An Emergency Department-based Intervention after Pelvic Examination to Increase Patient Knowledge Regarding Pap Smear Screening

2002 ◽  
Vol 9 (5) ◽  
pp. 465-b-466
Author(s):  
M. S Lyons
Keyword(s):  
Emergency Department ◽  
Pap Smear ◽  
Patient Knowledge ◽  
Pelvic Examination ◽  
Pap Smear Screening

scholarly journals Conducting health policy analysis in primary care research: turning clinical ideas into action

2019 ◽  
Vol 7 (2) ◽  
pp. e000076 ◽  
Author(s):  
Alina Engelman ◽  
Ben Case ◽  
Lisa Meeks ◽  
Michael D Fetters
Keyword(s):  
Primary Care ◽  
Health Policy ◽  
Policy Analysis ◽  
Pap Smear ◽  
Policy Research ◽  
Primary Care Providers ◽  
Care Providers ◽  
Total Hysterectomy ◽  
Health Policy Analysis ◽  
Pap Smear Screening

Healthcare guidelines play a prominent role in the day-to-day practice of primary care providers, and health policy research leads to the formation of these guidelines. Health policy research is the multidisciplinary approach to public policy explaining the interaction between health institutions, special interests and theoretical constructs. In this article, we demonstrate how primary care providers can conduct high-impact health policy research using Eugene Bardach’s eightfold policy analysis framework in a primary care context. In a medical case, a woman with a history of total hysterectomy had scheduled a visit for a Papanicolaou (Pap) smear screening test as part of a well-woman health check-up with a family medicine resident. Conflicting recommendations on Pap smear screening after total hysterectomy sparked an investigation using the US Preventive Services Task Force criteria for conducting a health policy analysis. We illustrate broadly how clinical care dilemmas can be examined by using Bardach’s broadly applicable health policy framework in order to inform meaningful policy change. Bardach’s framework includes (1) defining the problem, (2) assembling evidence, (3) constructing alternatives, (4) selecting criteria, (5) projecting outcomes, (6) confronting trade-offs, (7) decision-making and (8) sharing the results of the process. The policy analysis demonstrated insufficient evidence to recommend Pap test screening after hysterectomy and the findings contributed to national recommendations. By following Bardach’s steps, primary care researchers have a feasible and powerful tool for conducting meaningful health policy research and analysis that can influence clinical practice.

scholarly journals Pap smear screening in antenatal women: an opportunistic way to save life

2021 ◽  
Vol 10 (8) ◽  
pp. 3158
Author(s):  
Sana Siddiqui ◽  
Suhailur Rehman ◽  
Imam Bano ◽  
Sayeedul H. Arif
Keyword(s):  
Trichomonas Vaginalis ◽  
Pap Smear ◽  
Cervical Screening ◽  
Target Population ◽  
Antenatal Clinic ◽  
Demographic Variables ◽  
Viable Option ◽  
Chi Square ◽  
Cross Sectional ◽  
Pap Smear Screening

Background: Cancer cervix is the most common genital tract malignancy encountered in developing countries. In India, first visit to the gynaecologist for most women is during pregnancy and it may be the only visit. Hence, prenatal care offers an excellent opportunity to implement cervical screening in patients of young age, especially in women who do not seek routine health care. Therefore, this study was conducted to know the prevalence of abnormal Pap smear among the ante-natal women and to evaluate the result in relation to various risk factors.Methods: Cross sectional observational study conducted on 425 ante-natal women attending the antenatal clinic using questioner addressing various socio-demographic variables. Measures of central tendency calculated and result was tabulated by using chi-square test.Results: Maximum number of cases in our study was NILM i.e.314 (74%) followed by 68 cases of Candida (16%), 30 cases of Bacterial vaginosis (7.1%) and 10 cases of Trichomonas vaginalis (2.4%). Only 3 cases of abnormal Pap smear was reported i.e. 2 of ASCUS and 1 of LSIL. Thus, prevalence of abnormal Pap smear was 0.7%.Conclusions: In country like India where organised screening programme are not available, as well as the awareness and uptake of available services by the target population is also poor; screening in pregnancy is worthwhile and may be a viable option to reduce the burden of cervical carcinoma. 

scholarly journals Evaluation of cervicovaginal smear results at postmenopausal period

2016 ◽  
Vol 2 (1) ◽  
Author(s):  
Sefa Kelekci ◽  
Emre Destegül ◽  
Servet Gençdal ◽  
Emre Ekmekçi ◽  
Hüseyin Aydoğmuş ◽  
...  
Keyword(s):  
Postmenopausal Women ◽  
Pap Smear ◽  
Premalignant Lesions ◽  
Low Grade ◽  
High Grade ◽  
Squamous Intraepithelial Lesion ◽  
Screening Programs ◽  
Postmenopausal Period ◽  
Pap Smear Screening ◽  
Intraepithelial Lesion

