School of Nursing, Sun Yat-sen University, Guangzhou, Guangdong, China.
The Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong SAR, China.
Worldviews Evid Based Nurs. 2024 Jun;21(3):245-252. doi: 10.1111/wvn.12689. Epub 2023 Nov 10.
First-degree relatives (FDRs) of colorectal cancer (CRC) patients have a higher risk of developing CRC than the general population. Ensuring that these at-risk populations receive colonoscopy screening is an effective strategy for reducing the increased risk, but the rates remain low. Colonoscopy screening behavior is influenced by factors at multiple levels. However, most previous reviews failed to review them and their interactions systematically.
To explore factors influencing FDRs' colonoscopy screening behavior according to the ecological model.
A mixed-method systematic review was performed in accordance with The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guideline. A comprehensive literature search was conducted using eight bibliographic databases (Medline, EMBASE, PubMed, the Cochrane Library, Scopus, China National Knowledge Infrastructure, Wan Fang Data, and China Biology Medicine) for the period from January 1995 to February 2023. The Joanna Briggs Institute critical appraisal checklists were applied to assess studies qualities. A convergent integrated approach was used for data synthesis and integration.
In total, 24 articles reporting on 23 studies were included. Only one study was rated low quality, and the other 22 studies were rated moderate to high quality. The findings revealed that certain factors and their interactions affected FDRs' colonoscopy screening behaviors according to the ecological model, including misconceptions about CRC and colonoscopy, concerns about the procedure, perceived susceptibility to developing CRC, health motivation, fear of CRC, fatalism, the recommendation from CRC patients, and recommendations from physicians, colonoscopy schedules, cancer taboo, health insurance and cost of colonoscopy.
Family communication-centered multilevel interventions are recommended to promote colonoscopy screening behavior among FDRs of CRC patients.
结直肠癌（CRC）患者的一级亲属（FDR）比一般人群患 CRC 的风险更高。确保这些高危人群接受结肠镜筛查是降低风险的有效策略，但筛查率仍然较低。结肠镜筛查行为受到多个层次因素的影响。然而，大多数先前的综述未能系统地审查这些因素及其相互作用。
根据生态模型探讨影响 FDR 结肠镜筛查行为的因素。
根据《系统评价和荟萃分析的首选报告项目》（PRISMA）指南，进行了混合方法系统综述。使用 8 个文献数据库（Medline、EMBASE、PubMed、Cochrane 图书馆、Scopus、中国国家知识基础设施、万方数据和中国生物医学文献数据库），对 1995 年 1 月至 2023 年 2 月期间的文献进行了全面检索。使用 Joanna Briggs 研究所的批判性评估清单评估研究质量。采用融合综合方法进行数据综合和整合。
共纳入 24 篇报告 23 项研究的文章。仅有 1 项研究被评为低质量，其余 22 项研究被评为中高质量。研究结果表明，根据生态模型，某些因素及其相互作用会影响 FDR 结肠镜筛查行为，包括对 CRC 和结肠镜检查的误解、对程序的担忧、对患 CRC 的易感性感知、健康动机、对 CRC 的恐惧、宿命论、CRC 患者的建议和医生的建议、结肠镜检查时间表、癌症禁忌、健康保险和结肠镜检查的费用。
建议开展以家庭沟通为中心的多层次干预，以促进 CRC 患者 FDR 的结肠镜筛查行为。
