Decision-making about participation in colorectal cancer screening in Sweden: Autonomous, value-dependent but uninformed?

PATIENT EDUCATION AND COUNSELING

卷:104

Article

Wangmar, Johanna¹  Wengstrom, Yvonne^1,2  Jervaeus, Anna¹  Hultcrantz, Rolf³  Fritzell, Kaisa^1,2 

[1] Karolinska Inst, Dept Neurobiol Care Sci & Soc, Div Nursing, Alfred Nobels Alle 23, S-14183 Stockholm, Sweden

[2] Karolinska Univ Hosp, Theme Canc, Stockholm, Sweden

[3] Karolinska Inst, Dept Med, Stockholm, Sweden

关键词: Colorectal cancer;    Screening;    Participation;    Shared decision-making;    Knowledge;    Values;    Preferences;    Involvement;   

DOI  :  10.1016/j.pec.2020.09.005

来源: Elsevier

【 摘 要 】

Objective: To investigate knowledge, values and preferences, and involvement among screening participants and non-participants in relation to colorectal cancer (CRC) and screening decision. Methods: Individuals (N = 2748) from the Screening of Swedish Colons trial were invited to respond to the SCREESCO questionnaire, assessing information/knowledge, values/preferences, and involvement. Results: Respondents' (screening participants, n = 1320; non-participants, n = 161) knowledge varied across items; 90 % recognised faecal blood as a CRC symptom, but less than half cited overweight, smoking, alcohol, and physical inactivity as risk factors. Incidence and case fatality were often over- and underestimated, respectively (>45 and 40 %). Non-participants were more uncertain about their CRC risk (p = 0.015) and less convinced that screening reduces the risk of dying from CRC (p < 0.001). In decision-making, screening participants took most into consideration the importance of early detection and CRC worry, and non-participants the risk of discomfort and complications due to the screening examination (p < 0.001). Most individuals made the decision without involving others. Conclusion: For informed and shared decisions, efforts need to be made to increase public knowledge about CRC and to develop interventions to support individuals in decision-making. Practice implications: These results can inform and guide future initiatives to facilitate high quality decisions and CRC screening uptake in Sweden. (C) 2020 The Authors. Published by Elsevier B.V.

【 授权许可】

Free