Patient and provider perspectives on the relationship between multiple morbidity management and disease prevention.
Patient and provider perspectives on the relationship between multiple morbidity management and disease prevention.
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DOI：
10.1177/0733464813499641
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发表时间：
2015-04
期刊：
影响因子：
--
通讯作者：
Fleming ST
中科院分区：
文献类型：
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作者：
Schoenberg NE;Tarasenko YN;Bardach SH;Fleming ST
尽管多重发病率（MM）管理和疾病预防的竞争需求，我们最近对1，153名年龄在50至76岁的阿巴拉契亚居民的调查记录了MM患者比没有MM的人更有可能获得结直肠癌筛查（CRCS）。为了深入了解这种关系，我们进行了9个焦点小组，6个与提供者，3个与患者。出现了三种主要解释：（a）患者的MM增加了提供者对其他健康脆弱性的警惕性;（B）患有MM增加了患者自身的警惕性;以及（c）患者的警惕性可能源于经历更多症状、具有癌症家族史以及成功获得医疗保健。与保健提供者更频繁的接触似乎鼓励预防性转诊，特别是在低收入人口中，否则他们可能得不到这种咨询。我们强调与会者的建议，以改善MM的管理和预防。
Despite competing demands of multiple morbidity (MM) management and disease prevention, our recent survey of 1,153 Appalachian residents aged 50 to 76 documented that individuals with MM were more likely to obtain colorectal cancer screening (CRCS) than those without MM. Nearly two thirds of respondents obtained CRCS, and the more MM, the greater the likelihood of screening. To gain insight into this relationship, we conducted nine focus groups, six with providers and three with patients. Three main explanations emerged: (a) patients’ MM increases providers’ vigilance for other health vulnerabilities; (b) having MM increases patients’ own vigilance; and (c) patients’ vigilance may stem from experiencing more symptoms, having a family history of cancer, and having successfully obtained health care. More frequent contact with health care providers appears to encourage preventive referral, especially in low-income populations that otherwise may not receive such counselling. We highlight participant recommendations to improve MM management and prevention.