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Zhang M, Sit JWH, Wang T, Chan CWH. Exploring the sources of cervical cancer screening self-efficacy among rural females: A qualitative study. Health Expect 2023; 26:2361-2373. [PMID: 37504888 PMCID: PMC10632632 DOI: 10.1111/hex.13840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Revised: 06/02/2023] [Accepted: 07/26/2023] [Indexed: 07/29/2023] Open
Abstract
AIM Evidence showed self-efficacy was relevant to rural females' cervical cancer screening behaviour. However, little is known about sources of self-efficacy in cervical cancer screening among rural females. This study aimed to explore sources of self-efficacy in cervical cancer screening among rural females. DESIGN A qualitative descriptive study was conducted. Both users and providers of cervical cancer screening services in rural areas of China were recruited through maximum variation sampling. METHODS Individual semi-structured interviews through telephone calls were conducted. Data were analysed via six main stages of the framework method, with the social cognitive theory as a reference. RESULTS Four main sources were identified, including personal screening experience, hearing about other women's screening experiences, professional health education and consultation, and emotional status. Personal screening experience included enactive mastery of completing the screening behaviour and cognitive mastery of internalisation of the screening. Only the experience of completing cervical cancer screening behaviour was not strong enough to improve self-efficacy. Cognitive mastery showed more critical influence. CONCLUSION These four sources of rural females' cervical cancer screening self-efficacy matched with the major sources of self-efficacy of the social cognitive theory. Cognition was critical to influencing the screening self-efficacy. Intervention strategies aimed at enhancing rural females' cervical cancer screening self-efficacy can be developed from these four major sources. PUBLIC CONTRIBUTION A registered nurse with rich experience in cervical cancer-related research and qualitative study was the interviewer of this study. Rural females and cervical cancer screening services providers (healthcare professionals and village staff) were recruited as interviewees. The interview guides were developed by the research team and evaluated by an expert panel including two nurse leaders of gynaecological cancer, one doctor specialised in cervical cancer, and one medical director in a local rural hospital.
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Affiliation(s)
- Mengyue Zhang
- The Nethersole School of Nursing, Faculty of MedicineThe Chinese University of Hong KongHong KongChina
| | - Janet W. H. Sit
- The Nethersole School of Nursing, Faculty of MedicineThe Chinese University of Hong KongHong KongChina
| | - Tingxuan Wang
- School of Nursing, LKS Faculty of MedicineThe University of Hong KongHong KongChina
| | - Carmen W. H. Chan
- The Nethersole School of Nursing, Faculty of MedicineThe Chinese University of Hong KongHong KongChina
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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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Li M, Chan CW, Choi KC, Zhang H, Ng SN, Huang L, Zhang M, Zhao W. The Chinese version of the Revised Dyadic Adjustment Scale for gynaecological cancer patients and their partners: Translation and psychometric evaluation. Asia Pac J Oncol Nurs 2021; 9:48-54. [PMID: 35528790 PMCID: PMC9072179 DOI: 10.1016/j.apjon.2021.12.004] [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: 06/02/2021] [Accepted: 08/23/2021] [Indexed: 11/15/2022] Open
Abstract
Objective The objective of the study was to translate the revised dyadic adjustment scale into Chinese and evaluate its psychometric properties in gynaecological cancer patients and their male partners. Methods A cross-sectional design with a random subsample re-tested at the one-week interval was adopted. Gynaecological cancer patients and their partners were asked to complete the Chinese version of the revised dyadic adjustment and quality of marriage index. Internal consistency, test-retest reliability, convergent validity, structural validity and known-group validity was assessed. Results A total of 252 participants (i.e., 126 female patients and 126 male partners) were recruited. The Chinese version of the Revised Dyadic Adjustment showed good internal consistency (Cronbach's α = 0.85), test–retest reliability (r = 0.88), known group validity and adequate convergent validity with a significant positive correlation (r = 0.60) with the Quality of Marriage Index. Confirmatory factor analysis indicated an acceptable model fit to a second-order three-factor structure (GFI = 0.913, RMR = 0.046, CFI = 0.932). Conclusions The Chinese version of revised dyadic adjustment demonstrated good reliability and acceptable validity in gynaecological cancer patients and male partners. The scale can be used to assess the effectiveness of clinical nursing services for couples on their relationship and to compare marital satisfaction and adjustment between China and other parts of the world.
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Chawla B, Taneja N, Awasthi AA, Kaur KN, Janardhanan R. Knowledge, attitude, and practice on screening toward cervical cancer among health professionals in India-A review. ACTA ACUST UNITED AC 2021; 17:17455065211017066. [PMID: 34396854 PMCID: PMC8371743 DOI: 10.1177/17455065211017066] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Background: Globally, 570,000 cases of cervical cancer and 311,000 deaths from the
disease occurred in 2018. Cervical cancer is the fourth most common cancer
in women. About 96,922 new cervical cancer cases are diagnosed annually in
India. Objective: To summarize the knowledge, attitude, and practice toward screening of
cervical cancer among health professionals in India. Materials and methods: Health sciences electronic databases PubMed and Google Scholar were searched
for studies published between 2012 and March 2020. Keywords used for the
search were (“CERVICAL CANCER”), (“SCREENING”), (“KNOWLEDGE”), (“ATTITUDE”),
(“PRACTICE”), (“HEALTH PROFESSIONALS”), AND (“INDIA”). A total of 22
articles were included in the review based on the eligibility criteria.
Statistical software SPSS-V.23 was used for the statistical application. Results: A total of 22 studies met the inclusion criteria with total of 6811 health
professionals. The age of the study participants ranged from 18 to 60 years.
The overall knowledge of cervical cancer among health professionals was
75.15%. The knowledge toward signs and symptoms and risk factors was
adequate among health professionals. The knowledge, attitude, and practice
toward screening was 86.20%, 85.47%, and 12.70%, respectively. Conclusion: The health professionals have optimum level of knowledge of cervical cancer
and knowledge of screening of cervical cancer with appropriate attitude
toward screening with low uptake of practice toward screening.
