Identifying personal health-related resources of women with breast cancer for nursing: An integrative review

Personal health-related resources are essential for women with breast cancer, as these help them to maintain their own health and well-being during different phases of their illness. The purpose of this integrative review was to identify, describe and synthetise what personal health-related resources have already been identified for this patient group. We carried out an integrative review to find papers that focused on personal health-related resources for women with breast cancer aged 18–64 years. The search covered 1 January 2005 to 31 May 2021 and was carried out using the CINAHL, PubMed, PsycINFO, Web of Science and Cochrane Library databases. It was limited to peer-reviewed scientific papers with abstracts published in English and 23 papers met the inclusion criteria. The data were analysed using content analysis. Personal health-related resources for women with breast cancer consisted of three different, but inherently interconnected, categories of personal strengths, person-centred cancer care and social support from and involvement in their cultural community. Personal health-related resources for women with breast cancer were multifaceted. Women need nursing support to identify and use these resources and future studies are needed to strengthen how they are measured.     

Arguments in favor of HPV testing for cervical screening and post-treatment CIN2+ monitoring

Several studies have shown that the human papilloma virus (HPV) test is a more sensitive and objective primary cervical cancer screening tool than cytology. Therefore, conversion of cytology into HPV screening (as is planned in The Netherlands and some other European regions) will result in a better protection against cervical cancer and high-grade precursor lesions. Moreover, offering self-sampling for HPV testing will increase screening attendance by re-attracting former non-attendees. However, triage of HPV positive women is necessary because the specificity of HPV testing is 2–4% lower than of cytology. Several triage strategies have been evaluated, of which two, with cytology testing included, are feasible and were recently recommended. As an alternative for cytology triage, objective, non-morphological disease markers are upcoming and so far have shown promising results. Finally, HPV testing can also contribute to a more efficient monitoring of women treated for high-grade cervical precursor lesions, permitting fewer follow-up visits.     

人乳头瘤病毒检测及液基细胞学检查在宫颈癌筛查中的应用

目的比较人乳头瘤病毒(HPV)检测、液基细胞学检测在宫颈癌和癌前病变筛查中的应用价值。方法对门诊1 200例女性患者行液基细胞学检测(thinprep cytologic test,TCT),对256例患者行HPV-DNA检测。对结果阳性的患者进行阴道镜下宫颈组织病理学检测。结果行TCT检测的1 200例患者中阳性患者为50例,占所有标本的4.2%,行HPV-DNA检测的256例患者中,阳性患者为37例,占所有标本的14.5%。HPV-DNA检测的阳性检出率高于TCT检测,其差异有统计学意义(P<0.01)。结论 HPV检测、液基细胞学检测结合起来的检测方法,明显提高了诊断的准确性,较适合基层医院常规的筛查。     

A decision theory perspective on why women do or do not decide to have cancer screening: systematic review

Title.  A decision theory perspective on why women do or do not decide to have cancer screening: systematic review.
Aim.  This paper is a report of a review in which decision theory from economics and psychology was applied to understand why some women with access to care do not seek cancer screening.
Background.  Mammography and cervical smear testing are effective modes of cancer screening, yet many women choose not to be screened. Nurses need to understand the reasons behind women's choices to improve adherence.
Data sources.  Research papers published between January 1994 and November 2008 were identified using the Cumulative Index to Nursing and Allied Health Literature, MEDLINE and PsycINFO data bases. The search was performed using the following terms: cervical cancer screening, breast cancer screening, decision, choice, adherence and framing. Forty-seven papers were identified and reviewed for relevance to the search criteria.
Methods.  Nineteen papers met the search criteria. For each paper, reasons for obtaining or not obtaining cancer screening were recorded, and organized into four relevant decision theory principles: emotions, Prospect Theory, optimism bias and framing.
Findings.  All women have fears and uncertainty, but the sources of their fears differ, producing two main decision scenarios. Non-adherence results when women fear medical examinations, providers, tests and procedures, do not have/seek knowledge about risk and frame their current health as the status quo. Adherence is achieved when women fear cancer, but trust care providers, seek knowledge, understand risk and frame routine care as the status quo.
Conclusion.  Nurses need to address proactively women's perceptions and knowledge about screening by openly and uniformly discussing the importance and benefits.     

女性宫颈癌早期筛查认知程度的调查分析

目的 了解妇科门诊就诊女性对宫颈癌早期筛查的认知程度.方法 选取1 590例门诊就诊女性,采用自设问卷进行认知程度调查.结果 知道宫颈癌的占96.60％.城市女性对宫颈癌知识的认知程度高于农村;文化程度越高的女性对宫颈癌知识的认知程度越高,差异均具有统计学意义(P＜0.01).结论 女性对宫颈癌早期筛查重要性的认知程度...     

