Perceptions and experiences of patients and clinicians in anal cytology screening and high resolution anoscopy

: a hermeneutic phenomenological study

  • Anosha Madanjith Sirpath

Student thesis: Doctoral ThesisDoctor of Philosophy

Abstract

Background
Anal Intraepithelial Neoplasia (AIN) is a well-recognised precursor for invasive squamous anal cancer. The prevalence of anal cancer is increasing in people living with HIV. This hermeneutic phenomenology study explores the perceptions and experiences of patients and clinicians in anal cytology screening and high resolution anoscopy in sexual health clinics in the UK.

Methods
This study was conducted in the interpretative paradigm using hermeneutic phenomenology informed by Heidegger. A purposive sample comprising 14 patients and 8 clinicians was recruited. In-depth unstructured interviews were conducted between May and June 2014. Interpretive phenomenological analysis (IPA) was used to develop in depth interpretations of participants’ perceptions and experiences of anal cancer screening. Data were analysed using the six stages in the analysis process i.e. immersion, understanding, abstraction, synthesis and theme development, illumination and illustration of phenomena, integration and critique.

Findings
Five themes emerged from the data from both patients and clinicians: psychological effects of anal cancer screening, screening procedures, education, knowledge and training, social and sexual activity, guidelines and practices. Findings of this study demonstrate that anal cancer screening is acceptable, but tolerability is variable; education, knowledge and information on anal cancer screening is limited to the media, press, magazines and those clinicians offering screening at their sexual health clinics in the UK. Although the social life of most patients was not affected, their sexual activity was affected. This study suggests that a screening program as part of routine HIV care in an outpatient sexual health clinic.

Conclusion
Anal cancer screening benefits outweigh any psychological harm caused by tests and diagnostic procedures for people living with HIV. The emotional responses highlighted were not associated with significant psychological harm. Anal cancer screening should be considered in future guidelines in the UK for people living with HIV.
Date of AwardJun 2020
Original languageEnglish
Awarding Institution
  • Coventry University
  • Buckinghamshire New University

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