured interviews in Spanish with nine oncologists providing care for patients with CRC in Puerto Rico. We reached data saturation. We performed thematic analysis to identify key patterns and themes within the interview data. The coding scheme evolved through team discussions, with discrepancies addressed for consistency. Quotes were translated from Spanish to English.ResultsFive key themes were: (1) social determinants of health, (2) diagnosis pathways, (3) factors influencing treatment decisions, (4) survivorship and end-of-life care, and (5) care coordination and communication. Oncologists treating patients with CRC and MCC identified the lack of a social support network as a notable care coordination challenge. The health insurance system’s pre-authorization requirements for procedures and treatments further complicated care delivery, particularly for older adults, who faced challenges navigating these administrative processes without sufficient support. A lack of transportation and local specialized care services was a noted barrier to comprehensive patient care. Communication between patients, physician and caregivers proved challenging when multiple physicians and procedures were involved with patient’s care, often requiring patients to schedule appointments with different specialists themselves. Inter-provider communication primarily relied on phone calls or notes sent with the patient.ConclusionsOncologists caring for Hispanic older adults with CRC and MCC encounter complex challenges influenced by unmet social needs and the presence of comorbidities. Tailored approaches, culturally sensitive care, and improved coordination among physicians are vital to enhance the quality of care for this patient population. Colorectal cancer (CRC) is the leading cause of cancer-related death in Puerto Rico, posing significant challenges for patients with multiple chronic conditions (MCC). This qualitative study aimed to explore oncologists' perspectives regarding the care of patients with CRC and MCC in Puerto Rico. We conducted semi-structured interviews in Spanish with nine oncologists providing care for patients with CRC in Puerto Rico. We reached data saturation. We performed thematic analysis to identify key patterns and themes within the interview data. The coding scheme evolved through team discussions, with discrepancies addressed for consistency. Quotes were translated from Spanish to English. Five key themes were: (1) social determinants of health, (2) diagnosis pathways, (3) factors influencing treatment decisions, (4) survivorship and end-of-life care, and (5) care coordination and communication. Oncologists treating patients with CRC and MCC identified the lack of a social support network as a notable care coordination challenge. The health insurance system's pre-authorization requirements for procedures and treatments further complicated care delivery, particularly for older adults, who faced challenges navigating these administrative processes without sufficient support. A lack of transportation and local specialized care services was a noted barrier to comprehensive patient care. Communication between patients, physician and caregivers proved challenging when multiple physicians and procedures were involved with patient's care, often requiring patients to schedule appointments with different specialists themselves. Inter-provider communication primarily relied on phone calls or notes sent with the patient. Oncologists caring for Hispanic older adults with CRC and MCC encounter complex challenges influenced by unmet social needs and the presence of comorbidities. Tailored approaches, culturally sensitive care, and improved coordination among physicians are vital to enhance the quality of care for this patient population. Colorectal cancer (CRC) is the leading cause of cancer-related death in Puerto Rico, posing significant challenges for patients with multiple chronic conditions (MCC). This qualitative study aimed to explore oncologists' perspectives regarding the care of patients with CRC and MCC in Puerto Rico. We conducted semi-structured interviews in Spanish with nine oncologists providing care for patients with CRC in Puerto Rico. We reached data saturation. We performed thematic analysis to identify key patterns and themes within the interview data. The coding scheme evolved through team discussions, with discrepancies addressed for consistency. Quotes were translated from Spanish to English. Five key themes were: (1) social determinants of health, (2) diagnosis pathways, (3) factors influencing treatment decisions, (4) survivorship and end-of-life care, and (5) care coordination and communication. Oncologists treating patients with CRC and MCC identified the lack of a social support network as a notable care coordination challenge. The health insurance system's pre-authorization requirements for procedures and treatments further complicated care delivery, particularly for older adults, who faced challenges navigating these administrative processes without sufficient support. A lack of transportation and local specialized care services was a noted barrier to comprehensive patient care. Communication between patients, physician and caregivers proved challenging when multiple physicians and procedures were involved with patient's care, often requiring patients to schedule appointments with different specialists themselves. Inter-provider communication primarily relied on phone calls or notes sent with the patient. Oncologists caring for Hispanic older adults with CRC and MCC encounter complex challenges influenced by unmet social needs and the