Demonstrating respect and building trust

Learn how to discuss cervical screening with your patients.

General tips for discussing cervical screening with patients

When you discuss cervical screening with your patients, particularly with under-screened or never-screened people, remember to:

  • build trust and rapport – it is vital to create safety and security around the subject of screening
  • demonstrate respect and inclusivity through your language and by creating an inclusive atmosphere in your health service (e.g. waiting room displays and consumer resources in various languages)
  • enquire about past screening experiences, identifying the barriers (e.g. shame, past trauma, discomfort, body-image embarrassment)
  • take the time to help your patient feel supported, comfortable and clear on the benefits of cervical screening
  • reassure patients that the Cervical Screening Test will be undertaken carefully and respectfully
  • let them know they will be able to undress in private, be given a sheet to cover their lower body, or be provided with a private place to self-collect their own vaginal sample
  • ensure patients understand their Cervical Screening Test results will remain confidential
  • offer patients a choice of collection method for their Cervical Screening Test – either clinician-collected or self-collected sampling
  • explain that a self-collected sample is a vaginal swab and does not have to touch the cervix
  • reassure patients that it is very difficult to make a mistake and that guidance and support will be given
  • offer assistance with self-collection for patients who may have difficulty collecting a vaginal sample by themselves, or are not confident collecting their own sample (e.g. you can collect the sample on their behalf using a self-collection swab, without using a speculum)
  • give patients time to feel comfortable with new information, ask questions and make informed decisions
  • not make assumptions about a patient’s cultural background, sexual history, sexual preferences, literacy levels or knowledge of their bodies
  • use visual aids (videos, diagrams and anatomical models) where appropriate, especially with patients with low literacy levels or those who may be embarrassed to discuss sexual activity or their genitalia
  • use a face-to-face or telephone interpreter if language is a barrier, or allow a chaperone, if desired by the patient.

Ways to engage

Strategy

Details

Education and support

People view healthcare providers as an important source of information about cervical screening. It is important for healthcare providers to engage patients in a conversation about cervical screening to help patients understand:

  • what collection options are available (i.e. self-collection or clinician-collection) and the pros and cons of each option
  • what cervical screening involves
  • why it is important (i.e. because regular cervical screening is one of the main methods to prevent cervical cancer)
  • why it is relevant to them
  • what their test results mean
  • what follow up they may require (e.g. tif HPV is detected on a self-collected sample they will need further testing).

Healthcare providers also have an important role in supporting patients to undertake cervical screening and counselling them about any perceived barriers. Open communication will help to create a safe and secure environment that enables patients to feel comfortable to have the test performed.

Include local people in the promotion of programs in communities (e.g. where it is appropriate to advertise an event, especially women's business in remote/ Aboriginal communities).

Although a healthcare provider may view the Cervical Screening Test as routine, it is important to remember that for patients the experience is generally something that is out of the ordinary. Healthcare providers should acknowledge that cervical screening is a personal and potentially difficult experience for some people. This might include:

  • offering self-collection as a more comfortable and acceptable option
  • encouraging patients to express their concerns
  • acknowledging and addressing the patient’s feelings of embarrassment and/or anxiety
  • giving the patient the power and permission to stop at any time
  • being aware of and sensitive to any cultural issues
  • reassuring the patient about the test
  • offering the patient an opportunity to ask questions.

Making the screening experience as comfortable as possible

  • Offer self-collection as a more comfortable and acceptable option for screening.
  • If clinician-collection is chosen, some of the below points may assist.
    • Some patients may prefer to insert their own speculum and it can be helpful to offer this option.
    • Providing instructions on calming and deep breathing techniques can also help the patient to relax.
    • A prescription of vaginal oestrogen cream prior to the appointment can be effective in decreasing pain or discomfort for post-menopausal patients.
    • Provide a mirror in case the patient wants to view their own cervix.
  • Let the patient know that the appointment is private and confidential.
  • Patients can bring a relative or friend with them to help them feel more comfortable.
  • Patients can ask for a female nurse or doctor.

Invitation, recall and reminder letters

  • Healthcare providers can either manually or electronically (using their practice’s clinical software) identify which patients have no record of screening, who is due for screening and who is overdue. Healthcare providers can also find out a patient’s screening history by accessing the National Cancer Screening Register’s Healthcare Provider Portal via PRODA.
  • These patients can then be targeted individually with a personalised invitation, phone call, reminder letter or SMS. Letters are particularly effective when they include an endorsement from a healthcare provider.
  • Consult with local patients about how this would happen.

Educational resources

  • Education resources may include printed or audio-visual materials. These materials work best when combined with other strategies (e.g. when provided in the context of a healthcare consultation).
  • Locally designed, developed and owned resources always work best (e.g. something designed in Top End NT doesn’t necessarily work in Central Australia).

Healthcare providers reminders

  • A note or flag identifying each patient’s cervical screening status can be added to the patient’s electronic record to prompt healthcare providers to discuss cervical screening when the patient next attends the health service.
  • Send patient reminders or recalls to get patients to call and make an appointment when they are due or overdue for screening.
  • Healthcare providers can view a patient’s screening history and status by accessing the National Cancer Screening Register’s Healthcare Provider Portal via PRODA.

Audit and feedback activity

Clinical audits involve assessing performance in delivering and/or offering screening to patients (using patient record management software), either at a practitioner or health service level. Healthcare providers are then presented with information/feedback about their performance. Results can be compared with a benchmark screening rate. It is expected that this activity will then prompt healthcare providers to improve their performance.

Resources

You can provide these resources to patients, to help them before, during and post screening. See the full resource library.

    Before screening appointment

    During screening appointment

    Post screening appointment

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