首页> 外文期刊>Journal of primary care & community health. >Psychosocial Barriers to Follow-up Adherence After an Abnormal Cervical Cytology Test Result Among Low-Income, Inner-City Women
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Psychosocial Barriers to Follow-up Adherence After an Abnormal Cervical Cytology Test Result Among Low-Income, Inner-City Women

机译:低收入,内城女性宫颈细胞学检查结果异常后随访依从性的社会心理障碍

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Objectives: Low-income, inner-city women bear a disproportionate burden of cervical cancer in both incidence and mortality rates in the United States, largely because of low adherence to follow-up recommendations after an abnormal cervical cytology result in the primary care setting. The goals of the present study were to delineate the theory-based psychosocial barriers underlying these persistent low follow-up rates and their sociodemographic correlates. Methods: Guided by a well-validated psychosocial theory of health behaviors, this cross-sectional, correlational study assessed the barriers to follow-up adherence among underserved women (N = 210) who received an abnormal cervical cytology result. Participants were recruited through an inner-city hospital colposcopy clinic, and were assessed by telephone prior to the colposcopy appointment. Results: Participants were largely of African American race (82.2%), lower than high school completion education (58.7%), single, never married (67.3%), and without full-time employment (64.1%). Knowledge barriers were most often endorsed (68%, M = 3.22), followed by distress barriers (64%, M = 3.09), and coping barriers (36%, M = 2.36). Forty-six percent reported more than one barrier category. Less education and being unemployed were correlated with higher knowledge barriers (P < .0001 and P < .01, respectively) and more coping barriers (P < .05 and P < .05, respectively). Women who were younger than 30 years displayed greater distress barriers (P < .05). Conclusion: In the primary care setting, assessing and addressing knowledge and distress barriers after feedback of an abnormal cervical cytology result may improve adherence to follow-up recommendations. The use of structured counseling protocols and referral to navigational and other resources may facilitate this process and thereby reduce disparities in cervical cancer.
机译:目标:在美国,低收入,内城区妇女在宫颈癌的发病率和死亡率上承担着不成比例的负担,这在很大程度上是由于在初级保健机构中宫颈细胞学异常导致对随访建议的依从性较低。本研究的目的是勾勒出这些持续的低随访率及其社会人口学相关因素背后的基于理论的心理社会障碍。方法:在一项经过验证的健康行为心理社会理论的指导下,这项横断面的相关研究评估了接受宫颈细胞学检查结果异常的服务不足的女性(N = 210)的随访依从性。通过市内医院阴道镜检查诊所招募参与者,并在预约阴道镜检查之前通过电话进行评估。结果:参加者主要是非裔美国人种族(82.2%),低于高中完成学历(58.7%),单身,从未结婚(67.3%)和没有全职工作(64.1%)。知识障碍最常得到认可(68%,M = 3.22),其次是遇险障碍(64%,M = 3.09)和应对障碍(36%,M = 2.36)。 46%的人报告了不止一种障碍类别。受教育程度较低和失业与较高的知识障碍(分别为P <.0001和P <.01)和较高的应对障碍(分别为P <.05和P <.05)相关。 30岁以下的女性表现出更大的困扰壁垒(P <.05)。结论:在基层医疗机构中,评估并解决异常子宫颈细胞学检查结果反馈后的知识和困扰障碍可能会提高对随访建议的依从性。结构化咨询协议的使用以及对导航和其他资源的推荐可以促进此过程,从而减少子宫颈癌的差异。

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