Colorectal cancer screening barriers in persons with low income
Colorectal cancer screening barriers in persons with low income
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DOI：
10.1046/j.1523-5394.2002.105003.x
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发表时间：
2002-09-01
期刊：
影响因子：
--
通讯作者：
Given, CW
中科院分区：
文献类型：
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作者：
Holmes-Rovner, M;Williams, GA;Given, CW
目得：本研究的目的是提供深入了解的医生和病人的教育和提醒程序，提高筛选率从37%到49%的农村符合医疗补助条件的患者在西部Michigan. Description研究：以下四个焦点小组进行：非洲裔美国人的男性，非洲裔美国人的女性，白色男性和白色女性，与主持人的性别和种族相匹配的适度成功。通过联系先前符合条件的筛选拒绝者选择样本，完成接受筛选的便利样本组。21名年龄>50岁的患者参加了研究。筛查拒绝率男性为19%，女性为9%。开放式的问题引导讨论结直肠癌（CRC）的态度，信念，和practices.RESULTS：所有参与者相信癌症筛查的疗效。白色妇女更好地了解筛查目的和程序。筛查的主要障碍是护理质量（即，认为缺乏提供筛查和后续的测试结果）和潜在的疼痛从筛查或治疗CRC，如果它是discovered.CLINICAL的影响：成功的努力，以提高认识的重要性和有效性的筛查必须进一步解决深深持有的怀疑和恐惧CRC筛查在这一人群。一个富有成效的方向，这一难题似乎是改善沟通（消极和积极的测试结果）。如果没有反馈，阴性结果的患者可能会认为缺乏提供者的跟进。
PURPOSE: The purpose of this study was to provide insight into the modest success of a physician and patient education and reminder program that improved screening rates from 37% to 49% among rural Medicaid-eligible patients in western Michigan.DESCRIPTION OF STUDY: The following four focus groups were conducted: African American men, African American women, White men, and White women, matched with moderators by gender and ethnicity. The sample was selected by contacting prior eligible screening refusers, completing groups with a convenience sample who had accepted screening. Twenty-one patients participated who were ages >50 years. The screening refusal rates were 19% for men and 9% for women. Open-ended questions guided the discussion of colorectal cancer (CRC) attitudes, beliefs, and practices.RESULTS: All participants believed in the efficacy of cancer screening. White women were better informed about screening purposes and procedures. The major barriers to screening were quality of care (ie, the perceived lack of offering screening and the follow-up of test results) and the potential for pain from screening or treatment of CRC, should it be discovered.CLINICAL IMPLICATIONS: Successful efforts to improve awareness of the importance and efficacy of screening must further address deeply held skepticism and fears about CRC screening in this population. A fruitful direction for this difficult problem appears to be improved communication (both negative and positive test results). Without feedback, patients with negative results may assume lack of provider follow-through.