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Affiliation(s)
- Bhavika Chawla
- Laboratory of Disease Dynamics & Molecular Epidemiology, Amity Institute of Public Health, Amity University, Noida, India
| | - Neha Taneja
- Laboratory of Disease Dynamics & Molecular Epidemiology, Amity Institute of Public Health, Amity University, Noida, India.,Laboratory of Health Data Analytics & Visualization Environment, Amity Institute of Public Health, Amity University, Noida, India
| | - Aanchal Anant Awasthi
- Laboratory of Health Data Analytics & Visualization Environment, Amity Institute of Public Health, Amity University, Noida, India
| | - Karuna Nidhi Kaur
- Laboratory of Disease Dynamics & Molecular Epidemiology, Amity Institute of Public Health, Amity University, Noida, India
| | - Rajiv Janardhanan
- Laboratory of Disease Dynamics & Molecular Epidemiology, Amity Institute of Public Health, Amity University, Noida, India.,Laboratory of Health Data Analytics & Visualization Environment, Amity Institute of Public Health, Amity University, Noida, India
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Holt HK, Zhang X, Hu SY, Zhao FH, Smith JS, Qiao YL. Inequalities in Cervical Cancer Screening Uptake Between Chinese Migrant Women and Local Women: A Cross-Sectional Study. Cancer Control 2021; 28:1073274820985792. [PMID: 33517761 PMCID: PMC8482714 DOI: 10.1177/1073274820985792] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Revised: 11/23/2020] [Accepted: 12/10/2020] [Indexed: 12/24/2022] Open
Abstract
INTRODUCTION Uptake of cervical cancer screening services in Chinese migrant workers is unknown and may be lower than non-migrant workers in China. METHODS We conducted a cross-sectional study among migrant and non-migrant women aged 21-65 at 7 provinces across China and administered a questionnaire investigating knowledge and attitudes regarding cervical cancer, human papillomavirus (HPV), and HPV vaccine. We used multivariable logistic regression to evaluate odds of previous cervical cancer screening in migrant workers. RESULTS 737 women participated in the study. Mean age was 41.9 ± 7.2 years. 50.2% of the participants were migrant workers. 27.6% of the migrant workers reported previous cervical cancer screening compared to 33.2% of local participants. 36.6% migrant workers reported awareness of HPV compared to 40.2% of local participants. In adjusted analysis migrant status was not associated with increased odds of previous cervical cancer screening (aOR = 1.11 95%CI: 0.76-1.60). High school or higher education compared to less than high school education and employer-sponsored insurance compared to uninsured were associated with increased odds of previous cervical cancer screening (aOR = 2.15 95%CI: 1.41-3.27 and aOR = 1.67 95% CI: 1.14-2.45, respectively). Having heard of HPV compared to no awareness of HPV was associated with increased odds of cervical cancer screening (aOR = 2.02 95%CI: 1.41-2.91). Awareness of HPV among migrant workers was associated with increased odds of cervical cancer screening compared to migrant and local participants without awareness (aOR = 2.82 95% CI: 1.70-4.69 and 2.97 95%CI: 1.51-5.83, respectively). CONCLUSIONS Efforts to increase education opportunities, provide insurance, and promote HPV awareness could increase cervical cancer screening uptake in migrant women in China.
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Affiliation(s)
- Hunter K. Holt
- Department of Family and Community Medicine, University of California, San Francisco, CA, USA
| | - Xi Zhang
- Beijing Office for Cancer Prevention and Control, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Peking University Cancer Hospital & Institute, Beijing, China
- Department of Cancer Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/ Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Shang-Ying Hu
- Department of Cancer Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/ Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Fang-Hui Zhao
- Department of Cancer Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/ Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jennifer S. Smith
- Department of Epidemiology, UNC Gillings School of Global Public Health, Chapel Hill, NC, USA
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, USA
| | - You-Lin Qiao
- Department of Cancer Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/ Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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Gebresillassie BM, Ayele AA, Abegaz TM. Unmet supportive care needs and determinants among cancer patients treated at University of Gondar Specialized Hospital, Northwest Ethiopia: A prospective cross-sectional study. J Oncol Pharm Pract 2020; 27:1869-1877. [PMID: 33148130 DOI: 10.1177/1078155220971035] [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] [Indexed: 01/19/2023]
Abstract
BACKGROUND Assessment of supportive care needs is an important requirement to plan supportive care intervention. This study aimed to assess the unmet supportive care needs of cancer patients treated at the University of Gondar Specialized Hospital, Ethiopia. METHODS A prospective cross-sectional study was conducted from January 1, 2017 to August 30, 2017. Adult (18 years and greater) cancer patients and those who were receiving therapy were included. The 34-Item short-form Supportive Care Needs Survey(SCNS-SF34) tool was used to assess unmet needs. The data collected were analyzed using SPSS version-21. RESULTS A total of 150 interview guides were included in the analysis (97.4% of response rate). In the majority of 65(43.3%) the participants, the disease was metastasized even though they have undergone surgery 78 (52%). The overall mean score level of unmet need for cancer care was 3.49. The highest unmet need mean score was reported from the health system and information need domain. A significant unmet need difference concerning different need domain was found in sex, age, residence, occupation status, and monthly income. Sex and residence were found to be independent predicting factors for unmet supportive care needs. CONCLUSION The overall level of unmet need was high. A significant unmet need difference was found in sex, age, residence, occupation status, and monthly income. Sex and residence were found to be independent predicting factors. Hence, professionals working in the oncology unit should be aware of unmet needs and expect changes over time. Certain programs and services to address the identified unmet needs should be urgently provided.
