在社区实践环境中使用基于web的结肠直肠癌筛查交互式决策辅助工具的感卡塔尔世界杯8强波胆分析知障碍和促进因素:来自与初级保健临床医生和医务办公室工作人员的焦点小组的调查结果%A Jimbo,Masahito %A Shultz,Cameron Garth %A Nease,Donald Eugene %A Fetters,Michael Derwin %A Power,Debra %A Ruffin IV,Mack Thomas +密歇根大学家庭医学和泌尿系，密歇根州安娜堡市富勒街1018号，48104-1213，美国，1734 998 7120，mjimbo@umich.edu %K结肠癌%K结肠镜检查%K癌症筛查%K癌症早期发现%K提醒系统%K决策支持技术%K焦点小组%K健康信息技术%D 2013 %7 18.12.2013 %9原始论文%J J医学互联网Res %G英文%X背景:缺乏关于那些在社区实践环境中工作的人利用健康信息技术进行结直肠癌筛查的能力的信息。目的:为了解决这一差距，我们要求那些在社区实践环境中工作的人分享他们对基于web的患者主导决策辅助的实施可能影响患者-临床医生关于结直肠癌筛查和日常临床工作流程的对话的观点。方法:在5个社区实践环境中进行了5个焦点小组，由8名医生，1名医生助理和18名临床工作人员组成。焦点小组使用半结构化讨论指南组织，旨在确定中介和阻碍使用基于web的决策辅助工具的因素，旨在澄清患者对结直肠癌筛查的偏好，并在临床遇到时触发共享决策。结果:所有医生、医生助理和18名临床工作人员中的8名是焦点小组的积极参与者。来自每个环境的临床医生和工作人员参与者报告了一个信念，即基于网络的患者主导的决策辅助可以成为一个信息和教育工具;除一种情况外，所有参与者都表示愿意向患者推荐该工具。例外情况涉及一家诊所的临床医生，他们描述了对筛查选择较少的患者的偏好，并指出结肠镜检查是他们诊所患者的首选筛查方式。 Perceived barriers to utilizing the Web-based decision aid included patients’ lack of Internet access or low computer literacy, and potential impediments to the clinics’ daily workflow. Expanding patients’ use of an online decision aid that is both easy to access and understand and that is utilized by patients outside of the office visit was described as a potentially efficient means for soliciting patients’ screening preferences. Participants described that a system to link the online decision aid to a computerized reminder system could promote a better understanding of patients’ screening preferences, though some expressed concern that such a system could be difficult to keep up and running. Conclusions: Community practice clinicians and staff perceived the Web-based decision aid technology as promising but raised questions as to how the technology and resultant information would be integrated into their daily practice workflow. Additional research investigating how to best implement online decision aids should be conducted prior to the widespread adoption of such technology so as to maximize the benefits of the technology while minimizing workflow disruptions. %M 24351420 %R 10.2196/jmir.2914 %U //www.mybigtv.com/2013/12/e286/ %U https://doi.org/10.2196/jmir.2914 %U http://www.ncbi.nlm.nih.gov/pubmed/24351420