scholarly journals “They Should Be Asking Us”: A Qualitative Decisional Needs Assessment for Women Considering Cervical Cancer Screening

2018 ◽  
Vol 5 ◽  
pp. 233339361878363 ◽  
Author(s):  
Brianne Wood ◽  
Virginia L. Russell ◽  
Ziad El-Khatib ◽  
Susan McFaul ◽  
Monica Taljaard ◽  
...  
Keyword(s):  
Health Care ◽  
Cervical Cancer ◽  
Decision Making ◽  
Cancer Screening ◽  
Shared Decision Making ◽  
Cervical Cancer Screening ◽  
Cervical Screening ◽  
Hpv Testing ◽  
Shared Decision ◽  
Care Providers

In this study, we examine from multiple perspectives, women’s shared decision-making needs when considering cervical screening options: Pap testing, in-clinic human papillomavirus (HPV) testing, self-collected HPV testing, or no screening. The Ottawa Decision Support Framework guided the development of the interview schedule. We conducted semi-structured interviews with seven screen-eligible women and five health care professionals (three health care providers and two health system managers). Women did not perceive that cervical screening involves a “decision,” which limited their knowledge of options, risks, and benefits. Women and health professionals emphasized how a trusted primary care provider can support women making a choice among cervical screening modalities. Having all cervical screening options recommended and funded was perceived as an important step to facilitate shared decision making. Supporting women in making preference-based decisions in cervical cancer screening may increase screening among those who do not undergo screening regularly and decrease uptake in women who are over-screened.

Knowledge and Practice of Cervical Cancer Screening among Women in Orlu Local Government Area, Imo State, Nigeria.

2019 ◽  
Vol 1 (1) ◽  
pp. 55-65
Author(s):  
Jude Egwurugwu ◽  
S.D. Ejikunle ◽  
E.I. Dike ◽  
M.C. Ohamaeme ◽  
Jude Egwurugwu ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Cancer Screening ◽  
Local Government ◽  
Cervical Cancer Screening ◽  
Cervical Screening ◽  
Local Government Area ◽  
Care Providers ◽  
Imo State ◽  
Study Results ◽  
Knowledge And Practice

Background: Cervical cancer is the 2nd commonest cancer among women worldwide and the most common cancer among women in developing countries like Nigeria. Though preventable by screening for premalignant and early cervical lesions, this is predicated on the knowledge and practice of a cervical screening. Objective: To assess the knowledge and practice of cervical cancer screening among women in Orlu, Local Government Area(LGA) Imo State, Nigeria. Materials & Methods: A community based cross-sectional study with the use of 502 interviewer – administered questionnaires was conducted among women in Orlu LGA of Imo State. All the women in the communities attending the annual August Meeting who consented were recruited for this study. Results: The study showed that the mean age of the respondents was 42±2.8years. Furthermore, 82.3% of respondents attained postsecondary school educational level, 61.8% & 21.1% were multiparous and grand multiparous respectively. Also, 80.5% of respondents have heard about cervical cancer screening. Majority (67.5%) of these respondents heard it from health care providers. There was a positive statistically significant relationship between educational status and the likelihood of having knowledge of cervical cancer screening, (p< 0.01). The level of practice of cervical cancer screening was very low among the respondents(13.5%).Though majority of the respondents have high level of educational attainment this did not reflect their practice of cervical cancer screening. Conclusion: There was high knowledge of cervical cancer and cervical screening modalities among women in Orlu but their practice of cervical cancer screening was very low. There is an urgent need to educate and encourage women on the benefits of cervical cancer screening. Key words: cervical cancer, knowledge, Practice, Orlu women, Screening.

scholarly journals Strategies to reach marginalized women for cervical cancer screening: A qualitative study of stakeholder perspectives

2018 ◽  
Vol 25 (1) ◽  
pp. 8 ◽  
Author(s):  
B. Wood ◽  
A. Lofters ◽  
M. Vahabi
Keyword(s):  
Cervical Cancer ◽  
Cancer Screening ◽  
Qualitative Study ◽  
Cervical Cancer Screening ◽  
Health Care Providers ◽  
Cervical Screening ◽  
Primary Care Providers ◽  
Care Providers ◽  
Structured Interviews ◽  
Primary Screening

