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不当卵巢癌筛查的动机:对女性及其临床医生的调查。

Motivators of Inappropriate Ovarian Cancer Screening: A Survey of Women and Their Clinicians.

机构信息

Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia.

Department of General Practice, Monash University, Melbourne, Australia.

出版信息

JNCI Cancer Spectr. 2020 Dec 8;5(1). doi: 10.1093/jncics/pkaa110. eCollection 2021 Feb.

Abstract

BACKGROUND

This study examined why women and doctors screen for ovarian cancer (OC) contrary to guidelines.

METHODS

Surveys, based on the Theoretical Domains Framework, were sent to women in the Kathleen Cuningham Foundation Consortium for Research into Familial Breast Cancer and family physicians and gynecologists who organized their screening.

RESULTS

Of 1264 Kathleen Cuningham Foundation Consortium for Research into Familial Breast Cancer women, 832 (65.8%) responded. In the past 2 years, 126 (15.1%) had screened. Most of these (n = 101, 80.2%) would continue even if their doctor told them it is ineffective. For women, key OC screening motivators operated in the domains of social role and goals (staying healthy for family, 93.9%), emotion and reinforcement (peace of mind, 93.1%), and beliefs about capabilities (tests are easy to have, 91.9%). Of 531 clinicians 252 (47.5%) responded; a minority (family physicians 45.8%, gynecologists 16.7%) thought OC screening was useful. For gynecologists, the main motivators of OC screening operated in the domains of environmental context (lack of other screening options, 27.6%), and emotion (patient peace of mind, 17.2%; difficulty discontinuing screening, 13.8%). For family physicians,, the strongest motivators were in the domains of social influence (women ask for these tests, 20.7%), goals (a chance these tests will detect cancer early, 16.4%), emotion (patient peace of mind, 13.8%), and environmental context (no other OC screening options, 11.2%).

CONCLUSION

Reasons for OC screening are mostly patient driven. Clinician knowledge and practice are discordant. Motivators of OC screening encompass several domains, which could be targeted in interventions to reduce inappropriate OC screening.

摘要

背景

本研究旨在探讨女性和医生为何违背指南对卵巢癌(OC)进行筛查。

方法

基于理论领域框架,向凯思琳·坎宁安家族乳腺癌研究联合会的女性成员以及组织其筛查的家庭医生和妇科医生发送了调查。

结果

在凯思琳·坎宁安家族乳腺癌研究联合会的 1264 名女性中,有 832 名(65.8%)做出了回应。在过去的 2 年中,有 126 名(15.1%)进行了筛查。其中大多数人(n=101,80.2%)即使医生告诉他们这种筛查无效也会继续进行。对于女性来说,OC 筛查的关键动机存在于社会角色和目标(为了家人保持健康,93.9%)、情感和强化(安心,93.1%)以及对能力的信念(检查很容易进行,91.9%)等领域。在 531 名临床医生中,有 252 名(47.5%)做出了回应;少数人(家庭医生 45.8%,妇科医生 16.7%)认为 OC 筛查有用。对于妇科医生来说,OC 筛查的主要动机存在于环境背景(缺乏其他筛查选择,27.6%)和情感(患者安心,17.2%;难以停止筛查,13.8%)等领域。对于家庭医生来说,最强的动机存在于社会影响(女性要求进行这些检查,20.7%)、目标(这些检查有机会早期发现癌症,16.4%)、情感(患者安心,13.8%)和环境背景(没有其他 OC 筛查选择,11.2%)等领域。

结论

OC 筛查的原因主要是患者驱动的。临床医生的知识和实践存在不一致。OC 筛查的动机涉及多个领域,这可能是减少不适当 OC 筛查的干预措施的目标。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c049/7853181/cf4ae6141f3b/pkaa110f1.jpg

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