Lauver D, Coyle M, Panchmatia B
School of Nursing, University of Wisconsin-Madison, USA.
Womens Health Issues. 1995 Spring;5(1):27-35. doi: 10.1016/1049-3867(94)00060-4.
Of note, these findings are based on women who did seek care for symptoms, rather than those who did not. However, the sample does include late care seekers; 23% of participants sought care after 3 months, and 3.6% waited more than a year. Delay often is defined as seeking care 3 months after symptoms are noted. Community health workers, such as public health nurses, may be able to document barriers among women who have symptoms but have not sought care. In this sample of predominantly low-income, minimally educated participants, women were motivated to seek care for their breast symptoms to obtain consultations and diagnoses, as well as to deal with their concerns about their symptoms and possible cancer diagnoses. Clinicians can recognize women's need to know the meaning of their symptoms, providing clarification as soon as possible and reassurance as appropriate. Clinicians and families can affirm that making time for women's symptom evaluations is a priority. Knowing that women's common barriers to accessing the health care system involve financial, time, and logistical considerations can direct health care administrators' agendas. Administrators, clinicians, and women can work for changes in health policies to assure universal coverage for preventive services for all women.
值得注意的是，这些发现基于那些确实因症状而寻求治疗的女性，而非未寻求治疗的女性。然而，样本中确实包括了延迟寻求治疗者；23%的参与者在出现症状3个月后才寻求治疗，3.6%的人等待了一年以上。延迟通常被定义为在出现症状3个月后才寻求治疗。社区卫生工作者，如公共卫生护士，或许能够记录有症状但未寻求治疗的女性所面临的障碍。在这个主要由低收入、受教育程度极低的参与者组成的样本中，女性因乳房症状而寻求治疗的动机是为了获得咨询和诊断，以及处理她们对症状和可能的癌症诊断的担忧。临床医生能够认识到女性了解自身症状含义的需求，尽快给予解释并在适当的时候给予安慰。临床医生和家人可以确认，优先为女性进行症状评估。了解到女性在获取医疗保健系统服务方面常见的障碍涉及经济、时间和后勤等方面的考虑，能够指导医疗保健管理人员的工作议程。管理人员、临床医生和女性可以共同努力推动卫生政策的变革，以确保为所有女性提供普遍的预防性服务覆盖。
