健康信念水平对大肠癌初筛阳性社区居民肠镜复筛行为的影响研究  

Influence of Health Belief on Rescreening Colonoscopy Practice in Community Residents with Initially Screened Colorectal Cancer

作　　者：刘伟峰 鲍建敏 神福妹 钟丽兰 林楠柠 翁帆[3] Liu Weifeng;Bao Jianmin;Shen Fumei;Zhong Lilan;Lin Nanning;Weng Fan(Department of General Clinic,Yuexiu District,Guangzhou 510030,Guangdong,China;Department of Public Health,Community Health Service Center of Mineral Spring Street,Yuexiu District,Guangzhou 510030,Guangdong,China;Department of Chronic Disease Control and Prevention,Center for Disease Control and Prevention in Yuexiu District,Guangzhou 510055,Guangdong,China)

机构地区：[1]广州市越秀区矿泉街社区卫生服务中心全科门诊,广州510030 [2]广州市越秀区矿泉街社区卫生服务中心公卫科,广州510030 [3]广州市越秀区疾病预防控制中心慢性病防制科,广州510055

出　　处：《肿瘤预防与治疗》2023年第2期111-116,共6页Journal of Cancer Control And Treatment

摘　　要：目的:了解大肠癌初筛阳性的社区居民肠镜复筛行为与健康信念的关系,探讨健康信念对肠镜复筛行为的影响,为提高高危人群肠镜筛查顺应性提供可行性参考建议。方法:采用前瞻性病例对照研究设计,连续纳入2015年3月至2021年12月在广州市越秀区矿泉街社区卫生服务中心行大肠癌初筛阳性的社区居民654例作为研究对象,将其中接受肠镜复筛者纳入病例组(n=306),拒绝接受肠镜复筛者纳入对照组(n=348),采用《大肠癌筛查相关的健康信念模式量表》对两组居民的健康信念水平进行评估,比较两组健康信念总分及维度分的差异,采用Logistic回归模型分析健康信念对肠镜复筛行为的影响。结果:肠镜复筛组居民对疾病严重性认知、疾病易感性认知和行为益处认知得分明显高于拒绝肠镜复筛组居民,而行为障碍认知得分则表现为肠镜复筛组居民低于拒绝肠镜复筛组居民,差异均有统计学意义(均P<0.05)。多因素Logistic回归分析显示:在校正年龄(OR=0.851,95%CI:0.817~0.887,P<0.001)的影响后,疾病严重性认知(OR=1.140,95%CI:1.004~1.295,P=0.010)是初筛阳性居民进行肠镜复筛的保护因素,行为障碍认知是居民进行肠镜复筛的危险因素(OR=0.922,95%CI:0.866~0.982,P=0.032)。结论:疾病严重性认知是初筛阳性居民进行肠镜复筛的保护因素,行为障碍认知是其危险因素,社区应制定针对性的健康教育措施,以提高肠镜复筛的顺应性。Objective:To investigate the relationship between second colonoscopy and health belief of community residents with initially screened colorectal cancer,and explore the impact of health belief on rescreening colonoscopy,so as to provide feasible suggestions for improving the compliance with colonoscopy screening by high-risk population.Methods:A prospective case-control design was used to continuously collect 654 community residents with initially screened colorectal cancer in Community Health Service Center of Mineral Spring Street of Yuexiu District from March 2015 to December 2021 as the study subjects.Residents who were willing to receive second colonoscopy were included in the case group(n=306),and those who refused to receive colonoscopy again were included in the control group(n=348).Health Belief Model Scale for Colorectal Cancer Screening was used to evaluate the health belief between the two groups,and compare the difference in total and dimension scores between two groups.The impact of health belief on rescreening colonoscopy practice was analyzed by using the logistic regression model.Results:Scores in Perceived Threat,Perceived Susceptibility and Perceived Benefit in the case group were significantly higher than those in the control group,while scores in Perceived Barriers in the former were significantly lower than those in the latter(all P<0.05).Multivariate logistic regression analysis showed that after adjusting age(OR=0.851,95%CI:0.817-0.887,P<0.001),Perceived Threat(OR=1.140,95%CI:1.004-1.295,P=0.010)was a protective factor for second colonoscopy in initially screened colorectal cancer residents,and Perceived Barriers was a risk factor for second colonoscopy(OR=0.922,95%CI:0.866-0.982,P=0.032).Conclusion:Perceived Benefit is the protective factor for second colonoscopy in initially screened colorectal cancer residents,and Perceived Barriers is its risk factor.The community should develop targeted health education measures to improve the compliance with rescreening colonoscopy.

关 键 词：健康信念模式 大肠癌 肠镜检查 筛查 病例对照研究 

分 类 号：R735.3[医药卫生—肿瘤]