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量身定制的电话咨询,以提高少数族裔、医疗服务不足的女性在巴氏涂片异常后对后续治疗方案的依从性。

Tailored telephone counseling to improve adherence to follow-up regimens after an abnormal pap smear among minority, underserved women.

作者信息

Miller Suzanne M, Hui Siu-kuen Azor, Wen Kuang-Yi, Scarpato John, Zhu Fang, Buzaglo Joanne, Hernandez Enrique E

机构信息

Department of Psychosocial and Behavioral Medicine, Fox Chase Cancer Center/Temple University Health System, USA.

出版信息

Patient Educ Couns. 2013 Dec;93(3):488-95. doi: 10.1016/j.pec.2013.08.008. Epub 2013 Aug 19.

Abstract

OBJECTIVE

The present study explored the impact of a tailored telephone counseling intervention on increasing follow-up adherence after an abnormal Pap smear result among low-income, minority women, which may reduce cervical cancer disparity.

METHODS

Participants (N=211) were randomly assigned to receive: (1) a telephone reminder that included an assessment of barriers to adherence, as well as counseling tailored to the barriers elicited; (2) telephone reminder and barriers assessment, followed by a mailed home tailored barriers print brochure; or (3) enhanced standard care comprising telephone reminder and barriers assessment. Assessments were obtained at initial contact and 1-week later, as well as at 6- and 12-months after the initial colposcopy.

RESULTS

The telephone counseling group showed greater adherence to follow-up recommendations than did the combined other two groups (p<0.05). For the initial colposcopy, tailored telephone barriers counseling was more effective among women with a high school education or less.

CONCLUSION

Tailored telephone barriers counseling improves adherence to initial colposcopy, as well as to longer-term medical follow-up, among low-income, inner-city women.

PRACTICE IMPLICATIONS

Dissemination of barriers counseling into ongoing telephone reminder calls and contacts may decrease disparities in cancer outcomes, especially among women with less than post-secondary education.

摘要

目的

本研究探讨了针对性电话咨询干预对提高低收入少数族裔女性巴氏涂片结果异常后的随访依从性的影响,这可能会减少宫颈癌差异。

方法

参与者(N = 211)被随机分配接受:(1)电话提醒,包括对依从性障碍的评估以及针对所发现障碍的咨询;(2)电话提醒和障碍评估,随后邮寄一份针对家庭的定制障碍印刷手册;或(3)强化标准护理,包括电话提醒和障碍评估。在初次接触时、1周后以及初次阴道镜检查后的6个月和12个月进行评估。

结果

电话咨询组比其他两组的组合表现出更高的随访建议依从性(p<0.05)。对于初次阴道镜检查,针对性电话障碍咨询在高中及以下学历的女性中更有效。

结论

针对性电话障碍咨询可提高低收入城市女性对初次阴道镜检查以及长期医学随访的依从性。

实践意义

将障碍咨询纳入正在进行的电话提醒呼叫和联系中可能会减少癌症结局的差异,尤其是在高中以下学历的女性中。

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