Møen Kathy Ainul, Terragni Laura, Kumar Bernadette, Diaz Esperanza
a Department of Global Public Health and Primary care , University of Bergen , Bergen , Norway.
b Norwegian Center for Minority Health Research, Norwegian Institute of Public Health , Oslo , Norway.
Scand J Prim Health Care. 2018 Dec;36(4):415-422. doi: 10.1080/02813432.2018.1523986. Epub 2018 Oct 5.
To explore health care providers' (HCPs) experiences regarding cervical cancer screening (CCS) among immigrant women, their strategies to facilitate these consultations and their need for further information.
Exploratory qualitative design.
HCPs who perform CCS: general practitioners, midwives and private gynaecologists, working in Oslo, Norway.
We interviewed 26 general practitioners, 3 midwives and 3 gynaecologists.
Both focus groups and personal in depth semi structured interviews. Interview transcripts were analysed using a thematic analysis approach.
Some of the HCPs' experiences related to CCS were common for all women regardless of their immigrant background, such as the understanding of routines and responsibilities for prevention. Aspects specific for immigrant women were mainly related to organization, language, health literacy levels, culture and gender. Several strategies targeting organizational (longer consultations), language (using interpreters), health literacy (using anatomy models to explain) and culture (dealing with the expression of pain) were reported. Most HCPs had not previously reflected upon specific challenges linked to CCS among immigrant women, thus the interviews were an eye-opener to some extent. HCPs acknowledged that they need more knowledge on immigrant women's' reproductive health.
HCPs' biases, stereotypes and assumptions could be a key provider-level barrier to low uptake of CCS test among immigrants if they remained unexplored and unchallenged. HCPs need more information on reproductive health of immigrant women in addition to cultural awareness. Key Points The participation rate of immigrant women to cervical cancer screening in Norway is low, compared to non-immigrants. This might be partly attributed to health care system and provider, and not only due to the women's preferences. Our focus groups and interviews among health care providers show, that in addition to cultural competence and awareness, they need knowledge on reproductive health of immigrants. We recommend an intervention targeting health care providers to close the gap in cervical cancer screening.
探讨医疗服务提供者（HCPs）在为移民妇女提供宫颈癌筛查（CCS）方面的经历、促进这些咨询的策略以及他们对更多信息的需求。
探索性定性设计。
在挪威奥斯陆工作的进行CCS的HCPs，包括全科医生、助产士和私人妇科医生。
我们采访了26名全科医生、3名助产士和3名妇科医生。
采用焦点小组和个人深度半结构化访谈。访谈记录采用主题分析法进行分析。
一些HCPs在CCS方面的经历对所有女性来说都是常见的，无论其移民背景如何，比如对预防程序和责任的理解。移民妇女特有的方面主要与组织、语言、健康素养水平、文化和性别有关。报告了一些针对组织（更长时间的咨询）、语言（使用口译员）、健康素养（使用解剖模型进行解释）和文化（处理疼痛表达）的策略。大多数HCPs以前没有思考过与移民妇女CCS相关的具体挑战，因此这些访谈在一定程度上让他们大开眼界。HCPs承认他们需要更多关于移民妇女生殖健康的知识。
如果HCPs的偏见、刻板印象和假设得不到探索和质疑，可能会成为移民中CCS检测接受率低的关键提供者层面的障碍。除了文化意识之外，HCPs还需要更多关于移民妇女生殖健康的信息。要点与非移民相比，挪威移民妇女宫颈癌筛查的参与率较低。这可能部分归因于医疗保健系统和提供者，而不仅仅是妇女的偏好。我们在医疗服务提供者中进行的焦点小组和访谈表明，除了文化能力和意识之外，他们还需要关于移民生殖健康的知识。我们建议针对医疗服务提供者进行干预，以缩小宫颈癌筛查方面的差距。
