Lung cancer screening: what do long-term smokers know and believe?
Lung cancer screening: what do long-term smokers know and believe?
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DOI：
10.1111/hex.12433
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发表时间：
2017-02-01
影响因子：
3.2
通讯作者：
Rawl, Susan M.
中科院分区：
文献类型：
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作者：
Carter-Harris, Lisa;Ceppa, DuyKhanh Pham;Rawl, Susan M.
目的探讨长期吸烟者对肺癌、相关危险因素及肺癌筛查的认知和信念，设计基于扩展健康信念模型的定性研究。采用内容分析法对26名长期吸烟者进行肺癌筛查前后的肺癌相关知识和信念、相关危险因素及肺癌筛查的主题进行分析（n = 9; n = 3）最近进行了筛选，（n = 7;结果虽然大多数人认为肺癌是致命的，在原因和相关风险因素方面存在混淆或不准确的信息。与肺癌筛查相关的知识以及如何进行肺癌筛查的知识很低;长期吸烟与肺癌风险相关的意识仍然不理想。已确定的筛查的感知益处包括：（i）早期发现肺癌;（ii）让人安心;（iii）戒烟的动力。识别的感知障碍筛查包括：（一）不便;（二）不信任;和（三）stigment.Conclusions感知障碍肺癌筛查，如不信任和耻辱，必须解决肺癌筛查变得更广泛实施。对卫生保健系统的不信任程度提高可能会影响筛查方案的成功实施。与吸烟相关的耻辱感可能导致患者对医疗护理的参与程度较低，并减少癌症筛查的参与。还必须确定可修改的干预目标，以加强保健提供者与高风险患者之间的共同决策过程。
Objective To explore knowledge and beliefs of long-term smokers about lung cancer, associated risk factors and lung cancer screening.Design Qualitative study theoretically framed by the expanded Health Belief Model based on four focus group discussions. Content analysis was performed to identify themes of knowledge and beliefs about lung cancer, associated risk factors and lung cancer screening among long-term smokers' who had and had not been screened for lung cancer.Methods Twenty-six long-term smokers were recruited; two groups (n = 9; n = 3) had recently been screened and two groups (n = 7; n = 7) had never been screened.Results While most agreed lung cancer is deadly, confusion or inaccurate information exists regarding the causes and associated risk factors. Knowledge related to lung cancer screening and how it is performed was low; awareness of long-term smoking's association with lung cancer risk remains suboptimal. Perceived benefits of screening identified include: (i) finding lung cancer early; (ii) giving peace of mind; and (iii) motivation to quit smoking. Perceived barriers to screening identified include: (i) inconvenience; (ii) distrust; and (iii) stigma.Conclusions Perceived barriers to lung cancer screening, such as distrust and stigma, must be addressed as lung cancer screening becomes more widely implemented. Heightened levels of health-care system distrust may impact successful implementation of screening programmes. Perceived smoking-related stigma may lead to low levels of patient engagement with medical care and decreased cancer screening participation. It is also important to determine modifiable targets for intervention to enhance the shared decision-making process between health-care providers and their high-risk patients.