马塞诸斯州大学波士顿

Nursing PhD Candidates Deogwoon Kim and SangA Lee traveled to Malawi this past spring to conduct research for their dissertations on women’s health. Building on the 马塞诸斯州大学波士顿 connection with Malawi that was formed by their mentor and advisor Professor of Nursing Haeok Lee, 谁曾前往马拉维进行子宫颈癌检测, Kim和Lee的研究重点是马拉维妇女的预防性保健.

Kim’s dissertation on cervical cancer screening behavior among women in Malawi with a specific focus on human papillomavirus infection (HPV) screening tests explores how willing Malawian women are to embrace new self-sampling screening tests that have the potential to reduce health care barriers. Cervical cancer has become a symbol of global health disparities because it’s easily preventable through noninvasive screening procedures, but low-income countries often don't have the infrastructure or money to provide screenings for their most vulnerable populations, 金说. 未确诊的人乳头瘤病毒病例有发展为子宫颈癌和, 没有适当的筛选, the cancer diagnosis may already be in the late stage by the time the patient can go to a clinic.  

“如果女性能自己取样，那就太好了. They don’t necessarily need to visit a clinic for the screening so they can just do it at home and then send the sample to the clinic,金说。. “Those who can’t afford transportation to the clinic just for a screening can easily do the screening themselves.” 

Lee’s dissertation on tuberculosis (TB) transmission prevention behaviors among women living with HIV and TB in Malawi leads with a hygiene-geo-temporal approach. 他花了10年时间研究传染病, her dissertation combines two diseases that she had previously studied separately. 

“我在韩国获得硕士学位，我的论文是澳门官方老葡京肺结核的, 然后当我搬到美国.S., I focused on the HIV population since there aren’t that many people here with TB,” 李说. “我对传染病很感兴趣, 马拉维将这两个种群合并为一个研究, 所以我认为这是一个深入投资的机会.”  

尽管他们分别进行了研究, 金和李在马拉维期间也有类似的经历. 通过他们在当地社区的工作, 他们发现，妇女保健与赋予妇女权力是密切相关的, and providing efficient preventative care can only be achieved through health care education. Malawi is a highly patriarchal society and experiencing how that impacts women’s access to preventative care was surprising, 他们说.  

由于马拉维文化的父权本质, building a trusting relationship with the local community was necessary to recruit research participants and gain a deeper understanding of the obstacles that Malawian women face when it comes to advocating for their own health. 通过与潜在研究参与者的访谈, Kim learned that Malawian women would need to ask for their husband’s permission to be able to participate in the study, 她说.  

“In order to share those subtle things, it’s not like you can just ask directly,金说。. “找出这些信息, 我必须打破心理和情感上的障碍，建立融洽的关系. 获得有意义的数据对我来说很重要.” 

李说，这是因为文化规范, many vulnerable and marginalized communities in Malawi conceal their health status from their families, which made it difficult to find participants who were living with HIV and TB until she was able to find the “gatekeeper” of the community who helped make introductions. Once she built trust with the research participants by ensuring their individual status wouldn’t be shared publicly, 李说 the women were enthusiastic about telling her anything she needed to know because they felt she was there to support and help them. 

Malawi is often visited by researchers from outside the country to do survey and data collection, so the added benefit of building a rapport with participants in the local communities ensured that the data they collected was genuine and that they were able to reach, 积极的互动, 低收入和弱势群体, 李说.  

“One approach I really prioritized when I met the participants was doing my best not to academically or mentally colonize or westernize them. 这是一个重要的教训. 李给我的，”她说. “当你去那里的时候, 这已经发生了, 如果我没有在澳门新葡新京官方学习, 我从来没有意识到这一点.” 

金说 it was also important to be transparent with participants that the data she was collecting was for her dissertation but that the research is meant to contribute to the local community and be the start of something meaningful. She wants to continue her research to study actual behavior and if participants are able to do the HPV self-screening sampling. Kim credits her time with the Asian American Studies department and Nursing program at 马塞诸斯州大学波士顿 for teaching her how to look at health disparities at a systemic level and take the time to listen to the marginalized voices that are impacted by those health issues. 

在过去的十年里她一直在研究传染病, 李说 she’s realized that there are a lot of stigmas against people with infectious diseases that prevent communities from addressing health care disparities. She explained that Malawian women are powerless, but they are the center of the household. 对于感染某种疾病的妇女, 他们可以把它传染给他们的家庭和社区, 虽然这看起来很极端, 有可能蔓延到全国, 李说.  

在她完成论文之后, Lee’s interested in continuing this research by including men in her next study, 但她承认，在像马拉维这样的男权结构国家, 男性很难与女性研究人员一起工作.  

“If we don’t change men’s attitudes towards women and disease, we can’t change things,” 李说. “我意识到，在那些有这种文化的国家, we have to do something with men at the same time otherwise it cannot be changed.” 

“他们说, 这就是我们的文化,但对我来说, 我认为有些地方我们可以做得更好,金说。. “Indirect information like literacy and education level is also related to their health outcomes, 从长远来看, all those things need to come together and it’s all related to women empowerment. 我们需要赋予妇女权力，促进这些国家的妇女健康.”