Presentation on theme: "A pilot study to identify why women choose different services for the provision of routine cervical screening S Milligan, ME Cupples, P Milsom. The Queen’s."— Presentation transcript:
A pilot study to identify why women choose different services for the provision of routine cervical screening S Milligan, ME Cupples, P Milsom. The Queen’s University of Belfast Introduction Since its introduction in 1988, the NHS cervical screening program has been reported to have reduced the death rate from cervical cancer by 42%, preventing 3900 1 cases of invasive cervical cancer and more than 1300 2 deaths in the UK each year. Currently cervical smears may be done in general practice (GP) or family planning clinics (FPC) but there is little information as to why different women choose different settings for their smear test. This project aimed to examine the possible differences, in respect of socio-economic factors and reason stated for choice of venue, between women choosing to have their routine smear test taken in GP and at a FPC. Method Semi-structured questionnaires were administered to women attending for routine cervical cytology at GP or FPCs in three different locations. Questions relating to educational attainment, distance from home to clinic, cervical cytology history, smoking habit and the reason for choosing each venue were posed. Sample size calculations indicated that 60 patients were required to detect differences between two groups. Statistical analysis was done using SPSS. Free text answers were analysed qualitatively. Discussion These results show there are differences in respect of reasons why women attend different types of service for routine cervical cytology. However, we found no significant differences, with regard to socio-demographic characteristics, between the groups attending different types of centres. In keeping with previous findings 3 our work has shown that clinic location is associated with attendance for cervical screening. Recall letters have been shown to improve smear uptake 4. No such letter is sent from the FPC but since observations indicated that patients tend to re-attend either FPC or GP services, we suggest close liaison between GPs and FPCs is essential. Qualitative differences were seen between FPC attendees who agreed with previous research 5 based in xxxxxx that nurse time was important, as was an out-of-hours service and GP attendees who thought an appointment system was important. These findings suggest that the services offered are different but complementary. It appears appropriate that these co-exist to allow women choice of service and contribute to efforts to increase the uptake of cervical cytology. Women who attended FPCs felt that dedicated nurse time and out of hours sessions were important features of the service (p<0.05). Those attending GPs felt an appointment system was important (p<0.05). Both groups felt that having a female smear operator was important. Proximity to a FPC appeared to have a significant effect on choice of service (p=0.001). (Table 1) Most women who lived closer to a FPC than their GP chose to attend the FPC. However when clinics were equidistant, more attended their GP. References 1. Secretary of state for health. Our healthier nation. www.ohn.gov.uk//ohn/priorities 18. 10.01 www.ohn.gov.uk//ohn/priorities 2. Department of Health, News desk. Women assured that cervical screening saves lives. 4.5.01. 3. Elkind A, Haron D, Eardley A, Spencer B.Reasons for non attendance for computer-managed cervical screening:pilot interviews. Soc Sci Med 1998;27:651- 4. Moodie P, Kijakovic M, McLeod D. An audit of a cervical smear screening programe. NJ Med J 1989;102:374-6 5 Gun M, A continuing smear campaign. NZ Nurs J 1991;Feb: 19-20 Results Our sample of 60 women included 28 who were married, 26 who had tertiary level education, 36 who were younger than 40 years of age and 8 who were in social classes I and II. There was no significant difference between the two groups ( GP and FPC attendees) with regard to age, social class, educational attainment or marital status. Only five of the participants did not have a female GP. All these attended FPCs (p=0.05). Women tended to re-attend the same service (p<0.001) (Table 2) Table 1 Table 2
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