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Hamdiui N, Marchena E, Stein ML, van Steenbergen JE, Crutzen R, van Keulen HM, Reis R, van den Muijsenbergh METC, Timen A. Decision-making, barriers, and facilitators regarding cervical cancer screening participation among Turkish and Moroccan women in the Netherlands: a focus group study. ETHNICITY & HEALTH 2022; 27:1147-1165. [PMID: 33412893 DOI: 10.1080/13557858.2020.1863921] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Accepted: 12/09/2020] [Indexed: 06/12/2023]
Abstract
OBJECTIVES: Whether the lower Dutch cervical cancer (CC) screening participation of Turkish- and Moroccan-Dutch women is based on informed decision-making is unknown. Our aim was to explore how and why Turkish- and Moroccan-Dutch women decide to participate or not in the current Dutch CC screening programme as well as to learn their perceptions on self-sampling.DESIGN: Six focus group discussions were conducted between March and April 2019 with Turkish (n = 24) and Moroccan (n = 20) women in the Netherlands, aged 30-60 years. Questions were based on an extended version of the Health Belief Model. Discussions were transcribed verbatim and thematically analysed.RESULTS: Participants lacked knowledge about CC and its screening, and seemed to be unaware of the cons of CC screening. Perceived barriers for screening were lack of a good command of the Dutch language, having a male general practitioner, fatalism, shame and taboo, and associations of CC with lack of femininity and infertility. Other barriers were fear of the test result, cancer, suffering, death, and leaving their children behind after death. Perceived facilitators were a high perceived severity of disease, social support, and short procedure time. An additional religious facilitator included the responsibility to take care of one's own health using medical options that God provided. Participants had low self-efficacy expectations towards performing correct self-sampling.CONCLUSIONS: Although participants' informed-decision making seems to be limited, this study showed that women do not only consider factual medical information, but also practical, emotional, cultural, and religious aspects prior to deciding to screen or not. Information materials should be tailored to these aspects, as well as translated to appropriate languages due to lack of a good command of the Dutch language. Self-efficacy expectations towards performing correct self-sampling should be enhanced to promote informed CC screening participation among Turkish- and Moroccan-Dutch women.
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Affiliation(s)
- Nora Hamdiui
- National Coordination Centre for Communicable Disease Control, Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, Netherlands
- Department of Primary and Community Care, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, Netherlands
| | - Eline Marchena
- National Coordination Centre for Communicable Disease Control, Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, Netherlands
| | - Mart L Stein
- National Coordination Centre for Communicable Disease Control, Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, Netherlands
| | - Jim E van Steenbergen
- National Coordination Centre for Communicable Disease Control, Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, Netherlands
- Centre for Infectious Diseases, Leiden University Medical Centre, Leiden, Netherlands
| | - Rik Crutzen
- Department of Health Promotion, Care and Public Health Research Institute, Maastricht University, Maastricht, Netherlands
| | - Hilde M van Keulen
- Child Health, Netherlands Organization for Applied Scientific Research (TNO), Leiden, Netherlands
| | - Ria Reis
- Amsterdam Institute for Social Science Research, University of Amsterdam, Amsterdam, Netherlands
- The Children's Institute, School of Child and Adolescent Health, University of Cape Town, Cape Town, South Africa
- Department of Public Health and Primary Care, Leiden University Medical Centre, Leiden, Netherlands
| | - Maria E T C van den Muijsenbergh
- Department of Primary and Community Care, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, Netherlands
- Pharos: Dutch Centre of Expertise on Health Disparities, Program Prevention and Care, Utrecht, Netherlands
| | - Aura Timen
- National Coordination Centre for Communicable Disease Control, Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, Netherlands
- Athena Institute for Research on Innovation and Communication in Health and Life Sciences, VU University Amsterdam, Amsterdam, Netherlands
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Altunkurek ŞZ, Mohamed SH, Şahin E, Yilmaz S. Knowledge and attitudes of healthcare professionals working in a training and research hospital on early diagnosis of cervical cancer (a Somalia example): cross-sectional study. BMC Womens Health 2022; 22:228. [PMID: 35698067 PMCID: PMC9195217 DOI: 10.1186/s12905-022-01808-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 06/01/2022] [Indexed: 11/11/2022] Open
