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结直肠癌筛查依从性影响因素定性研究的系统评价
作者姓名:Deng SX  Cai QC  An W  Gao J  Hong SY  Zhu W  Li ZS
作者单位:1. 第二军医大学附属长海医院消化内科,200433
2. 第二军医大学临床流行病学与循证医学中心
摘    要:目的 系统收集影响结直肠癌筛查依从性的因素,了解筛查障碍的原因,为增强依从性提供理论基础.方法 计算机检索Pubmed、EMbase、CBM、CNKI、VIP等数据库,手工检索相关文献,纳入影响结直肠癌筛查依从性的定性研究文献.阅读和评价后,采用荟萃分析方法对研究结果进行合并.结果 共纳入15项研究,分析结果提示:患者缺乏癌症及筛查相关知识、筛查费用、筛查尴尬心理、害怕筛查并发症或不适性、筛查执行障碍、缺乏医患沟通、缺乏症状和筛查意识等是引起依从性降低的重要因素和原因.结论 增强患者认知、改善医患沟通和减少筛查费用,将有利于改善患者筛查依从性,提高筛查效能.

关 键 词:结直肠肿瘤  普查  病人依从  系统评价

Factors influencing patient compliance in colorectal cancer screening: qualitative research synthesis
Deng SX,Cai QC,An W,Gao J,Hong SY,Zhu W,Li ZS.Factors influencing patient compliance in colorectal cancer screening: qualitative research synthesis[J].National Medical Journal of China,2010,90(38):2679-2683.
Authors:Deng Shang-xin  Cai Quan-cai  An Wei  Gao Jie  Hong Shang-you  Zhu Wei  Li Zhao-shen
Institution:Department of Gastroenterology, Changhai Hospital, Second Military Medical University, Shanghai 200433, China.
Abstract:Objective To systematically collect and analyze the influencing factors of patient compliance with colorectal cancer screening in qualitative studies so as to provide a theoretical basis for improving compliance. Methods The databases of Pubmed, EMbase, CBMdisc, CNKI and VIP and the relevant articles were searched. According to the predefined inclusion and exclusion criteria, the qualitative studies of the influencing factors of patient compliance with screening were included. After selection and critical appraisal of the retrieved studies, a meta-analysis was performed. Results A total of 15 studies were included. It was found that several factors had a great impact on the patient compliance of screening. They included a lack of knowledge of cancer and screening, screening costs, a feeling of embarrassment, a fear of screening complications or discomfort, barriers to implementation of screening, a lack of communication with physicians and a lack of symptoms and awareness. Conclusion Screening compliance may be improved through enhancing cognitive function in patients, ameliorating physician-patient communication and lowing the screening costs.
Keywords:Colorectal neoplasms  Mass screening  Patient compliance  Systematic review
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