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Petersen Z, Jaca A, Ginindza TG, Maseko G, Takatshana S, Ndlovu P, Zondi N, Zungu N, Varghese C, Hunting G, Parham G, Simelela P, Moyo S. Barriers to uptake of cervical cancer screening services in low-and-middle-income countries: a systematic review. BMC Womens Health 2022; 22:486. [PMID: 36461001 PMCID: PMC9716693 DOI: 10.1186/s12905-022-02043-y] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Accepted: 10/10/2022] [Indexed: 12/03/2022] Open
Abstract
OBJECTIVES Low-and-middle-income countries (LMICs) bear a disproportionate burden of cervical cancer mortality. We aimed to identify what is currently known about barriers to cervical cancer screening among women in LMICs and propose remedial actions. DESIGN This was a systematic review using Medical Subject Headings (MeSH) terms in Google Scholar, PubMed, Scopus, and Web of Science databases. We also contacted medical associations and universities for grey literature and checked reference lists of eligible articles for relevant literature published in English between 2010 and 2020. We summarized the findings using a descriptive narrative based on themes identified as levels of the social ecological model. SETTING We included studies conducted in LMICs published in English between 2010 and 2020. PARTICIPANTS We included studies that reported on barriers to cervical cancer screening among women 15 years and older, eligible for cervical cancer screening. RESULTS Seventy-nine articles met the inclusion criteria. We identified individual, cultural/traditional and religious, societal, health system, and structural barriers to screening. Lack of knowledge and awareness of cervical cancer in general and of screening were the most frequent individual level barriers. Cultural/traditional and religious barriers included prohibition of screening and unsupportive partners and families, while social barriers were largely driven by community misconceptions. Health system barriers included policy and programmatic factors, and structural barriers were related to geography, education and cost. Underlying reasons for these barriers included limited information about cervical cancer and screening as a preventive strategy, poorly resourced health systems that lacked policies or implemented them poorly, generalised limited access to health services, and gender norms that deprioritize the health needs of women. CONCLUSION A wide range of barriers to screening were identified across most LMICs. Urgent implementation of clear policies supported by health system capacity for implementation, community wide advocacy and information dissemination, strengthening of policies that support women's health and gender equality, and targeted further research are needed to effectively address the inequitable burden of cervical cancer in LMICs.
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Affiliation(s)
- Z. Petersen
- grid.417715.10000 0001 0071 1142Human & Social Capabilities (HSC), Human Sciences Research Council, Pretoria, South Africa
| | - A. Jaca
- grid.415021.30000 0000 9155 0024Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa
| | - T. G. Ginindza
- grid.16463.360000 0001 0723 4123Public Health Medicine, University of KwaZulu-Natal (UKZN), Durban, South Africa ,Cancer & Infectious Diseases Epidemiology Research Unit (CIDERU), Durban, South Africa
| | - G. Maseko
- grid.417715.10000 0001 0071 1142Human & Social Capabilities (HSC), Human Sciences Research Council, Pretoria, South Africa
| | - S. Takatshana
- grid.417715.10000 0001 0071 1142Human & Social Capabilities (HSC), Human Sciences Research Council, Pretoria, South Africa
| | - P. Ndlovu
- grid.417715.10000 0001 0071 1142Human & Social Capabilities (HSC), Human Sciences Research Council, Pretoria, South Africa
| | - N. Zondi
- grid.417715.10000 0001 0071 1142Human & Social Capabilities (HSC), Human Sciences Research Council, Pretoria, South Africa
| | - N. Zungu
- grid.417715.10000 0001 0071 1142Human & Social Capabilities (HSC), Human Sciences Research Council, Pretoria, South Africa ,grid.16463.360000 0001 0723 4123Public Health Medicine, University of KwaZulu-Natal (UKZN), Durban, South Africa
| | - C. Varghese
- grid.3575.40000000121633745Cervical Cancer Elimination Initiative, World Health Organization, Geneva, Switzerland
| | - G. Hunting
- grid.3575.40000000121633745Cervical Cancer Elimination Initiative, World Health Organization, Geneva, Switzerland
| | - G. Parham
- grid.3575.40000000121633745Cervical Cancer Elimination Initiative, World Health Organization, Geneva, Switzerland
| | - P. Simelela
- grid.3575.40000000121633745Cervical Cancer Elimination Initiative, World Health Organization, Geneva, Switzerland
| | - S. Moyo
- grid.417715.10000 0001 0071 1142Human & Social Capabilities (HSC), Human Sciences Research Council, Pretoria, South Africa ,grid.7836.a0000 0004 1937 1151School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
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Hu Z, Sun Y, Ma Y, Chen K, Lv L, Wang L, He Y. Examining Primary Care Physicians' Intention to Perform Cervical Cancer Screening Services Using a Theory of Planned Behavior: A Structural Equation Modeling Approach. Front Public Health 2022; 10:893673. [PMID: 35685761 PMCID: PMC9171050 DOI: 10.3389/fpubh.2022.893673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Accepted: 04/20/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundPromoting cervical cancer screening (CCS) is undoubtedly effective in combating severe public health problems in developing countries, but there are challenges to its implementation. Understanding the factors influencing primary care physicians' intentions to provide CCSs to rural women is crucial for the future implementation of screening programs. The aim of this study was to assess the intentions of primary care physicians to provide cervical cancer screening services (CCSSs) to rural women and their determinants.MethodsThis cross-sectional study included 1,308 primary care physicians in rural primary health care, and the data collection tool was developed based on the theory of planned behavior (TPB), which included demographic characteristics, the basic constructs of TPB, and the degree of knowledge of CCSSs as an extended variable of the TPB model. Structural equation modeling was used to analyze the relationships between each factor.ResultsPathway analysis found that TPB is an appropriate theoretical basis for predicting primary care physicians' intent to provide CCSSs (χ2/df = 2.234 < 3, RMSEA = 0.035, and SRMR = 0.034). Meanwhile, the structural equation model showed that attitude (β = 0.251, p < 0.001), subjective norm (β = 0.311, p < 0.001), perceived behavioral control (β = 0.162, p < 0.001), and knowledge level (β = 0.152, p < 0.01) positively predicted primary care physicians' intention to provide CCSSs.ConclusionsTPB model, with the addition of knowledge, was useful in predicting primary care physicians' intention to provide CCSSs for rural Chinese women. The findings of this study provide a reference for the government and hospitals to develop strategies to improve the intent of primary care physicians to provide CCSSs.
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Affiliation(s)
- Zhiqing Hu
- Institute of Medical Humanities, Nanjing Medical University, Nanjing, China
- School of Marxism, Nanjing Medical University, Nanjing, China
| | - Yanjun Sun
- Institute of Medical Humanities, Nanjing Medical University, Nanjing, China
- School of Marxism, Nanjing Medical University, Nanjing, China
| | - Yuhao Ma
- Institute of Medical Humanities, Nanjing Medical University, Nanjing, China
- School of Marxism, Nanjing Medical University, Nanjing, China
| | - Kejin Chen
- Department of Women's Healthcare, Changzhou Maternal and Child Health Care Centre, Changzhou, China
| | - Ling Lv
- Department of Women's Healthcare, Nanjing Maternity and Child Health Care Hospital, Nanjing, China
| | - Lingling Wang
- Department of Psychology, Kangning Hospital, Rushan, China
| | - Yuan He
- Institute of Medical Humanities, Nanjing Medical University, Nanjing, China
- School of Marxism, Nanjing Medical University, Nanjing, China
- Research Center for Social Risk Management of Major Public Health Events (Key Research Base of Philosophy and Social Sciences of Universities in Jiangsu), Nanjing Medical University, Nanjing, China
- *Correspondence: Yuan He
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Okayama M, Nagaoka T, Sugisaki K. Cancer Screening Rate and Related Factors in the Japanese Child-Rearing Generation. Healthcare (Basel) 2022; 10:healthcare10030508. [PMID: 35326986 PMCID: PMC8950849 DOI: 10.3390/healthcare10030508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 03/07/2022] [Accepted: 03/08/2022] [Indexed: 02/01/2023] Open
Abstract
In Japan, although the incidence of cancer is increasing, the cancer screening rate is low compared to that in other countries. This study aimed to evaluate the factors associated with cancer screening behavior in Japanese men and women of child-rearing age. The survey was conducted among 2410 child-rearing adults from a countrywide database in August 2018. Among the respondents, there were 1381 (57.3%) who had been screened for cancer and 1029 (42.7%) who had not been screened. When stratified by sex, 503 (40.9%) men and 878 (74.3%) women had been screened for cancer, and education, income, and family history were associated with cancer screening. Among the men, where they lived, age, and family history were associated with cancer screening. In women, annual income was associated with stomach, colon, breast, and uterine cancer screening. In addition, uterine cancer screening was related to the women’s educational level. Our results suggest a need to improve the cancer screening rate among the child-rearing generation, especially for those with limited education and low income.
