基于卡诺模型的社区乳腺癌患者健康服务需求分析

Demand analysis of health care services for community-dwelling breast cancer survivors based on the Kano model:A cross-sectional study

目的为乳腺癌患者提供满意的医疗服务,可有效减轻患者的负担和医疗资源压力。本研究的目的是利用卡诺模型探讨社区乳腺癌患者的健康服务需求。方法2023年1月—3月对某三级肿瘤医院出院的乳腺癌患者进行横断面调查。患者填写了基于卡诺模型自行设计的健康服务需求调查问卷,同时也提供了社会人口学信息。调查问卷中包括30项健康服务内容,基于卡诺模型对这些项目的属性进行分类和优先级排序。结果共回收有效问卷296份。对30项医疗服务的需求属性进行评价的结果显示,30项服务中有1项被归类为“必备型属性”(身体形象管理),13项被归类为“期望型属性”(侧重于医疗保障支持、健康管理和健康咨询),3项被归类为“魅力型属性”(侧重于沟通需求和远程保健服务),11项被归类为“无差异型属性”(主要集中在社会心理服务领域)。结论社区乳腺癌患者对不同健康服务项目的需求程度不同。医务工作者应根据患者需求确定有效的健康服务策略,优先提供必备型和期望型属性的服务,努力提供魅力型属性服务,以提高社区乳腺癌患者的生活质量。

Objectives:Providing satisfactory healthcare services for breast cancer survivors can effectively reduce their burden and the pressure on medical resources.The aim of this study was to explore health care service demands for community-dwelling breast cancer survivors using the Kano model.Methods:A cross-sectional survey was conducted from January to March 2023 among breast cancer survivors discharged from a tertiary cancer hospital.Participants were asked to fill out a self-designed questionnaire involving the Kano model,which helped to categorize and prioritize the attributes of healthcare services.The questionnaire included 30 health care services.Additionally,their social demographic characteristics were collected during the survey.Results:A total of 296 valid questionnaires were collected,and demand attributes of the 30 health care services were evaluated.The findings revealed that one of 30 services was classified as“must-be attributes”(body image management),13 as“one-dimensional attributes”(focused on medical security support,health management,and health counseling),3 as“attractive attributes”(focused on communication needs and telehealth services),and 11 as“indifferent attributes”(mainly in the area of psychosocial services).Conclusions:Breast cancer survivors in the community have different levels of need for various health care services.It’s crucial for healthcare providers to identify these needs and devise effective strategies to deliver the appropriate services.Services with must-be and one-dimensional attributes should be given priority,and efforts should be made to provide services with attractive attributes,hence improving the quality of life of breast cancer survivors.