CIBER de Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain.
Psychooncology. 2012 Jun;21(6):618-29. doi: 10.1002/pon.1940. Epub 2011 Mar 7.
Inequalities between immigrant and native populations in terms of access and use of health services have been described. The objective is to compare knowledge, attitudes, vulnerabilities, benefits and barriers related to breast cancer (BC) and screening mammography among women from different countries resident in Barcelona.
A cross-sectional survey carried out in Barcelona in 2009. The study population consisted of female residents in Barcelona between 45 and 69 years of age; participants were Spanish nationals or immigrants from low-income countries. 960 participants were asked 72 questions, mainly with Likert responses. The dependent variables were five quantitative scales: (1) knowledge of BC and early detection, (2) attitude towards health and BC, (3) vulnerability to BC, (4) barriers to mammography, (5) benefits of mammography. The independent variables were country of origin, social class, setting, cohabitation, age, mammography use, length of residence and fluency of the language. Analyses compared scale scores stratified by the independent variables. Multivariable linear regression models were fitted to determine the relationship between the scales and the independent variables.
We observed inequalities according to country of origin on all scales after adjustment for independent variables. Chinese women presented the greatest differences with respect to native women, followed by Maghrebi and Filipino women. Inequalities exist on the vulnerability and barriers scales according to social class and urban/rural setting, and on the attitude scale according to social class.
Country of origin, social class and urban/rural setting are key contributors to inequality in these scales.
描述了移民和本地人群在获得和使用卫生服务方面的不平等现象。本研究旨在比较居住在巴塞罗那的不同国家的女性在乳腺癌（BC）及其筛查乳房 X 光检查方面的知识、态度、脆弱性、获益和障碍。
这是 2009 年在巴塞罗那进行的一项横断面调查。研究人群为年龄在 45 至 69 岁之间的巴塞罗那女性居民；参与者为西班牙国民或来自低收入国家的移民。960 名参与者被问及 72 个问题，主要采用李克特量表回答。因变量为五个定量量表：（1）BC 和早期检测知识，（2）对健康和 BC 的态度，（3）BC 脆弱性，（4）乳房 X 光检查障碍，（5）乳房 X 光检查获益。自变量为原籍国、社会阶层、居住环境、同居情况、年龄、乳房 X 光检查使用情况、居住时间和语言流利程度。根据独立变量对量表评分进行分层比较分析。拟合多变量线性回归模型，以确定量表与独立变量之间的关系。
在调整了独立变量后，我们观察到所有量表上的原籍国差异。与本地女性相比，中国女性在所有量表上的差异最大，其次是马格里布和菲律宾女性。根据社会阶层和城乡环境，在脆弱性和障碍量表上存在不平等，根据社会阶层，在态度量表上也存在不平等。
原籍国、社会阶层和城乡环境是这些量表中不平等的主要因素。
