"Day or night, no matter what, I will go": Women's perspectives on challenges with follow-up care after cervical cancer screening in Iquitos, Peru: a qualitative study.
Cervical Cancer
Lost to follow-up
Screening
Journal
BMC women's health
ISSN: 1472-6874
Titre abrégé: BMC Womens Health
Pays: England
ID NLM: 101088690
Informations de publication
Date de publication:
31 05 2023
31 05 2023
Historique:
received:
09
12
2022
accepted:
05
05
2023
medline:
2
6
2023
pubmed:
1
6
2023
entrez:
31
5
2023
Statut:
epublish
Résumé
The study's objective was to explore the factors associated with loss to follow-up among women with abnormal cervical cancer screening results in Iquitos, Peru from women's perspectives. In-depth interviews were conducted with 20 screen-positive women who were referred for follow-up care but for whom evidence of follow-up was not found. Interview transcripts were thematically analyzed inductively, and the codes were then categorized using the Health Care Access Barriers Model for presentation of results. All interviewed women were highly motivated to complete the continuum of care but faced numerous barriers along the way, including cognitive barriers such as a lack of knowledge about cervical cancer and poor communication from health professionals regarding the process, structural barriers such as challenges with scheduling appointments and unavailability of providers, and financial barriers including out-of-pocket payments and costs related to travel or missing days of work. With no information system tracking the continuum of care, we found fragmentation between primary and hospital-level care, and often, registration of women's follow-up care was missing altogether, preventing women from being able to receive proper care and providers from ensuring that women receive care and treatment as needed. The challenges elucidated demonstrate the complexity of implementing a successful cervical cancer prevention program and indicate a need for any such program to consider the perspectives of women to improve follow-up after a positive screening test.
Sections du résumé
BACKGROUND
The study's objective was to explore the factors associated with loss to follow-up among women with abnormal cervical cancer screening results in Iquitos, Peru from women's perspectives.
METHODS
In-depth interviews were conducted with 20 screen-positive women who were referred for follow-up care but for whom evidence of follow-up was not found. Interview transcripts were thematically analyzed inductively, and the codes were then categorized using the Health Care Access Barriers Model for presentation of results.
RESULTS
All interviewed women were highly motivated to complete the continuum of care but faced numerous barriers along the way, including cognitive barriers such as a lack of knowledge about cervical cancer and poor communication from health professionals regarding the process, structural barriers such as challenges with scheduling appointments and unavailability of providers, and financial barriers including out-of-pocket payments and costs related to travel or missing days of work. With no information system tracking the continuum of care, we found fragmentation between primary and hospital-level care, and often, registration of women's follow-up care was missing altogether, preventing women from being able to receive proper care and providers from ensuring that women receive care and treatment as needed.
CONCLUSIONS
The challenges elucidated demonstrate the complexity of implementing a successful cervical cancer prevention program and indicate a need for any such program to consider the perspectives of women to improve follow-up after a positive screening test.
Identifiants
pubmed: 37259075
doi: 10.1186/s12905-023-02414-z
pii: 10.1186/s12905-023-02414-z
pmc: PMC10234072
doi:
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Langues
eng
Sous-ensembles de citation
IM
Pagination
293Subventions
Organisme : NCI NIH HHS
ID : R01 CA190366
Pays : United States
Organisme : NCI NIH HHS
ID : P30 CA118100
Pays : United States
Investigateurs
Meda Del Carpio-Morgan
(M)
Henrry Daza Grandez
(HD)
Magaly Figueredo Escudero
(MF)
Esther Y Garcia Satalay
(EY)
Sarah D Gilman
(SD)
Karina Gonzales Díaz
(KG)
José Jerónimo
(J)
Alcedo Jorges
(A)
Anna Kohler-Smith
(A)
Margaret Kosek
(M)
Gabriela Ladrón de Guevarra
(GL)
Daniel Lenin de Cuadro
(DL)
Renso Lopez Liñán
(RL)
Andrea Matos Orbegozo
(AM)
Jaime Marín
(J)
Helen E Noble
(HE)
Victor A Palacios
(VA)
Reyles Ríos Reátegui
(RR)
Karina Román
(K)
Anne F Rositch
(AF)
Carlos Santos-Ortiz
(C)
Hermann F Silva Delgado
(HF)
Sandra Soto
(S)
Nolberto Tangoa
(N)
Javier Vásquez Vásquez
(JV)
Giannina Vásquez Del Aguila
(GV)
Karen Zevallos
(K)
Informations de copyright
© 2023. The Author(s).
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