为何病患会忽略癌症的警告症状


  【24drs.com】英国癌症研究调查认为,人们通常会警觉到一些癌症警告症状,却避免或延后与他们的主要照护提供者谘商,或许这正是英国一年癌症存活率不佳的原因。
  
  Surrey大学健康科学院资深讲师Katriina Whitaker博士表示,我们知道,英国的癌症存活率比其它有类似健康照护系统的高所得国家还要糟糕。
  
  Whitaker博士表示,我们想要执行一些以社区为基础的研究,借以了解人们在实际生活中,在不知道可能是癌症下,对于初期癌症警讯是如何诠释与回应。
  
  这些结果发表于2月的英国一般医学期刊。
  
  Whitaker博士的团队发出一份健康调查给4,858名50岁以上、在2010年某3个月期间内于伦敦三个一般开业机构之一就诊者;伦敦的一年存活率是英国最低的。
  
  调查并未使用癌症这个语词,而是列出癌症防治意识所提及的17症状。
  
  回覆的1,724人中,915人表示至少有一项癌症相关症状,482同意与研究人员联系;研究团队选择48人进行深度访谈,38人是面谈,10人是电话访谈。
  
  有许多研究对象知道他们的症状与癌症有关,其中一些症状被视为「没有明天」或「恶魔」。
  
  不过,有45%的研究对象并未与主治医师连络告知症状,理由包括:症状间歇出现、不想打扰医师或浪费国家健康服务资源、认为经常找医师谘商是代表虚弱、认为症状是因为老化。
  
  Whitaker博士报告指出,有些研究对象与医师谘商是因为接触到癌症警觉活动、或者是接受亲友的建议。癌症警觉活动包括:从电视和广播节目得知结肠癌的症状;让其它人催促亲友寻求帮助的「警告症状」是持续咳嗽(健康活动强调这是肺癌的潜在症状) 。
  
  研究人员发现,在一些情况下人们会寻求帮助:悬而未决的症状、感觉到哪里里有问题、担心是癌症,不过,担心是癌症的想法会使有些人反而不采取行动,其它人会延迟到因为其它原因就医时才告诉医师这些症状。
  
  有些人会变得习惯这些症状而开始认为这是正常的,另外有许多研究对象,整天都陷于担忧癌症的影响,有些人是对医疗系统不信任,有些人表示难以预约、分配给体检的时间太短。
  
  研究者认为,有些研究对象倾向会忍耐相当程度的不适,例如持续吞咽困难、肠道蠕动出血,这是英国人「咬紧牙关」的特色。
  
  Whitaker博士解释,国际比较研究发现,英国比其它国家如澳大利亚、加拿大、丹麦、挪威和瑞典更担心会浪费医师的时间。另外有研究发现病人会延迟中风和心脏疾病的迹象,所以我认为,我们的研究结果不只适用于癌症,而且能更广泛应用。
  
  英国癌症研究、及早诊断小组负责人Sara Hiom表示,及早确定和治疗癌症表示病患有更好的机会对抗疾病,所以,我们了解为何有些有潜在症状的人决定不立即检查是很重要的。
  
  Hiom解释,这篇研究让我们深入了解患者的决策过程,可帮助我们找到鼓励有症状者尽早寻求协助的方法。
  
  研究限制包括,质性研究的本质、样本少,有关研究对象对于可能代表癌症症状之追踪态度的访谈资料只有一点点。
  
  资料来源:http://www.24drs.com/professional/list/content.asp?x_idno=7156&x_classno=0&x_chkdelpoint=Y
  

Why Patients Ignore Cancer 'Alarm' Symptoms

By Ricki Lewis, PhD
Medscape Medical News

The finding that people are often aware of "alarm" symptoms of cancer but avoid or delay consulting their primary care provider might explain the poor 1-year cancer survival rates in the United Kingdom, a Cancer Research UK survey suggests.

"We know that in the United Kingdom there is worse survival from cancer than in other high-income countries with similar healthcare systems," said Katriina Whitaker, PhD, senior lecturer in the School of Health Sciences at the University of Surrey.

"We wanted to do some community-level research to understand how people interpret and respond to symptoms that could give an early warning sign of cancer in real life, without imposing a cancer perspective," Dr Whitaker told Medscape Medical News.

In results were published in the February issue of the British Journal of General Practice.

Dr Whitaker's team developed and sent a health survey to 4858 people older than 50 years who attended one of three general practices in London during a 3-month period in 2012. The 1-year survival rates in London are among the lowest in the United Kingdom.

The survey did not use the word "cancer," but listed 17 symptoms from the Cancer Awareness Measures.

Of the 1724 respondents, 915 reported having at least one cancer-associated symptom, and 482 gave their consent to be contacted by the researchers.

The team chose 48 participants for in-depth interviews; 38 were conducted in person and 10 were conducted over the phone.

Many of the participants recognized their symptoms as being associated with cancer, which some referred to as "the big C" or "the bogeyman."

However, 45% of the participants did not contact a primary care physician about their symptoms. Reasons for not doing so included the intermittent nature of the symptoms, not wanting to bother a physician or waste National Health Service resources, the perception that frequently consulting a doctor is a sign of weakness, and the attribution of the symptoms to aging.

Some of the participants consulted a physician only after exposure to a cancer awareness campaign or on the advice of a friend or family member, Dr. Whitaker reported. One awareness campaign cited involved TV and radio spots describing the symptoms of colon cancer; an "alarm symptom" that often provoked others to push a friend or relative to seek help was persistent coughing (highlighted in a health campaign as a potential symptom of lung cancer).

The researchers identified some circumstances under which people do seek help: unresolved symptoms, a feeling that something is wrong, and awareness or fear of cancer. However, fear of cancer kept some individuals from taking action, and others delayed mention of the symptom until they visited a primary care physician for another reason.

Some people became accustomed to the symptom and began to think of it as normal. For many participants, fear centered around the effect of cancer on daily life. Some reported a distrust of the healthcare system, and some cited difficulty making an appointment and the short times allotted for medical exams.

The researchers attribute the propensity of some participants to endure considerable discomfort, such as persistent difficulty swallowing and bloody bowel movements, to the British characteristic of a "stiff upper lip."

"International comparisons have shown that in the United Kingdom, we are more worried about wasting the doctor's time than in other countries, such as Australia, Canada, Denmark, Norway, and Sweden," Dr. Whitaker explained. "There's also been research looking into patient delay for signs of stroke and heart disease, so I think the findings have more general application beyond cancer."

"Spotting and treating cancer early means that patients have a far better chance of beating the disease, so it's important we understand why some people with potential symptoms decide not to get them checked out straight away," said Sara Hiom, director of early diagnosis at Cancer Research UK.

"This study gives us valuable insight into the decision-making process, and could help us find ways to encourage everyone with worrying symptoms to seek help as early as possible," Hiom explained.

Limitations of this study include the qualitative nature of the investigation, the small sample size, and the fact that the interviews provided only glimpses of each participant's attitude toward following-up on symptoms that could indicate cancer.

Dr Whitaker and Ms Hiom have disclosed no relevant financial relationships.

Br J Gen Pract. 2015;65(631):e96-e105.

    
相关报导
地中海饮食减少心血管事件、癌症、糖尿病风险
2016/7/29 下午 02:55:42
溜溜球减肥不太可能有癌症风险
2015/8/27 上午 10:10:11
BMI越高 癌症风险大幅增加
2014/8/20 上午 11:09:43

上一页
   1   2   3   4   5   6   7   8   9   10  




回上一页