开发和试验一项干预措施,以减少镜检查的缺失和相应的不平等:一种混合方法的研究
Allison Cowling1, Lisa Nevens1, Nicole Contogiorgi1
1Northumbria Healthcare Trust Public Health Office, North Tyneside General Hospital, North Tyneside, UK.
Lancet (London, England)
|November 24, 2023
概括
一个有针对性的电话干预显著降低了镜缺席率,特别是在年轻和贫困的患者中. 这种方法提高了宫癌查效率,并减少了健康不平等.
科学领域:
- 公共卫生
- 妇科医生
- 医疗服务研究
背景情况:
- 宫癌不成比例地影响低收入人群,贫困地区和年轻人中不参加大肠镜检查的比例更高.
- 宫癌查的诊断延迟可能导致未被发现或晚期治疗的癌前病症,从而减少查的益处.
- 为了提高查计划的有效性和减少健康差异,了解和解决查出席的障碍至关重要.
研究的目的:
- 调查镜检查缺席的主要原因.
- 开发和试验一项有针对性的干预措施,旨在改善结肠镜检查的出席率.
- 评估这项干预措施对镜检查缺席率的影响,特别是在弱势群体中.
主要方法:
- 通过对参加,取消或不参加结肠镜检查的患者进行采访,收集了定性数据.
- 主题分析确定了参与的主要障碍和推动因素,为试点干预的设计提供了信息.
- 实行了预约前的电话联系干预,以识别和解决个人出勤障碍,与干预前和后的非出勤率相比.
主要成果:
- 主要的出席障碍包括行政问题,忘记约会,焦虑,工作,照顾孩子和交通困难.
- 试点干预包括预约前的电话,成功联系了65%的预约患者.
- 在干预期间,总体来说,缺席率从干预前的10%下降到8%. 在最贫困地区的25至39岁患者中,缺席率从20%降至12%.
结论:
- 一个主动的电话干预有效地解决了镜检查的障碍,从而降低了缺席率.
- 有针对性的干预措施有望提高宫癌查效率,并缓解健康不平等,特别是在年轻和贫困人口中.
- 需要进一步的研究来验证这些发现在研究的特定NHS信托之外的更广泛的环境中.
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