Liebermann Erica J, VanDevanter Nancy, Shirazian Taraneh, Frías Gúzman Natalia, Niles Mimi, Healton Cheryl, Ompad Danielle
New York University, New York, NY, USA.
Instituto Nacional de Cáncer Rosa Emilia Sánchez Pérez de Tavares, Santo Domingo, Dominican Republic.
J Transcult Nurs. 2020 Mar;31(2):121-127. doi: 10.1177/1043659619846247. Epub 2019 May 3.
Cervical cancer is the second leading cause of cancer death among women in the Dominican Republic, and high rates persist despite existing Pap smear screening programs. The purpose of this study was to explore Dominican women's knowledge and attitudes regarding human papillomavirus (HPV) and cervical cancer, cervical cancer screening practices, and perceived barriers and facilitators to early detection of cervical cancer. Six focus groups ( = 64) were conducted in Spanish in urban, suburban, and rural locations, in private and public school settings, community and workplace settings, in or near Santo Domingo, as part of a larger study on barriers and facilitators to HPV vaccine implementation. Audio recordings were transcribed verbatim and translated from Spanish to English. Qualitative data analysis used inductive and deductive approaches. Knowledge regarding HPV and cervical cancer varied across groups, but all agreed there was significant stigma and fear regarding HPV. Most women reported having Pap screening at least yearly. Follow-up of abnormal Pap testing was less consistent, with cost and uncertainty about provider recommendations identified as barriers. Broader examination of provider-level and health system barriers and facilitators to cervical cancer prevention in the Dominican Republic is essential, in order to inform interventions to improve the effectiveness of cervical cancer screening and treatment programs and reduce preventable deaths.
宫颈癌是多米尼加共和国女性癌症死亡的第二大主要原因，尽管有现有的巴氏涂片筛查项目，但高发病率仍然存在。本研究的目的是探讨多米尼加女性对人乳头瘤病毒（HPV）和宫颈癌的认识与态度、宫颈癌筛查做法，以及对宫颈癌早期检测的感知障碍和促进因素。作为一项关于HPV疫苗实施的障碍和促进因素的更大规模研究的一部分，在圣多明各及其附近的城市、郊区和农村地区，在私立和公立学校环境、社区和工作场所环境中，用西班牙语进行了6个焦点小组访谈（n = 64）。录音逐字转录并从西班牙语翻译成英语。定性数据分析采用归纳法和演绎法。各群体对HPV和宫颈癌的了解各不相同，但所有人都认为对HPV存在严重的污名化和恐惧。大多数女性报告至少每年进行一次巴氏筛查。对异常巴氏检测的后续跟进不太一致，成本和医生建议的不确定性被确定为障碍。对多米尼加共和国医生层面和卫生系统在宫颈癌预防方面的障碍和促进因素进行更广泛的研究至关重要，以便为改善宫颈癌筛查和治疗项目的有效性及减少可预防死亡的干预措施提供信息。
