格林模式健康教育对育龄妇女宫颈癌筛查知信行水平的影响

目的 探讨格林模式健康教育对育龄妇女宫颈癌筛查知信行水平的影响.方法 将228例育龄妇女按照随机数字表法分为对照组(n=114)和观察组(n=114),对照组行常规健康教育,观察组行格林模式健康教育.比较干预前后两组相关知识掌握情况、态度评分、宫颈癌筛查率以及干预后的满意度.结果 干预后,两组研究对象宫颈癌基础知识和宫颈癌筛查相关事项评分、态度各维度评分均明显高于干预前,且观察组均明显高于对照组,差异均有统计学意义(P﹤0.01).干预后,两组研究对象宫颈癌筛查率均明显提高,且观察组宫颈癌筛查率明显高于对照组,差异均有统计学意义(P﹤0.01).观察组干预满意度明显高于对照组,差异有统计学意义(P﹤0.01).结论 相比传统的健康教育模式,格林模式的健康教育有利于提高育龄妇女的宫颈癌防治相关知识,改善了其对宫颈癌筛查的态度,提高宫颈癌筛查率,这对宫颈癌的预防与治疗有积极意义.     

西藏地区女性对宫颈癌及HPV疫苗认知调查

目的 了解西藏地区9～45岁女性对宫颈癌及HPV疫苗的认知情况,并分析相关因素,引导更多女性做好筛查工作,为西藏地区宫颈癌防治工作提供可靠依据。方法 于2021-01-21-2022-05-10采用偶遇抽样法抽取西藏地区945名9～45岁藏族女性展开问卷调查。根据调查对象对宫颈癌及HPV疫苗认知程度分为认知良好组和认知不良组,采用单因素方差分析、二元logistic回归法分析宫颈癌及HPV疫苗认知程度的影响因素。结果 调查对象对宫颈癌及HPV疫苗的认知良好占9.63%(91/945),认知不良占90.37%(854/945)。被调查者宫颈癌及HPV疫苗认知情况得分为6.16±4.63,认知水平较低。但对疫苗的接受度为87.72%(829/945),处于较高水平。在影响认知程度的单因素分析中,认知良好组年龄在9～30岁,学历为高中及以上,婚姻状况为未婚,常住地址为城镇,家庭人均年收入<2 000元或≥4 000元,职业为公务员或事业单位、公司职员、学生、医务人员的认知程度,高于认知不良组,均P<0.05。影响宫颈癌及HPV疫苗认知程度的多因素logistic回归性分析显示,家...     

图文式健康教育对中晚期肺癌介入治疗患者认知水平、自我管理能力的影响

目的 探究图文式健康教育对中晚期肺癌介入治疗患者认知水平、自我管理能力的影响.方法 将104例中晚期肺癌患者采用简单随机分组法分为观察组及对照组,每组52例.对照组患者接受常规健康教育干预,观察组患者接受图文式健康教育干预,比较两组患者的负性情绪、认知水平、自我管理能力、医护满意度情况以及并发症发生情况.结果 出院前,...     

认知行为干预对乳腺癌患者不良情绪和生活质量的影响

目的探讨认知行为干预对乳腺癌患者不良情绪和生活质量的影响。方法回顾性分析86例女性乳腺癌患者的临床资料,所有患者均接受术后化疗。根据入院后护理方法的不同将患者分为对照组和观察组,每组43例,对照组患者接受常规护理,观察组患者在对照组的基础上接受认知行为干预。比较护理干预前后两组患者的焦虑抑郁量表(HADS)评分及生活质量评分。结果干预前,两组患者的焦虑和抑郁量表评分比较,差异均无统计学意义(P﹥0.05);干预后,两组患者的焦虑和抑郁量表评分均低于本组干预前(P﹤0.05),且观察组患者的焦虑和抑郁量表评分均明显低于对照组(P﹤0.01)。干预前,两组患者的各项生活质量评分比较,差异均无统计学意义(P﹥0.05);干预后,观察组患者情绪功能、认知功能、总体健康评分均高于对照组,疲乏、恶心呕吐、失眠评分均低于对照组,差异均有统计学意义(P﹤0.05)。结论认知行为干预可以有效改善乳腺癌化疗患者的不良情绪,提高其生活质量,值得推广。     

