Chan Dorothy N S, So Winnie K W
Author Affiliation: The Nethersole School of Nursing, The Chinese University of Hong Kong, Shatin, Hong Kong.
Cancer Nurs. 2017 Nov/Dec;40(6):E1-E30. doi: 10.1097/NCC.0000000000000436.
Cervical cancer can be prevented by effective screening using Papanicolaou tests, but the utilization rate is lower among ethnic minorities than in the general population. Understanding the factors influencing minorities' use of such screening can aid the design of an appropriate intervention to increase their uptake rate.
The aims of this study were to examine the factors that influence ethnic minority women in using cervical cancer screening and the similarities and differences in associated factors across different groups and to explore the interrelationships between the factors identified.
A literature search was conducted using Ovid MEDLINE, Cumulative Index to Nursing and Allied Health Literature Plus, Scopus, PsycINFO, and PubMed. Furthermore, 1390 articles were retrieved, of which 24 met the inclusion criteria. Critical appraisal was performed by means of a quality assessment tool. The findings were summarized in tabular and narrative forms.
The findings showed that certain factors commonly affected ethnic minority women's screening behavior, including knowledge, attitude and perceptions, physician's recommendation, quality of care and service, language, and acculturation. Culture-related factors, religion, and acculturation exhibited close interrelationships with the attitude and perceptions factor, resulting in behavioral change.
The review sheds light on how common or unique are the factors across ethnic minorities and how these factors interact to influence behavior. Further studies are warranted to develop and test empirically a comprehensive model leading to a better understanding of the interrelationships between multiple factors.
The model should be useful in informing policy makers about appropriate resource allocation and in guiding the development of culturally relevant programs to increase screening uptake.
通过巴氏涂片检查进行有效筛查可预防宫颈癌，但少数族裔的利用率低于普通人群。了解影响少数族裔进行此类筛查的因素有助于设计适当的干预措施以提高其接受率。
本研究旨在探讨影响少数族裔女性进行宫颈癌筛查的因素、不同群体相关因素的异同，并探究所确定因素之间的相互关系。
使用Ovid MEDLINE、护理学与健康相关文献累积索引升级版、Scopus、PsycINFO和PubMed进行文献检索。此外，检索到1390篇文章，其中24篇符合纳入标准。通过质量评估工具进行批判性评价。研究结果以表格和叙述形式进行总结。
研究结果表明，某些因素通常会影响少数族裔女性的筛查行为，包括知识、态度和认知、医生建议、护理和服务质量、语言以及文化适应。与文化相关的因素、宗教和文化适应与态度和认知因素密切相关，从而导致行为改变。
该综述揭示了少数族裔中这些因素的普遍程度或独特性，以及这些因素如何相互作用以影响行为。有必要进行进一步研究，以开发并实证检验一个综合模型，从而更好地理解多种因素之间的相互关系。
该模型应有助于告知政策制定者适当的资源分配，并指导制定与文化相关的项目以提高筛查接受率。
