Wilding Sarah, Wighton Sarah, Halligan Daisy, West Robert, Conner Mark, O'Connor Daryl B
School of Psychology, University of Leeds, Leeds, UK.
NHS England and NHS Improvement (North East & Yorkshire), Leeds, UK.
Health Psychol Behav Med. 2020 Aug 7;8(1):314-328. doi: 10.1080/21642850.2020.1798239.
: Cervical cancer is the fourth most commonly occurring cancer in women worldwide. The UK has one of the highest cervical screening rates in Europe, yet attendance has been decreasing. This study aimed to identify barriers and facilitators to screening attendance and assess the perceived importance of these factors. : 194 women living in the UK were recruited via an online research recruitment website to an online survey. Most participants ( = 128, 66.0%) were currently up-to-date with cervical screening, 66 participants (34.0%) had never been screened, or were overdue for screening. Participants identified barriers and facilitators to cervical screening attendance via free-text responses and were also asked to rate a list of factors as most to least influential over decision making. Results were analysed using thematic content analysis and ratings analysed using multivariable analyses. : The most commonly reported barriers were: Pain/discomfort; Embarrassment; and Time. These were also rated as most influential for decision making. The most commonly reported facilitators were: Ease of making appointments; Peace of mind; and Fear of cancer/preventing serious illness. While importance rating of barriers did not differ by previous screening behaviour, ratings of some facilitators significantly differed. Up-to-date women rated believing screening is potentially life-saving and part of personal responsibility as significantly more important than overdue/never screened women. : This study confirmed that factors which encourage screening are key to the decision of whether to attend screening. Women suggested several improvements that might make attending easier and improve uptake, including flexibility of screening locations to fit around work hours and childcare arrangements. Psychological facilitators included the peace of mind that screening brings and the belief that cervical cancer screening is potentially life-saving. Public health interventions should target factors which facilitate screening and how these interplay with barriers in order to improve uptake.
宫颈癌是全球女性中第四大常见癌症。英国的宫颈癌筛查率在欧洲位居前列，但筛查参与率却一直在下降。本研究旨在确定影响筛查参与的障碍和促进因素，并评估这些因素被感知到的重要性。194名居住在英国的女性通过在线研究招募网站被招募参与一项在线调查。大多数参与者（n = 128，66.0%）目前宫颈癌筛查及时，66名参与者（34.0%）从未接受过筛查或筛查逾期。参与者通过自由文本回复确定了宫颈癌筛查参与的障碍和促进因素，并被要求对一系列因素在决策中的影响程度从高到低进行评分。结果采用主题内容分析法进行分析，评分采用多变量分析法进行分析。最常报告的障碍是：疼痛/不适；尴尬；以及时间。这些因素在决策中也被评为最具影响力。最常报告的促进因素是：预约方便；安心；以及对癌症的恐惧/预防重病。虽然障碍的重要性评分不因先前的筛查行为而有所不同，但一些促进因素的评分存在显著差异。筛查及时的女性认为筛查可能挽救生命且是个人责任的一部分，这一点比筛查逾期/从未筛查的女性更为重要。本研究证实，鼓励筛查的因素是决定是否参与筛查的关键。女性提出了一些可能使参与筛查更容易并提高参与率的改进建议，包括筛查地点的灵活性以适应工作时间和儿童保育安排。心理促进因素包括筛查带来的安心感以及认为宫颈癌筛查可能挽救生命的信念。公共卫生干预应针对促进筛查的因素以及这些因素与障碍之间的相互作用，以提高参与率。
