Holroyd Eleanor, Twinn Sheila, Adab Peymane
The Nethersole School of Nursing, The Chinese University of Hong Kong, Shatin, Hong Kong, China.
J Adv Nurs. 2004 Apr;46(1):42-52. doi: 10.1111/j.1365-2648.2003.02964.x.
Compared with other countries, Hong Kong has a relatively high rate of cervical cancer. Much of this morbidity should be avoidable with cervical screening, but uptake rates for screening in Hong Kong are low. In programmes to promote cervical screening attendance, it is essential that aspects of the socio-cultural system be taken into account to provide appropriate preventive health strategies.
This paper outlines an investigation of the cultural and social factors contributing to Chinese women's attendance for cervical screening.
A mixed methods design was employed, combining and comparing two data sets. The initial data set was drawn from 10 focus groups involving both screened and unscreened Chinese women (n = 54). The second data set was drawn from a total population of Hong Kong doctors, and involved face-to-face semi-structured interviews (n = 28).
Thematic analysis of the data from women indicated that the social factors of cost, educational base, knowledge of risk, the social value of early detection and cultural issues such as modesty and embarrassment contributed to screening attendance. The doctors perceived a cultural tendency towards fatalism, as well as seeing the gender, interpersonal and interprofessional skills of the practitioner to be important in influencing levels of Chinese women's shyness and discomfort, and hence affecting attendance. The lay and practitioner data sets varied in the perceptions of women's pain, embarrassment and risk factors.
Programmes providing services for Chinese women need to ensure that the philosophy of the staff and the approach and materials used are culturally relevant. Recommendations are that nurses equipped with relevant social and cultural knowledge of population groups should have a central role in health promotion and screening services.
与其他国家相比，香港的宫颈癌发病率相对较高。通过宫颈癌筛查，大部分此类发病率是可以避免的，但香港的筛查参与率较低。在促进宫颈癌筛查参与的项目中，必须考虑社会文化系统的各个方面，以提供适当的预防性健康策略。
本文概述了对影响中国女性参加宫颈癌筛查的文化和社会因素的调查。
采用混合方法设计，合并并比较两个数据集。第一个数据集来自10个焦点小组，参与者包括已接受筛查和未接受筛查的中国女性（n = 54）。第二个数据集来自香港医生的总人口，涉及面对面的半结构化访谈（n = 28）。
对女性数据的主题分析表明，成本、教育基础、风险知识、早期发现的社会价值以及诸如谦逊和尴尬等文化问题等社会因素影响了筛查参与情况。医生们察觉到一种宿命论的文化倾向，同时认为从业者的性别、人际和专业间技能对于影响中国女性的羞怯和不适感很重要，进而影响参与情况。普通人和从业者数据集在对女性疼痛、尴尬和风险因素的认知上存在差异。
为中国女性提供服务的项目需要确保工作人员的理念以及所采用的方法和材料与文化相关。建议具备相关人群社会和文化知识的护士应在健康促进和筛查服务中发挥核心作用。
