Research Article
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Factors Barring Disadvantaged Roma Women from Participating in Cervical Cancer Screening: Qualitative Analysis

Year 2023, Volume: 12 Issue: 1, 177 - 184, 15.03.2023
https://doi.org/10.53424/balikesirsbd.1050115

Abstract

Objective: The research was carried out to examine the barriers perceived by Roma women, who are among the disadvantaged groups, regarding their cervical cancer early diagnosis behaviors. Materials and Methods: A descriptive phenomenological research method was used. The research was conducted with 20 participants between 16.12.2019 and 3.02.2020. The research data were analyzed by Giorgi in four basic steps proposed for descriptive phenomenological research. Results: The mean age of the Romani women participating in the study is 38.9±8.6 (min:30, max:59). It was determined that 18 of the Romani women had heard of cervical cancer, but they did not have enough information about protection from cervical cancer and there was no diagnosis of cervical cancer in their family history. Conclusion: It was determined that Roma women did not participate in cervical cancer screenings due to "lack of knowledge and awareness", "inability to distinguish between screening and diagnostic tests", "perceived indifference to screenings", "fear" and seeking alternative applications.

References

  • 1. Andreassen, T., Weiderpass, E., Nicula, F., Suteu, O., Itu, A., Bumbu, M., ... & Moen, K. (2017). Controversies about cervical cancer screening: A qualitative study of Roma women's (non) participation in cervical cancer screening in Romania. Social Science & Medicine, 183, 48-55.
  • 2. Aydın Avci, İ., & Aydın, M. (2020). Awareness and health beliefs regarding cervical cancer and screenings of women living two different ethnic groups. Progress in Health Sciences, 10(2), 39–47.
  • 3. Aweke, Y. H., Ayanto, S. Y., & Ersado, T. L. (2017). Knowledge, attitude and practice for cervical cancer prevention and control among women of childbearing age in Hossana Town, Hadiya zone, Southern Ethiopia: Community-based cross-sectional study. PloS one, 12(7), e0181415.
  • 4. Brown, R. F., Muller, T. R., & Olsen, A. (2019). Australian women's cervical cancer screening attendance as a function of screening barriers and facilitators. Social Science & Medicine, 220, 396-402.
  • 5. Bukirwa, A., Mutyoba, J. N., N Mukasa, B., Karamagi, Y., Odiit, M., Kawuma, E., & Wanyenze, R. K. (2015). Motivations and barriers to cervical cancer screening among HIV infected women in HIV care: a qualitative study. BMC women's health, 15(1), 1-11.
  • 6. Cancer Research UK. Health inequalities in cancer and Black and Minority Ethnic Communities.2014. https://www.cancerresearchuk.org/prod_consump/groups/cr_common/@nre/@ pol/documents/generalcontent/crukmig_1000ast-3348.pdf. Erişim tarihi: 20.11.2021
  • 7. CDC (2015). Health, United States, 2015 With Special Feature on Racial and Ethnic Health Disparities. Erişim tarihi: 10.11.2021. https://www.cdc.gov/nchs/data/hus/hus15.pdf
  • 8. Creswell J, Poth C. Qualitative inquiry and research design: choosing among five approaches. Health Promotion Practice. 2015;16:473-475. DOI: 10.1177/1524839915580941).
