Ideström Monica, Milsom Ian, Andersson-Ellström Agneta
Department of Obstetrics and Gynaecology, Central Hospital, Karlstad, Sweden.
Acta Obstet Gynecol Scand. 2007;86(6):742-8. doi: 10.1080/00016340701371272.
Midwives in Sweden are responsible for taking Papanicolaou (Pap) smears as part of the cervical cancer screening program. The aim of this study was to investigate midwives knowledge, experience and management of the cervical cancer screening program, and their apprehension of women's knowledge about Pap-smear screening.
A postal questionnaire was sent to midwives working in primary health care in 3 different areas in Sweden. A total of 156 (77%) out of 201 midwives completed the questionnaire.
Four of 5 midwives considered themselves to have the education they needed to manage the screening program. However, the study indicated that midwives lacked a basic structure when giving information. As many as every third midwife refrained from or had an irrelevant answer to the proposed question, what is meant by a cellular atypia? Almost all midwives saw themselves as the main informant about Pap-smear screening. At the same time, the midwives perceived that women lacked knowledge about cellular atypia, and thought it was the same as cancer. Some 38% of the midwives expressed a wish to terminate the 'assembly line-like' screening system. The remaining midwives were completely satisfied with the organisation.
Many midwives lacked time and a structured guidance when discussing screening and cervical atypia. Improvement in the organisation and certified education for Pap-smear screening with access to recent research, could develop a more empowering exchange between the midwives and the women participating in cervical screening.
在瑞典，助产士负责进行巴氏涂片检查，作为宫颈癌筛查项目的一部分。本研究的目的是调查助产士对宫颈癌筛查项目的知识、经验和管理情况，以及他们对女性巴氏涂片筛查知识的了解。
向瑞典3个不同地区从事初级卫生保健工作的助产士发送了一份邮政调查问卷。201名助产士中共有156名（77%）完成了问卷。
五分之四的助产士认为自己具备管理筛查项目所需的教育背景。然而，研究表明，助产士在提供信息时缺乏基本结构。多达三分之一的助产士对“细胞异型性是什么意思？”这个问题避而不答或给出不相关的答案。几乎所有助产士都认为自己是巴氏涂片筛查的主要信息提供者。与此同时，助产士们意识到女性缺乏关于细胞异型性的知识，并且认为它与癌症是一样的。约38%的助产士表示希望终止这种“流水线式”的筛查系统。其余助产士对该组织完全满意。
许多助产士在讨论筛查和宫颈异型性时缺乏时间和结构化的指导。改进组织架构并提供经过认证的巴氏涂片筛查教育，使其能够获取最新研究成果，这可能会在助产士和参与宫颈筛查的女性之间开展更具启发性的交流。
