Objective: The study was planned with the purpose of examining the attitude of women who have pap-smear test for the early diagnosis of cervical cancer, factors affecting their decisions and their feelings and experiences during this period. Materials and Methods: A phenomenological method was used. Data were collected between March 2012 and April 2012 using standard and purposive samplings from 17 women. A detailed interview with women were held in their houses and recorded. The data collection tool consisted of two parts, one of which is information form with 17 questions identifying sociodemographic and cervical cancer risk factors of women and the second part is made up of semi-structured interview form with 15 alternative questions taking literature and the pap-smear test into consideration. Collected data were put into a written document. Content analysis was held by loading the documents into NVIVO 8 Statistical Programme. Results: The study comprised themes such as cervical risk factor, decision of taking pap-smear test, taking pap-smear test, knowledge about pap-smear test, relieving factors during pap-smear test, obstructive factors during pap-smear test, gynecological examination and feelings of women during and after pap-smear test while waiting for the results. Conclusions: As women perceive gynaecological examinations differently from other examinations, they have different feelings in each process of the Pap smear test. Medical staff should advise women more clearly on the nature and advantages of the Pap-smear test.
The purpose of this study was to determine the relationship between emotion related to Pap smear and continuous participation in Pap smear screening by married women. The subjects for this study were 209 married women who had at least one previous Pap smear. The data were collected using a self reported survey questionnaire which was developed by the researchers. It's Cronbach's alpha score ranged from .8799 to .9118. Data analysis was done by descriptive statistics. ANOVA, t-test and Pearson correlation using the SPSS Win program. The results are as follows: 1. The mean for continuous participation in Pap smear screening over the past three years was 1.95. 2. The mean score for negative emotions related to Pap smear screening was 3.2. 3. The mean score for positive emotions related to Pap smear screening was 3.9 4. Positive correlations were found between positive emotion and continuous participation in Pap smear screening (r=.417, p<.05). A weak negative correlation was found between negative emotion and continuous participation in Pap smear screening (r=-.213, p<.05). In conclusion, negative and positive emotions had a significant effect on continuous participation in the Pap smear screening among married women. This suggests that reducing negative emotions and activating messages which relate to positive emotions may be an effective strategy for increasing continuous participation in Pap smear screening.
Background: Coverage of cervical pap smear test in Nepal is below general global values. One of the reasons may be that cervical cancer prevention policy of Nepal has 'Visual Inspection of Cervix with Acetic Acid' as the only screening tool. The focus of present study was to find out association of demographic factors, knowledge and attitude regarding cervical Pap smear test with its practice by women in Nepal. Materials and Methods: This cross sectional analytical observational study was conducted between February 1, 2013 and April 30, 2013. Participants were interviewed with the help of a structured questionnaire. Chi square and multivariate logistic regression tests were used to detect associations of variables with pap smear practice. Results: Chi square test showed that practice was significantly associated with knowledge about pap smear test and cervical cancer, having favourable attitude towards the test, urban residency and 36-50 years age-group. Pap smear utilization was not associated with age-at-marriage, parity and age-at-first-child-birth. Multivariate logistic regression showed favorable attitude towards pap smear test as the only variable which significantly influenced pap smear practice (p= 0.006, OR: 2.4). Conclusions: Pap smear coverage has been found to be 15.7% which is lower than global average and that for developing countries. Health education programs which are effective not only in increasing knowledge about cervical cancer and pap smear test but also effective in positively changing attitude towards the test should be organized to increase pap smear coverage.
