胃灼热人群接受胶囊海绵筛查的障碍与促进因素：一项英国社区定性研究

文献信息

中文摘要

引言： 非内镜胶囊海绵装置是一项有前景的新技术。它们可能通过检测和监测巴雷特食管并早期识别异型增生以便及时治疗，从而改善食管癌的结局。评估其临床效用的试验正在进行中。
目的： 本研究旨在了解胃灼热人群接受胶囊海绵筛查的潜在障碍与促进因素。
方法： 于2024年10月至2025年4月期间，对55-79岁男性和65-79岁女性中定期服用反流药物者进行了40次半结构化访谈。参与者为有意抽样。转录文本采用主题框架分析法进行分析。
结果： 参与者总体上对该检测充满热情，但并非所有人都感到愿意或能够参与。影响其态度的关键因素被归纳为三个总体主题。第一，参与者描述了她们如何应对反流相关照护并与医疗专业人员就此进行协商。她们考虑了胶囊海绵筛查将如何融入这种协作模式。第二，参与者表现出对不确定性的厌恶，指出胶囊海绵筛查既可能制造也可能减少其健康方面的不确定性。第三，参与者对自身是否符合资格的理解因风险感知、自我效能感以及对检测结果采取行动的看法而有所不同。一些人表示自己感觉不如其他人那样是“值得”的候选者。
结论： 总体而言，胶囊海绵检测筛查因其快速、简单且微创的方法而吸引了许多人。然而，关于反流照护责任、候选资格和不确定性的担忧可能会影响对该检测的态度和意向，如果实施该检测，这些应成为关键考虑因素。
生活经验或公众贡献： 三名具有反流、巴雷特食管和食管癌生活经验的人士参与了本研究及相关材料的设计。

英文摘要

INTRODUCTION: Non-endoscopic capsule sponge devices are a promising new technology. They could potentially improve oesophageal cancer outcomes by detecting and monitoring Barrett's oesophagus and identifying dysplasia early to allow timely treatment. Trials assessing their clinical utility are underway.
OBJECTIVE: This study sought to understand potential barriers and enablers to capsule sponge screening among people with heartburn.
METHODS: Forty semi-structured interviews were conducted between October 2024 and April 2025 with men aged 55-79 and women aged 65-79 taking regular reflux medication. Participants were purposively sampled. Transcripts were analysed using Thematic Framework Analysis.
RESULTS: Participants were generally enthusiastic about the test, but not all felt willing or able to take part. Key factors influencing their attitudes are described in three overarching themes. First, participants described how they navigate reflux-related care and negotiate this with healthcare professionals. They considered how capsule sponge screening would fit into this collaborative model. Second, participants showed an aversion to uncertainty, noting that capsule sponge screening could both create and reduce uncertainty about their health. Third, participants' understanding of their candidacy varied based on risk perceptions, self-efficacy and views about acting on test results. Some expressed a sense of being less 'worthy' candidates than others.
CONCLUSION: Overall, the capsule sponge test screening appealed to many due to its quick, simple and minimally invasive approach. Nevertheless, concerns about responsibility for reflux care, candidacy and uncertainty will likely shape attitudes and intention towards the test and should be key considerations if this test is implemented.
LIVED EXPERIENCE OR PUBLIC CONTRIBUTION: Three individuals with lived experience of reflux, Barrett's oesophagus and oesophageal cancer were involved in the design of this study and associated materials.