Shaheen N J, Crosby M A, O'Malley M S, Murray S C, Sandler R S, Galanko J A, Ransohoff D F, Klenzak J S
The School of Medicine, University of North Carolina, Chapel Hill, USA.
Am J Gastroenterol. 2000 Nov;95(11):3259-65. doi: 10.1111/j.1572-0241.2000.03262.x.
Although nurse practitioners and physician assistants form a large and growing portion of the primary care workforce, little is known about their colorectal cancer screening practices. The aim of this study was to assess the colorectal cancer screening practices, training, and attitudes of nurse practitioners and physician assistants practicing primary care medicine.
All nurse practitioners (827) and physician assistants (1178) licensed by the Medical Board of the State of North Carolina were surveyed by mail. Both groups were further divided into primary care versus non-primary care by self-described roles. Self-reported practices, training, and attitudes with respect to colorectal cancer screening were elicited.
Response rates were 71.4% and 61.2%, for nurse practitioners and physician assistants respectively. A total of 51.3% of nurse practitioners and 50.3% of physician assistants described themselves as adult primary care providers. No primary care nurse practitioners and only 3.8% of primary care physician assistants performed screening flexible sigmoidoscopy. However, 76% of primary care physician assistants and 69% of primary care nurse practitioners reported recommending screening flexible sigmoidoscopy. A total of 95% primary care physician assistants and 92% of primary care nurse practitioners reported performing fecal occult blood testing. Only 9.4% of physician assistants and 2.8% of nurse practitioners received any formal instruction in flexible sigmoidoscopy while in their training. Additionally, 41.4% of primary care physician assistants and 27.7% of primary care nurse practitioners reported that they would be interested in obtaining formal training in flexible sigmoidoscopy.
Physician assistants and nurse practitioners are motivated, willing and underutilized groups with respect to CRC screening. Efforts to increase education and training of these professionals may improve the availability of CRC screening modalities.
尽管执业护士和医师助理在基层医疗劳动力中占比很大且不断增加，但对他们的结直肠癌筛查实践知之甚少。本研究的目的是评估从事基层医疗的执业护士和医师助理的结直肠癌筛查实践、培训情况及态度。
通过邮件对北卡罗来纳州医学委员会颁发执照的所有执业护士（827名）和医师助理（1178名）进行调查。两组人员根据自我描述的角色进一步分为基层医疗和非基层医疗两类。调查了他们在结直肠癌筛查方面的自我报告实践、培训情况及态度。
执业护士和医师助理的回复率分别为71.4%和61.2%。共有51.3%的执业护士和50.3%的医师助理将自己描述为成人基层医疗服务提供者。没有基层医疗执业护士进行筛查性乙状结肠镜检查，只有3.8%的基层医疗医师助理进行此项检查。然而，76%的基层医疗医师助理和69%的基层医疗执业护士报告推荐进行筛查性乙状结肠镜检查。共有95%的基层医疗医师助理和92%的基层医疗执业护士报告进行粪便潜血检测。在培训期间，只有9.4%的医师助理和2.8%的执业护士接受过任何关于乙状结肠镜检查的正规指导。此外，41.4%的基层医疗医师助理和27.7%的基层医疗执业护士报告称他们有兴趣接受乙状结肠镜检查的正规培训。
在结直肠癌筛查方面，医师助理和执业护士是积极性高、意愿强烈但未得到充分利用的群体。加强对这些专业人员的教育和培训的努力可能会提高结直肠癌筛查方式的可及性。
