An exploration of opportunities and challenges facing cervical cancer managers in Kenya.
An exploration of opportunities and challenges facing cervical cancer managers in Kenya.
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DOI：
10.1186/1756-0500-6-136
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发表时间：
2013-04-08
影响因子：
1.8
通讯作者：
McDonnell, Geoff
中科院分区：
文献类型：
--
作者：
Kivuti-Bitok, Lucy W;Pokhariyal, Ganesh P;McDonnell, Geoff
背景：与其他发展中国家一样，肯尼亚的资源配置较低，在宫颈癌的管理方面面临着许多挑战。这项研究从卫生保健工作者的角度记录了在管理宫颈癌方面遇到的机遇和挑战。对参与宫颈癌手术水平管理的护士和医生的宫颈癌管理人员进行了定性研究。受访者来自肯尼亚的四家省级医院和仅有的两家主要的国家公立转诊医院。21[21]名护士经理和12[12]名医生使用标准化的面试指南进行了访谈。这些回复被录音，逐字转录，并以新兴主题分析内容。FINDINGS：确定了四个主题。与患者相关的挑战包括大量患者在疾病晚期出现，对宫颈癌的知识水平较低，筛查水平较低，对筛查程序的态度较差。个别保健提供者发现，缺乏专门培训、难以向患者披露诊断结果、对宫颈癌筛查程序的态度不佳以及对宫颈癌患者的态度不佳。卫生设施缺乏基础设施和医疗用品。一些经理人觉得自己的技术技能很差，而大多数人无法上网。在肯尼亚，手机被认为具有改善宫颈癌管理的巨大潜力。结论：肯尼亚在宫颈癌管理方面面临着无数的挑战。对筛查程序的特殊负面态度和一些管理人员对宫颈癌患者的负面态度亟待关注。应该探索手机在宫颈癌治疗中的潜在用途。
BACKGROUND: Kenya like other developing countries is low in resource setting and is facing a number of challenges in the management of cervical cancer. This study documents opportunities and challenges encountered in managing cervical cancer from the health care workers' perspectives. A qualitative study was conducted among cervical cancer managers who were defined as nurses and doctors involved in operational level management of cervical cancer. The respondents were drawn from four provincial hospitals and the only two main National public referral hospitals in Kenya. Twenty one [21] nurse managers and twelve [12] medical doctors were interviewed using a standardized interview guide. The responses were audio recorded, transcribed verbatim and the content analyzed in emerging themes.FINDINGS: Four themes were identified. Patient related challenges included a large number of patients, presenting in the late stage of disease, low levels of knowledge on cancer of the cervix, low levels of screening and a poor attitude towards screening procedure. Individual health care providers identified a lack of specialised training, difficulty in disclosure of diagnosis to patients, a poor attitude towards cervical cancer screening procedure and a poor attitude towards cervical cancer patients. Health facilities were lacking in infrastructure and medical supplies. Some managers felt ill-equipped in technological skills while the majority lacked access to the internet. Mobile phones were identified as having great potential for improving the management of cervical cancer in Kenya.CONCLUSION: Kenya faces a myriad of challenges in the management of cervical cancer. The peculiar negative attitude towards screening procedure and the negative attitude of some managers towards cervical cancer patients need urgent attention. The potential use of mobile phones in cervical cancer management should be explored.