Background Self-sampling for human papillomavirus (hpv) has the potential to reach marginalized populations that are underserved for cervical cancer screening. However, before implementing an alternative screening strategy such as self-sampling for under- and never-screened women, the key processes, facilitators, and barriers to reform need to be understood.Methods A descriptive qualitative study was conducted that involved semi-structured interviews with Canadian and international cancer screening health care providers and policy-makers. Respondents were purposively selected from a list of thirty stakeholders generated through an environmental scan. The interviews were transcribed verbatim and analyzed using directed content analysis.Results Nineteen stakeholders participated in the interviews. Most respondents thought that self-sampling was an appropriate cervical screening alternative for hard-to-reach populations, as it addressed barriers to cervical screening related to various social determinants of health. All respondents emphasized that transitioning to hpv primary screening would catalyze a policy shift towards self-sampling. Clinician respondents were less enthusiastic about self-sampling strategies since that discouraged women’s appointments with primary care providers, because cervical screening offered an opportunity to discuss other preventive health topics. There also was little consensus between respondents on whether the state of evidence was satisfactory to integrate a self-sampling option into policy, or whether more Canadian research was needed.Conclusion Canadian cervical cancer screening stakeholders should collaborate to identify the knowledge gaps that researchers should address and leverage the existing literature to implement tailored, patient-centred alternative cervical screening strategies. The transition to hpv primary screening would be a key first step in the broad implementation of hpv self-sampling in Canada.

scholarly journals An integrated knowledge translation approach to develop a shared decision-making strategy for use by Inuit in cancer care: a qualitative study

2019 ◽  
Vol 26 (3) ◽  
Author(s):  
J. Jull ◽  
A. Hizaka ◽  
A. J. Sheppard ◽  
A. Kewayosh ◽  
P. Doering ◽  
...  
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Knowledge Translation ◽  
Shared Decision Making ◽  
Cancer Care ◽  
Community Support ◽  
Integrated Knowledge Translation ◽  
Shared Decision ◽  
Care Providers ◽  
Integrated Knowledge

Background In relation to the general Canadian population, Inuit face increased cancer risks and barriers to health services use. In shared decision-making (sdm), health care providers and patients make health care decisions together. Enhanced participation in cancer care decisions is a need for Inuit. Integrated knowledge translation (kt) supports the development of research evidence that is likely to be patient-centred and applied in practice.Objective Using an integrated kt approach, we set out to promote the use of sdm by Inuit in cancer care.Methods An integrated kt study involving researchers with a Steering Committee of cancer care system partners who support Inuit in cancer care (“the team”) consisted of 2 theory-driven phases:■ using consensus-building methods to tailor a previously developed sdm strategy and developing training in the sdm strategy; and■ training community support workers (csws) in the sdm strategy and testing the sdm strategy with community members.Results The team developed a sdm strategy that included a workshop and a booklet with 6 questions for use by csws with patients. The sdm strategy (training and booklet) was finalized based on feedback from 5 urban-based Inuit csws who were recruited and trained in using the strategy. Trained csws were matched with 8 community members, and use of the sdm strategy was assessed during interviews, reported as 6 themes. Participants found the sdm strategy to be useful and feasible for use.Conclusions An integrated kt approach of structured research processes with partners developed a sdm strategy for use by Inuit in cancer care. Further work is needed to test the sdm strategy.

scholarly journals Shared decision-making in food allergy management

2020 ◽  
Vol 2 (1) ◽  
pp. 124-127
Author(s):  
Meera Patrawala ◽  
Gerald Lee ◽  
Brian Vickery
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Food Allergy ◽  
Shared Decision Making ◽  
Health Care Providers ◽  
Decision Aids ◽  
Shared Decision ◽  
Care Providers ◽  
Patient Centered ◽  
Evidenced Based

