评估与患者和提供者讨论有关肺癌查的相关因素,使用安德森的健康服务利用行为模型
Owen Y Cai1, Jessica R Fernandez2, Melinda C Aldrich3
1Department of Medicine, Health, and Society, Vanderbilt University, Nashville, TN.
Clinical lung cancer
|July 6, 2025
概括
肺癌查 (LCS) 的讨论至关重要,但未得到充分利用. 诸如COPD,家族病史和收入等因素会影响讨论,而女性或缺乏初级保健提供者会减少讨论.
科学领域:
- 公共卫生 公共卫生
- 医疗保健服务研究 医疗服务研究
- 预防医学 预防医学
背景情况:
- 共同决策对于肺癌查指南至关重要.
- 在符合条件的患者中影响LCS讨论的因素尚不清楚.
- 安德森的健康服务利用行为模型指导了调查.
研究的目的:
- 确定与患者和医疗服务提供者关于肺癌查的讨论相关的因素.
- 检查影响LCS讨论的倾向性,支持性和需求因素.
主要方法:
- 在516名符合LCS资格标准的美国成年人 (年龄在50-80岁,吸烟史≥20包年) 进行的在线调查.
- 后勤回归分析以确定LCS讨论与各种患者特征之间的关联.
- 研究的因素包括慢性阻塞性肺病 (COPD),家族病史,性别,收入,初级保健提供者 (PCP) 状态和目前的吸烟.
主要成果:
- 只有36%的符合条件的参与者曾与提供者讨论过LCS.
- 诊断COPD (OR=3.56) 和患有肺癌的一级亲属 (OR=1.78) 与较高的讨论几率有关.
- 女性 (OR=0.37),没有PCP的个人 (OR=0.39) 和目前的吸烟者 (OR=0.38) 的LCS讨论几率较低.
结论:
- 在符合条件的个人中,在LCS讨论的吸收方面存在显著的差异.
- 干预是必要的,以改善获得和利用LCS讨论.
- 解决诸如获得初级保健和戒烟等因素可能会加强查讨论.
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