Processes of care in cervical and breast cancer screening and follow-up--the importance of communication.
Processes of care in cervical and breast cancer screening and follow-up--the importance of communication.
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DOI：
10.1016/j.ypmed.2004.03.010
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发表时间：
2004-07
影响因子：
5.1
通讯作者：
J. Zapka;E. Puleo;S. Taplin;K. V. Goins;M. Yood;M. Yood;J. Mouchawar;C. Somkin;M. Manos
中科院分区：
文献类型：
--
作者：
J. Zapka;E. Puleo;S. Taplin;K. V. Goins;M. Yood;M. Yood;J. Mouchawar;C. Somkin;M. Manos
BackgroundGiven有限的研究，我们调查了病人报告的过程中的护理相关的筛查后续工作，结果通知的时间，沟通问题，并坚持以下异常乳房X光检查或巴氏试验。MethodsWomen年龄50岁及以上的异常筛查乳房X光检查和妇女年龄18岁及以上的异常巴氏试验结果完成了调查。乳房X光检查和巴氏检查调查工具有类似的项目，但与乳房X光检查或巴氏检查特定的措施有关。使用卡方列联表分析探讨了护理变量（检测结果、结果接收、建议依从性、混淆/冲突信息接收）过程与总体满意度之间的双变量关联。Multivariable logistic regression modeling was carried. Results 1134名妇女（79.1%）完成了乳房X线检查调查和1087名妇女（69.7%）完成了巴氏涂片调查。大多数妇女很快就得到了检查结果。据报告，对短期后续行动建议的遵守率很高。少数妇女报告了令人困惑/困惑的信息，但与报告“护理可以更好”显著正相关。患者缺乏对模棱两可的调查结果的理解是显而易见的。ConclusionsThis研究证实，患者需要明确的信息有关的建议，特别是当调查结果是模棱两可的，多个供应商参与的过程中作出临床决策。
BackgroundGiven limited research, we investigated patient reports of processes of care related to screening follow-up, timing of result notification, communication issues, and adherence following an abnormal mammogram or Pap test.MethodsWomen age 50 and over with an abnormal screening mammogram and women age 18 and above with an abnormal Pap test result completed surveys. The mammogram and Pap survey instruments had similar items except pertaining to measures specific to mammography or Pap tests. Bivariate associations between processes of care variables (test results, result receipt, recommendation adherence, receipt of confusing/conflicting information) and global satisfaction were explored using chi-square contingency table analysis. Multivariable logistic regression modeling was conducted.ResultsOne thousand one hundred thirty-four women (79.1%) completed the mammogram survey and 1087 women (69.7%) completed the Pap survey. The majority of women received test results quickly. High compliance was reported with recommendations for short-term follow-up. Conflicting/confusing information was reported by a minority of women, but was significantly and positively related to reporting that “care could be better”. Patient's lack of understanding about equivocal findings was evident.ConclusionsThis study confirms that patients need clear messages about recommendations, especially when findings are equivocal and where multiple providers are involved in the process of making clinical decisions.