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澳大利亚女性对于子宫颈癌筛查中人类乳头瘤病毒信息的需求及偏好。

Australian women's needs and preferences for information about human papillomavirus in cervical screening.

作者信息

McCaffery Kirsten, Irwig Les

机构信息

Screening and Test Evaluation Program, School of Public Health, University of Sydney, NSW 2006, Australia.

出版信息

J Med Screen. 2005;12(3):134-41. doi: 10.1258/0969141054855238.

Abstract

OBJECTIVE

The role of human papillomavirus (HPV) in cervical cancer and developments in medical technology to prevent cervical cancer has changed information needs for women participating in cervical screening.

DESIGN

Qualitative face-to-face interviews were conducted with 19 women diagnosed with HPV infection on their Pap smear following routine cervical screening.

SETTING

Family planning clinics, general practice and specialist gynaecologist practices in Sydney and the surrounding area, Australia.

MAIN OUTCOME MEASURES

Women's information needs, preferences and experiences of HPV diagnosis.

RESULTS

Women wanted further information on different HPV viral types, transmission, implications for sexual partners, prevalence, latency and regression of HPV, their management options and the implications of infection for cancer risk and fertility. Uncertainty about the key aspects of HPV, the style in which the clinician communicated the result and the mode of delivering the result (letter, telephone or consultation) influenced women's psychological response to the diagnosis of HPV. The delivery of results by letter alone was linked to considerable anxiety among the women interviewed. Women's experience of searching the Internet for further information about HPV was reported as difficult, anxiety provoking and contributing to the stigma of the infection because information was often located in the context of other sexually transmitted infections, with multiple sexual partners highlighted as a risk factor for infection.

CONCLUSION

Women participating in cervical screening need high-quality information about HPV and its role in cervical cancer prior to screening rather than afterwards, when they face an abnormal result. The clinician potentially plays an important role in moderating the effects of diagnosis through the manner and mode in which an HPV diagnosis is delivered. Revision of cervical screening policy and practice in light of the changes in the understanding of HPV is recommended.

摘要

目的

人乳头瘤病毒(HPV)在宫颈癌中的作用以及预防宫颈癌的医学技术发展,改变了参与宫颈癌筛查的女性的信息需求。

设计

对19名在常规宫颈癌筛查后巴氏涂片检查诊断为HPV感染的女性进行了定性面对面访谈。

地点

澳大利亚悉尼及周边地区的计划生育诊所、全科诊所和妇科专科诊所。

主要观察指标

女性对HPV诊断的信息需求、偏好和经历。

结果

女性希望获得有关不同HPV病毒类型、传播途径、对性伴侣的影响、HPV的患病率、潜伏期和消退情况、治疗选择以及感染对癌症风险和生育能力影响的更多信息。HPV关键方面的不确定性、临床医生传达结果的方式以及结果传达模式(信件、电话或会诊)影响了女性对HPV诊断的心理反应。仅通过信件传达结果与受访女性的严重焦虑有关。据报道,女性在互联网上搜索有关HPV的更多信息的经历困难、引发焦虑且加重了感染的污名化,因为信息通常与其他性传播感染相关,且强调多个性伴侣是感染的风险因素。

结论

参与宫颈癌筛查的女性在筛查前而非面对异常结果后,需要有关HPV及其在宫颈癌中作用的高质量信息。临床医生可能通过传达HPV诊断的方式和模式在减轻诊断影响方面发挥重要作用。建议根据对HPV认识的变化修订宫颈癌筛查政策和实践。

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