Mainous Arch G, Kern Donna, Hainer Berry, Kneuper-Hall Rayna, Stephens Julie, Geesey Mark E
Department of Family Medicine, Medical University of South Carolina, Charleston, SC 29425, USA.
Fam Med. 2004 Jan;36(1):35-9.
While continuity of care has been associated with an increased rate of cancer screening, it is unclear if continuity leads to earlier detection of cancer. This study examined the relationship between continuity of care and trust in one's physician with stage of cancer among newly diagnosed colorectal and breast cancer patients.
A total of 119 newly diagnosed cancer patients (97 breast, 22 colorectal) were surveyed in face-to-face interviews. The relationship between continuity of care and trust with the patient's primary care physicians prior to diagnosis were examined in relationship to the patient's stage at diagnosis via Spearman correlations and chi-square analyses. A stepwise logistic regression model was computed to examine the best predictors of stage at diagnosis.
Half of the patients reported that their cancer was found through screening. Continuity of care prior to diagnosis was related to receiving mammography. Continuity of care was not, however, significantly related to earlier detection. Trust in one's primary care physician was related to earlier detection among both the entire sample of patients with colon and breast cancer and among a subsample of women with breast cancer. In a multivariate model, only detection through screening and trust predicted stage of diagnosis.
Continuity of care is not related to earlier detection of cancer, while trust with a regular physician was associated with earlier detection of cancer.
虽然连续性护理与癌症筛查率的提高有关，但连续性护理是否能导致癌症的早期发现尚不清楚。本研究调查了新诊断的结直肠癌和乳腺癌患者中连续性护理、对医生的信任与癌症分期之间的关系。
对119例新诊断的癌症患者（97例乳腺癌患者，22例结直肠癌患者）进行了面对面访谈调查。通过Spearman相关性分析和卡方分析，研究了诊断前连续性护理及对患者初级保健医生的信任与患者诊断时分期之间的关系。计算逐步逻辑回归模型以检验诊断时分期的最佳预测因素。
一半的患者报告其癌症是通过筛查发现的。诊断前的连续性护理与接受乳房X光检查有关。然而，连续性护理与早期发现并无显著关联。对初级保健医生的信任与结肠癌和乳腺癌患者总体样本以及乳腺癌女性子样本中的早期发现均有关联。在多变量模型中，只有通过筛查发现和信任能够预测诊断分期。
连续性护理与癌症的早期发现无关，而与常规医生的信任则与癌症的早期发现有关。
