Department of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institutet, Stockholm, Sweden.
Department of Health and Caring Sciences, University of Gävle, Gävle, Sweden.
Eur J Public Health. 2017 Dec 1;27(6):1079-1084. doi: 10.1093/eurpub/ckw266.
To explore how individuals reason when they make decisions about participating in colorectal cancer (CRC) screening.
Individuals randomized to FIT or colonoscopy included in the Screening of Swedish Colons (SCREESCO) program was invited to focus group discussions and individual telephone interviews. The concept of shared decision-making (SDM: information; values/preferences; involvement) was used as a matrix for the analyses. To validate findings, additional focus group discussions using the nominal group technique were performed.
Lack of knowledge of CRC and CRC screening was prominent for participants and non-participants, while the results differed between the groups in relation to their values and preferences. The influence of significant others promoted participation while it prevented it among non-participants. Those who participated and those who did not made it clear that there was no need to involve health care professionals when making the decision.
Based on the results, a display of different ways to spread knowledge and communicate about CRC and CRC-screening could be applied such as, community-based information campaigns, decisions aids, interactive questionnaires, chat-functions and telephone support. The disparity in values and preferences between participants and non-participants may be the key to understand why non-participants make their decisions not to participate and warrant further exploration.
探讨个体在决定参与结直肠癌（CRC）筛查时的推理方式。
随机分配至 FIT 或结肠镜检查的参与者被邀请参加焦点小组讨论和个人电话访谈，该研究纳入了瑞典结直肠筛查（SCREESCO）项目。共享决策（SDM：信息；价值观/偏好；参与）的概念被用作分析的矩阵。为了验证研究结果，还使用名义群体技术进行了额外的焦点小组讨论。
缺乏结直肠癌和 CRC 筛查的知识在参与者和非参与者中都很突出，而两组在价值观和偏好方面的结果存在差异。重要他人的影响促进了参与者的参与，而对非参与者则起到了阻碍作用。那些参与和不参与的人都明确表示，在做出决策时无需涉及医疗保健专业人员。
基于研究结果，可以应用不同的方法来传播关于 CRC 和 CRC 筛查的知识和信息，例如，基于社区的信息宣传活动、决策辅助工具、交互式问卷、聊天功能和电话支持。参与者和非参与者之间价值观和偏好的差异可能是理解非参与者做出不参与决定的关键，值得进一步探讨。
