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妇产科医生和执业护士的结直肠癌筛查实践

Colorectal cancer screening practices among obstetrician/gynecologists and nurse practitioners.

作者信息

Menees Stacy B, Patel Divya A, Dalton Vanessa

机构信息

Eastern Virginia Medical School, Norfolk, VA 23502, USA.

出版信息

J Womens Health (Larchmt). 2009 Aug;18(8):1233-8. doi: 10.1089/jwh.2008.1117.

Abstract

OBJECTIVE

Obstetrician/gynecologists (Ob/Gyn) and nurse practitioners (NP) are essential providers of primary and preventive care for their female patients. Therefore, colorectal cancer (CRC) screening should be part of their routine preventive practices. The purpose of our study is to evaluate the CRC screening practices of these providers.

METHODS

A self-administered survey was mailed to a national sample of 1130 Ob/Gyns and NPs to assess providers' demographics, current CRC screening practices, and familiarity with CRC guidelines.

RESULTS

Three hundred thirty-six providers (29.7%) returned our survey (54% Ob/Gyns and 46% NPs). Three fourths of providers routinely performed screening for CRC, compared with 95% for breast and cervical cancer. Routine CRC screening was more common among Ob/Gyns (87.2%) than NPs (61.7%) (p < 0.001). Slightly over half of providers correctly identified the recommended age to begin CRC screening for the average-risk patient, with no significant difference between provider types. Overall, Ob/Gyns scored higher than NPs on a series of questions assessing CRC screening (p < 0.03). Several provider factors were found to be significantly associated with screening practices, including practicing >10 years (p < 0.01), practicing in a multispecialty group (2.62 times more likely), and having an older patient population (p < 0.001).

CONCLUSIONS

Ob/Gyns and NPs underuse CRC screening compared with breast and cervical cancer screening and lack knowledge about appropriate use of CRC screening modalities. Opportunities to further educate Ob/Gyns and NPs should be sought to improve compliance with current CRC screening guidelines.

摘要

目的

妇产科医生(Ob/Gyn)和执业护士(NP)是为女性患者提供初级和预防性护理的重要医疗服务提供者。因此,结直肠癌(CRC)筛查应成为他们常规预防措施的一部分。我们研究的目的是评估这些医疗服务提供者的CRC筛查实践情况。

方法

向全国范围内抽取的1130名妇产科医生和执业护士发放了一份自填式调查问卷,以评估医疗服务提供者的人口统计学特征、当前的CRC筛查实践情况以及对CRC指南的熟悉程度。

结果

336名医疗服务提供者(29.7%)回复了我们的调查问卷(其中54%为妇产科医生,46%为执业护士)。四分之三的医疗服务提供者常规进行CRC筛查,而乳腺癌和宫颈癌筛查的比例为95%。常规CRC筛查在妇产科医生中(87.2%)比执业护士中(61.7%)更为常见(p<0.001)。略超过一半的医疗服务提供者正确识别出了平均风险患者开始CRC筛查的推荐年龄,不同类型的医疗服务提供者之间无显著差异。总体而言,在一系列评估CRC筛查的问题上,妇产科医生的得分高于执业护士(p<0.03)。发现几个医疗服务提供者因素与筛查实践显著相关,包括从业超过10年(p<0.01)、在多专科团队执业(可能性高2.62倍)以及拥有年龄较大的患者群体(p<0.001)。

结论

与乳腺癌和宫颈癌筛查相比,妇产科医生和执业护士对CRC筛查的利用不足,并且缺乏关于CRC筛查方式合理使用的知识。应寻求进一步教育妇产科医生和执业护士的机会,以提高对当前CRC筛查指南的依从性。

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