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Affiliation(s)
- Mutsumi Okayama
- Department of Health and Welfare, Graduate School of Niigata University of Health and Welfare, 1398 Shimami-cho, Kita-Ku, Niigata 950-3198, Japan; (M.O.); (T.N.)
- Department of Psychology, Faculty of Education and Humanities, Jumonji University, 2-1-28 Sugasawa, Niiza 352-8510, Japan
| | - Tomo Nagaoka
- Department of Health and Welfare, Graduate School of Niigata University of Health and Welfare, 1398 Shimami-cho, Kita-Ku, Niigata 950-3198, Japan; (M.O.); (T.N.)
- Department of Sports Science, Juntendo University, 1-1 Hiraka-gakuendai, Inzai 270-1695, Japan
| | - Koshu Sugisaki
- Department of Health and Sports, Niigata University of Health and Welfare, 1398 Shimami-cho, Kita-Ku, Niigata 950-3198, Japan
- Correspondence:
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Lin S, Chen WT, Gu C, Cheng HL, Wang H, Tang S. Knowledge, perception of HIV symptom severity and cervical cancer screening behaviour among women living with HIV in China. Eur J Cancer Care (Engl) 2021; 31:e13542. [PMID: 34961999 DOI: 10.1111/ecc.13542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 10/07/2021] [Accepted: 12/02/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVE This study aimed to examine the previous uptake of cervical cancer screening and intention to be screened and its associated factors among women living with HIV in China. METHODS We conducted a cross-sectional survey of 213 women living with HIV to collect information about cervical cancer screening behaviour, demographics, knowledge about cervical cancer and screening, and perception of HIV symptom severity. RESULTS Seventy-eight women living with HIV (36.6%) had undergone cervical cancer screening, and 83 (61.5%) of the nonscreened women had the intention to be screened in the future. Using multivariate analysis, women who had more knowledge about cervical cancer screening (OR = 2.373, 95% CI = 1.593-3.534, p = 0.000) and had at least one nongynecological symptom (OR = 0.446, 95% CI = 0.204-0.978, p = 0.044) were more likely to have received screening previously. CONCLUSION This study emphasised that knowledge, as a salient factor, was crucial to promoting cervical cancer screening behaviour among women living with HIV. Effective measures should be taken to promote the knowledge about cervical cancer prevention. A new healthcare model, including preventive healthcare in addition to HIV/AIDS care, may be needed to address the complex needs of women living with HIV in China.
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Affiliation(s)
- Shuxian Lin
- Xiang-Ya School of Nursing, Central South University, Changsha, China
| | - Wei-Ti Chen
- School of Nursing, University of California Los Angeles, Los Angeles, California, USA
| | - Can Gu
- Xiang-Ya School of Nursing, Central South University, Changsha, China
| | - Hui-Lin Cheng
- School of Nursing, Hong Kong Polytechnic University, Kowloon, Hong Kong
| | - Honghong Wang
- Xiang-Ya School of Nursing, Central South University, Changsha, China
| | - Siyuan Tang
- Xiang-Ya School of Nursing, Central South University, Changsha, China
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Enyan NIE, Akaba S, Amoo SA. Women diagnosed with HIV and unknown HIV status perceived susceptibility to cervical cancer and perceived benefits of cervical cancer screening in Ghana: a cross-sectional study. BMC Womens Health 2021; 21:367. [PMID: 34657607 PMCID: PMC8522230 DOI: 10.1186/s12905-021-01509-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2021] [Accepted: 09/24/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Cervical cancer is an issue of global health concern, and it seems to be the next epidemic in Sub-Saharan Africa after Human Immunodeficiency Virus (HIV). This study compared the perceptions of susceptibility to cervical cancer and benefits of cervical cancer screening among women diagnosed and those with unknown HIV status and determined the association between socio-demographic factors and HIV status. METHODS A cross-sectional study was conducted with 600 women diagnosed with HIV and 600 women with unknown HIV status in the Central Region of Ghana. Convenience sampling was used and a structured interview schedule was the main data collection instrument. Data were analysed using frequencies, percentages, chi-square test and independent samples t-test. RESULTS A high proportion of women diagnosed with HIV 94.8% (n = 569) and those with unknown HIV status 93.5% (n = 561) agreed that "screening can find cervical changes". Also, 58.0% (n = 348) of women diagnosed with HIV agreed that they have been in polygamous relationships so they may get cervical cancer. There was a statistically significant association between marital status (X2 = 167.071, p = 0.001), religion (X2 = 57.720, p = 0.001), level of education (X2 = 118.997, p = 0.001), employment status (X2 = 782.646, p = 0.001) and HIV status. A comparison of the mean difference for women diagnosed and those with unknown HIV status in relation to perceived benefits of cervical cancer screening showed a statistically significant difference (t = 7.418, df = 1198, p = 0.001). Nonetheless, there was no statistically significant difference in the means for women diagnosed and those with unknown HIV status regarding perceived susceptibility to cervical cancer (t = 0.935, df = 1198, p = 0.351). CONCLUSIONS Women with HIV perceived higher benefits of cervical cancer screening. Perception of susceptibility to cervical cancer by women with and those without HIV need to be addressed in efforts to improve their health. Furthermore, interventions for women with HIV should consider some important sociodemographic factors.
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Affiliation(s)
- Nancy Innocentia Ebu Enyan
- Department of Adult Health, School of Nursing and Midwifery, University of Cape Coast, Cape Coast, Ghana
| | - Selorm Akaba
- Department of Agricultural Economics and Extension, School of Agriculture, University of Cape Coast, Cape Coast, Ghana
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Shin HY, Song SY, Jun JK, Kim KY, Kang P. Barriers and strategies for cervical cancer screening: What do female university students know and want? PLoS One 2021; 16:e0257529. [PMID: 34610022 PMCID: PMC8491915 DOI: 10.1371/journal.pone.0257529] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2020] [Accepted: 09/03/2021] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE This study aimed to identify the distinct barriers and knowledge level of cervical cancer screening among female university students and establish intervention strategies to overcome these barriers. METHODS This study used a mixed-methods design with 26 female university students aged 20-29 years. We first conducted a quantitative online survey for the same study participants, divided them into three groups, and conducted focus group interviews (FGIs). Group A: participants who had sexual experience and had undergone cervical cancer screening; Group B: participants who had sexual experience and had not undergone cervical cancer screening; Group C: participants who did not have sexual experience and had not undergone cervical cancer screening. RESULTS The participants' ages were 21.92 ± 1.26 years. The knowledge levels for cervical cancer and screening were low to moderate. The four main themes that emerged as barriers to cervical cancer screening through the FGIs were: 1) socio-cultural barrier: conservative social perception of unmarried women's sexual life, 2) knowledge barrier: lack of knowledge and information, 3) psychological barrier: discomfort, and 4) practical barrier: time-consuming. The three themes identified for strategies were: 1) socio-cultural intervention: changing social perceptions and ensuring confidentiality, 2) educational intervention: improvement of knowledge and accessibility, and 3) alternative screening intervention: comfortable screening methods. CONCLUSIONS While university students' sexual experience rapidly increased, the socio-cultural perceptions of sexual health remained closed, and they had a reasonably low level of knowledge about cervical cancer screening. Therefore, various strategies sensitive to female university students' culture should be implemented to increase the knowledge level, and social efforts should be made to change the socio-cultural perception of unmarried young women's sexual health.