Abstract
Background Despite the early diagnosis and treatment of cervical cancer, it is still a significant public health problem in Somalia. This study was conducted to evaluate the knowledge and attitudes of healthcare professionals towards the early diagnosis of cervical cancer. Methods This study was conducted in Mogadishu, the capital of Somalia, between December 2020 and February 2021. The cross-sectional study consisted of a total of 280 healthcare professionals. The study data was collected using a questionnaire consisting of 38 questions evaluating the knowledge and attitudes of all healthcare professionals towards the early diagnosis of cervical cancer, an additional 15 questions for women only, and a total of 43 questions. Results 22.1% of the participants received cervical cancer training during vocational education and training. Cervical cancer education after graduation is 16.8%, and the rate of providing education to patients is only 29.6%. The rate of female healthcare professionals having a Pap smear test is 2%. The participants' cervical cancer total knowledge score was 16.5 ± 6.69, and the success rate was 63.46. The highest success rate in knowledge subgroup questions was HPV questions with 69.6. A statistically significant difference was found between the participants' profession, training on the subject during their vocational education, and total knowledge scores (p < 0.001). When the knowledge question subscales were compared, a significant difference was found between participants' gender and HPV questions subscale score (p = 0.028). A statistically significant difference was found between the participants' professions, receiving training on the subject during vocational training, and all subscales (p < 0.05). A statistically significant difference was found between the participants' income status and risk factors questions scores (p = 0.026). Conclusion This study shows that the knowledge and training of healthcare professionals working in a training and research hospital in Somalia for early cervical cancer diagnosis are not sufficient. In addition, it reveals that female healthcare professionals have almost no Pap smears. Therefore, studies and training should be planned to train all healthcare professionals, especially female healthcare professionals, and overcome all possible obstacles to the acceptance of the screening tests by women.
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Affiliation(s)
- Şeyma Zehra Altunkurek
- Public Health Nursing Department, Gulhane Faculty of Nursing, University of Health Sciences, Ankara, Türkiye
| | - Samira Hassan Mohamed
- Somalia Mogadishu Recep Tayyip Erdoğan Faculty of Health Sciences, University of Health Sciences, Mogadishu, Somalia.
| | - Eda Şahin
- Obstetric and Gynecologic Nursing Department, Health Science Faculty, Giresun University, Giresun, Türkiye
| | - Sümeyra Yilmaz
- Public Health Nursing Department, Faculty of Health Science, University of Gazi, Ankara, Türkiye
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Onsuz MF, Hidiroglu S, Sarioz A, Metintas S, Karavus M. Knowledge, attitudes and behaviors of women over 20 years old on cervix cancer in Istanbul, Turkey. Asian Pac J Cancer Prev 2015; 15:8801-7. [PMID: 25374211 DOI: 10.7314/apjcp.2014.15.20.8801] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
PURPOSE The aim of the study was to evaluate knowledge, attitudes and behaviors of Turkish women over 20 years old on cervix cancer. MATERIALS AND METHODS This descriptive study was performed at a primary care center covering 246 women using a questionnaire composed of 3 sections and 38 questions. The data were analyzed using descriptive statistics, chi-square test in univariate analysis and multivariate hierarchical logistic regression analysis. RESULTS Of the 93.7% women who knew about cervical cancer, 68.0% of them had heard pap smear test and 46.1% had actually undergone a Pap smear once or more throughout their lives. According to the results of the hierarchical logistic regression analysis about factors affecting the Pap smear test; in Model 1, increase in age and education levels, in Model 2 and Model 3 increase in age and cervical cancer information points were determined. The most important information source for cervical cancer was TV-radio/media (59.9%) and health care workers (62.8%) for pap smear test. CONCLUSIONS Although most women have heard of cervical cancer, knowledge about cervical cancer and also Pap smear screening rate are significantly lower. Having Pap smear test for women was affected by age and knowledge level about cervical cancer. Informing women about cervical cancer would be an important intervention.
