McKee M D, Lurio J, Marantz P, Burton W, Mulvihill M
Department of Family Medicine, Albert Einstein College of Medicine, Bronx, NY, USA.
Arch Fam Med. 1999 Mar-Apr;8(2):129-34. doi: 10.1001/archfami.8.2.129.
To determine factors predictive of failure to return for colposcopy among women with significant abnormalities on Papanicolaou smears in a high-risk clinical population.
Telephone survey.
An urban community health center.
Two hundred seventy-nine women randomly selected from all women seen at the health center with abnormal Papanicolaou smears requiring colposcopy during 1993 to 1994. Six (2%) refused participation, and 19% could not be reached for inclusion. Subjects were mostly minority women receiving Medicaid.
Completion of colposcopy.
Of the 279 selected women, 79% were interviewed. The rate of adherence with colposcopy was 75% for the respondents. Women who did not know the results of their smear or who incorrectly understood their results were significantly less likely to return for colposcopy (P = .001). Younger women, especially teenagers, were less likely to return (P = .02). Socioeconomic status, education, primary language, health beliefs, fear of cancer, and clinician's gender or discipline were not associated with rate of follow-up. Barriers involving transportation, child care, and insurance also did not predict follow-up.
Effective communication of results is the most important factor related to follow-up after abnormal Papanicolaou smear in this setting. In other settings, other factors may be of greater importance.
确定在一个高风险临床人群中，巴氏涂片检查有显著异常的女性未返回接受阴道镜检查的预测因素。
电话调查。
一个城市社区卫生中心。
从1993年至1994年期间在该卫生中心接受巴氏涂片异常且需要阴道镜检查的所有女性中随机选取279名女性。6名（2%）拒绝参与，19%无法联系到以纳入研究。受试者大多是接受医疗补助的少数族裔女性。
完成阴道镜检查情况。
在279名被选中的女性中，79%接受了访谈。受访者中阴道镜检查的依从率为75%。不知道涂片结果或对结果理解错误的女性返回接受阴道镜检查的可能性显著降低（P = 0.001）。年轻女性，尤其是青少年，返回的可能性较小（P = 0.02）。社会经济地位、教育程度、主要语言、健康观念、对癌症的恐惧以及临床医生的性别或专业与随访率无关。涉及交通、儿童照料和保险的障碍也不能预测随访情况。
在这种情况下，有效传达检查结果是巴氏涂片异常后随访的最重要相关因素。在其他情况下，其他因素可能更重要。
