Department of Nursing, Chosun University, 309 Pilmun-daero, Dong-gu, Gwangju, 501-759, Republic of Korea.
School of Nursing, University of California, Los Angeles, CA, USA.
BMC Public Health. 2018 Feb 14;18(1):254. doi: 10.1186/s12889-018-5147-9.
Cancer is the greatest disease burden in Korea. Cancer screening can reduce the burden of cancer but cancer screening rates among Koreans remain low. The purposes of this study were to a) understand Koreans' beliefs and knowledge about cancer screening, and b) explore preferred strategies for increasing cancer screening utilization.
We conducted a descriptive, qualitative study using eight face-to-face focus groups with a total of 64 Koreans aged 40 and over. Participants answered semi-structured, open-ended questions assessing their experiences with, and beliefs, knowledge, and opinions about, cancer screening. All interview data were recorded and analyzed in the context of the health belief model (HBM).
The most important themes that emerged from the focus group data were (a) perceived susceptibility (most of the participants believed they were not susceptible to cancer; those who perceived themselves susceptible to cancer were reluctant to express it); (b) perceived benefits (early detection and feelings of relief after cancer screening were benefits; participants had screening because they wanted to take advantage of the Korean government's Medical Payment Support program for cancer patients who have participated in the National Cancer Screening program); (c) perceived barriers (no symptoms; self-care when having symptoms; widespread distrust of tests, doctors, and hospitals; unkind health care providers; the financial burdens of advanced cancer screening tests; and the discomfort during cancer screening); and (d) knowledge of the causes of cancer (incorrect knowledge including beliefs that stress, personality, and body overuse cause cancer). Almost all of the participants were very knowledgeable about the seriousness of cancer and were confident that they were able to have cancer screening. Participants preferred strategies of cancer screening using group interventions with family or friends; various information delivery methods; information emphasizing the importance of cancer prevention; convenient, free, or inexpensive services; and kind health care providers.
This HBM-based research suggests that beliefs in low susceptibility to cancer, many barriers to cancer screening, and incorrect knowledge should be the foci for increasing cancer screening rates in Koreans. Interventions could change individual cultural beliefs and increase knowledge as well as the quality of health care for Koreans.
癌症是韩国最大的疾病负担。癌症筛查可以减轻癌症负担，但韩国人的癌症筛查率仍然很低。本研究的目的是：a）了解韩国人对癌症筛查的信念和知识，b）探索提高癌症筛查利用率的首选策略。
我们使用 8 个面对面的焦点小组进行了描述性的定性研究，共有 64 名年龄在 40 岁及以上的韩国人参加。参与者回答了半结构化的开放式问题，评估了他们对癌症筛查的经验、信念、知识和意见。所有访谈数据都在健康信念模型（HBM）的背景下进行了记录和分析。
焦点小组数据中出现的最重要主题是：（a）感知易感性（大多数参与者认为自己不易患癌症；那些认为自己易患癌症的人不愿意表达出来）；（b）感知益处（早期发现和癌症筛查后的解脱感是益处；参与者进行筛查是因为他们想利用韩国政府为参加国家癌症筛查计划的癌症患者提供的医疗支付支持计划）；（c）感知障碍（无症状；有症状时自我护理；对测试、医生和医院的广泛不信任；不友善的医疗保健提供者；先进癌症筛查测试的经济负担；癌症筛查期间的不适）；（d）癌症原因的知识（不正确的知识，包括压力、个性和身体过度使用导致癌症的信念）。几乎所有参与者都非常了解癌症的严重性，并相信自己能够进行癌症筛查。参与者更喜欢使用家庭或朋友群体干预、各种信息传递方法、强调癌症预防重要性的信息、方便、免费或廉价的服务以及友善的医疗保健提供者进行癌症筛查的策略。
这项基于 HBM 的研究表明，应将对癌症低易感性的信念、癌症筛查的许多障碍和不正确的知识作为提高韩国人癌症筛查率的重点。干预措施可以改变个人的文化信念，提高知识水平，并改善韩国人的医疗保健质量。