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Affiliation(s)
- Hye Young Shin
- National Cancer Control Institute, National Cancer Center, Goyang, Republic of Korea
- College of Nursing, Baekseok Culture University, Cheonan-si, Republic of Korea
| | - Soo Yeon Song
- National Cancer Control Institute, National Cancer Center, Goyang, Republic of Korea
| | - Jae Kwan Jun
- National Cancer Control Institute, National Cancer Center, Goyang, Republic of Korea
- Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Republic of Korea
| | - Ka Young Kim
- Department of Nursing, College of Nursing, Gachon University, Incheon, Republic of Korea
| | - Purum Kang
- College of Nursing, Woosuk University, Wanju, Jeollabuk-do, Republic of Korea
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Ezati Rad R, Mohseni S, Kamalzadeh Takhti H, Hassani Azad M, Shahabi N, Aghamolaei T, Norozian F. Application of the protection motivation theory for predicting COVID-19 preventive behaviors in Hormozgan, Iran: a cross-sectional study. BMC Public Health 2021; 21:466. [PMID: 33685426 PMCID: PMC7938277 DOI: 10.1186/s12889-021-10500-w] [Citation(s) in RCA: 65] [Impact Index Per Article: 21.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Accepted: 02/24/2021] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND The high prevalence and mortality of coronavirus disease 2019 (COVID-19) have made it the most important health and social challenge around the world. However, this disease can be largely prevented by adherence to hygienic principles and protective behaviors. It seems that identifying the processes involved in protective health behaviors can be effective in planning and implementing suitable interventions to encourage the community toward protective behaviors. Therefore, the present study aimed to predict the preventive behaviors of COVID-19 according to the Protection Motivation Theory (PMT). METHODS This cross-sectional study was conducted over 2 months in Hormozgan Province, Iran. The study population consisted of all citizens above the age of 15 years. An online questionnaire was used to collect the data. The questionnaire link was available to the participants through social networks. The questionnaire consisted of two sections, including the demographic information and the PMT constructs. All statistical calculations and hypothesis testing were performed in SPSS Version 21 and AMOS Version 21. The significance level was considered to be 0.05 for hypothesis testing. RESULTS A total of 2032 subjects, with the mean age of 34.84 ± 9.8 years (r = 15-98), participated in this study. Most of the participants were 31-40 years old, female (60.4%), married (72%), urban residents (87.3%), and employed (58.8%). The majority of them also had a bachelor's degree or higher (58.8%). Significant positive correlations were observed between the preventive behaviors of COVID-19 and the perceived vulnerability (r = 0.192, P < 0.001), perceived severity (r = 0.092, P < 0.001), response efficacy (r = 0.398, P < 0.001), self-efficacy (r = 0.497, P < 0.001), and protection motivation (r = 0.595, P < 0.001). On the other hand, significant negative correlations were found between the preventive behaviors of COVID-19 and maladaptive behavior rewards (r = - 0.243, P < 0.001) and perceived costs (r = - 0.121, P < 0.001). CONCLUSION The present findings showed that maladaptive behavior reward and fear negatively predicted the protective behaviors. On the other hand, response efficacy and self-efficacy positively predicted the protective behaviors; the impact of self-efficacy was the strongest. Overall, the information provided in this study can contribute to health policymaking in Iran.
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Affiliation(s)
- Roghayeh Ezati Rad
- Student Research Committee, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Shokrollah Mohseni
- Social Determinants in Health Promotion Research Center, Hormozgan Health Institute, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Hesamaddin Kamalzadeh Takhti
- Department of Community Medicine, School of Medicine, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Mehdi Hassani Azad
- Infectious and Tropical Diseases Research Center, Hormozgan Health Institute, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Nahid Shahabi
- Student Research Committee, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Teamur Aghamolaei
- Cardiovascular Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran.
| | - Fatemeh Norozian
- Social Determinants in Health Promotion Research Center, Hormozgan Health Institute, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
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Liu N, Li P, Wang J, Guo PP, Zhang XH, Yang S, Yu L, Zhang XM, Zhang W. Factors influencing breast cancer awareness: a cross-sectional study in China. J Comp Eff Res 2020; 9:679-689. [PMID: 32648473 DOI: 10.2217/cer-2020-0037] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Aim: This study aimed to explore the factors that influence breast cancer awareness. Materials & methods: A community-based cross-sectional study was conducted between January and April 2019 in Changchun, Jilin Province, China. Results: A total of 274 women were recruited for this cross-sectional study. Participants had a moderate level of breast cancer awareness (median = 76.50 [68.75, 84.00]). Women in the action/maintenance stages reported higher breast cancer awareness (p = 0.044). Women's breast cancer awareness was positively associated with high health information literacy level, husbands' higher educational degrees, seeing doctors after detecting abnormal breast changes and living within a short distance from the nearest hospital. Conclusion: History of screening and higher health information literacy levels are important positive factors linked to higher breast cancer awareness.
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Affiliation(s)
- Na Liu
- Nursing School, Jilin University, Changchun, Jilin Province, China
| | - Ping Li
- Department of Developmental Pediatrics, The Second Hospital of Jilin University, Changchun, Jilin Province, China
| | - Jie Wang
- Nursing School, Jilin University, Changchun, Jilin Province, China
| | - Ping-Ping Guo
- Nursing School, Jilin University, Changchun, Jilin Province, China
| | - Xue-Hui Zhang
- Nursing School, Jilin University, Changchun, Jilin Province, China
| | - Shu Yang
- Nursing School, Jilin University, Changchun, Jilin Province, China
| | - Lin Yu
- Nursing School, Jilin University, Changchun, Jilin Province, China
| | - Xiu-Min Zhang
- School of Public Health of Jilin University, Changchun, Jilin Province, China
| | - Wei Zhang
- Nursing School, Jilin University, Changchun, Jilin Province, China
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Ahmed NU, Rojas P, Degarege A. Knowledge of Cervical Cancer and Adherence to Pap Smear Screening Test Among Female University Students in a Multiethnic Institution, USA. J Natl Med Assoc 2020; 112:300-307. [PMID: 32291069 DOI: 10.1016/j.jnma.2020.03.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2019] [Revised: 02/17/2020] [Accepted: 03/13/2020] [Indexed: 11/25/2022]
Abstract
BACKGROUND/PURPOSE This study assessed cervical cancer knowledge and examined its correlation with adherence to Pap smear guidelines. METHODS We carried out a cross-sectional survey in 141 undergraduate female college students. The response rate of the survey was 91.5%. Knowledge scores (0 - 4) were calculated based on students' answers to four items. RESULTS About 61.7% of the participants did not have annual checkups within a year, and 69% have never received Pap-test. Students who never received Pap-test mentioned procrastination (82%), lack of interest and fear as reasons for not practicing the behavior. About 92.9% of the students were not aware that the university student health service provides free Pap tests. More than double of annual checkup recipients undergone Pap test (33%) compared with those who did not have annual checkups (14.3%). Students who knew multi-partners sexual activity as a risk factor for cervical cancer had higher odds of receiving Pap test than those who didn't know the correlation between the number of sexual partner and the risk of cervical cancer [aOR= 2.87; 95% CI 1.07- 8.90]. Students with knowledge scores about cervical cancer risk factors and prevention methods at least a median had higher odds of receiving Pap test than those with knowledge scores lower than the median [aOR=6.49; 95% CI 2.8 - 14.7]. The increase in receipt of Pap test was associated with an increase in the level of knowledge about risk factors of cervical cancer. CONCLUSIONS This study confirmed a correlation of the receipt of Pap test with knowing the causes and prevention mechanisms of cervical cancer. Adequate knowledge about cervical cancer causes, and prevention/control strategies may help to improve adherence to Pap smear testing in college students.
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Affiliation(s)
- Nasar U Ahmed
- Department of Epidemiology, Robert Stempel College of Public Health & Social Work, Florida International University, Miami, USA.
| | - Patria Rojas
- Department of Health Promotion and Disease Prevention, Robert Stempel College of Public Health & Social Work, Florida International University, Miami, USA
| | - Abraham Degarege
- Department of Epidemiology, College of Public Health, University of Nebraska Medical Center, Omaha, NE, USA
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Li Q, Liu Q, Chen X, Tan X, Zhang M, Tuo J, Xiang Q, Yu Q, Zhu Z. Protection motivation theory in predicting cervical cancer screening participation: A longitudinal study in rural Chinese women. Psychooncology 2019; 29:564-571. [PMID: 31823462 DOI: 10.1002/pon.5307] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Revised: 11/20/2019] [Accepted: 11/26/2019] [Indexed: 12/24/2022]
Abstract
OBJECTIVE To examine factors longitudinally associated with cervical cancer screening uptake among rural Chinese women, guided by protection motivation theory (PMT). METHODS A large sample of women (n = 2408, aged 35-65 years old) was randomly selected from a rural county in China in 2015 and followed up for 2 years. Data for demographic factors, knowledge of cervical cancer screening, screening outcome, and six PMT constructs measured at the baseline in 2015 were used to predict cervical cancer screening participation at the follow-up in 2017 using structural equation model method. RESULTS Among the 2408 women at the baseline, 1879 (78.03%) participated in the screening services at the follow-up. In addition to significant direct effect of age, social status and baseline screening outcome, and three (perceived severity, fear arousal and response efficacy) of the six PMT subconstructs, four variables (age, social status, knowledge of cervical cancer screening, and baseline screening outcome) at the baseline were indirectly associated with screening participation, mediated by the three significant PMT subconstructs. CONCLUSIONS Findings of this study indicate that the rate of participating in cervical cancer screening for rural women needs to be further improved. In addition to the commonly reported influential factors, PMT subconstructs play important roles in encouraging rural women in China to participate in cervical cancer screening. These longitudinal findings provided data much needed for future research to develop evidence-based intervention programs to enhance cervical cancer screening among rural women in China.
