A Systematic Review and Quantitative Meta-Analysis of the Accuracy of Visual Inspection for Cervical Cancer Screening: Does Provider Type or Training Matter.Reportar como inadecuado


 A Systematic Review and Quantitative Meta-Analysis of the Accuracy of Visual Inspection for Cervical Cancer Screening: Does Provider Type or Training Matter.


A Systematic Review and Quantitative Meta-Analysis of the Accuracy of Visual Inspection for Cervical Cancer Screening: Does Provider Type or Training Matter. - Descarga este documento en PDF. Documentación en PDF para descargar gratis. Disponible también para leer online.



Type of Resource: text

Genre: Electronic Thesis or Dissertation

Date Created: Fall 2016

Date Issued: 2016

Publisher: Florida Atlantic University

Physical Form: pdf

Extent: 213 p.

Language(s): English

Summary: Background: A global cervical cancer health disparity persists despite the demonstrated success ofprimary and secondary preventive strategies, such as cervical visual inspection (VI). Cervicalcancer is the leading cause of cancer incidence and death for women in many low resourceareas. The greatest risk is for those who are unable or unwilling to access screening. Barriersinclude healthcare personnel shortages, cost, transportation, and mistrust of healthcare providersand systems. Using community health workers (CHWs) may overcome these barriers, increasefacilitators, and improve participation in screening for women in remote areas with limited accessto clinical resources.Aim: To determine whether the accuracy of VI performed by CHWs was comparable to VI byphysicians or nurses and to consider the affect components of provider training had on VIaccuracy.Methods: A systematic review and quantitative meta-analysis of published literature reporting on VIaccuracy, provider type, and training was conducted. Strict inclusion/exclusion criteria, studyquality, and publication bias assessments improved rigor and bivariate linear mixed modeling (BLMM) was used to determine the affect of predictors on accuracy. Unconditional andconditional BLMMs, controlling for VI technique, provider type, community, clinical setting, HIVstatus, and gynecological symptoms were considered.Results: Provider type was a significant predictor of sensitivity (p=.048) in the unconditional VImodel. VI performed by CHWs was 15% more sensitive than physicians (p=.014). Provider typewas not a significant predictor of accuracy in any other models. Didactic and mentored hourspredicted sensitivity in both BLMMs. Quality assurance and use of a training manual predictedspecificity in unconditional BLMMs, but was not significant in conditional models. Number oftraining days, with ≤5 being optimal, predicted sensitivity in both BLMMs and specificity in theunconditional model.Conclusion: Study results suggest that community based cervical cancer screening with VI conductedby CHWs can be as, if not more, accurate than VI performed by licensed providers. Locally basedscreening programs could increase access to screening for women in remote areas.Collaborative partnerships in “pragmatic solidarity” between healthcare systems, CHWs, and thecommunity could promote participation in screening resulting in decreased cervical cancerincidence and mortality.

Identifier: FA00004755 (IID)

Note(s): Includes bibliography.Dissertation (Ph.D.)--Florida Atlantic University, 2016.

Held by: Florida Atlantic University Digital Library

Sublocation: Boca Raton, Fla.

Persistent Link to This Record: http://purl.flvc.org/fau/fd/FA00004755

Restrictions on Access: All rights reserved by the source institution

Owner Institution: FAU



Autor: Driscoll, Susan D., author Tappen, Ruth Dr., Thesis advisor Christine E. Lynn College of Nursing, Degree grantor

Fuente: http://fau.digital.flvc.org/islandora/object/fau%3A33911



DESCARGAR PDF




Documentos relacionados