Decision making about Pap test use among Korean immigrant women: A qualitative study

Abstract

BackgroundUnderstanding how individuals make decisions about Pap tests concerning their personal values helps health‐care providers offer tailored approaches to guide patients’ decision making. Yet research has largely ignored decision making about Pap tests among immigrant women who experience increased risk of cervical cancer.ObjectiveTo explore decision making about Pap tests among Korean immigrant women.MethodsWe conducted a qualitative descriptive study using 32 semi‐structured, in‐depth interviews with Korean immigrant women residing in a north‐eastern metropolitan area. Data were audio‐recorded, transcribed verbatim and analysed using inductive coding.ResultsAlthough most women with positive decisions made their own decisions, some women deferred to their providers, and others made decisions in collaboration with their providers and significant others. While women making positive decisions tended to consider both barriers to and facilitators of having Pap tests, women making negative decisions predominantly discussed the barriers to having Pap tests, such as modesty and differences between the South Korean and US health‐care systems. The women's reflections on their decisions differed regarding their Pap test decisions.ConclusionsWomen's desired roles in the decision‐making process and reflection on their decision outcome appeared to vary, although most participants with positive decisions made their own decisions and were satisfied with their decisions. Future research should conduct longitudinal, quantitative studies to test our findings regarding decision‐making processes and outcomes about Pap tests.ImplicationsThe findings should be incorporated into cervical cancer screening practices to fulfil the unmet needs of immigrant women in patient‐provider communication and to facilitate women's decision making about Pap tests.

Human Papillomavirus Vaccine Predictors Among U.S. Adults Aged 18 to 45 by Sexual Orientation

“…Ample evidence supports that having a primary care provider is one of the strongest correlates of HPV vaccination completion as well as initiation (Hoffman et al, 2014; Kim, Kim, Choi, Song, & Han, 2015; Kim, Kim, Gallo, Nolan, & Han, 2017). Reiter et al (2015) found that more than four in five adult bisexual and gay men who had received HPV vaccine recommendations by their provider were vaccinated, whereas only 5% were vaccinated without receiving the recommendation.…”

“…One possible explanation for the nonsignificant impact of having a health care provider on HPV vaccine uptake in certain young sexual minority respondents may be mistrust between providers and patients affected by stigmatization and providers’ lack of knowledge, and discrimination against and negative attitudes toward sexual minority men/women (Fernandez, Allen, Mistry, & Kahn, 2010; Quinn et al, 2015; Ylitalo, Lee, & Mehta, 2013). In the context of cancer control, how providers give recommendations and communicate with their patients is critical for patients to adopt desirable preventive behaviors (Hoffman et al, 2014; Kim et al, 2015; Kim et al, 2017). Yet, ineffective communication within the patient–provider relationship is prevalent.…”

Variation in Cervical Cancer Screening Preferences among Medically Underserved Individuals in the United States: A Systematic Review

“…Torres and colleagues similarly found that the majority of Hispanics interviewed preferred a Spanish-speaking health care professional (58). Although Kim and colleagues found that the majority of Korean immigrant women interviewed preferred a female provider who spoke Korean, their provider language preference changed if seeing a male doctor, preferring a male provider who did not speak Korean out of concern for privacy (61).…”

A qualitative study exploring factors associated with Pap test use among North Korean refugees

“…Although the access-enhancing approach was relatively successful in South Korean women, no known study has tested a navigator program to promote cancer screenings among North Korean refugees residing in South Korea. Based on the successful results in the previous studies (Lee & Jo, 2011; Percac-Lima et al, 2012), we suggest a navigation program to help North Korean women find an appropriate healthcare provider, particularly for those who encounter challenges in seeking a female healthcare provider in the Korean community (K. Kim, 2015).…”