Purpose: This study's aim was to investigate participation in Pap smear screening among married immigrant women and their behavior and its related factors. Methods: A survey was conducted among 165 married immigrant women in Gyeongsangnam-do from January 1 to March 20, 2010. Results: Results in this study showed that 51.5% have never participated in Pap Smear screening. Among those who have participated in the Pap Smear screening, 10.9% had regular screening, while 37.6% had irregular screening. Pap smear screening behavior was significantly different according to the experiences in health checkup ($x^2$=34.009, p<.001)', whether or not there was a hospital the woman regularly visited ($x^2$=7.768, p=.021) and perceived barriers (F=3.214, p=.043). Conclusion: For improvement of Pap smear participation, this study proposes to develop various nursing intervention programs which can improve perceived barriers in regards to the related variables. In addition, it is necessary to come up with a strategy to advertise the participation in Pap smear screening in a systematic and continuous manner in order to raise womens' awareness and to make married immigrant women realize the importance of regular Pap smear screenings.
Objective : To estimate the significance of the Pap smear as a screening tool for cervical cancer. Methods : A total of 79,840 Pap smear results peformed at Pusan Paik Hospital over the 20 year period from 1979 to 1998 were collected and analyzed. Results : The number of Pap smear cases increased markedly during this period, and the results as a whole were classified as of 96.4% normal and benign cytology, 2.2% pre-cancerous cytology, and 1.4% cervical cancer. The relative frequency of cervical cancer decreased from 1.6% in 1979 to 0.7% in 1998. About 64% of the Pap smears were distributed within the age range of 30 to 49 years, and the rate of cervical cancer increased with age, age of marriage and experience of childbirth (p<0.01). The overall agreement of Pap smear results with histologic diagnosis by one histologic degree was 92.7%(1,128/1,217) with 73 overestimated cases and 16 underestimated cases of Pap smear compared to histologic diagnosis. Conclusion : This result implies that the Pap smear is an excellent screening tool for cervical cancer with respect to both its scale and validity. Periodic and active Pap smear testing would be helpful for the secondary prevention of cervical cancer.
Abdul Rashid, Rima Marhayu;Ramli, Sophia;John, Jennifer;Dahlui, Maznah
Asian Pacific Journal of Cancer Prevention
Cervical cancer screening in Malaysia is by opportunistic Pap smear which contributes to the low uptake rate. To overcome this, a pilot project called the SIPPS program (translated as information system of Pap smear program) had been introduced whereby women aged 20-65 years old are invited for Pap smear and receive recall to repeat the test. This study aimed at determining which recall method is most cost-effective in getting women to repeat Pap smear. A randomised control trial was conducted where one thousand women were recalled for repeat smear either by registered letter, phone messages, phone call or the usual postal letter. The total cost applied for cost-effectiveness analysis includes the cost of sending letter for first invitation, cost of the recall method and cost of two Pap smears. Cost-effective analysis (CEA) of Pap smear uptake by each recall method was then performed. The uptake of Pap smear by postal letter, registered letters, SMS and phone calls were 18.8%, 20.0%, 21.6% and 34.4%, respectively (p<0.05). The CER for the recall method was lowest by phone call compared to other interventions; RM 69.18 (SD RM 0.14) compared to RM 106.53 (SD RM 0.13), RM 134.02 (SD RM 0.15) and RM 136.38 (SD RM 0.11) for SMS, registered letter and letter, respectively. ICER showed that it is most cost saving if the usual method of recall by postal letter be changed to recall by phone call. The possibility of letter as a recall for repeat Pap smear to reach the women is higher compared to sending SMS or making phone call. However, getting women to do repeat Pap smear is better with phone call which allows direct communication. Despite the high cost of the phone call as a recall method for repeat Pap smear, it is the most cost-effective method compared to others.