维吾尔族宫颈癌患者认知程度、筛查状况与临床分期的相关性分析

[目的]探讨维吾尔族宫颈癌患者对宫颈癌的认知程度和既往筛查状况与诊断时临床期别的关系。[方法]对初次确诊为宫颈癌的维吾尔族患者进行社会特征、对宫颈癌的认知度、既往宫颈癌筛查间隔时间的问卷调查,并进行统计分析。[结果]共238例患者参与调查,平均年龄为49.62±10.56岁,有42.02%患者对宫颈癌相关知识几乎不知道,仅有22.69%患者有所了解;65.55%患者从未做过宫颈涂片,近3年曾做过宫颈涂片的仅占12.18%。不同期别宫颈癌的患者既往宫颈筛查间隔及宫颈癌相关知识认知程度均有明显差异(χ2=164.26,68.297;P均<0.001);随着既往宫颈筛查间隔时间的延长,宫颈癌相关知识认知程度的降低,宫颈癌期别均呈加重趋势(r=0.521,0.479;P<0.001)。[结论]维吾尔族宫颈癌患者对宫颈癌相关知识认知度低,患者既往筛查状况差,可能是维吾尔宫颈癌患者就诊时期别较晚的重要原因。     

居家认知行为治疗对卵巢癌患者化疗期间心理症状群及希望水平的影响

目的探讨居家认知行为治疗(IH-CBT)对卵巢癌患者化疗期间心理症状群和希望水平的影响。方法采用简单随机化分组的方法将195例行化疗的卵巢癌患者随机分为对照组97例(接受常规护理)和干预组98例(在常规护理的基础上接受IH-CBT)。采用简式简明心境量表(POMS-SF)测评两组患者的心理症状群,采用Herth希望量表测评两组患者的希望水平。结果化疗后,两组患者仍存在紧张-焦虑症状群、精力不足症状群、怨恨症状群,但信息缺乏症状群均消失;对照组患者紧张-焦虑症状群、精力不足症状群、怨恨症状群的各症状均变化不大,干预组患者紧张-焦虑症状群、精力不足症状群、怨恨症状群的各症状均明显缓解。化疗后,干预组患者的希望水平评分明显高于本组化疗前和同时间点对照组患者,差异均有统计学意义(P<0.01)。结论IH-CBT可改善卵巢癌患者的心理症状,提高希望水平,具有临床推广价值。     

云南省成年妇女乳腺癌与宫颈癌筛查率及影响因素分析

摘 要：［目的］ 分析云南省妇女乳腺癌及宫颈癌的筛查率及影响因素。［方法］ 利用2015年中国成人慢性病与营养监测云南省调查数据,分析3428名女性调查对象乳腺癌及宫颈癌筛查率,采用基于复杂抽样的统计分析方法对筛查率及其95%CI进行加权估计,通过多因素Logistic回归模型分析影响筛查率的主要因素。［结果］ 云南省成年妇女乳腺癌筛查率为16.7%（95%CI：13.7%～20.1%）,其中40～69岁妇女乳腺癌筛查率为19.4%（95%CI：17.4%～21.4%）;成年妇女宫颈癌筛查率为21.4%（95%CI：19.4%～23.6%）,其中35～64岁妇女筛查率为24.8%（95%CI：22.1%～27.7%）。多因素分析结果显示,年龄是两癌筛查率的影响因素,35～59岁者乳腺癌筛查率较高,≥70岁者筛查率较低,35～49岁妇女宫颈癌筛查率较高,≥65岁者筛查率较低（P＜0.05）;其他少数民族与汉族相比,乳腺癌筛查率较低（P＜0.05）;文化程度越高的人群、已婚/同居者、城市妇女的两癌筛查率较高（P＜0.05）。［结论］ 云南省妇女两癌筛查率低于全国平均水平,扩展两癌筛查老年人群的年龄覆盖范围、扩大筛查项目覆盖面是目前提高云南省妇女两癌筛查率的主要途径。     

