Morris D L, McLean C H, Bishop S L, Harlow K C
School of Nursing, University of Texas Medical Branch at Galveston, USA.
Nurse Pract. 1998 Apr;23(4):101-2, 108-10, 113-4.
Cervical dysplasia, a precursor to cervical cancer, affects approximately 6% to 10% of women in the United States. Although cervical dysplasia traditionally is diagnosed and treated by gynecologists, nurse practitioners with special education and expertise in the evaluation and treatment of the condition have begun providing care to many women in rural and other medically underserved areas where there is limited access to specialized physicians. This study compared cervical dysplasia evaluation and treatment techniques of 11 gynecologists and 6 nurse practitioners using abstracted patient records. The MDs showed a greater variation in performance than nurse practitioner colposcopists (NPCs) when evaluated on 10 criteria. NPC practices fell within the range of MDs, and when they were statistically different, NPC practices were more consistent with generally accepted medical practice. These data suggest that NPCs were more likely to adhere to a consistent set of practices. It can be concluded that NPCs are viable alternative providers in the evaluation and treatment of cervical dysplasia.
宫颈发育异常是宫颈癌的前驱病变，在美国约6%至10%的女性受其影响。传统上，宫颈发育异常由妇科医生诊断和治疗，但经过特殊教育且在该病症评估和治疗方面具备专业知识的执业护士，已开始为农村及其他医疗服务不足地区的众多女性提供护理，这些地区获得专科医生的机会有限。本研究使用提取的患者记录，比较了11名妇科医生和6名执业护士对宫颈发育异常的评估和治疗技术。在按照10项标准进行评估时，医学博士（MD）的表现差异比执业护士阴道镜检查医师（NPC）更大。NPC的操作落在医学博士的范围内，当二者存在统计学差异时，NPC的操作更符合普遍接受的医疗实践。这些数据表明，NPC更有可能坚持一套一致的操作方法。可以得出结论，在宫颈发育异常的评估和治疗中，NPC是可行的替代医疗服务提供者。
