Table 3 Needs and Perceptions of Iranian HPV-positive women about receiving health care
Categories | sub-categories | Example of codes |
|---|---|---|
1. Communication and Counseling Skills | a. Understandable discussion about HPV | Skills in breaking bad news Providing adequate HPV-information with understandable, colloquial language Taking time to answer the patient’s questions Delivering HPV-information gradually Avoid exaggerating or underestimating HPV risks Listen intently to the patient and not to dominate the conversation |
b. Emotional support and acceptance | Paying attention to the patients’ feelings and concerns Encouraging words to strengthen the patient’s spirit The need for compassionate doctors in the medical centers Doctor’s positive and hopeful attitude towards HPV clearance | |
c. Need to receive HPV-related guidance and advice | Explaining the risk and providing advice and solutions to strengthen immunity and reduce the cancer risk Discussing sexual practice, diet, alcohol and tobacco prohibitions or modification Vaccine recommendations | |
d. Clinical appointment considerations | Not requesting for HIV and hepatitis tests at the first visit Not sharing the colposcopy monitor with patient unless she wants Explaining colposcopy before performing it Not asking/ reporting low-risk HPV strains | |
2.Commitment to Professional Principles | a. Confidentiality and privacy | Visiting patients one by one Clinic’s staff awareness of the patient’s secrecy patient privacy in the gynecology clinics Consider cultural sensitivity |
b. Ethics in research and practice | Avoid try and error in patients’ management Obtaining written informed consent from patients in cases of doing research | |
c. Non- judgmental language and behaviors | Adopt non-judgmental attitude toward patient’s sexual behavior Building mutual trust/ Being honest with patient | |
d. Considering the patient’s financial issues | Avoiding humiliating behaviors towards poor patients Introducing patients to governmental-funded services instead of private centers Adopt scientific approaches Avoid prescribing self-made medications | |
3. knowledgeable and competent provider | a. Adherence to screening guidelines | Adopt scientific management and avoid overuse tests Screening eligible woman Adherence to test intervals Follow-up according to the national cervical cancer guideline |
b. Addressing uncertainties and misconceptions | Discussing the current gaps in HPV-knowledge Citing conflicting views Communicating intentionally inexact about infection source Avoid exaggerating about HPV transmission by overusing protective equipment Avoid Instilling fallacy that HPV has a treatment (self-made suppositories, fungi, and probiotic products) HCPs’ participating in retaining programs | |
c. Taking multidisciplinary approach | HPV women’ need for multidisciplinary team Wandering from the duality of therapists’ opinions Unnecessary patients’ referrals (to be on the safe side) Women’s wandering to find required specialist (Gynecologist-Infectious disease specialist-Oncologist-Urologist-Dermatologist-ENT specialist-Dentist) Counseling about anti-wart treatments (in oral, anal and genital area) Refer women with genital warts to dermatology clinics |