澳大利亚国家宫颈癌筛查计划中，经临床医生支持的自我采集宫颈癌筛查在未筛查和从未筛查过的参与者中的应用体验。
The experience of under-screened and never-screened participants using clinician-supported self-collection cervical screening within the Australian National Cervical Screening Program.
机构信息
Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia.
VCS Population Health, VCS Foundation, Carlton, VIC, Australia.
出版信息
Womens Health (Lond). 2022 Jan-Dec;18:17455065221075905. doi: 10.1177/17455065221075905.
BACKGROUND
Australia has had significant successes in the prevention of cervical cancer. However, there is considerable scope for improving screening participation. In December 2017, Australia shifted from cytology to a human papillomavirus-based screening program as part of the renewed National Cervical Screening Program. This provided the opportunity to introduce a clinician-supported self-collection cervical screening pathway, which allows screening participants aged 30 years or more and who are under-screened or never-screened to screen via a self-collected human papillomavirus test.
OBJECTIVE
This study aimed to explore screening participant experiences of a clinician-supported self-collection cervical screening pathway.
METHODS
Interviews (n = 45) were conducted with participants who had used the clinician-supported self-collection cervical screening pathway in the Australian National Cervical Screening Program between December 2017 and April 2019. Interviews were analyzed using template analysis.
RESULTS
Under-screened and never-screened participants reported a variety of interrelated barriers to cervical screening due to the nature of the test. For these participants, self-collection was a preferable way to perform screening as it overcame various barriers, was easy to use and promoted a sense of empowerment. Participants reported that the role of their practitioner was influential in their decision to undertake cervical screening, and that the support and information provided was a key factor in their experiences of the self-collection pathway.
CONCLUSION
Findings support the use of a clinician-supported model of care, as an alternative screening modality in Australia's National Cervical Screening Program. As more countries consider the move from a cytology to human papillomavirus-based cervical screening program, this model may assist in greater engagement of under-screened participants.
背景
澳大利亚在预防宫颈癌方面取得了重大成功。然而，在提高筛查参与率方面仍有很大的空间。2017 年 12 月，澳大利亚将宫颈癌筛查从细胞学检查转变为基于人乳头瘤病毒的筛查项目，作为国家宫颈癌筛查项目更新的一部分。这为引入临床医生支持的自我采集宫颈癌筛查途径提供了机会，该途径允许年龄在 30 岁及以上、筛查不足或从未接受过筛查的筛查参与者通过自我采集的人乳头瘤病毒检测进行筛查。
目的
本研究旨在探讨筛查参与者对临床医生支持的自我采集宫颈癌筛查途径的体验。
方法
对 2017 年 12 月至 2019 年 4 月期间在澳大利亚国家宫颈癌筛查项目中使用临床医生支持的自我采集宫颈癌筛查途径的参与者进行了 45 次访谈。采用模板分析对访谈进行分析。
结果
筛查不足和从未接受过筛查的参与者报告了由于检测性质而导致的各种相互关联的宫颈癌筛查障碍。对于这些参与者来说，自我采集是进行筛查的一种更可取的方式，因为它克服了各种障碍，使用方便，并增强了赋权感。参与者报告说，他们的医生的角色对他们进行宫颈癌筛查的决定有影响，并且所提供的支持和信息是他们自我采集途径体验的关键因素。
结论
研究结果支持在澳大利亚国家宫颈癌筛查项目中使用临床医生支持的护理模式作为替代筛查方式。随着越来越多的国家考虑从细胞学检查转向基于人乳头瘤病毒的宫颈癌筛查项目，这种模式可能有助于提高筛查不足的参与者的参与度。
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