Nessler Katarzyna, Chan Sze Kay Florence, Ball Francis, Storman Monika, Chwalek Michal, Krztoń-Królewiecka Anna, Kryj-Radziszewska Elżbieta, Windak Adam
Department of Family Medicine, Jagiellonian University Medical College, Kraków, Poland
Department of Family Medicine, Jagiellonian University Medical College, Kraków, Poland.
BMJ Open. 2019 Aug 30;9(8):e031317. doi: 10.1136/bmjopen-2019-031317.
Despite worldwide efforts in encouraging routine pap smears for early detection of cervical cancer, Poland's screening rate lags behind the rest of the European Union at 20.2%. Family physicians (FPs) in Poland rarely perform pap smears, and little is known about the experiences and attitudes of Polish patients regarding pap smear screening in a primary healthcare (PHC) setting.
A cross-sectional questionnaire-based survey was performed. Questionnaires were distributed among 43 FPs and 418 of their patients in one Polish region. The data from patients were associated with the doctors' characteristics. Descriptive statistics, the χ test and the Mann-Whitney U test were used for analysis.
Nearly two-thirds of patients (66%) declared willingness to undergo free pap smear screening by their FPs, with the most common reason being time saved. Among those objecting to receive pap smears from their FPs, immediate specialist care provided by gynaecologists in case of adverse results was the main concern. The factors that positively influenced the patients' decision to undergo cervical cancer screening in PHC were: (1) living in a city with more than 100 000 inhabitants, (2) being single, (3) having a female FP or (4) a physician with specialty training in family medicine.
There is high level of acceptance for pap smears performed in PHC offices among patients in Poland. They are more likely to comply with the screening due to easy access. Establishing a solid physician-patient relationship is also crucial in encouraging screening.
尽管全球都在努力鼓励进行常规巴氏涂片检查以早期发现宫颈癌，但波兰的筛查率仅为20.2%，落后于欧盟其他国家。波兰的家庭医生很少进行巴氏涂片检查，对于波兰患者在初级医疗保健（PHC）环境中进行巴氏涂片筛查的经历和态度知之甚少。
进行了一项基于问卷调查的横断面研究。在波兰的一个地区，向43名家庭医生及其418名患者发放了问卷。患者的数据与医生的特征相关联。采用描述性统计、χ检验和曼-惠特尼U检验进行分析。
近三分之二的患者（66%）表示愿意接受家庭医生提供的免费巴氏涂片筛查，最常见的原因是节省时间。在那些拒绝接受家庭医生进行巴氏涂片检查的患者中，主要担忧是如果结果不佳，妇科医生能否立即提供专科护理。对患者在初级医疗保健机构进行宫颈癌筛查决策产生积极影响的因素包括：（1）居住在人口超过10万的城市，（2）单身，（3）有女性家庭医生或（4）有家庭医学专业培训的医生。
波兰患者对在初级医疗保健机构进行巴氏涂片检查的接受程度较高。由于易于获得，他们更有可能遵守筛查。建立稳固的医患关系对于鼓励筛查也至关重要。