多瘤别癌症风险评估工具对乳腺癌筛查行为的影响

目的 探讨多瘤别癌症风险评估工具对社区女性乳腺癌筛查行为的影响。方法 以2018年5月-2020年5月参与社区居民癌症筛查与早发现管理项目的上海市近郊2个社区共计10 326名女性居民为研究对象,采用自身前后对照的研究方法,比较总体和不同特征对象在风险评估前后乳腺癌筛查行为的变化。采用配对χ²检验对癌症风险评估前后筛查参与率进行比较,以逐步前进法对评估前后筛查参与率的影响因素进行多因素logistic回归分析,并通过皮尔森χ²检验或Fisher确切概率法比较评估后筛查参与者中新增筛查者与非新增筛查者、评估后新增筛查者与评估前筛查者的人群特征差异。结果 研究对象风险评估前2年内和评估后2年内的乳腺癌筛查参与率分别为3.07%(317/10 326)和2.61%(269/10 326)。评估后参加筛查的对象中,新增者占93.31%(251/269)。文化程度、家庭人均月收入、一级亲属癌症家族史和乳腺相关症状史等评估前筛查参与率的影响因素对评估后筛查参与率不再有影响;评估后筛查参与者中,无一级亲属癌症家族史、无二级亲属癌症家族史、无乳腺癌相关疾病史...     

城市女性乳腺癌高危评估及筛查结果分析

目的 分析城市女性乳腺癌高危人群的流行病学特征,为乳腺癌防治提供科学依据。方法 以高危评估问卷、临床体格检查、乳腺B超和钼靶为基础,对24016名城市女性开展乳腺癌筛查,并对筛查结果进行统计学分析。结果 在24016名参加问卷的妇女中,经问卷初筛评估为高危人群的有1890名,其中有14例被诊断为乳腺癌,乳腺癌筛查阳性率为0.583‰。单因素分析显示,乳腺癌检出率在饮酒习惯、精神压抑状况、月经初潮年龄、初育年龄、哺乳时长及乳腺癌家族史方面的差异有统计学意义。多因素分析显示,经常饮酒(OR=2.31,95%CI:1.53~4.17)、精神压抑(OR=3.20,95%CI:1.20~8.34)、哺乳时长≤12个月(OR=2.49,95%CI:1.23~5.18)以及有乳腺癌家族史(OR=3.17,95%CI:1.15~5.23)为影响本组人群乳腺癌检出率的独立影响因素。结论 乳腺癌高危人群筛查策略是一种高效经济的筛查方式。经常饮酒、精神压抑、哺乳时长≤12个月以及有乳腺癌家族史人群是乳腺癌筛查过程中需重点关注的人群。     

宫颈癌放疗患者的健康教育

宫颈癌是女性常见的恶性肿瘤，发病率居首位。放疗是治疗浸润性宫颈癌最有效的方法。但在进行放射治疗时，可出现局部和／或全身的放疗反应。由于疗程长，不良反应多，患者对治疗的配合起着非常重要的作用。自2002年1月～2003年11月以来，我们对112例宫颈癌放疗患者进行了宫颈癌放疗知识的健康教育，使患者在治疗中能够积极参与，主动配合，取得良好效果。所有患者均顺利地完成了疗程，熟悉了放疗中和出院后的注意事项，减轻或减少了放疗的不良反应及常见并发症的发病率，提高了生活质量。现将健康教育的方法报告如下。     

Differences in predictors of cervical and breast cancer screening by screening need in uninsured Latino women

BACKGROUND: Latino women experience higher mortality for cervical cancer and lower 5-year survival for breast cancer than non-Latino White women. Adherence with screening recommendations can increase chances of survival, yet the factors that influence screening behaviors in uninsured women are not well documented. METHODS: Uninsured Latino women (N = 467) recruited in four US cities participated in the study. Logistic regression was used to model adherence to recommendations by screening type (cervical or breast cancer) and screening need (needs to obtain initial screening, overdue for rescreening, up-to-date with rescreening). RESULTS: Predictors differed by type of screening and screening need. Women who reported exposure to cancer education were more likely to have had a mammogram and to be up-to-date with Pap smear screening than women without such exposure. Women who were younger, had more than a sixth grade education, and/or had children were more likely to have had a Pap smear. Older women who had been in the US the longest were more likely to be overdue for a Pap smear. Women with incomes 5000 to 7000 were more likely to have obtained a mammogram. Regional differences were found with respect to mammography screening and maintenance behaviors. CONCLUSIONS: Exposure to cancer education is an important predictor of screenings among uninsured urban Latino women. The potential of creating educational interventions that can increase screening rates among women who evidence health disparities is encouraging. Recruitment strategies to reach women in need of screenings are provided.     

