Smith Sian K, Simpson Judy M, Trevena Lyndal J, McCaffery Kirsten J
Psychosocial Research Group, Prince of Wales Clinical School, Faculty of Medicine University of New South Wales, NSW, Australia (SKS)
Sydney School of Public Health, University of Sydney, NSW, Australia (JMS)
Med Decis Making. 2014 Aug;34(6):756-72. doi: 10.1177/0272989X13518976. Epub 2014 Jan 13.
Making informed decisions about cancer screening involves understanding the benefits and harms in conjunction with personal values. There is little research examining factors associated with informed decision making or participation in screening in the context of a decision aid trial.
To identify factors associated with informed choice and participation in fecal occult blood testing (FOBT) among lower education populations.
Randomized controlled trial of an FOBT decision aid conducted between July and November 2008.
Socioeconomically disadvantaged areas in New South Wales, Australia.
Included 572 adults aged 55 to 64 years with lower education.
Sociodemographic variables, perceived health literacy, and involvement preferences in decision making were examined to identify predictors of informed choice (knowledge, attitudes, and behavior).
Multivariate analysis identified independent predictors of making an informed choice as having higher education (relative risk [RR], 1.49; 95% confidence interval [CI], 1.13-1.95; P = 0.001), receiving the decision aid (RR, 2.88; 95% CI, 1.87-4.44; P < 0.001), and being male (RR, 1.48; 95% CI, 1.11-1.97; P = 0.009). Participants with no confidence in completing forms and poorer self-reported health were less likely to make an informed choice (RR, 0.74; 95% CI, 0.53-1.03; P = 0.05 and RR, 0.57; 95% CI, 0.36-0.89; P = 0.007, respectively). Independent predictors of completing the FOBT were positive screening attitudes, receiving the standard information, preference for making the decision alone, and knowing that screening may lead to false-positive/negative results.
We did not objectively measure health literacy.
Participants with the lowest levels of education had greater difficulties making an informed choice about participation in bowel screening. Alternative methods are needed to support informed decision making among lower education populations.
就癌症筛查做出明智决策需要结合个人价值观来理解其益处和危害。在决策辅助试验的背景下，很少有研究探讨与明智决策或参与筛查相关的因素。
确定低教育水平人群中与明智选择和参与粪便潜血试验（FOBT）相关的因素。
2008年7月至11月间进行的一项关于FOBT决策辅助工具的随机对照试验。
澳大利亚新南威尔士州社会经济条件不利的地区。
纳入572名年龄在55至64岁之间、教育水平较低的成年人。
对社会人口统计学变量、感知健康素养以及决策参与偏好进行了研究，以确定明智选择（知识、态度和行为）的预测因素。
多变量分析确定了明智选择的独立预测因素为较高的教育水平（相对风险[RR]，1.49；95%置信区间[CI]，1.13 - 1.95；P = 0.001）、接受决策辅助工具（RR，2.88；95% CI，1.87 - 4.44；P < 0.001）以及男性（RR，1.48；95% CI，1.11 - 1.97；P = 0.009）。对填写表格没有信心且自我报告健康状况较差的参与者做出明智选择的可能性较小（RR，0.74；95% CI，0.53 - 1.03；P = 0.05和RR，0.57；95% CI，0.36 - 0.89；P = 0.007）。完成FOBT的独立预测因素为积极的筛查态度、接受标准信息、偏好独自做决定以及知晓筛查可能导致假阳性/阴性结果。
我们没有客观地测量健康素养。
教育水平最低的参与者在就参与肠道筛查做出明智选择方面困难更大。需要采用替代方法来支持低教育水平人群做出明智决策。
Zotero 插件