Beliefs and behaviors about Pap and breast self-examination among Thai immigrant women in Brisbane, Australia.

Regular screening is an important preventive method in reducing morbidity and mortality from cervical and breast cancer. In 1998, a cross-sectional study was conducted in Brisbane, Australia, among 145 Thai immigrant women, to explore cultural and social factors related to their use of Pap smear tests and breast self-examination (BSE). The study aimed at describing women's beliefs and perceptions about the body, breast and cervical cancer, and their perceptions of the causes of the diseases. It explored the women's perception of the severity and the effects of both cancers on aspects of patients' lives, and their chance of developing both cancers. The Thai immigrant women explained the causes of breast and cervical cancer using both traditional beliefs and medical knowledge. They perceived that both cancers affect a patient's health and her daily activities. Some women believed that they would develop cervical cancer if their perineum or vulva was "dirty." Some believed that they would have breast cancer because they had a history of benign tumor or cyst of a breast. Forty-four percent of the women had biennial Pap smears in the past five years and only 25% conducted BSE monthly in the past two years. Information relating to perceived barriers to undertake regular cervical cancer and breast cancer screenings and other health beliefs can be applied by health care personnel to increase Thai immigrant women's preventive health behaviors.     

Influence of women's knowledge on maternal health care utilization in southern Laos

This study aims to clarify women's knowledge on obstetric care and to analyse the situation of maternal health care (MHC) utilization in southern Laos. Face to face structured questionnaire and focus group discussions were carried out for 205 mothers aged 29.6 +/- 6.7 who had children under the age of five. Three measurements of MHC utilization comprised: 1) antenatal care (ANC), 2) tetanus toxoid (TT) inoculation, and 3) attendance delivery by health professional. Women's knowledge on obstetric care was scored. Women's knowledge was positively correlated with ANC and TT inoculation. It was found that the women with strong superstitious belief were less likely to utilize all three types of MHC than the others. Accessibility to health care facilities strongly affected ANC and attendance delivery. Enhancing women's knowledge on obstetric care and reducing barriers related with sociocultural beliefs are essential to improving maternal health in southern Laos.     

Women users' views on the role and value of the practice nurse

Aspects of the views of women aged 16–65 years on practice nurses in the primary health care setting are explored. The extent to which women consult practice nurses and the reasons for consultation are first identified. Women's assessments of practice nurses are then examined. The findings are from a 3-year research project where 1251 women completed a postal questionnaire and 70 women were interviewed in depth about issues concerning women's perceptions and experiences of both general practitioners (GPs) and practice nurses. Two thirds of the sample had consulted the practice nurse; 22% about specific women's health issues (including 13% for cervical screening). For most women's health issues, more women expressed a preference to be seen by a general practitioner (GP) than a practice nurse, except for breast examination among women aged 49 to 65 years where 57% expressed a preference for a practice nurse compared with 43% for a GP. Women gave similarly positive evaluations of the approachability of practice nurses and GPs. Positive views of practice nurses were high among older women, women who saw practice nurses in well-women clinics and women who saw practice nurses in relation to women's health issues. Among women who had not consulted a practice nurse, there was both a lack of awareness of the level and range of expertise of practice nurses, and a perception that in the main they offered only minor routine services. Health promotion, disease prevention and family planning do not appear to feature centrally in women's expectations of services provided by the practice nurse.     

Predicting iron-fortified soy sauce consumption intention: application of the theory of planned behavior and health belief model

