Lake Superior Rural Cancer Care Project, Part III: provider practice.
Lake Superior Rural Cancer Care Project, Part III: provider practice.
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苏必利尔湖农村癌症护理项目，第三部分：提供者实践。
DOI：
10.1046/j.1523-5394.2002.102005.x
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发表时间：
2002
期刊：
影响因子：
--
通讯作者：
Jensen,PatriciaB
中科院分区：
文献类型：
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作者：
Elliott,ThomasE;Elliott,BarbaraA;Regal,RonaldR;Renier,ColleenM;Haller,IrinaV;Crouse,ByronJ;Witrak,MarthaT;Jensen,PatriciaB
目的：需要有效的方法来鼓励农村初级保健医生采用最先进的癌症管理做法。这项研究的目的是评估改善农村初级保健医生癌症执业行为的教育和系统战略。研究描述：莱克苏必利尔湖农村癌症护理项目是一项在美国中北部18个农村社区进行的为期4年的随机对照试验。虽然分析的单位是社区，但受试者是104名初级保健医生和2089名农村癌症患者。这项干预措施具有教育性，包括针对农村初级保健医生及其医疗保健提供系统的战略。结果：干预显著改善了37个癌症实习终点中的5个。这项研究的总体结果并不支持大多数研究假设。由于16个实习终点被发现处于可接受的表现水平，因此可测量的干预效果的可能性是有限的。临床意义：早些时候，作者报告了干预结果对提供者癌症管理知识的影响，显示出显著的改善。目前的研究结果表明，提高服务提供者的知识并不一定会提高实践绩效。改变练习行为需要付出更多的努力。此外，被发现对其他疾病、提供者类型或环境有效的干预措施可能不适用于农村提供者的癌症管理。
purpose:Effective methods that encourage rural primary‐care physicians to adopt state‐of‐the‐art cancer‐management practices are needed. The purpose of this study was to evaluate educational and systems strategies to improve rural primary‐care physicians' cancer practice behaviors.description of study:The Lake Superior Rural Cancer Care Project was a group‐randomized, controlled trial conducted with 18 rural communities in the North Central United States over 4 years. Although the unit of analysis was the community, the subjects were 104 primary‐care physicians and 2089 rural patients with cancer. The intervention was educational and comprised systems strategies that targeted rural primary‐care physicians and their healthcare delivery systems. The outcome measures reported here were physician practice behaviors regarding cancer diagnosis, staging, treatment, clinical trial participation, and post‐treatment surveillance.results:The intervention significantly improved 5 of the 37 cancer practice end points. The overall result of the study did not support the majority of the study hypotheses. Because 16 practice end points were found to be at acceptable performance levels, the possibility of a measurable intervention effect was limited.clinical implications:Earlier, the authors reported the results of the intervention on providers' cancer management knowledge, which showed significant improvement. The present study findings demonstrated that improving provider knowledge does not necessarily improve practice performance. Changing practice behaviors requires much more effort. Furthermore, interventions found to be effective in other diseases, types of providers, or settings may not work on rural providers for cancer management.