Sommer Isolde, Titscher Viktoria, Gartlehner Gerald
Department for Evidence-based Medicine and Clinical Epidemiology, University of Continuing Education (Danube University Krems), Dr.-Karl-Dorrek-Straße 30, 3500, Krems, Austria.
RTI-UNC Evidence-based Practice Center, Research Triangle Institute International, 3040 East Cornwallis Road, P.O. Box 12194, Research Triangle Park, Raleigh, North Carolina, 27709-2194, USA.
BMC Health Serv Res. 2018 Oct 30;18(1):823. doi: 10.1186/s12913-018-3640-6.
The engagement of citizens in the development of evidence-based screening programs is internationally supported. The aim of our research was to explore the motivations and reasons of adult citizens in Austria for attending periodic health examinations (PHE) as well as their satisfaction with the way PHE are organized.
We conducted three focus groups with a random sample of previous attenders of PHE. Participants were stratified by age, gender, and education. The discussions were recorded, transcribed, and analyzed using a thematic analysis approach.
Main motivations of attenders (n = 30) were to detect diseases early, to prevent suffering, and to live a long, healthy life. They believed that PHE work as an incentive of health behavior change. As possible reasons not to attend PHE, participants mentioned lack of awareness, time constraints, unpleasant prior experiences, and fear of harm or negative consequences. They wanted the range of examinations to be selected based on individual risks and to be more comprehensive. Some participants expressed frustration with the lack of time doctors dedicated to the examination or discussion of the results. Throughout the discussion, participants realized there is a great diversity among doctors in the quality of health examinations and how content is delivered.
The study showed that attenders of PHE have high expectations concerning the beneficial outcomes of PHE. They requested a comprehensive and individualized program that does not reflect the scientific evidence from effectiveness studies of PHE. These findings indicate serious shortcomings in the communication of benefits and harms of screening interventions and highlight the need for a more proactive communication about aims and content of the program.
公民参与循证筛查项目的制定在国际上得到支持。我们研究的目的是探讨奥地利成年公民参加定期健康检查（PHE）的动机和原因，以及他们对PHE组织方式的满意度。
我们对PHE的既往参与者进行随机抽样，开展了三个焦点小组。参与者按年龄、性别和教育程度分层。讨论进行了录音、转录，并采用主题分析方法进行分析。
参与者（n = 30）的主要动机是早期发现疾病、预防痛苦以及健康长寿。他们认为PHE是健康行为改变的一种激励。作为不参加PHE的可能原因，参与者提到缺乏认知、时间限制、不愉快的既往经历以及对伤害或负面后果的恐惧。他们希望根据个人风险选择检查项目，并且检查项目更加全面。一些参与者对医生用于检查或讨论结果的时间不足表示不满。在整个讨论过程中，参与者意识到医生在健康检查质量和内容呈现方式上存在很大差异。
研究表明，PHE的参与者对PHE的有益结果有很高期望。他们要求有一个全面且个性化的项目，但该项目并未反映PHE有效性研究的科学证据。这些发现表明在筛查干预的利弊沟通方面存在严重不足，并突出了对项目目标和内容进行更积极沟通的必要性。
