Modeling the decision to undergo colorectal cancer screening: insights on patient preventive decision making.

Martin School of Public Policy and Administration, University of Kentucky, Lexington, KY 40506-0027, USA.
Medical care (Impact Factor: 3.23). 10/2008; 46(9 Suppl 1):S17-22. DOI: 10.1097/MLR.0b013e31817eb332
Source: PubMed


Little is known about how patients decide whether or not to undergo colorectal cancer screening. Although low screening rates evidence the outcome of these decisions, the processes patients use to balance benefits, risks, and costs with their own values and preferences are unclear. To increase screening rates, and ultimately save lives, it is important for providers to be aware of how patients make screening decisions.
The purpose of this study was to identify patterns of patient colorectal cancer screening decisions that might be supported by health care providers.
In this study, we focused on people from Central Kentucky--a region with historically low screening rates.
We interviewed patients using a semi-structured format. Three members of the research team independently analyzed each interview transcript for factors that influenced the decision, and a pictorial representation of each decision process, based on Kurt Lewin's theory of decision making, was constructed for each participant. The individual decision processes were compared with identify patterns.
Seventeen women and 13 men made up the sample. We discerned 7 decision patterns.
This research documents 7 patterns and identifies common driving and restraining forces.

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    • "information about the disease and screening methods, negative attitudes toward screening preparation and procedures , and perceptions of low level of risk for the disease [4,8–14]. In addition, several studies have indicated the importance of the recommendation of a physician in influencing a patient's colorectal cancer screening decision [15] [16] [17] [18]. While the importance of a physician recommendation has been widely reported, it has been suggested that merely mentioning colorectal cancer screening is not enough to motivate all patients to be screened [16] [19] [20]. "
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