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乳腺癌专题(一)研究:华裔妇女参与癌症筛查率低于其他族裔群体

来源:贴心姐妹网   更新:2015-01-18 11:48:28   作者:施雅芳
乳腺癌专题(一)研究:华裔妇女参与癌症筛查率低于其他族裔群体
 
图/冼凤娟博士提供    冼凤娟博士
 
(编者按:中国大陆歌手姚贝娜在33岁时因乳腺癌早逝,令人唏嘘,也让人们关注乳腺癌对女性健康的潜在危害。贴心姐妹网专访了近年就大陆移民女性对乳房健康检查的看法进行了研究的冼凤娟博士,并提醒女性安省在乳腺癌检查方面的项目。)
 
凤凰大学健康管理博士冼凤娟(Dr. Heidi Sin)在她的博士论文《 华裔移民女性对乳房健康检查的看法》(Breast-Health Screening Perceptions of Chinese Canadian Immigrant Women)中指出,尽管有些女性认识到乳腺癌的后果和乳房检查的益处,但她们不愿利用这些检查的机会。
 
冼凤娟博士说,尽管早期的检查和及时的治疗可以降低乳腺癌造成的死亡率,但21世纪全球性的乳腺癌发病率仍在不断增高。尽管癌症的发生、诊断的阶段和幸存率在不同族裔群体间有不同,通过乳房健康检查及早发现癌症和及时的治疗可以有效减低死亡率。
 
她采用定性研究的方式,用立意抽样的方式选择了研究对象——27位30岁至69岁、在加拿大居住了5年、没有乳腺癌历史的中国大陆移民女性。她通过对这些女性的半结构性访谈和两个座谈会了解这些女性在乳房健康检查方面的经历和看法。她的研究发现,尽管这些女性认识到乳腺癌的普遍性和乳房检查的益处,但她们不愿利用这些检查的机会。
 
冼凤娟博士的研究是研究对象较少的立意抽样定性研究。她表示,研究对象人数更多的更广泛的研究可以有助于进一步制订出促进尽早查出乳腺癌的策略。
 
以下是贴心姐妹网和冼凤娟博士的书面专访:
 
Loving Sister:Why did you decide to conduct a study specifically on women from Mainland China?
贴心姐妹网:你为什么决定对中国大陆移民女性群体进行研究?
 
Dr. Heidi Sin: There is limited study regarding participation in breast-health screening among ethnic groups in Canada. 
Chinese is accounted for higher population among ethno-cultural groups in Canada. According to recent statistics, more immigrants came from Mainland China.
Previous study indicated that cancer screening participation rate in Chinese women was low compared to other ethnic groups.
冼凤娟博士:在加拿大,有关族群参与乳房健康检查的研究有限。华人是加拿大族裔群体中人数较多的群体。根据最近的统计,更多的移民来自中国大陆。过去的研究表明,华裔妇女参与癌症筛查率低于其他族裔群体。
 
Loving Siser:Why did you choose the group of women who have been in Canada for 5 years?
贴心姐妹网:您为何选择在加拿大居住了5年的女性为研究对象?
 
Dr. Heidi Sin:This study was focused on understanding new immigrant women as most of the new immigrants experience more barriers in accessing services than those who have been in Canada for longer years. 
冼凤娟博士:本研究的重点是了解新移民妇女,因为在进接服务上,大多数新移民比那些已经在加拿大更长时间的移民经历更多的障碍。
 
Loving Sister:What are the specific causes for low participation of this group of people in the screening? It was a qualitative study, would you like to share some quotes on the causes from the participants in the study?
贴心姐妹网:研究对象参与乳房健康检查率低的原因是什么?这是一项定性研究,您能分享一些这些女性不愿意参与乳房健康检查原因的表述吗?
 
