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低剂量计算机断层扫描用于肺癌筛查的障碍

Barriers to Lung Cancer Screening With Low-Dose Computed Tomography.

作者信息

Lei Fang, Lee Eunice

机构信息

University of California, Los Angeles.

出版信息

Oncol Nurs Forum. 2019 Mar 1;46(2):E60-E71. doi: 10.1188/19.ONF.E60-E71.

Abstract

PROBLEM IDENTIFICATION

Despite lung cancer screening guidelines and insurance coverage changes, rates of lung cancer screening with low-dose computed tomography remain suboptimal among the eligible population in the United States.

LITERATURE SEARCH

Electronic literature databases, including PubMed, CINAHL®, PsycINFO, and Google Scholar, were searched.

DATA EVALUATION

After applying filter information and inclusion and exclusion criteria, 10 articles were reviewed. Methodological rigor was evaluated.

SYNTHESIS

Based on the social-ecological approach, barriers to lung cancer screening at the individual level, including sociodemographic characteristics, financial cost, lack of knowledge, inaccurate beliefs about lung cancer screening, distrust of the medical system, stigma around smoking and lung cancer, negative attitudes about outcomes of lung cancer screening, and inconvenience of receiving lung cancer screening, were identified. Barriers at the health-system level included lack of information from primary care providers.

IMPLICATIONS FOR PRACTICE

Overcoming barriers to lung cancer screening at individual and health-system levels is essential to increase lung cancer screening uptake rates.

摘要

问题识别

尽管有肺癌筛查指南且保险覆盖范围有所变化,但在美国符合条件的人群中,低剂量计算机断层扫描肺癌筛查率仍未达到最佳水平。

文献检索

检索了包括PubMed、CINAHL®、PsycINFO和谷歌学术在内的电子文献数据库。

数据评估

应用筛选信息及纳入和排除标准后,对10篇文章进行了综述,并评估了方法的严谨性。

综合分析

基于社会生态方法,确定了个体层面肺癌筛查的障碍,包括社会人口学特征、经济成本、知识缺乏、对肺癌筛查的错误认知、对医疗系统的不信任、围绕吸烟和肺癌的污名化、对肺癌筛查结果的负面态度以及接受肺癌筛查的不便。卫生系统层面的障碍包括初级保健提供者缺乏信息。

对实践的启示

克服个体和卫生系统层面的肺癌筛查障碍对于提高肺癌筛查接受率至关重要。

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