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接受结直肠癌症筛查假阳性结果的心理社会后果:一项定性研究。

Psychosocial consequences of receiving false-positive colorectal cancer screening results: a qualitative study.

机构信息

a Center for Research & Education in General Practice , Copenhagen , Denmark.

b Primary Health Care Research Unit , Region Zealand , Denmark.

出版信息

Scand J Prim Health Care. 2019 Jun;37(2):145-154. doi: 10.1080/02813432.2019.1608040. Epub 2019 May 11.

Abstract

The objective of this study was to investigate the psychosocial consequences of receiving false-positive colorectal cancer (CRC) screening results, following a positive immunochemical faecal occult blood test. We conducted a qualitative study with four semi-structured focus group interviews with 16 participants aged 50-74, all of whom had received a false-positive result in the national Danish CRC screening programme. We selected, recruited, and grouped participants to ensure maximum variation, and to enable a level of confidence to speak openly about experiences of screening. We subjected interview data, audio-recordings, and transcripts to a strategy of qualitative analysis called systematic text condensation. We identified four main themes which described the psychosocial consequences of false-positive CRC screening results: anxiety; discomfort; changed self-perception and behaviour; and considerations on participation in screening. Each of these themes covered a wide range of experiences which were relevant to the informants and broadly shared by them in many aspects. Receiving false-positive results from CRC screening can lead to negative psychosocial consequences such as changes in self-perception and anxiety: some participants may experience subsequent relief, others not. These negative psychosocial consequences might persist over time. Negative psychosocial consequences from false-positive CRC screening results may result in a greater use of general practitioner services by healthy people who need reassurance or further tests. More research using condition-specific measures is required to further understand the degree and potential persistence of psychosocial consequences of false-positive results from CRC screening. Key Points Participants who receive false-positive colorectal cancer (CRC) screening results may experience negative psychosocial consequences e.g. anxiety and subsequent relief. Participants who receive false-positive CRC screening results may experience discomfort during the screening process. Participants who receive false-positive CRC screening results may experience longer term changes of self-perception. Participants who receive false-positive CRC screening results may experience ambivalence about the offered diagnostic down-stream procedures including colonoscopy.

摘要

本研究旨在调查免疫化学粪便潜血试验阳性后,接受结直肠癌(CRC)假阳性筛查结果的心理社会后果。我们进行了一项定性研究,对 16 名年龄在 50-74 岁之间的参与者进行了四次半结构化焦点小组访谈,他们都在丹麦全国 CRC 筛查计划中收到了假阳性结果。我们选择、招募和分组参与者,以确保最大的变化,并使他们能够自信地公开谈论筛查体验。我们对访谈数据、录音和记录进行了称为系统文本浓缩的定性分析策略。我们确定了四个主要主题,描述了 CRC 假阳性筛查结果的心理社会后果:焦虑;不适;自我认知和行为的改变;以及对参与筛查的考虑。这些主题中的每一个都涵盖了广泛的经验,这些经验与受访者有关,并且在许多方面都得到了他们的广泛认同。接受 CRC 筛查的假阳性结果可能导致焦虑等负面心理社会后果:一些参与者可能会随后感到宽慰,而另一些则不会。这些负面心理社会后果可能会持续存在。假阳性 CRC 筛查结果的负面心理社会后果可能会导致更多健康人因需要安心或进一步检查而使用全科医生服务。需要使用特定于疾病的措施进行更多研究,以进一步了解 CRC 筛查假阳性结果的心理社会后果的程度和潜在持久性。关键点:接受结直肠癌(CRC)假阳性筛查结果的患者可能会经历负面的心理社会后果,例如焦虑和随后的缓解。接受 CRC 假阳性筛查结果的患者可能会在筛查过程中感到不适。接受 CRC 假阳性筛查结果的患者可能会经历长期的自我认知变化。接受 CRC 假阳性筛查结果的患者可能会对提供的下游诊断程序(包括结肠镜检查)持矛盾态度。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8577/6566584/97eb27759869/IPRI_A_1608040_F0001_B.jpg

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