Revista Gaúcha de Enfermagem

Facilitators and barriers to the Papanicolaou test on women in countryside of Amazonas

ABSTRACT Objective: To identify the facilitators and barriers of performing the Papanicolaou test on women living in countryside of Amazonas. Method: This is an exploratory-descriptive study, with a qualitative approach, conducted with 37 women in two basic health units in the municipality of Coari, Amazonas, from March to April 2022. Data collection took place through individual semi-structured interviews and an audio-recorded focus group technique. The material obtained was submitted to Bardin’s Content Analysis Technique, anchored in the theoretical framework of the health belief model. Results: Facilitators for undergoing the preventive exam included: access to health services, availability of the test at river-based health units, invitation from a health professional and living in an urban area. The main barriers included: lack of forms, time, shortage of professionals, delay in delivering test results, restrictions imposed by husbands, lack of information about the test, financial difficulties, shame, fear, fatalism and geographical difficulties. Conclusion: The main barriers affecting screening adherence rates were institutional, individual and psycho-emotional aspects. Structural actions related to health service management and educational actions aimed at prevention and health promotion may improve the effectiveness of screening programs.

Prevalence and factors associated to cervical changes in units from the Single Health System

ABSTRACT Objective: To estimate the prevalence and risk factors associated with cytopathological changes in the uterine cervix of women treated by the Unified Health System. Method: This is a cross-sectional study carried out with 350 women, between 14 and 79 years old who underwent pap smear tests in heath units in Francisco Beltrão, Paraná. Cervical cytopathological analyses and a questionnaire were applied to obtain socioeconomic information, as well as data on sexual behavior, gynecological aspects, and life habits. Chi-square test and logistic regression with p <0.05 were applied for statistical analysis. Results: The prevalence of cervical changes was 3.4% and the main categories found were low-grade cervical intraepithelial lesion, high-grade cervical intraepithelial lesion, and atypical cells of undetermined significance. From these, the first were present in 16.6% of women under 25 years old. The multivariate analysis pointed at associations between previous results of the cytopathology test (OR = 25.693), smoking (OR = 7.576), and oral contraceptives (OR = 5.265) and the outcome. Conclusion: Women with a history of previous cervical cytopathological abnormality, use of oral contraceptives, and smokers were more likely to have an abnormal result in the pap smear test.