基于教会的中国成年人医患癌症筛查交流——以照顾者经验和家族史为视角
Doctor-Patient Cancer Screening Communications among Church-based Chinese Adults - The Role of Caregiver Experience and Family History.
机构信息
Department of Health Management & Informatics, College of Community Innovation and Education, University of Central Florida, Orlando, FL, USA.
出版信息
Asian Pac J Cancer Prev. 2021 Jan 1;22(1):241-247. doi: 10.31557/APJCP.2021.22.1.241.
OBJECTIVE
Significant gap exists in the literature examining cancer screening communication related factors among Chinese immigrants. This study examined the role of cancer caregiver experience and family history on doctor-patient cancer screening communication among church-based Chinese adults.
METHODS
A self-administered survey was conducted among adults from 9 Chinese churches (n=372). Cancer Communication was measured by "Dr. recommended screenings" and "Talked to doctors about cancer screenings". The survey was developed in English and translated in Chinese.
RESULTS
Mean age was 44.31 (SD=14.74), 60% were males, 72% were married, majority had college education (85%), and 17% reported had been a primary cancer caregiver and 54% reported having family cancer history. Cancer caregivers scored higher on doctor-patient cancer communication, as well as cancer knowledge and screening norms. Participants with family cancer history were also more likely to talk to doctor about screening, as well as perceived higher cancer risk, lower health status, and screening barriers. Multiple regression analyses showed that primary caregiver experience was still a significant predictor on talking to doctors about cancer screenings (OR=2.1; 95%CI=[1.10, 4.01]; p=0.025), yet doctors more like to recommend screening among caregivers became non-significant. The significant influence of family cancer history on talking with doctors on cancer screenings also disappeared. Older age (OR=2.52; p=0.006) and being married (OR=2.45; p=0.022) were significant on predicting communication of cancer screenings with doctors. Data also showed that doctors were more likely to recommend cancer screenings to older (OR=2.75, p <.001), married (OR=2.57; p=0.006) adults.
CONCLUSION
Current study calls attentions to primary cancer caregiver experience, family history, age, and marital factors when designing tailored doctor-patient cancer screening communication programs among church-based Chinese to address cancer disparities.
目的
在针对中国移民的癌症筛查相关因素的文献中，存在着显著的差距。本研究旨在探讨癌症照顾者经历和家族史对教会背景下的中国成年人医患癌症筛查沟通的影响。
方法
对 9 个华人教堂的成年人进行了一项自我管理调查（n=372）。癌症沟通通过“医生推荐的筛查”和“与医生讨论癌症筛查”来衡量。该调查是用英语编写的，并翻译成中文。
结果
平均年龄为 44.31 岁（SD=14.74），60%为男性，72%已婚，大多数受过大学教育（85%），17%报告曾是主要癌症照顾者，54%报告有家族癌症史。癌症照顾者在医患癌症沟通、癌症知识和筛查规范方面的得分更高。有家族癌症史的参与者也更有可能与医生讨论筛查问题，并且认为癌症风险更高、健康状况更差、筛查障碍更大。多元回归分析显示，主要照顾者经历仍然是与医生讨论癌症筛查的重要预测因素（OR=2.1；95%CI=[1.10, 4.01]；p=0.025），但医生更倾向于推荐照顾者进行筛查的因素变得不再显著。家族癌症史对与医生讨论癌症筛查的显著影响也消失了。年龄较大（OR=2.52；p=0.006）和已婚（OR=2.45；p=0.022）对预测与医生进行癌症筛查沟通具有显著意义。数据还显示，医生更有可能向年龄较大（OR=2.75，p<0.001）、已婚（OR=2.57；p=0.006）的成年人推荐癌症筛查。
结论
本研究呼吁在针对教会背景下的中国人群设计有针对性的医患癌症筛查沟通方案时，关注主要癌症照顾者经历、家族史、年龄和婚姻因素，以解决癌症差异问题。
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