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Affiliation(s)
- Qinmei Li
- Department of Epidemiology, School of Health Sciences, Wuhan University, Wuhan, China
| | - Qing Liu
- Department of Epidemiology, School of Health Sciences, Wuhan University, Wuhan, China
| | - Xinguang Chen
- Department of Epidemiology, School of Health Sciences, Wuhan University, Wuhan, China.,Department of Epidemiology, University of Florida, Gainesville, Florida
| | - Xiaodong Tan
- Department of Epidemiology, School of Health Sciences, Wuhan University, Wuhan, China
| | - Min Zhang
- Office of Cancer Prevention and Treatment, Institute of Cancer Prevention and Control, Wuhan, China
| | - Jiyu Tuo
- Office of Cancer Prevention and Treatment, Institute of Cancer Prevention and Control, Wuhan, China
| | - Qunying Xiang
- Family Planning Service Center, Maternal and Child Health Care Hospital, Wufeng, China
| | - Qiuli Yu
- Department of Epidemiology, School of Health Sciences, Wuhan University, Wuhan, China
| | - Zhu Zhu
- Department of Epidemiology, School of Health Sciences, Wuhan University, Wuhan, China
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Chan CWH, Choi KC, Chan HYL, Wong MMH, Ling GCC, Chow KM, Chow AYM, Lo R, Sham MMK. Unfolding and displaying the influencing factors of advance directives from the stakeholder's perspective: A concept mapping approach. J Adv Nurs 2019; 75:1549-1562. [DOI: 10.1111/jan.14017] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2018] [Revised: 01/22/2019] [Accepted: 03/15/2019] [Indexed: 11/30/2022]
Affiliation(s)
- Carmen W. H. Chan
- The Nethersole School of Nursing The Chinese University of Hong Kong Hong Kong SAR China
| | - Kai C. Choi
- The Nethersole School of Nursing The Chinese University of Hong Kong Hong Kong SAR China
| | - Helen Y. L. Chan
- The Nethersole School of Nursing The Chinese University of Hong Kong Hong Kong SAR China
| | - Martin M. H. Wong
- The Nethersole School of Nursing The Chinese University of Hong Kong Hong Kong SAR China
| | - Gigi C. C. Ling
- The Nethersole School of Nursing The Chinese University of Hong Kong Hong Kong SAR China
| | - Ka M. Chow
- The Nethersole School of Nursing The Chinese University of Hong Kong Hong Kong SAR China
| | - Amy Y. M. Chow
- Department of Social Work and Social Administration The University of Hong Kong Hong Kong
| | - Raymond Lo
- Department of Medicine and Therapeutics the Chinese University of Hong Kong Hong Kong
- Bradbury Hospice Hong Kong
- Geriatrics and Palliative Medicine Shatin Hospital Hong Kong
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12
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Cervical Cancer Screening Behaviors Among Post-Menopausal Women. INTERNATIONAL JOURNAL OF CANCER MANAGEMENT 2019. [DOI: 10.5812/ijcm.80026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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13
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Abstract
OBJECTIVES To explore barriers to free cervical cancer screening among rural women in China from the perspective of women, healthcare providers and women's husbands to inform intervention planning. DESIGN A qualitative study framed around potential policy and practice options, drawing on the concepts of descriptive phenomenology and implementation research. SETTING This study was carried out at township level within two counties in Jining Prefecture of eastern China. PARTICIPANTS AND DATA COLLECTION Semi-structured in-depth interviews with 21 women and five healthcare providers, focus group discussions with nine healthcare providers and key informant interviews with four husbands of women eligible for screening. RESULTS Thematic analysis generated five major themes: (1) gaps in knowledge of cervical cancer and health awareness, (2) fear of cancer and screening outcomes, (3) cultural barriers including reticence for intimate examinations, (4) influence of close contacts on screening decisions and (5) inconvenience. These demonstrate key knowledge gaps challenging current community health education. Important barriers, including fear of treatment cost and the time needed for screening, were also raised. CONCLUSION Our study details important barriers to cervical cancer screening relating to knowledge gaps, attitudes of fear or embarrassment and the role of contacts and service models. These provide data for policy and planning to improve the screening that will decrease the incidence and mortality rates of cervical cancer in China.
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Affiliation(s)
- Huan Yang
- Shandong University, Jinan, China
- NHC Key Laboratory of Health Economics and Policy Research (Shandong University), Jinan, China
| | - Shun-Ping Li
- Shandong University, Jinan, China
- NHC Key Laboratory of Health Economics and Policy Research (Shandong University), Jinan, China
| | - Qing Chen
- Shandong University, Jinan, China
- NHC Key Laboratory of Health Economics and Policy Research (Shandong University), Jinan, China
| | - Christopher Morgan
- Burnet Institute, Melbourne, Victoria, Australia
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
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14
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Yeo C, Fang H, Thilagamangai, Koh SSL, Shorey S. Factors affecting Pap smear uptake in a maternity hospital: A descriptive cross-sectional study. J Adv Nurs 2018; 74:2533-2543. [PMID: 29920737 DOI: 10.1111/jan.13769] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2018] [Accepted: 05/24/2018] [Indexed: 11/30/2022]
Abstract
AIM To understand factors that influence women's decisions to go for Pap smears. BACKGROUND Globally, cervical cancer is the fourth most common cancer among women. In Singapore, cervical cancer is on the rise and has been found to be the eighth highest cause of death among women. Research has shown that regular screening for cervical cancer with Pap smear reduces cervical cancer-related mortality. However, Pap smear awareness is still limited and its uptake in Singapore is highly opportunistic, requiring the need for a deeper understanding of the factors that influence Pap smear uptake among women in Singapore. DESIGN A descriptive cross-sectional study design was used. METHODS Convenience sampling was used to recruit 350 participants (postnatal women of at least 21 years old) from a local maternity hospital. Data were collected using validated questionnaires. Logistic regression was used to analyse the data. RESULTS Demographic factors, such as age, ethnicity and religion, as well as women's beliefs about the effectiveness of Pap smear in detecting cervical cancer, the desire to discover health problems early and considering Pap smear to be painful, were found to be factors significantly influencing Pap smear uptake. Healthcare professionals need to be mindful of these factors to address women's needs to encourage women to go for Pap smears. CONCLUSION Various factors were found to influence Pap smear uptake. Future interventions can take these factors into account for increasing Pap smear awareness.
