Katz Mira L, James Aimee S, Pignone Michael P, Hudson Marlyn A, Jackson Ethel, Oates Veronica, Campbell Marci K
Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
BMC Public Health. 2004 Dec 15;4:62. doi: 10.1186/1471-2458-4-62.
A healthcare provider's recommendation to undergo screening has been shown to be one of the strongest predictors of completing a colorectal cancer (CRC) screening test. We sought to determine the relationship between the general quality of self-rated patient-provider communication and the completion of CRC screening.
A formative study using qualitative data from focus groups and quantitative data from a cross-sectional survey of church members about the quality of their communication with their healthcare provider, their CRC risk knowledge, and whether they had completed CRC screening tests. Focus group participants were a convenience sample of African American church members. Participants for the survey were recruited by telephone from membership lists of 12 African American churches located in rural counties of North Carolina to participate in the WATCH (Wellness for African Americans Through Churches) Project.
Focus Groups. Six focus groups (n = 45) were conducted prior to the baseline survey. Discussions focused on CRC knowledge, and perceived barriers/motivators to CRC screening. A theme that emerged during each groups' discussion about CRC screening was the quality of the participants' communication with their health care provider. Survey. Among the 397 participants over age 50, 31% reported CRC screening within the recommended guidelines. Participants who self-rated their communication as good were more likely to have been screened (36%) within the recommended guidelines than were participants with poor communication (17%) (OR = 2.8, 95% CI 1.2, 6.4; p = 0.013). Participants who had adequate CRC knowledge completed CRC screening at a higher rate than those with inadequate knowledge (p = 0.011). The percentage of participants with CRC screening in the recommended guidelines, stratified by communication and knowledge group were: 42% for good communication/adequate knowledge; 27% for good communication/inadequate knowledge; 29% for poor communication/adequate knowledge; and 5% for poor communication/inadequate knowledge.
Participants who rated their patient-provider communication as good were more likely to have completed CRC screening tests than those reporting poor communication. Among participants reporting good communication, knowledge about colorectal cancer was also associated with test completion. Interventions to improve patient-provider communication may be important to increase low rates of CRC screening test completion among African Americans.
医疗服务提供者建议进行筛查已被证明是完成结直肠癌（CRC）筛查测试的最强预测因素之一。我们试图确定患者自评的医患沟通总体质量与CRC筛查完成情况之间的关系。
一项形成性研究，使用焦点小组的定性数据和对教会成员进行的横断面调查的定量数据，内容涉及他们与医疗服务提供者的沟通质量、CRC风险知识以及他们是否完成了CRC筛查测试。焦点小组参与者是非洲裔美国教会成员的便利样本。调查参与者通过电话从北卡罗来纳州农村县的12个非洲裔美国教会的成员名单中招募，以参与“通过教会促进非裔美国人健康”（WATCH）项目。
焦点小组。在基线调查之前进行了6个焦点小组（n = 45）。讨论集中在CRC知识以及CRC筛查的感知障碍/动机。在每个小组关于CRC筛查的讨论中出现的一个主题是参与者与医疗服务提供者的沟通质量。调查。在397名50岁以上的参与者中，31%报告在推荐指南范围内进行了CRC筛查。自评沟通良好的参与者在推荐指南范围内接受筛查的可能性（36%）高于沟通不良的参与者（17%）（OR = 2.8，95% CI 1.2，6.4；p = 0.013）。拥有足够CRC知识的参与者完成CRC筛查的比例高于知识不足的参与者（p = 0.011）。按沟通和知识组分层，在推荐指南范围内进行CRC筛查的参与者百分比为：沟通良好/知识充足组为42%；沟通良好/知识不足组为27%；沟通不良/知识充足组为29%；沟通不良/知识不足组为5%。
将医患沟通评为良好的参与者比报告沟通不良的参与者更有可能完成CRC筛查测试。在报告沟通良好的参与者中，关于结直肠癌的知识也与测试完成情况相关。改善医患沟通的干预措施对于提高非裔美国人中较低的CRC筛查测试完成率可能很重要。
