A qualitative study exploring why individuals opt out of lung cancer screening
A qualitative study exploring why individuals opt out of lung cancer screening
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DOI：
10.1093/fampra/cmw146
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发表时间：
2017-04-01
期刊：
影响因子：
2.2
通讯作者：
Buist, Diana S. M.
中科院分区：
文献类型：
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作者：
Carter-Harris, Lisa;Brandzel, Susan;Buist, Diana S. M.
背景。根据美国预防服务工作组B级建议，每年进行低剂量计算机断层扫描的肺癌筛查对于美国长期吸烟者来说是相对较新的。随着筛查项目在全国范围内得到更广泛的实施，以及医疗服务提供者让患者参与肺癌筛查，了解那些选择退出的高风险吸烟者的行为，以改善肺癌筛查的共同决策过程，是至关重要的。本研究的目的是探讨符合筛查条件的患者在接受医生推荐后选择不接受筛查的原因。从2015年11月到2016年1月，对18名符合年龄、吸烟和包年史肺癌筛查标准的参与者进行了半结构化定性电话访谈。两名具有癌症筛查和定性方法专业知识的研究人员利用录音访谈的专题内容分析程序进行数据分析。选择不参加肺癌筛查的原因主要有五个方面：(i)回避知识；认为价值低；（iii）假阳性忧虑；实际障碍；（五）患者误解。我们研究的参与者提供了为什么一些患者决定选择退出低剂量计算机断层扫描筛查的见解，这提供了可以为干预开发提供信息的知识，以加强长期吸烟者和他们的提供者之间的共同决策过程，并减少关于筛查的决策冲突。
Background. Lung cancer screening with annual low-dose computed tomography is relatively new for long-term smokers in the USA supported by a US Preventive Services Task Force Grade B recommendation. As screening programs are more widely implemented nationally and providers engage patients about lung cancer screening, it is critical to understand behaviour among highrisk smokers who opt out to improve shared decision-making processes for lung cancer screening.Objective. The purpose of this study was to explore the reasons for screening-eligible patients' decisions to opt out of screening after receiving a provider recommendation.Methods. Semi-structured qualitative telephone interviews were performed with 18 participants who met lung cancer screening criteria for age, smoking and pack-year history in Washington State from November 2015 to January 2016. Two researchers with cancer screening and qualitative methodology expertise conducted data analysis using thematic content analytic procedures from audio-recorded interviews.Results. Five primary themes emerged for reasons of opting out of lung cancer screening: (i) Knowledge Avoidance; (ii) Perceived Low Value; (iii) False-Positive Worry; (iv) Practical Barriers; and (v) Patient Misunderstanding.Conclusion. The participants in our study provided insight into why some patients make the decision to opt out of low-dose computed tomography screening, which provides knowledge that can inform intervention development to enhance shared decision-making processes between long-term smokers and their providers and decrease decisional conflict about screening.