跨代际大肠癌病人一级亲属筛查决策困境的纵向质性研究OA

Objective:To explore the screening decision-making dilemmas among intergenerational first-degree relatives of patients with colorectal cancer.Methods:A longitudinal qualitative research method was adopted.A total of 32 first-degree relatives of patients with colorectal cancer treated in the department of gastrointestinal surgery at a tertiary grade A hospital in Wuhan city were selected as the study subjects from September to December 2024.Three semi-structured interviews were conducted regarding their decision-making dilemmas about undergoing colonoscopy screening.The dilemmas at different time points were summarized and analyzed using the Colaizzi 7-step analysis method.Results:Based on three time points,16 themes regarding the screening decision-making dilemmas among intergenerational first-degree relatives of patients with colorectal cancer were summarized from different generational perspectives.During the first week after surgery,three months after discharge,and six months after discharge,the screening decision-making dilemmas of first-degree relatives overall were,in turn,lack of knowledge,insufficient resources and conditions,and inadequate psychological preparation.For first-generation first-degree relatives,the screening decision-making dilemmas were,in turn,psychological concerns,insufficient improvement in screening awareness,and age bias.For second-generation first-degree relatives,the screening decision-making dilemmas were,in turn,role conflict,limited family support,and life conflicts.For third-generation first-degree relatives,the screening decision-making dilemmas were,in turn,focus on personal feelings,influence of life attitudes,and lack of encouragement.Conclusions:The screening decision-making dilemmas among different generations' first-degree relatives of patients with colorectal cancer varied and changed over time.Healthcare providers could implement targeted interventions based on the characteristics of these dilemmas at different time points to help improve the rate of colonoscopy screening.