宫颈癌高危患者对宫颈癌筛查的认知度和依从性

摘要

目的 探讨宫颈癌高危患者对疾病危险因素的认知程度和筛查依从性的水平并分析影响因素.方法 收集2014-10至2015-06间连续宫颈癌高危患者资料450例,年龄21～65岁,按长期居住地及有无医疗保险分为4组:(第1组)北京市居民有医疗保险组;(第2组)北京市居民无医疗保险组;(第3组)周边地区居民有医疗保险组;(第4组)周边地区居民无医疗保险组.设计封闭式调查问卷进行研究.采用单因素ANOVA及多因素二元回归分析等统计学方法.结果 6项主要危险因素包括高危型人乳头瘤病毒感染、既往多个性伴侣、过早初次性行为、性伴侣为阴茎癌患者、吸烟及多次阴道分娩史.研究对象的认知程度分别为71.1％、38.9％、18.7％、22.0％、13.6％和18.2％.北京地区高于周边地区,医保患者高于无医保患者.研究对象中,90.2％定期筛查宫颈癌,96.7％认同定期筛查宫颈癌,87.1％愿意接受医师的建议.文化程度、有无医疗保险以及长期居住地与宫颈癌筛查的依从性存在相关性(P＜0.05).结论 宫颈癌高危患者对HPV感染的认知度较好,而对其他多种危险因素认知度不高.患者筛查依从性较好,独立影响因素包括文化程度、有无医疗保险和长期居住地.%Objective To assess the amount of knowledge of risk factors for cervical cancer,compliance with screening and influencing factors among high-risk patients.Methods Four hundred and fifty consecutive patients aged 21 to 65 were involved.Data collection took place between October 2014 and June 2015.Participants were divided into four groups:those living in Beijing with health care insurance(group 1),those living in Beijing without health care insurance(group 2),those living in peripheral areas of Beijing with health care insurance(group 3),and those living in peripheral areas without health care insurance(group 4).Enclosed questionnaires were adopted.ANOVA and multivariate logistic regression were used for data analysis.Results Six risk factors of cervical cancer were identified:HR-HPV infection,multiple sexual partners,early-onset of sexual activity,partners with penis carcinoma,cigarette smoking and multiple vaginal deliveries.The awareness rate of the six risk factors was 71.1％,38.9％,18.7％,22.0％,13.6％ and 18.2％,respectively.90.2％ of the participants were regularly screened for cervical carcinoma,96.7％ agreed to regular cervical carcinoma screening,and 87.1％ would like to follow the professional advice about cervical cancer prevention.Education levels,health care insurance and places of residence were correlated with compliance with cervical cancer screening (P ＜ 0.05).Conclusions The awareness of HPV infections is satisfactory while the rate of awareness of other risk factors is generally low in this study.Participants have good compliance with cervical cancer screening.Education levels,health insurance and places of residence are the main influencing factors.Knowledge of the disease should be popularized and health insurance coverage expanded.