Eborall Helen, Davies Richard, Kinmonth Ann-Louise, Griffin Simon, Lawton Julia
General Practice and Primary Care Research Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge CB2 0SR.
BMJ. 2007 Sep 8;335(7618):490. doi: 10.1136/bmj.39308.392176.BE. Epub 2007 Aug 30.
To provide insight into factors that contribute to the anxiety reported in a quantitative study of the psychological effect of screening for type 2 diabetes. To explore expectations of and reactions to the screening experience of patients with positive, negative, and intermediate results.
Prospective qualitative interview study of patients attending a screening programme for type 2 diabetes.
Seven general practices in the ADDITION (Cambridge) trial in the east of England.
23 participants (aged 50-69) attending different stages in the screening process.
Participants' perceptions changed as they progressed through the screening programme; the stepwise process seemed to help them adjust psychologically. The first screening test was typically considered unimportant and was attended with no thought about its implications. By the final diagnostic test, type 2 diabetes was considered a strong possibility, albeit a "mild" form. After diagnosis, people with screen detected type 2 diabetes tended to downplay its importance and talked confidently about their plans to control it. Participants with intermediate results seemed uncertain about their diagnosis, and those who screened negative were largely unaware of their remaining high risk.
This study helps in understanding the limited psychological impact of screening for type 2 diabetes quantified previously, in particular by the quantitative substudy of ADDITION (Cambridge). The findings have implications for implementing such a screening programme in terms of timing and content.
深入了解在2型糖尿病筛查心理效应的定量研究中报告的焦虑相关因素。探讨筛查结果为阳性、阴性和中间结果的患者对筛查体验的期望和反应。
对参加2型糖尿病筛查项目的患者进行前瞻性定性访谈研究。
英格兰东部ADDITION（剑桥）试验中的7家普通诊所。
23名参与者（年龄在50 - 69岁之间）处于筛查过程的不同阶段。
参与者在筛查项目过程中的认知发生了变化；逐步的过程似乎有助于他们在心理上进行调整。第一次筛查测试通常被认为不重要，参加时没有考虑其影响。到最后诊断测试时，2型糖尿病被认为很有可能，尽管是“轻度”形式。诊断后，筛查出2型糖尿病的人倾向于淡化其重要性，并自信地谈论他们控制病情的计划。筛查结果为中间结果的参与者似乎对自己的诊断不确定，而筛查为阴性的参与者大多没有意识到自己仍处于高风险中。
本研究有助于理解先前量化的2型糖尿病筛查有限的心理影响，特别是ADDITION（剑桥）试验的定量子研究。这些发现对在时间安排和内容方面实施此类筛查项目具有启示意义。
