Department of Preventive Medicine and Public Health, University of Kansas School of Medicine, Kansas City, Kansas, United States of America.
(Retired) School of Nursing, University of Missouri Kansas City, Kansas City, Missouri, United States of America.
PLoS One. 2019 Jul 1;14(7):e0219178. doi: 10.1371/journal.pone.0219178. eCollection 2019.
Despite women with criminal justice involvement reporting routine Papanicolaou (Pap) testing, significant disparities in cervical cancer outcomes exist when compared to women without criminal justice involvement. A possible reason for the discrepancy is that this group of women may be misreporting Pap testing. The objective of this study was to validate self-reported cervical cancer screening among women leaving jails.
We used three methods to validate self-reported cervical cancer screening for women recently released from jail: 1) Medical record review; 2) Semi-structured interview; 3) Pap test knowledge survey. After validating women's self-reported Pap tests with a review of their medical records, we scored interviews for Pap test recall, and used Pap test knowledge survey scores to compare scores between women who accurately reported Pap tests vs. those who did not.
Sixty-one percent (N = 14/23) self-reported cervical cancer screenings were accurate per medical record review. Comparing participants who did and did not accurately self-report a Pap test, we found a significant difference in Pap test recall scores (1.90 vs. 0.00, t = 3.87, p < .01) and Pap test knowledge scores (13.50 vs. 12.13, t = 2.42, p < .05).
Self-report of cervical cancer screening was more likely to be accurate if a woman's Pap test knowledge was high. Clinicians might take extra care in describing screening and distinguishing between Pap tests and pelvic exams to support the cervical health of women with lower knowledge.
尽管有刑事司法涉案经历的女性报告例行巴氏涂片(Pap)检查,但与没有刑事司法涉案经历的女性相比,其宫颈癌结局仍存在显著差异。出现这种差异的一个可能原因是,这群女性可能对巴氏涂片检查的报告有误。本研究的目的是验证刚出狱女性自我报告的宫颈癌筛查情况。
我们使用三种方法来验证刚从监狱释放的女性自我报告的宫颈癌筛查情况:1)病历审查;2)半结构化访谈;3)巴氏涂片检查知识调查。在对女性的巴氏涂片检查进行病历审查验证后,我们对访谈进行巴氏涂片检查回忆评分,并使用巴氏涂片检查知识调查评分来比较准确报告巴氏涂片检查的女性与未准确报告的女性之间的得分。
根据病历审查,61%(N=14/23)的自我报告宫颈癌筛查结果是准确的。比较准确和不准确自我报告巴氏涂片检查的参与者,我们发现巴氏涂片检查回忆评分(1.90 与 0.00,t=3.87,p<.01)和巴氏涂片检查知识评分(13.50 与 12.13,t=2.42,p<.05)存在显著差异。
如果女性的巴氏涂片检查知识较高,那么其对宫颈癌筛查的自我报告更有可能是准确的。临床医生在描述筛查并区分巴氏涂片检查和盆腔检查时可能需要格外小心,以支持知识水平较低的女性的宫颈健康。