Early detection of cervical cancer according to the discourses of primary care midwives in Segovia, Spain

Detalhes bibliográficos
Autor(a) principal: Otero, Laura
Data de Publicação: 2011
Outros Autores: Sanz, Belén, Blasco, Teresa
Tipo de documento: Artigo
Idioma: spa
eng
Título da fonte: Revista de Saúde Pública
Texto Completo: https://www.revistas.usp.br/rsp/article/view/33025
Resumo: OBJECTIVE: To analyze the discourses of primary care midwives on access to and utilization of the Cervical Cancer Prevention Program. METHODS: A qualitative study was conducted in an area of low population density with a high proportion of rural population in Segovia, Spain, between 2008 and 2009. Semi-structured interviews were carried out. Ten primary care midwives were interviewed covering the 16 basic health districts of the city. Data analysis was based on grounded theory methodology. RESULTS: Access to and utilization of the Cervical Cancer Prevention Program was associated with attendance to midwife visits, women's experiences with cervical smears and their perception of risk of cervical cancer. Geographic distance to the health center, difficult access to immigrant women who have no health insurance, and being unaware of the program offered are some of the perceived barriers. Social exclusion is also perceived as a barrier of access to and utilization of the program. The recommendation to participate in the program made by the primary care physician was identified as the main facilitator. CONCLUSIONS: The midwives perceived inequalities in access to and utilization of the Cervical Cancer Prevention Program that are associated to individual characteristics of women, and contextual characteristics such as the geographical environment where they live and Program's infrastructure. There is inequality of access to care of underrepresented groups of women such as immigrant women and those residing in rural areas.
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spelling Early detection of cervical cancer according to the discourses of primary care midwives in Segovia, Spain Detección precoz de cáncer de cérvix según los discursos de las matronas de atención primaria en Segovia, España Detecção precoce de câncer cervical segundo discursos de parteiras na atenção primária em Segóvia, Espanha Neoplasias do Colo do Útero^i3^sprevenção & contrAcesso aos Serviços de SaúdeObstetrizConhecimentos^i3^sAtitudes e Prática em SaPesquisa QualitativaNeoplasias del Cuello Uterino^i1^sprevención & contAccesibilidad a los Servicios de SaludMatronasConocimientos^i1^sActitudes y Práctica en SaInvestigación CualitativaUterine Cervical Neoplasms^i2^sprevention & contHealth Services AccessibilityMidwivesHealth Knowledge^i2^sAttituHealth Knowledge^i2^sPractQualitative Research OBJECTIVE: To analyze the discourses of primary care midwives on access to and utilization of the Cervical Cancer Prevention Program. METHODS: A qualitative study was conducted in an area of low population density with a high proportion of rural population in Segovia, Spain, between 2008 and 2009. Semi-structured interviews were carried out. Ten primary care midwives were interviewed covering the 16 basic health districts of the city. Data analysis was based on grounded theory methodology. RESULTS: Access to and utilization of the Cervical Cancer Prevention Program was associated with attendance to midwife visits, women's experiences with cervical smears and their perception of risk of cervical cancer. Geographic distance to the health center, difficult access to immigrant women who have no health insurance, and being unaware of the program offered are some of the perceived barriers. Social exclusion is also perceived as a barrier of access to and utilization of the program. The recommendation to participate in the program made by the primary care physician was identified as the main facilitator. CONCLUSIONS: The midwives perceived inequalities in access to and utilization of the Cervical Cancer Prevention Program that are associated to individual characteristics of women, and contextual characteristics such as the geographical environment where they live and Program's infrastructure. There is inequality of access to care of underrepresented groups of women such as immigrant women and those residing in rural areas. OBJETIVO: Analizar los discursos de las matronas de atención primaria sobre el acceso y la utilización del Programa Preventivo de Cáncer de Cérvix. PROCEDIMIENTOS METODOLÓGICOS: Se desarrolló un estudio cualitativo en un área de baja densidad poblacional, Segovia, España, que cuenta con un alto porcentaje de población rural, entre 2008 y 2009. Se utilizó como técnica la entrevista semi-estructurada. Se realizaron diez entrevistas a las matronas de atención primaria de las 16 Zonas Básicas de Salud. El análisis de la información se basó en las propuestas de la Teoría