“你得从底层做起……”理解利用率降低的原因：丹麦一家收容所中弱势群体男性接受结直肠癌筛查的定性研究。
"You're dealing with the bottom here…" understanding reasons for reduced utilisation: a qualitative study on colorectal cancer screening among vulnerable men at a drop-in centre in Denmark.
机构信息
Department of Public Health Programmes, University Research Clinic for Cancer Screening, Randers Regional Hospital, Randers, Denmark.
Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.
出版信息
BMC Public Health. 2024 Oct 30;24(1):3012. doi: 10.1186/s12889-024-20496-8.
BACKGROUND
Colorectal cancer (CRC) screening can reduce both CRC incidence and mortality, and faecal immunochemical testing (FIT)-based screening programmes are therefore now being implemented in many countries. However, social inequality in FIT-based screening participation is well documented, and initiatives to address this challenge are understudied. We explored the perceptions of CRC screening and the perceived barriers and facilitators towards FIT-based CRC screening among men visiting a drop-in centre for people with severe social problems in Denmark.
METHODS
The study was a qualitative interview study. Participants were sixteen men visiting a drop-in centre in Denmark. A local staff member provided supplementary information and assisted with the recruitment process. The interviews were transcribed verbatim, followed by an inductive content analysis.
RESULTS
The men were often dealing with health and social problems, and they often had low self-esteem. At first, they stated that they did not think much about cancer and their own risk of being diagnosed with it. They argued that they had little time, energy, and resources to participating in, for example, CRC screening programmes, and barriers to participating were facts of life such as comorbidity and cognitive difficulties. Further, they were not sure how to participate, and some misunderstood the concept of screening. However, during the interviews, the main part of the participants became very keen to participate, and they suggested that in the future, they could receive regular information about cancer screening in face-to-face interactions with someone who cared and was interested in helping them.
CONCLUSION
Men in a vulnerable position visiting a drop-in centre were interested in CRC screening. If we intervene in a way that meets the needs among these vulnerable citizens, it may contribute to reducing social inequality in FIT-based CRC screening programmes.
背景
结直肠癌（CRC）筛查可以降低 CRC 的发病率和死亡率，因此现在许多国家都在实施基于粪便免疫化学检测（FIT）的筛查计划。然而，基于 FIT 的筛查参与存在社会不平等，针对这一挑战的举措研究不足。我们探讨了在丹麦一个为有严重社会问题的人提供服务的临时收容中心就诊的男性对 CRC 筛查的看法，以及他们对基于 FIT 的 CRC 筛查的感知障碍和促进因素。
方法
本研究是一项定性访谈研究。参与者是 16 名在丹麦一个临时收容中心就诊的男性。一名当地工作人员提供了补充信息，并协助了招募过程。访谈内容逐字转录，然后进行了归纳内容分析。
结果
这些男性经常面临健康和社会问题，他们的自尊心通常较低。起初，他们表示，他们对癌症和自己患癌的风险没有太多考虑。他们认为，他们没有时间、精力和资源去参与例如 CRC 筛查计划，并且参与的障碍是生活中的事实，例如合并症和认知困难。此外，他们不确定如何参与，并且有些人误解了筛查的概念。然而，在访谈过程中，参与者的主要部分变得非常热衷于参与，他们建议在未来，他们可以通过与关心和有兴趣帮助他们的人进行面对面的互动，定期获得有关癌症筛查的信息。
结论
在临时收容中心就诊的弱势男性对 CRC 筛查感兴趣。如果我们以满足这些弱势公民需求的方式进行干预，可能有助于减少基于 FIT 的 CRC 筛查计划中的社会不平等。
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