OBJECTIVE: To identify variables that significantly predict the intention of iron ethylenediaminetetraacetic acid (NaFeEDTA)-fortified soy sauce (FeSS) consumption. DESIGN: A cross-sectional questionnaire survey, based on the Theory of Planned Behavior (TPB) and Health Belief Model (HBM), was administered, and a multistage, stratified sampling method was carried out to select study samples. SETTING: Urban and rural areas in Guizhou province, China. SUBJECTS: 636 women from rural areas and 454 from urban areas completed 1090 eligible questionnaires. VARIABLES MEASURED: Women's knowledge of FeSS; perceived severity and susceptibility of iron deficiency (ID) or iron deficiency anemia (IDA); and attitudes toward behavior, control beliefs, barriers, cues, intention to buy FeSS, health value, and health behavior identity factors were measured. ANALYSIS: A path analysis was conducted to test the goodness of fit of the model and to modify the model. Scale and factor analyses were conducted to verify the scale's reliability and construct validity. The alpha level was set at .05. RESULTS: The model explained 35% to 55% of the variance of behavioral intention. FeSS knowledge directly and indirectly affected the intention to buy FeSS. The behavioral intention was also impacted by women's health value and perception of perceived susceptibility and severity of IDA through the behavior identity and attitudes toward behavior. Cues, as an external factor, greatly affected the intention. The external control belief was a weak factor affecting intention. IMPLICATIONS FOR RESEARCH AND PRACTICE: Integrated TPB and HBM explained the behavioral intention of FeSS consumption among women in Guizhou, China. Nutrition education should emphasize behavioral attitudes and identity, and improve knowledge of FeSS and perception of ID and IDA, which would relieve anxiety about FeSS.     

Women's health centers: are the National Centers of Excellence in Women's Health a new model?

This paper describes the characteristics of the clinical centers of the first 12 National Centers of Excellence (CoE) in Women's Health, designated by the U.S. Department of Health and Human Services Office on Women's Health between 1996 and 1997. These centers are compared with 56 hospital-sponsored primary care women's health centers identified in the 1994 National Survey of Women's Health Centers, the only source of nationally representative data on primary care women's health centers. While analysis demonstrates that some organizational and clinical attributes of primary care women's health centers were in evidence before the CoE program was initiated, the CoE centers demonstrate further integration of clinical services with research and medical training in women's health, and the delivery of services to a more diverse population of women.     

Violence against women, symptom reporting, and treatment for reproductive tract infections in Kerala state, Southern India

In this article we examine factors associated with women's self-reports of reproductive ill health symptoms and factors associated with seeking and receiving treatment for the symptoms. We focus on indicators of women's societal position, especially empowerment (indicated by experience of and attitudes toward violence against women), autonomy, and education. We used data from the National Family Health Survey-2 from Kerala state in Southern India. Based on our results we suggest that violence against women, whether actually experienced or internalized as acceptance of its justification, is associated with increased ill health symptoms, and the acceptance of violence is associated with decreased chance of treatment. Women's higher formal education appeared to reduce treatment seeking for reproductive ill health, perhaps due to the stigma associated with sexually transmitted disease (STD) in this cultural setting. Women's work participation had no significant impact, nor did indicators of women's economic and personal autonomy.     

深圳市皇岗社区妇女健康普查分析

目的:(1)探讨皇岗社区妇女生殖健康状况;(2)探讨皇岗社区妇女的更年期症状及其对心理和生活的影响;(3)探讨皇岗社区妇女健康服务水平及需求。方法:采用发放调查问卷及妇科检查等方法对皇岗社区常住妇女进行健康普查。结果:(1)皇岗社区妇女前3位妇科常见病患病率是:生殖道感染30.95%,月经失调23.50%,乳腺小叶增生3.87%。生殖道感染随年龄增加,发病率下降(P<0.01)。(2)约3成的妇女有更年期综合征。36~45岁组更年期综合征患病率为65.20%,与其他年龄组对比有高度显著性(P<0.01)。(3)超过8成的妇女认为现时深圳市妇女健康服务足够,并对自身保健具有自觉性和迫切感。结论:要确保社区妇女健康水平不断提高,必须坚持开展妇女病普查,做好普查后的普治和随访工作,充分利用社区资源开展社区健康促进活动,加强妇科常见病防治和更年期保健知识的宣传教育,组织妇科专家为社区妇女举办妇女病和更年期知识讲座,努力满足社区妇女的健康需求。     

Using women's health research to develop women leaders in academic health sciences: the National Centers of Excellence in Women's Health

