Early detection of cervical cancer according to the discourses of primary care midwives in Segovia, Spain
Autor(a) principal: | |
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Data de Publicação: | 2011 |
Outros Autores: | , |
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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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 |
_version_ |
1800221792551305216 |