Department of Emergency Medicine, Thomas Jefferson University Hospital, Philadelphia, PA 19107, USA.
AJR Am J Roentgenol. 2010 Nov;195(5):1151-8. doi: 10.2214/AJR.09.3847.
The purpose of this study was to assess knowledge and attitudes about radiation from CT among emergency department patients with symptoms prompting CT who were stratified on the basis of demographic variables, pain, and perceived illness.
This survey study was based on three knowledge and three attitude questions asked of patients who underwent any CT examination from June 23 through July 31, 2008. Data were analyzed with chi-square for categoric data and the Student's t test or analysis of variance for continuous data.
The survey was completed by 383 patients (mean age, 48 ± 18 years; 60% women; 40% black; 52% white; 8% other race). In answering the three knowledge-based questions, 79% and 83% of patients correctly estimated their risk of cancer from chest radiography and CT, respectively, as none, small, or very small. Patients who were white, more educated, and had lower pain scores were more likely to be correct. Only 34% of all patients correctly thought that CT gave more radiation than chest radiography; the more educated patients were more likely to be correct. In answering the three attitude questions, 74% of patients believed having their condition diagnosed with CT was more important than worrying about radiation. Patients preferred a better test with more radiation, although 68% wanted their physician to take the time to discuss the risk and benefits rather than using their judgment to order the best test. Privately insured patients preferred to have their condition diagnosed with CT rather than worry about radiation. Blacks and patients with less pain wanted the risks and benefits explained at the expense of time. Whites preferred a more definitive test at the expense of more radiation.
Patients did not estimate the risk of development of cancer from their imaging examinations as high and were more concerned about having their condition diagnosed with CT than about the risk of future cancer. Knowledge and attitudes differed by age, race, education, insurance status, and pain level but not by sex, body mass index, or perceived seriousness of condition.
本研究旨在评估基于人口统计学变量、疼痛和感知疾病对 CT 检查的急诊科患者的 CT 辐射的知识和态度。
这项调查研究基于对 2008 年 6 月 23 日至 7 月 31 日期间接受任何 CT 检查的患者提出的三个知识问题和三个态度问题。对分类数据采用卡方检验，对连续数据采用学生 t 检验或方差分析进行数据分析。
共完成 383 例患者（平均年龄 48 ± 18 岁；60%为女性；40%为黑人；52%为白人；8%为其他种族）的调查。在回答三个基于知识的问题时，79%和 83%的患者分别正确估计了胸部 X 射线和 CT 检查患癌症的风险为无、小或非常小。白人、受教育程度较高和疼痛评分较低的患者更有可能回答正确。只有 34%的患者正确认为 CT 比胸部 X 射线辐射更大；受教育程度较高的患者更有可能回答正确。在回答三个态度问题时，74%的患者认为使用 CT 诊断病情比担心辐射更重要。患者更愿意选择辐射较大的更好的检查，尽管 68%的患者希望医生花时间讨论风险和益处，而不是凭自己的判断开出最佳检查。有私人保险的患者更愿意接受 CT 检查来诊断病情，而不是担心辐射。黑人患者和疼痛较轻的患者希望在不浪费时间的情况下解释风险和益处。白人患者则更倾向于选择辐射更大的确定性检查。
患者并未将其影像学检查的癌症发病风险估计得那么高，并且更担心使用 CT 检查来诊断病情，而不是担心未来癌症的风险。知识和态度因年龄、种族、教育程度、保险状况和疼痛程度而异，但与性别、体重指数或感知病情的严重程度无关。
