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脑瘫女性定期参加筛查项目的障碍和促进因素:定性生命历程研究。

Barriers and enablers to participating in regular screening programmes for women with cerebral palsy: A qualitative life course study.

机构信息

School of Nursing, University of Birmingham, Birmingham, UK.

Birmingham Women's and Children's Hospital NHS Foundation Trust, Birmingham, UK.

出版信息

J Adv Nurs. 2022 Mar;78(3):823-833. doi: 10.1111/jan.15058. Epub 2021 Oct 6.

Abstract

AIMS

To determine the barriers and enablers to regular, women-oriented screening programmes for women with cerebral palsy (CP); and to discuss the participants' suggestions for change.

DESIGN

Qualitative life course approach.

METHODS

Twenty-five life course interviews were conducted with women in 2020 who identified as having a diagnosis of CP. Interviews were conducted in person or using electronic platforms. Framework analysis was used to interpret the data.

FINDINGS

Access and utilization of regular screening programmes for women with CP across the life course are determined by multiple socioecological factors. Three themes are discussed focusing particularly on cervical and breast screening: 1. barriers, 2. enablers and 3. women's suggestions for change. Some women chose to opt out of sexual health checks for fear they would be too uncomfortable or the procedure would be too difficult. Practitioner attitudes towards disability in general, as well as the extent to which they understood the effects of CP for women, was highlighted as a barrier. Accessibility and adaptability of the environment also influenced women's uptake of screening.

CONCLUSION

Women with CP face many challenges to their sexual and reproductive healthcare. These can deter them from participating in regular women-oriented screening programmes, which puts them at higher risk of preventable diseases. Understanding the lifelong effects of CP for women, and the interaction with their reproductive health could help to reduce unmet needs and increase participation in relevant screening across the life course.

IMPACT

Knowledge of the challenges to regular screening programmes experienced by women with CP across the life course is crucial to provide appropriate preventative healthcare for women with CP across different stages of life. Elements of this knowledge could have benefits for the care of all disabled women.

摘要

目的

确定针对脑瘫(CP)女性的定期、以女性为导向的筛查计划的障碍和促进因素;并讨论参与者对改变的建议。

设计

定性生命历程方法。

方法

2020 年,对 25 名被诊断为 CP 的女性进行了 25 次生命历程访谈。访谈通过面对面或电子平台进行。使用框架分析来解释数据。

结果

在整个生命历程中,CP 女性定期接受筛查计划的机会和利用率取决于多个社会生态因素。讨论了三个主题,重点关注宫颈癌和乳腺癌筛查:1. 障碍,2. 促进因素,3. 女性对改变的建议。一些女性选择不参加性健康检查,因为她们担心会感到太不舒服或检查过程太困难。医生对残疾的一般态度,以及他们对 CP 对女性的影响的理解程度,被认为是一个障碍。环境的可及性和适应性也影响了女性对筛查的接受程度。

结论

CP 女性在性健康和生殖健康方面面临许多挑战。这些因素可能会阻止她们参加常规的以女性为导向的筛查计划,从而使她们面临更高的可预防疾病风险。了解 CP 对女性的终身影响以及与生殖健康的相互作用,有助于减少未满足的需求,提高整个生命历程中相关筛查的参与度。

影响

了解 CP 女性在整个生命历程中定期筛查计划所面临的挑战,对于为不同生命阶段的 CP 女性提供适当的预防保健至关重要。这些知识的某些方面可能对所有残疾女性的护理都有好处。

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