presence of comorbidities. Tailored approaches, culturally sensitive care, and improved coordination among physicians are vital to enhance the quality of care for this patient population. Abstract Background Colorectal cancer (CRC) is the leading cause of cancer-related death in Puerto Rico, posing significant challenges for patients with multiple chronic conditions (MCC). This qualitative study aimed to explore oncologists’ perspectives regarding the care of patients with CRC and MCC in Puerto Rico. Methods We conducted semi-structured interviews in Spanish with nine oncologists providing care for patients with CRC in Puerto Rico. We reached data saturation. We performed thematic analysis to identify key patterns and themes within the interview data. The coding scheme evolved through team discussions, with discrepancies addressed for consistency. Quotes were translated from Spanish to English. Results Five key themes were: (1) social determinants of health, (2) diagnosis pathways, (3) factors influencing treatment decisions, (4) survivorship and end-of-life care, and (5) care coordination and communication. Oncologists treating patients with CRC and MCC identified the lack of a social support network as a notable care coordination challenge. The health insurance system’s pre-authorization requirements for procedures and treatments further complicated care delivery, particularly for older adults, who faced challenges navigating these administrative processes without sufficient support. A lack of transportation and local specialized care services was a noted barrier to comprehensive patient care. Communication between patients, physician and caregivers proved challenging when multiple physicians and procedures were involved with patient’s care, often requiring patients to schedule appointments with different specialists themselves. Inter-provider communication primarily relied on phone calls or notes sent with the patient. Conclusions Oncologists caring for Hispanic older adults with CRC and MCC encounter complex challenges influenced by unmet social needs and the presence of comorbidities. Tailored approaches, culturally sensitive care, and improved coordination among physicians are vital to enhance the quality of care for this patient population. |
| ArticleNumber | 898 |
| Audience | Academic |
| Author | Castañeda-Avila, Maira A. Latoni-Guillermety, Daniela Lapane, Kate L. Sabatino, Meagan Ortiz-Ortiz, Karen J. |
| Author_xml | – sequence: 1 givenname: Maira A. orcidid: 0000-0002-2376-7656 surname: Castañeda-Avila fullname: Castañeda-Avila, Maira A. email: maira.castanedaavila@umassmed.edu organization: Division of Epidemiology, Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School – sequence: 2 givenname: Daniela surname: Latoni-Guillermety fullname: Latoni-Guillermety, Daniela organization: Duquesne University – sequence: 3 givenname: Meagan surname: Sabatino fullname: Sabatino, Meagan organization: Division of Epidemiology, Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School – sequence: 4 givenname: Karen J. surname: Ortiz-Ortiz fullname: Ortiz-Ortiz, Karen J. organization: Cancer Control and Population Sciences Program, The University of Puerto Rico Comprehensive Cancer Center, Department of Health Services Administration, Graduate School of Public Health, Medical Sciences Campus, University of Puerto Rico – sequence: 5 givenname: Kate L. surname: Lapane fullname: Lapane, Kate L. organization: Division of Epidemiology, Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School |
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Colorectal cancer (CRC) is the leading cause of cancer-related death in Puerto Rico, posing significant challenges for patients with multiple... Colorectal cancer (CRC) is the leading cause of cancer-related death in Puerto Rico, posing significant challenges for patients with multiple chronic... Background Colorectal cancer (CRC) is the leading cause of cancer-related death in Puerto Rico, posing significant challenges for patients with multiple... BackgroundColorectal cancer (CRC) is the leading cause of cancer-related death in Puerto Rico, posing significant challenges for patients with multiple chronic... Abstract Background Colorectal cancer (CRC) is the leading cause of cancer-related death in Puerto Rico, posing significant challenges for patients with... |
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| SubjectTerms | Adult Aged Analysis Attitude of Health Personnel Biomedical and Life Sciences Biomedicine Cancer Cancer Research Care and treatment Chronic illnesses Codes Colorectal cancer Colorectal carcinoma Colorectal Neoplasms - diagnosis Colorectal Neoplasms - epidemiology Colorectal Neoplasms - therapy Comorbidity Demographics Diabetes Diagnosis Female Females Health aspects Health Promotion and Disease Prevention Hispanic Americans Hispanic or Latino Humans Hypertension Interviews Male Medicine/Public Health Middle Aged Multiple Chronic Conditions - epidemiology Multiple Chronic Conditions - therapy Older people Oncologists Oncologists - psychology Oncology Palliative care Patient compliance Patients Physicians Population Practice Puerto Rico - epidemiology Qualitative Research Risk factors Social aspects Social determinants of health Social interactions Social organization Social Support Surgical Oncology Survival Terminal Care Young adults |
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| Title | Challenges oncologists face when caring for hispanics living in puerto rico with colorectal cancer and multiple chronic conditions |
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