Cadman Louise, Waller Jo, Ashdown-Barr Lesley, Szarewski Anne
Centre for Cancer Prevention, Wolfson Institute of Preventive Medicine, Queen Mary University of London, Bart's and the London School of Medicine, London, UK.
J Fam Plann Reprod Health Care. 2012 Oct;38(4):214-20. doi: 10.1136/jfprhc-2012-100378.
To explore self-reported cervical screening history and barriers to attendance among women who have been sexually abused and to identify measures to improve the experience of cervical screening for these women.
Women visiting the website of the National Association for People Abused in Childhood (NAPAC), who had been sexually abused, were invited to complete a survey of their views and experiences of cervical screening. This included closed questions on demographic characteristics and cervical screening attendance, open questions on barriers to screening, and the opportunity to submit suggestions to improve this experience for women who have been sexually abused. Content analysis was used to code responses to the open questions. Four women also participated in a discussion group.
Overall, 135 women completed the closed questions and 124 provided open-ended responses. 77.5% of responding women who were eligible for cervical screening in England had ever attended, 48.5% at least once in the previous 5 years, but 42.1% of women aged 25-49 within 3 years. A total of nine higher order themes were identified related to barriers to screening, one related to intention to attend screening and five related to suggestions to improve screening.
This study supports the idea that women who have experienced sexual abuse are less likely to attend for regular cervical screening, with under half screened in the last 5 years compared to the National Health Service Cervical Screening Programme figure of 78.6%. Suggestions to improve the experience for abused women focused on communication, safety, trust and sharing control. Further research in this area is warranted to ensure that this at-risk population is appropriately served by cervical screening.
探讨曾遭受性虐待的女性自我报告的宫颈筛查史及筛查障碍，并确定改善这些女性宫颈筛查体验的措施。
邀请访问全国童年受虐者协会（NAPAC）网站且曾遭受性虐待的女性，完成一项关于她们对宫颈筛查的看法和经历的调查。这包括关于人口统计学特征和宫颈筛查参与情况的封闭式问题、关于筛查障碍的开放式问题，以及为改善曾遭受性虐待女性的这种体验提交建议的机会。采用内容分析法对开放式问题的回答进行编码。四名女性还参加了一个讨论小组。
总体而言，135名女性完成了封闭式问题，124名提供了开放式回答。在英格兰符合宫颈筛查条件的女性中，77.5%的应答女性曾参加过筛查，48.5%的女性在过去5年中至少参加过一次，而年龄在25 - 49岁的女性中，42.1%在过去3年中参加过。总共确定了九个与筛查障碍相关的高阶主题、一个与参加筛查意愿相关的主题以及五个与改善筛查建议相关的主题。
本研究支持这样一种观点，即曾遭受性虐待的女性不太可能定期参加宫颈筛查，与英国国家医疗服务体系宫颈筛查计划78.6%的比例相比，过去5年中接受筛查的比例不到一半。为改善受虐女性体验提出的建议集中在沟通、安全、信任和共享控制权方面。有必要在这一领域进行进一步研究，以确保这一高危人群能得到适当的宫颈筛查服务。
