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患者对使用临床决策支持系统进行癌症筛查和预防的看法:“要是没有它,我都不会想到去做筛查。”

Patient Perceptions of Using Clinical Decision Support for Cancer Screening and Prevention: "I wouldn't have thought about getting screened without it.".

作者信息

Saman Daniel M, Harry Melissa L, Freitag Laura A, Allen Clayton I, O'Connor Patrick J, Sperl-Hillen JoAnn M, Bianco Joseph A, Truitt Anjali R, Ekstrom Heidi L, Elliott Thomas E

机构信息

Nicklaus Children's Health System, Miami, FL.

Essentia Institute of Rural Health, Essentia Health, Duluth, MN.

出版信息

J Patient Cent Res Rev. 2021 Oct 18;8(4):297-306. doi: 10.17294/2330-0698.1863. eCollection 2021 Fall.

Abstract

PURPOSE

We sought to gain an understanding of cancer prevention and screening perspectives among patients exposed to a clinical decision support (CDS) tool because they were due or overdue for certain cancer screenings or prevention.

METHODS

Semi-structured qualitative interviews were conducted with 37 adult patients due or overdue for cancer prevention services in 10 primary care clinics within the same health system. Data were thematically segmented and coded using qualitative content analysis.

RESULTS

We identified three themes: 1) The CDS tool had more strengths than weaknesses, with areas for improvement; 2) Many facilitators and barriers to cancer prevention and screening exist; and 3) Discussions and decision-making varied by type of cancer prevention and screening. Almost all participants made positive comments regarding the CDS. Some participants learned new information, reporting the CDS helped them make a decision they otherwise would not have made. Participants who used the tool with their provider had higher self-reported rates of deciding to be screened than those who did not.

CONCLUSIONS

Learning about patients' perceptions of a CDS tool may increase understanding of how patient-tailored CDS impacts cancer screening and prevention rates. Participants found a personalized CDS tool for cancer screening and prevention in primary care useful and a welcome addition to their visit. However, many providers were not using the tool with eligible patients.

摘要

目的

我们试图了解接触过临床决策支持(CDS)工具的患者对于癌症预防和筛查的看法,这些患者因某些癌症筛查或预防已到期或逾期未做。

方法

对同一医疗系统内10家初级保健诊所中37名因癌症预防服务已到期或逾期未做的成年患者进行了半结构化定性访谈。采用定性内容分析法对数据进行主题分类和编码。

结果

我们确定了三个主题:1)CDS工具优点多于缺点,仍有改进空间;2)癌症预防和筛查存在许多促进因素和障碍;3)癌症预防和筛查的讨论及决策因类型而异。几乎所有参与者都对CDS做出了积极评价。一些参与者学到了新信息,称CDS帮助他们做出了原本不会做的决定。与医疗服务提供者一起使用该工具的参与者自我报告的决定接受筛查的比例高于未使用者。

结论

了解患者对CDS工具的看法可能会增进对量身定制的CDS如何影响癌症筛查和预防率的理解。参与者发现初级保健中用于癌症筛查和预防的个性化CDS工具很有用,是就诊时的一项受欢迎的补充。然而,许多医疗服务提供者并未与符合条件的患者使用该工具。

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