  • 9. Conde-Ferráez, L., Allen, R. E. S., Martinez, J. R. C., Ayora-Talavera, G., & Gonzalez-Losa, M. D. R. (2012). Factors associated with cervical cancer screening amongst women of reproductive age from Yucatan, Mexico. Asian Pacific Journal of Cancer Prevention, 13(9), 4719-4724.
  • 10. Condon, L., Curejova, J., Morgan, D. L., Miles, G., & Fenlon, D. (2021). Knowledge and experience of cancer prevention and screening among Gypsies, Roma and Travellers: a participatory qualitative study. BMC public health, 21(1), 1-11.
  • 11. Darj, E., Chalise, P., & Shakya, S. (2019). Barriers and facilitators to cervical cancer screening in Nepal: A qualitative study. Sexual & Reproductive Healthcare, 20, 20-26.
  • 12. De Abreu, C., Horsfall, H., & Learmonth, D. (2013). Adherence barriers and facilitators for cervical screening amongst currently disadvantaged women in the greater Cape Town region of South Africa. African Journal of Primary Health Care and Family Medicine, 5(1), 1-10.
  • 13. Ersin, F., Kıssal, A., Polat, P., Koca, B., Erdoğan, M. (2016). Kadın Sağlık Personelinin Servikal Kansere Yönelik Algıları ve Bunu Etkileyen Faktörler. Hemşirelik Araştırma Geliştirme Dergisi.18(2-3):31-43.
  • 14. Fort, V. K., Makin, M. S., Siegler, A. J., Ault, K., & Rochat, R. (2011). Barriers to cervical cancer screening in Mulanje, Malawi: a qualitative study. Patient preference and adherence, 5, 125.
  • 15. Giorgi, A. (2009). The descriptive phenomenological method in psychology: A modified Husserlian approach. Pittsburg, PA: Duquesne University.
  • 16. Kirubarajan, A., Leung, S., Li, X., Yau, M., & Sobel, M. (2021). Barriers and facilitators for cervical cancer screening among adolescents and young people: a systematic review. BMC Women's Health, 21(1), 1-13.
  • 17. Kumar, H. H. N., & Tanya, S. (2014). A study on knowledge and screening for cervical cancer among women in Mangalore city. Annals of medical and health sciences research, 4(5), 751-756.
  • 18. Lee, H., Lee, S. Y., Mtengezo, J. T., Makin, M., Park, J. H., & Thompson, L. (2019). Cancer screening and diagnostic tests in global contexts: Case study and concept analysis. Asia-Pacific journal of oncology nursing, 6(1), 86.
  • 19. Liebermann, E. J., VanDevanter, N., Hammer, M. J., & Fu, M. R. (2018). Social and cultural barriers to women’s participation in pap smear screening programs in low-and middle-income Latin American and Caribbean countries: an integrative review. Journal of Transcultural Nursing, 29(6), 591-602.
  • 20. Lorenzi, N. P. C., Termini, L., Longatto Filho, A., Tacla, M., de Aguiar, L. M., Beldi, M. C., ... & Soares-Júnior, J. M. (2019). Age-related acceptability of vaginal self-sampling in cervical cancer screening at two university hospitals: a pilot cross-sectional study. BMC public health, 19(1), 1-11.
  • 21. Maseko, F. C., Chirwa, M. L., & Muula, A. S. (2015). Health systems challenges in cervical cancer prevention program in Malawi. Global health action, 8(1), 26282.
  • 22. McFadden, A., Siebelt, L., Gavine, A., Atkin, K., Bell, K., Innes, N., ... & MacGillivray, S. (2018). Gypsy, Roma and Traveller access to and engagement with health services: a systematic review. The European Journal of Public Health, 28(1), 74-81.
  • 23. Menon U, Szalacha LA, Prabhughate A. (2012). Breast and cervical cancer screening among South Asian immigrants in the United States. Cancer Nursing. 35(4):278-87.
  • 24. Millan, M., & Smith, D. (2019). A comparative sociology of Gypsy Traveller health in the UK. International journal of environmental research and public health, 16(3), 379.
