Exploring Cervical Cancer smear tests experience of inpatient Women.
Research type
Research Study
Full title
Exploring the experiences of Cervical Cancer smear tests in inpatient women with a trauma history.
IRAS ID
314530
Contact name
Dipti Mistry
Contact email
Sponsor organisation
Staffordshire University
Clinicaltrials.gov Identifier
n/a, n/a
Duration of Study in the UK
0 years, 9 months, 30 days
Research summary
Research Summary
Cervical Cancer is the 4th most common cancer in women worldwide, affecting approximately 570,000 women globally and 3,152 women in the UK each year. Most Cervical Cancer cases are linked to infection with high-risk human papillomaviruses (HPV), an extremely common virus transmitted through sexual contact. Most Cervical Cancer cases can be prevented through effective primary (HPV vaccination) and secondary prevention approaches (screening for and treating precancerous lesions) can prevent most Cervical Cancer cases.
Research has understood some of the barriers and facilitators for women attending Cervical Cancer smear tests in community settings. Some of these barriers to attendance have included experiences of pain and discomfort, anxiety, embarrassment, self-efficacy, and practical issues, with facilitators to uptake including ease of appointments, reminders, education, invitation, peace of mind and fear of cancer or preventing a serious illness.
The experiences of women in secure settings are less understood. Women in secure settings are known to have complex mental health needs, trauma histories and forensic backgrounds. These women are considered higher risk of the HPV infection, a known link to Cervical Cancer, due to their sexual trauma history, lower engagement in preventative healthcare (e.g., safe sex practices) and overall experience of more gynaecological problems (e.g., pelvic pain). There is also a recognised importance in understanding women’s reproductive history and how this informs engagement with professional’s around gynaecological care. This to ensure these experiences of gynaecological care are not re-traumatising or reminders of historical abuse is important to professionals working with women in secure settings.
The study aims to understand and describe the experiences of cervical cancer smear tests in inpatient women with a trauma history, in the context of their reproductive history.
Research questions:
1.How does history of sexual abuse trauma and experiences of reproductive healthcare influence uptake of Cervical Cancer smear tests assessments in inpatients?
2.What are the perceptions of this population in relation to how Cervical Cancer smear tests uptake can be improved?This study will be conducted across two secure hospitals for women and will involve individual semi-structured interviews with participants.
Summary of Results
In 2023, there was a piece of research that was completed in the Women’s Pathway at two NHS inpatient secure hospitals. The research looked at people’s experiences of cervical screening.
Individual semi-structured interviews were completed with 8 people across the two services. Each interview was audio-recorded and transcribed (written out) and analysed using Interpretative Phenomenological Analysis (IPA). This is a type of qualitative research method analysis to help understand individual/ personal meanings about an experience (e.g., smear tests). Analysing the data/ what people said allowed to create themes and sub-themes.
From the interviews, 2 main themes and 5 smaller themes were identified. This is what people said:Main theme 1: Internal Conflict
Here people shared how earlier experiences of gynaecological examinations influenced beliefs about smear test and engagement with healthcare professionals. This theme includes two smaller themes of ‘Influences of earlier experiences’ and ‘Importance of cervical screening’. Some people shared how their first experience after an examination was after trauma (e.g., sexual trauma) which affected their beliefs about smear tests. Patients also shared how they find or are concerned that cervical screening can re-enact their trauma. This was a reason why they did not attend. However, people also shared how they understood having a cervical screening is important for their health. Some people had learnt from their family whereas other had overheard other people talk about it while in hospital and the information is often frightening. People therefore shared how they are conflicted between knowing its important but concerned based on their earlier experiences.
Main theme 2: Manufacturing Control
Here people shared ways in which they have need to feel in control to feel psychologically safe during the smear test process. This theme includes three smaller themes of ‘Facilitating empowerment’, ‘Psychological readiness’ and ‘Learning, knowledge and having a shared understanding’. This theme illustrates how services create a sense of safety while individuals implement strategies to feel empowered and in control. This includes the importance of being mentally prepared and having enough knowledge about smear tests. People shared how it was important to learn about cervical screening and they wanted to do this while in hospital. This theme highlights, in the absence of this, the negative impacts on an individual’s mental health, recovery and risk, which can contribute to feelings of disempowerment and powerlessness about smear tests. This may also mean people are less likely to have their smear tests.REC name
West of Scotland REC 3
REC reference
22/WS/0120
Date of REC Opinion
17 Oct 2022
REC opinion
Further Information Favourable Opinion