Carla Freijomil-Vázquez

Asymmetric Power Relations in Gynaecological Consultations for Cervical Cancer Prevention: Biomedical and Gender Issues

A generic qualitative research, using a poststructuralist feminist perspective, was conducted in a Spanish gynaecology unit with the following aims: (a) to analyse how asymmetric power relations in relation to biomedical knowledge and gender shape the medical encounters between gynaecologists and women diagnosed with cervical intraepithelial neoplasia and (b) to explore the cognitive, moral, and emotional responses expressed by patients. A total of 21 women diagnosed with cervical intraepithelial neoplasia were recruited through purposive sampling. Semi-structured interviews were recorded and transcribed, and a thematic analysis was carried out. Two major themes were identified: (a) gendered relations in cervical intraepithelial neoplasia medical encounters are based on hidden, judgmental moral assumptions, making women feel irresponsible and blamed for contracting the human papillomavirus infection; (b) biomedical power is based on the positivist assumption of a single truth (scientific knowledge), creating asymmetric relations rendering women ignorant and infantilised. Women reacted vehemently during the interviews, revealing a nexus of cognitive, moral, and emotional reactions. In medical encounters for management of cervical intraepithelial neoplasia, patients feel they are being morally judged and given limited information, generating emotional distress. Healthcare professionals should question whether their practices are based on stereotypical gender assumptions which lead to power asymmetries during encounters.

The Intersecting Effects of Biomedicine and Patriarchy on the Social Lives of Women Undergoing Cervical Cancer Prevention

This article examines how participating in a cervical cancer prevention program affects women's social lives. A generic qualitative study was carried out in a gynecology unit of a public hospital in the northwestern region of Spain. Using purposive sampling, 21 women aged between 21 and 52 years diagnosed with cervical intraepithelial neoplasia of varying degrees, were recruited. Semi-structured interviews were audio recorded and transcribed. The data was analyzed using thematic analysis, based on a poststructuralist feminist perspective. Verification of doubts during data collection, triangulation of researchers' perspectives in data analysis and reflexivity and positionality strategies were employed to ensure study rigor. Two significant themes were identified: (a) the social effects of a cervical intraepithelial neoplasia diagnostic and subsequent follow-up for heterosexual couples within a biomedical healthcare system in a patriarchal society and (b) the social effects of a cervical intraepithelial neoplasia diagnostic and subsequent follow-up for relationships with family members and friends in a patriarchal society. Participants' relationships with partners, relatives and friends were impacted by cervical cancer prevention, revealing an emphasis on the treatment of the physical body and disregard for other dimensions of human life. Two dominant discourses, biomedicine and patriarchy, intersected the care delivery processes, adversely affecting patients' lives. Nurses should broaden their understanding of the social dimensions of cervical cancer prevention and treatment to encompass the multifaceted impact on various individuals, including patients, their partners, family members and friends. The social effects of the diagnostic and treatment of cervical intraepithelial neoplasia should be included in care plans.