医疗机构开展基于人群的癌症筛查意愿：一项在中国天津市基层医疗机构的横断面研究。

Willingness of healthcare providers to perform population-based cancer screening: a cross-sectional study in primary healthcare institutions in Tianjin, China.

机构信息

Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.

Department of Epidemiology and Health Statistics, Tianjin Medical University, Tianjin, China.

出版信息

BMJ Open. 2024 Apr 2;14(4):e075604. doi: 10.1136/bmjopen-2023-075604.

DOI:10.1136/bmjopen-2023-075604

PMID:38569674

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10989173/

Abstract

OBJECTIVE

To evaluate the willingness of healthcare providers to perform population-based screening in primary healthcare institutions in China.

METHODS

Healthcare providers of 262 primary healthcare institutions in Tianjin were invited to fill out a questionnaire consisting of demographic characteristics, workload, and knowledge of, attitude towards and willingness to perform breast, cervical and colorectal cancer screening. Willingness to screen was the primary outcome. Multilevel logistic regression models were conducted to analyse the determinants of healthcare providers' willingness to screen. ORs and 95% CIs were estimated.

RESULTS

A total of 554 healthcare providers from 244 institutions answered the questionnaire. 67.2%, 72.1% and 74.3% were willing to perform breast, cervical and colorectal cancer screening, respectively. A negative attitude towards screening was associated with a low willingness for cervical (OR=0.27; 95% CI 0.08, 0.94) and colorectal (OR=0.08; 95% CI 0.02, 0.30) cancer screening, while this was not statistically significant for breast cancer screening (OR=0.30; 95% CI 0.08, 1.12). For breast, cervical and colorectal cancer screening, 70.1%, 63.8% and 59.0% of healthcare providers reported a shortage of staff dedicated to screening. A perceived reasonable manpower allocation was a determinant of increased willingness to perform breast (OR=2.86; 95% CI 1.03, 7.88) and colorectal (OR=2.70; 95% CI 1.22, 5.99) cancer screening. However, this was not significant for cervical cancer screening (OR=1.76; 95% CI 0.74, 4.18).

CONCLUSIONS

In China, healthcare providers with a positive attitude towards screening have a stronger willingness to contribute to cancer screening, and therefore healthcare providers' attitude, recognition of the importance of screening and acceptable workload should be optimised to improve the uptake of cancer screening.

摘要

目的

评估中国基层医疗机构医疗服务提供者开展基于人群的筛查意愿。

方法

邀请天津市 262 家基层医疗机构的医疗服务提供者填写一份问卷，内容包括人口统计学特征、工作量以及对乳腺癌、宫颈癌和结直肠癌筛查的知识、态度和意愿。筛查意愿为主要结局。采用多水平逻辑回归模型分析医疗服务提供者筛查意愿的决定因素。估计比值比（OR）及其 95%置信区间（CI）。

结果

共收到来自 244 家机构的 554 名医疗服务提供者对问卷的回答。分别有 67.2%、72.1%和 74.3%的人愿意开展乳腺癌、宫颈癌和结直肠癌筛查。对筛查的消极态度与宫颈癌（OR=0.27；95%CI 0.08, 0.94）和结直肠癌（OR=0.08；95%CI 0.02, 0.30）筛查意愿较低相关，但对乳腺癌筛查无统计学意义（OR=0.30；95%CI 0.08, 1.12）。对于乳腺癌、宫颈癌和结直肠癌筛查，分别有 70.1%、63.8%和 59.0%的医疗服务提供者报告说筛查专门人员短缺。认为人力分配合理是增加开展乳腺癌（OR=2.86；95%CI 1.03, 7.88）和结直肠癌（OR=2.70；95%CI 1.22, 5.99）筛查意愿的决定因素。然而，对宫颈癌筛查无统计学意义（OR=1.76；95%CI 0.74, 4.18）。