| Summary: | 碩士 === 高雄醫學大學 === 性別研究所 === 98 === The thesis examines medical discourses on women who avoided doing Pap smear in which they were portrayed as ignorant of correct knowledge, irresponsible of their own health, and conservative regarding their body being examined by male physicians. By interviewing women themselves, the medical discourses were limited in that many women were not ignorant nor irresponsible. Instead, they paid considerable attention to their own bodies and health. In addition, I also explore how public health nurses carried out the various projects to promote Pap smear, how they understood women who did not do Pap test (annually), and the policies and procedures they developed to improve the screening rate.
This research is based on qualitative methods, including several interviews with women who did not do Pap test, and participation observations on several focus group discussions organized by the Women Friendly Health Care project run by the Health of Department of the Kaohsiung City Government.
Women who did not do Pap test, according to the existing medical discourses, were prevented by their concerns of modesty and were reluctant to see a male physician. However, the gender of the physician was not the only reason why women did not do Pap test, if not irrelevant. Some older women even desexualized their body and genitals and made the point that a male phtysician did not matter as much as people assumed. They saw that communicatons with female gynecologists are easier than with male gynecologists. In addition, some women mentioned their bad experience with a female gynecologist. Furthermore, the women who believed that they were healthy were very well-informed in health information.They made rational choices, had control over their own bodies, and paid attention to their body to avoid having Pap smear.
Despite the fact that the major health care system in Taiwan is dominated by western medicine and Pap smear is an effective measure for cervical cancer prevention, traditional Chinese medicine and other alternative care of the body co-exist in Taiwan. Many women are equipped with these resources, and, with a certain degree of tactic knowledge of their own bodies, they were able to question the mainstream and empower themselves to do otherwise. In addition, in response to the much popularized notion of risk groups for cervical cancer ( i.e. multiple sex partners) in this study, women who were above 50 or single who don’t take Pap test (annually) believed that because they practiced safe sex or did not have conventional sex they were at low risk of cervical cancer.
Little has been done on women don’t take Pap test (annually) from the viewpoints of the public nurses. In order to promote the screening rate of Pap smear, public nurses worked hard to meet the policy’s demand. They did so by ensuring the privacy of the exam room (supplying free tea, coffee and cookies for the waiting room), offering gifts and other tests. But in fact privacy was not the only issue, many women were concerned about the accuracy of Pap smear. Some women believed that tests done in the hospital would be more professional, modern, and well-equipped than those in the health stations, despite the fact that others believed that doing Pap test in at the health stations is more convenient.
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