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改善全科医疗患者癌症风险因素的自我管理、癌症筛查不足及抑郁症状况:一项随机对照试验的研究方案

Improving self-management of cancer risk factors, underscreening for cancer and depression among general practice patients: study protocol of a randomised controlled trial.

作者信息

Carey Mariko, Sanson-Fisher Rob, Oldmeadow Christopher, Mansfield Elise, Walsh Justin

机构信息

Faculty of Health and Medicine, Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, New South Wales, Australia.

Hunter Medical Research Institute, Kookaburra Circuit, New Lambton Heights, New South Wales, Australia.

出版信息

BMJ Open. 2016 Nov 18;6(11):e014782. doi: 10.1136/bmjopen-2016-014782.

Abstract

INTRODUCTION

General practitioners have a key role in reducing cancer risk factors, screening for cancer and managing depression. Given the time-limited nature of consultations, a new and more time-efficient approach is needed which addresses multiple health needs simultaneously, and encourages patient self-management to address health risks. The aim of this cluster randomised controlled trial is to test the effectiveness of a patient feedback intervention in improving patient self-management of health needs related to smoking, risky alcohol consumption and underscreening for cancers at 1 month follow-up.

METHODS AND ANALYSIS

Adult general practice patients will be invited to participate in a baseline survey to assess cancer risk factors, screening needs and depression. A total of 360 participants identified by the baseline survey as having at least one health need (a self-reported cancer risk factor, underscreening for cancer, or an elevated depression score) will be randomised to an intervention or control group. Participants in the intervention group will receive tailored printed feedback summarising their identified health needs and recommended self-management actions to address these. All participants will be invited to complete a telephone interview 1 month following recruitment to assess self-management actions taken in relation to health needs identified in the baseline survey. Control group participants will receive tailored printed feedback on their identified health needs after their follow-up interview. A logistic regression model, with group allocation as the main predictor, will be used to assess the impact of the intervention on self-management actions.

ETHICAL CONSIDERATIONS AND DISSEMINATION

Participants identified as being at risk of depression will be advised to speak with their doctor. Results will be disseminated via publication in peer-reviewed journals. The study has been approved by the University of Newcastle Human Research Ethics Committee.

TRIAL REGISTRATION NUMBER

ACTRN12616001443482.

摘要

引言

全科医生在降低癌症风险因素、癌症筛查及抑郁症管理方面发挥着关键作用。鉴于诊疗时间有限,需要一种新的、更高效的方法,该方法能同时满足多种健康需求,并鼓励患者自我管理以应对健康风险。这项整群随机对照试验的目的是在1个月随访时,测试患者反馈干预措施在改善患者对与吸烟、危险饮酒及癌症筛查不足相关的健康需求进行自我管理方面的有效性。

方法与分析

将邀请成年全科医疗患者参与基线调查,以评估癌症风险因素、筛查需求及抑郁症情况。通过基线调查确定的共有360名至少有一项健康需求(自我报告的癌症风险因素、癌症筛查不足或抑郁评分升高)的参与者将被随机分为干预组或对照组。干预组的参与者将收到量身定制的打印反馈,总结他们已确定的健康需求及针对这些需求建议采取的自我管理行动。所有参与者将在招募后1个月被邀请完成一次电话访谈,以评估针对基线调查中确定的健康需求所采取的自我管理行动。对照组参与者将在随访访谈后收到关于其已确定健康需求的量身定制的打印反馈。将使用以分组分配为主要预测因素的逻辑回归模型来评估干预措施对自我管理行动的影响。

伦理考量与传播

被确定有抑郁症风险的参与者将被建议与他们的医生交谈。研究结果将通过在同行评审期刊上发表进行传播。该研究已获得纽卡斯尔大学人类研究伦理委员会的批准。

试验注册号

ACTRN12616001443482。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1892/5128774/ed106e40a776/bmjopen2016014782f01.jpg

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