Patient-Rated Importance and Receipt of Information for Colorectal Cancer Screening
Patient-Rated Importance and Receipt of Information for Colorectal Cancer Screening
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DOI：
10.1158/1055-9965.epi-11-0281
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发表时间：
2011-10-01
影响因子：
3.8
通讯作者：
Lafata, Jennifer Elston
中科院分区：
文献类型：
--
作者：
Flocke, Susan A.;Stange, Kurt C.;Lafata, Jennifer Elston
背景资料：医生的建议是获得结直肠癌（CRC）筛查的最重要的决定因素之一;然而，很少有人知道CRC筛查讨论的程度，包括患者报告的重要信息，以指导筛查决策。本研究探讨和比较患者的重要性和医生沟通的关键信息元素CRC筛查在每年的体检。方法：设计：横断面队列。设置：在中西部的综合交付系统的26个门诊诊所。参与者：64名初级保健医生和415名年龄在50至80岁之间的CRC筛查患者。患者完成了一项预先调查，以评估在做出预防性筛查决定时特定信息的重要性。访问的音频记录，以评估筛选discussions.Results的内容：大多数患者评价测试的准确性（85%），测试的替代品（83%），测试的利弊（86%），和测试过程（78%）非常重要的预防性筛查决策时。91%的访视包括CRC筛查讨论;然而，CRC筛查谈话很少包括患者认为重要的信息。医生很少询问患者是否有关于CRC筛查的问题（5%）;然而，49%的患者询问了CRC筛查问题，其中绝大多数与筛查后勤有关。录音证实，CRC筛查的讨论往往缺乏患者表示在做出预防性健康决策时非常重要的信息，并且患者在访问期间的问题不会引起注意影响：这些发现提供了可操作的信息，以改善CRC筛查讨论。癌症流行病学生物标志物Prev; 20（10）; 2168-73。(C)2011年AACR。
Background: Physician recommendation is one of the most important determinants of obtaining colorectal cancer (CRC) screening; however, little is known about the degree to which CRC screening discussions include information that patients report as important to guide screening decisions. This study examines and compares both patient rated importance and physician communication of key information elements about CRC screening during annual physical examinations.Methods: Design: Cross-sectional cohort. Setting: 26 ambulatory clinics of an integrated delivery system in the Midwest. Participants: 64 primary care physicians and 415 patients aged 50 to 80 due for CRC screening. Patients completed a previsit survey to assess importance of specific information when making a preventive screening decision. Visits were audio recorded to assess the content of screening discussions.Results: Most patients rated test accuracy (85%), testing alternatives (83%), the pros and cons of testing (86%), and the testing process (78%) very important when making preventive screening decisions. Ninety-one percent of visits included a CRC screening discussion; however, CRC screening talk rarely included information that patients rated as important. Physicians infrequently asked whether patients had questions pertaining to CRC screening (5%); however, 49% of patients asked a CRC screening question, with the vast majority pertaining to screening logistics.Conclusions: Audio recordings confirm that discussions of CRC screening are often lacking information that patients indicate is very important when making preventive health decisions and patient questions during the visit are not eliciting information to fill the gap.Impact: These findings provide actionable information to improve CRC screening discussions. Cancer Epidemiol Biomarkers Prev; 20(10); 2168-73. (C) 2011 AACR.