Historically, the role of the health-care provider in medical practice has been primarily paternalistic by offering information, compassion, and decisive views with regard to medical decisions. This approach would exclude patients in the decision-making process. In a shift toward more patient-centered care, health-care providers are routinely encouraged to practice shared decision making (SDM). SDM uses evidence-based information about the options, elicitation of patient preferences, and decision support based on the patient’s needs with the use of decision aids or counseling. Although there are well-known benefits of SDM, including improvements in psychological, clinical, and health-care system domains providers have found it challenging to apply SDM in everyday clinical practice. In allergy, we have a unique role in the treatment of children and adults, and SDM should be applied appropriately when engaging with these specific groups. There are many situations in which there is not a clear best option (food allergy testing, food introduction and challenges, and immunotherapy). Therefore, decision aids specific to our field, coupled with evidenced-based information that ultimately leads to a decision that reflects the patient’s values will make for a vital skill in practice. In this article, we defined SDM, the benefits and barriers to SDM, unique situations in SDM, and approach to SDM in food allergy.

scholarly journals KNOWLEDGE, ATTITUDE AND PRACTICES IN CERVICAL CANCER SCREENING IN KAKAMEGA COUNTY, KENYA

2021 ◽  
Vol 7 (3) ◽  
pp. 51-66
Author(s):  
Gregory Sakwa ◽  
Peter Bukhala ◽  
Mary Kipmerewo ◽  
Zachary Kwena
Keyword(s):  
Health Care ◽  
Cervical Cancer ◽  
Cancer Screening ◽  
Cervical Cancer Screening ◽  
Positive Attitude ◽  
Reproductive Age ◽  
Research Approach ◽  
Unique Contribution ◽  
Care Providers ◽  
Poor Knowledge

Purpose: Early cervical cancer screening (CCS) and treatment is effective method of controlling the disease, however its uptake is poor. Women only screen for cervical cancer when they experience symptoms or when advised by healthcare workers. Main objective of the study was to assess knowledge, attitude and practices of cervical cancer screening among women in Kakamega County. Methodology: The target population was 208,905 women of reproductive age residing in Kakamega County. This was a quantitative research approach utilizing descriptive study design. An interviewer administered questionnaire was used to collect data. Multi-stage sampling was used to select 872 women aged 25-49 from 16 community units of Kakamega County. Participants were assured of confidentiality, voluntary participation and freedom to exit the study at any point. Descriptive statistics were used to analyze knowledge and attitude levels towards cervical cancer screening. Logistic regression along with odds ratios at 95% confidence intervals was used to analyze factors affecting uptake of screening. Findings: Majority (81%) of participants had heard of cervical cancer screening mainly from media and Health Care workers. Only 16 % and 13% had good knowledge about signs of and risk factors of cervical cancer respectively. More than 78% had positive attitude towards cervical cancer screening. Less than 22% of participants had been screened for cervical cancer previously. Uptake of cervical cancer screening was low, and there was poor knowledge on aspects of cervical cancer. Poor to average knowledge is not sufficient to enable women make decisive actions on CCS. Unique Contribution to Theory, Practice and Policy: Women should be encouraged to seek for more information about CCS through the various sources of media available to them. Healthcare providers need to be empowered further on delivering key information about CCS. The Ministry of Health should consider and strengthen alternative sources of information on CCS by use of Community Health Volunteers to complement health care providers. The government should further initiate a monitoring and evaluation program to track trends of factors barring uptake of CCS. A qualitative research need to be conducted to establish deeper factors associated with poor knowledge and uptake of CCS despite positive attitude.

scholarly journals A Systematic Literature Review of Shared Decision Making in Cancer Care (Preprint)

2018 ◽  
Author(s):  
Colleen A. McHorney ◽  
Lindsey T. Murray ◽  
Dayo Jagun ◽  
Jennifer Whiteley ◽  
Miriam Kimel ◽  
...  
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Quality Of Care ◽  
Shared Decision Making ◽  
Cancer Care ◽  
Quantitative Measure ◽  
Shared Decision ◽  
Care Providers ◽  
Clinician Communication