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Affiliation(s)
- Celestine Yeo
- Division of Nursing, KK Women's and Children's Hospital, Singapore
| | - Huang Fang
- Division of Nursing, KK Women's and Children's Hospital, Singapore
| | - Thilagamangai
- Division of Nursing, KK Women's and Children's Hospital, Singapore
| | - Serena Siew Lin Koh
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Shefaly Shorey
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.,National University Health System, Singapore
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15
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Tang FW, Chan CW, Choy YP, Loong HH, Chow KM, So WK. A feasibility study on using tablet personal computers for self-reported symptom assessment in newly diagnosed lung cancer patients. Int J Nurs Pract 2018; 24:e12658. [DOI: 10.1111/ijn.12658] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2017] [Revised: 03/06/2018] [Accepted: 03/06/2018] [Indexed: 12/25/2022]
Affiliation(s)
- Fiona W.K. Tang
- The Nethersole School of Nursing, Faculty of Medicine; The Chinese University of Hong Kong, Hong Kong Special Administrative Region; Shatin New Territories Hong Kong
| | - Carmen W.H. Chan
- The Nethersole School of Nursing, Faculty of Medicine; The Chinese University of Hong Kong, Hong Kong Special Administrative Region; Shatin New Territories Hong Kong
| | - Yin-Ping Choy
- Department of Oncology; Princess Margaret Hospital, Hospital Authority. Hong Kong Special Administrative Region; Kowloon Hong Kong
| | - Herbert H.F. Loong
- Department of Clinical Oncology, Faculty of Medicine; The Chinese University of Hong Kong, Hong Kong Special Administrative Region; Shatin New Territories Hong Kong
| | - Ka Ming Chow
- The Nethersole School of Nursing, Faculty of Medicine; The Chinese University of Hong Kong, Hong Kong Special Administrative Region; Shatin New Territories Hong Kong
| | - Winnie K.W. So
- The Nethersole School of Nursing, Faculty of Medicine; The Chinese University of Hong Kong, Hong Kong Special Administrative Region; Shatin New Territories Hong Kong
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16
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Ebu NI. Facilitators and barriers to cervical cancer screening among HIV-positive women in Ghana. ACTA ACUST UNITED AC 2018. [DOI: 10.12968/ajmw.2018.12.2.93] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Nancy Innocentia Ebu
- Lecturer, University of Cape Coast, School of Nursing and Midwifery, Department of Public Health, Ghana
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17
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Chow KM, So WKW, Choi KC, Chan CWH. Sexual function, psychosocial adjustment to illness, and quality of life among Chinese gynaecological cancer survivors. Psychooncology 2018; 27:1257-1263. [DOI: 10.1002/pon.4663] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2017] [Revised: 01/22/2018] [Accepted: 01/28/2018] [Indexed: 11/08/2022]
Affiliation(s)
- Ka Ming Chow
- The Nethersole School of Nursing; The Chinese University of Hong Kong; Hong Kong SAR China
| | - Winnie Kwok Wei So
- The Nethersole School of Nursing; The Chinese University of Hong Kong; Hong Kong SAR China
| | - Kai Chow Choi
- The Nethersole School of Nursing; The Chinese University of Hong Kong; Hong Kong SAR China
| | - Carmen Wing Han Chan
- The Nethersole School of Nursing; The Chinese University of Hong Kong; Hong Kong SAR China
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18
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Gu C, Chan CWH, Chow KM, Yang S, Luo Y, Cheng H, Wang H. Understanding the cervical screening behaviour of Chinese women: The role of health care system and health professions. Appl Nurs Res 2018; 39:58-64. [PMID: 29422178 DOI: 10.1016/j.apnr.2017.09.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2016] [Revised: 06/24/2017] [Accepted: 09/23/2017] [Indexed: 12/21/2022]
Abstract
BACKGROUND In China, cervical cancer cases are increasing, making an impact on the worldwide burden of cervical cancer. Despite the initiatives undertaken by the Chinese government, the current coverage of cervical screening in China remains suboptimal. There is an urgent need to identify the facilitators and barriers associated with the uptake of cervical cancer screening among the Chinese population. PURPOSE The study aimed to explore the experiences and perceptions of cervical cancer screening of mainland Chinese women in relation to their screening behaviour, particularly in the aspects of health care system and health profession roles. METHODS A qualitative research was conducted using semi-structured interviews. A total of 27 Chinese women aged 25 to 50 (both screened and non-screened women) completed the interviews. The analysis of the interview data was undertaken inductively using latent content analysis. DISCUSSION AND CONCLUSION Results showed that organised health examination programmes provide a good basis for integrating cervical screening into broader checks on the health of women, and utilising different networks of social support facilitate the utilisation of the screening service. However, education on cervical cancer and screening must be made more generally available. More importantly, there is a need for a more participatory and empowering exchange in the encounter between health professions and these women. Appropriate training program is strongly recommended for health professions about communicate skills with patients. Future work should focus on identifying strategies to overcome the barriers to cervical screening related to health care system and medical professions among this population.
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Affiliation(s)
- Can Gu
- Xiangya School of Nursing, Central South University, Changsha, PR China.
| | - Carmen W H Chan
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong.
| | - Ka Ming Chow
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong.
| | - Shengbo Yang
- Third Xiangya Hospital, Central South University, Changsha, PR China.
| | - Yang Luo
- Xiangya School of Nursing, Central South University, Changsha, PR China.
| | - Huilin Cheng
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong.
| | - Honghong Wang
- Xiangya School of Nursing, Central South University, Changsha, PR China.
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Soares MBO, Silva SRD. Interventions that facilitate adherence to Pap smear exam: integrative review. Rev Bras Enferm 2017; 69:404-14. [PMID: 27280579 DOI: 10.1590/0034-7167.2016690226i] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2015] [Accepted: 12/26/2015] [Indexed: 11/21/2022] Open
Abstract
RESUMO Objetivo: identificar produções científicas que apresentem intervenções relevantes para implementar o Programa de Prevenção do Câncer Cérvico-Uterino, aumentando a adesão à realização do exame. Método: revisão integrativa da literatura, realizada por busca on-line, nas bases de dados: LILACS, SciELO e Pubmed®, abrangendo artigos publicados de 2009 a 2014. Resultados: trinta e oito artigos compuseram a amostra final do estudo. Estes indicaram as seguintes intervenções: utilização de gerente de caso, contato telefônico, carta-convite, atividades educativas, divulgação na mídia, agentes de saúde da comunidade, parcerias, rastreamento de base populacional e múltiplas intervenções. Conclusão: as pesquisas concentram-se entre mulheres provenientes de países em desenvolvimento, e estas intervenções são eficazes no aumento da adesão e do conhecimento destas mulheres em relação à prevenção do câncer cérvico-uterino.
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Affiliation(s)
- Maurícia Brochado Oliveira Soares
- Universidade Federal do Triângulo Mineiro, Programa de Pós-Graduação em Atenção à Saúde, Uberaba MG , Brazil, Universidade Federal do Triângulo Mineiro, Programa de Pós-Graduação em Atenção à Saúde. Uberaba-MG, Brasil., Universidade Federal do Triângulo Mineiro
| | - Sueli Riul da Silva
- Universidade Federal do Triângulo Mineiro, Programa de Pós-Graduação em Atenção à Saúde, Uberaba MG , Brazil, Universidade Federal do Triângulo Mineiro, Programa de Pós-Graduação em Atenção à Saúde. Uberaba-MG, Brasil., Universidade Federal do Triângulo Mineiro
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20
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Gu C, Chen WT, Zhang Q, Chow KM, Wu J, Tao L, Chan CWH. Exploring Chinese Women's Perception of Cervical Cancer Risk as It Impacts Screening Behavior: A Qualitative Study. Cancer Nurs 2017; 40:E17-E25. [PMID: 27281034 PMCID: PMC10680370 DOI: 10.1097/ncc.0000000000000400] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Chinese women rarely undergo regular cervical screening. Women's decisions about cervical screening may be influenced by their perception of the risk of cervical cancer. Therefore, understanding how women perceive the risk of cervical cancer, how personal risk factors are interpreted, and the influence of cultural issues on cervical screening behavior is important. OBJECTIVE The aim of this study is to understand cervical cancer risk perception and the role of personal risk factors as they influence screening behavior among Chinese women. METHOD An exploratory qualitative research design was used. We conducted semistructured, in-depth interviews of 27 women in Changsha, a medium-size city in Hunan province, China. RESULTS Participants identified that cervical cancer had serious consequences, but they distanced themselves psychologically from the disease because they felt that "cervical cancer is a shameful and deadly disease." Although women identified some of the risk factors for the disease, they had little specific knowledge of human papillomavirus infection, its association with cervical cancer, and the importance of cervical screening. CONCLUSION This study contributes new knowledge to the understanding of cervical screening behavior within a specific social and cultural context. Better efforts should be made to educate Chinese women on the risk of cervical cancer and emphasize that effective cancer treatments are available and that there is a good chance of survival. IMPLICATIONS FOR PRACTICE Nurses working with Chinese women should ensure that the information they provide is culturally sensitive, particularly by acknowledging the normative beliefs of this population group.
