Efficacy Expectations for Colorectal Cancer Screening in Primary Care: Identifying Barriers and Facilitators for Patients and Clinicians
Efficacy Expectations for Colorectal Cancer Screening in Primary Care: Identifying Barriers and Facilitators for Patients and Clinicians
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DOI：
10.1080/10410230902889241
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发表时间：
2009-01-01
影响因子：
3.9
通讯作者：
Mahoney, Martin C.
中科院分区：
文献类型：
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作者：
Feeley, Thomas Hugh;Cooper, James;Mahoney, Martin C.
初级保健(PC)专科的医生(MD)、护士从业者(NP)和医师助理(PA)以及患者参加了一系列同龄人级别的焦点小组，以探讨如何在PC中进行结直肠癌(CRC)筛查。共进行了27个焦点小组，包括8个MD组(n=56)、7个NP/PAS组(n=47)和12个病人组(n=103)。临床医生(MD、NPS、PA)报告在探井期间讨论了CRC筛查，并通过流程图、图表提醒(纸质、电子)或办公室人员提醒需要筛查的患者，并指出缺乏时间、患者不情愿以及与安排结肠镜检查相关的挑战是筛查的障碍。临床医生认为沟通技巧和办公室筛查程序的便利性是结直肠癌筛查的促进者。患者回忆起在PC办公室就诊时讨论的结直肠癌筛查，以及最常见的结肠镜检查和粪便潜血试验作为常见的结直肠癌筛查试验。医生推荐和认识患有癌症的人是促使患者决定完成结直肠癌筛查的最常见因素。结果是根据患者和临床医生对与结直肠癌筛查相关的自我效能感的看法而制定的。
Physicians (MDs), nurse practitioners (NPs), and physician assistants (PAs) in primary care (PC) specialties, as well as patients, participated in a series of peer-level focus groups to explore how colorectal cancer (CRC) screening is approached in PC. Twenty-seven focus groups were conducted, including 8 groups composed of MDs (n = 56), 7 with NP/PAs (n = 47), and 12 with patients (n = 103). Clinicians (MDs, NPs, PAs) reported discussing CRC screening during well visits and were alerted to patients in need of screening through flow sheets, chart reminders (paper, electronic) or by office personnel, and cited lack of time, patient reluctance, and challenges related to scheduling colonoscopy as barriers to screening. Clinicians identified communication skills and the convenience of office-based screening procedures as facilitators of CRC screening. Patients recalled discussing CRC screening during PC office visits and most commonly identified colonoscopy and fecal occult blood test as common CRC screening tests. Physician recommendation and knowing someone who has/had cancer were the most common factors motivating patients' decision to complete CRC screening. Results are framed according to patient and clinician perceptions of self-efficacy related to CRC screening.