Department of Public Health, Camden Primary Care Trust, St Pancras Hospital, London NW1 0PE, UK.
Public Health. 2009 Oct;123(10):680-5. doi: 10.1016/j.puhe.2009.09.011. Epub 2009 Oct 27.
To explore barriers to, and ways to improve, uptake of cervical screening among Somali women in Camden, London.
A qualitative research study using focus group discussions and in-depth interviews.
A qualitative study (comprising seven focus groups and eight in-depth interviews) was conducted with 50 first-generation Somali women aged 25-64 years. Both the groups and the interviews explored participants' understanding of the purpose of cervical screening, and the various risk factors for cervical cancer, as well as their opinions on barriers to screening and suggestions for overcoming those barriers.
Knowledge about the purpose of cervical screening was limited among Somali women. There was also a lack of understanding of risk factors for cervical cancer, and many of the women held fatalistic attitudes, associated with the idea of 'God's will', about this cancer and other aspects of health. Another culturally specific barrier was embarrassment associated with female circumcision, i.e. female genital mutilation. Other barriers suggested by the participants were: lack of knowledge about the need for cervical screening, practical problems such as appointment times and childcare needs, language difficulties, fear of the test and negative past experiences. Possible solutions suggested by the participants included the provision of education and information about cervical screening in the Somali language by Somali community workers. They also suggested that healthcare staff should be trained about Somali culture, particularly regarding female circumcision, and that general practitioners should more proactively encourage Somali women to attend screening.
Language difficulties and specific cultural issues are key barriers to first-generation Somali women attending cervical screening. Providing education and information orally, as well as improving access to a more culturally appropriate screening service, could lead to improved uptake among this group.
探索伦敦卡姆登地区索马里女性接受宫颈癌筛查的障碍和改进方法。
采用焦点小组讨论和深入访谈的定性研究。
对 50 名年龄在 25-64 岁的第一代索马里女性进行了一项定性研究（包括 7 个焦点小组和 8 个深入访谈）。这些小组和访谈探讨了参与者对宫颈癌筛查目的的理解，以及宫颈癌的各种风险因素，以及他们对筛查障碍的看法和克服这些障碍的建议。
索马里女性对宫颈癌筛查目的的了解有限。对宫颈癌的风险因素也缺乏了解，许多女性对这种癌症和其他健康方面持有宿命论的态度，认为这是“上帝的旨意”。另一个文化特定的障碍是与女性割礼（即女性生殖器切割）相关的尴尬。参与者提出的其他障碍包括：缺乏对宫颈癌筛查必要性的了解、预约时间和儿童保育需求等实际问题、语言障碍、对检查的恐惧和负面的过去经历。参与者提出的可能的解决方案包括由索马里社区工作者以索马里语提供关于宫颈癌筛查的教育和信息。他们还建议培训医疗保健人员了解索马里文化，特别是关于女性割礼的问题，并建议全科医生更积极地鼓励索马里女性接受筛查。
语言障碍和特定的文化问题是第一代索马里女性接受宫颈癌筛查的主要障碍。通过口头提供教育和信息，以及改善获得更符合文化的筛查服务的机会，可以提高该群体的参与率。