  • 25. Munthali, A. C., Ngwira, B. M., & Taulo, F. (2015). Exploring barriers to the delivery of cervical cancer screening and early treatment services in Malawi: some views from service providers. Patient preference and adherence, 9, 501.
  • 26. Okoeki, M. O., Steven, A., & Geddes, L. (2016). Psychological factors affecting participation in cervical screening for young women: a qualitative study. The Lancet, 388, S82.
  • 27. Paz-Soldan, V. A., Bisika, T., deGraft-Johnson, J., & Tsui, A. O. (2012). Community, social group, and individual level correlates of rural Malawian men’s and women’s reproductive health intentions and practices. African journal of reproductive health, 16(3).
  • 28. Pierz, A. J., Randall, T. C., Castle, P. E., Adedimeji, A., Ingabire, C., Kubwimana, G., Uwinkindi, F., Hagenimana, M., Businge, L., Musabyimana, F., Munyaneza, A., & Murenzi, G. (2020). A scoping review: Facilitators and barriers of cervical cancer screening and early diagnosis of breast cancer in Sub-Saharan African health settings. Gynecologic oncology reports, 33, 100605. https://doi.org/10.1016/j.gore.2020.100605
  • 29. Pitney WA, Parker J. Qualitative research in physical activitiy and the health professions. Leeds: Human Kinetics Pub.2009. 30. Polit, D. F., & Beck, C. T. (2010). Generalization in quantitative and qualitative research: Myths and strategies. International journal of nursing studies, 47(11), 1451-1458.
  • 31. Ports, K. A., Reddy, D. M., & Rameshbabu, A. (2015). Cervical cancer prevention in Malawi: a qualitative study of women's perspectives. Journal of health communication, 20(1), 97-104.
  • 32. Santamaría-Ulloa, C., Quirós-Rojas, I., Montero-López, M., & Quesada-Leitón, H. (2021). Women’s participation in Pap smear screening in a developing country: evidence for improving Health Systems. Frontiers in Oncology, 11.
  • 33. T.C. Sağlık Bakanlığı. Sağlık İstatistikleri Yıllığı 2019. Sağlık Bilgi Sistemleri Genel Müdürlüğü. Ankara. 2021
  • 34. T.C. Sağlık Bakanlığı. Türkiye Halk Sağlığı Kurumu. Türkiye Kanser Kontrol Programı. Ankara: 2016. 1. Baskı. https://hsgm.saglik.gov.tr/depo/birimler/kanser-db/yayinlar/Kitaplar/TURKIYE_KANSER_KONTROL_PROGRAMI_2016.pdf
  • 35. Twinomujuni, C., Nuwaha, F., & Babirye, J. N. (2015). Understanding the Low Level of Cervical Cancer Screening in Masaka Uganda Using the ASE Model: A Community-Based Survey. PloS one, 10(6), e0128498. https://doi.org/10.1371/journal.pone.0128498
  • 36. WHO. 2021. Cervical Cancer. https://www.who.int/health-topics/cervical-cancer#tab=tab_1. Erişim tarihi: 20.11.2021
  • 37. World Health Organization. Comprehensive Cervical Cancer Control: A Guide to Essential Practice. 2nd ed. Geneva: World Health Organization (2014). Erişim tarihi: 20.11.2021
  • 38. WHO. 11 November 2020. Human Papillomavirus (HPV) And Cervical Cancer. https://www.who.int/news-room/fact-sheets/detail/human-papillomavirus-(hpv)-and-cervical-cancer. Erişim tarihi: 20.11.2021
  • 39. Yanikkerem, E., Selçuk, A. K., & Esmeray, N. (2018). Women's attitude and beliefs about cervical cancer and Pap smear test by using the health belief model. Int J Cancer Clin Res, 5, 102-11.
  • 40. Yıldırım, A. ve Şimşek, H. (2006). Sosyal bilimlerde nitel araştırma yöntemleri. Ankara: Seçkin Yayıncılık

