患者肺癌查决策以及环境和心理社会因素
Jennifer Richmond1, Jessica R Fernandez2,3, Kemberlee Bonnet4,5
1Division of Public Health Sciences, Department of Social Sciences and Health Policy, Wake Forest University School of Medicine, Winston-Salem, North Carolina.
JAMA network open
|May 31, 2024
概括
患者对肺癌查的决定受到种族主义,不信任和实际障碍的影响. 解决这些系统性问题是提高查普及率和降低肺癌死亡率的关键.
科学领域:
- 公共卫生 公共卫生
- 健康差异 在健康上的差异
- 定性研究是指质量研究.
背景情况:
- 低剂量计算机断层扫描 (LDCT) 查肺癌降低了死亡率,但在美国的吸收率很低.
- 了解患者的决策对于改善肺癌查 (LCS) 的参与至关重要.
- 个人心理社会因素得到了充分的研究,但环境和修饰因素也会影响LCS决策.
研究的目的:
- 调查影响肺癌查决策的环境,心理和修改因素.
- 开发一个概念框架,说明这些影响因素之间的关系.
主要方法:
- 一个使用虚拟半结构面试和焦点小组的多方法定性研究.
- 参与者 (N=34) 满足了美国预防服务特别工作组 (US Preventive Services Task Force) 对LCS资格的标准.
- 数据使用代的诱导-演方法进行分析.
主要成果:
- 历史和当前的种族主义显著影响了参与者对医疗保健提供者的信任和避免查.
- 环境因素,如公共交通和修改因素,如保险覆盖影响了决策.
- 心理社会因素包括感知到的好处,风险评估以及对诊断或负面医疗保健遭遇的恐惧是关键因素.
结论:
- 环境,心理社会和修饰因素极大地影响患者对肺癌查的决策.
- 需要在系统层面进行干预,以解决患者之前的负面医疗经历,并促进明智的查决策.
- 有效的干预需要医疗保健提供者理解和讨论这些多方面的患者担忧.
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