What are the patient needs?

Hello Everyone!

Here is an update about what I have been working on the past couple of weeks. My mentor gave me the task of ‘coding’ three individual on-one-one interviews. For those who don’t know what ‘coding’ is, it is the process of reading and analyzing information and recognizing common trends among the information and organizing the ideas accordingly. These interviews were with women who have HIV and cervical cancer and the purpose was to discover what barriers, if any were keeping them from their doctor’s appointments and from getting their pap smears. To say the least, there were so many different answers and feedback from these questions and each one was similar, yet specific to each individual patient.

After reviewing the interviews, I have come up with a list of trends among the three interviews that strike me as important to look further into. This list includes, but is not limited to lack of knowledge, lack of empathy/understanding, lack of trust with health care provider, common misconceptions, and fear. Each individual had their own experiences that shaped their reasons for feeling the way they do about physicians or being diagnosed.

One topic that cut me to the core was fear and lack of trust. One of the common responses I read was the fact that they felt isolated when they went to their appointments and because they have HIV, they are treated differently than the other patients in the clinic. They also responded that the physicians were very insensitive to the fact that they had this diagnoses and aren’t always honest about possible treatment options or social support.

During my presentation, I would like to present the patients with the facts, possible solution options for their concerns, and also resources around their community that they can use to help cope with their diagnoses. It is important for the patients to know about the disease, but you should also inform them as much as possible about the entire spectrum.  As I’ve learned in nursing school, we want our patients to receive holistic care. While I was shocked to hear some of the responses, it was what I needed to become aware of the real issues that lie within the system and the patients. The research team did an awesome job on the interviews, they were able to gain the trust of the patient/participant and answer questions necessary to make a difference.

Overall, this was a great learning experience and I look forward to attending the focus groups, giving my presentation, and making a difference in the community!

Research Article on Cervical Cancer

Hello Everyone! I have attached a research article I stumbled upon regarding cervical cancer. This data came from Atlanta, GA and focused on young African American women ages 18-24. This was very interesting findings related to sexual abuse and it's association with increasing the risk of HPV. While these young women do not have HIV they are at an increased risk. I am within the age and demographics for this study do I found it very interesting. I hope you do too! 

Background

Genital human papillomavirus (HPV) is the most common sexually transmitted infection in the United States. Noticeably absent from the known risk factors for HPV infection is history of sexual abuse. The present study examined the association between sexual abuse and incident high-risk HPV among young adult African-American women.

Results

The prevalence of high-risk HPV was 38.9%. Age-stratified multiple regression analyses examined sexual abuse that occurred over the 12 month follow-up and acquisition of high-risk HPV; known risk factors for HPV were entered as covariates. Women 18–24 with a history of sexual abuse in the past year, relative to participants without a history, were 4.5 times more likely to test positive for an incident high-risk HPV infection (P < .007). This relationship was not significant for the overall sample or for women 25–29.

DISCUSSION

This is among the first studies to demonstrate an association between recent experience of sexual abuse and infection with high-risk HPV among young women 18–24 years of age. Specifically, this study indicated that women who experienced a history of sexual abuse in the past 12 months had a four-and-a half fold increase in high-risk HPV incidence at the 12-month follow-up. Moreover, the association between history of sexual abuse and high-risk HPV infection persisted after adjusting for traditional HPV risk factors.

The prevalence of high-risk HPV in this study corroborates findings observed in other studies.19 The current study suggests that health care providers should routinely screen young adults for a history of sexual abuse, and those identified with this experience should be tested for HPV. Furthermore, young adult women reporting a history of abuse should be referred for appropriate counseling. Given the greater vulnerability of African-American women for high-risk HPV acquisition,13,19 the considerable prevalence of sexual abuse in the population,20 and the association observed between sexual abuse and HPV acquisition, HPV vaccination recommendations for African-American women 18–24 years of age warrant special consideration.

African-American women in this age group could benefit greatly from HPV vaccination. However, if African-American women are uninsured or their health insurance does not include coverage for vaccines, and they cannot afford the vaccine, existing racial disparities could worsen. What is needed is a health policy that provides for unfettered access to these medical advances. Together, advances in medical technology, such as the advent of efficacious vaccines (e.g., HPV), and health policy that provides for unfettered access to these medical advances, can effectively reduce health disparities among women.

The study has several limitations. First, the measure used to asses the primary exposure, recent sexual abuse, was crude and did not assess the frequency and severity of sexual abuse. The present study examined cross-sectional analyses; therefore, the causal and temporal associations between recent sexual abuse and incident high-risk HPV infection cannot be assessed. Additionally, this study was limited to African-American women, 18–29 years of age. Subsequent studies should assess the observed relationship among non-African-American women and with younger samples.