BACKGROUND Shared decision making (SDM) is a process in which health care providers and patients relate to and influence each other as they collaborate in making decisions about patients’ health care. Hypothesized as a means to improve quality of care, successful applications of SDM in routine cancer care have not been widely documented. OBJECTIVE The objective of this study was to examine the literature to determine if elements of SDM implementation between cancer patients and their clinicians were more or less successful at improving the quality of care and health outcomes. METHODS A systematic literature search of SDM approaches and outcomes in cancer care was conducted using PubMed and EMBASE. An integrative model for SDM was used to classify elements included in SDM intervention studies and the resulting outcomes. RESULTS From 1,018 unique publications, 23 articles meeting eligibility criteria were included. Only three studies addressed elements of patient-clinician interaction as part of the study objectives. Interventions included decision aid (DA) evaluation (n=22) and clinician communication training (n=1). SDM elements commonly included were: defining/explaining the problem (n=23); presenting options (n=19); discussing pros and cons (n=17); assessing patient priorities and preferences (n=17); clinician knowledge and recommendations (n=15); and making or deferring treatment decisions (n=12). The most frequently-measured outcomes were patient-reported outcomes including treatment preference or decision (n=12), decisional conflict (n=10), patient satisfaction (n=10), patient participation (n=9), and patient knowledge (n=7). No clear patterns demonstrating relationships between SDM elements and outcomes were identified. Information on how patients and clinicians utilized DA information to promote SDM was limited. CONCLUSIONS Evaluation of SDM in cancer care has been increasing. However, the term “SDM” was generally applied to studies that focused on the development and/or evaluation of DAs which limited the current analyses to a review of SDM elements as part of the DAs. Most studies did not include a qualitative or quantitative measure of SDM specific to patient-clinician communication and interaction. Instead, there was an underlying assumption that SDM occurred organically with DA implementation. Without a qualitative or quantitative measure of SDM, identification of successful SDM elements and their relationships to patient outcomes remains unclear. Additional research is warranted on SDM implementation and measurement in real-world cancer care settings.

scholarly journals Who Should Decide? Decision-Making Preferences for Primary HPV Testing for Cervical Cancer Screening Among U.S. Women

2021 ◽  
Vol 4 (1) ◽  
Author(s):  
Erika L. Thompson ◽  
Ashvita Garg ◽  
Katharine J Head ◽  
Stacey B Griner ◽  
Annalynn M Galvin ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Decision Making ◽  
Cancer Screening ◽  
Cervical Cancer Screening ◽  
Hpv Testing

scholarly journals Shared Decision-making between health care providers and patients at a Tertiary Hospital Diabetic Clinic in Tanzania

2020 ◽  
Author(s):  
Oswald Vedasto ◽  
Baraka Morris ◽  
Francis Fredrick Furia
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Shared Decision Making ◽  
Health Care Providers ◽  
Shared Decision ◽  
Care Providers ◽  
Muhimbili National Hospital ◽  
National Hospital ◽  
Diabetic Clinic ◽  
Participation In Decision Making

Abstract Background Patients’ participation in decision making regarding their treatment play an important role in treatment outcome through improvement in self-care and adherence to treatment. There is scarcity of information regarding shared decision making in sub-Saharan Africa. This study was conducted to assess participation of patients and health care providers in decision-making process in the diabetic clinic at Muhimbili National Hospital, Dar es Salaam, Tanzania.Methods This study employed a phenomenological study design using in-depth interview technique. Study participants were diabetic patients visiting the clinic and healthcare providers working in the diabetic clinic at Muhimbili National Hospital. Data was collected using interview guide with open ended questions using an audio digital recorder. Content analysis method was used during analysis whereby categories were reached through the process of coding with assistance by Nvivo 12 software. Results Several themes were identified in this study including some form of participation in decision making of patients, use of decision aids in the clinic and belief and values regarding patients’ engagement in decision making. Several factors were identified as barriers to shared decision making as noted from participants interview, these included lack of time, literacy level, beliefs and values. Decision aids were reported to be important for improving patient’s knowledge and subsequently their involvement in decisions that were made although it was also noted that these were not prepared by the health care providers in the clinic and they were not adequately provided.Conclusion Some form of participation in decision making was observed in the diabetic clinic at Muhimbili national Hospital, and barriers identified for shared decision-making included time, literacy, beliefs and values.

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