School of Nursing, Fujian Medical University, Fuzhou, Fujian, China.
School of Nursing, Fujian Medical University, Fuzhou, Fujian, China.
Lung Cancer. 2022 Oct;172:9-18. doi: 10.1016/j.lungcan.2022.07.022. Epub 2022 Aug 2.
Numerous factors contribute to the low adherence to lung cancer screening (LCS) programs. A theory-informed approach to identifying the obstacles and facilitators to LCS uptake is required. This study aimed to identify, assess, and synthesize the available literature at the individual and healthcare provider (HCP) levels based on a social-ecological model and identify gaps to improve practice and policy decision-making. Systematic searches were conducted in nine electronic databases from inception to December 31, 2020. We also searched Google Scholar and manually examined the reference lists of systematic reviews to include relevant articles. Primary studies were scored for quality assessment. Among 3938 potentially relevant articles, 36 studies, including 25 quantitative and 11 qualitative studies, were identified for inclusion in the review. Fifteen common factors were extracted from 34 studies, including nine barriers and six facilitators. The barriers included individual factors (n = 5), health system factors (n = 3), and social/environmental factors (n = 1). The facilitators included only individual factors (n = 6). However, two factors, age and screening harm, remain mixed. This systematic review identified and combined barriers and facilitators to LCS uptake at the individual and HCP levels. The interaction mechanisms among these factors should be further explored, which will allow the construction of tailored LCS recommendations or interventions for the Chinese context.
许多因素导致肺癌筛查(LCS)计划的参与率低。需要采用一种基于社会生态学模型的理论指导方法来确定 LCS 接受的障碍和促进因素。本研究旨在根据社会生态学模型,在个人和医疗保健提供者(HCP)层面上识别、评估和综合现有文献,并确定差距,以改善实践和决策。从开始到 2020 年 12 月 31 日,在九个电子数据库中进行了系统搜索。我们还在 Google Scholar 上进行了搜索,并手动检查了系统评价的参考文献,以纳入相关文章。对主要研究进行了质量评估。在 3938 篇潜在相关文章中,有 36 项研究(包括 25 项定量研究和 11 项定性研究)被纳入综述。从 34 项研究中提取了 15 个常见因素,包括 9 个障碍因素和 6 个促进因素。障碍因素包括个人因素(n=5)、卫生系统因素(n=3)和社会/环境因素(n=1)。促进因素仅包括个人因素(n=6)。然而,年龄和筛查危害这两个因素仍然存在争议。本系统综述确定并综合了个人和 HCP 层面上接受 LCS 的障碍和促进因素。这些因素之间的相互作用机制应进一步探讨,这将有助于为中国的情况制定定制的 LCS 建议或干预措施。
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