Mammograms and Pap smears for Australian deaf women

This study aimed to assess baseline knowledge about mammograms and Pap smears among Australian Deaf women, to investigate their participation in breast and cervical cancer screening services, and to explore, where relevant, their perceptions about their access to breast and cervical screening services. An interview schedule was developed, and a convenience sample of 13 Deaf women was interviewed face-to-face by the first researcher with an accredited Auslan interpreter. The Deaf women's knowledge about mammograms and Pap smears often was incomplete. However, most of the eligible women had undergone a mammogram and had been rescreened within the recommended time frame. Although most had received a Pap smear, some were not attending as recommended by the Cancer Council of Australia. This exploration into the experiences of Deaf women can prompt all nurses to consider the needs of particular minorities and the barriers they may face to participate fully in health services.     

Cervical cancer screening--"For better or worse...": women's experience of screening

In Sweden, the population-based cervical cancer screening program has been in progress since the 1970s and is directed toward women between 23 and 60 years of age. The aim of this study was to explore women's experience of cervical screening after being diagnosed with cancer. A qualitative study inspired by Grounded Theory was used. Eleven women were interviewed. The interviews were analyzed using the constant comparative method. "Screening-For Better or Worse..." was identified as the core category, around which the categories "Unawareness," "Trust," "Search for Understanding," and "Making the Invisible Visible" were integrated and on which the conceptual model was built. The experience of screening had both a positive and a negative dimension for the women stricken by cervical cancer. The women had a positive experience of screening as such and they believed in its benefits. However, many women felt deceived and, because of their unawareness, questions arose for which they searched for understanding. The women requested adequate and understandable information. Their trust remained because the contact with healthcare professionals involved in screening and in the follow-up program had been reassuring.     

Integrative review of cervical cancer screening in Western Asian and Middle Eastern Arab countries

Population‐based screening programs have resulted in minimizing mortality and morbidity from cervical cancer. The aim of this integrative review was to explore the factors influencing access of women from Western Asian and Middle Eastern Arab countries to cervical cancer screening. A systematic search for studies conducted in Arab countries in those regions, and published in English between January 2002 and January 2017, was undertaken. Thirteen papers were selected and subjected to quality appraisal. A three step analysis was used, which involved a summary of the evidence, analysis of both quantitative and qualitative data, and integration of the results in narrative form. Few population‐based cervical cancer screening programs had been implemented in the relevant countries, with low knowledge of, and perceptions about, cervical screening among Arab women, the majority of whom are Muslim. Factors affecting the uptake of cervical cancer screening practices were the absence of organized, systematic programs, low screening knowledge among women, healthcare professionals’ attitudes toward screening, pain and embarrassment, stigma, and sociocultural beliefs. Policy changes are urgently needed to promote population‐based screening programs. Future research should address the promotion of culturally‐sensitive strategies to enable better access of Arab Muslim women to cervical cancer screening.     

对门诊女性患者宫颈癌筛查知信行的调查

目的了解门诊女性患者对宫颈癌筛查知识的认知以及相关的态度和行为,为提高宫颈癌筛查参与率的护理干预方案提供理论依据。方法采取随机抽样法,使用宫颈癌筛查知识的认知以及相关的态度和行为的调查问卷,对门诊就诊的1116例女性患者进行调查。结果本研究显示,不同年龄、文化程度、经济收入妇女对宫颈癌筛查相关知识认知度不同,差异均有统计学意义（X2=42．377,138．7,32．519,P〈0．01）,学历较高者、经济情况较好者对宫颈癌筛查知识知晓率较高。76．3％赞成“早期发现宫颈癌可提高生存率”这一观点,47．5％赞成“筛查可以早期发现宫颈癌”,45．3％的妇女愿意接受宫颈癌筛查。43．8％的妇女曾经做过宫颈癌筛查,定期每年做1次的有4．9％。不同年龄、受教育程度、经济收入妇女宫颈癌筛查率的比较差异均有统计学意义（X2=16．155,9．052,28．801,P〈0．01）。结论女性患者对宫颈癌筛查知识了解不足,文化程度低、经济条件差的患者对宫颈癌筛查的认知度低,实际参加宫颈癌筛查率低。护理人员应帮助患者树立积极态度,提高对宫颈癌筛查的认知,根据患者不同情况采取不同形式和渠道进行宫颈癌筛查健康教育,从而改善宫颈癌筛查率低的现状。     

Chinese women's motivation to receive future screening: The role of social-demographic factors,knowledge and risk perception of cervical cancer

