Walking the Journey of Womanhood

Yakama Indian Women and Papanicolaou (Pap) Test Screening

Authors

  • C. June Strickland Ph.D., R.N.,

    Corresponding author
    1. C. June Strickland and Noel J. Chrisman are with the University of Washington School of Nursing, Seattle, Washington.
      Address correspondence to C. June Strickland, Ph.D., R.N., University of Washington, School of Nursing, Box 357263, Seattle, WA 98195.
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  • Noel J. Chrisman Ph.D., M.P.H.,

    1. C. June Strickland and Noel J. Chrisman are with the University of Washington School of Nursing, Seattle, Washington.
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  • Martha Yallup Ph.D.,

    1. Martha Yallup is with the Yakama Nation Health Administration, Toppenish, Washington.
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  • Kolynn Powell B.S., R.N.,

    1. Kolynn Powell and Marion Dicks Squeoch are with the Yakama Indian Health Center, Toppenish, Washington.
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  • Marion Dick Squeoch M.P.H.

    1. Kolynn Powell and Marion Dicks Squeoch are with the Yakama Indian Health Center, Toppenish, Washington.
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Address correspondence to C. June Strickland, Ph.D., R.N., University of Washington, School of Nursing, Box 357263, Seattle, WA 98195.

Abstract

Abstract Cervical cancer is the second leading cancer among Alaska Native. American Indian women, who have a high incidence of cervical cancer and low survival rates (Boss, 1991; Michalek & Mahoney, 1990; Page & Asire, 1985). The purpose of this Grounded Theory study was to gain a greater understanding of the meaning of the papanicolaou (Pap) test to the Yakama Indian women of eastern Washington to support the Tribe in the design of effective screening interventions. Data from 15 interviews, focus groups, and participant observation were included in the data analysis. The major theme was: Walking the Journey of Womanhood. Four phases of the journey were identified: (a) Starting the Journey, (b) Blooming, (c) Heading the Household, and (d) Becoming an Elder. In this study we found that interventions to influence Pap test screening among the Yakama women must address structures of care, provider-patient communications, and education for the women. Women heading the households and elders were identified as priority populations for education because they have negative attitudes from previous experiences and have a great influence on the younger women. Messages need to be wellness oriented and traditional methods of education, such as the talking circle, role model, and storytelling, need to be used.

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