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De Waele A, Hendrickx G, Valckx S, Domínguez À, Toledo D, Castilla J, Tuells J, Van Damme P. The Vaccine Training Barometer: Assessing healthcare providers' confidence to answer vaccine-related questions and their training needs. Vaccine 2024; 42:2421-2428. [PMID: 38458873 DOI: 10.1016/j.vaccine.2024.02.078] [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: 06/07/2023] [Revised: 01/19/2024] [Accepted: 02/25/2024] [Indexed: 03/10/2024]
Abstract
Healthcare providers (HCP) are seen by the public as the most trustworthy source of information about vaccination. While HCPs could be a valuable partner to increase vaccine confidence in general, it is not clear whether they feel confident themselves to address questions concerning vaccination. In the context of the EU Joint Action on Vaccination (EU-JAV), the Vaccine Training Barometer, an online survey tool, was developed to assess how frequently HCPs receive questions about vaccination, how confident they feel to answer these questions, and to what extent they are willing to follow extra training. After a pilot test in Flanders, Belgium, the Barometer was launched and completed by 833 HCPs in Flanders and 291 HCPs in the Spanish regions of Catalonia, Navarre and Valencian Community from November 2020 until January 2021, during the COVID-19 pandemic, just before and during the start of the first COVID-19 vaccination campaigns. In both countries, HCPs frequently received questions about vaccination (mostly on a daily or weekly basis), and about two thirds of them indicated that the frequency of questions had increased during the three months prior to completing the survey. Most questions were about the side effects and safety of vaccines. In both countries, a considerable proportion of HCPs did not feel confident to answer vaccine-related questions (31.5% felt confident in Flanders, 21.6% in Spain). A large proportion of HCPs received questions in the last three months before the survey that they could not answer (52.4% of respondents in Flemish sample, 41.5% in Spanish sample). Only 11.4% (Flanders) and 11.3% (Spain) of the respondents felt they gained sufficient knowledge through their standard education to be able to answer questions about vaccination. Almost all respondents were willing to follow extra training on vaccination (Flanders: 95.4%, Spain: 96.6%). The Vaccine Training Barometer is thus a useful tool to monitor HCPs' confidence to answer questions about vaccination and to capture their training needs.
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Affiliation(s)
- Aurélie De Waele
- Centre for Evaluation of Vaccination, University of Antwerp, Drie Eikenstraat 663, 2650 Edegem, Belgium; Departement of Communication Studies, Faculty of Social Sciences, University of Antwerp, Sint-Jacobsstraat 2, 2000 Antwerp, Belgium.
| | - Greet Hendrickx
- Centre for Evaluation of Vaccination, University of Antwerp, Drie Eikenstraat 663, 2650 Edegem, Belgium.
| | - Sara Valckx
- Centre for Evaluation of Vaccination, University of Antwerp, Drie Eikenstraat 663, 2650 Edegem, Belgium.
| | - Àngela Domínguez
- Universitat de Barcelona, Department of Medicine, C/ de Casanova, 143, 08036 Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, C/ Monforte de Lemos 3-5, Pabellón 11, Planta 0, 28029 Madrid, Spain.
| | - Diana Toledo
- Universitat de Barcelona, Department of Medicine, C/ de Casanova, 143, 08036 Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, C/ Monforte de Lemos 3-5, Pabellón 11, Planta 0, 28029 Madrid, Spain.
| | - Jesús Castilla
- CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, C/ Monforte de Lemos 3-5, Pabellón 11, Planta 0, 28029 Madrid, Spain; Instituto de Salud Pública de Navarra (IdiSNA), C. de Irunlarrea, 3, 31008 Pamplona, Navarra, Spain.
| | - José Tuells
- Edificio Ciencias Sociales, University of Alicante, Carr. de San Vicente del Raspeig, 03690 San Vicente del Raspeig, Alicante, Spain; Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), Avda Pintor Baeza, 12, 03010 Alicante, Spain.
| | - Pierre Van Damme
- Centre for Evaluation of Vaccination, University of Antwerp, Drie Eikenstraat 663, 2650 Edegem, Belgium.
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Barati M, Jormand H, Khazaei S, Bashirian S, Sadri M, Afshari M. Factors affecting subsequent dose of COVID-19 vaccine uptake based on BASNEF model among older adults. BMC Infect Dis 2024; 24:18. [PMID: 38166817 PMCID: PMC10763401 DOI: 10.1186/s12879-023-08903-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Accepted: 12/13/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND Vaccination is a primary prevention approach to preventing disease by disconnecting the transmission chain. The current study utilized a BASNEF model framework to identify factors influencing subsequent doses of COVID-19 vaccination among older adults. METHODS This cross-sectional study was performed in the west of Iran in May 2022. The participants were selected via multi-stage sampling. Finally, 1120 participants contributed to the present study. The questionnaire consisted of three sections: a) Socio-demographic characteristics, b) cognitive impairments tests, and c) Questionnaire about the subsequent dose of COVID-19 vaccine uptake based on the BASNEF model. Data were analyzed using the software IBM AMOS-20 and SPSS-23 via one-way analysis of variance (ANOVA) and independent sample T-tests were used, too. The significance level of statistical tests was regarded as less than 0.05. RESULTS The presented results of analyzing 50% of the variance of vaccination intention as the dependent variable (R square = 0.497) and 10% of the behavior variance as the dependent variable (R square = 0.104) can be explained based on the BASNEF model. The enabling factors (β = 0.636, p < 0.001) and the intention (β = 0.322, p < 0.001) were important factors for subsequent doses of COVID-19 vaccine uptake in older adults. CONCLUSION So, planning and implementing promotional intervention programs for older people (over 65; 80), females, illiterate, widows and divorced, good economic status, and urban areas is essential. It seems that enabling factors such as free vaccinations, vaccination inaccessible places such as public social security agencies, social supports such as involvement of the government and physicians, and improving information by the medium or knowledge-sharing experience, which can be further used to enhance the acceptance of subsequent doses of COVID-19 uptake in older adults.
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Affiliation(s)
- Majid Barati
- Social Determinants of Health Research Center, Hamadan University of Medical Sciences and Department of Public Health, Asadabad School of Medical sciences, Asadabad, Iran, Hamadan, IR, Iran
| | - Hanieh Jormand
- Urology and Nephrology Research Center, Hamadan University of Medical Sciences, Hamadan, IR, Iran.
| | - Salman Khazaei
- Department of Epidemiology, School of Public and Social Determinants of Health Research Center, Hamadan University of Medical Sciences, Hamadan, IR, Iran
| | - Saeed Bashirian
- Department of Public Health, School of Public Health and Social Determinants of Health Research Center, Hamadan University of Medical Sciences, Hamadan, IR, Iran
| | - Mohadeseh Sadri
- Iranian Research Center on Aging, University of Social Walfare and Rehablitation Sciences, Tehran, IR, Iran
| | - Maryam Afshari
- Department of Public Health, School of Public Health and Social Determinants of Health Research Center, Hamadan University of Medical Sciences, Hamadan, IR, Iran
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Sağtaş F, Gürsoy MY. Knowledge, attitudes, and practices towards human papillomavirus (HPV) and HPV vaccination among male nurses. Int J Nurs Pract 2023:e13228. [PMID: 38113644 DOI: 10.1111/ijn.13228] [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: 03/30/2023] [Revised: 10/22/2023] [Accepted: 11/28/2023] [Indexed: 12/21/2023]
Abstract
AIM This study aimed to determine the knowledge, attitudes, and practices of male nurses towards human papillomavirus (HPV) and HPV vaccination and to examine whether knowledge about the HPV vaccine affects attitudes and beliefs about HPV vaccines. BACKGROUND HPV is responsible for ≈5% of all cancers worldwide. Therefore, vaccination against HPV is recommended to prevent HPV infections and HPV-related cancers in men and women. METHODS The study group included 383 male nurses who were asked to complete online questionnaires. The data were collected using the following tools: a sociodeomographical characteristics form, the Human Papillomavirus Knowledge Scale (HPVKS), and The Carolina HPV Immunization Attitudes and Beliefs Scale (CHIAS). RESULTS It was determined that the general HPV knowledge of the male nurses participating in the study was at a moderate level, but their knowledge of HPV screening test, HPV vaccination, and current HPV vaccination programmes were at a low level. Male nurses' HPV vaccination rates were relatively low, and most of them did not intend to be vaccinated. In addition, CHIAS Attitudes and Beliefs scores of the male nurses were at an average level and HPV knowledge affected the attitudes and beliefs of the nurses. CONCLUSION These results demonstrate an opportunity to improve information and awareness about HPV and vaccines by nursing education.