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Affiliation(s)
- Can Gu
- Author Affiliations: Department of Medicine, Xiangya Hospital (Drs Gu and Tao), and Xiang-Ya School of Nursing (Dr Gu), Central South University, Changsha, P.R. China; School of Nursing, Yale University, West Haven, Connecticut (Dr Chen); The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, P.R. China (Ms Zhang); The Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong (Drs Chow and Chan); and Third Xiangya Hospital, Central South University, Changsha, P.R. China (Dr Wu)
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21
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Bai Y, Liu Q, Chen X, Gao Y, Gong H, Tan X, Zhang M, Tuo J, Zhang Y, Xiang Q, Deng F, Liu G. Protection motivation theory in predicting intention to receive cervical cancer screening in rural Chinese women. Psychooncology 2017; 27:442-449. [PMID: 28749603 DOI: 10.1002/pon.4510] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2017] [Revised: 06/14/2017] [Accepted: 07/21/2017] [Indexed: 11/11/2022]
Affiliation(s)
- Yang Bai
- School of Health Sciences; Wuhan University; Wuhan Hubei China
| | - Qing Liu
- School of Health Sciences; Wuhan University; Wuhan Hubei China
| | - Xinguang Chen
- School of Health Sciences; Wuhan University; Wuhan Hubei China
- Department of Epidemiology; University of Florida; Gainesville FL USA
| | - Yanduo Gao
- School of Health Sciences; Wuhan University; Wuhan Hubei China
| | - Huiyun Gong
- School of Health Sciences; Wuhan University; Wuhan Hubei China
| | - Xiaodong Tan
- School of Health Sciences; Wuhan University; Wuhan Hubei China
| | - Min Zhang
- Institute of Cancer Prevention and Control; Wuhan Hubei China
| | - Jiyu Tuo
- Institute of Cancer Prevention and Control; Wuhan Hubei China
| | - Yuling Zhang
- Institute of Cancer Prevention and Control; Wuhan Hubei China
| | - Qunying Xiang
- Maternal and Child Health Care Hospital; Wufeng Hubei China
| | - Fenghua Deng
- Maternal and Child Health Care Hospital; Wufeng Hubei China
| | - Guiling Liu
- Maternal and Child Health Care Hospital; Wufeng Hubei China
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22
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Wu E, Tiggelaar SM, Jiang T, Zhao H, Wu R, Wu R, Xu F. Cervical cancer prevention-related knowledge and attitudes among female undergraduate students from different ethnic groups within China, a survey-based study. Women Health 2017; 58:661-684. [DOI: 10.1080/03630242.2017.1333076] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Affiliation(s)
- Enqi Wu
- State Nationalities Affairs Commission and Department of Educational Key Lab of Minority Traditional Medicine, Minzu University of China, Beijing, China
| | - Sarah M. Tiggelaar
- UT Family Medicine, University of Tennessee Health Science Center, University of Tennessee, Memphis, Tennessee, USA
| | - Tao Jiang
- State Nationalities Affairs Commission and Department of Educational Key Lab of Minority Traditional Medicine, Minzu University of China, Beijing, China
| | - Huanhu Zhao
- State Nationalities Affairs Commission and Department of Educational Key Lab of Minority Traditional Medicine, Minzu University of China, Beijing, China
| | - Ritu Wu
- State Nationalities Affairs Commission and Department of Educational Key Lab of Minority Traditional Medicine, Minzu University of China, Beijing, China
| | - Rilige Wu
- School of Economics and Management, Inner Mongolia University for the Nationalities, Tongliao, China
| | - Fangmei Xu
- Department of Pediatrics, Hubei Danjiangkou Maternal and Child Health Care Hospital, Danjiangkou, China
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Sidabutar S, Martini S, Wahyuni CU. Analysis of Factors Affecting Women of Childbearing Age to Screen Using Visual Inspection with Acetic Acid. Osong Public Health Res Perspect 2017; 8:61-64. [PMID: 28443225 PMCID: PMC5402845 DOI: 10.24171/j.phrp.2017.8.1.08] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Objectives The purpose of this study was to evaluate patient factors such as knowledge, attitude, motivation, perception, socio-economic status and travel time to health facilities and assess how these factors affected patients’ decision to pursue cervical cancer screening with visual inspection with acetic acid (VIA). Methods A total of 80 women of childbearing age who visited Kenjeran and Balongsari Public Health Centers for health assessments were involved in this study. Patients who agreed to participate in the study underwent a verbal questionnaire to evaluate various factors. Results Bivariate analysis concluded that knowledge, attitude, motivation, perception, socioeconomic status, and travel time to health facilities were significantly different between women who received VIA screening and women who did not receive VIA screening (p < 0.05). The factors of knowledge, attitudes, motivation, perception, socio-economic status, and the travel time to health facilities accounted for 2.920-fold, 2.043-fold, 3.704-fold, 2.965-fold, 3.198-fold and 2.386-fold possibility, respectively, of patients to pursue cervical cancer screening with VIA. Multivariate analysis showed that perception, socio-economic status, and travel time to health facilities were the most important factors influencing whether or not women pursued VIA screening. Conclusion Knowledge, attitude, motivation, perception, socio-economic status, and travel time to health facilities appears to affect women’s’ decision to pursue cervical cancer screening with VIA, with the largest intake being the motivational factor.
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Affiliation(s)
- Sondang Sidabutar
- Faculty of Public Health, Airlangga University, Surabaya, Indonesia.,Public Health Study Programme, Faculty of Health, Efarina University, Simalungun, Indonesia
| | - Santi Martini
- Department of Epidemiology, Faculty of Public Health, Airlangga University, Surabaya, Indonesia
| | - Chatarina Umbul Wahyuni
- Department of Epidemiology, Faculty of Public Health, Airlangga University, Surabaya, Indonesia
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Women's preferences for contralateral prophylactic mastectomy following unilateral breast cancer: What risk-reduction makes it worthwhile? Breast 2016; 31:233-240. [PMID: 27969575 DOI: 10.1016/j.breast.2016.11.025] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2016] [Revised: 10/23/2016] [Accepted: 11/30/2016] [Indexed: 01/11/2023] Open
Abstract
OBJECTIVES Contralateral prophylactic mastectomy (CPM) reduces the risk of contralateral breast cancer (BC) following unilateral BC, but may not increase survival in BRCA1/2 mutation negative women. Despite this, and the risk for adverse physical and psychological impact, uptake is increasing in BRCA1/2 mutation negative women. We aimed to quantify the degree of reduction in lifetime contralateral BC risk women required to justify CPM, and to explore demographic, disease and psychosocial predictors of preferences using Protection Motivation Theory (PMT) as a theoretical framework. Reasoning behind preferences was also examined. MATERIALS AND METHODS 388 women previously diagnosed with unilateral BC, of negative or unknown BRCA1/2 status, were recruited from an advocacy group research database. Two hypothetical risk trade-off scenarios were used to quantify the reduction in lifetime contralateral BC risk that women judged necessary to justify CPM, using a 5% and 20% baseline. Demographic, disease and PMT measures were assessed using a questionnaire. RESULTS Most women required their risk to be more than halved from a 5% or 20% baseline to justify CPM. Polarised preferences were also common, with some women consistently accepting or refusing CPM independent of risk/benefit trade-offs. Preferences were associated with coping self-efficacy and having a prior CPM. Explanations for judging CPM worthwhile included reducing or eliminating contralateral BC risk, attaining breast symmetry and reducing worry. CONCLUSION Risk-reduction preferences were highly variable. Decisive factors in women's preferences for CPM related to clinical, psychological and cosmetic outcomes, but not to demographic or disease characteristics.
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Chan CWH, Choi KC, Wong RS, Chow KM, So WKW, Leung DYP, Lam WWT, Goggins W. Examining the Cervical Screening Behaviour of Women Aged 50 or above and Its Predicting Factors: A Population-Based Survey. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2016; 13:ijerph13121195. [PMID: 27918456 PMCID: PMC5201336 DOI: 10.3390/ijerph13121195] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/28/2016] [Revised: 11/11/2016] [Accepted: 11/23/2016] [Indexed: 11/16/2022]
Abstract
Under-screening may increase the risk of cervical cancer in middle-aged women. This study aimed to investigate cervical cancer screening behaviour and its predictors among women aged 50 years or above. A population-based sample of 959 women was recruited by telephone from domestic households in Hong Kong, using random methods, and a structured questionnaire developed to survey participants. Multivariable logistic regressions were performed to examine the factors independently associated with cervical screening behaviour. Nearly half the sample (48%) had never had a cervical smear test. Multivariable analyses showed that age, educational level, marital status, family history of cancer, smoking status, use of complementary therapy, recommendation from health professionals, and believing that regular visits to a doctor or a Chinese herbalist were good for their health were predictors of cervical screening behaviour. Misconceptions concerned with menopause may reduce women's perceived susceptibility to cervical cancer, especially if they are 50 or above, and exert a negative effect on their screening behaviour. Healthcare professionals should actively approach these high-risk groups-older unmarried women, smokers, those less educated and who are generally not much concerned with their health.
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Affiliation(s)
- Carmen W H Chan
- The Nethersole School of Nursing, The Chinese University of Hong Kong, New Territories, Hong Kong, China.
| | - Kai Chow Choi
- The Nethersole School of Nursing, The Chinese University of Hong Kong, New Territories, Hong Kong, China.
| | - Rosa S Wong
- The Nethersole School of Nursing, The Chinese University of Hong Kong, New Territories, Hong Kong, China.
| | - Ka Ming Chow
- The Nethersole School of Nursing, The Chinese University of Hong Kong, New Territories, Hong Kong, China.
| | - Winnie K W So
- The Nethersole School of Nursing, The Chinese University of Hong Kong, New Territories, Hong Kong, China.
| | - Doris Y P Leung
- The Nethersole School of Nursing, The Chinese University of Hong Kong, New Territories, Hong Kong, China.
| | - Wendy W T Lam
- School of Public Health, The University of Hong Kong, Hong Kong, China.
| | - William Goggins
- School of Public Health and Primary Care, The Chinese University of Hong Kong, New Territories, Hong Kong, China.
