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



To explore decision making about Pap tests among Korean immigrant women.



We 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.



Although 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.



Women'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.



The 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.
School of Nursing, University of Connecticut, Storrs, CT, USA.
Kyounghae
K
Kim
Department of Community-Public Health, School of Nursing, Johns Hopkins University, Baltimore, MD, USA.
Soohyun
S
Kim
Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University Baltimore, Baltimore, MD, USA.
Joseph J
JJ
Gallo
Department of Acute and Chronic Care, School of Nursing, Johns Hopkins University, Baltimore, MD, USA.
Marie T
MT
Nolan
Department of Community-Public Health, School of Nursing, Johns Hopkins University, Baltimore, MD, USA.
Hae-Ra
HR
Han
D000328:Adult; D003657:Decision Making; D055088:Early Detection of Cancer; D054242:Emigrants and Immigrants / Q000523:psychology*; D005260:Female; D006801:Humans; D008875:Middle Aged; D065006:Papanicolaou Test / Q000379:methods*; D036301:Qualitative Research; D056910:Republic of Korea / Q000208:ethnology; D014481:United States; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis
cervical cancer screening; decision-making; immigrant women; qualitative study
J Natl Med Assoc. 2009 Jun;101(6):541-51
19585922
Womens Health Issues. 2015 Sep-Oct;25(5):501-8
26219676
Soc Sci Med. 1997 Mar;44(5):681-92
9032835
Med Decis Making. 2010 Sep-Oct;30(5 Suppl):53S-64S
20881154
Psychol Bull. 1970 Mar;73(3):221-30
5484257
Am J Public Health. 2016 Apr;106(4):e3-e28
26890177
Med Care. 2008 Jul;46(7):738-45
18580394
Taehan Kanho Hakhoe Chi. 2004 Jun;34(4):617-24
15502427
Cancer Epidemiol Biomarkers Prev. 2007 Jun;16(6):1298-302
17548702
Health Expect. 2013 Jun;16(2):177-88
21726363
Prev Med. 2003 Dec;37(6 Pt 1):585-92
14636792
JAMA. 1992 Apr 22-29;267(16):2221-6
1556799
Womens Health Issues. 2015 Mar-Apr;25(2):112-9
25747518
Patient Educ Couns. 2015 Mar;98(3):338-43
25499004
J Pers. 2001 Dec;69(6):907-24
11767823
Psychooncology. 2011 Aug;20(8):871-9
20623805
N Engl J Med. 2012 Mar 1;366(9):780-1
22375967
Med Decis Making. 2017 Jan;37(1):70-78
27430237
Oncol Nurs Forum. 2007 Nov;34(6):1203-9
18024347
Am J Prev Med. 2014 Sep;47(3):251-9
24923862
Res Nurs Health. 1995 Apr;18(2):179-83
7899572
Patient Educ Couns. 2008 Nov;73(2):251-5
18723307
MMWR Morb Mortal Wkly Rep. 2004 Aug 27;53(33):765-7
15329652
West J Nurs Res. 2008 Dec;30(8):960-74
18539883
Psychooncology. 2011 Apr;20(4):341-51
20878847
Cancer. 2010 Feb 15;116(4):949-56
20029972
CA Cancer J Clin. 2007 Jul-Aug;57(4):190-205
17626117
Oncol Nurs Forum. 2007 May;34(3):713-20
17573330
J Health Care Poor Underserved. 2015 May;26(2):431-40
25913341
J Transcult Nurs. 2013 Jan;24(1):86-93
22802299
Cancer Causes Control. 2008 Apr;19(3):227-56
18066673