Women’s knowledge regarding cervical smear test

What is Women’s knowledge regarding cervical smear test?
By
Ranjitha Babu 18111092
A thesis submitted in partial fulfilment of the requirements for the degree of
M.Sc. Nursing Studies
University of Limerick- 2018-2019
COURSE LEADERS:
Jan McCarthy and Claire O’Donnell
Department of Nursing & Midwifery University of Limerick

Sample Declaration of Authorship
I, the undersigned declare that this dissertation which I am submitting is all my own work.
Print Name: RanjithaBabu ID: 18111092
Signature: ________________
Date: 16 / 07 /19

ACKNOWLEDGMENT
I would first like to thank my thesis advisor Jan McCarthy of the department
of Nursing at the University of Limerick. The door to her office was always
open whenever I ran into a trouble or had a question about my thesis or
writing. She consistently allowed this paper to be my own work and steered
me in the right direction whenever she thought I needed it.
I would also like to acknowledge Claire O Donnel of the department of
Nursing at the University of Limerick. Her smile and positive words inspired
and motivated me throughout the period of course. I am also gratefully
indebted to her for her very valuable comments on this thesis.
I would also like to thank my friends for the stimulating discussions, for the
sleepless nights we were working together before deadlines, and for all the
fun we have had in the last one year.
Last but not the least, I would like to thank my family: my parents and to my
sister for supporting me spiritually throughout writing this thesis and my life
in general.

Table of Contents
CHAPTER 1- INTRODUCTION....................................................................................................7
Background......................................................................................................................................7
Rationale:.......................................................................................................................................10
Chapter 2-Methodology.................................................................................................................12
2.1 Introduction..........................................................................................................................12
Research Question:....................................................................................................................16
SELECTING DATABASE:..........................................................................................................17
Search Terms Used to Access Literature...................................................................................19
SELECTING THE LITERATURE:..............................................................................................21
MEDLINE SEARCH:...............................................................................................................24
PsycINFO search:......................................................................................................................25
Conclusion:................................................................................................................................29
SEARCHING THE LITERATURE..........................................................................................29
CHAPTER 3-FINDINGS..............................................................................................................32

INTRODUCTION:....................................................................................................................32
Data extraction...........................................................................................................................33
ORIGIN OF THE ARTICLES..................................................................................................41
Methodologies:..........................................................................................................................43
Lack of knowledge:...............................................................................................................46
Fear of intimate procedure:....................................................................................................48
Doctors influenced:................................................................................................................48
Conclusion.................................................................................................................................49

CHAPTER 1- INTRODUCTION
Background
Cervical cancer is the second most common cancer among women globally (Walsh 2006)
and accounts for 6% of all malignancies in females (Donnelly et al 2013). However, cervical
cancer is a preventable malignant tumour, during an early stage, almost 90% of cases can be
recognized and treated with simple procedures (Donnelly et al 2013).
Cervical cancer is a cancer, develops in cervix, characterised by the growth of abnormal
cells which has capacity to invade or spread to other body parts (Drife et al 2007), types of
cervical cancer are squamous cell carcinoma, cervical adenocarcinoma, adenosquamous
carcinomas, mixed carcinomas, clear-cell and small cell carcinomas (Drife et al 2007), among
above all squamous cell carcinoma is the most common type and cells are flat shaped, which
formulate the thin layer on the surface of the cervix and vagina. cervical adenocarcinomas are
usually cultivated in gland cells which produce mucus and shaped like columns. The remaining
types of cervical cancers are very rare. mostly cervical cancer is caused by the HPV (Human
Papilloma Virus) an estimated nine million people worldwide infected with this virus and
annually 700,000 new cases are reported, spread via sexual intercourse.
Symptoms of cervical cancer are depending on the stages of the cancer, generally the
precancerous symptoms cannot be seen, an early stage the symptoms are very mild like, blood
spots following the period, bleeding after the intercourse, pain during sexual intercourse,

indescribable back pain and vaginal bleeding during menopause, although, these symptoms may
worse and differ if cancer reaches the metastatic stage.
Likewise, the diagnostic procedures also depend on the stages of cancer the patient in.
during the precancerous phase, the Pelvic examination and the Pap test are considered to be the
first and foremost diagnostic procedure those two tests are typically performed together in the
outpatient department. The pelvic examination helps to feel the unusual changes of pelvic organ
and pap test it helps to find the precancerous cells.
George N Papanicolaou is the first man who discovered that the malignant cells from the
cervix can be identified in vaginal smear (Edmund 2009). The procedure is very simple a sterile
instrument called speculum inserted through vagina for the clear view then a small number of
cells can be scraped out from the cervix and send to the laboratory for further evaluations. The
typical version of the Pap test is very hard to read because the extracted cells can be dried out
quickly but with liquid-based cytology preserves sample from drying out. Next to the computer-
based pap test, which is nothing but using a computer to scan the samples for cancerous cells,
can be known as Auto pap.
Globally, every country tries to minimise the cervical cancer incidence by introducing
awareness programmes like school health programmes, awareness campaign, celebrating
cervical cancer day and utilizing mass media for spreading the information ,for example,
according to the health service executives (HSE.ie2017) Ireland offers cost-free cervical