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www.lxws.net meeloun论文网 专业留学生论文写作辅导中心留学论文写作宫颈癌筛查中的护理干预Nurses deliver care to patients in an ever-changing environment that revolves around changes in local and governmental policies as well as technology and pharmaceutical advancement for effective practice, (Ellis, 2016). According to Nursing and Midwifery Council (NMC) Code of Conduct (2015), nurses assess patients needs and deliver timely, efficient and effective patient care based on the best available evidence. Evidence Based Practice is the integration of best research evidence with nursing practice and patient needs and values to facilitate effective care, it also promotes quality, safe and cost-effective treatment for patients, families, healthcare providers and health care system, (Brown, 2014; Craig and Smyth 2012). This assignment aims to explore an area in nursing, identifying gaps between theory and practice. Using research and discussing strength of the literature and overcoming related issues in the specified area.The assignment will focus on barriers to cervical screening and nurses intervention to improve screening programmes. Cervical cancer screening can be detected early and treatment of precancerous cells and cervical cancer, (White et al., 2015) continues to exist. Cervical cancer starts from a pre-invasive stage known as cervical intraepithelial neoplasia (CIN) however, it can be detected through cervical screening, (Foran et al., 2015). Cervical cancer is the second most common cancer among women globally after breast cancer, (World Health Organization, 2016). According to the Department of Health (DH) (2012a) detecting cervical cancer at an early stage can prevent around 75% from developing. World Health Organization (WHO) (2015a) asserts that prevention and early detection of cervical cancer is cost effective and a long-term strategy. Hoppenot et al (2012) points out that screening can reduce incidence and death rates. Research shows cervical screening is associated with improved treatment for invasive cervical cancer, (Andrea et al., 2012). This highlights the importance of cervical screening programmes.Cervical screening reduces the occurrence of cervical cancer and research shows it prevents approximately 4500 deaths annually in Britain, (Bryant, 2012). In England, there is an invitation for screening for women aged 25-64. Women aged 25-49 should attend screening appointment every three years and women aged 50-64 every five years, (Health and Social Care Information, 2012). However, the last fifteen years has seen a gradual increase in more women being left unscreened for five years or above, from 16% in 1999 to 22% in 2013 (Health and Social Care Information Centre, 2013). Research shows differences in screening is among women who are younger, lower income earners, less educated or women from minority ethnic background and sexually abused women, (Waller et al., 2012; Cadman et al.,2012; Marlow et al., 2015; Albrow et al., 2014).A comprehensive search of databases for literature review namely, Medline, Science Direct, CINAHL, National Institute for Health and Care Excellence (NICE) and Cochrane. An advance search strategy including Cervical Screening, Barriers to Cervical Screening, Early Detection Cervical Cancer and Cervical Screening Adherence. The search was refined to literature in the past five years and incorporated international literatures from United Kingdom, Australia, Sweden and Korea to give an insight of those barriers from a global perspective.Firstly, as regards discussion of non-attendance among women from minority ethnic background. Marlow et al (2015) conducted both qualitative and quantitative study titled Understanding cervical screening non-attendance among ethnic minority women in England. The study investigated and compared differences in attendance among 720 women from minority ethnic background and White British women. For clarification purpose, ethnic minority are black, Asian and minority ethnicity (BAME). The study found that BAME women were less likely to attend cervical screening with 44-71% non-attenders compared to 12% white British women. This highlights the need for more intervention by nurses to improve practice. Reducing inequality in cancer pathway particularly among minority ethnic groups is a policy priority (Dept. of Health 2011).Marlow et al (2015) found that women from ethnic minority viewed that they were not sexually active so they did not have to do the test. This is an important aspect for nurses to educate in order to improve practice and to promote attendance with educational materials in various languages for better interpretation. The study also found 65% women from minority ethnic background believed they do not need to attend smear test in the absence of any symptoms compared to 6% white British women. These barriers are primarily associated with lower education and lower socio- economic status, (Fang and Baker, 2013). It is surprising that women
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