While the number of women entering U.S. medical schools has risen substantially in the past 25 years, the number of women in leadership positions in academic medicine is disproportionately small. The traditional pathway to academic leadership is through research. Women's health research is an ideal venue to fill the pipeline with talented women physicians and scientists who may become academic leaders in positions where they can promote positive change in women's health as well as mentor other women. The Office on Women's Health (OWH) in the U.S. Department of Health and Human Services has contracted with 18 academic medical centers to develop National Centers of Excellence in Women's Health. Emphasizing the integral link between women's health and women leaders, each of the Centers of Excellence must develop a leadership plan for women in academic medicine as part of the contract requirements. This paper describes the training programs in women's health research that have developed at five of the academic medical centers: the University of Wisconsin, Magee Women's Hospital, the University of Maryland, Medical College of Pennsylvania Hahnemann University, and the University of Illinois at Chicago. We discuss some of the challenges faced for both initiation and future viability of these programs as well as criteria by which these programs will be evaluated for success.     

上海农村围绝经期妇女健康状况及保健需求的分析

目的:了解农村社区40~55岁围绝经期妇女健康状况和保健服务需求,阐述在农村社区妇女中开展围绝经期保健的重要性和必要性,探讨在农村社区中开展围绝经期保健的适宜技术。方法:选择上海市嘉定区某社区40~55岁妇女1667人进行问卷调查,了解其健康状况、围绝经期相关保健知识知晓情况和保健服务需求。结果:48.59%的被调查者至少有一种及以上围绝经期相关症状。34.5%的被调查者对围绝经期综合征有认知。15.9%的有围绝经期症状妇女接受过医疗保健服务,其中到社区医院就诊的仅占13.4%,到妇科就诊的占70.1%,而其余的去内外科或精神科就诊。结论:①农村社区40~55岁妇女中将近半数有不同程度围绝经期综合征症状。②围绝经期妇女缺乏相关保健知识,不能及时就医及有乱投医情况。③社区围绝经期保健服务滞后。总之,在农村社区开展围绝经期妇女保健工作相当重要和必要,顺应农村妇女的需求,是妇女保健工作内涵的深入,也是社区六位一体功能的体现。     

Information technology and the National Centers of Excellence in Women's Health

Women are increasingly turning to the Internet for health information. The National Centers of Excellence in Women's Health (U.S. Dept. of Health and Human Services) have as one goal the use of information technology to improve care of women. Telemedicine, the Internet, and Resource Centers were used for patient consultation, patient support, support of women in academics, and clinician education regarding women's health. Access of the lay public to high-quality health information was achieved using the Internet as well as Resource Centers employing Internet educational modalities. Telemedicine, distance learning for clinicians and patient consultations for those far from medical care, has been used successfully. For clinicians, continuing medical education regarding women's health and calendars of opportunities for education in women's health were made available on-line. Creative new uses of information technology have been developed by the Centers of Excellence in Women's Health. These modalities may be adopted, tested, and adapted by others seeking to improve the care and health of women.     

农村生殖道感染妇女的就医行为及影响因素

为了研究影响患生殖道感染的妇女就医行为的社会文化因素 ,采用 Andersen的社会行为模式 ,于 1998～ 1999年对河北省迁安县患生殖道感染的已婚妇女共 378例进行了横断面调查 ,并对 8例妇女进行了深入访谈 ,采用归类 -分析总结 -分析 -总结的方法进行分析。结果显示 :妇女的就医行为各不相同。有去正规医院诊所就医的、有采用自我治疗方法的 ,多数妇女未采用任何治疗措施。影响妇女就医行为的因素有妇女患生殖道感染的严重程度 ,妇女对生殖道感染严重性的认识、有关自我治疗生殖道感染的知识、妇女因患生殖道感染而感到的社会耻辱感、对生殖道感染病因的认识 ,家庭经济收入和药物价格、工作和家庭负担。很有必要给育龄妇女以及男性提供有关生殖道感染方面的知识 ,减少社会对生殖道感染的不良看法 ,给妇女更多的社会支持 ,提高妇女的地位 ,提高保健服务的质量     

Homeless women's gynecological symptoms and use of medical care

Information is lacking on homeless women's gynecological symptoms and use of medical care for symptoms. This paper documents and explains gynecological symptoms and conditions and use of medical care in a probability sample of 974 reproductive-age (15-44) homeless women. Two-thirds of women reported symptoms during the previous year; 71 percent of those received medical care for their gynecological symptoms. Pregnancy, drug dependence, more episodes of homelessness, and general physical health symptoms were positively associated with a number of gynecological symptoms. Gynecological symptoms, younger age, better perceived health, and insurance coverage were positively associated with medical care; women reporting recent drug use and rape received less care. These findings support the importance of medical care and other treatment and support services for homeless women, including expanded care during pregnancy and substance abuse treatment. Health insurance coverage and an interruption in the cycle of homelessness also appear vital to women's health.     

