Department of Obstetrics & Gynecology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
Patient Educ Couns. 2010 Oct;81(1):106-12. doi: 10.1016/j.pec.2009.11.022. Epub 2010 Jan 8.
To investigate provider and patient views about communication regarding cervical cancer screening follow-up.
Using qualitative analysis, we interviewed 20 providers and 10 patients from two urban clinics that serve low-income African American and Hispanic women. Semi-structured interviews and focus groups assessed familiarity with National Cancer Institute's Cancer Information Service (CIS) and reactions to a letter asking women with abnormal Pap test to telephone CIS. The letter suggested questions to ask prior to receiving follow-up.
No patient or provider was familiar with CIS. Providers but not patients expressed discomfort with use of the word 'cancer' in the letter and in CIS's name. Providers feared that reference to cancer would provoke fatalism and impede timely follow-up, whereas patients felt information about cancer risk was needed to prompt timely follow-up. Information providers found necessary to convey in order to accurately explain abnormal Pap tests surpassed patients' literacy levels.
Qualitative data suggest important gaps in perspective between providers and patients. There is a need to bridge the gap and overcome communication challenges to promote timely medical follow-up and have better health outcomes.
Implications and strategies for improving patient-provider education and communication about abnormal Pap test are discussed.
调查提供者和患者对宫颈癌筛查随访沟通的看法。
采用定性分析方法，我们采访了来自两家为低收入非裔美国人和西班牙裔妇女服务的城市诊所的 20 名提供者和 10 名患者。半结构化访谈和焦点小组评估了他们对国家癌症研究所癌症信息服务（CIS）的熟悉程度，以及对要求异常巴氏涂片检查的女性致电 CIS 的信件的反应。这封信建议在接受随访前询问一些问题。
没有患者或提供者熟悉 CIS。提供者而非患者对信中和 CIS 名称中使用“癌症”一词表示不适。提供者担心提到癌症会引起宿命论并阻碍及时的随访，而患者则认为需要有关癌症风险的信息来促使及时的随访。为了准确解释异常巴氏涂片检查结果，提供的信息需要超过患者的阅读水平。
定性数据表明提供者和患者之间的观点存在重要差距。需要弥合这一差距并克服沟通挑战，以促进及时的医疗随访并获得更好的健康结果。
讨论了改善异常巴氏涂片检查的患者-提供者教育和沟通的影响和策略。