Dezavantajlı Roman Kadınların Servikal Kanser Taramalarına Katılımını Engelleyen Faktörler: Kalitatif Analiz

Year 2023, Volume: 12 Issue: 1, 177 - 184, 15.03.2023
https://doi.org/10.53424/balikesirsbd.1050115

Abstract

ÖZ
Amaç: Araştırma dezavantajlı gruplardan olan Roman kadınların serviks kanseri erken tanı davranışları ile ilgili algıladıkları engellerin incelenmesi amacıyla yapılmıştır. Gereç ve Yöntem: Tanımlayıcı fenomenolojik araştırma yöntemi kullanılmıştır. Araştırma 16.12.2019- 3.02.2020 tarihleri arasında 20 katılımcı ile yapılmıştır. Araştırma verileri Giorgi tarafından tanımlayıcı fenomenolojik araştırmalar için önerdiği dört temel adımda analiz edilmiştir. Bulgular: Araştırmaya katılan Roman kadınların yaş ortalamaları 38.9 ± 8.6 (min:30, max:59) dır. Roman kadınların 18’inin serviks kanserini duyduğu ancak serviks kanserinden korunma hakkında yeterli bilgiye sahip olmadıkları ve aile öykülerinde serviks kanseri tanısının olmadığı saptanmıştır. Sonuç: Roman kadınların “bilgi ve farkındalık eksikliği”, “tarama ve tanı testleri arasında ayrım yapamama”, “taramalara karşı algılanan ilgisizlik”, “korku” ve alternatif uygulama arayışı” nedeniyle serviks kanseri taramalarına katılmadıkları saptanmıştır.

