School of Nursing, University of Louisville, Louisville, Kentucky, United States.
College of Nursing, University of Kentucky, Lexington, United States.
Policy Polit Nurs Pract. 2021 Feb;22(1):28-40. doi: 10.1177/1527154420965537. Epub 2020 Oct 19.
Racial disparities in breast cancer screening, morbidity, and mortality persist for Black women. This study examines Black women's mammography beliefs and experiences with specific focus on barriers to mammography access in an urban city in the South East, United States. This retrospective, qualitative study used Penchansky and Thomas' conceptualization of health care access as the framework for the data analysis. In-depth, semistructured interviews were conducted with 39 Black women. Structural and personal factors continue to create barriers to mammography among Black women. Barriers to mammography were identified for each of the Penchansky and Thomas five dimensions of access to care: accessibility, affordability, availability, accommodation, and acceptability. Clinical practice strategies to increase mammography screening in Black women must be multifactorial, patient-centered, and culturally congruent. Policy development must address the structural barriers to mammography screening through expansion of health insurance coverage and increased accessibility to health care.
种族差异在乳腺癌筛查、发病率和死亡率方面仍然存在于黑人女性中。本研究检查了黑人女性的乳房 X 光检查信念和经验,特别关注美国东南部一个城市中获得乳房 X 光检查的障碍。这项回顾性的定性研究使用了彭钱斯和托马斯的医疗保健获取概念作为数据分析的框架。对 39 名黑人女性进行了深入的半结构化访谈。结构性和个人因素继续为黑人女性的乳房 X 光检查造成障碍。在彭钱斯和托马斯的五个医疗保健获取维度中,每个维度都确定了乳房 X 光检查的障碍:可及性、可负担性、可用性、适应性和可接受性。为了增加黑人女性的乳房 X 光检查率,临床实践策略必须是多因素的、以患者为中心的、与文化一致的。政策制定必须通过扩大医疗保险覆盖范围和增加获得医疗保健的机会来解决乳房 X 光检查的结构性障碍。