Sheikh I, Ogden J
Department of General Practice, United Medical School of Guys, London, UK.
Patient Educ Couns. 1998 Sep;35(1):35-42. doi: 10.1016/s0738-3991(98)00081-0.
The study involved quantitative methods to assess the relationship between knowledge about cancer related symptoms and help seeking behaviour and qualitative methods to explore the role of patient's beliefs about cancer in explaining the gap between knowledge and behaviour. Patients (288) (response rate 72%) from one urban general practice completed a questionnaire consisting of 25 symptoms which they rated for whether they were cancer symptoms (knowledge) and whether the symptoms would prompt them to visit the doctor (hypothetical help seeking behaviour). Twenty patients were then selected who represented a range of knowledge levels and help seeking behaviour and interviewed about their beliefs about cancer. The results showed that the majority of patients had fair knowledge and appropriate help seeking behaviour and indicated a significant association between these variables. However, this relationship was not absolute and although significant the correlation was low. Accordingly, although the subjects knew which symptoms were indicative of cancer, this knowledge was not entirely predictive of their help seeking behaviour. The interviews provided insights into the beliefs which may explain the knowledge/behaviour gap. In particular, analysis of the interviews indicated that the interviewees represented cancer in terms of feelings of fear and death, that they described the process of symptom recognition as involving a fear of finding out the truth, they regarded screening programmes as something to be avoided and understood the causes of cancer either in terms of personal behaviour and internal causes which may result in recriminations or external causes which were beyond their control. The results are discussed in terms of the role of beliefs in mediating the association between knowledge and behaviour and the possible implications for developing educational programmes.
该研究采用定量方法评估癌症相关症状知识与求助行为之间的关系，并采用定性方法探讨患者对癌症的信念在解释知识与行为差距方面的作用。来自一个城市全科诊所的288名患者（回复率72%）完成了一份问卷，问卷包含25种症状，他们对这些症状是否为癌症症状（知识）以及这些症状是否会促使他们去看医生（假设的求助行为）进行了评分。然后从代表不同知识水平和求助行为的患者中选取了20名进行访谈，询问他们对癌症的信念。结果显示，大多数患者有一定的知识和适当的求助行为，且这些变量之间存在显著关联。然而，这种关系并非绝对，尽管具有显著性，但相关性较低。因此，尽管受试者知道哪些症状表明患有癌症，但这种知识并不能完全预测他们的求助行为。访谈提供了可能解释知识/行为差距的信念方面的见解。特别是，对访谈的分析表明，受访者将癌症与恐惧和死亡的感觉联系在一起，他们将症状识别过程描述为包含对发现真相的恐惧，他们将筛查项目视为应避免的事情，并且从可能导致自责的个人行为和内部原因或超出其控制的外部原因来理解癌症的成因。研究结果从信念在调节知识与行为之间关联中的作用以及对制定教育项目的可能影响方面进行了讨论。