Fundamentada. ANÁLISIS DE RESULTADOS: El acceso y utilización del Programa Preventivo de Cáncer de Cérvix se relaciona con la utilización de la consulta de la matrona por las mujeres, sus vivencias de los exámenes de citología vaginal y su percepción de riesgo a padecer un cáncer de cuello uterino. La barrera percibida es la distancia para acceder a la consulta de la matrona, y para las mujeres inmigrantes, además son barreras la posibilidad de no disponer de tarjeta sanitaria y desconocer la existencia del Programa. La exclusión social es también considerada una barrera de acceso y utilización. Se identificó como el principal facilitador, la recomendación de los médicos de familia de participar en el Programa. CONCLUSIONES: Las matronas perciben desigualdades de acceso y utilización del Programa Preventivo de Cáncer de Cérvix que se relacionan tanto con características individuales de las mujeres, como con el medio geográfico donde viven y con la propia estructura del Programa. Hay situaciones de vulneración de la equidad en colectivos de mujeres poco representadas a nivel encuestal, como las mujeres inmigrantes y las que residen en zonas rurales. OBJETIVO: Analisar os discursos das parteiras atuantes na atenção primária sobre o acesso e utilização do Programa Preventivo de Câncer Cervical. PROCEDIMENTOS METODOLÓGICOS: Estudo qualitativo realizado em Segóvia, em uma área de baixa densidade populacional na Espanha, com alta proporção de populações rurais e imigrantes, de 2008 a 2009. Utilizou-se a entrevista semi-estruturada para coleta de informações. Foram entrevistadas dez parteiras das 16 Zonas Básicas de Saúde. A análise da informação baseou-se nas propostas da Teoria Fundamentada. ANÁLISE DOS RESULTADOS: O acesso e utilização do Programa Preventivo de Câncer Cervical relacionam-se a mulheres atendidas pela parteira, as vivências das mulheres em relação os resultados do exame de citologia vaginal e sua percepção de risco de sofrer um câncer de colo uterino. A barreira percebida é a distância para comparecer à consulta com a parteira. Para as mulheres imigrantes há ainda a possibilidade de não dispor de carteira de saúde e desconhecer o programa. A exclusão social também está relacionada a barreiras de acesso e utilização. O principal facilitador identificado foi o aconselhamento dos médicos de família para participar do programa. CONCLUSÕES: As parteiras percebem desigualdades de acesso e utilização do Programa Preventivo de Câncer Cervical que se relacionam tanto com características individuais das mulheres como com o meio geográfico em que vivem e com a própria estrutura do Programa. Há situações de vulnerabilidade da eqüidade de grupos de mulheres pouco representadas em nível de inquéritos populacionais, como as imigrantes e as que moram em zonas rurais. Universidade de São Paulo. Faculdade de Saúde Pública2011-10-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfapplication/pdfhttps://www.revistas.usp.br/rsp/article/view/3302510.1590/S0034-89102011005000061Revista de Saúde Pública; Vol. 45 No. 5 (2011); 824-830 Revista de Saúde Pública; Vol. 45 Núm. 5 (2011); 824-830 Revista de Saúde Pública; v. 45 n. 5 (2011); 824-830 1518-87870034-8910reponame:Revista de Saúde Públicainstname:Universidade de São Paulo (USP)instacron:USPspaenghttps://www.revistas.usp.br/rsp/article/view/33025/35676https://www.revistas.usp.br/rsp/article/view/33025/35677Copyright (c) 2017 Revista de Saúde Públicainfo:eu-repo/semantics/openAccessOtero, LauraSanz, BelénBlasco, Teresa2012-07-11T22:48:26Zoai:revistas.usp.br:article/33025Revistahttps://www.revistas.usp.br/rsp/indexONGhttps://www.revistas.usp.br/rsp/oairevsp@org.usp.br||revsp1@usp.br1518-87870034-8910opendoar:2012-07-11T22:48:26Revista de Saúde Pública - Universidade de São Paulo (USP)false
dc.title.none.fl_str_mv Early detection of cervical cancer according to the discourses of primary care midwives in Segovia, Spain
Detección precoz de cáncer de cérvix según los discursos de las matronas de atención primaria en Segovia, España
Detecção precoce de câncer cervical segundo discursos de parteiras na atenção primária em Segóvia, Espanha
title Early detection of cervical cancer according to the discourses of primary care midwives in Segovia, Spain
spellingShingle Early detection of cervical cancer according to the discourses of primary care midwives in Segovia, Spain
Otero, Laura
Neoplasias do Colo do Útero^i3^sprevenção & contr
Acesso aos Serviços de Saúde
Obstetriz
Conhecimentos^i3^sAtitudes e Prática em Sa
Pesquisa Qualitativa
Neoplasias del Cuello Uterino^i1^sprevención & cont
Accesibilidad a los Servicios de Salud
Matronas
Conocimientos^i1^sActitudes y Práctica en Sa
Investigación Cualitativa
Uterine Cervical Neoplasms^i2^sprevention & cont
Health Services Accessibility
Midwives
Health Knowledge^i2^sAttitu
Health Knowledge^i2^sPract
Qualitative Research
