退伍军人肺癌风险概念化与肺癌查 与临床医生共享决策对话:一种定性研究
Jacqueline H Boudreau1,2, Rendelle E Bolton1,2, Eduardo R Núñez1,2,3,4
1Center for Healthcare Optimization & Implementation Research, VA Boston Healthcare System, Boston, MA, USA.
概括
退伍军人认为肺癌风险来自多种因素,包括空气传播的危害,但临床医生在查讨论中主要关注吸烟. 这种脱节可能会阻碍肺癌查 (LCS) 的有效共享决策.
科学领域:
- 肺部医学 肺部医学
- 在瘤学瘤学.
- 医疗保健服务研究 医疗服务研究
背景情况:
- 退伍军人健康管理局 (VA) 建议进行肺癌查 (LCS),并分享决策.
- 了解退伍军人对肺癌风险的看法以及他们与临床医生的讨论至关重要.
研究的目的:
- 为了描述老兵对肺癌风险的概念化.
- 检查退伍军人和临床医生关于LCS的共享决策讨论的帐户.
- 评估LCS讨论是否反映了退伍军人的关切.
主要方法:
- 在6个VA地点对48名临床医生和34名退伍军人进行了定性采访.
- 对成绩单的专题分析,重点关注风险感知和决策对话.
主要成果:
- 退伍军人的风险感知包括吸烟,职业危险和家庭病史.
- 临床医生主要关注吸烟作为主要风险因素.
- 在LCS的谈话中,焦点是吸烟,往往忽视了退伍军人发现的其他重大风险.
结论:
- 临床医生在LCS讨论期间专注于吸烟,忽视了退伍军人感知到的其他重大风险因素,例如空气中的危险.
- 这种差异可能导致共享决策过程的参与度降低,并可能导致耻辱化.
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