Lung cancer screening: Practice guidelines and insurance coverage are not enough.
Adult
Aged
Early Detection of Cancer
Female
Health Services Needs and Demand
Humans
Insurance Coverage
Interviews as Topic
Lung Neoplasms
/ diagnostic imaging
Male
Mass Screening
/ methods
Middle Aged
Nurse Practitioners
Practice Guidelines as Topic
Practice Patterns, Nurses'
/ statistics & numerical data
Surveys and Questionnaires
United States
Young Adult
Journal
Journal of the American Association of Nurse Practitioners
ISSN: 2327-6924
Titre abrégé: J Am Assoc Nurse Pract
Pays: United States
ID NLM: 101600770
Informations de publication
Date de publication:
Jan 2019
Jan 2019
Historique:
pubmed:
16
11
2018
medline:
29
1
2019
entrez:
16
11
2018
Statut:
ppublish
Résumé
Low-dose computed tomography (LDCT) is expected to increase early detection of lung cancer and improve survival. The growth in the number of advanced nurse practitioners (NPs) in primary care settings increases the likelihood that an NP will serve as a patient's provider. This study's purpose was to examine knowledge, attitudes, and practices regarding LDCT among NPs who work in primary care settings. An explanatory, sequential, mixed-method design used a 32-item questionnaire, followed by a semi-structured telephone interview. The development of the survey and interview questions were guided by a conceptual framework representing a temporal sequence for behavior change and potential barriers to guideline adherence. Nurse practitioners believe that shared decision making with their high-risk patients about LDCT is within their scope of their practice. Working in time-constrained primary care settings, NPs have limited abilities to improve the uptake of LDCT. Substantial patient barriers exist that deter follow through on providers' recommendation. Disseminating guidelines and authorizing health insurance reimbursement is insufficient. Research is needed that investigates the screening process so that barriers can be closely studied. Culture change is needed where early detection has greater value for insurers, providers, and patients.
Sections du résumé
BACKGROUND AND PURPOSE
OBJECTIVE
Low-dose computed tomography (LDCT) is expected to increase early detection of lung cancer and improve survival. The growth in the number of advanced nurse practitioners (NPs) in primary care settings increases the likelihood that an NP will serve as a patient's provider. This study's purpose was to examine knowledge, attitudes, and practices regarding LDCT among NPs who work in primary care settings.
METHODS
METHODS
An explanatory, sequential, mixed-method design used a 32-item questionnaire, followed by a semi-structured telephone interview. The development of the survey and interview questions were guided by a conceptual framework representing a temporal sequence for behavior change and potential barriers to guideline adherence.
CONCLUSIONS
CONCLUSIONS
Nurse practitioners believe that shared decision making with their high-risk patients about LDCT is within their scope of their practice. Working in time-constrained primary care settings, NPs have limited abilities to improve the uptake of LDCT. Substantial patient barriers exist that deter follow through on providers' recommendation. Disseminating guidelines and authorizing health insurance reimbursement is insufficient.
IMPLICATIONS FOR PRACTICE
CONCLUSIONS
Research is needed that investigates the screening process so that barriers can be closely studied. Culture change is needed where early detection has greater value for insurers, providers, and patients.
Identifiants
pubmed: 30431549
doi: 10.1097/JXX.0000000000000096
pmc: PMC6487865
mid: NIHMS1023648
pii: 01741002-201901000-00007
doi:
Types de publication
Journal Article
Langues
eng
Pagination
33-45Subventions
Organisme : NHLBI NIH HHS
ID : K23 HL133596
Pays : United States
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