The relationship between perceived burden of chronic conditions and colorectal cancer screening among Appalachian residents.
The relationship between perceived burden of chronic conditions and colorectal cancer screening among Appalachian residents.
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阿巴拉契亚居民对慢性病的感知负担与结直肠癌筛查之间的关系。
DOI：
10.1111/jrh.12035
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发表时间：
2014
期刊：
影响因子：
--
通讯作者：
Schoenberg,NancyE
中科院分区：
文献类型：
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作者：
Tarasenko,YelenaN;Fleming,StevenT;Schoenberg,NancyE
随着患有多种并发慢性疾病或多种发病率（MM）的人口增加，了解如何有效地将预防工作纳入疾病管理变得更加重要，特别是在农村，服务不足的人群中。与城市居民相比，农村居民患病率更高，获得的预防服务更少，而且往往生活在限制获得最佳医疗服务的环境中。本研究描述了农村居民对疾病管理的感知负担，并探讨了这些负担（作为个人竞争需求的代理）与结直肠癌筛查（CRCS）之间的关系。MethodsWe进行了一项横断面研究，基于1,012名阿巴拉契亚居民的电话调查数据，年龄为50 - 75岁，患有1种或多种慢性疾病。感知MM负担的措施，开发了85个试点访谈的基础上进行供应商和MM患者居住在阿巴拉契亚肯塔基州。ResultsMany participants（81%）同意1个或多个声明，表明感知负担的疾病管理的影响，接受CRCS。较高比例的农村（与非农村）阿巴拉契亚人认为负担与医生的建议，结肠镜检查的准备，以及时间管理和负担能力的现有疾病和筛查。这些差异并没有改变将MM视为负担和放弃CRCS之间的总体关联。与医生和时间管理的互动相关的感知负担的CRCS的负面影响是较低的参与者与多个，而不是单一的morbidity.ConclusionFuture的研究旨在解决MM的感知负担和改善与医疗保健提供者的互动可能会加强关键的预防工作弱势人群。
PurposeAs the population living with several concurrent chronic conditions or multiple morbidity (MM) increases, understanding how to effectively fit prevention efforts into disease management becomes more important, particularly among rural, underserved populations. Compared to their urban counterparts, rural residents suffer higher rates of disease, receive fewer preventive services, and often live in environments limiting access to optimal medical care. This study describes rural residents’ perceived burdens of disease management and explores the relationship between these burdens, as proxies of individuals’ competing demands, and colorectal cancer screening (CRCS).MethodsWe conducted a cross‐sectional study, based on telephone survey data from 1,012 Appalachian residents, ages 50‐75, with 1 or more chronic conditions. Measures of perceived MM burdens were developed based on 85 pilot interviews previously undertaken with providers and patients with MM residing in Appalachian Kentucky.ResultsMany participants (81%) agreed with 1 or more statements indicating perceived burdens of disease management effects on receiving CRCS. A higher percentage of rural (vs nonrural) Appalachians perceived burdens related to physician's recommendation, preparation to colonoscopy, and time management and affordability of both current diseases and screening. These differences did not modify the overall association between perceiving MM as burdensome and forgoing CRCS. The negative effect on CRCS of perceived burdens related to interaction with physician and time management was lower for participants with multiple rather than single morbidity.ConclusionFuture research designed to address perceived burdens of MM and improved interaction with health care providers may enhance critical prevention efforts among vulnerable populations.