Development and implementation of novel community outreach methods in women's health issues: the National Centers of Excellence in Women's Health

Numerous outreach efforts have been employed to educate both lay and professional communities about many medical issues. As part of our contracts with the Public Health Service, Office of Women's Health, Department of Health and Human Services, the National Centers of Excellence (CoEs) in Women's Health have been charged with creating innovative and effective methods of educating these audiences about the major issues involved in women's health. This mission is particularly critical in the arena of women's health, as women are responsible for approximately 75% of the healthcare decisions made by and for American families, and past efforts to provide them with good, evidence-based information have been fraught with difficulties ranging from financial to cultural. We report herein some of our successful novel outreach efforts. A common thread throughout this account is that among the most successful of the outreach activities are those that involve or incorporate existing community groups committed to women's health.     

Knowledge and perception of oral health promotion in schools among dental nurses in Sarawak, Malaysia

In recent years, the concept of a Health-Promoting School has received much interest. In Malaysia, dental nurses are ideally placed to play a lead role in promoting Oral Health within the school setting. This study aims to provide information on the knowledge, perception and perceived role of Oral Health Promotion in schools, among dental nurses. A postal questionnaire was used to measure dental nurses' knowledge, perception and perceived role of Oral Health Promotion. The majority (60%) of dental nurses had good knowledge of Oral Health Promotion. Generally, they perceived that they play an important role in promoting Oral Health in schools. However, a sizeable proportion (25%) did not think they had a role to play in working together with school authorities to provide children with healthy food choices in school canteens. The majority (60%) of dental nurses did not perceive Oral Health Promotion to be important as a whole. They had a good perception of the concepts: it supports behaviour change, it has appropriate goals, it integrates oral health and general health and relieves anxiety. However, they had a poorer perception of the concepts; diverse educational approaches, participation, focus on prevention, early intervention, "spread of effect" of dental health education and "make healthier choices the easier choices". Years of service was not significantly associated with knowledge and perception of Oral Health Promotion. Dental nurses should be reoriented towards a more holistic practice of Oral Health Promotion. Workshops that invite active participation from dental nurses should be conducted to equip them with the necessary knowledge and skills.     

Intimate partner violence and women's physical, mental, and social functioning

OBJECTIVE: To describe the relationship between women's health and the timing, type, and duration of intimate partner violence (IPV) exposure. METHODS: A telephone interview was completed by 3429 women aged 18 to 64 randomly selected from a large health plan, to assess IPV exposure and heath status (response rate 56.4%). Questions from the Behavioral Risk Factor Surveillance System and the Women's Experience with Battering scale were used to construct IPV exposures: (1) recent (past 5 years) and remote (before past 5 years only) IPV exposure of any type (physical, sexual, or non-physical); (2) recent (past 5 years) IPV exposure to physical and/or sexual or non-physical only; and (3) IPV duration (0 to 2 years, 3 to 10 years, and >10 years). Health outcomes were measured using the Short Form-36 survey (SF-36), the Center for Epidemiologic Studies Depression scale, and the National Institute of Mental Health Presence of Symptoms survey. RESULTS: In adjusted models, compared to women with no IPV in their adult lifetime, more-pronounced adverse health effects were observed for women with recent (vs remote) IPV; for physical and/or sexual (vs non-physical) IPV; and for longer IPV exposure. Compared to women who never experienced IPV, women with any recent IPV (physical, sexual, or non-physical) had higher rates of severe (prevalence ratio [PR]=2.6; 95% confidence interval [CI]=1.9-3.6) and minor depressive symptoms (PR=2.3; 95% CI=1.9-2.8); higher number of physical symptoms (mean, 1.0; 95% CI=0.7-1.2); and lower SF-36 mental and social functioning scores (range, 4.3-5.5 points lower across subscales). Women with recent physical and/or sexual IPV were 2.8 times as likely to report fair/poor health, and had SF-36 scores that ranged from 5.3 to 7.8 points lower, increased risk of depressive symptoms (PR=2.6) and severe depressive symptoms (PR=4.0), and more than one additional symptom. Longer duration of IPV was associated with incrementally worse health. CONCLUSIONS: Women's health was adversely affected by the proximity, type, and duration of IPV exposure.     

