Wiser Healthcare, Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia.
Sydney Health Literacy Lab, Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia.
Fam Pract. 2024 Aug 14;41(4):543-553. doi: 10.1093/fampra/cmac126.
Older adults should be supported to make informed decisions about cancer screening. However, it is unknown how general practitioners (GPs) in Australia communicate about cancer screening with older people.
To investigate GPs' views and experiences of communicating about cancer screening (breast, cervical, prostate, and bowel) with older people (≥70 years).
Qualitative, semi-structured interviews, Australia.
Interviews were conducted with GPs practising in Australia (n = 28), recruited through practice-based research networks, primary health networks, social media, and email invitation. Interviews were audio-recorded and analysed thematically using Framework Analysis.
Findings across GPs were organized into 3 themes: (i) varied motivation to initiate cancer screening discussions; some GPs reported that they only initiated screening within recommended ages (<75 years), others described initiating discussions beyond recommended ages, and some experienced older patient-initiated discussions; (ii) GPs described the role they played in providing screening information, whereby detailed discussions about the benefits/risks of prostate screening were more likely than other nationally funded screening types (breast, cervical, and bowel); however, some GPs had limited knowledge of recommendations and found it challenging to explain why screening recommendations have upper ages; (iii) GPs reported providing tailored advice and discussion based on personal patient preferences, overall health/function, risk of cancer, and previous screening.
Strategies to support conversations between GPs and older people about the potential benefits and harms of screening in older age and rationale for upper age limits to screening programmes may be helpful. Further research in this area is needed.
应当支持老年人做出有关癌症筛查的知情决策。然而，目前尚不清楚澳大利亚的全科医生（GP）如何与老年人就癌症筛查（乳腺癌、宫颈癌、前列腺癌和肠癌）进行沟通。
调查澳大利亚的 GP 就癌症筛查（乳腺癌、宫颈癌、前列腺癌和肠癌）与老年人（≥70 岁）进行沟通的看法和经验。
定性、半结构化访谈，澳大利亚。
通过基于实践的研究网络、初级保健网络、社交媒体和电子邮件邀请，招募了在澳大利亚执业的 GP（n=28）参与此项研究。访谈采用音频记录，并使用框架分析法进行主题分析。
研究结果在 GP 中分为 3 个主题：（i）启动癌症筛查讨论的动机各不相同；一些 GP 报告称，他们仅在建议年龄（<75 岁）内启动筛查，另一些 GP 则描述了在建议年龄之外启动讨论，还有一些 GP 经历了老年患者发起的讨论；（ii）GP 描述了他们在提供筛查信息方面所扮演的角色，详细讨论前列腺筛查的获益/风险比其他国家资助的筛查类型（乳腺癌、宫颈癌和肠癌）更有可能；然而，一些 GP 对建议的了解有限，发现难以解释为什么筛查建议有年龄上限；（iii）GP 报告根据个人患者偏好、整体健康/功能、癌症风险和之前的筛查情况提供量身定制的建议和讨论。
支持 GP 与老年人就老年人群中筛查的潜在获益和危害以及筛查计划上限年龄的理由进行对话的策略可能会有所帮助。需要在这一领域开展进一步的研究。
