School of Health Sciences, University of Surrey, Guildford, UK.
School of Health Sciences, University of Surrey, Guildford, UK.
Eur J Oncol Nurs. 2019 Aug;41:149-164. doi: 10.1016/j.ejon.2019.06.007. Epub 2019 Jun 14.
Primary care nurses can contribute to cancer early diagnosis. The objective of this systematic review was to identify, appraise and synthesise evidence on primary care nurses' contribution towards cancer early diagnosis in developed countries.
The following databases were searched in September 2017: MEDLINE, PsychINFO, CINAHL, SCOPUS, and EMBASE. Data were extracted on nurses': knowledge of cancer; frequency of 'cancer early diagnosis-related discussions' with patients; and perceived factors influencing these discussions. Studies were appraised using the Mixed Methods Appraisal Tool.
Twenty-one studies were included from: United States, United Kingdom, Ireland, Spain, Turkey, Australia, Brazil and Middle East. Studies were mostly of low quality (one did not meet any appraisal criteria, 15 met one, four met two, and one met three). Nurses' knowledge of cancer, and their frequency of 'cancer early diagnosis-related discussions', varied across countries. This may be due to measurement bias or nurses' divergent roles across healthcare systems. Commonly perceived barriers to having screening discussions included: lack of time, insufficient knowledge and communication skills, and believing that patients react negatively to this topic being raised.
Findings suggest a need for nurses to be adequately informed about, and have the confidence and skills to discuss, the topic of cancer early diagnosis. Further high-quality research is required to understand international variation in primary care nurses' contribution to this field, and to develop and evaluate optimal methods for preparing them for, and supporting them in, this.
初级保健护士可以为癌症的早期诊断做出贡献。本系统评价的目的是确定、评价和综合发达国家初级保健护士在癌症早期诊断方面的贡献的证据。
2017 年 9 月，我们对以下数据库进行了检索：MEDLINE、PsychINFO、CINAHL、SCOPUS 和 EMBASE。我们提取了护士对癌症的了解、与患者进行“癌症早期诊断相关讨论”的频率以及感知到的影响这些讨论的因素。使用混合方法评价工具对研究进行评价。
共纳入 21 项来自美国、英国、爱尔兰、西班牙、土耳其、澳大利亚、巴西和中东的研究。这些研究的质量大多较低（一项研究未满足任何评价标准，15 项研究仅满足一项标准，4 项研究满足两项标准，一项研究满足三项标准）。各国护士对癌症的了解程度以及他们进行“癌症早期诊断相关讨论”的频率存在差异。这可能是由于测量偏差或护士在医疗保健系统中的角色不同所致。普遍认为进行筛查讨论的障碍包括：缺乏时间、知识和沟通技巧不足，以及认为患者对提出这个话题会有负面反应。
研究结果表明，护士需要充分了解癌症早期诊断的相关内容，并具有信心和技能来讨论这个话题。需要进一步开展高质量的研究，以了解国际上初级保健护士在这一领域的贡献的差异，并开发和评估最佳方法，为他们提供准备和支持。
