Exploring Loss to Follow-up. Abnormal Pap Screening in Hispanic Patients
| Autor: | Mark D. Soucy, Katherine B. de Voogd, Linda M. Hunt, Judith C. D. Longworth |
|---|---|
| Rok vydání: | 2002 |
| Předmět: |
Adult
medicine.medical_specialty MEDLINE Uterine Cervical Neoplasms Nursing care Abnormal PAP Smear Ambulatory care Ambulatory Care Humans Medicine Vaginal smear Poverty General Nursing Aged Vaginal Smears Cervical cancer business.industry Medical record Public health Hispanic or Latino Health Services Middle Aged Patient Acceptance of Health Care medicine.disease Texas Oncology Family medicine Physical therapy Patient Compliance Female Nursing Care business Follow-Up Studies Papanicolaou Test |
| Zdroj: | Cancer Practice. 10:122-129 |
| ISSN: | 1523-5394 1065-4704 |
| DOI: | 10.1046/j.1523-5394.2002.103010.x |
| Popis: | purpose: The loss of patients to follow-up for abnormal findings from Pap screenings is an important public health concern, particularly among poor and minority women. This study explores factors affecting incomplete follow-up among a group of Hispanic women with low incomes. description of study: A qualitative descriptive study was conducted of 11 Hispanic patients with incomplete Pap smear follow-up at a public clinic in a major city in south Texas. Patients were interviewed using a semistructured, open-ended schedule of questions, and their medical records were abstracted. The clinic's five staff members also were interviewed. Comparative chronologies were constructed for each case, contrasting patient and staff accounts of the same set of events. All data were coded by at least two investigators. results: All study patients had mildly abnormal Pap smear results and had not met the follow-up criteria, but all understood and were committed to Pap screening. Although viewed by staff as noncompliant, none of the patients viewed her behavior this way. This staff-patient discrepancy was attributable to poor communication, mixed messages, clinic errors, and, perhaps most importantly, to a conflict between program policies and the specific circumstances of individual cases. Two case examples are presented to illustrate key points. clinical implications: Strategies that may help to reduce loss to follow-up among similar patients include the following: allowing clinic staff more flexibility in follow-up procedures for women who have consistently normal follow-up tests, including Spanish translations of written messages; enlisting patients' agreement in setting appointments; and updating patient records to reflect follow-up care that had been received in other clinics. |
| Databáze: | OpenAIRE |
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