Influences on uptake of cancer screening in mental health service users: a qualitative study
Influences on uptake of cancer screening in mental health service users: a qualitative study
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DOI：
10.1186/s12913-016-1505-4
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发表时间：
2016-07-12
影响因子：
2.8
通讯作者：
Barley, Elizabeth A.
中科院分区：
文献类型：
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作者：
Clifton, Abigail;Burgess, Caroline;Barley, Elizabeth A.
背景：癌症是世界范围内的主要死亡原因。患有精神疾病的人死于癌症的可能性比普通人群高30%。其中一个原因可能是精神疾病患者对国家提供的癌症筛查测试的接受率较低。我们的目的是确定乳腺癌，宫颈癌和肠癌筛查的障碍和促进者，精神疾病患者的摄入，以告知干预措施，以促进平等access.Methods：访谈研究进行了城市和农村环境。这项研究是由理论领域框架，使用框架分析和三角测量的参与者群体。参与者包括45名心理健康服务使用者（服务用户）有资格进行癌症筛查，29名精神卫生专业人员和11名专业人员参与癌症screen.Results：主题新兴的数据，影响摄取包括知识的筛查计划，由服务用户和医疗服务提供者，知识，和态度，精神疾病，卫生服务提供因素;服务使用者对癌症普查的信念和关注，以及实际问题。这些与筛选过程的不同阶段有关。服务使用者如果入院，不会收到筛查或癌症检测包的邀请。如果他们没有在全科医生那里注册，就不会被常规邀请进行筛查。缺乏综合护理意味着精神卫生工作人员不知道某人是否逾期未做检查，在健康促进过程中往往不考虑癌症筛查。包括信息处理问题在内的障碍、筛查过程使症状恶化的程度、工作人员与客户关系不佳以及旅行困难因人而异。筛查专业人员有动力提供帮助，但可能缺乏时间或培训来管理心理健康需求。反应措施是可用的，但服务用户必须请求帮助，他们可能会发现difficult.Conclusions：有具体的障碍，癌症筛查摄取心理健康服务的用户，防止平等的照顾。需要在个人、政策和服务提供层面采取个性化的干预措施。初级和二级保健工作人员和政策制定者应共同努力，制定一个综合的方法，在这一人群中进行癌症筛查。
Background: Cancers are a leading cause of death worldwide. People with mental illness are 30 % more likely to die from cancer than the general population. One reason for this may be low uptake of nationally offered cancer screening tests by people with mental illness. We aimed to identify barriers and facilitators for breast, cervical and bowel cancer screening uptake by people with mental illness in order to inform interventions to promote equal access.Methods: The interview study was conducted in both urban and rural settings. The study was informed by the Theoretical Domains Framework, using framework analysis and triangulation across participant groups. Participants included 45 mental health service users (service users) eligible for cancer screening, 29 mental health professionals and 11 professionals involved in cancer screening.Results: Themes emerging from the data that affected uptake included knowledge of screening programmes by both service users and healthcare providers; knowledge of, and attitudes towards, mental illness; health service-delivery factors; service users' beliefs and concerns about cancer screening, and practical issues. These are relevant to different stages of the screening process. Service users do not receive invitations to screening or cancer testing kits if they are admitted to hospital. They are not routinely invited for screening if they are not registered with a general practitioner (GP). Lack of integrated care means that mental health staff do not know if someone is overdue for a test and cancer screening is often not considered during health promotion. Barriers including information processing problems, the extent to which the screening process aggravates symptoms, poor staff client relationships and travel difficulties vary between individuals. Screening professionals are motivated to help, but may lack time or training to manage mental health needs. Reactive measures are available, but service users must request help which they may find difficult.Conclusions: There are specific barriers to cancer screening uptake for mental health service users that prevent equality of care. Interventions that can be personalised are needed at individual, policy and service-delivery levels. Primary and secondary care staff and policy-makers should work together to develop an integrated approach to cancer screening in this population.