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Affiliation(s)
| | - Asnakew Achaw Ayele
- Department of Clinical Pharmacy, School of Pharmacy, University of Gondar, Gondar, Ethiopia
| | - Tadesse Melaku Abegaz
- Department of Clinical Pharmacy, School of Pharmacy, University of Gondar, Gondar, Ethiopia
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Ruel-Laliberté J, Bernard-Genest MP, Waddell G, Desindes S. Incitation à participer à une campagne de dépistage du cancer du col de l'utérus : expérience d'un centre de soins tertiaires au Canada. JOURNAL OF OBSTETRICS AND GYNAECOLOGY CANADA 2020; 42:734-739. [DOI: 10.1016/j.jogc.2019.10.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2019] [Revised: 10/18/2019] [Accepted: 10/18/2019] [Indexed: 12/01/2022]
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Ampofo AG, Adumatta AD, Owusu E, Awuviry-Newton K. A cross-sectional study of barriers to cervical cancer screening uptake in Ghana: An application of the health belief model. PLoS One 2020; 15:e0231459. [PMID: 32352983 PMCID: PMC7192489 DOI: 10.1371/journal.pone.0231459] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Accepted: 03/24/2020] [Indexed: 02/02/2023] Open
Abstract
Background The high incidence (32.9, age-standardized per 100,000) and mortality (23.0, age-standardized per 100,000) of cervical cancer (CC) in Ghana have been largely attributed to low screening uptake (0.8%). Although the low cost (Visual inspection with acetic acid) screening services available at various local health facilities screening uptake is meager. Objective The purpose of the study is to determine the barriers influencing CC screening among women in the Ashanti Region of Ghana using the health belief model. Methods A analytical cross-sectional study design was conducted between January and March 2019 at Kenyase, the Ashanti Region of Ghana. The study employed self-administered questionnaires were used to collect data from 200 women. Descriptive statistics were used to examine the differences in interest and non-interest in participating in CC screening on barriers affecting CC screening. Multivariable logistic regression was used to determine factors affecting CC screening at a significance level of p<0.05. Results Unemployed women were less likely to have an interest in CC screening than those who were employed (adjustes odds ratio (aOR) = 0.005, 95%CI:0.001–0.041, p = 0.005). Women who were highly educated were 122 times very likely to be interested in CC screening than those with no or low formal education (aOR = 121.915 95%CI: 14.096–1054.469, p<0.001) and those who were unmarried were less likely to be interested in CC screening than those with those who were married (aOR = 0.124, 95%CI: 0.024–0.647, p = 0.013). Also, perceived threat, perceived benefits, perceived barriers and cues for action showed significant differences with interest in participating in screening with a P-values <0.003. The association was different for long waiting time, prioritizing early morning and late evening screening which showed no significant difference (P-value > 0.003). Conclusions Married women, unemployed and those with no formal education are less likely to participate in CC screening. The study details significant barriers to cervical cancer screening uptake in Ghana. It is recommended that the Ghana health services should develop appropriate, culturally tailored educational materials to inform individuals with no formal education through health campaigns in schools, churches and communities to enhance CC screening uptake.
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Affiliation(s)
- Ama G. Ampofo
- Department of Nursing, Garden City University College, Kumasi, Ghana
- Health Behaviour Research Collaborative, Priority Research Centre for Health Behaviour, School of Medicine and Public Health, University of Newcastle, Newcastle, Australia
- Hunter Medical Research Institute, New Lambton Heights, Australia
- * E-mail:
| | - Afia D. Adumatta
- Department of Nursing, Garden City University College, Kumasi, Ghana
| | - Esther Owusu
- Department of Nursing, Garden City University College, Kumasi, Ghana
| | - Kofi Awuviry-Newton
- Priority Research Centre for Generational Health and Ageing, Faculty of Health and Medicine, University of Newcastle, Newcastle, Australia
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Fatiregun O, Sowunmi AC, Habeebu M, Okediji P, Alabi A, Fatiregun O, Adeniji A, Awofeso O, Adegboyega B. Prevalence and Correlates of Unmet Supportive Needs of Nigerian Patients With Cancer. J Glob Oncol 2019; 5:1-9. [PMID: 31246552 PMCID: PMC6613661 DOI: 10.1200/jgo.19.00043] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
PURPOSE Diagnosis and treatment of cancer are associated with significant psychological distress, and patients face a broad range of challenges that create a vacuum of unmet needs felt by patients, such as a loss of personal control and frustration. The aim of the current study was to determine the magnitude, distribution, and correlates of unmet needs in Nigerian patients with cancer. PATIENTS AND METHODS Using a descriptive cross-sectional approach, we assessed 205 patients with cancer who attended oncology outpatient clinics at the Lagos University Teaching Hospital. Eligible patients were administered the Supportive Care Needs Survey (SCNS) –Short Form 34 with a focus on five domains of need: psychological, health system and information, physical and daily living, patient care and support, and sexuality. RESULTS Mean age was 47.4 ± 12.3 years and patients were predominantly female (96.6%). The most common diagnosis was breast cancer (92.2%), and mean duration since diagnosis was 20.9 ± 21.9 months for all patients. Mean SCNS score was 83.9 ± 24.8 and at least 46% of participants indicated unmet needs in 15 items of the SCNS. The most frequent unattended needs were related to the health information (53.4%), physical and daily living (49.4%), psychological (48.5%), sexuality, and patient care and support domains. None of the factors considered—age, sex marital status, family type, educational attainment, employment status, economic status, the presence of financial support, social support, and cancer type—was significantly predictive of unmet needs in these patients (P > .05). CONCLUSION Nigerian patients with cancer experience considerable levels of unmet needs. These needs require urgent and long-term interventions to help patients achieve increased care satisfaction and a better quality of life.
