Rolnick S J, LaFerla J J, Jackson J, Akkerman D, Compo R
HealthPartners Research Foundation, Minneapolis, Minnesota 55440, USA.
Prev Med. 1999 May;28(5):530-4. doi: 10.1006/pmed.1998.0473.
An evaluation was conducted to assess patient perceptions and comfort levels with a new triennial Pap smear screening guideline.
A random sample of women ages 20-69 (N = 673) was selected among members of three provider groups within a large health maintenance organization and mailed a survey. Questions pertained to Pap smear history and perceptions of the new guideline.
The overall response rate was 63%. Over one-half of respondents had no recollection of being informed about the change in recommendation. Fourteen percent of subjects responded positively to the change, 16% were neutral, 20% were skeptical, and 50% made negative comments. Women significantly more likely to be negative or skeptical about the new guide line were those who reported more frequent prior Pap smears (P < 0.0001), those reporting a history of abnormal Pap smear (P < 0.01), and more educated women (P < 0.05). No statistical differences were found for those reporting a recent abnormal result, or based on provider group, age, or recollection of being informed.
Regardless of patient knowledge and intellectual understanding of screening intervals, this new guideline raises patient concern about preventive care. More must be done to educate women regarding the change in recommended screening frequency and the reasons for it.
对一项新的每三年进行一次巴氏涂片筛查指南进行了评估,以了解患者的看法和舒适度。
在一个大型健康维护组织的三个医疗服务提供组的成员中,随机抽取了年龄在20 - 69岁之间的女性样本(N = 673),并邮寄了一份调查问卷。问题涉及巴氏涂片检查史和对新指南的看法。
总体回复率为63%。超过一半的受访者不记得曾被告知推荐建议的变化。14%的受试者对这一变化持积极态度,16%持中立态度,20%持怀疑态度,50%发表了负面评论。对新指南更有可能持负面或怀疑态度的女性是那些报告以前巴氏涂片检查更频繁的人(P < 0.0001)、报告有巴氏涂片异常史的人(P < 0.01)以及受教育程度更高的女性(P < 0.05)。对于那些报告近期有异常结果的人,或基于医疗服务提供组、年龄或是否记得被告知等因素,未发现统计学差异。
无论患者对筛查间隔的了解程度和理性认识如何,这项新指南都引发了患者对预防保健的担忧。必须进一步开展工作,让女性了解推荐筛查频率的变化及其原因。