title_short Early detection of cervical cancer according to the discourses of primary care midwives in Segovia, Spain
title_full Early detection of cervical cancer according to the discourses of primary care midwives in Segovia, Spain
title_fullStr Early detection of cervical cancer according to the discourses of primary care midwives in Segovia, Spain
title_full_unstemmed Early detection of cervical cancer according to the discourses of primary care midwives in Segovia, Spain
title_sort Early detection of cervical cancer according to the discourses of primary care midwives in Segovia, Spain
author Otero, Laura
author_facet Otero, Laura
Sanz, Belén
Blasco, Teresa
author_role author
author2 Sanz, Belén
Blasco, Teresa
author2_role author
author
dc.contributor.author.fl_str_mv Otero, Laura
Sanz, Belén
Blasco, Teresa
dc.subject.por.fl_str_mv Neoplasias do Colo do Útero^i3^sprevenção & contr
Acesso aos Serviços de Saúde
Obstetriz
Conhecimentos^i3^sAtitudes e Prática em Sa
Pesquisa Qualitativa
Neoplasias del Cuello Uterino^i1^sprevención & cont
Accesibilidad a los Servicios de Salud
Matronas
Conocimientos^i1^sActitudes y Práctica en Sa
Investigación Cualitativa
Uterine Cervical Neoplasms^i2^sprevention & cont
Health Services Accessibility
Midwives
Health Knowledge^i2^sAttitu
Health Knowledge^i2^sPract
Qualitative Research
topic Neoplasias do Colo do Útero^i3^sprevenção & contr
Acesso aos Serviços de Saúde
Obstetriz
Conhecimentos^i3^sAtitudes e Prática em Sa
Pesquisa Qualitativa
Neoplasias del Cuello Uterino^i1^sprevención & cont
Accesibilidad a los Servicios de Salud
Matronas
Conocimientos^i1^sActitudes y Práctica en Sa
Investigación Cualitativa
Uterine Cervical Neoplasms^i2^sprevention & cont
Health Services Accessibility
Midwives
Health Knowledge^i2^sAttitu
Health Knowledge^i2^sPract
Qualitative Research
description OBJECTIVE: To analyze the discourses of primary care midwives on access to and utilization of the Cervical Cancer Prevention Program. METHODS: A qualitative study was conducted in an area of low population density with a high proportion of rural population in Segovia, Spain, between 2008 and 2009. Semi-structured interviews were carried out. Ten primary care midwives were interviewed covering the 16 basic health districts of the city. Data analysis was based on grounded theory methodology. RESULTS: Access to and utilization of the Cervical Cancer Prevention Program was associated with attendance to midwife visits, women's experiences with cervical smears and their perception of risk of cervical cancer. Geographic distance to the health center, difficult access to immigrant women who have no health insurance, and being unaware of the program offered are some of the perceived barriers. Social exclusion is also perceived as a barrier of access to and utilization of the program. The recommendation to participate in the program made by the primary care physician was identified as the main facilitator. CONCLUSIONS: The midwives perceived inequalities in access to and utilization of the Cervical Cancer Prevention Program that are associated to individual characteristics of women, and contextual characteristics such as the geographical environment where they live and Program's infrastructure. There is inequality of access to care of underrepresented groups of women such as immigrant women and those residing in rural areas.
publishDate 2011
dc.date.none.fl_str_mv 2011-10-01
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.uri.fl_str_mv https://www.revistas.usp.br/rsp/article/view/33025
10.1590/S0034-89102011005000061
url https://www.revistas.usp.br/rsp/article/view/33025
identifier_str_mv 10.1590/S0034-89102011005000061
dc.language.iso.fl_str_mv spa
eng
language spa
eng
dc.relation.none.fl_str_mv https://www.revistas.usp.br/rsp/article/view/33025/35676
https://www.revistas.usp.br/rsp/article/view/33025/35677
dc.rights.driver.fl_str_mv Copyright (c) 2017 Revista de Saúde Pública
info:eu-repo/semantics/openAccess
rights_invalid_str_mv Copyright (c) 2017 Revista de Saúde Pública
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
application/pdf
dc.publisher.none.fl_str_mv Universidade de São Paulo. Faculdade de Saúde Pública
publisher.none.fl_str_mv Universidade de São Paulo. Faculdade de Saúde Pública
dc.source.none.fl_str_mv Revista de Saúde Pública; Vol. 45 No. 5 (2011); 824-830
Revista de Saúde Pública; Vol. 45 Núm. 5 (2011); 824-830
Revista de Saúde Pública; v. 45 n. 5 (2011); 824-830
1518-8787
0034-8910
reponame:Revista de Saúde Pública
instname:Universidade de São Paulo (USP)
instacron:USP
instname_str Universidade de São Paulo (USP)
instacron_str USP
institution USP
reponame_str Revista de Saúde Pública
collection Revista de Saúde Pública
repository.name.fl_str_mv Revista de Saúde Pública - Universidade de São Paulo (USP)
repository.mail.fl_str_mv revsp@org.usp.br||revsp1@usp.br
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