Interval cancers following breast cancer screening in Singaporean women

Our study reports on the interval cancers arising in the subsequent 3 years in women screened as part of the Singapore Breast Cancer Screening Programme that commenced in 1994. Women, the majority of Chinese ethnicity, were either invited or not invited by random allocation to be screened. All women, other than those identified with breast cancer at screening, whether invited or not, were followed for 3 years, and information on all breast cancers arising in this period was obtained through the national registry. In particular, the cancers arising from those women who were deemed free of the disease at screening were noted. The mammographs taken at screening of those women who developed such an interval cancer were rereviewed by 3 radiologists. In the 28,099 women who were screened and deemed free of disease, 59 interval cancers were reported with annual rates of 2.1, 10.6 and 10.8 per 10,000 women-years in the succeeding 3-year periods. In 39,425 women who were invited but declined screening, the rates were 17.0, 15.5 and 11.7, while the corresponding rates from 97,294 women not invited were 12.8, 13.3 and 13.0. Whereas the annual incidence at 1 year in women who have been screened is much lower than those in the 2 groups who were not screened, it is of a similar magnitude by 2 years. This suggests that locally an optimal screening interval may be close to 1 year. The rereview of the mammograms of those 59 women with interval cancers suggested that the maximum possible number of these that might have been detected at screening was 10 (17%).     

卫生资源匮乏地区绝经后妇女宫颈癌筛查方法的探讨

目的:探讨适合于卫生资源匮乏地区绝经后妇女的宫颈癌筛查策略.方法:选择已绝经女性405例,所有筛查对象均进行宫颈薄层液基细胞学检测(liquid-based cytology test,LBC)、高危型人乳头瘤病毒DNA检测(high-risk human papilloma virus test,HR-HPV)及P1...     

Effect of mammographic service screening on stage at presentation of breast cancers in Sweden

BACKGROUND

Previous results have shown a reduction in mortality with service screening in Sweden on the order of 40%. If the rate of tumors at a later stage were similarly reduced, this would give further support to the mortality findings.

METHODS

The rates of lymph node‐positive cancers, of tumors >2 cm in pathological size, and of tumors of TNM stage II or worse before and after the introduction of screening were compared in 13 areas in Sweden, adjusted for changes in overall incidence during the period of study and stratified by age (40–49 and 50–69 years).

RESULTS

Data were obtained on a total of 23,092 cancers and 10,177,113 person‐years of observation. In women exposed to screening in the screening epoch, there was a significant 45% reduction in tumors of size >2 cm compared with the prescreening (relative risk [RR] = 0.55, 95% confidence interval [CI]: 0.46–0.66) in the 40–49 age group, and a 33% reduction in the 50–69 group (RR = 0.67, 95% CI: 0.62–0.72). For lymph node‐positive and stage II+ disease, there were smaller but still significant reductions. No reduction in incidence in later‐stage disease was observed in the unexposed women in the screening epoch.

CONCLUSIONS

Screening has significantly and substantially reduced the rates of larger tumors and lymph node‐positive breast cancer in Sweden, and the magnitude of the reduction is consistent with the reduction in breast cancer mortality. Cancer 2007. © 2007 American Cancer Society.     

Knowledge attitudes and practices of cervical cancer screening among urban and rural Nigerian women: a call for education and mass screening

NWANKWO K.C., ANIEBUE U.U., AGUWA E.N., ANARADO A.N. & AGUNWAH E. (2011) European Journal of Cancer Care 20 , 362–367
Knowledge attitudes and practices of cervical cancer screening among urban and rural Nigerian women: a call for education and mass screening The incidence of cervical cancer has declined in developed nations due to routine use of cervical cancer screening services. In developing nations opportunistic screening is the practice, and many women present with late‐stage disease. This study was designed to ascertain the knowledge of the women in Nigeria to cervical cancer, their practice of cervical cancer screening and factors hindering the use of available screening services. A cross‐sectional study was done with interviewer‐administered questionnaire. Only the consenting women attending an annual Christian religious meeting in 2007 in three towns in Enugu, South Eastern Nigeria participated. Only 15.5% of the respondents were aware of availability of cervical cancer screening services. The awareness significantly varied with the level of educational attainment (P < 0.0001). Only 4.2% had ever done Pap smear test and all were referred for screening. The most important factors hindering the use of available cervical cancer screening services were lack of knowledge (49.8%) and the feeling that they had no medical problems (32.0%). There is very poor knowledge and practice of cervical cancer screening among Nigerian women. Effective female education and free mass screening are necessary for any successful cervical cancer screening programme in Nigeria.     