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Affiliation(s)
| | | | | | - Paul Okediji
- Solar Center for International Development and Research, Abuja, Nigeria
| | - Adewumi Alabi
- Lagos University Teaching Hospital, Idi-araba, Lagos, Nigeria
| | | | | | - Opeyemi Awofeso
- Lagos University Teaching Hospital, Idi-araba, Lagos, Nigeria
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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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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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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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Hou SI, Liu LJ. Objective and Subjective Cancer Knowledge Among Faith-Based Chinese Adults. INTERNATIONAL QUARTERLY OF COMMUNITY HEALTH EDUCATION 2018; 38:47-56. [PMID: 29298633 DOI: 10.1177/0272684x17749567] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This study examined cancer knowledge between church-going younger versus older Chinese adults. Hou's 8-item validated cancer screening knowledge test (CSKT) and a new 14-item cancer warning signs test (CWST) were used to assess objective knowledge. Subjective knowledge was measured by one overall 5-point Likert scale item. A total of 372 Taiwanese and Chinese Americans from nine churches participated. Although there were no significant differences by age on either the CSKT scores (younger = 5.89 vs. older = 5.71; p = .297) or the CWST (younger = 6.27 vs. older = 5.86; p = .245), subjective knowledge was higher among older Chinese adults (younger = 2.44 vs. older = 3.05, p < .001). Older Chinese adults were also more likely to identify cancer warning signs correctly, while younger adults were more likely to identify false warning signs correctly. Results have implication on tailoring cancer knowledge type (subjective vs. objective) and content domain (screening vs. warning signs). Findings can help health educators better understand cancer education needs among Chinese adults.
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Affiliation(s)
- Su-I Hou
- 1 50616 College of Health and Public Affairs, University of Central Florida , Orlando, FL, USA
| | - Ling Jie Liu
- 2 Department of Health Promotion and Behavior, College of Public Health, 1355 University of Georgia , Athens, GA, USA
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Gao H, Okoror TA, Hyner GC. Focus Group Study of Chinese International Students' Knowledge and Beliefs About HPV Vaccination, Before and After Reading an Informational Pamphlet About Gardasil(®). J Immigr Minor Health 2018; 18:1085-1092. [PMID: 26831655 DOI: 10.1007/s10903-016-0349-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
An increasing need for Human Papillomavirus (HPV) vaccines in China remains unmet in the mainland and the knowledge and intentions of Chinese youth regarding vaccination is unknown. In the fall of 2013, 44 Chinese international students (CIS) attending a university in the United States Midwest participated in 10 focus group discussions (five female and five male). Result showed that participants have limited awareness and knowledge about HPV infection and vaccination, participants erroneously believed that the causes of cervical cancer are abortion and miscarriage. Participants rely heavily on informal sources such as Chinese-based social media platforms and personal social networks for information on sexually transmitted infections. Sexual cultures and behaviors are perceived differently between CIS born in the 1990s and 1980s. Interestingly, participants' perceived stigma about HPV infection decreased with improving knowledge level during group discussions. In conclusion, HPV vaccine should be further promoted alongside sex education among CIS.
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Affiliation(s)
- Haijuan Gao
- Health and Exercise Science, University of Oklahoma, 1401 Asp Avenue, Norman, OK, 73019-6081, USA.
| | - Titilayo A Okoror
- Africana Studies, SUNY Binghamton University, 4400 Vestal Parkway East, Binghamton, NY, 13902, USA
| | - Gerald C Hyner
- Health and Kinesiology, Purdue University, 800 West Stadium Avenue, West Lafayette, IN, 47907-2046, USA
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Detection and genotyping of HPV in urine samples from Chilean women attending primary health care centers. Med Microbiol Immunol 2017; 207:95-103. [PMID: 29238853 DOI: 10.1007/s00430-017-0530-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2017] [Accepted: 12/09/2017] [Indexed: 12/22/2022]
Abstract
Cervical cancer is the second most common malignant neoplasm in women worldwide representing approximately 10% of all types of cancers. Triage of women through cervical cytology has been an important strategy for the surveillance and control of new cases of cervical cancer. However, in many regions around the world cervical cytology has a low coverage compared to developed countries. The molecular detection of HPV is the most effective method to increase the screening sensitivity of women at risk of developing cervical cancer. There are very few studies about the efficacy of urine testing for detection of HPV in women followed up in primary health care centers. Consequently, the efficacy of using urine HPV screening in these populations has not been addressed yet. Here, we compared the detection of HPV in simultaneous urine and cervical samples of women followed up in primary health care centers. Urine and cervical samples were analyzed in 543 women attending at primary health care centers. HPV was detected by real time PCR, and HPV typing performed by PCR-RLB. A general HPV concordance of 86.2% (κ = 0.72) was determined between urine and cervical samples. The concordance for HPV-16 and 18 was almost perfect (κ = 0.82) and strong (κ = 0.77), respectively. The sensitivity and specificity for all HPV genotypes in urine using cervical samples as reference were 82.1 and 93.7%, respectively. The results showed that urine is a good alternative as clinical sample for HPV screening in women attending primary health care centers. Therefore, urine should be used as an alternative sample for increasing triage coverage either in refractory women participating in Pap surveillance programs or when cervical samples are not available.