Reflections on a decade of experience in implementing a Center for Women's Health at an Academic Medical Center

On the 10th anniversary of the establishment of a Center for Women's Health (CWH) program, the opportunity to share the successes and limitations in developing a centralized approach to women's healthcare is provided. The development of the CWH at the Columbia University Medical Center, New York-Presbyterian Hospital was prompted by concerns that the health status for women is worse than for men in terms of disability, morbidity, and chronic illness. Moreover, women move through cycles of health and illness differently from men, and gender inequalities in research design and implementation and underrepresentation of women in clinical studies contributed to knowledge gaps concerning women's health, possibly leading to suboptimal care. The goal in developing a program was (1) to provide outstanding medical care to women based on prevention and treatment of unique aspects of women's health, (2) to develop professional training and multidisciplinary educational programs promoting knowledge, understanding, and credible scientific efforts, and (3) to foster collaborative research and communication among researchers, practitioners, policymakers, and organizations. In this paper, the clinical and educational programmatic activities and lessons learned are described.     

The Effect of Educational Program on Increasing Cervical Cancer Screening Behavior among Women in Hamadan, Iran: Applying Health Belief Model

Background: The systematic application of Pap test helps early diagnosis and effective treatment of cervical cancer. This study was conducted to assess the effect of education on health beliefs and practice of women eligible for Pap test using Health Belief Model (HBM). Methods: This quasi-experimental study was conducted in Hamadan City, the west of Iran, in 2010 using before-after design. In this study, 70 women aged 16 to 54 years participated voluntarily who had never done Pap test until the date of the study. The volunteers were divided into several small groups. For each group, 2-hour training session was held twice. The data collection tool was a self-administered multi-choice questionnaire that was developed based on HBM constructs. Health beliefs and practice of the target group were evaluated pre-intervention and four months later. Results: Our findings indicated that education based on HBM was effective and could enhance the participants' knowledge significantly and improve the HBM constructs including perceived susceptibility, severity, benefits, and barriers. The training program enhanced the practice from zero before intervention to 81.4% after that. The results of the present study revealed that increase in knowledge had effect on the HBM constructs. Furthermore, there was a significant relationship between knowledge and both age and educational level. Conclusion: Health education based on HBM can enhance women's knowledge of cervical cancer, change their health beliefs and improve their behaviors regarding screening programs like Pap test.     

The associations between health and domestic violence in older women: results of a pilot study

This study examined the association of domestic violence (DV) with the general physical and mental health of older women. This pilot cross-sectional survey studied 257 women, aged 50-79, who came for screening visits to the Observational Study arm of the Women's Health Initiative's (WHI) Newark, NJ, site between June 1995 and August 1996. A 27-item, interviewer-administered questionnaire was used to detect DV. To measure overall health status, we used questions from the Medical Outcomes Study Short Form 36. Of the 257 women interviewed, 82 (31.9%) had experienced DV at some point in their life; 51 (22.6%) had been threatened, and 31 (15%) had experienced physical assault. Women who were either physically assaulted or threatened had lower mental component summary (MCS) scores (50.0 versus 53.7). Women who had only been threatened had a mean MCS score of 49.7 compared with 53.8 for nonthreatened women. Both of these MCS scores indicate poorer mental health. DV, which about 1 in 4 women experience over their lifetime, has a negative relationship to health status. Women who have experienced DV have lower MCS scores than those who have not. They also tend to have lower physical component summary scores. These findings suggest the importance that detection and prevention of DV have for women's health.