Fayanju Oluwadamilola M, Kraenzle Susan, Drake Bettina F, Oka Masayoshi, Goodman Melody S
Department of Surgery, Washington University School of Medicine, St. Louis, MO, USA.
Joanne Knight Breast Health Center, The Alvin J. Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine, St. Louis, MO, USA.
Am J Surg. 2014 Sep;208(3):425-34. doi: 10.1016/j.amjsurg.2014.03.005. Epub 2014 May 4.
To investigate perceived barriers to mammography among underserved women, we asked participants in the Siteman Cancer Center Mammography Outreach Registry-developed in 2006 to evaluate mobile mammography's effectiveness among the underserved-why they believed women did not get mammograms.
The responses of approximately 9,000 registrants were analyzed using multivariable logistic regression. We report adjusted odds ratios (OR) and 95% confidence intervals (CI) significant at 2-tailed P values less than .05.
Fears of cost (40%), mammogram-related pain (13%), and bad news (13%) were the most commonly reported barriers. Having insurance was associated with not perceiving cost as a barrier (OR .44, 95% CI .40 to .49), but with perceiving fear of both mammogram-related pain (OR 1.39, 95% CI 1.21 to 1.60) and receiving bad news (OR 1.38, 95% CI 1.19 to 1.60) as barriers.
Despite free services, underserved women continue to report experiential and psychological obstacles to mammography, suggesting the need for more targeted education and outreach in this population.
为了调查医疗服务不足的女性在接受乳房X光检查时所面临的感知障碍，我们询问了参与2006年西曼癌症中心乳房X光检查外展登记项目的参与者，以评估移动乳房X光检查在医疗服务不足人群中的有效性——她们认为女性不进行乳房X光检查的原因。
使用多变量逻辑回归分析了约9000名登记者的回答。我们报告了在双侧P值小于0.05时具有统计学意义的调整后比值比（OR）和95%置信区间（CI）。
对费用的担忧（40%）、与乳房X光检查相关的疼痛（13%）和坏消息（13%）是最常被提及的障碍。拥有保险与不将费用视为障碍相关（OR 0.44，95% CI 0.40至0.49），但与将对乳房X光检查相关疼痛的恐惧（OR 1.39，95% CI 1.21至1.60）和收到坏消息（OR 1.38，95% CI 1.19至1.60）视为障碍相关。
尽管有免费服务，但医疗服务不足的女性仍报告在接受乳房X光检查时存在体验和心理障碍，这表明需要针对该人群开展更有针对性的教育和外展活动。