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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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Oba S, Toyoshima M, Ogata H. Association of Cervical Cancer Screening with Knowledge of Risk Factors, Access to Health Related Information, Health Profiles, and Health Competence Beliefs among Community-Dwelling Women in Japan. Asian Pac J Cancer Prev 2017; 18:2115-2121. [PMID: 28843231 PMCID: PMC5697469 DOI: 10.22034/apjcp.2017.18.8.2115] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Objective: The aim of this study was to evaluate the past attendance for cervical cancer screening with knowledge
of risk factors, access to health-related information, health profiles and health competence beliefs among Japanese
women. Methods: Women ages 25, 30, 35, 40, 45, 50, 55, and 60 were contacted cross-sectionally as part of a project
for the Japanese Ministry of Health, Labour and Welfare in Nikaho, Akita prefecture Japan between June 2010 and
March 2011, and 249 women were analyzed for the current study. The questionnaire asked about past cervical cancer
screening. Knowledge of each cervical cancer risk factor was determined on a four-point scale. A barriers to information
access scale was utilized to assess the degree of difficulty in accessing health-related information. Health profiles were
measured using the EuroQOL EQ-5D. Perceived health competence was measured using a scale (PHCS). The association
was evaluated with odds ratios with 95% confidence interval were calculated from a logistic regression analysis after
adjustment for age and potential confounders. The trend across the level was also assessed. Results: Women who knew
that sexual intercourse at young age was a risk factor were significantly more likely to have participated in cervical
cancer screening sometime in their lives (p for trend =0.02). Women who had pain/discomfort and those who had
anxiety/depression were significantly more likely to have participated in cervical screening within the past two years
(odds ratio [OR]: 2.02, 95% confidence interval [CI]: 1.04–3.94; OR: 2.32, 95% CI: 1.05–5.16, respectively). Women
with higher PHCS were significantly more likely to have attended for cervical screened at some point in their lives
(p=0.04). Conclusion: This study observed that specific knowledge of cervical cancer risk factors, health profiles and
PHCS were associated with the past attendance for cervical cancer screening among women in a community. Further
researches are warranted.
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Affiliation(s)
- Shino Oba
- Graduate School of Health Sciences, Gunma University, 3-39-22 Showa-machi, Maebashi, Gunma, Japan.
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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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Okediji PT, Salako O, Fatiregun OO. Pattern and Predictors of Unmet Supportive Care Needs in Cancer Patients. Cureus 2017; 9:e1234. [PMID: 28620565 PMCID: PMC5467772 DOI: 10.7759/cureus.1234] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2017] [Accepted: 05/09/2017] [Indexed: 11/20/2022] Open
Abstract
The incidence of cancers is increasing and this is associated with an increase in the burden of the disease. Patients with cancer have to deal with reduced physical functioning, emotional instability, difficulty in concentrating, and an overall diminished feeling of well-being. This creates deficits that have not been well catered for by traditional cancer care, leading to an overall dissatisfaction with care and a reduced quality of life. This review aims at assessing the pattern of unmet needs in cancer patients and to provide information as to the factors that influence the perception of unmet needs. Studies directly focused on unmet needs in cancer patients which were retrieved from Medical Literature Analysis and Retrieval System Online (MEDLINE), Public/Publisher Medline (PubMed), PsychINFO, Excerpta Medica database (EMBASE), and Google Scholar; from the earliest records till 2016. Unmet needs in cancer patients have been measured with a wide variety of tools, with the supportive care needs survey (SCNS) being the most commonly used as a result of its strong psychometric properties, ease of use, responsiveness, and its coverage of the major domains of unmet needs. The most common unmet needs were in the domains of health system and information, psychological, and physical and daily living. These needs are influenced by sociodemographic factors such as age, sex, marital status, income level; and clinical factors such as location of cancer, stage of disease, and tumor size. It is clear that cancer patients experience a wide range of unmet supportive needs, for which solutions need to be devised in order to improve the supportive care services for these patients and their overall quality of life.
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Affiliation(s)
| | - Omolola Salako
- Department of Radiotherapy, Lagos University Teaching Hospital
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Olson B, Gribble B, Dias J, Curryer C, Vo K, Kowal P, Byles J. Cervical cancer screening programs and guidelines in low- and middle-income countries. Int J Gynaecol Obstet 2016; 134:239-46. [DOI: 10.1016/j.ijgo.2016.03.011] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2015] [Revised: 03/04/2016] [Accepted: 05/17/2016] [Indexed: 01/23/2023]
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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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Edib Z, Kumarasamy V, Binti Abdullah N, Rizal AM, Al-Dubai SAR. Most prevalent unmet supportive care needs and quality of life of breast cancer patients in a tertiary hospital in Malaysia. Health Qual Life Outcomes 2016; 14:26. [PMID: 26898558 PMCID: PMC4762172 DOI: 10.1186/s12955-016-0428-4] [Citation(s) in RCA: 65] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2015] [Accepted: 02/12/2016] [Indexed: 12/16/2022] Open
Abstract
Background Addressing breast cancer patients’ unmet supportive care needs in the early stage of their survivorship have become a prime concern because of its significant association with poor quality of life (QOL), which in turn increases healthcare utilization and costs. There is no study about unmet supportive care needs of breast cancer patients in Malaysia. This study aims to assess the most prevalent unmet supportive care needs of Malaysian breast cancer patients and the association between QOL and patients’ characteristics, and their unmet supportive care needs. Methods A cross-sectional study was conducted at the Surgery and Oncology Clinic between May 2014 and June 2014 in a tertiary hospital in Malaysia. A total of 117 patients out of 133 breast cancer patients recruited by universal sampling were interviewed using a structured questionnaire consisted of three parts: participants’ socio-demographic and disease characteristics, Supportive Care Needs Survey-Short Form Questionnaire (SCNS-SF34) and European Organization for Research and Treatment of Cancer Quality of Life Questionnaire C30 (EORTC QLQ-C30). Results The highest unmet supportive care needs were observed in the psychological domain (Mean 53.31; SD ± 21.79), followed by physical domain (Mean 38.16; SD ± 27.15). Most prevalent unmet supportive care needs were uncertainty about the future (78.6 %), fears about the cancer spreading (76.1 %), feelings of sadness (69.2 %), feelings about death and dying (68.4 %), concerns about those close to the patient (65.0 %) and feeling down or depressed (65.0 %). Multivariate linear analysis showed that early breast cancer survivors diagnosed at an advanced stage and with greater physical and psychological needs were significantly (p < 0.05) associated with poorer QOL. Conclusion Most prevalent unmet needs among Malaysian breast cancer patients were found in the psychological domain. Early breast cancer survivors with late stage diagnosis who had more unmet needs in psychological and physical domains were more likely to have a poor QOL.
