Noncompliant behavior for colposcopy examination in women with abnormal pap smears
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Date
1994
Department
Nursing
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Abstract
The purpose of this study was to describe, through a
qualitative approach, the emotional, physical, and
psychosocial barriers experienced by women who are noncompliant
with their scheduled colposcopy exams. The
objectives were to describe from the women's own perspective
what they experienced when receiving abnormal Pap smear
results, to explore the barriers experienced to colposcopy
by non-compliant women, and to conceptualize without the
bias of race, age, or socioeconomic status, common causes of
non-compliance in women. It is hoped that programs can be
developed and tested that would address barriers to
colposcopy and result in successful increases in compliance. The sample consisted of six women noncompliant for
colposcopy after receiving abnormal Pap smears. Three
participants received their gynecological health care from
private physicians, one from a non-profit private
organization, and two from a local health department. Data
were collected prior to the participant's rescheduled
colposcopy exam using an open-ended questionnaire similarly
structured for all interviews. Data analysis was done
through transcriptions of the interviews and coding of
common concepts. Five categories describing the emotional, physical and psychosocial barriers emerged from 20 codes.
Validation of the codes and categories was accomplished
through confirmation interviews with two of the six
participants, the thesis chair and input from an experienced
ethnographic researcher. Five categories emerged from the data: fear, denial,
social and self influence, lack of knowledge and physical
obstacles. They comprised the experience of having an
abnormal Pap smear and noncompliance for colposcopy for the
six participants. The categories of fear and denial
contained the emotional response to the abnormal Pap smear
and the colposcopy procedure. The category, social and self
influence and lack of knowledge, elicited psychosocial
influences for colposcopy compliance. The category,
physical obstacles, consisted of physical and psychosocial
barriers to compliance for colposcopy examination. It is
important for nurses to consider the individual impact of
having an abnormal Pap smear and be aware of the multitude
of emotional, physical and psychosocial influences for
compliance to colposcopy and to tailor his or her counseling
to meet not only the woman's informational needs but her
emotional needs as well.