title: Experiences of Cervical Cancer Survivors in Rural Eastern North Carolina: a Qualitative Assessment.
abstract: Little qualitative research has been conducted with cervical cancer survivors. We sought to understand the experiences of survivors in rural Eastern North Carolina and identify any barriers which may have kept women from receiving preventive Papanicolaou screenings or follow-up care. We conducted semi-structured in-depth interviews with 15 low-income and underserved cervical cancer survivors living in Eastern North Carolina. Participants included English-speaking women who attended a large cancer center for care between March 2012 and March 2013. Participants ranged from being recently diagnosed with cervical cancer to being 15 years post-diagnosis. Interviews lasted approximately 1 h and were audio-tape-recorded. On average, women were 55 years old (range 35-85) and were diagnosed with cervical cancer 3 years prior to the interview (range 0.2 to 180 months). A good proportion was uninsured or Medicaid-insured (60 %). Half reported an annual household income of less than $20,000, and 13 % reported having a college degree. The majority of survivors had limited understanding of cervical cancer, experienced persistent symptoms related to their cancer before seeking care, and were nonadherent to Papanicolaou screening recommendations. The main barriers to care reported by participants was lack of money and health insurance, followed by the perception of overall health (which equated to the belief that medical care was not needed), transportation issues, and discomfort with provider. Health professionals should focus educational efforts on the benefits of Papanicolaou screenings, the symptoms sometimes associated with cervical cancer, and the free or low-cost services available to low-income women.
authors.affiliation: Department of Health Education and Promotion, College of Health and Human Performance, East Carolina University, 2209 Carol Belk Building, Greenville, NC, 27858, USA. richmana@ecu.edu.
authors.forename: Alice R
authors.initials: AR
authors.lastname: Richman
authors.affiliation: Department of Health Education and Promotion, College of Health and Human Performance, East Carolina University, 2209 Carol Belk Building, Greenville, NC, 27858, USA.
authors.forename: Jamie L
authors.initials: JL
authors.lastname: Troutman
authors.affiliation: Department of Health Education and Promotion, College of Health and Human Performance, East Carolina University, 3202 Carol Belk Building, Greenville, NC, USA.
authors.forename: Essie
authors.initials: E
authors.lastname: Torres
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003266:Continuity of Patient Care; D005260:Female; D005500:Follow-Up Studies; D007722:Health Knowledge, Attitudes, Practice; D006297:Health Services Accessibility; D006801:Humans; D007348:Insurance, Health; D007407:Interviews as Topic; D008875:Middle Aged; D009657:North Carolina; D011203:Poverty; D036301:Qualitative Research; D012424:Rural Population; D017741:Survivors / Q000523:psychology*; D002583:Uterine Cervical Neoplasms / Q000523:psychology / Q000628:therapy*; D014626:Vaginal Smears / Q000523:psychology*
keywords: Barriers to care; Cervical cancer; Human papillomavirus; Qualitative; Survivor