Barriers to accessing cervical cancer screening among HIV positive women in Kgatleng district, Botswana: A qualitative study
Barriers to accessing cervical cancer screening among HIV positive women in Kgatleng district, Botswana: A qualitative study
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DOI：
10.1371/journal.pone.0205425
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发表时间：
2018-10-24
期刊：
影响因子：
3.7
通讯作者：
Mash, Bob
中科院分区：
文献类型：
--
作者：
Matenge, Tjedza G.;Mash, Bob
与高收入国家相比，低收入和中等收入国家的宫颈癌负担更大，但筛查覆盖率较低。此外，农村地区和艾滋病毒阳性人群的筛查率和疾病结果普遍较差。提高筛查率的努力对于降低癌症相关发病率和死亡率至关重要。本研究旨在探讨的障碍，艾滋病病毒感染的妇女访问宫颈癌筛查Kgatterdistrict，Botswano.MethodsA现象学的定性研究利用半结构化的采访与14名艾滋病毒阳性的妇女，选定的目的性抽样。逐字转录的采访和5个步骤的框架方法，辅助下，通过EQUAS-TI软件，用于定性dataanalysis.ResultsContextual因素，包括距离，公共交通问题和工作承诺。卫生系统因素突出表明，没有结果、预约制度不一致、排长队和设备短缺以及以病人为中心的沟通技能差，特别是解释和规划技能差。确定的患者因素是缺乏宫颈癌的知识，筛查的好处，治疗的有效性，以及个人的恐惧和misconceptions.ConclusionCervical癌症筛查访问不佳，由于薄弱的初级保健系统，健康促进和信息不足，以及沟通技巧差。这些问题可以通过考虑替代技术和一站式检测和治疗模式得到部分解决。
BackgroundLow and middle-income countries have a greater share of the cervical cancer burden, but lower screening coverage, compared to high-income countries. Moreover, screening uptake and disease outcomes are generally worse in rural areas as well as in the HIV positive population. Efforts directed at increasing the screening rates are important in order to decrease cancer-related morbidity and mortality. This study aimed to explore the barriers to women with HIV accessing cervical cancer screening in Kgatleng district, Botswana.MethodsA phenomenological qualitative study utilising semi-structured interviews with fourteen HIV positive women, selected by purposive sampling. The interviews were transcribed verbatim and the 5-steps of the framework method, assisted by Atlas-ti software, was used for qualitative data analysis.ResultsContextual factors included distance, public transport issues and work commitments. Health system factors highlighted unavailability of results, inconsistent appointment systems, long queues and equipment shortages and poor patient-centred communication skills, particularly skills in explanation and planning. Patient factors identified were lack of knowledge of cervical cancer, benefits of screening, effectiveness of treatment, as well as personal fears and misconceptions.ConclusionCervical cancer screening was poorly accessed due to a weak primary care system, insufficient health promotion and information as well as poor communication skills. These issues could be partly addressed by considering alternative technology and one-stop models of testing and treating.