Integrative review of cervical cancer screening in Western Asian and Middle Eastern Arab countries

Population‐based screening programs have resulted in minimizing mortality and morbidity from cervical cancer. The aim of this integrative review was to explore the factors influencing access of women from Western Asian and Middle Eastern Arab countries to cervical cancer screening. A systematic search for studies conducted in Arab countries in those regions, and published in English between January 2002 and January 2017, was undertaken. Thirteen papers were selected and subjected to quality appraisal. A three step analysis was used, which involved a summary of the evidence, analysis of both quantitative and qualitative data, and integration of the results in narrative form. Few population‐based cervical cancer screening programs had been implemented in the relevant countries, with low knowledge of, and perceptions about, cervical screening among Arab women, the majority of whom are Muslim. Factors affecting the uptake of cervical cancer screening practices were the absence of organized, systematic programs, low screening knowledge among women, healthcare professionals’ attitudes toward screening, pain and embarrassment, stigma, and sociocultural beliefs. Policy changes are urgently needed to promote population‐based screening programs. Future research should address the promotion of culturally‐sensitive strategies to enable better access of Arab Muslim women to cervical cancer screening.     

Multifactorial falls interventions for people over 65 years in the acute hospital setting: An integrative review

BackgroundInpatient falls in the elderly are costly health care complications. Multifactorial falls interventions appear to be the most effective in preventing falls, however the majority of studies on multifactorial falls interventions have been conducted in residential aged care settings and rehabilitation units.AimTo evaluate the effectiveness of multifactorial falls interventions for people over 65 years, in the acute hospital setting.MethodsA systematic search of literature in four electronic databases, published in the English language from 2015 to 2020 was conducted. Whittemore and Knafl's framework guided the review.FindingsThe initial search identified 244 papers, nine met the inclusion criteria. Three themes associated with multifactorial falls interventions for people over 65 years in the acute hospital setting emerged from the analysis; (i) Information and education, (ii) Nursing team leadership and the falls team, and (iii) Framework for change.DiscussionMultifactorial falls interventions are effective in the acute hospital setting, particularly those that include a whole team approach, and are supported by strong nurse leadership at executive and ward level.ConclusionSeveral gaps were identified in the literature that may inform future practice, education and research. First, collaboration and co-design with the patient and bedside nurse in the planning, development, and evaluation of falls prevention projects was identified as an important omission. Second, individualised care for the cognitively impaired patient should be the focus of future research.     

Challenges in providing breast and cervical cancer screening services to Vietnamese Canadian women: the healthcare providers' perspective

Breast cancer and cervical cancer are major contributors to morbidity and mortality among Vietnamese Canadian women. Vietnamese women are at risk because of their low participation rate in cancer-preventative screening programmes. Drawing from the results of a larger qualitative study, this paper reports factors that influence Vietnamese women's participation in breast and cervical cancer screening from the healthcare providers' perspectives. The women participants' perspective was reported elsewhere.
Semistructured interviews were conducted with six healthcare providers. Analysis of these interviews reveals several challenges which healthcare providers encountered in their clinical practice. These include the physicians' cultural awareness about the private body, patient's low socioeconomic status, the healthcare provider–patient relationship, and limited institutional support.
This is the first Canadian study to identify the healthcare providers' perspective on giving breast and cervical cancer preventive care to the Vietnamese immigrant women. The insight gained from these healthcare providers' experiences are valuable and might be helpful to healthcare professionals caring for immigrant women of similar ethno-cultural backgrounds. Recommendations for the promotion of breast cancer and cervical cancer screening among Vietnamese women include: (i) effort should be made to recruit Vietnamese-speaking female healthcare professionals for breast and cervical health-promotion programmes; (ii) reduce woman–physicians hierarchical relationship and foster effective doctor–patient communication; (iii) healthcare providers must be aware of their own cultural beliefs, values and attitudes that they bring to their practice; and (iv) more institutional support and resources should be given to both Vietnamese Canadian women and their healthcare providers.     

