癌症筛查不足：缺乏医疗服务连续性比医患信任缺失是更大的障碍。
Inadequate Cancer Screening: Lack of Provider Continuity is a Greater Obstacle than Medical Mistrust.
作者信息
Arnold Lauren D, McGilvray Martha M, Kyle Cooper J, James Aimee S
出版信息
J Health Care Poor Underserved. 2017;28(1):362-377. doi: 10.1353/hpu.2017.0028.
BACKGROUND
Racial minorities and low-income individuals are generally less likely to have adequate cancer screening than Whites or higher-income individuals.
PURPOSE
To examine the roles of medical mistrust and lack of provider continuity in cancer screening in a low-income minority population.
METHODS
A total of 144 urban federally qualified health center patients completed a cross-sectional survey that included the Group Based Medical Mistrust Scale and questions on provider continuity and cancer-screening-history.
RESULTS
Breast cancer screening was associated with continuity of care but not mistrust (respectively p = .002, p > .05); colon cancer screening was not significantly associated with either factor (p > .05).
CONCLUSIONS
Findings suggest that among low-income minority adults continuity of care is more strongly associated with screening than medical mistrust. Shifting focus from medical mistrust-a patient-level issue-to establishing health care homes-a system-level issue-may be a more effective strategy for reducing racial and socioeconomic disparities in cancer screening.
背景
与白人或高收入人群相比，少数族裔和低收入人群通常进行充分癌症筛查的可能性更低。
目的
探讨医疗不信任和缺乏医护人员连续性在低收入少数族裔人群癌症筛查中的作用。
方法
共有144名城市联邦合格健康中心患者完成了一项横断面调查，该调查包括基于群体的医疗不信任量表以及关于医护人员连续性和癌症筛查史的问题。
结果
乳腺癌筛查与医疗连续性相关，但与不信任无关（分别为p = 0.002，p > 0.05）；结肠癌筛查与这两个因素均无显著关联（p > 0.05）。
结论
研究结果表明，在低收入少数族裔成年人中，医疗连续性与筛查的关联比医疗不信任更强。将重点从医疗不信任（一个患者层面的问题）转移到建立医疗之家（一个系统层面的问题），可能是减少癌症筛查中种族和社会经济差异的更有效策略。
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