Carter-Harris Lisa, Ceppa DuyKhanh Pham, Hanna Nasser, Rawl Susan M
Indiana University School of Nursing, Indianapolis, IN, USA.
Indiana University School of Medicine, Indianapolis, IN, USA.
Health Expect. 2017 Feb;20(1):59-68. doi: 10.1111/hex.12433. Epub 2015 Dec 23.
To explore knowledge and beliefs of long-term smokers about lung cancer, associated risk factors and lung cancer screening.
Qualitative study theoretically framed by the expanded Health Belief Model based on four focus group discussions. Content analysis was performed to identify themes of knowledge and beliefs about lung cancer, associated risk factors and lung cancer screening among long-term smokers' who had and had not been screened for lung cancer.
Twenty-six long-term smokers were recruited; two groups (n = 9; n = 3) had recently been screened and two groups (n = 7; n = 7) had never been screened.
While most agreed lung cancer is deadly, confusion or inaccurate information exists regarding the causes and associated risk factors. Knowledge related to lung cancer screening and how it is performed was low; awareness of long-term smoking's association with lung cancer risk remains suboptimal. Perceived benefits of screening identified include: (i) finding lung cancer early; (ii) giving peace of mind; and (iii) motivation to quit smoking. Perceived barriers to screening identified include: (i) inconvenience; (ii) distrust; and (iii) stigma.
Perceived barriers to lung cancer screening, such as distrust and stigma, must be addressed as lung cancer screening becomes more widely implemented. Heightened levels of health-care system distrust may impact successful implementation of screening programmes. Perceived smoking-related stigma may lead to low levels of patient engagement with medical care and decreased cancer screening participation. It is also important to determine modifiable targets for intervention to enhance the shared decision-making process between health-care providers and their high-risk patients.
探讨长期吸烟者对肺癌、相关危险因素及肺癌筛查的认知与信念。
基于四次焦点小组讨论，采用扩展健康信念模型进行理论框架构建的定性研究。对已接受和未接受肺癌筛查的长期吸烟者关于肺癌、相关危险因素及肺癌筛查的知识和信念主题进行内容分析。
招募了26名长期吸烟者；两组（n = 9；n = 3）最近接受了筛查，两组（n = 7；n = 7）从未接受过筛查。
虽然大多数人认同肺癌是致命的，但对于其病因和相关危险因素存在困惑或不准确的信息。与肺癌筛查及其实施方式相关的知识水平较低；对长期吸烟与肺癌风险关联的认识仍不理想。确定的筛查感知益处包括：（i）早期发现肺癌；（ii）安心；（iii）戒烟动力。确定的筛查感知障碍包括：（i）不便；（ii）不信任；（iii）耻辱感。
随着肺癌筛查的更广泛实施，必须解决肺癌筛查的感知障碍，如不信任和耻辱感。对医疗保健系统信任度的提高可能会影响筛查计划的成功实施。吸烟相关的耻辱感可能导致患者参与医疗护理的程度较低以及癌症筛查参与率下降。确定可改变的干预目标以加强医疗保健提供者与其高危患者之间的共同决策过程也很重要。