液基薄层细胞学在宫颈癌筛查中的应用

目的探讨液基薄层细胞学(LBP)在宫颈癌筛查中的应用价值。方法选取2010年1月至2014年9月于广东省第二人民医院行宫颈LBP检查的8 017例受检者为研究对象,根据年龄进行分组,观察结果阳性且愿意接受阴道镜及病理组织活检者的细胞学结果与组织学诊断的符合率。结果共有阳性人数703例,占8.8%,年龄17~70岁,40~49岁年龄组阳性率最高,达13.9%,各组间阳性率差异有统计学意义(χ2=25.741,P=0.000);共有566例患者随后接受了阴道镜检查和病理组织活检,占80.5%,细胞学与组织学结果总符合率为62.5%,高级别病变符合率100.0%。结论 LBP检查在宫颈癌筛查中具有操作简便、准确率高等优点,适合作为大范围宫颈癌筛查的首选方法。     

宫颈癌患者益处发现研究进展

据全球肿瘤报告(GLOBOCAN )2018 估计[1],全球新发宫颈癌病例57 万,死亡31.1 万人,在妇女人群中发病率和死亡率仅次于乳腺癌,严重威胁妇女生命健康.疾病诊断和子宫切除所造成的生育能力缺失、性障碍等治疗副作用,使患者身心遭受了极大痛苦,严重影响其生活质量[2-4].随着积极心理学的发展,越来越多的研究...     

Women's lay knowledge of cervical cancer/cervical screening: accounting for non-attendance at cervical screening clinics

An assessment of women’s knowledge of cervical screening and cervical cancer was considered important as up to 92% of those dying from this form of cancer had never been tested. What were the reasons which determined their non-attendance? Issues to be addressed were reactions to invitation, women’s knowledge of screening, and the possible factors which they envisaged as being associated with cervical cancer. Other issues to be considered were practical problems associated with attendance, and preference for the sex and professional status of the health professionals involved; 187 women in a general practitioner practice in Lothian, Scotland were targeted by questionnaire. As with other studies in this field 50% of those contacted were ineligible for a variety of reasons. Seventy-two women completed the questionnaire, providing a mix of qualitative and quantitative data. Although the majority of women felt the invitation to attend screening was clear and easy to understand, there was a lack of knowledge with regard to both the screening itself and the possible causes of cervical cancer. The main ‘causes’ were seen as higher sexual activity among those aged under 37 and smoking and a virus by those over 37. The majority of women showed preference for a female professional to take the smear. Practical problems of time and venue were not considered insurmountable. The main reasons cited for non-compliance were the fear and dislike of the test itself.     

液基细胞学检查联合人乳头瘤病毒基因分型检测在宫颈癌筛查中的效果

目的：研究液基细胞学检查（TCT）联合人乳头瘤病毒（HPV）基因分型检测（HPV-G）在宫颈癌筛查中的效果。方法选择2011年2月至2013年12月接诊的1210例宫颈癌变前筛查的患者进行观察。依次进行HPV 检测和 TCT 检查，并分析试验结果。结果（1）HSIL 组 HPV 阳性率为93．75％（15/16），明显高于正常＋炎症组的5．80％（65/1121），ASC 组的65．38％（34/52），LSIL 组的66．67％（14/21），差异有统计学意义（P ＜0．05）。且伴随着细胞学诊断级别的升高，HPV 感染率也逐渐上升。（2）HPV 与 TCT 均显阳性的患者中，CINⅡ以及 CINⅡ以上病例的检出率最大，HPV、TCT 均阴性患者中，未出现 CINⅡ以上病例的情况。（3）TCT 阳性者与病理阳性符合率为72．55％（74/102），HPV 阳性与病理阳性符合率为53．13％（68/128），TCT、HPV 均阳性与病理阳性符合率为86．95％（60/69），差异有统计学意义（P ＜0．05）。结论 HPV 联合 TCT 检测的方法可最大程度地找出宫颈异常的细胞，值得推荐。     

Barriers to undergoing cervical cancer screening among health sciences university students in Japan: A cross-sectional study

In most developed countries, cervical cancer screening and human papillomavirus vaccination have reduced cervical cancer incidence. However, the incidence has been increasing in Japan, possibly because of the low screening rate. Although cervical cancer incidence has increased in people in their 20s, the screening rate among 20–24-year-olds in Japan is only 10.2%, meaning that cervical cancer screening rates should be increased among young Japanese women. We conducted a questionnaire survey among students at health sciences universities to determine their knowledge of cervical cancer, screening rates, and barriers to screening. Students taking specialized medical courses were highly knowledgeable; recognition of the facts that “cervical cancer can be prevented through screening” and that “the risk of cervical cancer increases in one's 20s” was significantly high among those who underwent screening. On the other hand, only 7.5% of students used the free coupons provided for screening. Knowledge of cervical cancer improves screening rates. Therefore, educational programs to raise awareness of the importance of cervical cancer screening among non-medical and health sciences university students and young women in general are required.