乌干达穆拉戈医院医护人员对宫颈癌筛查的知识、态度和实践
Knowledge, attitudes and practices on cervical cancer screening among the medical workers of Mulago Hospital, Uganda.
作者信息
Mutyaba Twaha, Mmiro Francis A, Weiderpass Elisabete
机构信息
Department of Obstetrics and Gynaecology, Mulago Hospital, Makerere Medical School, P.O.Box 7051, Kampala, Uganda.
出版信息
BMC Med Educ. 2006 Mar 1;6:13. doi: 10.1186/1472-6920-6-13.
BACKGROUND
Cervical cancer is the commonest cancer of women in Uganda. Over 80% of women diagnosed in Mulago national referral and teaching hospital, the biggest hospital in Uganda, have advanced disease. Pap smear screening, on opportunistic rather than systematic basis, is offered free in the gynaecological outpatients clinic and the postnatal/family planning clinics. Medical students in the third and final clerkships are expected to learn the techniques of screening. Objectives of this study were to describe knowledge on cervical cancer, attitudes and practices towards cervical cancer screening among the medical workers of Mulago hospital.
METHODS
In a descriptive cross-sectional study, a weighted sample of 310 medical workers including nurses, doctors and final year medical students were interviewed using a self-administered questionnaire. We measured knowledge about cervical cancer: (risk factors, eligibility for screening and screening techniques), attitudes towards cervical cancer screening and practices regarding screening.
RESULTS
Response rate was 92% (285). Of these, 93% considered cancer of the cervix a public health problem and knowledge about Pap smear was 83% among respondents. Less than 40% knew risk factors for cervical cancer, eligibility for and screening interval. Of the female respondents, 65% didn't feel susceptible to cervical cancer and 81% had never been screened. Of the male respondents, only 26% had partners who had ever been screened. Only 14% of the final year medical students felt skilled enough to use a vaginal speculum and 87% had never performed a pap smear.
CONCLUSION
Despite knowledge of the gravity of cervical cancer and prevention by screening using a Pap smear, attitudes and practices towards screening were negative. The medical workers who should be responsible for opportunistic screening of women they care for are not keen on getting screened themselves. There is need to explain/understand the cause of these attitudes and practices and identify possible interventions to change them. Medical students leave medical school without adequate skills to be able to effectively screen women for cervical cancer wherever they go to practice. Medical students and nurses training curricula needs review to incorporate practical skills on cervical cancer screening.
背景
宫颈癌是乌干达女性中最常见的癌症。在乌干达最大的医院穆拉戈国家转诊和教学医院，超过80%被诊断出的女性患有晚期疾病。巴氏涂片筛查是在妇科门诊和产后/计划生育门诊以机会性而非系统性的方式免费提供。三年级和最后实习阶段的医学生需要学习筛查技术。本研究的目的是描述穆拉戈医院医务人员对宫颈癌的知识、对宫颈癌筛查的态度和做法。
方法
在一项描述性横断面研究中，使用自填式问卷对包括护士、医生和最后一年医学生在内的310名医务人员进行了加权抽样访谈。我们测量了关于宫颈癌的知识（危险因素、筛查资格和筛查技术）、对宫颈癌筛查的态度以及筛查做法。
结果
回复率为92%（285人）。其中，93%的人认为宫颈癌是一个公共卫生问题，受访者中对巴氏涂片的知晓率为83%。不到40%的人知道宫颈癌的危险因素、筛查资格和筛查间隔。在女性受访者中，65%认为自己不易患宫颈癌，81%从未接受过筛查。在男性受访者中，只有26%的伴侣曾接受过筛查。只有14%的最后一年医学生觉得自己有足够的技能使用阴道窥器，87%从未进行过巴氏涂片检查。
结论
尽管了解宫颈癌的严重性以及通过巴氏涂片筛查进行预防，但对筛查的态度和做法却是消极的。本应负责对其护理的女性进行机会性筛查的医务人员自己却不热衷于接受筛查。有必要解释/了解这些态度和做法的原因，并确定可能的干预措施来改变它们。医学生毕业时没有足够的技能，无法在他们未来执业的任何地方有效地为女性筛查宫颈癌。医学生和护士的培训课程需要进行审查，以纳入宫颈癌筛查的实践技能。
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