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Affiliation(s)
- Zobaida Edib
- Department of Community Medicine, International Medical University, Bukit Jalil, 57000, Kuala Lumpur, Malaysia.
| | - Verasingam Kumarasamy
- Department of Community Medicine, International Medical University, Bukit Jalil, 57000, Kuala Lumpur, Malaysia.
| | - Norlia Binti Abdullah
- Department of Surgery, Universiti Kebangsaan Malaysia Medical Centre, Cheras, 56000, Kuala Lumpur, Malaysia.
| | - A M Rizal
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Cheras, 56000, Kuala Lumpur, Malaysia.
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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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A Review of Psychoeducational Interventions to Improve Sexual Functioning, Quality of Life, and Psychological Outcomes in Gynecological Cancer Patients. Cancer Nurs 2016; 39:20-31. [DOI: 10.1097/ncc.0000000000000234] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Lee FH, Wang HH, Tsai HM, Lin ML. Factors associated with receiving Pap tests among married immigrant women of Vietnamese origin in southern Taiwan. Women Health 2015; 56:243-56. [PMID: 26362802 DOI: 10.1080/03630242.2015.1088113] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
The purpose of this study was to explore the factors associated with Pap testing among married immigrant women of Vietnamese origin residing in Taiwan, including demographics, knowledge of cervical cancer, knowledge of Pap tests, fatalism, attitudes toward cervical cancer, and barriers to receiving Pap tests. A cross-sectional correlational design was used. Data were collected from July 2012 to January 2013. Participants were recruited through snowball sampling in two communities in Southern Taiwan. A total of 451 married immigrant women of Vietnamese origin aged 30 years and over were invited to participate in the study and 427 participated. Data analysis included descriptive statistics and multivariate logistic regression. Participants with no children were significantly less likely to have received a Pap test (odds ratio = 0.278, 95% confidence interval [CI] = 0.135-0.569); each additional point of knowledge about Pap tests increased the likelihood of having a Pap test by 19% (odds ratio = 1.190, 95% CI = 1.093-1.297), and each additional point in barriers to receiving Pap tests decreased the chances of having received a Pap test (odds ratio = 0.714, 95% CI = 0.637-0.800). The results can provide governments with a reference for developing policies for cervical cancer prevention among married immigrant Vietnamese women.
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Affiliation(s)
- Fang-Hsin Lee
- a Department of Nursing , Chung Hwa University of Medical Technology , Tainan , Taiwan
| | - Hsiu-Hung Wang
- b College of Nursing , Kaohsiung Medical University , Kaohsiung , Taiwan
| | - Hsiu-Min Tsai
- c Department of Nursing , Chang Gung University of Science and Technology , Taoyuan , Taiwan
| | - Miao-Ling Lin
- d Health Management Division , Kaohsiung City Government Department of Health , Taiwan
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Wang B, He M, Chao A, Engelgau MM, Saraiya M, Wang L, Wang L. Cervical Cancer Screening Among Adult Women in China, 2010. Oncologist 2015; 20:627-34. [PMID: 25956407 PMCID: PMC4571778 DOI: 10.1634/theoncologist.2014-0303] [Citation(s) in RCA: 95] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2014] [Accepted: 02/06/2015] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION Cervical cancer is one of the most commonly diagnosed cancers among women in China. The World Health Organization (WHO) recommends routine screening for cervical cancer, and the WHO Global Monitoring Framework suggests that every nation monitors cervical cancer screening. However, little information is available on cervical cancer screening behavior among women in China. METHODS We used data from the 2010 China Chronic Disease and Risk Factor Surveillance System that included 51,989 women aged 18 years and older. We report the proportion of women who reported ever having had a Papanicolaou (Pap) test, stratified by sociodemographic characteristics and geographic region. Multivariable logistic regression modeling was performed to adjust for potential confounders. RESULTS Overall, 21% of 51,989 women reported having ever had a Pap test. The highest proportion was reported among women aged 30-39 years (30.1%, 95% confidence interval, 26.8%-33.4%). In all geographic regions, women in rural areas were consistently less likely than women in urban areas to report having had a Pap test. Among women who reported ever having a Pap test, 82% reported having the most recent test in the past 3 years. Factors associated with reporting ever having a test were being aged 30-49 years, higher education, being married, and having urban health insurance. CONCLUSION Our results indicate that screening programs need to be strengthened along with a more intense focus on specific demographic groups. National cervical cancer screening guidelines and comprehensive implementation strategies are needed to make screening services available and accessible to all women. IMPLICATIONS FOR PRACTICE This study is the largest nationwide and population-based assessment of self-reported history of Pap test for cervical cancer screening in China. This article describes cervical cancer screening behavior among women and examines key demographic and geographic factors. Only one fifth of Chinese women reported having ever had a Pap test for cervical cancer screening. The results highlight the urgent need to develop national cervical cancer screening guidelines and strategies that make screening services widely available, accessible, and acceptable to all women, especially to those who reside in rural areas and those with no health insurance.
