Conhecimentos, práticas, percepção e demandas das mulheres acerca das ações de prevenção do câncer de colo do útero na atenção primária à saúde

Abstract

Introduction: Cervical cancer (CC) is characterized by the disordered replication of the epithelial lining of the organ, affecting the underlying tissue and potentially invading nearby or distant structures and organs. This disease has a long progression period, with precursor lesions that can be easily identified through regular preventive screenings (Pap smears). Objective: This study aimed to analyze the knowledge, practices, perceptions, and demands of women followed up at a primary health care unit in Santo Antônio do Descoberto, Goiás, regarding cervical cancer prevention actions. Materials and Methods: This is a cross-sectional study with prospective data collection, using mixed quantitative and qualitative methods, conducted in two phases with women over 18 years old, registered and monitored by Family Health Strategy Unit 14. In the first phase, a questionnaire was applied to 302 randomly selected women in their homes. After this stage, a focus group was conducted with women who participated in the first phase and were willing to engage in the second phase. Results: Among the 302 women who participated in the first phase, the average age was 37.1 ± 14.3 years, with 125 (41.1%) married or in stable unions, 66.2% had a regular sexual partner, and the median family income was 1.38 minimum wages. Of the 302 women, regarding knowledge, 96.4% had heard about the CC prevention exam, 79.5% had never participated in educational activities related to CC prevention, 74.8% claimed to know what a Pap smear is, 69.9% had undergone a Pap smear, and 19.9% reported having it done annually. Affirmative responses were given by 56.6% when asked if they had heard of HPV, with 18.5% associating HPV with CC, 72.2% knew that the HPV vaccine is free, and 72.7% intended to vaccinate their children. Through the focus group, perceived facilitators for CC prevention were revealed, such as the ease of scheduling Pap smears and the existence of health education and clarifications provided by professionals. Perceived barriers included the delay or non-delivery of Pap smear results, difficulty in scheduling medical appointments, lack of communication, information, home visits, limited access to medications, household barriers, lack of awareness of the importance of the preventive exam, and fear of diagnosis. Regarding the perceptions experienced during the preventive exam, feelings of shame, fear, anxiety, and the impact of gender perception prevailed. Suggestions for improvements included continuing health education and the role of the Family Health Strategy (FHS) team, improving welcoming and accessibility, speeding up the diagnostic process and Pap smear result delivery, and enhancing communication. Technical Product : The study's technical product includes a communication tool in the form of a carousel post for social media and a conclusive technical report. Conclusion : These findings provide valuable insights for health professionals to implement effective preventive actions supported by health education, contributing to increased knowledge, equity, and quality of care in primary health care. This Master's Thesis is the result of the stricto sensu postgraduate program, Professional Master's in Family Health (PROFSAÚDE).