Torrens University Australia, 88 Wakefield Street, Adelaide, South Australia, 5000, Australia.
College of Medicine and Public Health, Flinders University of South Australia, GPO Box 2100, Adelaide, South Australia, 5001, Australia.
BMC Fam Pract. 2019 Jul 29;20(1):109. doi: 10.1186/s12875-019-0997-5.
Colorectal cancer (CRC) is the second most frequent cause of cancer death in Australia. Early detection can reduce incidence and mortality. General practice-based initiatives have been proposed to improve CRC screening rates but to date have had modest impact. As there is limited research into the patient experience of CRC screening decision making, this study explored patient perspectives on CRC screening and the potential role for general practice.
Ten participants, aged between 50 and 74, from a general practice in South Australia were recruited by practice staff. Semi-structured interviews were conducted. Concurrent data collection and analysis were performed, guided by interpretative phenomenological analysis.
Two key themes were evident: attitudes toward screening and potential roles for general practice. Participants structured the experience of screening in terms of being proactive, ambivalent or avoidant. Roles for general practice centred on tasks as educators, trusted advisors, monitors and screeners. Mixed views on whether general practice involvement was necessary prompted consideration of additional sources of health information and motivation around screening.
Exploration of the patient experience provides insight into how participants make sense of screening and perceived roles for general practice (or other agents) in screening. There is satisfaction with current Government-driven processes but perceived value in general practice playing a complementary part in increasing screening rates. A multifaceted strategy, accounting for attitudes, is required to improve screening and population health outcomes.
结直肠癌（CRC）是澳大利亚癌症死亡的第二大常见原因。早期发现可以降低发病率和死亡率。已经提出了基于全科医学的倡议来提高 CRC 筛查率，但迄今为止影响不大。由于对 CRC 筛查决策的患者体验研究有限，因此本研究探讨了患者对 CRC 筛查的看法以及全科医学的潜在作用。
通过全科医生的工作人员，在南澳大利亚的一家全科诊所招募了 10 名年龄在 50 至 74 岁之间的参与者。进行了半结构化访谈。同时进行数据收集和分析，由解释性现象学分析指导。
有两个主要主题很明显：对筛查的态度和全科医学的潜在作用。参与者根据积极主动、矛盾或回避的态度来构建筛查体验。全科医学的作用集中在教育者、可信赖的顾问、监测者和筛查者的任务上。对全科医学参与是否必要的混合看法促使考虑了其他健康信息来源和围绕筛查的动机。
探索患者的体验提供了对参与者如何理解筛查以及对全科医学（或其他机构）在筛查中作用的看法。对当前政府驱动的流程感到满意，但认为全科医学在提高筛查率方面发挥补充作用具有价值。需要一种多方面的策略，考虑到态度，以改善筛查和人口健康结果。
