McFall Stephanie L
University of Texas Health Science Center, School of Public Health, San Antonio, Tex 78229, USA.
Ann Fam Med. 2006 Sep-Oct;4(5):433-6. doi: 10.1370/afm.576.
Informed decision making is recommended for prostate cancer screening. I wanted to examine demographic and screening-related factors associated with men's discussion of the advantages and disadvantages of prostate-specific antigen (PSA) tests with their physicians.
I used data from 2,184 men aged 50 years and older who reported a screening prostate-specific antigen (PSA) test in the 2000 National Health Interview Survey cancer control supplement. The dependent variable was discussion of the advantages and disadvantages of the test before it was conducted.
Sixty-three percent of tested men reported a discussion in relation to their most recent PSA test. Discussion was more common for African American men and those with a usual source of care, and when the physician initiated the testing.
Characteristics of the patient-physician relationship were more central to the discussion of risks and benefits than were patient attributes. Future research should examine what role practice setting and the physician-patient relationship play in a discussion of PSA testing and how to facilitate active involvement of patients in decision making.
推荐在前列腺癌筛查中进行知情决策。我想研究与男性和医生讨论前列腺特异性抗原(PSA)检测利弊相关的人口统计学及筛查相关因素。
我使用了2000年国家健康访谈调查癌症控制补充调查中2184名50岁及以上男性的数据,这些男性报告进行了前列腺特异性抗原(PSA)筛查检测。因变量是在检测前对检测利弊的讨论。
63%接受检测的男性报告就其最近一次PSA检测进行了讨论。非洲裔美国男性以及有固定医疗服务来源的男性更常进行讨论,并且当医生发起检测时也是如此。
医患关系的特征在风险和益处的讨论中比患者属性更为关键。未来的研究应考察医疗机构环境和医患关系在PSA检测讨论中所起的作用,以及如何促进患者积极参与决策。