社区全科医生结直肠肿瘤筛查知信行调查问卷的初步构建  

Preliminary construction of a questionnaire on knowledge,attitude and practice of community general practitioners for colorectal cancer screening

作　　者：赵宁宁 马力[1] 徐梦楠 Zhao Ningning;Ma Li;Xu Mengnan(Department of General Practice,Beijing Tiantan Hospital,Capital Medical University,Beijing100070,China;Department of Gastroenterology,Air Force Medical Center,Beijing100142,China)

机构地区：[1]首都医科大学附属北京天坛医院全科,北京100070 [2]空军特色医学中心消化内科,北京100142

出　　处：《中华全科医师杂志》2024年第12期1284-1291,共8页Chinese Journal of General Practitioners

基　　金：高层次公共卫生技术人才建设项目培养计划(学科带头人-02-09)。

摘　　要：目的:构建社区全科医生结直肠肿瘤筛查的知识、态度和行为的调查问卷。方法:该研究为定性研究。2023年9月1日至2024年6月25日,以知识-态度-行为模式为理论框架,基于国内外结直肠肿瘤诊疗指南及相关研究结果形成初始问卷,包括知识(条目K1~K10)、态度(条目A1~A16)和行为(条目P1~P8)3个维度共34个条目。采用德尔菲法进行函询,根据函询结果修改条目,形成最终问卷。结果:共邀请21名函询专家,14名(66.7%)为全科医生,7名(33.3%)为消化内科医生;7名(33.3%)来自社区卫生服务中心,14名(66.7%)来自公立三级甲等医院;9名(42.9%)具有博士研究生学位,9名(42.9%)为主任医师。2轮函询专家积极性分别为100.0%、90.5%,专家意见集中程度分别为4.03~4.75分、4.39~4.93分,专家意见协调程度分别为0.09~0.22、0.03~0.12,肯德尔协调系数分别为0.154、0.390(均P<0.001)。最终形成的问卷包含知识、态度、行为3个维度共28个条目,其中知识条目K1~K9,包含风险人群的判定、风险因素、筛查方式、筛查间隔等内容;态度条目A1~A12,包含对于影响筛查的患者层面、医生层面、政府层面等因素的态度及对于筛查必要性的态度;行为条目P1~P7,包含在日常诊疗过程中对患者评估、建议等主动筛查行为。结论:该研究初步构建了全科医生的结直肠肿瘤筛查的知信行问卷。Objective To construct a questionnaire on the knowledge,attitude and practice(KAP)of community general practitioners for colorectal cancer screening.Methods From September 2023 to June 2024,an initial version of questionnaire on knowledge,attitude and practice(KAP)of community general practitioners for colorectal cancer screening was formed based on existing guidelines and related research results;then two-round Delphi experti consultation was held to finalize the initial questionnaire.ResultsTwenty one experts were invited for Delphi consultation,including 14 general practitioners and 7 gastroenterologists;7 from community health service centers and 14 from public tertiary hospitals.The enthusiasm of experts in the first round and second round consultations was 100.0%and 90.5%;the consistency of experts was 4.03-4.75 and 4.39-4.93;the coordination of experts was 0.09-0.22 and 0.03-0.12,respectively.The Kendall coordination coefficients were 0.154 and 0.390 respectively(P<0.001),indicating that there was significant consistency in expert opinions and the results of the letter inquiry were highly reliable.The final version of the KAP questionnaire included 28 items in three dimensions:knowledge,attitude,and behavior.Among them,knowledge items K1-K9 included the determination of risk population,risk factors,screening methods,screening intervals,and other contents;attitude items A1-A12 included attitudes towards factors of patients,doctors and government that affect screening,and attitudes towards the necessity of screening;behavior items P1-P7 included active screening behaviors such as patient assessment and advices for active screening.Conclusion This study has preliminarily constructed a questionnaire on knowledge,belief and behavior of general practitioners for colorectal cancer screening.

关 键 词：结直肠肿瘤 多相筛查 社区卫生中心 健康知识 态度 实践 德尔菲技术 

分 类 号：R735.34[医药卫生—肿瘤] R193[医药卫生—临床医学]