RESUMO
The work reported here, which was performed in Santiago, Chile, in 1993, explored factors relating to low Pap test coverage. A survey instrument was prepared and interviews were obtained with 299 women 25-54 years of age who were attending three primary health care clinics in Santiago. Most (at least 87%) of these women had not had a Pap test in three years. Only 28% knew the test's purpose was to detect cervical neoplasia; most (58%) knew the test was related to reproductive health but did not have a clear idea of its purpose; 14% knew nothing of the test or gave completely incorrect answers. Health personnel and the mass media were cited as principal sources of information about the test. Regarding anxieties relating to the test, 60% of the women said they were afraid of being reproached by a health practitioner for failing to come in sooner; 39% said they feared pain resulting from the test; 20% said they feared bleeding; and 14% were afraid they might lose part of the uterus. Also, of the 231 women with intrauterine devices, over 25% said they feared removal of the device. These results suggest a need to improve communication between health care workers and their patients, and to ensure that health personnel respect the rights of women, especially their right to sufficient information enabling them to make their own decisions.
PIP: This exploratory study was conducted among a sample of 299 women out of a total sample of 861 who had attended three primary health care clinics (La Feria, San Jose, and Maipu) in southern and western portions of Santiago, Chile. The interviews were conducted during June, August, and November 1993. The women were aged 25-54 years. Most were overdue for a Pap smear. The women had been seen at these clinics during January 1987 and January 1989. 248 refused to be interviewed, and 314 were lost to follow-up. One question about the purpose of the Pap test was answered only by 199 women. 34% of the 299 women interviewed reported a failure to have a Pap test due to forgetfulness. 27% did not think it was necessary to have the test every 3 years. 8% reported fear of the procedure. This proportion of fearful women remained the same regardless of educational level. The most educated women were the most likely to be up to date with Pap smear testing. 30% of women aged over 45 years were up to date with their Pap tests. 28% had knowledgeable answers about the purpose of the Pap test; 58% gave fair answers and 10% gave incorrect answers. 30% trusted that health care personnel had good quality information. 36% believed that mass media had good quality information, but 12% thought the media also gave incorrect information. 43% of better educated women, 25% of less educated women, and 23% of least educated women had good quality information. The proportion of good quality information was 19% among women aged over 45 years, 30% among women aged 36-45 years, and 27% among women aged under 36 years. 60% of the common fears were blamed on the criticism given by health workers for delaying a Pap test. 39% feared pain. Over 25% feared loss of their IUD during the Pap test.