A Qualitative Study of Lung Cancer Risk Perceptions and Smoking Beliefs Among National Lung Screening Trial Participants
A Qualitative Study of Lung Cancer Risk Perceptions and Smoking Beliefs Among National Lung Screening Trial Participants
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DOI：
10.1093/ntr/ntt133
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发表时间：
2014-02-01
影响因子：
4.7
通讯作者：
Nichter, Mark
中科院分区：
文献类型：
--
作者：
Park, Elyse R.;Streck, Joanna M.;Nichter, Mark
国家综合癌症网络和美国癌症协会最近发布了肺部筛查指南，其中包括对接受筛查的吸烟者进行戒烟咨询。以前的研究表明，国家肺筛查试验（NLST）参与者的吸烟行为和风险认知相对不变。我们探讨了美国放射学会成像网络（ACRIN）/NLST的前吸烟者和现吸烟者的风险认知，特别是为了（a）确定肺部筛查是否是行为改变的线索，（B）阐明肺癌和吸烟相关疾病的风险认知，以及（c）从4个ACRIN站点随机抽取35名参与者进行12年的定性访谈，后期我们使用了一个结构化的采访指南的基础上健康信念模型和自我调节模型的结构。大多数参与者赞同肺癌和吸烟相关疾病的高风险认知，但对这些风险的高度关注似乎并没有激励参与者寻求筛查。风险认知主要归因于参与者的严重吸烟史;前吸烟者表示风险大大降低。肺癌和与吸烟有关的疾病被认为是非常严重的，尽管参与者认可低担忧。目前的吸烟者对自己戒烟的能力信心不足，没有人报告在初次筛查后戒烟。肺部筛查似乎不是行为改变的提示，高风险的认知并没有转化为戒烟行为。认知和情感的失调和回避策略可能会阻止吸烟行为的改变。在肺筛查期间的戒烟和预防干预措施应探索风险认知，情绪和戒烟信心。
The National Comprehensive Cancer Network and the American Cancer Society recently released lung screening guidelines that include smoking cessation counseling for smokers undergoing screening. Previous work indicates that smoking behaviors and risk perceptions of the National Lung Screening Trial (NLST) participants were relatively unchanged. We explored American College of Radiology Imaging Network (ACRIN)/NLST former and current smokers risk perceptions specifically to (a) determine whether lung screening is a cue for behavior change, (b) elucidate risk perceptions for lung cancer and smoking-related diseases, and (c) explore postscreening behavioral intentions and changes.A random sample of 35 participants from 4 ACRIN sites were qualitatively interviewed 12 years postscreen. We used a structured interview guide based on Health Belief Model and Self-Regulation Model constructs. Content analyses were conducted with NVivo 8.Most participants endorsed high-risk perceptions for lung cancer and smoking-related diseases, but heightened concern about these risks did not appear to motivate participants to seek screening. Risk perceptions were mostly attributed to participants heavy smoking histories; former smokers expressed greatly reduced risk. Lung cancer and smoking-related diseases were perceived as very severe although participants endorsed low worry. Current smokers had low confidence in their ability to quit, and none reported quitting following their initial screen.Lung screening did not appear to be a behavior change cue to action, and high-risk perceptions did not translate into quitting behaviors. Cognitive and emotional dissonance and avoidance strategies may deter engagement in smoking behavior change. Smoking cessation and prevention interventions during lung screening should explore risk perceptions, emotions, and quit confidence.