The Healthcare Improvement Studies Institute, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
The Healthcare Improvement Studies Institute, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK.
BMJ Open. 2022 Mar 16;12(3):e051703. doi: 10.1136/bmjopen-2021-051703.
There is insufficient evidence to support national screening programmes for atrial fibrillation (AF). Nevertheless, some practitioners, policy-makers and special interest groups have encouraged introduction of opportunistic screening in primary care in order to reduce the incidence of stroke through earlier detection and treatment of AF. The attitudes of the public towards AF screening are unknown. We aimed to explore why AF screening participants took part in the screening.
Semistructured longitudinal interview study of participant engagement in the SAFER study (Screening for Atrial Fibrillation with ECG to Reduce stroke). We undertook initial interviews face to face, with up to two follow-up telephone interviews during the screening process. We thematically analysed and synthesised these data to understand shared views of screening participation.
5 primary care practices in the East of England, UK.
23 people taking part in the SAFER study first feasibility phase.
Participants were supportive of screening for AF, explaining their participation in screening as a 'good thing to do'. Participants suggested screening could facilitate earlier diagnosis, more effective treatment, and a better future outcome, despite most being unfamiliar with AF. Participating in AF screening helped attenuate participants' concerns about stroke and demonstrated their commitment to self-care and being a 'good patient'. Participants felt that the screening test was non-invasive, and they were unlikely to have AF; they therefore considered engaging in AF screening was low risk, with few perceived harms.
Participants assessed the SAFER AF screening programme to be a legitimate, relevant and safe screening opportunity, and complied obediently with what they perceived to be a recommendation to take part. Their unreserved acceptance of screening benefit and lack of awareness of potential harms suggests that uptake would be high but reinforces the importance of ensuring participants receive balanced information about AF screening initiatives.
ISRCTN16939438; Pre-results.
目前尚无足够证据支持全国范围内开展心房颤动（房颤）筛查项目。然而，一些从业者、政策制定者和特殊利益团体鼓励在初级保健中开展机会性筛查，以便通过早期发现和治疗房颤来降低中风的发生率。公众对房颤筛查的态度尚不清楚。我们旨在探讨房颤筛查参与者参与筛查的原因。
采用半结构式纵向访谈研究参与者对 SAFER 研究（心电图筛查心房颤动以降低中风风险）的参与情况。我们首先进行面对面的初始访谈，在筛查过程中最多进行两次后续电话访谈。我们对这些数据进行了主题分析和综合，以了解筛查参与的共同观点。
英国英格兰东部的 5 个初级保健机构。
参加 SAFER 研究的前可行性阶段的 23 人。
参与者支持房颤筛查，将其解释为“一件好事”。参与者表示，筛查可以促进早期诊断、更有效的治疗和更好的未来结果，尽管大多数人不熟悉房颤。参与房颤筛查有助于减轻参与者对中风的担忧，并表明他们对自我保健和成为“好病人”的承诺。参与者认为筛查测试是非侵入性的，他们不太可能患有房颤；因此，他们认为参与房颤筛查的风险较低，几乎没有感知到危害。
参与者评估 SAFER 房颤筛查计划是一个合法、相关和安全的筛查机会，并顺从地遵守他们认为是建议参与的筛查。他们对筛查益处的毫无保留的接受和对潜在危害的认识不足表明，参与率会很高，但这也强调了确保参与者获得有关房颤筛查计划的平衡信息的重要性。
ISRCTN82603018；预结果。
