Goldsmith Geoffrey, Chiaro Carrie
Department of Family and Preventive Medicine, College of Medicine, University of Arkansas for Medical Sciences, Little Rock, AR 72205-7199, USA.
J Fam Pract. 2008 Jul;57(7):E2-7.
We elicited patient opinions about how physicians can improve communications about colorectal cancer (CRC) screening.
We recruited 15 patients, ages 50 years and older, from an urban family medicine teaching clinic. All patients in the initial pool of candidates had been seen at the university of Arkansas for Medical Sciences Family Medical Center within the past 12 months. The recruits participated in 1 of 3 focus groups to discuss how to enhance the rate of CRC screening. Participants watched a videotape that described the different approaches to CRC screening. We then asked them to comment on how patients could be encouraged to undergo CRC screening.
using a qualitative analysis of focus group data, we determined the most common reasons participants had not undergone CRC screening: fear, lack of information, and failure of the physician to strongly recommend CRC screening. Participants offered 7 recommendations for how physicians could address their concerns. Participants emphasized the importance of strong physician endorsement of screening, of frank and informative dialogue about patient's concerns, and of using educational materials to supplement personal advice.
A physician's recommendation for screening is the most powerful motivator in patients' decisions. However, other sources of information such as videotapes, written materials, and even endorsement of CRC screening by the clinic's office staff can help patients decide to undergo screening.
我们征集了患者对于医生如何改善结直肠癌（CRC）筛查沟通的意见。
我们从一家城市家庭医学教学诊所招募了15名年龄在50岁及以上的患者。最初候选人群中的所有患者在过去12个月内都曾在阿肯色大学医学科学家庭医疗中心就诊。招募的患者参加了3个焦点小组中的1个，以讨论如何提高CRC筛查率。参与者观看了一盘描述CRC筛查不同方法的录像带。然后我们请他们就如何鼓励患者接受CRC筛查发表意见。
通过对焦点小组数据的定性分析，我们确定了参与者未接受CRC筛查的最常见原因：恐惧、信息缺乏以及医生未能强烈推荐CRC筛查。参与者就医生如何解决他们的担忧提出了7条建议。参与者强调了医生大力支持筛查、就患者的担忧进行坦诚且信息丰富的对话以及使用教育材料来补充个人建议的重要性。
医生对筛查的建议是患者决策中最有力的激励因素。然而，其他信息来源，如录像带、书面材料，甚至诊所办公室工作人员对CRC筛查的支持，都可以帮助患者决定接受筛查。
