Hatcher-Keller Jennifer, Rayens Mary Kay, Dignan Mark, Schoenberg Nancy, Allison Penne
Lexington, KY.
Lexington, KY.
J Emerg Nurs. 2014 Mar;40(2):e27-35. doi: 10.1016/j.jen.2013.01.015. Epub 2013 Mar 9.
One in 8 US women will develop invasive breast cancer in their lifetime. Despite evidence that mammography is an effective method of early detection, certain vulnerable groups, such as those using the emergency department as a medical home, do not adhere to mammography screening guidelines, and suffer disparate mortality from breast cancer. The purpose of this study was to investigate differences in beliefs regarding mammography screening among women attending the emergency department for nonurgent care and ultimately to develop interventions that promote mammography for this vulnerable population.
We explored the relationship between stage of readiness to adopt mammography behavior and barriers, benefits, and perceived susceptibility by administering scales for risk, benefits, and barriers to a sample of 110 women who had presented to the emergency department of a public hospital for nonurgent complaints or were seated in the ED waiting room. We also collected sociodemographic information and stage of readiness.
Mammography adherence was about 60%. Most women who were not compliant with current guidelines were contemplators. Those who were not contemplating being screened were significantly less likely to perceive themselves to be at risk of getting breast cancer. Women who had more barriers to mammography perceived less benefit from having a mammogram. African American women perceived less benefit from having a mammogram.
Mammography promotion is appropriately placed in the ED waiting room given the suboptimal rate at which this population is being screened. Beliefs regarding mammography differ for women in various stages of mammography adoption and for minority women. Understanding these differences will allow intervention in this setting to be tailored to the population. ED nurses are an important and sometimes sole point of health care contact for patients who routinely visit the emergency department. As such, they have a valuable opportunity to provide cancer screening promotion messages. It is critical that nurses in this setting understand the complexities of delivering this information and the need to do so.
美国每8名女性中就有1人在其一生中会患上浸润性乳腺癌。尽管有证据表明乳腺钼靶检查是早期检测的有效方法,但某些弱势群体,如那些将急诊科作为医疗之家的人,并不遵守乳腺钼靶筛查指南,且乳腺癌死亡率存在差异。本研究的目的是调查因非紧急护理前往急诊科的女性对乳腺钼靶筛查的信念差异,并最终制定促进该弱势群体进行乳腺钼靶检查的干预措施。
我们通过对110名因非紧急投诉前往公立医院急诊科或坐在急诊科候诊室的女性样本进行风险、益处和障碍量表测试,探讨了采用乳腺钼靶检查行为的准备阶段与障碍、益处和感知易感性之间的关系。我们还收集了社会人口统计学信息和准备阶段。
乳腺钼靶检查的依从率约为60%。大多数不遵守现行指南的女性处于考虑阶段。那些没有考虑进行筛查的女性明显不太可能认为自己有患乳腺癌的风险。对乳腺钼靶检查有更多障碍的女性从乳腺钼靶检查中获得的益处较少。非裔美国女性从乳腺钼靶检查中获得的益处较少。
鉴于该人群的筛查率不理想,在急诊科候诊室推广乳腺钼靶检查是合适的。对于处于乳腺钼靶检查采用不同阶段的女性和少数族裔女性,对乳腺钼靶检查的信念存在差异。了解这些差异将使针对该人群的干预措施更具针对性。急诊科护士对于经常前往急诊科的患者来说是重要且有时是唯一的医疗保健接触点。因此,他们有宝贵的机会提供癌症筛查推广信息。在这种情况下,护士了解提供此类信息的复杂性以及这样做的必要性至关重要。