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基于人群的癌症筛查在我国农村高危人群中的满意度:扬中地区上消化道癌早诊早治。

Satisfaction in population-based cancer screening in a Chinese rural high-risk population: the Yangzhong early diagnosis and treatment of upper gastrointestinal cancer.

机构信息

Institute of Tumour Prevention and Control, People's Hospital of Yangzhong City, Yangzhong, China.

Endoscopy Center, People's Hospital of Yangzhong City, Yangzhong, China.

出版信息

BMC Health Serv Res. 2022 May 19;22(1):675. doi: 10.1186/s12913-022-08076-1.

Abstract

BACKGROUND

Screening for upper gastrointestinal cancer (UGC) effectively reduces morbidity and mortality in gastric and esophageal cancers. It is considered one of the effective measures for cancer control in China, but studies on its functional quality are lacking. Our study assessed the quality of screening service funded by Upper Gastrointestinal Cancer Early diagnosis and treatment (UGCEDAT) and its correlation in Yangzhong People's hospital, China.

METHODS

A cross-sectional study was conducted among 516 screening users at a screening centre in Yanghzong People's hospital from April to July 2021. The service quality questionnaire (SERVQUAL) based on the service quality gap (SQG) model was adopted. We calculated the mean scores of perceptions and expectations and their gap. To determine the association between overall SQG and related features of participants, we used a multivariate logistic regression.

RESULTS

The average scores of screening service users' perceptions and expectations were 4.05 and 4.55, respectively. The SQG of five dimensions (tangibles, reliability, responsiveness, assurance and empathy) were negative, and the overall SQG was -0.51. The responsiveness dimension had the largest gap, and tangibles had the smallest gap. Occupation status (AOR: 0.57; CI: 0.37-0.89), health self-assessment (AOR: 4.97; CI: 1.35-18.23), endoscopy experience (AOR: 0.55; CI: 0.38-0.81), distance from screening hospital (AOR: 1.85; CI: 1.25-2.73) and frequency of visit (AOR: 1.65; CI: 1.10-2.46) were associated with the overall SQG.

CONCLUSIONS

We observed a negative gap between perceptions and expectations of the function quality of screening service, implying a high dissatisfaction across different dimensions. Service providers should take adequate measures to bridge the dimension with the largest quality gap. Meanwhile, attention should be paid to identifying the influencing factors of the overall SQG and the characteristics of dimensional expectations and perceptions to improve the effectiveness of the screening program.

摘要

背景

上消化道癌(UGC)筛查可有效降低胃癌和食管癌的发病率和死亡率。它被认为是中国癌症控制的有效措施之一,但关于其功能质量的研究尚缺乏。我们的研究评估了中国扬中市人民医院由上消化道癌早诊早治(UGCEDAT)资助的筛查服务的质量及其相关性。

方法

本研究采用基于服务质量差距(SQG)模型的服务质量问卷(SERVQUAL),于 2021 年 4 月至 7 月在扬中市人民医院筛查中心对 516 名筛查使用者进行了横断面研究。我们计算了感知和期望的平均得分及其差距。为了确定总体 SQG 与参与者相关特征之间的关系,我们使用了多变量逻辑回归。

结果

筛查服务使用者的感知和期望的平均得分为 4.05 和 4.55。五个维度(有形性、可靠性、响应性、保证和同理心)的 SQG 均为负值,总体 SQG 为-0.51。响应性维度差距最大,有形性维度差距最小。职业状态(AOR:0.57;CI:0.37-0.89)、健康自评(AOR:4.97;CI:1.35-18.23)、内镜检查经验(AOR:0.55;CI:0.38-0.81)、筛查医院距离(AOR:1.85;CI:1.25-2.73)和就诊频率(AOR:1.65;CI:1.10-2.46)与总体 SQG 相关。

结论

我们观察到筛查服务功能质量的感知和期望之间存在负差距,这意味着不同维度的满意度都较低。服务提供者应采取充分措施缩小差距最大的维度。同时,应注意识别总体 SQG 的影响因素以及维度期望和感知的特征,以提高筛查计划的效果。

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