结肠镜检查
医学
定性研究
主题分析
家庭医学
人口
梅德林
医疗保健
包裹体(矿物)
结直肠癌筛查
结直肠癌
癌症
心理学
内科学
社会学
法学
经济
环境卫生
社会心理学
经济增长
社会科学
政治学
作者
Robert Kerrison,Dahir Sheik-Mohamud,Emily McBride,Katriina L. Whitaker,Colin Rees,Stephen W. Duffy,Christian von Wagner
标识
DOI:10.1016/j.ypmed.2020.106413
摘要
Colonoscopy is the gold standard test in the diagnosis of colorectal cancer. Despite this, many people across the world decline the procedure when invited for screening, surveillance or diagnostic evaluation. The aim of this review was to characterise the barriers and facilitators of colonoscopy use described in the qualitative literature. We searched PubMed and PsychInfo for studies that explored barriers and facilitators of colonoscopy use. To determine the eligibility of studies, we first reviewed titles, then abstracts, and finally the full paper. We started with a narrow search, which we expanded successively, until the number of new publications eligible after abstract review was <1% of the total number of publications identified. Papers were eligible if they: 1) focussed on an adult population, 2) used a qualitative research design and, 3) described at least one patient-related theme regarding colonoscopy use. We then extracted qualitative data from eligible papers and analysed using thematic synthesis. Fifty-seven studies met the inclusion criteria. Most explored barriers and facilitators of screening colonoscopy (n=53, 93.0%) and were conducted in the USA (n=48, 84.2%). Key psychological and social factors included: ‘fear of pain and discomfort’, ‘concerns about doing the bowel preparation’, and whether the test was recommended by the patient's physician. Key practical factors included cost, and whether colonoscopy was covered by the patient's healthcare insurance. Studies mostly focussed on screening colonoscopy in the USA, where there is no universal healthcare coverage. To better understand the barriers and facilitators in other contexts, further research is needed.
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