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Affiliation(s)
- Furkan Sağtaş
- Istanbul University Cerrahpasa Medical Faculty Hospital, Istanbul, Turkey
| | - Melike Yalçın Gürsoy
- Health Sciences Faculty, Nursing Department, Çanakkale Onsekiz Mart University, Çanakkale, Turkey
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Leung SOA, Villa A, Duffey-Lind E, Welch K, Jabaley T, Hammer M, Feldman S. An Interactive Educational Tool to Improve Human Papillomavirus Vaccine Knowledge and Recommendation Among Nurses. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2023; 38:1880-1886. [PMID: 37610520 DOI: 10.1007/s13187-023-02352-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 08/02/2023] [Indexed: 08/24/2023]
Abstract
In United States, only 57% of women and 53% of men in the recommended age groups have received all recommended doses of the human papillomavirus (HPV) vaccine. Healthcare provider education has been associated with strong vaccine recommendation and vaccination uptake. Our objective was to create a 7-min interactive online educational tool to improve knowledge and willingness to recommend the HPV vaccine among nurses. This is a prospective pre-test/post-test study to evaluate the effectiveness of the educational tool consisting of 10 flashcards in a question-answer format. Oncology nurses at our cancer center were invited to participate by email, which led them to the educational tool (i.e., intervention) along with pre- and post-test questions on HPV-associated cancers, vaccine-eligible age groups, dosing schedules, adverse events, and willingness to recommend. Of the 110 participants (mean age of 41.2 ± 11.4, 98% female, 64% >10 years of practice), there was improvement in knowledge after intervention in HPV-associated cancers (81% to 97%; p = 0.02), percentage of cervical caused by HPV (33% to 64%; p < 0.05), and dosing schedule (47% to 93%; p < 0.05). All participants correctly stated that continued screening is needed after vaccination both pre- and post-intervention. Eighty-five percent strongly agreed that the intervention improved their HPV knowledge, and 77% stated they were more likely to recommend the HPV vaccine after the intervention. While nurses are willing to recommend the vaccine, there remains persistent knowledge gaps. A brief 7-min self-administered online interactive flashcard educational intervention is effective in improving the HPV vaccine knowledge among nurses.
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Affiliation(s)
- Shuk On Annie Leung
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, McGill University Health Center, Cedars Cancer Centre, D02.7224, 1001 Décarie Blvd., Montreal, QC, H4A 3J1, Canada.
| | - Alessandro Villa
- Oral Medicine, Oral Oncology and Dentistry, Miami Cancer Institute, Miami, FL, USA
| | - Eileen Duffey-Lind
- Department of Pediatric Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | | | - Theresa Jabaley
- Phyllis F. Cantor Center for Research in nursing and Patient Care Services, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Marilyn Hammer
- Phyllis F. Cantor Center for Research in nursing and Patient Care Services, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Sarah Feldman
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Brigham and Women's Hospital, Harvard Medical School, Dana-Farber Cancer Institute, Boston, MA, USA
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Ergün S. The Effect of University Students' Levels of Knowledge about HPV Infection and the HPV Vaccine on Their Health Beliefs: Health Sciences Students. Vaccines (Basel) 2023; 11:1126. [PMID: 37376515 DOI: 10.3390/vaccines11061126] [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: 05/07/2023] [Revised: 06/07/2023] [Accepted: 06/18/2023] [Indexed: 06/29/2023] Open
Abstract
The aim of this study was to determine health sciences students' levels of knowledge about HPV infection and the vaccine and their health beliefs, to compare them in terms of individual characteristics, and to examine the relationship between their knowledge of the HPV infection/vaccine and their health beliefs. The data of the study were collected from Health Sciences Faculty students through a face-to-face setting (n: 824). The data tools used in the study were the identification form, the health belief model scale for human papillomavirus infection and vaccination, and the human papillomavirus knowledge scale. The results showed that (1) although the students' levels of knowledge about HPV infection and the vaccine were low, (2) they did perceive HPV infection to be a severe problem. According to the multilinear regression analysis performed, the main predictor of the perceived severity (β = 0.29; 95% Cl: 0.04, 0.07), obstacle (β = 0.21; 95% Cl: 0.01, 0.04), and sensitivity (β = 0.22; 95% Cl: 0.02, 0.06) subscales of the HBMS-HPVV was general HPV knowledge. It was also determined that as the students' knowledge about HPV increased, their health belief levels regarding HPV infection and the vaccine increased as well (n: 824). In conclusion, for nurses and other healthcare professionals to be effective in informing individuals, they should have knowledge of HPV infection and the vaccine. In this context, the necessary education and advice about the importance of HPV infection and the vaccine should be provided to students receiving education in the field of healthcare.
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Affiliation(s)
- Sibel Ergün
- Faculty of Health Sciences, Department of Pediatric Nursing, Balıkesir University, Balıkesir 10145, Turkey
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Souza FDO, Werneck GL, Pinho PDS, Teixeira JRB, Lua I, Araújo TMD. [Influenza vaccine hesitancy among health workers, Bahia State, Brazil]. CAD SAUDE PUBLICA 2022; 38:e00098521. [PMID: 35107509 DOI: 10.1590/0102-311x00098521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Accepted: 07/29/2021] [Indexed: 08/19/2023] Open
Abstract
The World Health Organization acknowledges vaccine hesitancy as one of the ten most serious global health threats. The study investigated the association between confidence, convenience, and complacency and influenza vaccine hesitancy among male and female health workers. The study included 453 workers in primary and medium-complexity health services in a medium-sized city in the state of Bahia, Brazil. Vaccine-hesitant individuals were defined as those who had not received an influenza vaccine in 2019. Structural equation models were used to assess interrelations between target predictive variables and vaccine hesitancy. One-fourth of the workers (25.4%) hesitated to be vaccinated for influenza. Lower confidence (standardized coefficient - SC = 0.261; p = 0.044) and higher complacency (SC = 0.256; p < 0.001) were significantly associated with vaccine hesitancy. Convenience was not associated with vaccine hesitancy. Workers not involved in patient care, workers in medium-complexity services, and male workers reported less receptiveness from the health professional administering the vaccines. Fear of needles was associated with both lower confidence and greater vaccine hesitancy. History of vaccine reactions was not associated directly with vaccine hesitancy, but it was associated with greater complacency, that is, less perception of risk from vaccine-preventable diseases. Since annual influenza vaccination is recommended, influenza vaccine hesitancy can increase the burden of this disease in the population. The data back the hypothesis that factors related to confidence and complacency produce harms in this vaccine´s acceptance and should be considered in the development of strategies and actions for greater adherence to vaccination.
