Developing and testing a brief clinic-based lung cancer screening decision aid for primary care settings.
Developing and testing a brief clinic-based lung cancer screening decision aid for primary care settings.
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DOI：
10.1111/hex.12675
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发表时间：
2018-08
期刊：
影响因子：
--
通讯作者：
Eberth JM
中科院分区：
文献类型：
--
作者：
McDonnell KK;Strayer SM;Sercy E;Campbell C;Friedman DB;Cartmell KB;Eberth JM
癌症筛查相关决策要求患者在短时间内评估复杂的医疗信息，通常是由他们不认识的初级保健提供者 (PCP) 进行评估。 PCP 在促进全面共享决策 (SDM) 方面发挥着重要作用。为 PCP 和高危患者开发和测试决策辅助 (DA) 和 SDM 策略。 DA 用 20 个对组进行了测试。每对由一名 PCP 和一名符合筛查资格的患者组成。一项前瞻性、单组、混合方法研究设计测量了保真度、患者价值观、筛查意图、可接受性和满意度。从城市学术医疗中心招募了 4 名 PCP 和 20 名患者。大多数患者为女性（n = 14，70%），大多数已完成高中学业（n = 15，75%），平均年龄为 65 岁。一半是非裔美国人。患者和 PCP 认为 DA 有帮助、易于阅读和使用，并且在时间范围方面可以接受（观察时间 t = 11.6 分钟，SD 2.7）。大多数患者 (n = 16, 80%) 表示愿意接受筛查。 PCP 建议对大多数患者进行筛查（n = 17，85%）。有证据支持 LDCT 肺癌筛查对于特定高危患者的价值。指南支持让患者及其 PCP 参与 SDM 讨论。我们的研究结果表明，使用简短、互动、语言通俗易懂、文化敏感、基于理论的 DA 和 SDM 策略是可行的、可接受的，并且对于有效地将 LDCT 筛查建议转化和维持在临床环境中的采用可能至关重要。
Cancer screening‐related decisions require patients to evaluate complex medical information in short time frames, often with primary care providers (PCPs) they do not know. PCPs play an essential role in facilitating comprehensive shared decision making (SDM). To develop and test a decision aid (DA) and SDM strategy for PCPs and high‐risk patients. The DA was tested with 20 dyads. Each dyad consisted of one PCP and one patient eligible for screening. A prospective, one‐group, mixed‐method study design measured fidelity, patient values, screening intention, acceptability and satisfaction. Four PCPs and 20 patients were recruited from an urban academic medical centre. Most patients were female (n = 14, 70%), most had completed high school (n = 15, 75%), and their average age was 65 years old. Half were African American. Patients and PCPs rated the DA as helpful, easy to read and use and acceptable in terms of time frame (observed t = 11.6 minutes, SD 2.7). Most patients (n = 16, 80%) indicated their intent to be screened. PCPs recommended screening for most patients (n = 17, 85%). Evidence supports the value of lung cancer screening with LDCT for select high‐risk patients. Guidelines endorse engaging patients and their PCPs in SDM discussions. Our findings suggest that using a brief, interactive, plain‐language, culturally sensitive, theory‐based DA and SDM strategy is feasible, acceptable and may be essential to effectively translate and sustain the adoption of LDCT screening recommendations into the clinic setting.
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影响因子：
9.7
作者：
Legare, France;Witteman, Holly O.
通讯作者：
Witteman, Holly O.
影响因子：
9.7
作者：
Sepucha, Karen R.;Simmons, Leigh H.;Chaguturu, Sreekanth K.
通讯作者：
Chaguturu, Sreekanth K.
影响因子：
9.7
作者：
Levinson, Wendy;Lesser, Cara S.;Epstein, Ronald M.
通讯作者：
Epstein, Ronald M.
影响因子：
6.2
作者：
Ersek, Jennifer L.;Eberth, Jan M.;Friedman, Daniela B.
通讯作者：
Friedman, Daniela B.
影响因子：
39.2
作者：
Moyer, Virginia A.
通讯作者：
Moyer, Virginia A.