Efficacy of Training Program on Detection of Cervical Cancer using Visual Inspection with Acetic Acid by Nurses versus Clinicians

Abstract

In low-resource settings, the dearth of national screening programmes, lack of equipment and skilled technicians led to limitation of women’ access to cytology screening programmes. For that bridging the human resource gap with using low-cost methods have been implemented for screening, where resourceful visual inspection with acetic acid (VIA) by trained nurses and doctors is the most common approach. Aim:to assess the efficacy of training program on early detectionof cancer cervix using visual inspection with acetic acid (VIA) by nurses compared to junior clinicians. Setting: It was conducted at early detection clinic for cervical cancer in Women’s Health Hospital (WHH) at Assiut University, Egypt. Design:Quasi-experimental research design.Participants: A total of 100 eligible women who fulfilled the selection criteria underwent VIA done by 20 nurses and junior clinicians (10 for each). Tools: Three tools used: A structured interview; Pre-posttest Cervical Cancer knowledge Questionnaire and Observation Checklist. Method:A three weeks of intensive VIA training program for 20 nurses and clinicians prior start in clinical examination of the participants, the findings of VIA were interpreted independently. A colposcopy was carried out by a gynecologist blinded to the results of VIA and a directed biopsy was taken if indicated. Results: The findings delineated an improvement in knowledge concerning cancer cervix for both nurses and junior clinicians with no significant difference between both of them. For accuracy the nurse VIA had shown good diagnostic rate equivalent to clinician VIA as compared to colposcopy.Conclusion & Recommendation:Nurses had reasonable knowledge concerning cervical cancer as well as junior clinicians and with proper intensive training nurses can perform VIA test with acceptable accuracy regarding most steps of VIA with high sensitivity and specificity to clinicians in addition to the availability during their schedule work compared to clinicians.An intensive training and periodic reinforcement sessions are needed to slightly limit the false positive predictive value among nurses.