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结直肠癌筛查:患者和医生对决策因素的看法

Colorectal cancer screening: patients' and physicians' perspectives on decision-making factors.

作者信息

Tarasenko Yelena N, Wackerbarth Sarah B, Love Margaret M, Joyce Jennifer M, Haist Steven A

机构信息

Department of Behavioral Science, College of Medicine, University of Kentucky, Medical Behavioral Science Building, Lexington, KY 40536-0086, USA.

出版信息

J Cancer Educ. 2011 Jun;26(2):285-93. doi: 10.1007/s13187-010-0145-3.

Abstract

While patient barriers to colorectal cancer (CRC) screening have been identified, how well this knowledge is utilized during the patient-physician interaction is not fully understood. This study aims to assess among primary care physicians the degree of consensus between perceived and actual patients' CRC screening decision-making influential factors. During 2004-2006, 30 patients were interviewed to identify factors influencing screening decisions and 66 physicians were interviewed to understand what factors they thought were important to patients. The factors were categorized using the PRECEDE-PROCEED framework, and perspectives were compared. The researchers found little consensus on CRC screening decision-making influential factors between family practitioners, general internists, and patients. The recommendations to reach consensus are provided on the individual (e.g., updating the contents of a physician's screening recommendation to proactively address patients' decision-making needs) and population (e.g., providing cross-cultural training to medical students enabling them to better understand their patients) levels.

摘要

虽然已经确定了患者在结直肠癌(CRC)筛查方面存在的障碍,但在医患互动过程中这些知识的利用程度尚未得到充分了解。本研究旨在评估初级保健医生对感知到的和实际的患者CRC筛查决策影响因素之间的共识程度。在2004年至2006年期间,对30名患者进行了访谈以确定影响筛查决策的因素,并对66名医生进行了访谈以了解他们认为对患者重要的因素。使用PRECEDE-PROCEED框架对这些因素进行分类,并比较各方观点。研究人员发现,家庭医生、普通内科医生和患者之间在CRC筛查决策影响因素方面几乎没有达成共识。研究在个体层面(例如,更新医生筛查建议的内容以主动满足患者的决策需求)和人群层面(例如,为医学生提供跨文化培训,使他们能够更好地了解患者)给出了达成共识的建议。

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