Physician-patient discussions of controversial cancer screening tests
Physician-patient discussions of controversial cancer screening tests
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DOI：
10.1016/s0749-3797(00)00288-9
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发表时间：
2001-02-01
影响因子：
5.5
通讯作者：
Horowitz, CR
中科院分区：
文献类型：
--
作者：
Dunn, AS;Shridharani, KV;Horowitz, CR
背景资料：年轻女性的筛查性乳房X线摄影和前列腺特异性抗原（PSA）测量具有争议的益处和已知的潜在不良后果。虽然提供知情同意，并引起患者的喜好，提倡这些测试，很少有人知道这些讨论发生的频率或障碍，这些discussions.Methods：我们进行了一项调查，医务室工作人员和主治医生从事初级保健。《太阳报》调查了医生讨论筛查性乳房X光检查和PSA检测的可能性，以及影响这些讨论频率和质量的因素。结果：对于这三种情况，16%至34%的医生表示他们不讨论筛查性检测。进行讨论的可能性与以下因素显著相关：住院医生认为PSA筛查是有利的;住院医生和主治医生订购PSA检测的意图，以及主治医生订购乳房X光检查的意图;以及有争议的筛查适应症。最常见的障碍是缺乏时间的讨论，主题的复杂性，和语言barrier.Conclusions：医生报告说，他们经常不讨论癌症筛查测试与他们的病人。我们发现，医生的信念和意图，以旧的测试，以及外部因素，如时间限制和语言障碍，与讨论有关，这表明一些患者可能被不适当地剥夺了选择是否筛查乳腺癌和前列腺癌的机会。
Background: Screening mammography for younger women and prostate-specific antigen (PSA) measurement have controversial benefits and known potential adverse consequences. While providing informed consent and eliciting patient preference have been advocated for these tests, little is known about how often these discussions take place ol about barriers to these discussions.Methods: We administered a survey to medical house staff and attending physicians practicing primary care. The sun ey examined physicians' likelihood of discussing screening mammography and PSA testing, and factors: influencing the frequency and quality of these discussions.Results: For the three scenarios, 16% to 34% of physicians stated that they do not discuss the screening tests. The likelihood of having a discussion was significantly associated with house staff physicians' belief that PSA screening is advantageous; house staff and attending physicians' intention to order a PSA test, and attending physicians intention to order a mammogram; and a controversial indication for screening. The most commonly identified barriers to discussions were lack of time, the complexity of the topic, and a language barrier.Conclusions: Physicians report they often do not discuss cancer screening tests with their patients. Our finding that physicians' beliefs and intention to older the tests, and extraneous factors such as time constraints and a language barrier, are associated with discussions indicates that some patients may be inappropriately denied the opportunity to choose whether to screen for breast and prostate cancer.