The purpose of this study was to develop an explanatory model to predict factors related to continuous participation in the Pap smear screening among Korean women. A hypothetical model was constructed on the basis of Health Belief Model and extensive review of literature on the Pap smear screening. Exogeneous variables included in this model were knowledge, perceived sensitivity, perceived severity, negative and positive emotional responses and professional support from physicians and nurses. Endogeneous variables were threat to cervical cancer, perceived benefit of the Pap smear screening, perceived barrier, and the final outcome variable was continuous participation in the Pap smear screening. The hypothetical model was tested with an empirical study. The data was collected from 623 married women whose age range was 24 - 83 using a self-reported survey questionnaire which was developed by the researcher. It's Cronbach's alpha score ranged from .6478 to .9118. Data was collected at different locations in Seoul; a university hospital, a local health center, and apartment complexes. Data analysis was done using SPSS 7.5 WIN Program for descriptive statistics and LISREL 8.12a WIN Program for covariance structural analysis. In conclusion, threat, perceived benefit, perceived barrier, positive emotion and professional support had a significant direct effect on continuous participation in the Pap smear screening among Korean women. The results of this study also showed that perceived barrier had the most significant direct effect on continuous participation in the Pap smear screening while negative emotional response had the most significant direct effect on perceived barrier. It can be suggested that decreasing perceived barrier by reducing negative emotional responses may be the most effective strategies for increasing continuous participation in the Pap smear screening among married Korean women.
Onsuz, Muhammed Fatih;Hidiroglu, Seyhan;Sarioz, Abdullah;Metintas, Selma;Karavus, Melda
Asian Pacific Journal of Cancer Prevention
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.
Background: Cancer of the uterine cervix is one of the most common cancers among women worldwide. Industrialized countries have dramatically reduced the incidence of mortality from cervical carcinoma in the last 50 years through aggressive screening programs utilizing pelvic examinations and Papanicolaou (Pap) smears but it still remains a major problem in the developing world. Objectives: This study was performed to determine knowledge, attitude and practice of Pap smear as a screening procedure among nurses in a tertiary hospital in north eastern India. Material and Methods: This cross sectional study was carried out with a questionnaire survey covering the socio demographic factors, knowledge, attitude and practices about Pap smear screening among 224 nurses in Regional Institute of Medical Sciences, Imphal, Manipur, India during December 2011. Results: Two hundred and twenty one participants (98.6%) had heard about cervical carcinoma but 18.3% lacked adequate knowledge regarding risk factors. Knowledge about the Pap smear was adequate in 88.8% of the respondents. Out of these, only 11.6% had Pap smear at least once previously. The most common reasons for non-participation in screening were lack of any symptoms (58.4%), lack of counselling (42.8%), physician does not request (29.9%) and fear of vaginal examination (20.5%). Conclusion: Although knowledge of Pap smear as a screening procedure for cervical cancer is high, practice is still low. The nurses who should be responsible for opportunistic screening of women they care for are not keen on getting screened themselves. If we can improve the practice of Pap smear screening in such experts, they should be able to readily provide appropriate and accurate information and motivate the general population to join screening programs.
Background: Cervical cancer is the second most common in Thailand, but the mortality rate may be rising yearly. It is a cancer that can be prevented by early screening for precancerous lesions, several methods being available. Objective: To identify the prevalence of abnormal Papanicolaou (Pap) smears and lesions with visual inspection with acetic acid (VIA) in pregnant women and assess risk factors for this group. Materials and Methods: This prospective study was performed at Prapokklao Hospital, Thailand during April-July 2016. All pregnant women of gestational age between 12-36 weeks who attended an antenatal clinic were recruited. All participants were screened for cervical cancer by Pap smear and VIA. If results of one or both were abnormal, colposcopic examination was evaluated by gynecologic oncologist. Results: A total of 414 pregnant women were recruited. Prevalence of abnormal Pap smear and VIA were 6.0 and 6.7 percent, respectively. The most common abnormal Pap smear was low grade intraepithelial lesion (LSIL, 44%). Factors associated with abnormal Pap smear in pregnant women were low BMI, multiple partners and being a government officer. In pregnancy, Pap smear had higher sensitivity and specificity than VIA for detection of precancerous cervical lesion. Patients with young coitarche or more than 25 years of active sexual activity were high risk groups. Conclusions: Prevalence of abnormal Pap smear and VIA in pregnant women was 6.0 and 6.7 percent, respectively. Factors associated with abnormal Pap smear were coitarche, years of sexual activity, low BMI, multiple partners and being a government officer.
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