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Oranratanaphan S, Termrungruanglert W, Khemapech N. Acceptability of self-sampling HPV testing among Thai women for cervical cancer screening. Asian Pac J Cancer Prev 2015; 15:7437-41. [PMID: 25227855 DOI: 10.7314/apjcp.2014.15.17.7437] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Acceptability of self-sampling HPV testing is confirmed worldwide. However, some cultural differences may affect this question. Therefore, this study was conducted to evaluate the acceptability of self- sampling HPV testing in Thai women. MATERIALS AND METHODS One hundred women aged 30-65 years with an intact cervix were included in this study. The participants were asked to do the Pap test by physicians and then brush type self-sampling instruments were assigned for self-collection and finally completed a questionnaire for acceptability evaluation. The questionnaire contains 2 parts. Part one covered general information of the participants and part two is the acceptability questions. RESULTS Mean age was 40.6 years. The incidence of high risk HPV detection in this study was 16%. The most common reason for doing Pap smear was for annual checkup. On the topic of ease of use, 85 % of the subjects agreed. Most of the participants (82%) reported that they felt less pain. However, reliability of the result was not satisfactory because 37% of the participants hesitated to rely on the results of the test. According to the price, if the price is less than 1,000 Baht (32.59 Baht = 1USD), 82% of the subjects would use it for their next screening. CONCLUSIONS The acceptability of self-sampling device in this study is quite good but the reliability of the test was questioned by some of the participants. Moreover, the price of the test in Thailand may also influence the acceptability of the test.
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Affiliation(s)
- Shina Oranratanaphan
- Department of Obstetrics and Gynecology, Faculty of Medicine, King Chulalongkorn Memorial Hospital, Chulalongkorn University, Bangkok, Thailand E-mail :
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Chen SL, Hsieh PC, Chou CH, Tzeng YL. Determinants of women's likelihood of vaginal self-sampling for human papillomavirus to screen for cervical cancer in Taiwan: a cross-sectional study. BMC WOMENS HEALTH 2014; 14:139. [PMID: 25420580 PMCID: PMC4253005 DOI: 10.1186/s12905-014-0139-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/02/2014] [Accepted: 10/23/2014] [Indexed: 12/24/2022]
Abstract
Background Many Taiwanese women (43.8%) did not participate in regular cervical screening in 2011. An alternative to cervical screening, self-sampling for human papillomavirus (HPV), has been available at no cost under Taiwan’s National Health Insurance since 2010, but the extent and likelihood of HPV self-sampling were unknown. Methods A cross-sectional study was performed to explore determinants of women’s likelihood of HPV self-sampling. Data were collected by questionnaire from a convenience sample of 500 women attending hospital gynecologic clinics in central Taiwan from June to October 2012. Data were analyzed by descriptive statistics, chi-square test, and logistic regression. Results Of 500 respondents, 297 (59.4%) had heard of HPV; of these 297 women, 69 (23%) had self-sampled for HPV. Among the 297women who had heard of HPV, 234 (78.8%) considered cost a priority for HPV self-sampling. Likelihood of HPV self-sampling was determined by previous Pap testing, high perceived risk of cervical cancer, willingness to self-sample for HPV, high HPV knowledge, and cost as a priority consideration. Conclusions Outreach efforts to increase the acceptability of self-sampling for HPV testing rates should target women who have had a Pap test, perceive themselves at high risk for cervical cancer, are willing to self-sample for HPV, have a high level of HPV knowledge, and for whom the cost of self-sampling covered by health insurance is a priority. Electronic supplementary material The online version of this article (doi:10.1186/s12905-014-0139-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Shu-Ling Chen
- Department of Nursing, Hungkuang University, Taichung, Taiwan.
| | - Pao-Chun Hsieh
- Department of Obstetrics and Gynecology, Cheng Ching Hospital, Taichung, Taiwan.
| | - Chia-Hui Chou
- Department of Nursing, Hungkuang University, Taichung, Taiwan.
| | - Ya-Ling Tzeng
- School of Nursing, China Medical University, Taichung, Taiwan. .,Department of Nursing, China Medical University Hospital, Taichung, Taiwan.
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