与指导方针一致的宫癌查相关的因素出口:混合方法研究研究
Abigael Olson1, Lindsay Fuzzell2, Naomi C Brownstein3
1Boston Medical Center, Boston, Massachusetts.
概括
许多临床医生对宫癌查退出标准缺乏了解,导致老年妇女的查不足. 建议简化指南,以改善遵守和患者护理.
科学领域:
- 妇科 妇科 妇科 妇科
- 公共卫生 公共卫生
- 预防医学 预防医学
背景情况:
- 超过20%的宫癌发生在65岁以上的女性中.
- 目前的指导方针建议在符合特定标准的平均风险人群中,在65岁时停止查.
- 在美国,许多64-66岁的女性没有按照指导方针进行查.
研究的目的:
- 探索临床医生对宫癌查退出标准的知识.
- 确定与指导方针一致的查停止相关的因素,促进者和障碍.
主要方法:
- 一项混合方法研究,涉及全国调查 (n=1,251) 和临床医生的定性访谈 (n=55).
- 准则的一致性是通过对子宫切除术,帕普检测和HPV检测标准的认识来定义的,并排除了那些先前接受过癌前治疗的人.
主要成果:
- 只有35%的临床医生正确确定了所有查退出标准.
- 对于子宫切除术 (>70%) 和先前负面查 (>70%) 标准的认识更高.
- 与正确反应相关的因素包括男性性别,妇产科医生专业和学术/医院实践环境.
结论:
- 临床医生在应用宫癌查退出标准时表现出知识差距和实际困难.
- 增加预期寿命和降低子宫切除率将增加老年妇女的风险人数.
- 简化退出标准可能会提高遵守率并减少查差异.
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