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Affiliation(s)
- Baohua Wang
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, People's Republic of China; Center for Global Health, U.S. National Cancer Institute, Rockville, Maryland, USA; Center for Global Health and Center for Chronic Disease Prevention and Health Promotion, Division of Cancer Control and Prevention, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Minfu He
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, People's Republic of China; Center for Global Health, U.S. National Cancer Institute, Rockville, Maryland, USA; Center for Global Health and Center for Chronic Disease Prevention and Health Promotion, Division of Cancer Control and Prevention, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Ann Chao
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, People's Republic of China; Center for Global Health, U.S. National Cancer Institute, Rockville, Maryland, USA; Center for Global Health and Center for Chronic Disease Prevention and Health Promotion, Division of Cancer Control and Prevention, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Michael M Engelgau
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, People's Republic of China; Center for Global Health, U.S. National Cancer Institute, Rockville, Maryland, USA; Center for Global Health and Center for Chronic Disease Prevention and Health Promotion, Division of Cancer Control and Prevention, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Mona Saraiya
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, People's Republic of China; Center for Global Health, U.S. National Cancer Institute, Rockville, Maryland, USA; Center for Global Health and Center for Chronic Disease Prevention and Health Promotion, Division of Cancer Control and Prevention, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Limin Wang
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, People's Republic of China; Center for Global Health, U.S. National Cancer Institute, Rockville, Maryland, USA; Center for Global Health and Center for Chronic Disease Prevention and Health Promotion, Division of Cancer Control and Prevention, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Linhong Wang
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, People's Republic of China; Center for Global Health, U.S. National Cancer Institute, Rockville, Maryland, USA; Center for Global Health and Center for Chronic Disease Prevention and Health Promotion, Division of Cancer Control and Prevention, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia, 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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Chow KM, Chan CW, Chan JC, Choi KK, Siu K. A feasibility study of a psychoeducational intervention program for gynecological cancer patients. Eur J Oncol Nurs 2014; 18:385-92. [DOI: 10.1016/j.ejon.2014.03.011] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2013] [Revised: 03/14/2014] [Accepted: 03/26/2014] [Indexed: 10/25/2022]
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So WKW, Chow KM, Chan HYL, Choi KC, Wan RWM, Mak SSS, Chair SY, Chan CWH. Quality of life and most prevalent unmet needs of Chinese breast cancer survivors at one year after cancer treatment. Eur J Oncol Nurs 2014; 18:323-8. [PMID: 24703094 DOI: 10.1016/j.ejon.2014.03.002] [Citation(s) in RCA: 64] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2013] [Revised: 02/25/2014] [Accepted: 03/01/2014] [Indexed: 11/19/2022]
Abstract
PURPOSE This study aims to examine the supportive care needs of Chinese breast cancer survivors, and investigate the relationships with participant characteristics and quality of life. METHODS A total of 163 participants were recruited from a local public hospital and completed a self-administered questionnaire: the 34-item Supportive Care Needs Survey, the supplementary module of access to healthcare and ancillary support services, and the Functional Assessment of Cancer Therapy. RESULTS The five most commonly reported unmet needs were all in the health system information domain (range: 55-63%), and the majority (84%) reported at least one unmet need in relation to information on healthcare. Stepwise multivariable regression analyses revealed that the time spent on travelling from home to hospital, receiving hormonal therapy, and physical and psychological unmet needs were independently associated with poorer quality of life among the participants. CONCLUSIONS Breast cancer survivors perceive various unmet needs, and health system information is the most common one. Those who have more unmet needs in the physical and psychological domains were more likely to perceive a poorer quality of life.
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Affiliation(s)
- Winnie K W So
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong Special Administrative Region.
| | - Ka Ming Chow
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong Special Administrative Region
| | - Helen Y L Chan
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong Special Administrative Region
| | - Kai Chow Choi
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong Special Administrative Region
| | - Rayman W M Wan
- Department of Clinical Oncology, Prince of Wales Hospital, Hong Kong Special Administrative Region
| | - Suzanne S S Mak
- Department of Clinical Oncology, Prince of Wales Hospital, Hong Kong Special Administrative Region
| | - Sek Ying Chair
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong Special Administrative Region
| | - Carmen W H Chan
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong Special Administrative Region
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Chow KM, Chan CWH, Choi KC, Shiu ATY, Cheng KKF, Ip WY, Wong CMW. Psychometric properties of the Chinese version of Sexual Function after Gynecologic Illness Scale (SFAGIS). Support Care Cancer 2013; 21:3079-84. [DOI: 10.1007/s00520-013-1890-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2012] [Accepted: 06/24/2013] [Indexed: 11/25/2022]
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31
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Jia Y, Li S, Yang R, Zhou H, Xiang Q, Hu T, Zhang Q, Chen Z, Ma D, Feng L. Knowledge about cervical cancer and barriers of screening program among women in Wufeng County, a high-incidence region of cervical cancer in China. PLoS One 2013; 8:e67005. [PMID: 23843976 PMCID: PMC3699583 DOI: 10.1371/journal.pone.0067005] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2012] [Accepted: 05/16/2013] [Indexed: 12/17/2022] Open
Abstract
Purpose Cervical cancer screening is an effective method for reducing the incidence and mortality of cervical cancer, but the screening attendance rate in developing countries is far from satisfactory, especially in rural areas. Wufeng is a region of high cervical cancer incidence in China. This study aimed to investigate the issues that concern cervical cancer and screening and the factors that affect women’s willingness to undergo cervical cancer screening in the Wufeng area. Participants and Methods A cross-sectional survey of women was conducted to determine their knowledge about cervical cancer and screening, demographic characteristics and the barriers to screening. Results Women who were willing to undergo screenings had higher knowledge levels. “Anxious feeling once the disease was diagnosed” (47.6%), “No symptoms/discomfort” (34.1%) and “Do not know the benefits of cervical cancer screening” (13.4%) were the top three reasons for refusing cervical cancer screening. Women who were younger than 45 years old or who had lower incomes, positive family histories of cancer, secondary or higher levels of education, higher levels of knowledge and fewer barriers to screening were more willing to participate in cervical cancer screenings than women without these characteristics. Conclusion Efforts are needed to increase women’s knowledge about cervical cancer, especially the screening methods, and to improve their perceptions of the screening process for early detection to reduce cervical cancer incidence and mortality rates.