References

  • 1. Andreassen, T., Weiderpass, E., Nicula, F., Suteu, O., Itu, A., Bumbu, M., ... & Moen, K. (2017). Controversies about cervical cancer screening: A qualitative study of Roma women's (non) participation in cervical cancer screening in Romania. Social Science & Medicine, 183, 48-55.
  • 2. Aydın Avci, İ., & Aydın, M. (2020). Awareness and health beliefs regarding cervical cancer and screenings of women living two different ethnic groups. Progress in Health Sciences, 10(2), 39–47.
  • 3. Aweke, Y. H., Ayanto, S. Y., & Ersado, T. L. (2017). Knowledge, attitude and practice for cervical cancer prevention and control among women of childbearing age in Hossana Town, Hadiya zone, Southern Ethiopia: Community-based cross-sectional study. PloS one, 12(7), e0181415.
  • 4. Brown, R. F., Muller, T. R., & Olsen, A. (2019). Australian women's cervical cancer screening attendance as a function of screening barriers and facilitators. Social Science & Medicine, 220, 396-402.
  • 5. Bukirwa, A., Mutyoba, J. N., N Mukasa, B., Karamagi, Y., Odiit, M., Kawuma, E., & Wanyenze, R. K. (2015). Motivations and barriers to cervical cancer screening among HIV infected women in HIV care: a qualitative study. BMC women's health, 15(1), 1-11.
  • 6. Cancer Research UK. Health inequalities in cancer and Black and Minority Ethnic Communities.2014. https://www.cancerresearchuk.org/prod_consump/groups/cr_common/@nre/@ pol/documents/generalcontent/crukmig_1000ast-3348.pdf. Erişim tarihi: 20.11.2021
  • 7. CDC (2015). Health, United States, 2015 With Special Feature on Racial and Ethnic Health Disparities. Erişim tarihi: 10.11.2021. https://www.cdc.gov/nchs/data/hus/hus15.pdf
  • 8. Creswell J, Poth C. Qualitative inquiry and research design: choosing among five approaches. Health Promotion Practice. 2015;16:473-475. DOI: 10.1177/1524839915580941).
  • 9. Conde-Ferráez, L., Allen, R. E. S., Martinez, J. R. C., Ayora-Talavera, G., & Gonzalez-Losa, M. D. R. (2012). Factors associated with cervical cancer screening amongst women of reproductive age from Yucatan, Mexico. Asian Pacific Journal of Cancer Prevention, 13(9), 4719-4724.
  • 10. Condon, L., Curejova, J., Morgan, D. L., Miles, G., & Fenlon, D. (2021). Knowledge and experience of cancer prevention and screening among Gypsies, Roma and Travellers: a participatory qualitative study. BMC public health, 21(1), 1-11.
  • 11. Darj, E., Chalise, P., & Shakya, S. (2019). Barriers and facilitators to cervical cancer screening in Nepal: A qualitative study. Sexual & Reproductive Healthcare, 20, 20-26.
  • 12. De Abreu, C., Horsfall, H., & Learmonth, D. (2013). Adherence barriers and facilitators for cervical screening amongst currently disadvantaged women in the greater Cape Town region of South Africa. African Journal of Primary Health Care and Family Medicine, 5(1), 1-10.
  • 13. Ersin, F., Kıssal, A., Polat, P., Koca, B., Erdoğan, M. (2016). Kadın Sağlık Personelinin Servikal Kansere Yönelik Algıları ve Bunu Etkileyen Faktörler. Hemşirelik Araştırma Geliştirme Dergisi.18(2-3):31-43.
  • 14. Fort, V. K., Makin, M. S., Siegler, A. J., Ault, K., & Rochat, R. (2011). Barriers to cervical cancer screening in Mulanje, Malawi: a qualitative study. Patient preference and adherence, 5, 125.
  • 15. Giorgi, A. (2009). The descriptive phenomenological method in psychology: A modified Husserlian approach. Pittsburg, PA: Duquesne University.
  • 16. Kirubarajan, A., Leung, S., Li, X., Yau, M., & Sobel, M. (2021). Barriers and facilitators for cervical cancer screening among adolescents and young people: a systematic review. BMC Women's Health, 21(1), 1-13.
  • 17. Kumar, H. H. N., & Tanya, S. (2014). A study on knowledge and screening for cervical cancer among women in Mangalore city. Annals of medical and health sciences research, 4(5), 751-756.
  • 18. Lee, H., Lee, S. Y., Mtengezo, J. T., Makin, M., Park, J. H., & Thompson, L. (2019). Cancer screening and diagnostic tests in global contexts: Case study and concept analysis. Asia-Pacific journal of oncology nursing, 6(1), 86.
  • 19. Liebermann, E. J., VanDevanter, N., Hammer, M. J., & Fu, M. R. (2018). Social and cultural barriers to women’s participation in pap smear screening programs in low-and middle-income Latin American and Caribbean countries: an integrative review. Journal of Transcultural Nursing, 29(6), 591-602.
  • 20. Lorenzi, N. P. C., Termini, L., Longatto Filho, A., Tacla, M., de Aguiar, L. M., Beldi, M. C., ... & Soares-Júnior, J. M. (2019). Age-related acceptability of vaginal self-sampling in cervical cancer screening at two university hospitals: a pilot cross-sectional study. BMC public health, 19(1), 1-11.