Dr. Heidi Sin: The specific causes for low participation of this group of people in the breast-health screening included:
Cultural beliefs and practices, the majority of participants adopted lifestyle practices to maintain health and prevent diseases rather than practicing screening
Majority of participants were aware of the impact of breast cancer, benefits of screening but not aware of screening program
Barriers included lack of knowledge about breast-health screening, poor English language proficiency, inconvenience, embarrassment etc.
Some quotes included: 
“Not the same. If breast cancer is detected early, prompt treatment and surgery are provided. The person will not die”
“I am not quite clear. It is because I have just come here. Nobody has talked to me. Only know family doctor can do body check- up. Have not gone and done screening.”
“Although need to pay a little fee, I feel it is a lot faster, very convenient and no need to book appointment in advance.”
“Language barrier, English-do not understand by hearing, do not understand by reading; language barrier, outside information is cut off.”
“If using English to give out information, some people do not understand in reading, will treat it as garbage and throw it away.’
“Private parts. Male especially, do not want him to examine. Even female, also feel embarrassment.”
“I do not have a special feel. Therefore, not visit family doctor. Temporarily, do not have this need.”
冼凤娟博士:这个群体参与癌症筛查率低的原因有:
文化和习俗(cultural beliefs and practices),大多数这项研究的参与者採纳的生活习惯是保持健康,预防疾病,而不是参与筛查;
参与研究者多数都知道乳腺癌 的影响,筛查的好处,但不知道筛查的计划;
障碍包括缺乏了解乳房健康检查的知识,英语语言能力,不便,尴尬等。
一些参与研究者者的表述包括:
“不一样。如果早期发现乳腺癌,提供及时治疗和手术治疗。该人不会死。”
“我不是很清楚。那是因为我刚刚来到这裡。没有人找我谈话。只知道家庭医生可以做身体检查。没有去做筛查。“
“虽然需要付出一点费用,我觉得这是快了很多,非常方便,无需提前预约。”
“语言障碍,英语听不懂,也不能通过阅读理解;语言不通,外界的信息被切断。”
“如果提供英语的信息,有些人读不懂,将会把它当作垃圾扔掉。”
“私处。尤其是男性(医生),不想让他检查。即使是女性,也觉得尴尬。”
“我没有特别的感觉。因此,不去访问家庭医生。暂时没有这方面的需求。”
 
Loving Sister: What measures do you propose to improve the current status?
贴心姐妹网:从您的研究看,可以如何改变现状?
 
Dr. Heidi Sin: Data suggested that Chinese cultural beliefs and practices contribute to low participation in breast-health screening and represent opportunities for health care professionals to proactively educate communities on the benefits of preventive health and recommend breast-health screening.  Potential strategies to promote breast-health screening include culturally sensitive linguistic educational programs, physician recommendations or referrals to breast-health screening as a standard item within annual check-ups, expanded operating hours for screening clinics, and community-based outreach initiatives.   
冼凤娟博士:研究资料显示,中国文化和习俗是造成参与检查率低的原因,而这为健康护理专业人士就预防的益处积极教育社区以及推荐乳房检查的机会。宣传乳房健康检查的策略包括:提供文化上敏感、使用移民母语的计划;将推荐医生和转介乳房健康检查作为一年一度体检中标准的一项;延长乳房健康检查诊所的工作时间;基于社区的宣传乳房健康检查的创举。
 
Dr. Heidi Sin has been in the health care field for over 35 years. She earned the BScN at the Hong Kong Polytechnic University, BEd in Adult Education at the Brock University in Canada, MAED at the Central Michigan University, and Doctor of Health Administration at the University of Phoenix. She is now working as a public health nurse.
冼凤娟博士在健康护理领域工作了36年,她从香港理工大学获得护士本科学位,从加拿大Brock University成人教育专业获得教育本科学位,从美国中密歇根大学(Central Michigan University)获得教育学硕士学位,从美国凤凰大学获得健康管理博士学位。如今,她是安大略省的一位公共卫生护士。
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