Main D S, Cohen S J, DiClemente C C
Center for Studies in Family Medicine, University of Colorado Health Sciences Center, Denver 80220, USA.
Am J Prev Med. 1995 Jan-Feb;11(1):54-8.
Our objective was to describe the development and validation of an instrument for measuring physician readiness to change cancer screening and counseling. We designed a cross-sectional survey of primary care physicians. Participants were 745 enrollees in the Copic Insurance Company, a physician liability insurer of more than 80% of Colorado's physicians. A large percentage of physicians do not perceive a need to change their screening patterns for eligible patients in both mammography and Pap tests. Approximately one third of the physicians are contemplating screening more of their patients within the next six months for sigmoidoscopy, clinical skin, and oral cavity exams and counseling more of their patients on skin protection and dietary fat. Few physicians are planning significant changes in cancer screening and counseling within the next month. Scales of readiness to change screening and counseling, as well as an overall readiness-to-change scale, had high internal consistency: .81, .65, .84, for screening, counseling, and overall, respectively. We conclude that readiness to change may be a useful construct for determining if and when physicians may be willing to make behavior changes. Moreover, the assessment of physician readiness to change may facilitate the tailoring of interventions designed to foster physician behavior change and improve patient care.
我们的目标是描述一种用于衡量医生改变癌症筛查和咨询意愿的工具的开发与验证过程。我们针对初级保健医生设计了一项横断面调查。参与者为科皮克保险公司的745名参保人员，该保险公司承保了科罗拉多州80%以上医生的医疗责任险。很大一部分医生认为没有必要改变针对符合条件患者的乳房X线摄影和巴氏试验筛查模式。约三分之一的医生打算在未来六个月内对更多患者进行乙状结肠镜检查、临床皮肤和口腔检查，并就皮肤保护和饮食脂肪问题为更多患者提供咨询。很少有医生计划在未来一个月内对癌症筛查和咨询做出重大改变。改变筛查和咨询意愿的量表以及总体改变意愿量表具有较高的内部一致性：筛查、咨询和总体量表的内部一致性系数分别为0.81、0.65和0.84。我们得出结论，改变意愿可能是一个有用的指标，可用于确定医生是否以及何时愿意做出行为改变。此外，对医生改变意愿的评估可能有助于量身定制旨在促进医生行为改变和改善患者护理的干预措施。