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Affiliation(s)
- Fernanda de Oliveira Souza
- Universidade Federal do Recôncavo da Bahia, Feira de Santana, Brasil.,Universidade Estadual de Feira de Santana, Feira de Santana, Brasil
| | | | | | | | - Iracema Lua
- Instituto de Saúde Coletiva, Universidade Federal da Bahia, Salvador, Brasil
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Lin C, Mullen J, Smith D, Kotarba M, Kaplan SJ, Tu P. Healthcare Providers' Vaccine Perceptions, Hesitancy, and Recommendation to Patients: A Systematic Review. Vaccines (Basel) 2021; 9:vaccines9070713. [PMID: 34358132 PMCID: PMC8310254 DOI: 10.3390/vaccines9070713] [Citation(s) in RCA: 60] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Revised: 06/09/2021] [Accepted: 06/16/2021] [Indexed: 12/13/2022] Open
Abstract
Despite vaccines' effectiveness in reducing the rate of preventable diseases, vaccine hesitancy has threatened public health and economies worldwide. Healthcare providers' (HCP) communications and behavior strongly influence patient receptivity and uptake. The goal of this review was to examine HCP vaccine perceptions, knowledge, and reservations and how these attitudes affect their recommendations and vaccination practices. Primary research studies published by 16 September 2020 were searched in PubMed, Web of Science, Embase, CINAHL, and PsycINFO. A 14-item scale was developed for survey study and risk of bias appraisal (SSRBA). In total, 96 papers from 34 countries were included, covering 17 vaccines (HPV and influenza vaccines the most studied). Recommendation was positively associated with provider knowledge and experience, beliefs about disease risk, and perceptions of vaccine safety, necessity, and efficacy. HCP vaccination attitudes and practices varied across specialties, vaccines, and countries; demographic impact was inconclusive. Barriers included anticipation of patient/parental concerns or refusal, lacking clear guidelines, time constraints, and cost. For HPV, vaccines were more often recommended to older, female adolescents and by physicians who discussed sexual health. HCPs are vital advocates for patients and the public, but studies indicated a prevalence of provider hesitancy pertaining to inadequate knowledge, low vaccine confidence, and suboptimal uptake themselves. Improving HCP knowledge and assuring their access to information they deem trustworthy are essential to supporting HCPs' role as "trusted messengers" to promote vaccine acceptance.
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Affiliation(s)
- Cheryl Lin
- Policy and Organizational Management Program, Duke University, Durham, NC 27705, USA; (C.L.); (D.S.); (M.K.)
| | - Jewel Mullen
- Dell Medical School, The University of Texas at Austin, Austin, TX 78712, USA;
| | - Danielle Smith
- Policy and Organizational Management Program, Duke University, Durham, NC 27705, USA; (C.L.); (D.S.); (M.K.)
| | - Michaela Kotarba
- Policy and Organizational Management Program, Duke University, Durham, NC 27705, USA; (C.L.); (D.S.); (M.K.)
| | - Samantha J. Kaplan
- Medical Center Library and Archives, Duke University, Durham, NC 27710, USA;
| | - Pikuei Tu
- Policy and Organizational Management Program, Duke University, Durham, NC 27705, USA; (C.L.); (D.S.); (M.K.)
- Correspondence:
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Tosun H, Gul A, Yazici S. Survey on the knowledge level and attitudes of university students about human papilloma virus infection and vaccination and assessing healthy living behaviors. J Public Health (Oxf) 2021. [DOI: 10.1007/s10389-020-01420-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
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Pu J, He M, Pu Y, Liu Z, Le L, Wang H, Du X. Knowledge about Human Papillomavirus and Cervical Cancer Prevention among Intern Nurses. Asia Pac J Oncol Nurs 2020; 8:46-50. [PMID: 33426189 PMCID: PMC7785080 DOI: 10.4103/apjon.apjon_45_20] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Accepted: 08/13/2020] [Indexed: 12/24/2022] Open
Abstract
Objective: Intern nurses will play an important role in the use of vaccination to prevent cervical cancer. This study assesses the knowledge about human papillomavirus (HPV) infection and cervical cancer prevention among intern nurses. Methods: We developed a questionnaire to investigate intern nurses' knowledge about HPV infection and cervical cancer prevention. Participants included 323 intern nurses from eight schools. Results: The effective response rate was 79.8%. Some (7.0%) knew that early-stage cervical cancer is commonly asymptomatic. Only 9.7% knew that infection is generally asymptomatic and 20.5% knew that vaccination has no major side effects. There were differences in gender, age, school type, and place of residence for several questions. Conclusions: This study indicates a low level of knowledge about HPV infection and cervical cancer prevention among intern nurses. Our findings highlight the need for more education in this topic to increase the knowledge of intern nurses.
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Affiliation(s)
- Jing Pu
- Department of Dermatovenereology, Mianyang Central Hospital, Mianyang, Sichuan Province, China
| | - Mei He
- Department of Nursing, Mianyang Central Hospital, Mianyang, Sichuan Province, China
| | - Yaling Pu
- Department of Dermatovenereology, Mianyang Central Hospital, Mianyang, Sichuan Province, China
| | - Zhongli Liu
- Department of Dermatovenereology, Mianyang Central Hospital, Mianyang, Sichuan Province, China
| | - Li Le
- Department of Dermatovenereology, Mianyang Central Hospital, Mianyang, Sichuan Province, China
| | - Haiyan Wang
- Department of Nursing, Mianyang Central Hospital, Mianyang, Sichuan Province, China
| | - Xiaobo Du
- Department of Oncology, Mianyang Central Hospital, Mianyang, Sichuan Province, China
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Villanueva S, Mosteiro-Miguéns DG, Domínguez-Martís EM, López-Ares D, Novío S. Knowledge, Attitudes, and Intentions towards Human Papillomavirus Vaccination among Nursing Students in Spain. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16224507. [PMID: 31731616 PMCID: PMC6888169 DOI: 10.3390/ijerph16224507] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Revised: 11/12/2019] [Accepted: 11/13/2019] [Indexed: 12/22/2022]
Abstract
Human papillomavirus (HPV), which is linked to specific types of cancer, can be prevented by vaccination. This study aimed to determine the knowledge and attitudes of nursing students about HPV and its vaccine as well as their intentions towards personal vaccination. A total of 536 Spanish nursing students were invited to complete the Spanish version of the questionnaire “Knowledge, attitudes and intentions towards HPV”. Overall, 367 surveys were completed (68.4% response rate). Data analysis included the calculation of three scores: the knowledge score, categorized into low (<33%), moderate (33%–66%), and good knowledge (>66%); the attitude score, sorted into positive (<2.5), neutral (2.5–3.5), and negative attitude (>3.5); and the intention score, categorized into not favorable (<4), neutral (4–7), and favorable intention (>7). Knowledge about HPV and its vaccine was moderate (54.34 ± 0.9%), and the attitude towards vaccination was positive (2.34 ± 0.03). The intention towards personal vaccination increased significantly after completing the questionnaire (before: 4.14 ± 0.27, after: 6.02 ± 0.28; p < 0.001). The present study highlights the need of training future nurses about HPV and its vaccine, considering the important role it plays in the prevention of sexually transmitted diseases.
