Health-Seeking Behavior and Barriers to Care in Patients With Rectal Bleeding in Nigeria
Health-Seeking Behavior and Barriers to Care in Patients With Rectal Bleeding in Nigeria
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DOI：
10.1200/jgo.2016.006601
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发表时间：
2017-12-01
影响因子：
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通讯作者：
Kingham, T. Peter
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作者：
Alatise, Olusegun, I;Fischer, Sara E.;Kingham, T. Peter
结直肠癌（CRC）的发病率在尼日利亚稳步上升。由于财政和后勤方面的障碍，有组织的筛查在很大程度上仍然没有得到使用;大多数CRC是通过症状发现的。CRC的一个症状是直肠出血。本研究旨在确定尼日利亚直肠出血患者的就医行为和护理障碍。这项研究还调查了医生，以确定主要故障在accesstoacare.Methods这项研究的招募过程涉及结肠镜检查，因为直肠出血以及响应媒体广告免费结肠镜检查的患者。在非洲肿瘤研究小组会议上征聘了医生。根据直肠出血知识对患者反应进行评分。结果共82例患者和45名医生参与了本研究。不到40%的患者知道直肠出血可能是由癌症引起的。治疗的主要障碍是症状的解决（42%），不认为出血是有问题的（40%）和经济限制（22%）。教育程度与直肠出血知识和求医行为密切相关。虽然医生经常看到直肠出血的患者，他们中的大多数提供了痔疮的鉴别诊断和结肠镜检查的患者很少转介。结论一般的认识，大肠癌的迹象是缺乏的。这表明了对患者教育计划在这个问题上的强烈需求。医生还应该接受额外的培训，以区分潜在的癌症诊断与更良性的疾病，如痔疮。(C)2017年由美国临床肿瘤学会根据知识共享署名4.0许可证授权
Purpose Colorectal cancer (CRC) incidence rates are steadily increasing in Nigeria. Organized screening is still largely unused because of financial and logistical barriers; most CRCs are detected by symptoms. One symptom of CRC is rectal bleeding. This study sought to determine health-seeking behavior and barriers to care in patients with rectal bleeding in Nigeria. This study also surveyed physicians to determine major breakdowns in access to care.Methods The recruitment process for this study involved patients referred for colonoscopy because of rectal bleeding as well as response to a media advertisement for a free colonoscopy. Physicians were recruited at the African Research Group for Oncology meeting. Patient responses were scored on the basis of knowledge of rectal bleeding. The physician questionnaire was supporting information and mainly descriptive in nature.Results A total of 82 patients and 45 physicians participated in this study. Less than 40% of patients knew that rectal bleeding could be caused by cancer. Major barriers to care were resolution of the symptom (42%), no consideration of the bleeding as problematic (40%), and financial constraint (22%). Education was strongly correlated with knowledge of rectal bleeding and health-seeking behavior. Although physicians regularly saw patients with rectal bleeding, most of them provided a differential diagnosis of hemorrhoids and few referred patients for colonoscopy.Conclusion General awareness about the signs of colorectal cancer is lacking. This demonstrates the strong need for patient education programs about this issue. Physicians should also receive additional training on differentiation of a potential cancer diagnosis from something more benign, such as hemorrhoids. (C) 2017 by American Society of Clinical Oncology Licensed under the Creative Commons Attribution 4.0 License