Sex Transm Dis. Author manuscript; available in PMC 2010 December 1.Published in final edited form as: Sex Transm Dis. 2009 December; 36(12): 784- 786.doi: 10.1097/OLQ.0b013e3181b3567e

Gina M. Wingood, Puja Seth, Ralph J. DiClemente, LaShun Simpson Robinson

What is cervical cancer?

Hello everyone, I promised I would keep you updated on my personal research about cervical cancer, so here it is. Below are some basic questions and answers I found on www.cancercenter.com. I look forward to learning the ins and outs about this specific type of cancer and hopefully answering any questions you may have. Feel free to leave topics/questions!

What is cervical cancer? Cervical cancer is a disease in which cancer cells form in the cervix. The cervix is located in the lower portion of the uterus. It connects the uterus (where a baby grows when a woman is pregnant) to the vagina (birth canal).

Typically, cervical cancer develops slowly. The cancerous cells begin to grow in the tissues of the cervix. Gradually, the cells spread throughout the cervix and to surrounding areas.

Who does cervical cancer affect? The National Cancer Institute (NCI) estimates that approximately 11,000 women will be diagnosed with cervical cancer in 2008.

Did you know, from 2000-2004, the average age for women diagnosed with cervical cancer was 48!?

RISKS:

-Socioeconomic status is a major risk factor for cervical cancer
-Smoking
-A high number of sexual partners and sexual intercourse at an early age are other risk factors
-The most significant risk factor for developing cervical cancer is the human papillomavirus (HPV), a virus primarily spread through sexual contact.
** Many women who have cervical cancer also have HPV.

Routine gynecological examinations, including Pap tests, remain the most effective way to prevent invasive cervical cancer. Pap tests (or Pap smears) are simple procedures that enable doctors to look at cells from the cervix to determine if they may be cancerous or precancerous.

FROM ME TO YOU:

The research I am assisting with is conducting one-on-one interviews and focus groups with women diagnosed with HIV and Cervical Cancer to get to the root of why it is difficult for women to maintain their doctors' appointments and pap smears.

As a future nurse, I want to find out the problems that lie within the communities and homes of women diagnosed with cervical cancer and the many other women's health issues and improve the quality and access to care. I also have been coding some one-on-one interviews that were previously conducted in order to find specific trends among women around Alabama in relation to knowledge on cervical cancer, HIV, and what they can do to prevent the spread of the cancer and promote prevention. In the meantime, spread the word to your family members, friends, and even associates about getting Pap smears. I can't stress enough how important it is!

Hello Friend!

My name is Lauren Williams. I am currently a senior at UAB, studying nursing. I am in the UAB Nursing Honors Program and this program has opened up many different opportunities to me as I have been on this journey through nursing school. As my final project, I chose to assist with a research study being conducted in the state of Alabama. The population for the study is HIV infected African American women with cervical cancer. I am very excited to work in this population for a few different reasons. One, because I am an African American Female. Two, because I have lived in Huntsville Al for most of my life until college, and Three, because I am interested in women’s health which in my scope includes: Maternal and Infant care and the diseases that women are more susceptible for than men including but not limited to Breast Cancer, Cervical Cancer, and Ovarian Cancer.

If you continue browsing on my blog, you will understand more about why I chose women’s health specifically.  Most people do not understand the purpose of research and how it is related to the clinical setting, but every section of nursing whether it be education, informatics, research, or clinical practice ALL play an important part in patient holistic care. For instance, the research I am assisting with will answer questions regarding the barriers that are preventing these women from getting their screenings done and making their doctor’s appointments. From the results, we will be able to publish manuscripts and present data that explain what we found and organize a list of interventions that could help eliminate this problem. After these interventions have been proven successful, we then take this new knowledge into the hospital to educate the patients about their risks and what it means for them. We can also thoroughly explain to the patient why they should continue their screens and how it directly benefits them. I am so excited to begin a new area in nursing and I welcome you to follow me on this journey and learn with me! Feel free to comment or ask me questions. One of the tasks I will be working on is a presentation educating all about cervical cancer and its risks. Many women do not know about cervical cancer and how it’s contracted or spread. I hope to find the answers to these questions from various reliable databases. If I could leave you with one message it would be to get the proper screening done while you can. Prevention is a key factor in early detection. In reality, this separates detecting cancer during its first stage and working to prevent its spread versus discovering it in its fourth stage and trying to keep the person alive. This is an important topic that I will be educating the women in this study about, the women in my family, and the women in my community! That is all I have for now about me! Thank you again for visiting my blog and I hope you enjoy!

-Lauren C.