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Affiliation(s)
- Sara Villanueva
- School of Nursing, University of Santiago de Compostela, 15782 A Coruña, Spain;
| | - Diego Gabriel Mosteiro-Miguéns
- Galician Public Health Care Service, University Hospital Complex of Santiago de Compostela (CHUS), 15706 A Coruña, Spain;
| | | | - David López-Ares
- Galician Public Health Care Service, University Hospital Complex of A Coruña (CHUAC), 15006 A Coruña, Spain;
| | - Silvia Novío
- Department of Psiquiatry, Radiology, Public Health, Nursing and Medicine, University of Santiago de Compostela, 15782 A Coruña, Spain
- Correspondence:
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Šarenac T, Mikov M. Cervical Cancer, Different Treatments and Importance of Bile Acids as Therapeutic Agents in This Disease. Front Pharmacol 2019; 10:484. [PMID: 31214018 PMCID: PMC6558109 DOI: 10.3389/fphar.2019.00484] [Citation(s) in RCA: 57] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2018] [Accepted: 04/16/2019] [Indexed: 01/15/2023] Open
Abstract
Cervical cancer can be cured, because it has a long preinvasive period. Early diagnosis and treatment of cervical cancer at women are crucial for reducing of rate mortality. Today, there are many methods for detecting premalignant lesions and one of them is a conventional Papanicolaou test. Cervical cancer develops through a series of changes in the epithelium called cervical intraepithelial neoplasia (CIN). The biological and genetic characteristics of the cells at cancer in situ are irreversibly altered and abnormal cells have the potential to metastasize to others anatomical regions. Infection with human Papillomavirus, which is transmitted sexually, is considered the main cause and represent the necessary, but not the only factor for the development of cervical cancer. Types of high risk human Papillomavirus are often associated with invasive cervical cancer. The carcinogenic types of HPV 16 and 18 are responsible for 70% of cervical cancer and about 50% of CIN 3. Primary prevention of cervical cancer is aimed at reducing incidence, control of causes and risk factors. In this scientific work, in addition to explaining the various treatments necessary for the treatment of cervical carcinoma, we were discussed about the anticancer effects of the synthetic derivative of ursodeoxycholic acid, such as HS-1183, and synthetic derivatives of chenodeoxycholic acid such as HS-1199 and HS-1200. Also, the effects of bile acid complexes with metals such as platinum, zinc, nickel, and copper were considered in the effective treatment of cervical cancer. KEY POINTS • Lymphogenic spreading of cervical cancer occurs relatively early in the regional lymph nodes, while this sort of progression of cervical cancer is rarer in the juxtaregional (paraaortic), mediastinal and supraclavicular nodes. Clinically proven supraclavicular metastases are not a rarity. In stages IIb and IIIa with metastases in paraaortal nodes occur a 20% metastases at the neck lymph nodes. Hematogenic metastases are relatively rare and occur in the posterior phase. Distant metastases are detected in the lungs and liver. Preinvasive and microinvasive stages of cervical cancer are without symptoms. With deeper invasion of the strome, certain clinical symptoms such as prolonged menstruation, increased vaginal secretions, vaginal bleeding between the two periods, contact bleeding (after coitus), unilateral pelvic pain with spreading in hip joint (infiltration of the pelvic nerve plexus), dysuric disturbance, anemia, islet of the lower extremities. In order to diagnose the level spreading of primary lesion of cervical cancer most commonly are used the supplemental searches such as cytoscopy, rectoscopy, urography, irigography, lung and bone radiography, scintigraphy of the liver, kidney and bone, lymphography, CT (MR) of abdomen and pelvis, as well as laboratory analysis. Surgical treatment consists of transvaginal hysterectomy, transabdominal removal of the uterus (via laparotomy), bilateral adenectomy (removal of the ovaries and the fallopian tubes), upper and middle third of the vagina and lymphonodectomy of the regional lymph nodes. The most commonly used radiotherapy, intracavitary brachytherapy, manual afterloading technique and remote afterloading techniques. The synthetic derivatives of ursodeoxycholic acid and chenodeoxycholic acid such as HS-1183, HS-1199, and HS-1200 are used to treat cervical cancer. These derivatives of chenodeoxycholic acid and ursodeoxycholic acid are capable of inhibiting cell proliferation and inducing apoptosis in SiHa human cells of cervix. Platinum compounds are used as catalysts in cervical cancer therapy. Clinical use of platinum complexes for which the bile acids bind is based on the desire to achieve the death of tumor cells and the spectrum of drug activity in the treatment of cervical cancer. Bisursodeoxycholate (ethylenediamine) platinum (II) [Pt(UDC)2(en)] is characterized by important cytotoxicity against HeLa cervical carcinoma cells and this effect already being clearly detectable after 24 h.
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Affiliation(s)
- Tanja Šarenac
- Department of Pharmacology, Toxicology and Clinical Pharmacology, Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
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Fenton AT. Abandoning Medical Authority: When Medical Professionals Confront Stigmatized Adolescent Sex and the Human Papillomavirus (HPV) Vaccine. JOURNAL OF HEALTH AND SOCIAL BEHAVIOR 2019; 60:240-256. [PMID: 31113247 DOI: 10.1177/0022146519849895] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Despite authority's centrality to the medical profession, providers routinely forgo their medical authority during clinical encounters. Research focuses on patients challenging medical authority but indicates these confrontations are uncommon and providers seldom relinquish their authority in response. Using rare data of 75 audio recordings of adolescent vaccine discussions during clinical encounters and interviews with and observations of medical staff, I examine how staff leverage or abandon their medical authority to convince parents to vaccinate. I find medical professionals use less authority when at risk of stigmatizing patients: Medical professionals are less authoritative when recommending human papillomavirus (HPV) vaccination versus other adolescent vaccines, particularly when addressing the need to vaccinate before sexual onset due to concerns of labeling the child as sexually active. Medical staff defer to parents in ways that potentially discourage HPV vaccine uptake: They encourage HPV vaccination less than other vaccines and infrequently challenge parents' sex-related reasons for vaccine refusal.
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Affiliation(s)
- Anny T Fenton
- 1 Harvard University, Cambridge, MA, USA
- 2 Maine Medical Center Research Institute, Portland, ME
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Patel H, Austin-Smith K, Sherman SM, Tincello D, Moss EL. Knowledge, attitudes and awareness of the human papillomavirus amongst primary care practice nurses: an evaluation of current training in England. J Public Health (Oxf) 2018; 39:601-608. [PMID: 27412177 DOI: 10.1093/pubmed/fdw063] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2016] [Accepted: 05/23/2016] [Indexed: 11/13/2022] Open
Abstract
Background The incorporation of Human papillomavirus (HPV) testing into the English cervical screening programme has been met with fear and anxiety. Healthcare professionals need to be adequately informed about HPV to help alleviate patient concerns. The aim of this study was to evaluate the HPV training provided to practice nurses (PNs) and determine their level of HPV knowledge. Method A web-based survey was distributed to 147 General Practice surgeries in the Leicester, Leicestershire and Rutland regions, between May and July 2015. The survey explored four broad areas; demographics/level of experience, HPV knowledge, attitudes towards the HPV vaccine and self-perceived adequacy of HPV knowledge. Results A total of 128 surveys were completed, with 94 complete responses. Overall awareness of basic HPV facts was adequate; however, detailed, and in some cases basic, knowledge was lacking. 9.6% failed to identify that HPV can cause cervical cancer and 62.8% believed that HPV requires treatment. Not all PNs felt adequately informed about HPV and a need to improve the provision of training was identified. Conclusion PNs play a key role in increasing public awareness of HPV and implementing cervical cancer screening. The provision of education to PNs needs to be a priority and current methods of training need to be re-evaluated.
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Affiliation(s)
- H Patel
- Department of Gynaecology, University Hospitals Leicester, Gwendolen Road, Leicester LE5 4PW, UK
| | - K Austin-Smith
- Department of Gynaecology, Kettering General Hospital, Rothwell Road, KetteringNN16 8UZ, UK
| | | | - D Tincello
- University of Leicester, Centre for Medicine, Leicester LE1 7RH, UK
| | - E L Moss
- University Hospitals Leicester, Gwendolen Road, Leicester LE5 4PW, UK
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Meaningful Methods for Increasing Human Papillomavirus Vaccination Rates: An Integrative Literature Review. J Pediatr Health Care 2018; 32:119-132. [PMID: 28918994 DOI: 10.1016/j.pedhc.2017.07.005] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2017] [Revised: 07/13/2017] [Accepted: 07/21/2017] [Indexed: 11/20/2022]
Abstract
Human papillomavirus (HPV) is the most common sexually transmitted infection in the United States and is a well-known cause of oropharyngeal, cervical, vaginal, vulvar, penile, and anal cancers. Despite the proven efficacy of the HPV vaccine, vaccination rates remain persistently low. Much literature has focused on attitudes toward the HPV vaccine; however, researchers have also investigated strategies clinicians can use to improve vaccination attitudes and acceptance. Such strategies include provider education, vaccine reminder/recall, and chart audit and feedback. The purpose of this integrative review is to uncover the best evidence-based practice interventions, with the aim of improving HPV knowledge, patient-provider conversations, and immunization uptake. This integrative review concludes that multicomponent interventions have a synergistic effect, resulting in increased provider vaccine support, improved patient/parental attitudes toward HPV vaccination, and increased immunization uptake. Such strategies hold much promise for today's pediatric providers as they work to combat current vaccination disparities.
