Barriers and facilitators to colposcopy attendance following an abnormal pap smear: patient and provider perspectives

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dc.contributor.advisorMoodley, Jenniferen_ZA
dc.contributor.advisorHarries, Janeen_ZA
dc.contributor.authorDawood, Shanaazen_ZA
dc.date.accessioned2015-06-26T11:23:50Z
dc.date.available2015-06-26T11:23:50Z
dc.date.issued2014en_ZA
dc.descriptionIncludes bibliographical references.en_ZA
dc.description.abstractCervical cancer is a public health problem particularly in developing countries where incidence of cervical cancer remains high, either due to a lack of screening or poorly organised screening programmes. Cytology based cervical screening is only beneficial if women with abnormal Papanicolaou (Pap) smears are appropriately investigated. Colposcopy attendance following an abnormal Pap smear is a major problem in South Africa. The aim of this study was to explore barriers and facilitators to colposcopy attendance following an abnormal Pap smear result. A qualitative study was conducted at a public sector tertiary hospital colposcopy service and two primary health care clinics in Cape Town, South Africa. Data collection included 32 semi-structured interviews: 12 face-to-face interviews with colposcopy clinic attendees, 12 telephonic interviews with colposcopy clinic non- attendees and 8 face-to-face interviews with health care providers. Client interviews explored barriers and facilitators to colposcopy attendance; knowledge and experiences of Pap smears, cervical cancer and the colposcopy procedure; scheduling of colposcopy appointments; provider communication; reasons for non-attendance; and community support and beliefs. Provider interviews explored barriers and facilitators to colposcopy attendance from a provider’s perspective, the colposcopy referral process, and provider challenges in the provision of Pap smear or colposcopy services. Results from this study highlighted that the main barriers to colposcopy attendance were: poor levels of knowledge of the importance of a Pap smear and the colposcopy procedure; a lack of awareness of cervical cancer as a disease; a fear of cancer; the asymptomatic nature of the disease; and transport costs. Health system factors that impacted negatively on colposcopy clinic attendance included: the inadequate feedback of Pap smear results – clients were not informed of Pap smear results or colposcopy appointments and therefore did not attend; a disjointed system of colposcopy scheduling; and staff shortages which resulted in less time for client tracking. Factors which promoted colposcopy attendance included experiencing symptoms; a family history of cancer due to the experience with death; colposcopy services situated closer to clients; and social support receive d from family members. Addressing these barriers requires promoting client knowledge with educational materials and improving provider communication with clients. In addition, establishing colposcopy services closer to clients and standardising the system of colposcopy scheduling can improve colposcopy adherence.en_ZA
dc.identifier.apacitationDawood, S. (2014). <i>Barriers and facilitators to colposcopy attendance following an abnormal pap smear: patient and provider perspectives</i>. (Thesis). University of Cape Town ,Faculty of Health Sciences ,Department of Public Health and Family Medicine. Retrieved from http://hdl.handle.net/11427/13135en_ZA
dc.identifier.chicagocitationDawood, Shanaaz. <i>"Barriers and facilitators to colposcopy attendance following an abnormal pap smear: patient and provider perspectives."</i> Thesis., University of Cape Town ,Faculty of Health Sciences ,Department of Public Health and Family Medicine, 2014. http://hdl.handle.net/11427/13135en_ZA
dc.identifier.citationDawood, S. 2014. Barriers and facilitators to colposcopy attendance following an abnormal pap smear: patient and provider perspectives. University of Cape Town.en_ZA
dc.identifier.ris TY - Thesis / Dissertation AU - Dawood, Shanaaz AB - Cervical cancer is a public health problem particularly in developing countries where incidence of cervical cancer remains high, either due to a lack of screening or poorly organised screening programmes. Cytology based cervical screening is only beneficial if women with abnormal Papanicolaou (Pap) smears are appropriately investigated. Colposcopy attendance following an abnormal Pap smear is a major problem in South Africa. The aim of this study was to explore barriers and facilitators to colposcopy attendance following an abnormal Pap smear result. A qualitative study was conducted at a public sector tertiary hospital colposcopy service and two primary health care clinics in Cape Town, South Africa. Data collection included 32 semi-structured interviews: 12 face-to-face interviews with colposcopy clinic attendees, 12 telephonic interviews with colposcopy clinic non- attendees and 8 face-to-face interviews with health care providers. Client interviews explored barriers and facilitators to colposcopy attendance; knowledge and experiences of Pap smears, cervical cancer and the colposcopy procedure; scheduling of colposcopy appointments; provider communication; reasons for non-attendance; and community support and beliefs. Provider interviews explored barriers and facilitators to colposcopy attendance from a provider’s perspective, the colposcopy referral process, and provider challenges in the provision of Pap smear or colposcopy services. Results from this study highlighted that the main barriers to colposcopy attendance were: poor levels of knowledge of the importance of a Pap smear and the colposcopy procedure; a lack of awareness of cervical cancer as a disease; a fear of cancer; the asymptomatic nature of the disease; and transport costs. Health system factors that impacted negatively on colposcopy clinic attendance included: the inadequate feedback of Pap smear results – clients were not informed of Pap smear results or colposcopy appointments and therefore did not attend; a disjointed system of colposcopy scheduling; and staff shortages which resulted in less time for client tracking. Factors which promoted colposcopy attendance included experiencing symptoms; a family history of cancer due to the experience with death; colposcopy services situated closer to clients; and social support receive d from family members. Addressing these barriers requires promoting client knowledge with educational materials and improving provider communication with clients. In addition, establishing colposcopy services closer to clients and standardising the system of colposcopy scheduling can improve colposcopy adherence. DA - 2014 DB - OpenUCT DP - University of Cape Town LK - https://open.uct.ac.za PB - University of Cape Town PY - 2014 T1 - Barriers and facilitators to colposcopy attendance following an abnormal pap smear: patient and provider perspectives TI - Barriers and facilitators to colposcopy attendance following an abnormal pap smear: patient and provider perspectives UR - http://hdl.handle.net/11427/13135 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/13135
dc.identifier.vancouvercitationDawood S. Barriers and facilitators to colposcopy attendance following an abnormal pap smear: patient and provider perspectives. [Thesis]. University of Cape Town ,Faculty of Health Sciences ,Department of Public Health and Family Medicine, 2014 [cited yyyy month dd]. Available from: http://hdl.handle.net/11427/13135en_ZA
dc.language.isoengen_ZA
dc.publisher.departmentDepartment of Public Health and Family Medicineen_ZA
dc.publisher.facultyFaculty of Health Sciencesen_ZA
dc.publisher.institutionUniversity of Cape Town
dc.subject.otherPublic Healthen_ZA
dc.titleBarriers and facilitators to colposcopy attendance following an abnormal pap smear: patient and provider perspectivesen_ZA
dc.typeMaster Thesis
dc.type.qualificationlevelMasters
dc.type.qualificationnameMPHen_ZA
uct.type.filetypeText
uct.type.filetypeImage
uct.type.publicationResearchen_ZA
uct.type.resourceThesisen_ZA
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