Distribution of cervical and breast cancer risk factors in women and their screening behaviours

Breast cancer and cervical cancer are important causes of cancer‐related mortality in women all over the world. The present study was conducted in order to investigate the distribution of cervical and breast cancer risk factors in women and their knowledge and behaviours about cancer screening methods. The study is cross‐sectional in nature. It was conducted with the participation of 1,886 women in Turkey. Data were collected through a questionnaire. The knowledge and behaviours of women aged 40 and over about breast cancer or cervical cancer screening methods were investigated according to the education level; results showed that the rates of those who knew and did breast self‐examination were significantly lower in illiterate women. Besides, the rates of women who did breast self‐examination were significantly lower in those who were aged 40 and over, and the rates of those who had clinical breast examination and Pap smear test were significantly lower in women aged 39 and below (p < 0.01). This study identified the most notable breast and cervical cancer risk factors as low education levels, high number of deliveries, short breastfeeding period, obesity and low socio‐economic level. For this reason, public health policies should be developed to minimise these risk factors.     

Awareness of breast and cervical cancer risk factors and screening behaviours among nurses in rural region of Turkey

Breast and cervical cancer are the most common causes of cancer mortality among women worldwide, but actually they are largely preventable diseases. There is limited data on breast and cervical cancer knowledge, screening practices and attitudes of nurses in Turkey. A self-administered questionnaire was used to investigate the knowledge and attitude of nurses on risk factors of the breast and cervical cancer as well as screening programmes such as breast self-examination (BSE), clinical breast examination, mammography (MMG) and papanicolaou (pap) smear test. In total, 125 out of 160 nurses participated in the study (overall response rate was 80.6%). The risk factors and symptoms of breast cancer was generally well known, except for early menarche (23.2%) and late menopause (28.8%). For cervical cancer, the correct risk factors mostly indicated by the nurses were early age at first sexual intercourse (56%), smoking (76%), multiple sexual partners (71.2%). As for screening methods, it was believed that BSE was a beneficial method to identify the early breast changes (84.8%) and MMG was able to detect the cancer without a palpable mass (57.6%). Little was known about the fact that women should begin cervical cancer screening approximately 3 years after the onset of sexual intercourse (23.2%) and if repeated pap smear test were normal, it could be done every 2–3 years. Most of the nurses considered that MMG decreases the mortality in breast cancer (65.6%) and also believed that pap smear test decreases the mortality in cervical cancer (75.2%). Despite high level of knowledge of breast cancer risk factors, symptoms and screening methods, inadequate knowledge of cervical cancer screening method were found among nurses.     

Management of HPV-positive women in cervical screening using results from two consecutive screening rounds

We studied whether triage of human papillomavirus (HPV)-positive women participating in an HPV-based screening programme can be improved by including the HPV result at the previous screen in the triage algorithm. We analyzed data of a subgroup of 366 women from the POBASCAM trial, screened by cytology and HPV cotesting. Women were included if they tested HPV-positive in the second HPV-based screening round. We evaluated the clinical performance of 16 strategies, consisting of cytology, HPV genotyping, and/or previous screen HPV result. The clinical endpoint was cervical precancer or cancer (CIN3+). The current Dutch triage testing policy for HPV-positive women is to refer women for colposcopy if they have abnormal cytology at baseline or after 6–18 months. In the second HPV-based screening round, this strategy yielded a negative predictive value (NPV) of 95.8% (95% confidence interval: 91.9–98.2) and colposcopy referral rate of 37.6% (32.3–43.2%). Replacing repeat cytology by the previous screen HPV result yielded a similar NPV (96.9%, 93.3–98.9) and colposcopy referral rate (38.8%, 33.4–44.4). A higher NPV (99.2%, 96.3–100%) at the cost of a higher colposcopy referral rate (49.2%, 43.6–54.8) was achieved when cytology was combined with HPV16/18 genotyping. The other 13 triage strategies yielded a lower NPV, a higher colposcopy referral rate or performed similarly but required additional testing. HPV-positive women in the second HPV-based screening round can be suitably managed by cytology, HPV16/18 genotyping and the HPV result at the previous screen, obviating the need for repeat testing of HPV-positive, cytology negative women.