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Paterson P, Meurice F, Stanberry LR, Glismann S, Rosenthal SL, Larson HJ. Vaccine hesitancy and healthcare providers. Vaccine 2016; 34:6700-6706. [PMID: 27810314 DOI: 10.1016/j.vaccine.2016.10.042] [Citation(s) in RCA: 483] [Impact Index Per Article: 60.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2016] [Revised: 10/05/2016] [Accepted: 10/17/2016] [Indexed: 11/29/2022]
Abstract
While most people vaccinate according to the recommended schedule, this success is challenged by individuals and groups who delay or refuse vaccines. The aim of this article is to review studies on vaccine hesitancy among healthcare providers (HCPs), and the influences of their own vaccine confidence and vaccination behaviour on their vaccination recommendations to others. The search strategy was developed in Medline and then adapted across several multidisciplinary mainstream databases including Embase Classic & Embase, and PschInfo. All foreign language articles were included if the abstract was available in English. A total of 185 articles were included in the literature review. 66% studied the vaccine hesitancy among HCPs, 17% analysed concerns, attitudes and/or behaviour of HCPs towards vaccinating others, and 9% were about evaluating intervention(s). Overall, knowledge about particular vaccines, their efficacy and safety, helped to build HCPs own confidence in vaccines and their willingness to recommend vaccines to others. The importance of societal endorsement and support from colleagues was also reported. In the face of emerging vaccine hesitancy, HCPs still remain the most trusted advisor and influencer of vaccination decisions. The capacity and confidence of HCPs, though, are stretched as they are faced with time constraints, increased workload and limited resources, and often have inadequate information or training support to address parents' questions. Overall, HCPs need more support to manage the quickly evolving vaccine environment as well as changing public, especially those who are reluctant or refuse vaccination. Some recommended strategies included strengthening trust between HCPs, health authorities and policymakers, through more shared involvement in the establishment of vaccine recommendations.
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Affiliation(s)
- Pauline Paterson
- London School of Hygiene & Tropical Medicine, Keppel Street, London WC1E 7HT, United Kingdom.
| | - François Meurice
- GSK Vaccines, Avenue Fleming 20, Parc de la Noire Epine, B-1300 Wavre, Belgium.
| | - Lawrence R Stanberry
- Columbia University College of Physicians and Surgeons and New York-Presbyterian/Morgan Stanley Children's Hospital, New York, NY, USA.
| | - Steffen Glismann
- GSK Vaccines, Avenue Fleming 20, Parc de la Noire Epine, B-1300 Wavre, Belgium.
| | - Susan L Rosenthal
- Columbia University College of Physicians and Surgeons and New York-Presbyterian/Morgan Stanley Children's Hospital, New York, NY, USA.
| | - Heidi J Larson
- London School of Hygiene & Tropical Medicine, Keppel Street, London WC1E 7HT, United Kingdom; Department of Global Health, University of Washington, Seattle, USA.
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Yanikkerem E, Koker G. Knowledge, attitudes, practices and barriers towards HPV vaccination among nurses in Turkey: a longitudinal study. Asian Pac J Cancer Prev 2015; 15:7693-702. [PMID: 25292048 DOI: 10.7314/apjcp.2014.15.18.7693] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Human papilloma virus (HPV) occurs in women of all age groups, and causes cervical, anal, vaginal, vulvar, penile and oropharyngeal cancers. The aim of the study was to discover what nurses know about HPV infection, testing and vaccination and to determine vaccine practice of their daughters and perceived barriers. MATERIALS AND METHODS This cross-sectional and prospective study was carried out nurses who have worked in a hospital between January and June 2014. Pre-test and post-test were used to evaluate the nurses' knowledge about HPV infection, testing and vaccination. This study was performed with nurses who had girls between 9 and 26 years of age for evaluating the behavior of vaccination after three months of education. RESULTS The mean of pre-test and post-test scores about HPV infection, which included 22 items, were 8.2±5.6 and 19.2±1.5, respectively. Before education the HPV testing knowledge score was remarkably poor (1.9±1.7 over 5), after education it increased to 4.8±0.5. The mean HPV vaccine knowledge score were 3.7±2.7 (pre-test) 7.3±0.8 (post-test) on a 0-8 scale. The difference between mean total pre-test (13.9±9.1) and post-test (31.3±1.9) scores was statistically significant (p<0.001). After three months of education, only two of the nurses' daughters were vaccinated. The main reason was noted by nurses were not willing to be vaccinated was cost, doubts about safety and efficacy related to the vaccine. About one-third of nurses declared that they would receive the vaccine for their daughter later. CONCLUSIONS Nurses have a crucial role in the prevention, treatment, increasing public awareness and care for population. The education of the nurses about HPV infection, test and vaccination will play an important part decreasing cancer mortality and morbidity.
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Affiliation(s)
- Emre Yanikkerem
- Department of Obstetrics and Gynaecology Nursing, School of Health, Celal Bayar University, Manisa, Turkey E-mail :
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Antic LG, Djikanovic BS, Antic DZ, Aleksopulos HG, Trajkovic GZ. Differences in the level of knowledge on cervical cancer among health care students, midwives and patients in Serbia. Asian Pac J Cancer Prev 2015; 15:3011-5. [PMID: 24815439 DOI: 10.7314/apjcp.2014.15.7.3011] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Level of midwife knowledge is particularly important because of their role in the cervical cancer prevention programme. The aim of this study was to examine differences in the level of knowledge among health care students, midwives and women in the general population of Serbia. MATERIALS AND METHODS A cross-sectional approach was used with health care students of the medical shool, midwives in their practice, and women visiting a chosen general practitioner as respondents. RESULTS In comparison with the students and midwives, women had lower level of knowledge of causative agents of the cervical cancer, genital warts, HPV types, screening for cervical cancer as well as about the target population for vaccine and its role. Differences in the numbers of right answers of respondents were statistically significant (p<0.001). Four or more correct answers were obtained from 22.7% women, 35.3% from midwives and 83.8% from students. CONCLUSIONS Midwives should improve their own level of knowledge related to preventive practice for cervical cancer, as well as their personal compliance with recommended practices, in order to be qualified and credible promoters of cervical cancer control among women in Serbia.
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Affiliation(s)
- Ljiljana Gojko Antic
- Department for Medical Nurses-Midwives, College of Health Studies in Cuprija, Cuprija, Serbia E-mail :
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Antic LG, Vukovic DS, Vasiljevic MD, Antic DZ, Aleksopulos HG. Differences in risk factors for cervical dysplasia with the applied diagnostic method in Serbia. Asian Pac J Cancer Prev 2014; 15:6697-701. [PMID: 25169511 DOI: 10.7314/apjcp.2014.15.16.6697] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In the etiology of cervical cancer not only HPV infection is important, but also other factors such as demographic influences and sexual and reproductive health attitudes, as well as others related to preventive measure usage (or non usage). The aim of this study was to examine factors associated with cervical dysplasia in asymptomatic women who were examined by routine cytology and cervical biopsy for early detection of cervical cancer. MATERIALS AND METHODS Socio-demographic and other characteristics were obtained from medical files of 85 examinees with pathologic cytologic findings (Pap test) and histopathologic (HP) findings after biopsy. RESULTS According to the Pap test result, a greater probability for development of cervical dysplasia was noted with examinees having a larger number of sexual partners (OR= 5.01, 95% CI 1.04-24.10), and those who are afraid of the Pap finding. Risk factors for development of cervical dysplasia according to the bioptic finding were early beginning with sexual activities, presence of any STD in personal medical history and fear of the Pap test finding. CONCLUSIONS The only risk factor found to be important for both methods was fear of the Pap testing finding.
