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“实际上,我有点支持它”:澳大利亚早期采用维多利亚模式的从业者中,从业者支持的自我采集宫颈筛查的定性见解。

'I'm a bit of a champion for it actually': qualitative insights into practitioner-supported self-collection cervical screening among early adopting Victorian practitioners in Australia.

机构信息

Centre for Health Policy, Melbourne School of Population and Global Health, University of Melbourne, Level 4 207 Bouverie Street Carlton, Melbourne, VIC3053, Australia.

Australian Centre for the Prevention of Cervical Cancer, 265 Faraday Street Carlton, Melbourne, VIC3053, Australia (formally known as VCS Foundation).

出版信息

Prim Health Care Res Dev. 2023 Apr 27;24:e31. doi: 10.1017/S1463423623000191.

Abstract

BACKGROUND

Self-collection for cervical screening has been available in the Australian National Cervical Screening Program since 2017 and is now available to all people as an option for cervical screening through a practitioner-supported model. Documenting early adopting practitioner experiences with self-collection as a mechanism to engage people in cervical screening is crucial to informing its continuing roll-out and implementation in other health systems.

AIM

This study aimed to describe the experiences of practitioners in Victoria, Australia, who used human papillomavirus (HPV)-based self-collection cervical screening during the first 17 months of its availability.

METHODS

Interviews ( = 18) with practitioners from Victoria, who offered self-collection to their patients between December 2017 and April 2019, analysed using template analysis.

FINDINGS

Practitioners were overwhelmingly supportive of self-collection cervical screening because it was acceptable to their patients and addressed patients' barriers to screening. Practitioners perceived that knowledge and awareness of self-collection were variable among the primary care workforce, with some viewing self-collection to be inferior to clinician-collected screening. Practitioners championed self-collection at an individual level, with the extent of practice-level implementation depending on resourcing. Concerns regarding supporting the follow-up of self-collected HPV positive patients were noted. Other practical barriers included gaining timely, accurate screening histories from the National Cancer Screening Register to assess eligibility. Practitioners' role surrounded facilitating the choice between screening tests through a patient-centred approach.

摘要

背景

自 2017 年以来,澳大利亚国家宫颈癌筛查计划已经提供了自我采集宫颈癌筛查服务,现在作为一种通过医生支持模式进行宫颈癌筛查的选择,向所有人提供。记录早期采用者在自我采集方面的经验,作为一种让人们参与宫颈癌筛查的机制,对于告知其在其他卫生系统中的持续推广和实施至关重要。

目的

本研究旨在描述澳大利亚维多利亚州的医生在 HPV 为基础的自我采集宫颈癌筛查提供的经验,该服务在其可获得的头 17 个月内使用。

方法

对维多利亚州的医生进行了访谈(=18),他们在 2017 年 12 月至 2019 年 4 月期间为其患者提供了自我采集服务,使用模板分析进行分析。

发现

医生们非常支持自我采集宫颈癌筛查,因为它被患者接受,并解决了患者对筛查的障碍。医生们认为,初级保健人员对自我采集的知识和认识存在差异,有些人认为自我采集不如医生采集的筛查好。医生们在个人层面上支持自我采集,实践层面的实施程度取决于资源。对支持 HPV 阳性患者的自我采集后续工作的关注也存在。其他实际障碍包括从国家癌症筛查登记处及时、准确地获取筛查史以评估资格。医生的角色是通过以患者为中心的方法来促进筛查测试的选择。

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