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Tesson S, Richards I, Porter D, Phillips KA, Rankin N, Musiello T, Marven M, Butow P. Women's preferences for contralateral prophylactic mastectomy: An investigation using protection motivation theory. PATIENT EDUCATION AND COUNSELING 2016; 99:814-822. [PMID: 27529090 DOI: 10.1016/j.pec.2015.11.012] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
OBJECTIVE Most women diagnosed with unilateral breast cancer without BRCA1 or BRCA2 mutations are at low risk of contralateral breast cancer. Contralateral Prophylactic Mastectomy (CPM) decreases the relative risk of contralateral breast cancer, but may not increase life expectancy; yet international uptake is increasing. This study applied protection motivation theory (PMT) to determine factors associated with women's intentions to undergo CPM. METHODS Three hundred eighty-eight women previously diagnosed with unilateral breast cancer and of negative or unknown BRCA1 or BRCA2 status were recruited from an advocacy group's research database. Participants completed measures of PMT constructs based on a common hypothetical CPM decision-making scenario. RESULTS PMT constructs explained 16% of variance in intentions to undergo CPM. Response efficacy (CPM's advantages) and response costs (CPM's disadvantages) were unique individual predictors of intentions. CONCLUSION Decision-making appears driven by considerations of the psychological, cosmetic and emotional advantages and disadvantages of CPM. Overestimations of threat to life from contralateral breast cancer and survival benefit from CPM also appear influential factors. PRACTICE IMPLICATIONS Patients require balanced and medically accurate information regarding the pros and cons of CPM, survival rates, and recurrence risks to ensure realistic and informed decision-making.
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Chen SL, Tsai SF, Hsieh MM, Lee LL, Tzeng YL. Factors Predicting Nurse Intent and Status Regarding Pap Smear Examination in Taiwan: a Cross-sectional Survey. Asian Pac J Cancer Prev 2016; 17:165-70. [PMID: 26838204 DOI: 10.7314/apjcp.2016.17.1.165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Nurses are the most visible, frontline personnel providing health education to patients. In particular, nurse experience with Pap examinations have the potential to influence women's attitudes toward screening for cervical cancer. However, nurses in Taiwan have lower rates of Pap testing than the general population. Understanding the factors predicting nurse intent to have a Pap exam and Pap exam status would inform interventions and policies to increase their Pap exam uptake. Therefore, the present study was undertaken. MATERIALS AND METHODS Data were collected by questionnaire from a convenient sample of 504 nurses at a regional hospital in central Taiwan between August and October 2011 and analyzed by descriptive statistics, confirmatory factor analysis, and logistic regression. RESULTS Nurse intention to have a Pap exam was predicted by younger age, less negative attitudes toward Pap exams, and greater influence of others recommendations. However, nurses were more likely to actually have had a Pap exam if they were older, married, had sexual experience, and had a high intention to have a Pap exam. CONCLUSIONS Nurses who are younger than 34 years old, unmarried, sexually inexperienced, and with low intention to have a Pap exam should be targeted with interventions to educate them not only about the importance of Pap exams in detecting cervical cancer, but also about strategies to decrease pain and embarrassment during exams. Nurses with less negative attitudes and experiences related to Pap exams would serve as role models to persuade women to have Pap exams, thus increasing the uptake rate of Pap exams in Taiwan.
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Affiliation(s)
- Shu-Ling Chen
- Department of Nursing, Hungkuang University, Taichung, Taiwan E-mail :
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Psychosocial Predictors for Cancer Prevention Behaviors in Workplace Using Protection Motivation Theory. Adv Prev Med 2015; 2015:467498. [PMID: 26543649 PMCID: PMC4620287 DOI: 10.1155/2015/467498] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2015] [Accepted: 09/28/2015] [Indexed: 11/18/2022] Open
Abstract
Backgrounds. The aim of this study was to describe the preventive behaviors of industrial workers and factors influencing occupational cancer prevention behaviors using protection motivation theory. Methods. A self-administered questionnaire was completed by 161 petrochemical workers in Iran in 2014 which consisted of three sections: background information, protection motivation theory measures, and occupational cancers preventive behaviors. Results. A statistically significant positive correlation was found between PM and self-efficacy, response efficacy, and the cancer preventive behaviors. Meanwhile, statistically significant negative correlations were found between PM, cost, and reward. Conclusions. Among available PMT constructs, only self-efficacy and cost were significant predictors of preventive behaviors. Protection motivation model based health promotion interventions with focus on self-efficacy and cost would be desirable in the case of occupational cancers prevention.
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Stakeholder reactions toward iodine biofortified foods. An application of protection motivation theory. Appetite 2015; 92:295-302. [DOI: 10.1016/j.appet.2015.05.038] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2015] [Revised: 04/21/2015] [Accepted: 05/30/2015] [Indexed: 01/10/2023]
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Gu C, Niccolai LM, Yang S, Wang X, Tao L. Human papillomavirus vaccine acceptability among female undergraduate students in China: the role of knowledge and psychosocial factors. J Clin Nurs 2015; 24:2765-78. [PMID: 26179945 DOI: 10.1111/jocn.12871] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/07/2015] [Indexed: 11/26/2022]
Abstract
AIMS AND OBJECTIVES To examine young women's perceptions and acceptability of human papillomavirus vaccination and factors influencing acceptability in mainland China. BACKGROUND In the light of current concepts, human papillomavirus vaccines serve as new paradigms in cervical cancer prevention programme for young women. However, knowledge and acceptability of human papillomavirus vaccination and factors influencing acceptability among young Chinese women are not known. DESIGN We implemented a cross-sectional descriptive study in the Hunan province of China. METHODS One hundred and seventeen female undergraduate students completed confidential surveys in 2012. The questionnaire included five parts: background information, awareness and knowledge of human papillomavirus vaccine and cervical cancer, attitudes towards the vaccine and intentions to be vaccinated, psychosocial burden of human papillomavirus infection, and human papillomavirus-related sexual stigma. RESULTS Only 44% of the participants were willing to be vaccinated in the future. Young women demonstrated low awareness and knowledge about human papillomavirus vaccine and cervical cancer. Their intention to receive future vaccination was associated with the high levels of knowledge about risk factors for cervical cancer and perceptions that infected women are responsible for their own infection of human papillomavirus. CONCLUSION The results of this study suggest low awareness and knowledge among young Chinese women about the preventive nature and value of human papillomavirus vaccination. Social and cultural factors including moral obligation and STD-related stigma may influence young women's intention to future vaccination. RELEVANCE TO CLINICAL PRACTICE Educational interventions are necessary to promote public awareness and deliver information about human papillomavirus vaccination and cervical cancer prevention. Results of this study can help health care practitioners develop appropriate programmes for the promotion of human papillomavirus vaccination among this population.
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Affiliation(s)
- Can Gu
- Department of Medicine, Xiang-Ya Hospital, Central South University, Changsha, China.,Xiang-Ya School of Nursing, Central South University, Changsha, China
| | | | - Shengbo Yang
- Department of Dermatology, Third Xiang-Ya Hospital, Central South University, Changsha, China
| | - Xiuhua Wang
- Xiang-Ya School of Nursing, Central South University, Changsha, China
| | - Lijian Tao
- Department of Medicine, Xiang-Ya Hospital, Central South University, Changsha, China
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Zhao X, Mao Q, Kreps GL, Yu G, Li Y, Chou SWY, Perkosie A, Nie X, Xu Z, Song M, Kim P. Cancer information seekers in china: a preliminary profile. JOURNAL OF HEALTH COMMUNICATION 2015; 20:616-626. [PMID: 25845031 DOI: 10.1080/10810730.2015.1012244] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Cancer is now the leading cause of death in China. Effective communication about cancer risk and prevention is an important component of cancer control. Yet, research in this area is very limited in China. This study used probability sample survey data from 2 Chinese cities (Beijing and Hefei, Anhui Province) to investigate potential predictors of self-initiated cancer information seeking. Analysis showed that cancer information seekers in China were likely to be married, relatively educated, earning modest incomes, living in rural areas, smoking occasionally, having a family cancer history, relatively trusting of the media for health information, somewhat knowledgeable about cancer, having nonfatalistic attitudes about cancer, and seeing a personal need for more cancer information. The pattern of results, particularly the lack of influence of personal health and risk perception factors, highlights the possibility that seeking for others might be more prevalent than seeking for self in China. Overall, findings suggest that emphasizing family need and mobilizing family support might be a productive approach to cancer communication interventions in China.
