Forss Anette, Tishelman Carol, Widmark Catarina, Sachs Lisbeth
Department of Nursing, Karolinska Institutet, Sweden.
Sociol Health Illn. 2004 Apr;26(3):306-25. doi: 10.1111/j.1467-9566.2004.00392.x.
Cervical cancer screening is a preventive intervention directed towards women to both detect cervical cancer and identify those at risk for developing this disease. It has been argued that participation in screening programmes and early detection situations may lead to new kinds of sickness experiences. This article is based on qualitative phenomenological hermeneutical analysis of interviews with women who have received abnormal Pap smear test results through a population-based outreach screening programme in urban Sweden. The aim of this article is to illuminate the meaning, for the participating women, of the lived experience of receiving notification about an abnormal Pap smear result. The data are presented in terms of two themes: Pap smear for routine and recurrent confirmation of health and unexpected and ambiguous communication about Pap smear results. The findings are discussed as an unintentional transition from confirmation of health to liminality. Whereas medical diagnosis has been discussed as structuring the inchoate, an abnormal Pap smear did not create order for the interviewed women. On the contrary, the notification of an abnormal Pap smear created disorder as the women had expected to be confirmed as healthy but instead neither health nor disease were confirmed or excluded. Even 'simple' technology is shown to have an ontological dimension, with the ability to transform daily taken-for-grantedness of ourselves as primarily healthy to (potentially) unhealthy.
宫颈癌筛查是一项针对女性的预防性干预措施，旨在检测宫颈癌并识别有患此病风险的人群。有人认为，参与筛查计划和早期检测情况可能会导致新的疾病体验。本文基于对瑞典城市地区通过基于人群的外展筛查计划收到异常巴氏涂片检测结果的女性进行访谈的定性现象学诠释学分析。本文的目的是阐明对于参与其中的女性而言，收到异常巴氏涂片结果通知的生活经历的意义。数据呈现为两个主题：用于健康常规和反复确认的巴氏涂片，以及关于巴氏涂片结果的意外且模糊的信息传达。研究结果被讨论为从健康确认到阈限状态的无意转变。虽然医学诊断被认为是对初期情况进行结构化，但异常巴氏涂片结果并未为受访女性带来秩序。相反，异常巴氏涂片结果的通知造成了混乱，因为女性原本期望被确认为健康，但结果既未确认健康也未排除疾病。甚至“简单”的技术也显示出具有本体论维度，能够将我们自身主要健康的日常理所当然状态转变为（潜在的）不健康状态。