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Affiliation(s)
- Ljiljana Gojko Antic
- Department for Medical Nurses-Midwives, College of Health Studies in Cuprija, Cuprija, Serbia E-mail :
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Genc RE, Sarican ES, Turgay AS, Icke S, Sari D, Saydam BK. Determination of knowledge of Turkish midwifery students about human papilloma virus infection and its vaccines. Asian Pac J Cancer Prev 2014; 14:6775-8. [PMID: 24377604 DOI: 10.7314/apjcp.2013.14.11.6775] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Human papilloma virus (HPV) is one of the most common sexually transmitted agents and its infection is the most established cause of cervical cancer. Midwives play a key position in the implementation of cervical cancer. This descriptive study aimed to determine the level of knowledge concerning HPV and HPV vaccination among 268 midwifery students. Data were collected between November 15 and 30, 2011, through a self-reported questionnaire. The mean age of participants was 20.75 ± 1.60. Among all students, 44.4% had heard of HPV, while 40.4% had heard of HPV vaccinatiob. The relationship between the midwifery student knowledge on HPV and HPV vaccine and their current educational year was significant (p=0.001). In conclusion midwifery students have moderate level of knowledge about HPV and its vaccine and relevant information should be included in their teaching curriculum.
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Affiliation(s)
- Rabia Ekti Genc
- Izmir Ataturk School of Health, Ege University, Izmir, Turkey E-mail :
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Çetin O, Verit FF, Keskin S, Zebitay AG, Deregözü A, Usta T, Yücel O. Knowledge levels of adolescent girls about human papilloma virus and its vaccine. Turk Arch Pediatr 2014; 49:142-7. [PMID: 26078650 DOI: 10.5152/tpa.2014.1545] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2013] [Accepted: 03/04/2013] [Indexed: 11/22/2022]
Abstract
AIM The aim of our study was to evaluate the level of knowledge of the adolescent girls who presented to our clinic about human papilloma virus (HPV) infection and HPV vaccine. MATERIAL AND METHODS Five hundred and one adolescent girls aged between 13 and 18 years who presented to the gynecology outpatient clinic between March 2012 and March 2013 were asked to answer the questions of the questionnaire about HPV and HPV vaccine. The "Participant Information Form" and "HPV Information Assessment Form" were used by examination of the related literature by the investigators. The data obtained were entered into the computer using the SPSS 16.5 program and evaluated. Descriptive statistics were shown with mean, standard deviation, number and percentage values. RESULTS The mean age of 501 subjects who were included into the study was 15.92 years. 390 subjects (77.8%) who were included in the study had no information about HPV. 111 subjects (22.2%) stated that they heard of HPV before or had information about HPV. The mean age of the subjects who had information about human papilloma virus was found to be 16.52 years. The mean age of 390 subjects (77.8%) who had no information about human papilloma virus was 15.75 years. It was found that only one of the subjects (0.9%) was vaccinated with HPV vaccine. When the subjects who did not wish to be vaccinated were asked for the reason, 40.9% stated that the reason was inadequate information, 26.4% stated that the reason was high cost, 16.4% stated that the reason was the fact that they did not consider themselves at risk and 16.4% stated that the reason was the fact that they were afraid of side effects. CONCLUSIONS In our study, it was found that the adolescent girls who constituted our study group had insufficient information about HPV and HPV vaccine. Verbal, written and visual communication tools and internet should be used intensively and efficiently for the objective of introducing HPV vaccine and teaching the precautions related with prevention of cervix cancer in terms of public health. Primarily pediatrician and gynecologists and family physicians who give service for the adolescence age group should be supported to develop appropriate attitudes and behaviors related with HPV vaccine and infection.
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Affiliation(s)
- Orkun Çetin
- Department of Gynecology and Obstetrics, Süleymaniye Maternity Training and Research Hospital, İstanbul, Turkey
| | - Fatma Ferda Verit
- Department of Gynecology and Obstetrics, Süleymaniye Maternity Training and Research Hospital, İstanbul, Turkey
| | - Seda Keskin
- Department of Gynecology and Obstetrics, Süleymaniye Maternity Training and Research Hospital, İstanbul, Turkey
| | - Ali Galip Zebitay
- Department of Gynecology and Obstetrics, Süleymaniye Maternity Training and Research Hospital, İstanbul, Turkey
| | - Ayşegül Deregözü
- Department of Gynecology and Obstetrics, Süleymaniye Maternity Training and Research Hospital, İstanbul, Turkey
| | - Taner Usta
- Department of Gynecology and Obstetrics, Bağcılar Training and Research Hospital, İstanbul, Turkey
| | - Oğuz Yücel
- Department of Gynecology and Obstetrics, Süleymaniye Maternity Training and Research Hospital, İstanbul, Turkey
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Hoque ME, Monokoane S, Van Hal G. Knowledge of and attitude towards human papillomavirus infection and vaccines among nurses at a tertiary hospital in South Africa. J OBSTET GYNAECOL 2014; 34:182-6. [DOI: 10.3109/01443615.2013.861395] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Watson R, Cleary M, Hunt GE. What gets highly cited in JAN
? Can editors pick which articles will contribute to a journal's impact factor? J Adv Nurs 2013; 69:e30-4. [PMID: 24099516 DOI: 10.1111/jan.12261] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/20/2013] [Indexed: 11/28/2022]
Affiliation(s)
- Roger Watson
- University of Hull; UK
- University of Western Sydney; Australia
| | - Michelle Cleary
- Alice Lee Centre for Nursing Studies; Yong Loo Lin School of Medicine Level 2; Clinical Research Centre; Singapore
| | - Glenn E. Hunt
- Discipline of Psychiatry; Sydney Medical School; University of Sydney; Australia
- Research Unit; Concord Centre for Mental Health; Australia
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"HPV? Never heard of it!": a systematic review of girls' and parents' information needs, views and preferences about human papillomavirus vaccination. Vaccine 2013; 31:5152-67. [PMID: 24029117 DOI: 10.1016/j.vaccine.2013.08.091] [Citation(s) in RCA: 104] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2013] [Revised: 08/22/2013] [Accepted: 08/28/2013] [Indexed: 11/23/2022]
Abstract
BACKGROUND AND OBJECTIVE Two human papillomavirus vaccines were licenced in 2006/2007 for cervical cancer prevention. National vaccination programmes for schoolgirls were subsequently introduced in some European countries, North America and Australia. To understand factors influencing vaccine uptake and to inform the development of appropriate UK educational materials, we aimed to synthesise evidence of girls' and parents' information needs, views and preferences regarding HPV vaccination. DESIGN Systematic review and mixed method synthesis of qualitative and survey data. DATA SOURCES Twelve electronic databases; bibliographies of included studies 1980 to August 2011. REVIEW METHODS Two reviewers independently screened papers and appraised study quality. Studies were synthesised collaboratively using framework methods for qualitative data, and survey results integrated where they supported, contrasted or added to the themes identified. RESULTS Twenty-eight qualitative studies and 44 surveys were included. Where vaccination was offered, uptake was high. Intention to decline was related to a preference for vaccinating later to avoid appearing to condone early sexual activity, concerns about vaccine safety and low perception of risk of HPV infection. Knowledge was poor and there were many misconceptions; participants tried to assess the potential benefits and harms of vaccination but struggled to interpret limited information about HPV in the context of existing knowledge about sexually transmitted infections and cancer. Conclusion Many girls and their parents have limited understanding to an extent that impinges on their ability to make informed choices about HPV vaccination and could impact on future uptake of cervical screening. This is a considerable challenge to those who design and provide information, but getting the messages right for this programme could help in developing patient information about other HPV related cancers.