Purpose of the researchThis paper adopted Protection Motivation Theory (PMT) to examine Chinese women's knowledge and perceptions of cervical cancer risk and factors influencing their motivation to receive future screening.Methods and sampleA cross-sectional survey was conducted with 167 Chinese women (142 women were willing to receive a screening in the future and 25 women were not) in 2007 to collect women's socio-demographic information and sexual history, perceptions related to body health and knowledge about cervical cancer and screening, and Protection Motivation Theory measures.Key resultsThe majority of women stated they intended to receive future screening and response efficacy was significantly associated with their intention. However, no significant association was observed between sexual history and protection motivation. Using multivariate analysis, cancer in relatives (odds ratio, OR = 9.97, 95% CI [1.44–436.3], p = 0.010), a perception that visiting a doctor regularly is important to health (OR = 9.85, 95% CI [1.61–999.9], p = 0.009)), and ever attending for cervical screening during the previous three years (OR = 3.49, 95% CI [1.23–11.02], p = 0.016) were significantly associated with women' motivation to receive future screening.ConclusionThe findings of this study highlight the important role of women's beliefs in the value of cervical screening and previous screening experience in motivating them to receive a screening. Education intervention is needed to provide information and raise public awareness about the importance of cervical screening to women's health. Culture-related beliefs and social motivational processes in addition to those specified by PMT need to be addressed.     

Distance art groups for women with breast cancer: guidelines and recommendations

To overcome barriers that prevent women with breast cancer from attending support groups, innovative formats and modes of delivery both need to be considered. The present study was part of an interdisciplinary program of research in which researchers from counseling psychology, psycho-oncology, nursing, computer science, and fine arts have explored art making as an innovative format and telehealth as a mode of delivery. For this study, we conducted focus groups and interviews with 25 people with expertise about breast cancer, art, art therapy, and distance delivery of mental health services to generate guidelines for distance art-based psychosocial support services to women with breast cancer. A qualitative analysis of the focus group and interview data yielded guidelines for developers and facilitators of distance art groups for women with breast cancer pertaining to (a) emotional expression, (b) emotional support, (c) emotional safety, and (d) accommodating individual differences, plus special considerations for art therapy groups. Further research is needed pertaining to the use of computers, involvement of art therapists, and screening out vulnerable clients.     

Enhancing cancer nursing education through school of nursing partnerships: the Cancer Nursing Faculty Fellows Program

This article describes the Cancer Nursing Faculty Fellows Program, an innovative program designed to provide nurse educators with state-of-the-art cancer knowledge to enhance their ability to teach cancer content. The Faculty Fellows Program was developed at the University of Louisville School of Nursing and was part of a multifaceted educational intervention to improve cancer nursing education. This intervention included comprehensive curriculum reviews, conferences with national consultants, cancer-specific faculty seminars, and funded instructional projects. The Faculty Fellows Program consisted of a mentored experience attending the Oncology Nursing Society Congress and a month-long intensive program to provide faculty with exposure to cancer experts, researchers, and clinical and community resources. By providing a forum for nurse educators to obtain this knowledge and provide the resources they need to change the way they educate nursing students, the program can significantly affect cancer-related nursing education and, ultimately, the care of patients with cancer and survivors.     

Understanding the cervical screening behaviour of Chinese women: The role of health care system and health professions

BackgroundIn China, cervical cancer cases are increasing, making an impact on the worldwide burden of cervical cancer. Despite the initiatives undertaken by the Chinese government, the current coverage of cervical screening in China remains suboptimal. There is an urgent need to identify the facilitators and barriers associated with the uptake of cervical cancer screening among the Chinese population.PurposeThe study aimed to explore the experiences and perceptions of cervical cancer screening of mainland Chinese women in relation to their screening behaviour, particularly in the aspects of health care system and health profession roles.MethodsA qualitative research was conducted using semi-structured interviews. A total of 27 Chinese women aged 25 to 50 (both screened and non-screened women) completed the interviews. The analysis of the interview data was undertaken inductively using latent content analysis.Discussion and conclusionResults showed that organised health examination programmes provide a good basis for integrating cervical screening into broader checks on the health of women, and utilising different networks of social support facilitate the utilisation of the screening service. However, education on cervical cancer and screening must be made more generally available. More importantly, there is a need for a more participatory and empowering exchange in the encounter between health professions and these women. Appropriate training program is strongly recommended for health professions about communicate skills with patients. Future work should focus on identifying strategies to overcome the barriers to cervical screening related to health care system and medical professions among this population.     

女性宫颈癌早期筛查认知程度的调查分析

目的 了解妇科门诊就诊女性对宫颈癌早期筛查的认知程度.方法 选取1 590例门诊就诊女性,采用自设问卷进行认知程度调查.结果 知道宫颈癌的占96.60％.城市女性对宫颈癌知识的认知程度高于农村;文化程度越高的女性对宫颈癌知识的认知程度越高,差异均具有统计学意义(P＜0.01).结论 女性对宫颈癌早期筛查重要性的认知程度...     

