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Women with abnormal Pap smear result: a qualitative study of Swedish healthcare professionals' experiences
Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.ORCID iD: 0000-0002-1569-6675
Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. (Global hälsa)ORCID iD: 0000-0002-1944-773X
Karolinska Institute ; Kalmar County Hospital.
Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Linköping University.ORCID iD: 0000-0001-5200-1740
2016 (English)In: European Journal of Cancer Care, ISSN 0961-5423, E-ISSN 1365-2354, Vol. 25, no 6, p. 980-991Article in journal (Refereed) Published
Abstract [en]

A Papanicolaou (Pap) smear can be used to detect pre-cancerous cellular changes, so that they can be treated before they develop into cervical cancer. When the results of a Pap smear test are abnormal, women need further investigation, treatment and follow-up. Healthcare professionals (HCPs) are in a position to care for these women with abnormalities. The aim of this study was to explore the experiences of HCPs in caring for women with abnormal Pap smear results. In total, 20 HCPs from two counties in south-eastern Sweden participated in individual interviews, based on two open-ended questions. Interviews were recorded, transcribed verbatim and analysed using content analysis. The results showed that HCPs experienced that abnormal Pap smear results created anxiety in women, who often sought information from the Internet as a way to cope. Furthermore, the HCPs thought that it was a problem that women chose not to attend investigation, treatment and follow-ups. However, information about the seriousness of abnormal Pap smear results causes women to participate. It is a challenge for HCPs to inform in a reassuring manner. Finally, HCPs should collaborate with women to meet their information needs and to also provide support regarding finding and filtering reliable information on the Internet.

Place, publisher, year, edition, pages
John Wiley & Sons, 2016. Vol. 25, no 6, p. 980-991
Keywords [en]
Abnormal Pap smears, Experience, Healthcare professionals, Qualitative
National Category
Other Medical Sciences
Research subject
Health and Caring Sciences, Caring Science
Identifiers
URN: urn:nbn:se:lnu:diva-47091DOI: 10.1111/ecc.12415ISI: 000393077600006Scopus ID: 2-s2.0-84948845848OAI: oai:DiVA.org:lnu-47091DiVA, id: diva2:868091
Available from: 2015-11-09 Created: 2015-11-09 Last updated: 2018-05-17Bibliographically approved
In thesis
1. Women receiving notification of an abnormal Pap smear result: - experiences and impact on health-related quality of life
Open this publication in new window or tab >>Women receiving notification of an abnormal Pap smear result: - experiences and impact on health-related quality of life
2017 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Aim: The aim of this thesis was to investigate experiences of receiving notification of an abnormal Pap smear result and its impact on women’s health-related quality of life as well as to investigate women’s awareness of human papillomavirus.

 

Methods: In total, 176 women and 20 healthcare professionals participated. Data were collected through individual interviews (I, II) and a questionnaire (IV) including the instrument Functional Assessment of Chronic Illness Therapy – Cervical Dysplasia (FACIT-CD) and Hospital Anxiety and Depression Scale (HADS). For the translation and cross-cultural adaptation of the FACIT-CD, and for evaluation of its linguistic validity and reliability, cognitive debriefing interviews and a questionnaire consisting of the Swedish instrument FACIT-CD was used. Data were analysed by content analysis (I, II) and by using statistical analysis (III, IV), while one part (III) was analysed according to FACIT translation methodology.  

 

Results: Women receiving notification of an abnormal Pap smear result have good overall HRQoL; they become anxious but not depressed. Reasons for anxiety were mainly that women misinterpreted the result as cancer, which could lead to lower attendance for further investigation, treatment and follow-up. To cope with the anxiety, women sought emotional support and information. They primarily used the Internet for information but also turned to healthcare professionals for information needs. Moreover, women had low awareness of HPV, its sexually transmitted nature, and its relationship to abnormal Pap smear results and cervical cancer. An awareness of HPV as a sexually transmitted infection did not lead to higher level of anxiety or more depression symptoms or worse HRQoL, compared to not being aware. Finally, the Swedish FACIT-CD is equivalent to the English version and linguistically valid and exhibited good internal consistency reliability.

 

Conclusion: Women have low awareness of HPV and abnormal Pap smear results, whereupon they misinterpret their test result as cancer. It is of importance that women understand their test result, in order to minimise anxiety as well as to maintain high attendance for investigation, treatment and follow-up of abnormalities.

Place, publisher, year, edition, pages
Växjö: Linnaeus University Press, 2017. p. 96
Series
Linnaeus University Dissertations ; 294/2017
Keywords
Abnormal Pap smear, human papillomavirus, cervical cancer screening, health-related qualtiy of life, anxiety, depression, HADS, FACIT-CD, translation
National Category
Medical and Health Sciences
Research subject
Health and Caring Sciences, Caring Science
Identifiers
urn:nbn:se:lnu:diva-68093 (URN)978-91-88357-86-1 (ISBN)
Public defence
2017-10-13, V159, Stagneliusgatan 14, Kalmar, 10:00 (Swedish)
Opponent
Supervisors
Funder
The Kamprad Family Foundation, 20150012
Available from: 2017-09-25 Created: 2017-09-25 Last updated: 2017-09-25Bibliographically approved

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Rask, MarieOscarsson, MarieSwahnberg, Katarina

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