Division of Psychology & Mental Health, Manchester Centre for Health Psychology, School of Health Sciences, University of Manchester, Manchester, UK.
Nightingale & Prevent Breast Cancer Research Unit, Manchester University NHS Foundation Trust, Manchester, UK.
BMC Womens Health. 2022 May 2;22(1):142. doi: 10.1186/s12905-022-01730-0.
Providing women with personalized estimates of their risk of developing breast cancer, as part of routine breast cancer screening programmes, allows women at higher risk to be offered more frequent screening or drugs to reduce risk. For this to be feasible, the concept and practicalities have to be acceptable to the healthcare professionals who would put it in to practice. The present research investigated the acceptability to healthcare professionals who were responsible for the implementation of this new approach to screening in the ongoing BC-Predict study.
Four focus groups were conducted with 29 healthcare professionals from a variety of professional backgrounds working within three breast screening services in north-west England. An inductive-manifest thematic analysis was conducted.
Overall, healthcare professionals viewed the implementation of personalised breast cancer risk estimation as a positive step, but discussion focused on concerns. Three major themes are presented. (1) Service constraints highlights the limited capacity within current breast services and concerns about the impact of additional workload. (2) Risk communication concerns the optimal way to convey risk to women within resource constraints. (3) Accentuating inequity discusses how risk stratification could decrease screening uptake for underserved groups.
Staff who implemented risk stratification considered it a positive addition to routine screening. They considered it essential to consider improving capacity and demands on healthcare professional time. They highlighted the need for skilled communication of risks and new pathways of care to ensure that stratification could be implemented in financially and time constrained settings without impacting negatively on women.
在常规乳腺癌筛查计划中为女性提供乳腺癌风险的个性化估计，使高风险女性能够获得更频繁的筛查或降低风险的药物。为了使这成为可能，医护人员必须接受这一概念和实际操作，因为他们将负责实施这一新的筛查方法。本研究调查了正在进行的 BC-Predict 研究中负责实施这一新筛查方法的医护人员对其的接受程度。
在英格兰西北部的三个乳房筛查服务机构中，对 29 名来自不同专业背景的医护人员进行了 4 次焦点小组讨论。采用了归纳法的主题分析。
总体而言，医护人员认为实施个性化乳腺癌风险评估是一个积极的步骤，但讨论集中在关注问题上。提出了三个主要主题。（1）服务限制突出了当前乳房服务中的能力有限以及对额外工作量影响的关注。（2）风险沟通关注在资源有限的情况下向女性传达风险的最佳方式。（3）强调不公平性讨论了风险分层如何降低服务不足群体的筛查参与度。
实施风险分层的工作人员认为这是常规筛查的一个积极补充。他们认为，必须考虑改善医护人员的能力和时间需求。他们强调需要熟练地沟通风险和新的护理途径，以确保在财务和时间受限的情况下实施分层，而不会对女性产生负面影响。
