Pitama Suzanne, Cave Tami, Huria Tania, Lacey Cameron, Cuddy Jessica, Frizelle Frank
Maori Indigenous Health Institute, University of Otago, Christchurch, New Zealand.
N Z Med J. 2012 Jun 8;125(1356):75-84.
To explore Maori health worker perspectives on colorectal screening and identify factors that may influence Maori participation in a colorectal screening programme.
Thirty Maori health workers were interviewed to explore their experience with screening programmes, knowledge of colorectal cancer and their perspective on a potential colorectal screening programme. Health workers shared their perspective informed by both their own whanau and whanau they encountered professionally through their health work.
Participants were largely positive about potential colorectal screening; however, various access barriers were identified. These included patient-clinician engagement and communication, lack of provision for patient's privacy during screening and patients feeling discouraged to take part in screening. Factors enabling screening included having an established relationship with their General Practitioner, screening clinicians taking time to build rapport, answer questions and share information, screening practices that were inclusive of Maori cultural norms and possessing high health literacy.
Evidence points to growing disparity between the colorectal cancer incidence rates of Maori and non-Maori; disparities in colorectal cancer survival rates are already marked. Participants in the current pilot could provide valuable information to help ensure that the health education, promotion, and clinical practice surrounding a national colorectal screening programme are effective for Maori in reducing disparity and improving health outcomes.
探讨毛利族卫生工作者对结直肠癌筛查的看法,并确定可能影响毛利人参与结直肠癌筛查计划的因素。
对30名毛利族卫生工作者进行访谈,以了解他们在筛查计划方面的经验、对结直肠癌的了解以及他们对潜在结直肠癌筛查计划的看法。卫生工作者分享了他们自己的家庭以及他们在卫生工作中专业接触到的家庭所形成的观点。
参与者对潜在的结直肠癌筛查大多持积极态度;然而,也发现了各种获取障碍。这些障碍包括患者与临床医生的互动和沟通、筛查期间缺乏对患者隐私的保护以及患者参与筛查的积极性受挫。促进筛查的因素包括与全科医生建立良好关系、筛查临床医生花时间建立融洽关系、回答问题并分享信息、符合毛利文化规范的筛查做法以及具备较高的健康素养。
有证据表明毛利族和非毛利族的结直肠癌发病率差距在不断扩大;结直肠癌生存率的差距已经很明显。当前试点项目的参与者可以提供有价值的信息,以帮助确保围绕全国结直肠癌筛查计划的健康教育、推广和临床实践对毛利人有效,从而减少差距并改善健康结果。