Castellano P Z, Wenger N K, Graves W L
Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, Georgia, USA.
J Womens Health Gend Based Med. 2001 Jun;10(5):451-61. doi: 10.1089/152460901300233920.
Postmenopausal women with coronary heart disease (CHD) who volunteered for the Heart and Estrogen/Progestin Replacement Study (HERS) randomized clinical trial had high rates of gynecological abnormalities. We examined compliance with gynecological cancer screening and factors affecting this behavior. Women who met inclusion criteria for HERS and were seen for screening by the study gynecologist were considered eligible for this study. Data were abstracted from study records, and additional information was obtained by telephone questionnaire. Adherence to mammography, breast examination, pelvic examination, and Pap smear recommendations was assessed. Provider behavior and its effect on compliance were assessed. Compliance rates were 59.1% for monthly breast self-examination (BSE), 67.2% for yearly mammography, 73% for yearly Pap smear and pelvic examination, and 75.7% for provider breast examination. Over 50% of patients had most of their screening tests done within the last year. Provider behavior was significantly related to patient screening compliance for mammography, breast examination, Pap smear, and pelvic examination. Provider gender was not significantly related to adherence. There were no significant differences in compliance rates based on the type of most recent coronary event. Compliance rates did not differ significantly between patients with and without gynecological abnormalities, except for mammography (78.3% versus 48.3%, p = 0.02). The majority of patients were compliant with gynecological screening. Among patients with gynecological abnormalities, mammography compliance was significantly lower. Provider behavior was an important factor in influencing women to obtain preventive screening. There were no significant differences in compliance based on provider gender or type of coronary event preceding HERS enrollment.
自愿参加心脏与雌激素/孕激素替代研究（HERS）随机临床试验的绝经后冠心病（CHD）女性，妇科异常发生率较高。我们研究了妇科癌症筛查的依从性以及影响该行为的因素。符合HERS纳入标准且由研究妇科医生进行筛查的女性被认为符合本研究条件。数据从研究记录中提取，并通过电话问卷获取额外信息。评估了对乳房X光检查、乳房检查、盆腔检查和巴氏涂片检查建议的依从性。评估了医疗服务提供者的行为及其对依从性的影响。每月乳房自我检查（BSE）的依从率为59.1%，每年乳房X光检查的依从率为67.2%，每年巴氏涂片检查和盆腔检查的依从率为73%，医疗服务提供者乳房检查的依从率为75.7%。超过50%的患者在过去一年中完成了大部分筛查测试。医疗服务提供者的行为与患者乳房X光检查、乳房检查、巴氏涂片检查和盆腔检查的筛查依从性显著相关。医疗服务提供者的性别与依从性无显著相关性。根据最近一次冠心病事件的类型，依从率没有显著差异。有妇科异常和无妇科异常的患者之间，依从率没有显著差异，但乳房X光检查除外（78.3%对48.3%，p = 0.02）。大多数患者依从妇科筛查。在有妇科异常的患者中，乳房X光检查的依从性显著较低。医疗服务提供者的行为是影响女性进行预防性筛查的重要因素。根据医疗服务提供者的性别或HERS入组前冠心病事件的类型，依从性没有显著差异。