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Head KJ, Vanderpool RC, Mills LA. Health care providers' perspectives on low HPV vaccine uptake and adherence in Appalachian Kentucky. Public Health Nurs 2013; 30:351-60. [PMID: 23808860 PMCID: PMC4753794 DOI: 10.1111/phn.12044] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
OBJECTIVE Previous intervention research conducted in Appalachian Kentucky resulted in extremely low uptake and adherence to the human papillomavirus (HPV) vaccine among women ages 18-26, despite provision of free vaccine. Because of these findings, the purpose of this qualitative, follow-up study was to elicit health care providers' perspectives on barriers and facilitators to HPV vaccination and suggested strategies for improving vaccination rates. DESIGN AND SAMPLE Researchers conducted semi-structured qualitative interviews with a purposive sample of eight health care providers (seven nursing professionals, one physician) at the health clinic where the original HPV vaccination intervention took place. Interviews were audio-recorded and transcribed and authors used a constant-comparative method to analyze the data. RESULTS Significant themes emerged from the interviews, centering around two primary issues: vaccine uptake and vaccine adherence. Related to uptake, health care providers identified perceived patient barriers and inadequate HPV vaccine education. They also identified the vaccine schedule and clinic-centered communication deficiencies as adherence-related barriers. CONCLUSION These Appalachian Kentucky health care providers provided important insights into barriers and facilitators to HPV vaccine uptake and adherence that need to be readily addressed in this community. As informed by these providers, several suggestions for improving HPV vaccination, such as more targeted education efforts and patient-centered reminder systems, may be applicable to other nursing professionals working in rural and medically underserved communities.
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Affiliation(s)
- Katharine J. Head
- Department of Communication, University of Kentucky College of Communication and Information, Lexington, Kentucky
| | - Robin C. Vanderpool
- Department of Health Behavior, University of Kentucky College of Public Health, Lexington, Kentucky
| | - Laurel A. Mills
- Department of Health Promotion and Administration, Eastern Kentucky University, Richmond, Kentucky
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Wamai RG, Ayissi CA, Oduwo GO, Perlman S, Welty E, Welty T, Manga S, Onyango MA, Ogembo JG. Awareness, knowledge and beliefs about HPV, cervical cancer and HPV vaccines among nurses in Cameroon: an exploratory study. Int J Nurs Stud 2013; 50:1399-406. [PMID: 23395482 DOI: 10.1016/j.ijnurstu.2012.12.020] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2012] [Revised: 12/28/2012] [Accepted: 12/29/2012] [Indexed: 12/31/2022]
Abstract
BACKGROUND While it is known that sub-Saharan African countries face multiple obstacles such as cost in adopting vaccination against human papillomavirus (HPV), the crucial role nurses can play in implementing such programs has not been adequately examined. OBJECTIVES To investigate the knowledge and awareness of HPV, primary cause of cervical cancer and HPV vaccine among nurses working at four Cameroon Baptist Convention Health Services facilities, and to explore what factors influence nurses' willingness to inform and recommend HPV vaccine to adolescents and parents attending clinics. DESIGN AND SETTING A structured questionnaire survey was administered to a convenience sample of nursing staff working at the four health facilities. RESULTS Of 192 eligible nurses 76 (39.6%) participated in the study. There were moderately low levels of knowledge about HPV infection and prevention of cervical cancer, but a moderately high level of knowledge about HPV vaccine. Although 90.8% acknowledged that cervical cancer is directly linked to HPV infection, nearly 32% failed to identify it as a sexually transmitted infection (STI), while 43.4% believed it is an uncommon infection. Willingness to recommend the HPV vaccine was moderate, with 69.7% intentionally initiating discussions with patients about the subject. The most important factors considered when deciding to recommend the vaccine included effectiveness (56.6%) and side effects/safety (11.8%). Cost was less of a concern (6.6%), likely due to the availability of donated vaccine. CONCLUSION Despite high awareness about HPV, more education about the virus, cervical cancer and the vaccine are required to further increase nurses' willingness to recommend the vaccine and strengthen strategies for reaching adolescents through nurses in Cameroon.
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Uzunlar Ö, Özyer Ş, Başer E, Toğrul C, Karaca M, Güngör T. A survey on human papillomavirus awareness and acceptance of vaccination among nursing students in a tertiary hospital in Ankara, Turkey. Vaccine 2013; 31:2191-5. [PMID: 23375980 DOI: 10.1016/j.vaccine.2013.01.033] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2012] [Revised: 12/24/2012] [Accepted: 01/15/2013] [Indexed: 10/27/2022]
Abstract
OBJECTIVE The purpose of this study was to assess the awareness and knowledge regarding human papillomavirus (HPV), HPV related conditions and HPV vaccine among nursing students, and to identify their attitudes towards HPV vaccination. MATERIALS AND METHODS The study was carried out at a tertiary Women's Health Care Center in Ankara, Turkey. Self-administered questionnaires were filled out individually by the nursing students and by a control group including similar aged women. Data regarding demographic information, knowledge and awareness about HPV infection and HPV vaccine, attitudes towards vaccination, acceptance of HPV vaccine and assessment of HPV vaccination attitudes of the nurses with respect to the gender of their children was assessed and recorded. RESULTS A total of 752 participants was included in the analysis. Five hundred and twenty (69.14%) of the participants were nursing students and the rest (n=232; 30.8%) were control group. The mean ages of the nursing students and the control group were 19.4 (16-27) and 19.4 (16-25) years, respectively. Majority of the nursing students knew the causal relationship between HPV and cervical cancer. Seventy-eight percent of the nursing students and 22.4% of the control group stated that they had heard of HPV vaccine. While the rate of the willingness to be vaccinated was 33.7% in the nursing student group, it was only 13.4% in the control group. CONCLUSION The awareness and knowledge about HPV, its relation with cervical cancer and prevention of cervical cancer by HPV vaccine were favorable among nursing students at a tertiary hospital in Ankara, Turkey. However, although aware of the theoretical implications, they did not seem to apply it to practice, such as not having regular gynecologic examinations and Pap smears. Thus, further studies are needed to evaluate the factors that affect practical applications of health care professionals responsible for providing health education to the public.
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Affiliation(s)
- Özlem Uzunlar
- Zekai Tahir Burak Women's Health Education and Research Hospital, Ankara, Turkey.
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Hopkins TG, Wood N. Female human papillomavirus (HPV) vaccination: global uptake and the impact of attitudes. Vaccine 2013; 31:1673-9. [PMID: 23375978 DOI: 10.1016/j.vaccine.2013.01.028] [Citation(s) in RCA: 91] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2012] [Revised: 01/09/2013] [Accepted: 01/15/2013] [Indexed: 01/27/2023]
Abstract
Human papillomavirus (HPV) is the causative agent in cervical cancer and has been implicated in a range of other malignancies. Preventative vaccines are now internationally available and provide high levels of protection from common viral strains. The introduction of a comprehensive vaccination programme (except 'program' in computers) could prevent over 60% of current cervical cancer cases, but this is dependent on such programmes achieving a high level of coverage. In this review, we summarise the current trends in female HPV vaccination coverage throughout the world, and place it in the context of available research on attitudes towards vaccination amongst the public and health professionals. Where countries have the resources for mass vaccination programmes, uptake has varied. School-based opt-out programmes consistently achieve highest coverage, whilst countries and regions without systematic vaccination schemes have low coverage. In all countries, the success of vaccination programmes is dependent on the support of the public and healthcare professionals. Whilst public acceptance is dependent on multiple factors, it has repeatedly been shown that recommendation by a health professional, particularly clinicians, is key to vaccine uptake. Worryingly, it appears that a proportion of clinicians still have significant reservations about promoting vaccination, particularly for younger age groups. A commitment now, to fully educating both the public and clinicians, has the potential to make a dramatic future impact.
