Appraisal Exercise: Context of barriers to Pap testing in Korean women
Cervical cancer forms 9% of all growth of cancer among women in Korea. Even with the cost effective Paponicolauo test provided to help detect and fight cervical cancer early enough, the rate of Pap test participation in Korean women remained low. There must be factors relating to the low rate that call for the need to implement the target-focused interventions. This study makes us understand the barriers to Pap testing to Korean women and sends us a message for intervention.
Purpose and Research Questions
The purpose of the study is to explore the context of barriers to a Pap testing among Korean women. The research questions the authors intend to answer are: why is participation rate among Korean women low? why did women dislike a pap test? , and what were the women Pap test experiences? The purpose of the study answers the questions. The qualitative method used was effective as it is very useful in gathering the perceptions of people about the health risk.
The authors used both qualitative and quantitative studies for the study. They included information from CINAHL databases and statistics databases as well. The sources used are those researched between 1990 to 2004 and not very recent researches. The authors did not evaluate the effectiveness of the available studies, but I think the literature review is too old to provide information applicable today that relates to the author’s argument.
Frame of reference
The authors identified the health risk perception of people as the bases of the development of the study. One of the frameworks used by the authors comprised contextual themes which were findings from the qualitative inquires. The authors also included a framework of participants of Pap test and their experiences obtained from a Korean statistical database.
The research tradition implied in the study is the use of qualitative research through grounded theory approach. The authors were consistent with this approach by first recruiting a sample that would help in the development of the theory. The authors incorporated interviews and participant observations together with collecting texts from various databases which are all methods included in the development of grounded theory. The findings and conclusion were made from information gathered by the methods.
Sampling and sample
The participants were recruited through snowball sampling. The sample of the study was obtained from three metropolitan cities of Korea specifically from a suburb of each city. The samples were fit for the study because they represented a wide range of age groups and cultures in Korea. The inclusion criteria used was recruiting women of 40 years of age and below who were married and sexually active. This was because they were the group subjected to highest risk of cervical cancer and also because they were the ones allowed Korean culture to discuss social issues in public. The number of participants in discussion groups was not provided, but the statistics retrieved from Korean databases had 23 participants, and all provided full information as provided.
The study explored and used focus group for the study because they were effective in producing information from synergy effect of been in a group environment and had common backgrounds. Data was collected through unstructured interviews by asking participants open-ended questions. The discussions were recorded and translated into the English language. With the help of a nursing professor, the contextual themes were analyzed.The study took place in 2006.
Protection of human participants
The authors point out that the Korean culture is conservative on discussing sexual activities in public and therefore only married women were free discussing them. One benefit not identified by authors is that participating educated women about Pap test.The study used inclusion criteria where it used participants that were allowed by the culture to discuss sexual activities in public. The participants, therefore, include married women of 40 years and below. Further, in acknowledgment of participant sensitivity, unstructured interviews were used, and participants openly discussed their activities as a group. It was up to them to raise any issue.
Data management and analysis
In the analysis of the data collected, the audiotapes containing the recordings were transcribed, and content analysis together with the coding significant statement was done. Significant themes were grouped into categories. The authors assured rigor of process by involving an English native speaker, a nursing professor to validate the translated meanings and themes obtained. This process also prevented chances of research bias. The data management and analysis methods were useful and led to the development of contextual themes which satisfied the research purpose of finding out contextual barriers to Pap test.The discussions were made open, and women freely gave out their experiences and views about the test from which barriers could be identified.
The findings identified barriers that led to low Pap test participation rates in Korean women. The process of data analyses ensures that every significant and illuminating statements from the recorded discussions were coded and every issue addressed was taken into account. The interpretation made related to the type of data collected, and it was the best method to analyze information from open discussions. The authors revealed variation in sensitivity and extent of knowledge with age stating that women in their 20s and 30s were less sensitive to the issue because they thought they were less likely to get cancer. They were also less knowledged on the issue.
The study revealed two knew most significant factors to Pap Testing in Korean women. These factors were negative views by health professionals and dissatisfaction of healthcare system. The other factors included poor attitude by the healthcare service providers and lack of considering privacy issue which were said to be consistent with results of previous studies. The results address the significance of clinical practices and healthcare system which can be managed by the governmental reforms for quality healthcare. The authors suggest that healthcare provides should change their attitude to show respect and care to women. They also suggested improvement of environmental conditions to be conducive for women seeking the Pap test service. The authors also state that nursing laws are being established to ensure changes in practices and systems.
Logic and form of findings
The direct quotations of participants’ statements provided the reader with a better understanding of the phenomenon. The readers could easily identify methods used and the findings of the study. The methods used for the study and its outcomes were relevant and fit the purpose of the study. The form of presentation allowed for a follow-up of the results and comparing studies which gave a clear picture of the phenomenon.
Evaluation and Summary
The finding of the study reflects the barriers experienced today by women undertaking Pap test, not only in Korea but also in other countries around the world. Reading about women concerns helps all providers within the nursing practice to adjust to their practices to satisfy women’s needs. The findings advocate for the need to influence good attitude by service providers and improve environmental conditions where healthcare practices take place. Because sexual activity is unethical in Korea among the young people, the authors of this study suggest for more qualitative and quantitative researches to explore factors affecting the participation rate in Pap testing.