a Sexual and Reproductive Health , Papua New Guinea Institute of Medical Research , Goroka , Papua New Guinea.
b Kirby , UNSW , Sydney , Australia.
Ethn Health. 2018 Aug;23(6):659-681. doi: 10.1080/13557858.2017.1283393. Epub 2017 Feb 3.
Within their local realities, people experience and interpret disease in diverse ways that do not necessarily correlate or converge with Western biomedical interventions. In the high cervical cancer burden setting of Papua New Guinea, understanding how people experience and interpret cervical cancer is necessary for effective intervention. Drawing on work by Street on the production of unstable biomedical knowledge, we explored how ambiguity and uncertainty, coupled with cultural taboos and linguistic limitations, affect what and how people 'know' about women's reproductive organs and their associated disease.
A qualitative research approach was used to explore and understand how people in PNG articulate matters of health and disease as they relate to cervical cancer and HPV infection. Specifically, how unstable biomedical knowledge is produced and sustained. We employed a mixed-methods approach in collecting data from 208 (147 women) participants between 2011 and 2012 across 3 provinces in PNG.
We found that knowledge and awareness about cervical cancer were poor. Five thematic areas emerged in our analysis, which included the gendered knowledge of women's reproductive health, the burden of cervical cancer in the community and the role (or limitation) of language. We further identified four ways in which ambiguity and uncertainty operate on both sociocultural and biological levels, and in the intersection between to produce unstable biomedical knowledge. These included poor knowledge of where the cervix is located and the uncertainty or unreliability of (lay) diagnoses of disease.
Local understandings of cervical cancer reflected the limitations of Tok Pisin as a lingua franca as well as the wider uncertain biomedical environment where diagnoses are assembled and shared. There is a clear need to improve understanding of the female reproductive organs in order that people, women in particular, can be better informed about cervical cancer and ultimately better receptive to intervention strategies.
在当地现实中，人们以不同的方式体验和解释疾病，这些方式不一定与西方生物医学干预相关或一致。在巴布亚新几内亚宫颈癌负担较高的情况下，了解人们如何体验和解释宫颈癌对于有效的干预至关重要。借鉴 Street 关于不稳定生物医学知识生产的研究，我们探讨了模糊性和不确定性如何与文化禁忌和语言限制相结合，影响人们对女性生殖器官及其相关疾病的“了解”。
采用定性研究方法，探索和了解巴布亚新几内亚的人们如何表达与宫颈癌和 HPV 感染相关的健康和疾病问题。具体来说，探讨不稳定生物医学知识是如何产生和维持的。我们采用混合方法，于 2011 年至 2012 年在巴布亚新几内亚的 3 个省收集了 208 名（147 名女性）参与者的数据。
我们发现，人们对宫颈癌的知识和意识都很差。我们的分析中出现了五个主题领域，包括女性生殖健康的性别知识、社区中宫颈癌的负担以及语言的作用（或局限性）。我们进一步确定了四种模糊性和不确定性在社会文化和生物层面上以及在两者交叉处运作的方式，从而产生不稳定的生物医学知识。这些方式包括对宫颈位置的知识不足以及疾病的（非专业）诊断的不确定性或不可靠性。
当地对宫颈癌的理解反映了作为通用语的皮钦语的局限性以及更广泛的不确定生物医学环境，在这个环境中，诊断是组合和共享的。显然，有必要提高人们对女性生殖器官的理解，以便人们，特别是妇女，能够更好地了解宫颈癌，并最终更好地接受干预策略。
