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了解 HPV 阳性女性在患者与医务人员沟通问题方面的需求和体验:一项定性研究。

Understanding HPV-positive women's needs and experiences in relation to patient-provider communication issues: a qualitative study.

机构信息

Reproductive Health Department, School of Nursing and Midwifery, Tehran University of Medical Sciences, Eastern Nosrat st. Tohid sq, Tehran, 141973317, Iran.

Gynecology Oncology Department, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences (TUMS), Tehran, Iran.

出版信息

BMC Health Serv Res. 2021 Mar 31;21(1):286. doi: 10.1186/s12913-021-06283-w.

Abstract

BACKGROUND

HPV testing has been integrated in cervical cancer screening program. Patient-providers relationship is extremely important to improve cervical cancer screening outcomes. This qualitative study aims to understand HPV-positive women's needs and preferences about HCPs and patient-provider communication based on their experiences of accessing primary and specialized care.

METHODS

We conducted 40 semi-structured interviews with HPV-positive women. Recorded interviews transcribed and analyzed using conventional content analysis approach.

RESULTS

The analysis of the data led to the extraction of three main categories, including: provider's communication and counseling skills, commitment to professional principles, and knowledgeable and competent provider. Women needed understandable discussion about HPV, emotional support and acceptance, receiving HPV-related guidance and advice, and some considerations during clinical appointments. Women needed HCPs to treat them respectfully, gently and with non-judgmental attitude. "Precancerous" and "high-risk" words and watching colposcopy monitor during procedure had made women anxious. Weak referral system and limited interactions among gynecologists and other HCPs highlighted by participants.

CONCLUSION

The results of this study, based on the experiences and perceptions of HPV women receiving health care, contain messages and practical tips to healthcare providers at the primary and specialized levels of care to facilitate patient-provider communication around HPV. Providers need to approach the discussion of HPV with sensitivity and take individual needs and preferences into account to improve the HPV-positive women's healthcare experience.

摘要

背景

HPV 检测已纳入宫颈癌筛查计划。医患关系对于改善宫颈癌筛查结果至关重要。本定性研究旨在根据 HPV 阳性女性在接受初级和专科护理方面的经验,了解她们对卫生保健提供者(HCP)和医患沟通的需求和偏好。

方法

我们对 40 名 HPV 阳性女性进行了半结构式访谈。使用常规内容分析方法对记录的访谈进行转录和分析。

结果

数据分析得出了三个主要类别,包括:提供者的沟通和咨询技巧、对专业原则的承诺以及知识渊博和有能力的提供者。女性需要关于 HPV 的易懂讨论、情感支持和接受、获得 HPV 相关指导和建议,以及在临床预约期间的一些考虑。女性需要 HCP 以尊重、温柔和非评判的态度对待她们。“癌前病变”和“高危”等词以及在进行检查时观看阴道镜监测,使女性感到焦虑。参与者强调转诊系统薄弱以及妇科医生和其他 HCP 之间互动有限。

结论

本研究基于接受医疗保健的 HPV 阳性女性的经验和看法,为初级和专科医疗保健提供者提供了信息和实用建议,以促进围绕 HPV 的医患沟通。提供者需要以敏感性的方式开展 HPV 讨论,并考虑个人需求和偏好,以改善 HPV 阳性女性的医疗保健体验。

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