Psychological Factors that Influence Cervical Pre-Cancer Screening Among Women Attending Mbagathi Level Four Hospital, Nairobi, Kenya

Abstract

Cervical cancer continues to be one of the major causes of morbidity and mortality among women in Kenya and screening uptake is low despite the availability of services. While previous research has shown certain barriers, such as fear, stigma, and lack of awareness, little has been done analysing the combined effect of psychological factors, confidence levels, and cues to action. This study fills this gap by examining the influence of these determinants on women's participation in cervical pre-cancer screening at Mbagathi Level four hospital. The aimed to determine psychological factors that affect cervical pre-cancer screening for women who attend Mbagathi level four hospital, Nairobi, Kenya. The Health Belief Model provided the foundation for the study. The study was conducted at Mbagathi Level Four Hospital in Nairobi. Research design was analytical cross-section. The study population included women who were eligible for cervical cancer screening (1,500 women) which gave a sample size of 240 respondents. This was arrived at using systematic random sampling. Data collection was done with the aid of structured questionnaires and key informant interviews. Quantitative data was interpreted with the help of statistical software package version 27, and the descriptive statistics and the regression analysis were performed, while qualitative data was interpreted using the thematic approach. Results showed that psychological perceptions had a great impact on the behaviour of screening: 57.9 women considered screening uncomfortable, 67.1 feared the diagnosis, and 61.7 perceived stigma. On the contrary, 82.1% considered early detection important and 82.5% saw the screening as a personal responsibility. The results of the regression analysis showed that there were psychological factors which accounted for 11.9% variance in the screening uptake (R² = 0.119). Confidence levels were high, with more than 78% being very confident in sticking to schedules, communicating with providers and healthy behaviours. Cues to action like provider communication (74.2%) and media exposure (88.3%) increased awareness but are not a good independent predictor of uptake. The study concludes that psychological factors, confidence and cues to action play a large part in determining screening behaviour, although sociocultural factors and cost barriers are crucial. It recommends integrated interventions that will reduce fear and stigma, increase access to free or low-cost services and increase community sensitization through communication by providers, family support and consistent media campaigns to improve screening participation and early detection outcomes.