Cruz-Jiménez L, Torres-Mejía G, Mohar-Betancourt A, Campero L, Ángeles-Llerenas A, Ortega-Olvera C, Martínez-Matsushita L, Reynoso-Noverón N, Duggan C, Anderson B O
Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, Mexico.
Unidad de Epidemiología, Instituto Nacional de Cancerología, Mexico City, Mexico.
Int J Qual Health Care. 2018 Aug 1;30(7):520-529. doi: 10.1093/intqhc/mzy053.
To evaluate facilitators and barriers influencing mammography screening participation among women.
Mixed methods study.
Three hospital catchment areas in Hidalgo, Mexico.
Four hundred and fifty-five women aged 40-69 years.
Three hundred and eighty women completed a survey about knowledge, beliefs and perceptions about breast cancer screening, and 75 women participated in semi-structured, in-person interviews. Survey data were analyzed using logistic regression; semi-structured interviews were transcribed and analyzed using elements of the grounded theory method.
Women were categorized as never having had mammography or having had at least one mammogram in the past.
From survey data, having had a Pap in the past year was associated with ever having had breast screening (odds ratio = 2.15; 95% confidence interval 1.30-3.54). Compared with never-screened women, ever-screened women had better knowledge of Mexican recommendations for the frequency of mammography screening (49.5% vs 31.7% P < 0.001). A higher percentage of never-screened women perceived that a mammography was a painful procedure (44.5% vs 33.8%; P < 0.001) and feared receiving bad news (38.4% vs 22.2%; P < 0.001) compared with ever-screened women. Women who participated in semi-structured, in-person interviews expressed a lack of knowledge about Mexican standard mammographic screening recommendations for age for starting mammography and its recommended frequency. Women insured under the 'Opportunities' health insurance program said that they are referred to receive Pap tests and mammography.
Local strategies to reduce mammogram-related pain and fear of bad news should work in tandem with national programs to increase access to screening.
评估影响女性乳房X光检查参与率的促进因素和障碍。
混合方法研究。
墨西哥伊达尔戈州的三个医院服务区域。
455名年龄在40 - 69岁之间的女性。
380名女性完成了一项关于乳腺癌筛查的知识、信念和认知的调查，75名女性参与了半结构化的面对面访谈。调查数据采用逻辑回归分析；半结构化访谈进行转录，并采用扎根理论方法的要素进行分析。
女性被分为从未进行过乳房X光检查或过去至少进行过一次乳房X光检查。
从调查数据来看，过去一年进行过巴氏涂片检查与曾经进行过乳房筛查相关（比值比 = 2.15；95%置信区间1.30 - 3.54）。与从未接受筛查的女性相比，曾经接受筛查的女性对墨西哥乳房X光检查筛查频率的建议有更好的了解（49.5%对31.7%，P < 0.001）。与曾经接受筛查的女性相比，更高比例的从未接受筛查的女性认为乳房X光检查是一种痛苦的检查（44.5%对33.8%；P < 0.001），并且害怕收到坏消息（38.4%对22.2%；P < 0.001）。参与半结构化面对面访谈的女性表示，她们对墨西哥乳房X光检查的起始年龄标准筛查建议及其推荐频率缺乏了解。参加“机会”医疗保险计划的女性表示，她们会被转介接受巴氏涂片检查和乳房X光检查。
减少与乳房X光检查相关的疼痛和对坏消息恐惧的地方策略应与国家增加筛查可及性的计划协同实施。
