Ackerson Kelly, Gretebeck Kimberlee
University of Michigan School of Nursing, Ann Arbor, Michigan, USA.
J Am Acad Nurse Pract. 2007 Nov;19(11):591-601. doi: 10.1111/j.1745-7599.2007.00268.x.
This integrated review was conducted to evaluate the factors that inhibit or promote decisions by African American and Hispanic women to obtain cervical cancer screening.
Research articles were identified using MEDLINE, PubMed, and Cumulative Index to Nursing and Allied Health literature, published between 1999 and 2005.
Cervical cancer screening practices of African American and Hispanic women were influenced by extrinsic motivators including lack of insurance, no usual source of health care, acculturation, and socioeconomic factors. Intrinsic motivators were related to beliefs and perceptions of vulnerability, such as ignoring cervical cancer screening when no symptoms were present; believing that not knowing if one had cervical cancer was better; and thinking that only women who engage in sexual risk-taking behaviors need to obtain Papanicolaou (Pap) smear testing.
Nurse practitioners (NPs) have an opportunity to impact the incidence and mortality of cervical cancer by improving screening practices of minority women. They can emphasize the importance of obtaining Pap smears regularly, teach patients the risks for and signs and symptoms of cervical cancer, and provide recommendations for obtaining screening at low cost or no cost to the patient. To improve cancer screening practices, NPs need to address minority women's beliefs about cervical cancer and provide information and services in a culturally sensitive manner at an appropriate level of learning.
进行本次综合性综述,以评估抑制或促进非裔美国女性和西班牙裔女性进行宫颈癌筛查决策的因素。
使用MEDLINE、PubMed以及护理与联合健康文献累积索引,检索1999年至2005年间发表的研究文章。
非裔美国女性和西班牙裔女性的宫颈癌筛查行为受到外部激励因素的影响,包括缺乏保险、没有固定的医疗保健来源、文化适应以及社会经济因素。内在激励因素与对易感性的信念和认知有关,例如在没有症状时忽视宫颈癌筛查;认为不知道自己是否患有宫颈癌更好;以及认为只有从事性风险行为的女性才需要进行巴氏涂片检查。
执业护士有机会通过改善少数族裔女性的筛查行为来影响宫颈癌的发病率和死亡率。他们可以强调定期进行巴氏涂片检查的重要性,教导患者宫颈癌的风险以及体征和症状,并为患者提供低成本或免费进行筛查的建议。为了改善癌症筛查行为,执业护士需要解决少数族裔女性对宫颈癌的看法,并以文化敏感的方式在适当的学习水平上提供信息和服务。