Mahmoud Mohamed, Parambil Jessiya, Danjuma Mohammed, Abubeker Ibrahim, Najim Mostafa, Ghazouani Hafedh, Al-Mohanadi Dabia, Al-Mohammed Ahmed, Kartha Anand, Yassin Mohamed A
Department of Internal Medicine, Hamad Medical Corporation, Doha, Qatar.
Internal medicine, Rochester Regional Health Unit, USA.
Adv Med Educ Pract. 2020 Nov 6;11:843-850. doi: 10.2147/AMEP.S268315. eCollection 2020.
The aim of this study was to evaluate the rate of internal medicine residents' and faculties' (specialists and consultants) compliance to colorectal cancer screening in Hamad Medical Corporation (Doha, Qatar) and to identify barriers as well as facilitators that will assist in drawing up changes that would enhance physician-related cancer screening.
A cross-sectional web-based survey was distributed among internal medicine physicians at three component hospitals of Hamad Medical Corporation (HMC); focusing on knowledge and practice of colorectal cancer screening, its barriers and facilitators. Chi-square and -test statistics were used to draw conclusions where appropriate.
The response rate for the survey was 91% and over 75% of the survey respondents were post-graduate trainees. The majority (90.6%) of the physicians (n=144) mentioned that they would recommend colorectal cancer screening for their asymptomatic patients, though trainees tend to choose the correct modality of screening compared to the consultants, 86.21% vs 40.74%. Only 43.4% of the survey participants always to usually recommend screening to their patients in their clinics while only 29.4% do so for their inpatients. Even though there was no statistically significant difference among the frequency of outpatient colorectal cancer screening among trainees, specialists or consultants (=0.628), there was a clear increase in the reported referrals as the training years or the years of experience increases (=0.049 for trainees and =0.009 for faculty). Unclear pathway was reported as the main obstacle to outpatient cancer screening by 30.2% (n= 48) and 54% (n=87) pointed out that an easy and clear pathway for cancer screening would facilitate the same.
While the attitude towards colorectal cancer screening is positive, the actual practice of recommendation is sub-optimal. Further initiatives are required to facilitate awareness and compliance to colorectal cancer screening.
本研究旨在评估哈马德医疗公司(卡塔尔多哈)内科住院医师和教职员工(专科医生和顾问医生)对结直肠癌筛查的依从率,并确定有助于制定改进措施以提高医生相关癌症筛查水平的障碍因素和促进因素。
在哈马德医疗公司(HMC)的三家附属医院对内科医生开展了一项基于网络的横断面调查;重点关注结直肠癌筛查的知识与实践、其障碍因素和促进因素。在适当情况下使用卡方检验和t检验统计得出结论。
调查的回复率为91%,超过75%的受访者为研究生学员。大多数(90.6%)医生(n = 144)表示会为无症状患者推荐结直肠癌筛查,不过与顾问医生相比,学员更倾向于选择正确的筛查方式,分别为86.21%和40.74%。只有43.4%的调查参与者在诊所时总是或通常会向患者推荐筛查,而在住院患者中这一比例仅为29.4%。尽管学员、专科医生或顾问医生在门诊结直肠癌筛查频率方面无统计学显著差异(P = 0.628),但随着培训年限或工作经验的增加,报告的转诊率明显上升(学员P = 0.049,教职员工P = 0.009)。30.2%(n = 48)的受访者称不明确的流程是门诊癌症筛查的主要障碍,54%(n = 87)指出简单明了的癌症筛查流程将有助于提高筛查率。
虽然对结直肠癌筛查的态度是积极的,但实际推荐行为并不理想。需要进一步采取措施提高对结直肠癌筛查的认识并促进依从性。