Physician behaviors to promote informed decisions for prostate cancer screening: a National Research Network study.
Physician behaviors to promote informed decisions for prostate cancer screening: a National Research Network study.
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DOI：
10.1007/s13187-014-0613-2
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发表时间：
2014-06
期刊：
影响因子：
--
通讯作者：
Volk RJ
中科院分区：
文献类型：
--
作者：
Linder SK;Kallen MA;Mullen PD;Galliher JM;Swank PR;Chan EC;Volk RJ
前列腺癌筛查临床指南（PCS）建议医生讨论筛查的潜在危害和益处。然而，缺乏关于知情决策（IDM）的培训计划，并且不知道医生在执行IDM行为时最困难的是什么。识别困难的行为可以帮助定制训练计划。在为PCS开发医生IDM程序的背景下，我们旨在描述医生使用九个关键IDM行为的PCS讨论，并检查这些行为与医生特征之间的关系。美国家庭医生学会国家研究网络的横断面样本完成了关于他们对PCS行为的调查（N=246，回复率=58%）。调查包括9个关键的内科医生的IDM行为和一个单项目问题，描述他们的一般实践方式的个人电脑。最常见的IDM行为是邀请男性提问。报告中最不常见的两种行为与不确定筛查的患者有关（即，安排随访并为犹豫不决的男性提供额外信息）。无论医生是否报告与患者讨论PCS，他们都报告了这两种行为的困难。报告的关键IDM行为的使用与PCS的一般实践风格和住院医师培训计划有关。IDM的医师培训计划应包括医师技能，以解决不确定筛查的患者的需求。未来的研究应该确定实际行为是否与PCS讨论中自我报告的行为有关。
Clinical guidelines for prostate cancer screening (PCS) advise physicians to discuss the potential harms and benefits of screening. However, there is a lack of training programs for informed decision making (IDM), and it is unknown which IDM behaviors physicians have the most difficulty performing. Identifying difficult behaviors can help tailor training programs. In the context of developing a physician IDM program for PCS, we aimed to describe physicians’ use of nine key IDM behaviors for the PCS discussion and to examine the relation between the behaviors and physician characteristics. A cross-sectional sample of The American Academy of Family Physicians National Research Network completed surveys about their behavior regarding PCS (N=246; response rate=58%). The surveys included nine physician key IDM behaviors for PCS and a single-item question describing their general practice style for PCS. The most common IDM behavior was to invite men to ask questions. The two least common reported behaviors concerned patients uncertain about screening (i.e., arrange follow up and provide additional information for undecided men). Physicians reported difficulty with these two behaviors regardless whether they reported to discuss or not to discuss PCS with patients. Reported use of key IDM behaviors was associated with a general practice style for PCS and being affiliated with a residency training program. Physician training programs for IDM should include physician skills to address the needs of patients uncertain about screening. Future research should determine whether if actual behavior is associated with self-reported behavior for the PCS discussion.
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