“It Feels Like Health Care with the Patient in Mind”: VA Patient and Staff Perspectives on Self-Collected HPV Testing

IF 2.8 2区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH
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引用次数: 0

Abstract

Purpose

Self-collected testing for human papillomavirus (HPV) is poised to transform cervical cancer screening. Self-tests demonstrate similar accuracy to clinician-collected tests, but for the half a million women served by the Veterans Health Administration (VA) and their clinicians, self-collected cervical cancer screening would be a new practice. We examined VA patient and staff perspectives to inform future implementation.

Methods

Semi-structured telephone interviews were conducted between 2021 and 2022 with female veterans receiving VA care (n = 22) and VA women's health nurses, clinicians, and administrators (n = 27). Interviews were audio-recorded and transcribed. Interview questions addressed knowledge and interest, potential advantages or disadvantages, and any questions participants had about self-collected screening. Responses were analyzed using rapid qualitative methods.

Main findings

Five overarching themes were identified. Both patients and staff indicated high interest and enthusiasm for self-collected HPV testing, tempered by questions about test accuracy and logistical considerations. Familiarity with self-testing for other conditions such as colon-cancer screening or COVID made self-collection seem like a simple, convenient option. However, self-testing was not viewed as a good fit for all patients, and concerns about lost opportunities or missed incidental lesions were raised. Patients and staff described challenges with pelvic examinations for patients with past sexual trauma, particularly in the male-dominated VA environment. Pelvic exams can leave patients feeling vulnerable and exposed; self-collected testing was seen as a mechanism for patient empowerment.

Principal conclusions

Veteran patients and VA staff shared common perspectives about potential advantages and disadvantages of self-collected HPV testing. Self-collected HPV testing has the potential to improve trauma-informed preventive health care for veterans.

"以患者为中心的医疗服务":退伍军人事务部患者和工作人员对自采 HPV 检测的看法。
目的:人乳头瘤病毒(HPV)自采检测有望改变宫颈癌筛查。自我检测的准确性与临床医生采集的检测结果相似,但对于退伍军人健康管理局(VA)及其临床医生服务的 50 万妇女来说,自我采集宫颈癌筛查将是一种新的做法。我们研究了退伍军人健康管理局患者和工作人员的观点,为今后的实施提供参考:2021 年至 2022 年期间,我们对接受退伍军人事务部护理的女性退伍军人(22 人)以及退伍军人事务部妇女健康护士、临床医生和管理人员(27 人)进行了半结构化电话访谈。访谈进行了录音和转录。访谈问题涉及知识和兴趣、潜在的优势或劣势,以及参与者对自采筛查的任何疑问。采用快速定性方法对访谈结果进行了分析:主要结果:确定了五个重要主题。患者和医务人员都对自取式 HPV 检测表现出极大的兴趣和热情,但同时也存在检测准确性和后勤方面的问题。由于对结肠癌筛查或 COVID 等其他疾病的自我检测非常熟悉,自我检测似乎是一种简单、方便的选择。然而,并非所有患者都适合进行自我检测,有人担心会失去机会或错过偶然病变。患者和医务人员描述了对既往有性伤害的患者进行盆腔检查所面临的挑战,尤其是在男性主导的退伍军人事务部环境中。盆腔检查会让患者感到脆弱和暴露;自采检查被视为患者赋权的一种机制:退伍军人患者和退伍军人事务部的工作人员对自取式 HPV 检测的潜在利弊有着共同的看法。自取式 HPV 检测有可能改善退伍军人的创伤知情预防保健。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
4.50
自引率
6.20%
发文量
97
审稿时长
32 days
期刊介绍: Women"s Health Issues (WHI) is a peer-reviewed, bimonthly, multidisciplinary journal that publishes research and review manuscripts related to women"s health care and policy. As the official journal of the Jacobs Institute of Women"s Health, it is dedicated to improving the health and health care of all women throughout the lifespan and in diverse communities. The journal seeks to inform health services researchers, health care and public health professionals, social scientists, policymakers, and others concerned with women"s health.
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