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Affiliation(s)
- Yao Jia
- Department of Gynecology and Obstetrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, P.R. China
| | - Shuang Li
- Department of Gynecology and Obstetrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, P.R. China
| | - Ru Yang
- Department of Gynecology and Obstetrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, P.R. China
| | - Hang Zhou
- Department of Gynecology and Obstetrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, P.R. China
| | - Qunying Xiang
- Maternity and Child Health Care Hospital, Tujia Nationality Autonomous County, Wufeng, P.R. China
| | - Ting Hu
- Department of Gynecology and Obstetrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, P.R. China
| | - Qinghua Zhang
- Department of Gynecology and Obstetrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, P.R. China
| | - Zhilan Chen
- Department of Gynecology and Obstetrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, P.R. China
| | - Ding Ma
- Department of Gynecology and Obstetrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, P.R. China
- * E-mail: (DM); (LF)
| | - Ling Feng
- Department of Gynecology and Obstetrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, P.R. China
- * E-mail: (DM); (LF)
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Gu C, Chan CW, He GP, Choi K, Yang SB. Chinese women's motivation to receive future screening: The role of social-demographic factors, knowledge and risk perception of cervical cancer. Eur J Oncol Nurs 2013; 17:154-61. [DOI: 10.1016/j.ejon.2012.04.005] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2012] [Revised: 04/16/2012] [Accepted: 04/18/2012] [Indexed: 11/27/2022]
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So WKW, Leung DYP, Ho SSM, Lai ETL, Sit JWH, Chan CWH. Associations between social support, prevalent symptoms and health-related quality of life in Chinese women undergoing treatment for breast cancer: a cross-sectional study using structural equation modelling. Eur J Oncol Nurs 2012; 17:442-8. [PMID: 23238353 DOI: 10.1016/j.ejon.2012.11.001] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2012] [Revised: 11/04/2012] [Accepted: 11/10/2012] [Indexed: 10/27/2022]
Abstract
BACKGROUND There is little in the literature exploring the inter-relationship of social support, prevalent symptoms and health-related quality of life (HRQoL) among breast cancer patients. This study examines the inter-relationships among the three variables using the 'Theory of Unpleasant Symptoms' as a framework. METHODS 279 Chinese breast cancer patients undergoing treatment were recruited for face-to-face interviews. The instruments used were Chinese versions of the Brief Fatigue Inventory, Brief Pain Inventory, Hospital Anxiety and Depression Scales, Medical Outcomes Study Social Support Survey and Functional Assessment of Cancer Therapy for Breast Cancer. RESULTS Goodness-of-fit and misfit indices were obtained for the final model (SRMR = 0.034, robust RMSEA = 0.051 and robust CFI = 0.981), and the results showed that social support had large total effects on social/family (total effect = 0.704, P < 0.05) and functional well-being (total effect = 0.450, P < 0.05), but a minimal effect on the breast cancer scale (total effect = 0.036, P > 0.05). CONCLUSIONS The inter-relationships among the three variables give us a better understanding of breast cancer patients' experience and provide guidance for developing effective strategies to improve their HRQoL and relieving unpleasant symptoms.
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Affiliation(s)
- Winnie K W So
- The Nethersole School of Nursing, The Chinese University of Hong Kong, 7/F., Esther Lee Building, Shatin, New Territories, Hong Kong Special Administrative Region.
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Williams-Brennan L, Gastaldo D, Cole DC, Paszat L. Social determinants of health associated with cervical cancer screening among women living in developing countries: a scoping review. Arch Gynecol Obstet 2012; 286:1487-505. [DOI: 10.1007/s00404-012-2575-0] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2012] [Accepted: 09/13/2012] [Indexed: 12/01/2022]
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A multi-center survey of age of sexual debut and sexual behavior in Chinese women: suggestions for optimal age of human papillomavirus vaccination in China. Cancer Epidemiol 2012; 36:384-90. [PMID: 22377277 DOI: 10.1016/j.canep.2012.01.009] [Citation(s) in RCA: 89] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2011] [Revised: 12/11/2011] [Accepted: 01/30/2012] [Indexed: 12/23/2022]
Abstract
OBJECTIVE Cervical cancer is the second most common cancer among women worldwide, and over 85% of cervical cancers occur in developing countries such as China. Lack of resources for nationwide cervical cancer screening in China makes vaccination against oncogenic strains of HPV particularly important. Knowledge of age at sexual debut and sexual behavior is essential prior to implementation of a national vaccination program. METHODS AND MATERIALS A cross-sectional epidemiologic survey was conducted across 21 urban and rural sites in China to assess age at sexual debut and sexual behavior. 98.6% of the 11,852 recruited women aged 15-59 years were included in the analysis. Data were collected using a short, nurse-administered questionnaire and analyzed using standard descriptive statistics and survival analysis. RESULTS In urban areas, more than ten percent of the 15-19 year old age group were already sexually active at the time of interview; this number increased to nearly 44% in the 20-24 year old age group. Chinese young women with an occupation were more likely to be sexually active compared to female students of the same age, irrespective of area of residence. The crude median sexual debut age for the youngest age group was 17 years, earlier than the sexual debut age reported by older cohorts. Younger age cohorts had an earlier menarche age than older cohorts and were more likely to have more sexual partners than older women, and more likely to have partners with more than one female partner. CONCLUSION There is a trend towards earlier sexual debut and riskier sexual behaviors in younger age groups of Chinese women. These findings suggest that HPV vaccination of women between the ages of 13 and 15 years, before the completion of national compulsory education, is likely to contribute to the prevention of HPV infection and cervical cancer in China.
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Gu C, Chan CWH, Twinn S, Choi KC. The influence of knowledge and perception of the risk of cervical cancer on screening behavior in mainland Chinese women. Psychooncology 2011. [DOI: 10.1002/pon.2037] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Affiliation(s)
- Can Gu
- The Nethersole School of Nursing; The Chinese University of Hong Kong; Hong Kong
| | - Carmen W. H. Chan
- The Nethersole School of Nursing; The Chinese University of Hong Kong; Hong Kong
| | - Sheila Twinn
- The Nethersole School of Nursing; The Chinese University of Hong Kong; Hong Kong
| | - Kai Chow Choi
- The Nethersole School of Nursing; The Chinese University of Hong Kong; Hong Kong
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Chinese-Australian Women’s Knowledge, Facilitators and Barriers Related to Cervical Cancer Screening: A Qualitative Study. J Immigr Minor Health 2011; 13:1076-83. [DOI: 10.1007/s10903-011-9491-4] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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