Adherence to Screening Flexible Sigmoidoscopy in Asymptomatic Patients
Adherence to Screening Flexible Sigmoidoscopy in Asymptomatic Patients
复制标题
无症状患者坚持柔性乙状结肠镜筛查
作者：
R. Kelly;J. C. Shank
这项研究的目的是评估患者对医生推荐的筛查柔性乙状结肠镜的依从性。在家庭实践住院医师计划的设置中，将无症状患者(N=333，年龄≥50岁)的依从率在以下三组中进行比较：普通护理组；接受教育材料和电话提醒的干预组；以及长期与单一医生保持连续性的连续性组。邮寄问卷(N=180)的数据被用来检验人口统计因素和态度与依从性的关系。总体依从性为30.3%，与常规护理组相比，干预组的依从性没有显著增加。在对常规护理和连续性组进行的汇集分析中，连续性最高的那一半样本的粘附率显著高于其余样本(45%；P<；0.001)。在判别分析(78%的正确分类，P<；0.001)中，两个历史变量(癌症家族史；结肠问题家族史)、一个连续性指标(去看医生的次数)、一个人口统计学变量(较低的家庭收入)和两个态度因素(对灵活乙状结肠镜检查的痛苦程度的感知；对医生解释其重要性的感知)对依从性的预测具有统计学意义。研究结果表明，筛查柔性乙状结肠镜对于无症状的患者是可以接受的，而且连续性可能对依从性有积极的影响。由于态度提供了修改的可能性，我们建议医生向患者保证，柔性乙状结肠镜检查不会过度痛苦，并与患者单独讨论其对健康的重要性。
The purpose of this study was to assess patient adherence to physician-recommended screening flexible sigmoidoscopy. In the setting of a family practice residency program, adherence rates in asymptomatic patients (N = 333, age ≥50 years) were compared among a Usual Care Group; an Intervention Group that received educational materials and a phone reminder; and a Continuity Group, which had longstanding continuity with a single physician. Data from mailed questionnaires (N = 180) were used to examine the associations of demographic factors and attitudes with adherence. Adherence was 30.3% overall, with a nonsignificant increase in the Intervention Group compared with the Usual Care Group. In a pooled analysis of the Usual Care and Continuity Groups, the half of the sample with the highest continuity had a significantly higher adherence rate than the rest of the sample (45%; P < 0.001). In a discriminant analysis (78% correct classification, P < 0.001) two history variables (family history of cancer; family history of colon problems), one measure of continuity (number of physician visits), one demographic variable (lower household income), and two attitudinal factors (perception of how painful flexible sigmoidoscopy would be; perception of how well the physician explained its importance) made statistically significant contributions to the prediction of adherence. Results of the study show that screening flexible sigmoidoscopy is acceptable to asymptomatic patients, and that continuity is likely to have a positive impact on adherence. Because attitudes offer the potential for modification, we suggest that physicians reassure patients that flexible sigmoidoscopy is not unduly painful and discuss with patients individually its importance to their health.
登录
查看更多内容
了解结直肠癌以及 40-74 岁人群筛查测试的使用。
影响因子：
5.1
作者：
Polednak,AP
通讯作者：
Polednak,AP
长岛（纽约）和康涅狄格州的初级保健医生对结直肠癌进行筛查。
影响因子：
--
作者：
Polednak,AP
通讯作者：
Polednak,AP
HMO 人群中坚持结直肠癌筛查。
影响因子：
5.1
作者：
Myers,RE;Trock,BJ;Lerman,C;Wolf,T;Ross,E;Engstrom,PF
通讯作者：
Engstrom,PF
乙状结肠镜检查在结直肠癌筛查中的作用：批判性评论。
影响因子：
29.4
作者：
Neugut,AI;Pita,S
通讯作者：
Pita,S