Department of Obstetrics and Gynaecology, Odense University Hospital, Odense, Denmark.
Institute of Clinical Research, University of Southern Denmark, Odense, Denmark.
BMJ Open. 2019 Feb 27;9(2):e024011. doi: 10.1136/bmjopen-2018-024011.
The aim of this study was to understand causes of attendance and non-attendance to a follow-up cervical cancer screening among human papillomavirus (HPV)-positive women.
Semistructured, individual interviews with HPV-positive women and cervical cancer screening nurses. The interview guide and initial data analysis were guided by existing health behaviour theories. However, as the theories limited the potential of the data material, a grounded theory framework guided the final data analysis.
Interviews were conducted in Dar es Salaam, Tanzania, at Ocean Road Cancer Institute (ORCI) or in the homes of screening clients.
15 interviews were conducted with women who had tested HPV-positive during a patient-initiated screening and been appointed for a follow-up screening 14 months later. Nine women had not attended the follow-up appointment, four had delayed attendance and two had attended on the scheduled date. Further, individual interviews were conducted with the two nurses working at ORCI's screening clinic.
Perceived benefits for attending a patient-initiated screening include treatment of gynaecological symptoms and prevention of disease. The key perceived benefit of a health provider-initiated follow-up screening is prevention, which is challenged by the circumstance that it is seen by women as having merely potential benefit and therefore can be postponed when competing needs are present. Perceived challenges for screening attendance include emotional costs, in the form of fear of the disease, fear of the gynaecological examination as well as direct and indirect economic costs, such as transportation costs, lost income and waiting time.
Cervical cancer screening is one among many tasks that women living in a low-income setting must attend to. Since health provider-initiated follow-up screening is seen as having only potential benefit, attendance can be postponed when competing needs exist.
NCT02509702.
本研究旨在了解 HPV 阳性妇女参加和不参加宫颈癌随访筛查的原因。
对 HPV 阳性妇女和宫颈癌筛查护士进行半结构式个体访谈。访谈指南和初步数据分析以现有的健康行为理论为指导。然而，由于这些理论限制了数据材料的潜力，因此一个扎根理论框架指导了最终的数据分析。
访谈在坦桑尼亚达累斯萨拉姆的海洋路癌症研究所（ORCI）或筛查客户的家中进行。
15 名访谈对象为在患者发起的筛查中 HPV 检测呈阳性，并在 14 个月后预约接受随访筛查的妇女。9 名妇女未参加随访预约，4 名妇女延迟了就诊时间，2 名妇女按计划日期就诊。此外，还对在 ORCI 筛查诊所工作的两名护士进行了个体访谈。
参加患者发起的筛查的主要感知收益包括治疗妇科症状和预防疾病。健康提供者发起的随访筛查的主要感知收益是预防，这受到以下情况的挑战，即女性认为这种筛查只有潜在的益处，因此当存在竞争需求时可以推迟。参加筛查的主要感知挑战包括情绪成本，表现为对疾病的恐惧、对妇科检查的恐惧，以及直接和间接的经济成本，如交通成本、收入损失和等待时间。
宫颈癌筛查是生活在低收入环境中的妇女必须要做的众多任务之一。由于健康提供者发起的随访筛查被认为只有潜在的益处，因此当存在竞争需求时，可以推迟就诊。
NCT02509702。
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