  • 21. Maseko, F. C., Chirwa, M. L., & Muula, A. S. (2015). Health systems challenges in cervical cancer prevention program in Malawi. Global health action, 8(1), 26282.
  • 22. McFadden, A., Siebelt, L., Gavine, A., Atkin, K., Bell, K., Innes, N., ... & MacGillivray, S. (2018). Gypsy, Roma and Traveller access to and engagement with health services: a systematic review. The European Journal of Public Health, 28(1), 74-81.
  • 23. Menon U, Szalacha LA, Prabhughate A. (2012). Breast and cervical cancer screening among South Asian immigrants in the United States. Cancer Nursing. 35(4):278-87.
  • 24. Millan, M., & Smith, D. (2019). A comparative sociology of Gypsy Traveller health in the UK. International journal of environmental research and public health, 16(3), 379.
  • 25. Munthali, A. C., Ngwira, B. M., & Taulo, F. (2015). Exploring barriers to the delivery of cervical cancer screening and early treatment services in Malawi: some views from service providers. Patient preference and adherence, 9, 501.
  • 26. Okoeki, M. O., Steven, A., & Geddes, L. (2016). Psychological factors affecting participation in cervical screening for young women: a qualitative study. The Lancet, 388, S82.
  • 27. Paz-Soldan, V. A., Bisika, T., deGraft-Johnson, J., & Tsui, A. O. (2012). Community, social group, and individual level correlates of rural Malawian men’s and women’s reproductive health intentions and practices. African journal of reproductive health, 16(3).
  • 28. Pierz, A. J., Randall, T. C., Castle, P. E., Adedimeji, A., Ingabire, C., Kubwimana, G., Uwinkindi, F., Hagenimana, M., Businge, L., Musabyimana, F., Munyaneza, A., & Murenzi, G. (2020). A scoping review: Facilitators and barriers of cervical cancer screening and early diagnosis of breast cancer in Sub-Saharan African health settings. Gynecologic oncology reports, 33, 100605. https://doi.org/10.1016/j.gore.2020.100605
  • 29. Pitney WA, Parker J. Qualitative research in physical activitiy and the health professions. Leeds: Human Kinetics Pub.2009. 30. Polit, D. F., & Beck, C. T. (2010). Generalization in quantitative and qualitative research: Myths and strategies. International journal of nursing studies, 47(11), 1451-1458.
  • 31. Ports, K. A., Reddy, D. M., & Rameshbabu, A. (2015). Cervical cancer prevention in Malawi: a qualitative study of women's perspectives. Journal of health communication, 20(1), 97-104.
  • 32. Santamaría-Ulloa, C., Quirós-Rojas, I., Montero-López, M., & Quesada-Leitón, H. (2021). Women’s participation in Pap smear screening in a developing country: evidence for improving Health Systems. Frontiers in Oncology, 11.
  • 33. T.C. Sağlık Bakanlığı. Sağlık İstatistikleri Yıllığı 2019. Sağlık Bilgi Sistemleri Genel Müdürlüğü. Ankara. 2021
  • 34. T.C. Sağlık Bakanlığı. Türkiye Halk Sağlığı Kurumu. Türkiye Kanser Kontrol Programı. Ankara: 2016. 1. Baskı. https://hsgm.saglik.gov.tr/depo/birimler/kanser-db/yayinlar/Kitaplar/TURKIYE_KANSER_KONTROL_PROGRAMI_2016.pdf
  • 35. Twinomujuni, C., Nuwaha, F., & Babirye, J. N. (2015). Understanding the Low Level of Cervical Cancer Screening in Masaka Uganda Using the ASE Model: A Community-Based Survey. PloS one, 10(6), e0128498. https://doi.org/10.1371/journal.pone.0128498
  • 36. WHO. 2021. Cervical Cancer. https://www.who.int/health-topics/cervical-cancer#tab=tab_1. Erişim tarihi: 20.11.2021
  • 37. World Health Organization. Comprehensive Cervical Cancer Control: A Guide to Essential Practice. 2nd ed. Geneva: World Health Organization (2014). Erişim tarihi: 20.11.2021
  • 38. WHO. 11 November 2020. Human Papillomavirus (HPV) And Cervical Cancer. https://www.who.int/news-room/fact-sheets/detail/human-papillomavirus-(hpv)-and-cervical-cancer. Erişim tarihi: 20.11.2021
  • 39. Yanikkerem, E., Selçuk, A. K., & Esmeray, N. (2018). Women's attitude and beliefs about cervical cancer and Pap smear test by using the health belief model. Int J Cancer Clin Res, 5, 102-11.
  • 40. Yıldırım, A. ve Şimşek, H. (2006). Sosyal bilimlerde nitel araştırma yöntemleri. Ankara: Seçkin Yayıncılık
There are 39 citations in total.

Details

Primary Language Turkish
Subjects Health Care Administration
Journal Section Articles
Authors

Mesiya Aydın 0000-0002-4632-6562

İlknur Aydın Avcı 0000-0002-5379-3038

Publication Date March 15, 2023
Submission Date December 29, 2021
Published in Issue Year 2023 Volume: 12 Issue: 1

Cite

APA Aydın, M., & Aydın Avcı, İ. (2023). Dezavantajlı Roman Kadınların Servikal Kanser Taramalarına Katılımını Engelleyen Faktörler: Kalitatif Analiz. Balıkesir Sağlık Bilimleri Dergisi, 12(1), 177-184. https://doi.org/10.53424/balikesirsbd.1050115

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