Marie Oscarsson

Reasons for non-attendance at cervical screening as reported by non.attendees in Sweden

Purpose. To describe reasons for non-attendance at cervical screening, as reported by non-attendees, in Sweden. Methods. Four hundred women were randomized from a population-based register, of which 133 non-attendees answered the Cervical Screening Questionnaire (CSQ) in telephone interviews. Pearsons Chi2 and Mann–Whitney U-test were used to analyze differences between groups. Logistic regression was used to study the relationship between explanatory variables and a binary response variable. Results. The most common reasons for non-attendance were: feeling healthy, lack of time, and feelings of discomfort with the gynecologic examination. Non-attendees, who reported non-attendance due to experiences of discomfort associated with the gynecologic examination, estimated great discomfort at their latest examination. A history of sexual abuse was reported by 16.5%, but there were no differences regarding non-attendance due to experiences of discomfort associated with the gynecologic examination, between non-attendees who had no history of sexual abuse and those who had. Conclusion. It seems as though non-attendees did not attend cervical screening as they felt healthy, and thereby did not give time to preventive efforts. Earlier negative experiences such as discomfort during earlier gynecologic examinations seem to guide their decision not to attend.

'I do not need to... I do not want to... I do not give it priority... : why women choose not to attend cervical cancer screening

Objective To describe and interpret why women with no cervical smear taken during the previous 5 years choose not to attend a cervical cancer screening (CCS) programme.

Not the right time: why parents refuse to let their daughters have the human papillomavirus vaccination

To explore why parents refused to allow their 10‐ to 12‐year‐old daughters to receive the human papillomavirus (HPV) vaccination from the Swedish school‐based vaccination programme.

Women's Experiences of Pelvic Examination: An Interview Study

This qualitative study was designed to explore womens experiences when undergoing pelvic examination (PE). Earlier studies have shown that women are positive to the PE in general, but when describing the specific parts of the procedure, negative terms are used, for example, fear, pain, feelings of humiliation and embarrassment. Data were collected by tape-recorded narrative interviews, with six women aged 20–47 years, who had undergone several PE. A qualitative content analysis was used and three main themes were revealed: the experience of being exposed, the experience of having a trusting relationship with the examiner and the experience of a comforting environment. The findings revealed that it was not only the PE that affected the women, but also the relationship to the examiner. The experience of being exposed could be decreased by, for example, separating the body from the person, being able to relax and by having a trusting relationship with the examiner. The women appreciated having a homelike environment in the outpatient clinic. If women are met and confirmed in accordance with these findings, the examination may be an event without negative experiences for them.

Nonattendance in a cervical cancer screening program - what happens if women's requirements are met?

In this study we focus on women who have no registered cervical smear during the previous 5 years, their requirements for attendance, and promotive efforts performed. Of the 400 women randomly selected to answer a telephone-based questionnaire about future attendance at cervical cancer screening (CCS), 120 would consider having a cervical smear taken, and 50 of them wanted help to accomplish that. When meeting the womens requirements, such as being assured friendly treatment and a suitable appointment time, the numbers of registered cervical smears were higher for the study group compared with a control group. Still, the most highly resistant women did not attend.

Immigrant women's experiences and views on the prevention of cervical cancer: a qualitative study.

Many Western countries have cervical cancer screening programmes and have implemented nation‐wide human papillomavirus (HPV) vaccination programmes for preventing cervical cancer.

School-based intervention for the prevention of HPV among adolescents: a cluster randomised controlled study