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Affiliation(s)
- Xiaoquan Zhao
- a Department of Communication , George Mason University , Fairfax , Virginia , USA
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Pan XF, Zhao ZM, Sun J, Chen F, Wen QL, Liu K, Song GQ, Zhang JJ, Wen Y, Fu CJ, Yang CX. Acceptability and correlates of primary and secondary prevention of cervical cancer among medical students in southwest China: implications for cancer education. PLoS One 2014; 9:e110353. [PMID: 25360743 PMCID: PMC4215919 DOI: 10.1371/journal.pone.0110353] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2014] [Accepted: 09/14/2014] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVES To understand knowledge about, and acceptability of, cervical cancer screening and HPV vaccines among medical students; and to explore potential factors that influence their acceptability in China. METHODS We conducted a survey among medical students at six universities across southwest China using a 58-item questionnaire regarding knowledge and perceptions of HPV, cervical cancer, and HPV vaccines. RESULTS We surveyed 1878 medical students with a mean age of 20.8 years (standard deviation: 1.3 years). Of these, 48.8% and 80.1% believed cervical cancer can be prevented by HPV vaccines and screening respectively, while 60.2% and 71.2% would like to receive or recommend HPV vaccines and screening. 35.4% thought HPV vaccines ought to be given to adolescents aged 13-18 years. 32% stated that women should start to undergo screening from the age of 25. 49.2% felt that women should receive screening every year. Concern about side effects (38.3% and 39.8%), and inadequate information (42.4% and 35.0%) were the most cited barriers to receiving or recommending HPV vaccination and cervical cancer screening. Females were more likely to accept HPV vaccines (OR, 1.86; 95% CI: 1.47-2.35) or cervical cancer screening (OR, 3.69; 95% CI: 2.88-4.74). Students with a higher level of related knowledge were much more willing to receive or recommend vaccines (P<0.001) or screening (P<0.001). Students who showed negative or uncertain attitudes towards premarital sex were less likely to accept either HPV vaccines (OR, 0.67; 95% CI: 0.47-0.96), or screening (OR, 0.68; 0.47-0.10). Non-clinical students showed lower acceptability of cervical screening compared to students in clinical medicine (OR, 0.74; 95% CI: 0.56-0.96). CONCLUSIONS The acceptability of HPV vaccines and cervical cancer screening is relatively low among medical students in southwest China. Measures should be taken to improve knowledge about cervical cancer and awareness of HPV vaccines and screening among medical students at university.
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Affiliation(s)
- Xiong-Fei Pan
- Department of Epidemiology, West China School of Public Health, Sichuan University, Chengdu, China
| | - Zhi-Mei Zhao
- Department of Epidemiology, West China School of Public Health, Sichuan University, Chengdu, China
| | - Jing Sun
- Department of Pathology, Development and Regeneration Key Laboratory of Sichuan Province, Chengdu Medical College, Chengdu, China
| | - Feng Chen
- Department of Preventive Healthcare and Hospital Infection Control, Deyang People's Hospital, Deyang, China
| | - Qing-Lian Wen
- Department of Oncology, the Affiliated Hospital of Luzhou Medical College, Luzhou, China
| | - Kang Liu
- Institute of Tissue Engineering and Stem Cells, The Second Clinical Hospital of North Sichuan Medical College, Nanchong, China
| | - Gui-Qin Song
- Department of Biology, North Sichuan Medical University, Nanchong, China
| | - Jing-Jing Zhang
- School of Public Health, Kunming Medical University, Kunming, China
| | - Ying Wen
- Department of Epidemiology, West China School of Public Health, Sichuan University, Chengdu, China
| | - Chun-Jing Fu
- Department of Health Statistics and Information Management, School of Public Health and Management, Chongqing Medical University, Chongqing, China
| | - Chun-Xia Yang
- Department of Epidemiology, West China School of Public Health, Sichuan University, Chengdu, China
- * E-mail:
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Bynum SA, Guillaume DA, Brandt HM, Fletcher FE. Does knowledge influence pap test screening among young African-American women? JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2014; 29:478-481. [PMID: 24488589 DOI: 10.1007/s13187-013-0543-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Pap test screening among African-American women has substantially increased. However, African-American women continue to bear the burden of cervical cancer as compared to White women. The objective of this study was to assess the influence of Pap test knowledge on cervical screening history among young African-American women. Between January and April 2009, 320 women from historically black colleges and universities located in the southeastern United States who met study inclusion criteria completed an anonymous self-report questionnaire to assess their awareness, knowledge, and behaviors related to human papillomavirus and cervical cancer prevention and control. Seventy-six percent of women reported ever having a Pap test, 54 % reported having a Pap test less than 1 year ago, and 25 % reported ever having an abnormal Pap test result. The overall mean score on the six-point Pap test knowledge scale was 4.46 ± 1.02. Women who reported having an abnormal Pap test (4.96 ± 0.82) had significantly higher Pap test knowledge compared to those never having an abnormal result (4.49 ± 1.04), p < 0.01. No other differences were found. Efforts to improve Pap test knowledge among all women, including those with no prior abnormal Pap test history, are critical to cervical cancer prevention and control over the life course. Such efforts should include creating information that is relevant to the population and enables informed decision making about cervical health.
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Affiliation(s)
- Shalanda A Bynum
- Department of Preventive Medicine and Biometrics, F. Edward Hébert School of Medicine, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, MD, 20814, USA,
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Chan CWH, Yang SB, Gu C, Wang X, Tao L. Perception of cervical cancer risk and screening behavior: a literature review. Int J Nurs Knowl 2014; 26:2-18. [PMID: 24673974 DOI: 10.1111/2047-3095.12028] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
PURPOSE This review examines women's risk perception of cervical cancer, the factors influencing this perception, and the relationship between risk perception of cervical cancer and screening behavior. METHODS Integrative literature review method was used. FINDINGS The search procedure resulted in the identification of 42 studies, including 1 literature review and 41 primary studies. Trends and discrepancies in the literature are presented with interpretations and recommendations. CONCLUSION Existing theories of health behavior appear inadequate for understanding screening behavior, and further studies are recommended to enrich the knowledge base of nursing diagnoses in knowledge deficit and health-seeking behavior. IMPLICATIONS FOR NURSING PRACTICE Efforts would be made to improve nurses' understanding of risk perception of cervical cancer within specific cultural context.
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Affiliation(s)
- Carmen W H Chan
- Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong, China
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Chan CWH, Chui YY, Chair SY, Sham MMK, Lo RSK, Ng CSM, Chan HYL, Lai DCY. The evaluation of a palliative care programme for people suffering from life-limiting diseases. J Clin Nurs 2013; 23:113-23. [PMID: 23773212 DOI: 10.1111/jocn.12094] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/11/2012] [Indexed: 11/29/2022]
Affiliation(s)
- Carmen WH Chan
- The Chinese University of Hong Kong; Hong Kong SAR Hong Kong China
| | - Ying Yu Chui
- The Chinese University of Hong Kong; Hong Kong SAR Hong Kong China
| | - Sek Ying Chair
- The Chinese University of Hong Kong; Hong Kong SAR Hong Kong China
| | | | - Raymond SK Lo
- Shatin Hospital and Bradbury Hospice; Hong Kong SAR Hong Kong China
| | - Catalina SM Ng
- The Chinese University of Hong Kong; Hong Kong SAR Hong Kong China
| | - Helen YL Chan
- The Chinese University of Hong Kong; Hong Kong SAR Hong Kong China
| | - David CY Lai
- The Chinese University of Hong Kong; Hong Kong SAR Hong Kong China
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Ho SSM, So WKW, Leung DYP, Lai ETL, Chan CWH. Anxiety, depression and quality of life in Chinese women with breast cancer during and after treatment: a comparative evaluation. Eur J Oncol Nurs 2013; 17:877-82. [PMID: 23727448 DOI: 10.1016/j.ejon.2013.04.005] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2013] [Accepted: 04/16/2013] [Indexed: 01/24/2023]
Abstract
PURPOSE OF THE RESEARCH To compare the psychological health and quality of life (QoL) of women with breast cancer, and to determine the relationship between anxiety, depression and QoL during treatment and one year afterwards. METHODS AND SAMPLE For this secondary analysis, 269 women undergoing adjuvant therapy for breast cancer, and 148 women with breast cancer who had completed all treatment within the last year completed a self-report questionnaire covering the Hospital Anxiety and Depression Scale-Cantonese/Chinese version, Functional Assessment of Cancer Therapy-General, and demographic and clinical characteristics. KEY RESULTS The ongoing-therapy group showed higher levels of anxiety and depression and lower levels of all QoL dimensions than the post-therapy group. Linear regression results showed that both anxiety and depression were significantly related to physical and functional well-being, while depression was associated with social/family well-being in both groups. In the case of emotional well-being, anxiety had a strong significant association in both groups and depression a significant relationship only in the ongoing-therapy group. CONCLUSIONS The psychological health of women with breast cancer is affected during and after treatment. Psychological distress in these patients, including anxiety and depression, has independent associations with impaired emotional, functional, physical and social well-being. The results highlight the importance of timely detection of anxiety and depression, and their proper management, during the treatment and survivorship phases of the breast cancer trajectory.
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Affiliation(s)
- Simone S M Ho
- The Nethersole School of Nursing, The Chinese University of Hong Kong, 7/F., Esther Lee Building, Shatin, New Territories, Hong Kong, China
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