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background: Medical assistants/care coordinators play a crucial role in the coordinated care system. The tasks of nurses and some qualified supporting staff have been extended to include this role along with the implementation of the pilot program POZ Plus in Polish primary healthcare. A personalized approach to the patient is especially important during the implementation of large-scale prevention programs. Aim of the study: To assess who has the greatest influence on the patient’s decision to undergo screening colonoscopy and outline the current and potential roles of nurses in this process. Material and methods: This questionnaire-based study was conducted at the coordinated care facility Medical and Diagnostic Center (CMD) in Siedlce, Poland between March 1st and June 15th, 2017. results: 138 patients participated in the study. The majority (75; 54.4%) reported they were directly convinced to undergo colonoscopy by a primary care physician. 18 (13.0%) were convinced by a nurse, and 22 (15.9%) by another specialist. The remaining (23; 16.7%) patients indicated other factors. The majority of patients (74; 53.6%) responded saying that all necessary information about the entire test course was provided by the nurse, while 35 (25.4%) shared that this information had come from the primary care physician, 8 (5.80%) from the specialist doctor, 3 (2.17%) from the receptionist and 18 (13.0%) from other sources of information, such as the Internet, leaflets and notice boards. The rOLe Of PrIMArY CAre PhYSICIANS AND NurSeS IN CONvINCINg PATIeNTS TO PArTICIPATe IN A COLOreCTAL CANCer SCreeNINg PrOgrAM IN A POLISh COOrDINATeD CAre OrgANIzATION: A queSTIONNAIre-BASeD STuDY Marika guzek1 B-f • ORCID: 0000-0001-5398-9586 Sylwia Szafraniec-Buryło2 A,C-f • ORCID: 0000-0002-7497-4815 Adrianna Wyrębiak1 A,B • ORCID: 0000-0001-8830-9165 Dorota Kowalczyk3 C,e,f • ORCID: 0000-0001-8203-5589 grzegorz Bukato4 C,e,f • ORCID: 0000-0002-4170-7948 Artur Prusaczyk1 D,g • ORCID: 0000-0003-4577-1530 Paweł Żuk1 D,g • ORCID: 0000-0001-5293-8517 Marcin Czech2 D • ORCID: 0000-0001-7292-1712 Donata Kurpas5 A,C-f • ORCID: 0000-0002-6996-8920 1 Medical and Diagnostic Centre, Siedlce, Poland 2 Department of Pharmacoeconomics, Institute of Mother and Child, Warsaw, Poland 3 Prophmed, Łomianki, Poland 4 Department of Psychiatry, Physiotherapy Division, Medical university of Warsaw, Poland 5 Wroclaw Medical university, Wroclaw, Poland A – study design, b – data collection, C – statistical analysis, D – interpretation of data, E – manuscript preparation, F – literature review, G – sourcing of funding 25 The role of primary care physicians and nurses in convincing patients to participate in a colorectal cancer... Medical Science Pulse 2019 (13) 2 background Integrated care is a concept combining input resources, service delivery processes, management and organization health services for the purpose of health promotion, disease prevention, diagnostics, therapy and rehabilitation. Primary healthcare has a fundamental role in society, according to the prevailing opinions of experts and scientists. It is essential for the integration of care due to its “gate-keeper” function and involves the coordination of primary care physicians and their healthcare teams in local communities. Nurses as care coordinators play a crucial role in the integrated care system. Over the past few years, nurses’ responsibilities have increased significantly. Nurses are authorized to perform a wide range of activities in Poland, including tasks previously performed by doctors. This is especially important for the patient-centered approach during the implementation of large prevention programs [1–3]. Colorectal cancer (CrC) is the second leading cause of cancer death in Poland and europe [4,5]. According to Poland’s National Cancer registry, in 2010 there were 15,800 cases and almost 11,000 deaths due to CrC. CrC is therefore an important health problem across europe [5]. Most CrCs develop from nonmalignant precursor lesions called adenomas over a long period of time. This slow development provides an opportunity for screening tests, which may result in detection of CrC at an early stage and the initiation of treatment even before symptoms occur. early treatment of invasive lesions is both more effective than in more advanced stages and most likely less detrimental for the patient’s quality of life [4,6]. Implementation of CrC screening programmes is recommended in both eu Member States and the uS to lower the population’s cancer burden [6,7]. In Poland as part of the Colon Cancer Screening Program implemented by the Ministry of health, free preventive colonoscopies are performed [8]. Patients take part in the programme in one of two ways, either they directly contact the doctor, or they are invited by the doctor to participate. 1) In the noninvitation method, also known as “opportunistic”, the patient applies directly to any doctor or applies by filling out the questionnaire himself. These patients fall into three categories: 50–65 years of age, with or without family history, and have not had a colonoscopy in the prior ten years; 40–49 years, who have had a first degree relative diagnosed with colon cancer; 25–49 years, from families with hereditary colorectal cancer but not hNPCC (hereditary Non-Polyposis Colorectal Cancer). In cases of suspected hNPCC, it is necessary to refer the patient to the genetics clinic and if confirmed, have colonoscopies performed every 2–3 years. exceptions are patients in which genetic mutations are not found. A person may be dismissed from performing control colonoscopy. 2) The invitation method involves personal invitations to people aged 55–64 to participate in the study. Invitation to a preventive colonoscopy is active until the age of 64 by the invitee [9]. Aim of the study The main purpose of the study was to assess the influence of healthcare professionals on patients’ decisions to perform screening colonoscopy. Additionally, we wanted to outline the current and potential roles of nurses in this process. Material and methods Study design and setting The study was carried out in two endoscopy laboratories at the Medical and Diagnostic Centre, Siedlce, Poland between March 1st and June 15th, 2017 on patients undergoing a colonoscopy screening. Participants and study size Patients received a questionnaire after the examination and were instructed on how to fill it out. for the research purposes, 150 questionnaires were prepared, 145 were returned, of which 138 were filled out correctly and were statistically analyzed.

medical science pulse

The role of primary care physicians and nurses in convincing patients to participate in a colorectal cancer screening program in a Polish coordinated care organization: a questionnaire-based study