Objective To improve primary prevention of human papillomavirus (HPV) infection by promoting vaccination and increased condom use among upper secondary school students. Design Cluster randomised controlled trial. Setting 18 upper secondary schools in Sweden. Participants Schools were first randomised to the intervention or the control group, after which individual classes were randomised so as to be included or not. Of the 832 students aged 16 years invited to participate during the regular individual health interview with the school nurse, 751 (90.2%) agreed to participate and 741 (89.1%) students completed the study. Interventions The intervention was based on the Health Belief Model (HBM). According to HBM, a persons health behaviour can be explained by individual beliefs regarding health actions. School nurses delivered 30 min face-to-face structured information about HPV, including cancer risks and HPV prevention, by propagating condom use and HPV vaccination. Students in the intervention and the control groups completed questionnaires at baseline and after 3 months. Main outcome measures Intention to use condom with a new partner and beliefs about primary prevention of HPV, and also specifically vaccination status and increased condom use. Results All statistical analyses were performed at the individual level. The intervention had a significant effect on the intention to use condom (p=0.004). There was also a significant effect on HBM total score (p=0.003), with a 2.559 points higher score for the intervention group compared to the controls. The influence on the HBM parameters susceptibility and severity was also significant (p<0.001 for both variables). The intervention also influenced behaviour: girls in the intervention group chose to have themselves vaccinated to a significantly higher degree than the controls (p=0.02). No harms were reported. Conclusions The school-based intervention had favourable effects on the beliefs about primary prevention of HPV, and increased the HPV vaccination rates in a diverse population of adolescents. Trial registration number NCT02280967; Results.

Promotion of cervical screening among nonattendees: a partial cost-effectiveness analysis.

Measures to increase attendance rate in cervical screening programmes have been suggested, but few have been evaluated in terms of value for money. The aim of this study was to describe the cost-effectiveness of a resource-intensive intervention to promote attendance at cervical screening among women with no registered cervical smear during the last 5 years. Among all 56 644 women (28–65 years) in Kalmar County, January 2004, a total of 6565 women had no registered cervical smear during the last 5 years. From this population, 400 women were randomly selected to a study group and another 400 women to a control group. The intervention was composed of a variety of efforts intended to promote attendance at cervical screening. We included, for example, all costs for identifying the women, sending out invitation letters, making phone calls and helping to make arrangements. Data on registered cervical smears at follow-up were collected from a data register within 1 year. In the study group, 118 women had a registered cervical smear compared with 74 in the control group (P=0.000). In the study group, the cost per cervical smear taken was 66.87 &U20AC; compared with 16.63 &U20AC; in the ordinary screening programme. The incremental cost per additional registered cervical smear was calculated at 151.36 &U20AC; in an area with high coverage, efforts to promote attendance at cervical screening were related to high costs per extra cervical smear gained and is not considered as reasonable from a cost-effectiveness perspective.

Using the Internet as a source of information during pregnancy — A descriptive cross-sectional study in Sweden

OBJECTIVE The Internet plays a major role for pregnant women in seeking knowledge and for getting in touch with like-minded women. The information is available at all hours and can be accessed anywhere. The information provides the women with a sense of control and confidence but the large amount of information available can also be overwhelming. The aim of this study was to identify how women use the Internet as a source of information during their pregnancy and how it affects them. DESIGN AND SETTING A descriptive cross-sectional study was conducted.Data were collected through a questionnaire at antenatal clinics in the southern Sweden. The data were analyzed descriptively PARTICIPANTS A total of 193 Swedish women, pregnant at least 34 weeks, participated in the study. The response rate was 94%. FINDINGS Almost all (95%) of the women in the study used the Internet as a source of information. The main reason was to find information and read about people in the same situation. Reading pregnancy-related information on the Internet was seen as positive. However, a majority of the woman experienced feelings of worry due to something they read online. These feelings were most commonly coped with by talking to a partner, relatives, and friends or by asking the midwife at their next appointment. Eleven per cent of the women contacted the general healthcare services because of their feelings of worry. CONCLUSION Almost all women in this study searched the Internet to find pregnancy-related information, despite being satisfied with the information they received from the ANC. Using the Internet was seen as complementary to the information from professionals. It also caused feelings of worry, which could lead to the woman contacting healthcare services for support. ANC could help to reduce these feelings for some women by informing about the advantages and disadvantages with online information and recommending suitable web pages.

Psychological Adjustment of Women in Cervical Cancer Screening

Since the widespread introduction of cervical cancer screening programs the incidence and mortality of cervical cancer has declined. In general, cervical cancer screening programs are viewed as a v ...