Discipline of General Practice, Adelaide Medical School, The University of Adelaide, Adelaide, South Australia, Australia
GPEx Ltd, Unley, South Australia, Australia.
BMJ Open. 2022 Nov 14;12(11):e062823. doi: 10.1136/bmjopen-2022-062823.
To explore general practitioners' (GPs) perspectives on the barriers and facilitators to cervical cancer screening (CCS) for women from culturally and linguistically diverse (CALD) backgrounds.
Qualitative descriptive study involving semi-structured interviews, with interview guide informed by the Theoretical Domains Framework.
Adelaide, South Australia.
Twelve GPs with experience in providing CCS to women from CALD backgrounds participated.
Four main themes emerged: 'importance of clinician-patient relationship', 'patients' cultural understanding regarding health care and CCS', 'communication and language' and 'health system related'. Each theme had several subthemes. GPs' professional relationship with their patients and repeated advice from other clinicians, together with the provision of opportunistic CCS, were described as facilitators, and encompassed the theme of 'importance of clinician-patient relationship'. This theme also raised the possibility of self-collection human papilloma virus tests. Lack of awareness and knowledge, lower priority for cancer screening and patients' individual circumstances contributed to the theme of 'patients' cultural understanding regarding health care and CCS', and often acted as barriers to CCS. 'Communication and language' consisted of language difficulties, interpreter use and use of appropriate resources. Language difficulties were a barrier to the provision of CCS, and GPs used interpreters and written handouts to help overcome this. The theme of 'health system related' involved the increased time needed for CCS consults for CALD women, access to appointments, funding, health promotion and effective use of practice management software.
This study highlights that multiple, inter-related barriers and facilitators influence CALD women's engagement with CCS, and that GPs needed to manage all of these factors in order to encourage CCS participation. More efforts are needed to address the barriers to ensure that GPs have access to appropriate resources, and CALD patients have access to GPs they trust.
探讨全科医生（GP）对文化和语言多样化（CALD）背景下女性宫颈癌筛查（CCS）的障碍和促进因素的看法。
半结构式访谈的定性描述研究，访谈指南受理论领域框架的启发。
南澳大利亚州阿德莱德。
12 名具有为 CALD 背景女性提供 CCS 经验的全科医生参加了研究。
出现了四个主要主题：“临床医生-患者关系的重要性”、“患者对医疗保健和 CCS 的文化理解”、“沟通和语言”以及“与卫生系统相关”。每个主题都有几个子主题。GP 与患者的专业关系以及其他临床医生的反复建议，以及提供机会性 CCS，被描述为促进因素，并包含“临床医生-患者关系的重要性”这一主题。该主题还提出了自我采集人乳头瘤病毒（HPV）检测的可能性。缺乏意识和知识、对癌症筛查的重视程度较低以及患者的个人情况促成了“患者对医疗保健和 CCS 的文化理解”这一主题，并且常常成为 CCS 的障碍。“沟通和语言”包括语言困难、口译员的使用以及适当资源的使用。语言困难是提供 CCS 的障碍，GP 使用口译员和书面传单来帮助克服这一困难。“与卫生系统相关”的主题涉及为 CALD 女性进行 CCS 咨询所需的时间增加、预约机会、资金、健康促进以及实践管理软件的有效使用。
本研究强调了多种相互关联的障碍和促进因素影响了 CALD 女性对 CCS 的参与，并且 GP 需要管理所有这些因素，以鼓励 CCS 的参与。需要做出更多努力来解决这些障碍，以确保 GP 能够获得适当的资源，并且 CALD 患者能够获得他们信任的 GP。
