患者对肺癌筛查吸收和筛查意图的障碍和促进因素:使用理论领域框架的系统综述。

IF 3.4 3区 医学 Q1 RESPIRATORY SYSTEM
Maira Salman, Alice Cotton, Ada Humphrey, Tania Domun, Calvin Cheng, Gaby Judah
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引用次数: 0

摘要

背景:肺癌是世界范围内癌症死亡的主要原因。用低剂量CT (LDCT)筛查高危人群,通过早期发现和治疗可治愈降低死亡率。在有正式筛查规划的国家,符合条件的人群的接受率仍然很低。了解学习障碍有助于确定支持出勤的干预措施。目的:通过对现有文献的回顾,确定LDCT作为肺癌筛查形式的筛查意图和吸收的障碍和促进因素。方法:使用三个数据库并进行灰色文献检索。研究纳入标准:2001年至2024年间出版的英文出版物;研究患者报告的心理障碍和促进因素,以及与首次LDCT作为肺癌筛查方法的吸收(包括意图吸收)相关的心理障碍和促进因素。从论文中提取决定因素,以及这些决定因素是否被报道为障碍,促进者或两者兼而有之。然后将决定因素映射到理论领域框架(TDF)领域,使用基于理论的方法对决定因素进行分类。结果:从最初的2491个结果中,包括72篇论文(67%探索筛选意图),其中报告了34个变量,涵盖10个TDF域。恐惧(由于宿命论的肺癌诊断(22项研究)或筛查程序(13项))被归类为TDF领域情绪,是最常见的障碍,其次是环境背景和程序成本的资源障碍(28项),就诊不便(24项)和缺乏知识(24项)(TDF:知识)。最常见的促进因素是临床医生建议(26)(TDF:社会影响)和参加筛查的个人利益感知(25)(TDF:对结果的信念)。结论:为了提高筛查率,应该设计和测试针对这些决定因素的干预措施。这些措施可能包括干预措施,以减轻对筛查的恐惧,降低就诊费用,并促进临床医生的认可。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Patient barriers and facilitators to lung cancer screening uptake and intention to screen: a systematic review using the Theoretical Domains Framework.

Patient barriers and facilitators to lung cancer screening uptake and intention to screen: a systematic review using the Theoretical Domains Framework.

Background: Lung cancer is the leading cause of cancer deaths worldwide. Screening high-risk individuals with low-dose CT (LDCT) reduces mortality through earlier detection, when treatment may be curable. In countries where formal screening programmes exist, uptake among eligible populations remains low. Understanding barriers to uptake could help identify interventions to support attendance.

Aim: To identify barriers and facilitators to intention to screen and uptake of LDCT as a form of lung cancer screening, from a review of existing literature.

Method: Three databases were used along with a grey literature search. Inclusion criteria were studied: published in English between 2001 and 2024; looking at patient-reported psychological barriers and facilitators and related to uptake (including intent to uptake) of first LDCT as method of lung cancer screening. Determinants were extracted from the papers, and whether these were reported as a barrier, facilitator or both. Determinants were then mapped to the Theoretical Domains Framework (TDF) domains to classify determinants using a theory-based approach.

Results: From an initial 2491 results, 72 papers were included (67% explored intention to screen), which reported 34 variables covering 10 TDF domains. Fear (of either lung cancer diagnosis due to fatalism (22 studies) or of screening procedure (13)), categorised in TDF domain Emotion, was the most frequently reported barrier followed by Environmental Context and Resource barriers of cost of procedure (28), inconvenience of attending (24) and lack of knowledge (24) (TDF: Knowledge). Most frequently identified facilitators were clinician recommendation (26) (TDF: Social Influence) and perceived personal benefit from attending screening (25) (TDF: Beliefs about Consequences).

Conclusion: To increase uptake in screening, interventions addressing these determinants should be designed and tested. These could include interventions to mitigate fear of screening, reduce the costs of attending and promote clinician endorsement.

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来源期刊
BMJ Open Respiratory Research
BMJ Open Respiratory Research RESPIRATORY SYSTEM-
CiteScore
6.60
自引率
2.40%
发文量
95
审稿时长
12 weeks
期刊介绍: BMJ Open Respiratory Research is a peer-reviewed, open access journal publishing respiratory and critical care medicine. It is the sister journal to Thorax and co-owned by the British Thoracic Society and BMJ. The journal focuses on robustness of methodology and scientific rigour with less emphasis on novelty or perceived impact. BMJ Open Respiratory Research operates a rapid review process, with continuous publication online, ensuring timely, up-to-date research is available worldwide. The journal publishes review articles and all research study types: Basic science including laboratory based experiments and animal models, Pilot studies or proof of concept, Observational studies, Study protocols, Registries, Clinical trials from phase I to multicentre randomised clinical trials, Systematic reviews and meta-analyses.
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