Univ Lyon, Univ Lyon 1, IFSTTAR, UMRESTTE, Lyon, France.
Centre HYGÉE, Institut de Cancérologie de la Loire Lucien Neuwirth, Saint Etienne, France.
Occup Med (Lond). 2019 Jun 24;69(4):266-271. doi: 10.1093/occmed/kqz065.
Between 10 and 20% of lung cancers are of occupational origin. Screening for occupational risk factors is part of the diagnostic workup. A self-administered questionnaire to detect lung carcinogens of occupational origin, the RECAP questionnaire, was drawn up and validated with a view to limiting under-declaration of lung cancer as an occupational disease (OD).
Optimal administration conditions were investigated, to facilitate systematic use in the management of patients admitted to hospital with lung cancer.
The various care pathways of lung cancer patients were first studied in two centres, to identify the health-care professionals involved in medical management, the various care sites and the stages of treatment. A focus group of health-care professionals was set up, and semi-directive interviews were conducted with 24 patients.
Caregivers tended to suggest that a physician or nurse should present the RECAP questionnaire, whereas patients rather chose non-caregiver staff, seeing the undertaking as being 'administrative' in nature. Some caregivers and patients thought the questionnaire should not be administered at the outset of treatment, due to the psychological trauma entailed by diagnosis. Administration during chemotherapy was recommended by patients, as they are more freely available at that time, and by caregivers, who thought patients better able to pay attention then.
The study highlighted patients' lack of information on how lung cancer can be recognized as an OD. Implementing the RECAP questionnaire should facilitate patients' claims for insurance cover for lung cancer as an OD.
10%至 20%的肺癌与职业有关。对职业危险因素进行筛查是诊断工作的一部分。为了减少将肺癌作为职业病(OD)申报不足的情况,我们制定了一份用于检测职业性肺癌致癌物的自我管理问卷,即 RECAP 问卷,并对其进行了验证。
研究最佳的管理条件,以便于在管理因肺癌住院的患者时系统地使用该问卷。
首先在两个中心研究了肺癌患者的各种护理路径,以确定参与医疗管理的卫生保健专业人员、各种护理场所和治疗阶段。成立了一个卫生保健专业人员焦点小组,并对 24 名患者进行了半结构化访谈。
护理人员倾向于建议医生或护士出示 RECAP 问卷,而患者则更倾向于选择非护理人员,因为他们认为这是一种“管理”性质的行为。一些护理人员和患者认为,由于诊断带来的心理创伤,不应在治疗开始时进行问卷调查。患者和护理人员都建议在化疗期间进行问卷调查,因为此时患者的自由度更高,而且护理人员认为此时患者更能集中注意力。
该研究强调了患者对如何将肺癌确认为 OD 的信息了解不足。实施 RECAP 问卷将有助于患者为肺癌申请 OD 保险。