<p>This study evaluates the statistical analysis of cervicovaginal smear results at postmenopausal period accompanied by literature. Cervicovaginal smear results of 894 postmenopausal women were evaluated retrospectively according to the 2001 Bethesda system (BS) in Adana Numune Training and Research Hospital of Obstetrics and Gynecology Clinic from 2007–2010. The study found, normal results on 287 patients (32.1%), benign findings on 556 patients (62.2%), abnormal epithelial cell changes on 48 patients (5.36%) and malignant changes on 3 patients (0.33%). The abnormal epithelial changes were observed to be atypical cells of undetermined significance (ASC-US) for 22 patients (2.46%), <a href="http://medical-dictionary.thefreedictionary.com/high-grade+squamous+intraepithelial+lesion">low-grade squamous intraepithelial lesion</a> (LSIL) for 11 patients (1.23%), <a href="http://medical-dictionary.thefreedictionary.com/high-grade+squamous+intraepithelial+lesion">high-grade squamous intraepithelial lesion</a> (HSIL) for 7 patients (0.78%), findings that cannot exclude a high-grade squamous intraepithelial lesion (ASC-H) for 6 patients (0.55%) and atypical glandular cells-not otherwise specified (AGC-NOS) for 2 patients (0.22%). Malignant results were 2 squamous cell carcinomas (SCC) (0.22%) and 1 adenocarcinoma (ACC) (0.11%). Cervical cancer screening programs should be expanded and Pap smear screening should be applied to all postmenopausal women. The longer time span involved from premalignant lesions to cancer improves our chance for the diagnosis and treatment. As the incidence of invasive cancer increases in menopausal period, gynecological smear examination and regular check-up are crucial. A high rate of abnormalities of epithelial cells was detected in this study.</p><p> </p>

scholarly journals Feasibility and Efficacy of a Decision Aid for Emergency Department Patients with Suspected Ureterolithiasis: Protocol for an Adaptive Randomized Controlled Trial

2021 ◽  
Author(s):  
Elizabeth M Schoenfeld ◽  
Kye E Poronsky ◽  
Lauren M Westafer ◽  
Paul Visintainer ◽  
Brianna M DiFronzo ◽  
...  
Keyword(s):  
Emergency Department ◽  
Randomized Controlled Trial ◽  
Ct Scan ◽  
Radiation Exposure ◽  
Kidney Stone ◽  
Decision Aid ◽  
Controlled Trial ◽  
Signs And Symptoms ◽  
Patient Knowledge ◽  
Randomized Controlled

Abstract Background: Approximately 2 million patients present to Emergency Departments in the US annually with signs and symptoms of ureterolithiasis (or renal colic, the pain from an obstructing kidney stone). Both ultrasound and CT scan can be used for diagnosis, but the vast majority of patients receive a CT scan. Diagnostic pathways utilizing ultrasound have been shown to decrease radiation exposure to patients but are potentially less accurate. Because of these and other trade-offs, this decision has been proposed as appropriate for Shared Decision-Making (SDM), where clinicians and patients discuss clinical options and their consequences and arrive at a decision together. We developed a decision aid to facilitate SDM in this scenario. The objective of this study is to determine the effects of this decision aid, as compared to usual care, on patient knowledge, radiation exposure, engagement, safety, and healthcare utilization. Methods: This is the protocol for an adaptive randomized controlled trial to determine the effects of the intervention – a decision aid (“Kidney Stone Choice”) – on patient-centered outcomes, compared with usual care. Patients age 18-55 presenting to the Emergency Department with signs and symptoms consistent with acute uncomplicated ureterolithiasis will be consecutively enrolled and randomized. Participants will be blinded to group allocation. We will collect outcomes related to patient knowledge, radiation exposure, trust in physician, safety, and downstream healthcare utilization. Discussion: We hypothesize that this study will demonstrate that “Kidney Stone Choice,” the decision aid created for this scenario, improves patient knowledge and decreases exposure to ionizing radiation. The adaptive design of this study will allow us to identify issues with fidelity and feasibility and subsequently evaluate the intervention for efficacy. Trial registration: ClinicalTrials.gov - NCT04234035https://clinicaltrials.gov/ct2/show/NCT04234035Registered January 21, 2020 – Retrospectively Registered

scholarly journals Description of a Pilot Anal Pap Smear Screening Program Among Individuals Attending a Veteran's Affairs HIV Clinic

2011 ◽  
Vol 25 (4) ◽  
pp. 213-219 ◽  
Author(s):  
Isabella Rosa-Cunha ◽  
Vincent A. DeGennaro ◽  
Rene Hartmann ◽  
Clara Milikowski ◽  
Andres Irizarry ◽  
...  
Keyword(s):  
Pap Smear ◽  
Screening Program ◽  
Pap Smear Screening ◽  
Anal Pap Smear ◽  
Veteran's Affairs
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