Queen's University Belfast, Grosvenor Road, Belfast, Northern Ireland, UK.
BMC Public Health. 2010 Dec 3;10:749. doi: 10.1186/1471-2458-10-749.
Previous research showed that deprived individuals are less likely to attend breast screening and those providing intense amounts of informal care tend to be more deprived than non-caregivers. The aim of this study was to examine the relationship between informal caregiving and uptake of breast screening and to determine if socio-economic gradients in screening attendance were explained by caregiving responsibilities.
A database of breast screening histories was linked to the Northern Ireland Longitudinal Study, which links information from census, vital events and health registration datasets. The cohort included women aged 47 - 64 at the time of the census eligible for breast screening in a three-year follow-up period. Cohort attributes were recorded at the Census. Multivariate logistic regression was used to examine the relationship between informal caregiving and uptake of screening using STATA version 10.
37,211 women were invited for breast screening of whom 27,909 (75%) attended; 23.9% of the cohort were caregivers. Caregivers providing <20 hours of care/week were more affluent, while those providing >50 hours/week were more deprived than non-caregivers. Deprived women were significantly less likely to attend breast screening; however, this was not explained by caregiving responsibilities as caregivers were as likely as non-caregivers to attend (Odds Ratio 0.97; 95% confidence intervals 0.88, 1.06).
While those providing the most significant amounts of care tended to be more deprived, caregiving responsibilities themselves did not explain the known socio-economic gradients in breast screening attendance. More work is required to identify why more deprived women are less likely to attend breast screening.
先前的研究表明,贫困人群接受乳房筛查的可能性较低,而提供大量非正式护理的人群往往比非护理人员更贫困。本研究旨在探讨无偿护理与乳房筛查参与度之间的关系,并确定在筛查参与度方面是否存在社会经济梯度,其原因是否可以用护理责任来解释。
通过将乳房筛查史数据库与北爱尔兰纵向研究相关联,该研究将来自人口普查、重要事件和健康登记数据集的信息联系起来。该队列包括在人口普查时年龄在 47-64 岁之间、在接下来的三年随访期间有资格接受乳房筛查的女性。在人口普查时记录了队列的属性。使用 STATA 版本 10 通过多变量逻辑回归来检验无偿护理与筛查参与度之间的关系。
共有 37211 名女性被邀请进行乳房筛查,其中 27909 人(75%)参加了筛查;23.9%的队列是护理人员。每周提供<20 小时护理的护理人员更为富裕,而每周提供>50 小时护理的护理人员比非护理人员更为贫困。贫困女性接受乳房筛查的可能性显著降低;然而,这并不能用护理责任来解释,因为护理人员与非护理人员一样有可能接受筛查(优势比 0.97;95%置信区间 0.88,1.06)。
尽管提供大量护理的人往往更为贫困,但护理责任本身并不能解释已知的乳房筛查参与度方面的社会经济梯度。需要进一步研究以确定为什么贫困女性更不可能接受乳房筛查。