Arredondo Elva M, Pollak Kathryn I, Costanzo Philip, McNeilly Maya, Myers Evan
Department of Psychology, Duke University, Durham, NC 27708-0085, USA.
J Natl Med Assoc. 2003 Jul;95(7):576-84.
Cervical cancer screening rates in the United States are sub-optimal. Physician factors likely contribute to these lower rates. Previous studies provide inconclusive evidence about the association between physician characteristics and the likelihood of addressing cervical cancer. This report assesses potential mechanisms that explain why certain providers do not address cervical cancer screening.
One hundred primary care residents from various specialties were asked to indicate the preventive topics they would address with a hypothetical white female in her early 20s, who was portrayed as living a "high risk" lifestyle, and visiting her provider only for acute care reasons.
Among the provider characteristics assessed, only residents' ethnicity was associated with the likelihood of and time spent addressing cervical cancer screening. In particular, Asian-American residents were least likely to address cervical cancer, while African-American residents were most likely. A mediation analyses revealed that perceived barriers for addressing cervical cancer accounted for this difference.
Study results suggest that there may be cultural factors among health care providers that may account for differential referral and treatment practices. Findings from this study may help identify factors that explain why cervical cancer screening rates are not higher.
美国宫颈癌筛查率未达最佳水平。医生因素可能导致了这些较低的筛查率。先前的研究关于医生特征与开展宫颈癌筛查可能性之间的关联提供了不确定的证据。本报告评估了解释某些医疗服务提供者不进行宫颈癌筛查的潜在机制。
来自不同专业的100名初级保健住院医师被要求指出他们会与一名假设的20岁出头的白人女性讨论的预防话题,该女性被描述为过着“高风险”生活方式,仅因急性病护理原因就诊。
在评估的医疗服务提供者特征中,只有住院医师的种族与开展宫颈癌筛查的可能性及所花时间相关。具体而言,亚裔美国住院医师开展宫颈癌筛查的可能性最小,而非裔美国住院医师可能性最大。一项中介分析显示,开展宫颈癌筛查的感知障碍解释了这种差异。
研究结果表明,医疗服务提供者中可能存在文化因素,这可能导致不同的转诊和治疗行为。本研究结果可能有助于确定解释宫颈癌筛查率为何未更高的因素。