'Worse than HIV' or 'not as serious as other diseases'? Conceptualization of cervical cancer among newly screened women in Zambia
'Worse than HIV' or 'not as serious as other diseases'? Conceptualization of cervical cancer among newly screened women in Zambia
复制标题
DOI：
10.1016/j.socscimed.2012.01.028
复制
发表时间：
2012-05-01
影响因子：
5.4
通讯作者：
Chamot, Eric
中科院分区：
文献类型：
--
作者：
White, Heather L.;Mulambia, Chishimba;Chamot, Eric
侵袭性宫颈癌是全世界妇女中第二大常见癌症，约85%的疾病负担发生在发展中国家。迄今为止，很少有系统的努力来记录非洲妇女在参与以醋酸（VIA）为基础的“看到和治疗”宫颈癌预防项目的目视检查后对宫颈癌的认识。在2009年9月至2010年7月期间进行的这项研究中，对最近在赞比亚卢萨卡一家政府经营的初级保健诊所接受宫颈癌筛查的60名妇女进行了焦点小组和深入访谈。采访者询问了参与者对宫颈癌的因果描述、相关的身体体征和症状、感知到的身体和心理影响以及有关该疾病的社会规范。参与者在最近接触到项目宣传信息后所描绘的疾病因果关系模型在几个方面与世界其他地区所描述的因果模型有所不同。然而，因果概念化既包括非专业因素，也包括生物医学因素，这表明可能从纯粹传统的因果模型转变为结合传统概念和最近推广的生物医学概念的模型。大多数（但不是全部）妇女仍然将子宫颈癌与死亡等同起来，并认为它在赞比亚是一种高度污名化的疾病，因为它的解剖位置、可怕的自然病程、与社会谴责行为的联系以及与艾滋病毒/艾滋病的联系。尽管艾滋病毒抗体呈阳性的妇女承认，她们的免疫状况使她们更了解自己的健康状况，更有可能寻求医疗照顾，但艾滋病毒抗体状况在疾病概念方面没有实质性差异。应进一步关注妇女将新知识纳入她们对子宫颈癌的表述的过程。(C) 2012 Elsevier Ltd.版权所有。
Invasive cervical cancer is the second most common cancer among women worldwide, with approximately 85% of the disease burden occurring in developing countries. To date, there have been few systematic efforts to document African women's conceptualization of cervical cancer after participation in a visual inspection with acetic acid (VIA)-based "see and treat" cervical cancer prevention program. In this study, conducted between September, 2009 July, 2010, focus groups and in-depth interviews were conducted with 60 women who had recently undergone cervical cancer screening at a government-operated primary health care clinic in Lusaka, Zambia. Interviewers elicited participants' causal representations of cervical cancer, associated physical signs and symptoms, perceived physical and psychological effects, and social norms regarding the disease. The lay model of illness causation portrayed by participants after recent exposure to program promotion messages departed in several ways from causal models described in other parts of the world. However, causal conceptualizations included both lay and biomedical elements, suggesting a possible shift from a purely traditional causal model to one that incorporates both traditional concepts and recently promoted biomedical concepts. Most, but not all, women still equated cervical cancer with death, and perceived it to be a highly stigmatized disease in Zambia because of its anatomic location, dire natural course, connections to socially-condemned behaviors, and association with HIV/AIDS. No substantive differences of disease conceptualization existed according to HIV serostatus, though HIV positive women acknowledged that their immune status makes them more aware of their health and more likely to seek medical attention. Further attention should be dedicated to the processes by which women incorporate new knowledge into their representations of cervical cancer. (C) 2012 Elsevier Ltd. All rights reserved.