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假阳性筛查患者如何体验德国的肝硬化或纤维化筛查项目?一项定性研究。

How do (false) positively screened patients experience a screening programme for liver cirrhosis or fibrosis in Germany? A qualitative study.

机构信息

Section of Health Care Research and Rehabilitation Research, Institute of Medical Biometry and Statistics, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany.

Department of Internal Medicine I, University Medical Center of the Johannes Gutenberg-University, Mainz, Germany.

出版信息

Health Expect. 2023 Oct;26(5):1923-1930. doi: 10.1111/hex.13800. Epub 2023 Jun 19.

Abstract

OBJECTIVE

This study aimed to explore psychosocial consequences of (false) positive liver screening results and to identify influencing factors for perceived strain within a multistage screening programme for liver cirrhosis and fibrosis in Germany.

METHODS

Between June 2018 and May 2019, all positively screened patients were asked to participate in the study (n = 158). N = 11 telephone interviews and n = 4 follow-up interviews were conducted. Semi-structured telephone interviews were carried out. The analysis followed a structuring content analysis approach. Thereby, categories were first defined deductively. Second, the categories were revised inductively based on the data.

RESULTS

The main themes found regarding the consequences of the screening were categorised in emotional reactions and behavioural reactions. Few respondents described negative emotional consequences related to screening. Those seem to be mostly driven by suboptimal patient-provider communication and might be worsened when transparent information transfer fails to happen. As a result, patients sought information and support in their social environment. All patients reported positive attitudes towards liver screening.

CONCLUSION

To reduce the potential occurrence of psychosocial consequences during the screening process, medical screening should be performed in the context of transparent information. Regular health communication on the side of health professionals and increasing patients' health literacy might contribute to avoiding negative emotions in line with screening.

PATIENT OR PUBLIC CONTRIBUTION

This study recognises the wide-ranging patients' perspectives regarding the consequences of liver screening which should be taken into consideration when implementing a new screening programme to ensure a patient-centred approach.

摘要

目的

本研究旨在探讨(假)阳性肝脏筛查结果的心理社会后果,并确定德国肝硬化和纤维化多阶段筛查项目中感知压力的影响因素。

方法

2018 年 6 月至 2019 年 5 月期间,所有阳性筛查患者均被邀请参与本研究(n=158)。共进行了 n=11 次电话访谈和 n=4 次随访访谈。采用半结构化电话访谈。分析遵循结构化内容分析方法。首先,根据定义推导出类别;其次,根据数据归纳出类别。

结果

与筛查相关的主要主题分为情绪反应和行为反应。少数受访者描述了与筛查相关的负面情绪后果。这些似乎主要是由医患沟通不佳引起的,如果透明的信息传递失败,可能会恶化。因此,患者在社会环境中寻求信息和支持。所有患者均对肝脏筛查持积极态度。

结论

为了减少筛查过程中潜在的心理社会后果,医学筛查应在透明信息的背景下进行。卫生专业人员定期进行健康沟通并提高患者的健康素养,可能有助于避免符合筛查的负面情绪。

患者或公众贡献

本研究认识到患者对肝脏筛查后果的广泛看法,在实施新的筛查计划时应考虑这些看法,以确保以患者为中心的方法。

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