Teitelbaum M A, Weisman C S, Klassen A C, Celentano D
Department of Health Policy and Management, School of Hygiene and Public Health, Johns Hopkins University, Baltimore, MD 21205.
Med Care. 1988 Jun;26(6):607-18. doi: 10.1097/00005650-198806000-00009.
Using data from a survey of internists, family and general practitioners, and obstetricians and gynecologists, and of women in Maryland, this article examines congruence between physicians' recommendations and women's Papanicolaou (Pap) testing behavior. Both the specialty of the physicians and the age of the women are considered. The majority of all three physician specialties recommended annual Pap tests for all their patients. However, the internists and family or general practitioners were less likely to recommend annual Pap smears for their elderly patients than for their younger patients. Obstetrician-gynecologists were consistently more likely than the other specialties to recommend annual Pap tests, to send postcards to their patients reminding them to come in for Pap tests, and to view themselves as successful in inducing their patients to come in for routine Pap testing. Both the physicians and the women reported that elderly women were less likely than younger women to receive care from obstetrician-gynecologists. Women's reported Pap testing behavior indicated that they received Pap tests with far less frequency than the physicians recommended. Older age was related to less frequent Pap testing, while having a visit with an obstetrician-gynecologist was related to increased frequency. Findings indicate the need for education of physicians about methods of improving women's attendance for Pap testing and of women about the importance of routine Pap testing.
本文利用对内科医生、家庭医生和全科医生、妇产科医生以及马里兰州女性的调查数据，研究了医生的建议与女性巴氏试验行为之间的一致性。研究考虑了医生的专业和女性的年龄。所有这三个医生专业的大多数人都建议为其所有患者进行年度巴氏试验。然而，内科医生以及家庭医生或全科医生为老年患者推荐年度巴氏涂片检查的可能性低于为年轻患者推荐的可能性。妇产科医生始终比其他专业更有可能推荐年度巴氏试验，给患者寄明信片提醒她们前来进行巴氏试验，并认为自己成功地促使患者前来进行常规巴氏试验。医生和女性都报告说，老年女性比年轻女性接受妇产科医生护理的可能性更小。女性报告的巴氏试验行为表明，她们接受巴氏试验的频率远低于医生的建议。年龄较大与巴氏试验频率较低有关，而拜访妇产科医生则与频率增加有关。研究结果表明，需要对医生进行关于提高女性巴氏试验就诊率方法的教育，以及对女性进行关于常规巴氏试验重要性的教育。
