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      Understanding Reasons for Cancer Disparities in Italy: A Qualitative Study of Barriers and Needs of Cancer Patients and Healthcare Providers

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          Abstract

          Background

          The second leading cause of death in Italy is cancer. Substantial disparities persist in the level of care and outcomes for cancer patients across various communities, hospitals, and regions in Italy. While substantial progress has been made in medical research and treatment options, these advancements tend to disproportionately benefit the wealthier, better-educated, and more privileged areas and portions of the population. Therefore, the primary aim of the current study is to explore possible reasons for inequalities in access to and utilisation of care from the perspective of cancer patients, who are recipients of these treatments, and healthcare providers, who are responsible for their administration.

          Methods

          After being recruited through social media platforms, patients’ organisations, and hospital websites, cancer patients (n = 22) and healthcare providers (n = 16) from various Italian regions participated in online focus group discussions on disparities in access to and provision of care. Video and audio recordings of the interviews were analysed using Thematic analysis.

          Results

          Among cancer patients, 7 themes were identified, while 6 themes emerged from the healthcare providers highlighting encountered barriers and unmet needs in cancer care. Most of these emerging themes are common to both groups, such as geographical disparities, information deficiencies, and the importance of psycho-oncological support. However, several themes are specific to each group, for instance, cancer patients highlight the financial burden and the poor interactions with healthcare providers, while healthcare providers emphasise the necessity of establishing a stronger specialists’ network and integrating clinical practice and research.

          Conclusion

          Current findings reveal persistent challenges in cancer care, including long waiting lists and regional disparities, highlighting the need for inclusive healthcare strategies. The value of psycho-oncological support is underscored, as well as the potential of the Internet’s use for informational needs, emphasising the imperative for improved awareness and communication to overcome disparities in cancer care.

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          Most cited references42

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          Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups.

          Qualitative research explores complex phenomena encountered by clinicians, health care providers, policy makers and consumers. Although partial checklists are available, no consolidated reporting framework exists for any type of qualitative design. To develop a checklist for explicit and comprehensive reporting of qualitative studies (in depth interviews and focus groups). We performed a comprehensive search in Cochrane and Campbell Protocols, Medline, CINAHL, systematic reviews of qualitative studies, author or reviewer guidelines of major medical journals and reference lists of relevant publications for existing checklists used to assess qualitative studies. Seventy-six items from 22 checklists were compiled into a comprehensive list. All items were grouped into three domains: (i) research team and reflexivity, (ii) study design and (iii) data analysis and reporting. Duplicate items and those that were ambiguous, too broadly defined and impractical to assess were removed. Items most frequently included in the checklists related to sampling method, setting for data collection, method of data collection, respondent validation of findings, method of recording data, description of the derivation of themes and inclusion of supporting quotations. We grouped all items into three domains: (i) research team and reflexivity, (ii) study design and (iii) data analysis and reporting. The criteria included in COREQ, a 32-item checklist, can help researchers to report important aspects of the research team, study methods, context of the study, findings, analysis and interpretations.
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            Standards for reporting qualitative research: a synthesis of recommendations.

            Standards for reporting exist for many types of quantitative research, but currently none exist for the broad spectrum of qualitative research. The purpose of the present study was to formulate and define standards for reporting qualitative research while preserving the requisite flexibility to accommodate various paradigms, approaches, and methods.
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              A review of Internet use among older adults

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                Author and article information

                Journal
                Cancer Control
                Cancer Control
                spccx
                CCX
                Cancer Control : Journal of the Moffitt Cancer Center
                SAGE Publications (Sage CA: Los Angeles, CA )
                1073-2748
                1526-2359
                19 June 2024
                Jan-Dec 2024
                : 31
                : 10732748241258589
                Affiliations
                [1 ]Applied Research Division for Cognitive and Psychological Science, IEO, Ringgold 9290, universityEuropean Institute of Oncology ; universityIRCCS; , Milan, Italy
                [2 ]Laboratory of Behavioral Observation and Research on Human Development, Department of Psychology, Educational Science and Human Movement, universityUniversity of Palermo; , Palermo, Italy
                [3 ]Department of Oncology and Hemato-Oncology, universityUniversity of Milan; , Milan, Italy
                Author notes
                [*]Giulia Ferraris, Applied Research Division for Cognitive and Psychological Science, IEO, European Institute of Oncology IRCCS, Via Ripamonti 435, 20141 Milan, Italy. Email: giulia.ferraris@ 123456ieo.it

                Data Availability Statement included at the end of the article

                Author information
                https://orcid.org/0000-0003-0957-0918
                https://orcid.org/0009-0003-8238-2101
                https://orcid.org/0009-0009-0947-8020
                https://orcid.org/0000-0001-9544-2933
                https://orcid.org/0000-0002-9699-9626
                https://orcid.org/0000-0002-4843-4663
                Article
                10.1177_10732748241258589
                10.1177/10732748241258589
                11189013
                38897992
                e0db27b4-5cb7-48ef-8840-466564e7ce92
                © The Author(s) 2024

                This article is distributed under the terms of the Creative Commons Attribution 4.0 License ( https://creativecommons.org/licenses/by/4.0/) which permits any use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages ( https://us.sagepub.com/en-us/nam/open-access-at-sage).

                History
                : 21 February 2024
                : 16 April 2024
                : 10 May 2024
                Funding
                Funded by: This work was supported by “Beacon Cancer Care” funded by the European Union’s EU4Health Programme (EU4H) under Grant Agreement Number: 101080005;
                Award ID: 101080005
                Categories
                Disparities in Cancer Treatment and Outcome-Research Article
                Custom metadata
                ts10
                January-December 2024

                cancer disparities,cancer divide,cancer patients,cancer inequality,digital divide,healthcare providers

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