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Affiliation(s)
- Tom Glass Hopkins
- Institute of Reproductive and Developmental Biology, Imperial College, London, UK.
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Chan ZCY, Chan TS, Ng KK, Wong ML. A Systematic Review of Literature about Women's Knowledge and Attitudes toward Human Papillomavirus (HPV) Vaccination. Public Health Nurs 2012; 29:481-9. [PMID: 23078419 DOI: 10.1111/j.1525-1446.2012.01022.x] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Zenobia C. Y. Chan
- School of Nursing; The Hong Kong Polytechnic University; Hong Kong; China
| | - Tak Sing Chan
- School of Nursing; The Hong Kong Polytechnic University; Hong Kong; China
| | - Ka Kui Ng
- School of Nursing; The Hong Kong Polytechnic University; Hong Kong; China
| | - Man Lai Wong
- School of Nursing; The Hong Kong Polytechnic University; Hong Kong; China
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Midwives at youth clinics attitude to HPV vaccination and their role in cervical cancer prevention. SEXUAL & REPRODUCTIVE HEALTHCARE 2011; 2:137-42. [DOI: 10.1016/j.srhc.2011.09.001] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2011] [Revised: 08/11/2011] [Accepted: 09/23/2011] [Indexed: 11/22/2022]
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30
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Challenges and opportunities of a new HPV immunization program. Vaccine 2011; 29:4576-83. [DOI: 10.1016/j.vaccine.2011.04.054] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2011] [Revised: 03/18/2011] [Accepted: 04/18/2011] [Indexed: 11/24/2022]
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Nikula A, Nohynek H, Puukka P, Leino-Kilpi H. Vaccination Competence of Public Health Nurses. Public Health Nurs 2011; 28:533-42. [DOI: 10.1111/j.1525-1446.2011.00943.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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De Wals P. Optimizing the acceptability, effectiveness and costs of immunization programs: the Quebec experience. Expert Rev Vaccines 2011; 10:55-62. [PMID: 21162621 DOI: 10.1586/erv.10.151] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
In Canada, publicly funded immunization programs are a provincial/territorial responsibility. In the province of Quebec, much effort has been devoted to optimize the acceptability, effectiveness and cost-effectiveness of publicly funded immunization programs for children during the last 20 years. The aim of this article is to describe how programs are planned, implemented and evaluated and to identify key factors that contribute to the success of this enterprise. A comprehensive framework was developed for the evaluation of new vaccines and new programs in a societal perspective. It is used by the Quebec Immunization Committee to prepare reports proposing options with their costs and consequences for the public health authority. When a decision is made, the implementation of the new program is carefully planned. Surveys and consultations with stakeholders are systematically conducted to identify potential obstacles. A fraction of the budget is always reserved for program evaluation and monitoring. At the present time, the recommended immunization schedule targets 15 different diseases and only 20 injections are offered up to 15 years of age. Vaccine uptake rate is high and, although a reduced number of doses are recommended for several vaccines, program effectiveness is highly satisfactory, as shown for hepatitis B, meningococcal and pneumococcal diseases.
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Affiliation(s)
- Philippe De Wals
- Department of Social and Preventive Medicine, Laval University, 1050 Avenue de la Médecine, Quebec City, G1V 0A6, Canada.
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Kang HS, Shin H, Hyun MS, Kim MJ. Human papilloma virus vaccination: perceptions of young Korean women. J Adv Nurs 2010; 66:1946-52. [PMID: 20626486 DOI: 10.1111/j.1365-2648.2010.05369.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
AIM This paper is a report of a descriptive study of young Korean women's perceptions of use of the human papilloma virus vaccine. BACKGROUND In Korea, cervical cancer is one of the leading cancers in women, and the rate of human papilloma virus infection is increasing. A national media campaign has recently begun to promote human papilloma virus vaccination. However, research addressing the acceptability of this vaccine to women in Korea has been limited. METHOD Twenty-five Korean women, 21-30 years of age, participated in seven focus groups. The data were collected in 2007. FINDINGS Participants were concerned about the potential harmful effects of the human papilloma virus vaccine, a possible increase in unsafe sexual behaviours, and the high cost of the vaccine, which is not covered by health insurance. They suggested group vaccination at-cost or free of charge. They discussed ambivalence about the vaccination, the need for more information about the vaccine, and questions about its effectiveness. Most preferred to wait until more people have been vaccinated. CONCLUSION There is a need for more aggressive dissemination of information about the safety and efficacy of the human papilloma virus vaccine. More reasonable cost, insurance coverage, or free vaccination using a group approach might increase young Korean women's acceptance and use of the human papilloma virus vaccine.
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Affiliation(s)
- Hee Sun Kang
- Department of Nursing, College of Medicine, Chung-Ang University, South Korea
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HPV vaccine and males: Issues and challenges. Gynecol Oncol 2010; 117:S26-31. [DOI: 10.1016/j.ygyno.2010.01.028] [Citation(s) in RCA: 64] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2010] [Accepted: 01/20/2010] [Indexed: 11/20/2022]
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Liddon N, Hood J, Wynn BA, Markowitz LE. Acceptability of human papillomavirus vaccine for males: a review of the literature. J Adolesc Health 2010; 46:113-23. [PMID: 20113917 DOI: 10.1016/j.jadohealth.2009.11.199] [Citation(s) in RCA: 133] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2009] [Revised: 11/09/2009] [Accepted: 11/10/2009] [Indexed: 11/19/2022]
Abstract
The quadrivalent human papillomavirus virus vaccine was recently licensed for use in males in the United States. This study reviews available published literature on acceptability among parents, health care providers, and young males. Among 23 published articles, half were conducted in the United States. The majority (87%) used quantitative survey methodology, and 13% used more explorative qualitative techniques. Convenience samples were used in most cases (74%) and 26% relied on nationally representative samples. Acceptability of a human papillomavirus virus (HPV) vaccine that protects against cervical cancer and genital warts was high in studies conducted among male college students (74%-78%) but lower in a community sample of males (33%). Among mothers of sons, support of HPV vaccination varied widely from 12% to 100%, depending on the mother's ethnicity and type of vaccine, but was generally high for a vaccine that would protect against both genital warts and cervical cancer. Health providers' intention to recommend HPV vaccine to male patients varied by patient age but was high (82%-92%) for older adolescent patients. A preference to vaccinate females over males was reported in a majority of studies among parents and health care providers. Messages about cervical cancer prevention for female partners did not resonate among adult males or parents. Future acceptability studies might incorporate more recent data on HPV-related disease, HPV vaccines, and cost-effectiveness data to provide more current information on vaccine acceptability.
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Affiliation(s)
- Nicole Liddon
- Division of STD Prevention, National Centers for HIV, Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
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Szarewski A. Raising awareness of human papillomavirus and cervical cancer prevention: the need for clinical education. Future Virol 2009. [DOI: 10.2217/fvl.09.46] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
A variety of health professionals will be involved in dealing with issues surrounding human papillomavirus in the near future, but in many cases their own knowledge is insufficient to allow them to comfortably deal with patients’ concerns. Educational initiatives for health professionals are urgently needed. These must take into account attitudes, cultural issues and communication skills, as well as providing facts. The role of the media and advocacy groups should not be ignored.
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Affiliation(s)
- Anne Szarewski
- Cancer Research UK Centre for Epidemiology, Mathematics & Statistics, Wolfson Institute of Preventive Medicine, Charterhouse Square, London, EC1M 6BQ, UK
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Tierney AJ. Editor's Choice. J Adv Nurs 2009; 65:463. [DOI: 10.1111/j.1365-2648.2009.04968.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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