目的:这项研究的目的是绘制和比较利益相关者对七个欧洲国家弱势女性宫颈癌筛查障碍的看法。
方法:在协作用户委员会中,邀请利益相关方参与,以确定参与宫颈癌筛查的障碍.
方法:该研究嵌套在欧盟资助的CBIG-SCREEN项目中,该项目旨在解决弱势女性宫颈癌筛查中的不平等问题(www.cbig-screen.欧盟)。数据收集在保加利亚进行,丹麦,爱沙尼亚,法国,意大利,葡萄牙和罗马尼亚。
方法:参与者代表微观层面的利益相关者,涵盖用户代表,也就是说,脆弱的女人,涵盖医疗保健专业人员和社会工作者的中观利益相关者,以及涵盖方案管理人员和决策者的宏观利益攸关方。
方法:在七个国家/地区,在2021年10月至2022年6月期间,合作用户委员会举行了25次会议,为期2小时。会议是录像或录音,转录并翻译成英文进行定性框架分析。
结果:120名参与者参加了协作用户委员会。特定背景的障碍与不同的医疗保健系统和弱势群体的特征有关。在罗马尼亚和保加利亚,缺乏持续的筛查工作和缺乏确定合格妇女的方法被认为是所有妇女的障碍,而不是针对处于弱势地位的妇女。与会者在丹麦,爱沙尼亚,法国,意大利和葡萄牙认为提供者对弱势妇女缺乏文化和社会敏感性是障碍。在所有国家,脆弱的女人的恐惧,羞愧和缺乏对预防保健的重视被认为是心理障碍.
结论:该研究概述了七个欧洲国家中利益相关者对弱势妇女参与宫颈癌筛查的感知障碍。各国的医疗保健系统组织和筛查计划的成熟度不同,而弱势女性的心理障碍有几个相似之处。
OBJECTIVE: The aim of this study was to map and compare stakeholders\' perceptions of barriers towards cervical cancer screening for vulnerable women in seven European countries.
METHODS: In Collaborative User Boards, stakeholders were invited to participate to identify barriers towards participation in cervical cancer screening.
METHODS: The study is nested in the European Union-funded project CBIG-SCREEN which aims to tackle inequity in cervical cancer screening for vulnerable women (www.cbig-screen.eu). Data collection took place in Bulgaria, Denmark, Estonia, France, Italy, Portugal and Romania.
METHODS: Participants represented micro-level stakeholders covering representatives of users, that is, vulnerable women, meso-level stakeholders covering healthcare professionals and social workers, and macro-level stakeholders covering programme managers and decision-makers.
METHODS: Across the seven countries, 25 meetings in Collaborative User Boards with a duration of 2 hours took place between October 2021 and June 2022. The meetings were video recorded or audio recorded, transcribed and translated into English for a qualitative framework analysis.
RESULTS: 120 participants took part in the Collaborative User Boards. Context-specific barriers were related to different healthcare systems and characteristics of vulnerable populations. In Romania and Bulgaria, the lack of a continuous screening effort and lack of ways to identify eligible women were identified as barriers for all women rather than being specific for women in vulnerable situations. The participants in Denmark, Estonia, France, Italy and Portugal identified providers\' lack of cultural and social sensitivity towards vulnerable women as barriers. In all countries, vulnerable women\'s fear, shame and lack of priority to preventive healthcare were identified as psychological barriers.
CONCLUSIONS: The study provides an overview of stakeholders\' perceived barriers towards vulnerable women\'s cervical cancer screening participation in seven European countries. The organisation of healthcare systems and the maturity of screening programmes differ between countries, while vulnerable women\'s psychological barriers had several similarities.