Efficacy and cost-effectiveness of nationwide cervical cancer screening in Taiwan

The annual cervical screening programme using the Papanicolaou (Pap) smear test was launched for women aged 30 years and over from 1995 in Taiwan. This study aimed to evaluate the Taiwanese cervical screening policy and to make recommendations based on the empirical findings from cervical screening data between 1995 and 1998. We used a stochastic process to model the natural history of precancerous lesions and cervical cancer. Based on the estimated results, Monte-Carlo computer simulation was used to evaluate the effectiveness in terms of the reduction in incidence of and mortality from cervical cancer for screening regimes with different screening intervals. Annual Pap smear screening with 100% compliance was estimated to lead to an approximate 80% reduction in deaths from cervical cancer. With 50% compliance, around a 40% reduction was expected. Triennial screening with high compliance was as effective as annual screening with low compliance, and more cost-effective. Based on the observed Taiwan Pap smear-screening programme between 1995 and 1998, with 44.5% women attending at least once, there was an estimated reduction of 16% in deaths from cervical carcinoma. The estimated effectiveness was greater when the period was extended to 2001, in which period 61% of women attended at least once. The screening programme by 2001 was estimated to reduce cervical cancer mortality by 50% (95% confidence interval: 29-65%). The incremental cost-effectiveness was estimated as 8174 dollars per additional life-year gained. In conclusion, triennial screening targeting women aged 30-69 is recommended, along with efforts to enhance the compliance rate.     

Knowledge, barriers, and motivators related to cervical cancer screening among Korean-American women. A focus group approach

Cervical cancer is a significant health problem for Korean-American women. It currently is the number one female cancer diagnosed among women in South Korea. Despite this fact, Korean-American women have very low rates of cervical cancer screening. The purpose of this research were to gain an understanding of Korean women's knowledge about cervical cancer, and to identify major barriers to early screening for cervical cancer and the motivators for prevention and early detection. It is hoped that the findings will guide the development of community-based cervical cancer education and screening programs for adult Korean-American women. The health belief model (HBM) provided the theoretical basis for the study. A qualitative study with eight focus groups (n = 102) was conducted using 11 questions derived from the HBM. Focus group discussions revealed that there was misinformation and a lack of knowledge about cervical cancer. The women therefore were confused about the causative factors and preventive strategies related to cervical cancer. The findings showed that major structural barriers were economic and time factors along with language problems. Many participants were recent immigrants with no medical insurance and long work hours. The main psychosocial barriers were fear/fatalism, denial, and Confucian thinking. Participants stated that medical advice and education would influence them most to undergo a Pap test. Recommendations were made to reduce certain barriers and to increase knowledge and motivations.     

Towards improving cervical cancer screening in Nigeria: a review of the basics of cervical neoplasm and cytology

Cervical cancer screening is the key to reducing the incidence and mortality of cervical cancer in developing countries. In the absence of a national screening program, healthcare givers in Nigeria are encouraged to routinely inform and screen eligible women. This review aims at equipping health workers for this task by re-educating them on the basics of the disease and its screening by cytology. Relevant texts and online databases including Pubmed, African Journal Online, and Google Scholar, were searched for relevant literature on the subject area. Persistent infection by a high-risk human papilloma virus, especially types 16 and 18, is necessary for the development of cervical cancer. The exfoliation of cells from the metaplastic squamous cells of transformation zone of the cervix is the basis of cervical cytology. Organized Pap screening reduces the incidence and mortality of cervical cancer, but screening protocols vary. Nevertheless, annual screening is not recommended except for high-risk women such as HIV-positive women. Abnormal Pap smear results are currently reported using either the Bethesda System or the British Society for Clinical Cytology classification, and colposcopy with or without biopsy are necessary when indicated. In conclusion, the use of cervical cytology to detect pre-cancerous lesions followed by an appropriate treatment when necessary is the key to reducing invasive cervical cancer. The task of provider-initiated counseling and testing for cervical cancer by health practitioners requires update on the current etio-pathology of cervical cancer, and its screening as reviewed.     

上海市妇女对乳腺癌及其早期筛查认知情况的调查

目的了解上海市妇女对于乳腺癌及早期筛查的认知情况和获取相关信息的来源。方法采用乳腺癌及其早期筛查的知识问卷和有关信息来源的问卷对739名妇女进行调查。结果92%的妇女知道乳房肿块是乳腺癌的早期症状,有98.1%和95.7%的妇女认为乳腺自我检测和乳腺临床检查可以早期发现乳腺癌,只有26.7%和24.6%的妇女知道肥胖和年龄是乳腺癌的高危因素。居住在市区、文化程度高的妇女,乳腺癌的认知情况较好(P<0.01)。目前妇女了解乳腺癌早期筛查知识的渠道主要是通过报纸或杂志(43.3%),55.2%的人最想从医师或护士处得到相关信息,同时也有45.3%的人认为从医师或护士处得到的信息最有助于她们做出早期筛查的决定。结论妇女对于乳腺癌及早期筛查知识的掌握程度分布不均,传媒要加强对乳腺癌早期筛查的宣传,护理人员要加强有关的健康教育,针对不同人群实施有效的健康指导,以提高妇女的认知水平。     

Cervical cancer screening among vulnerable women: Factors affecting guideline adherence at a community health centre in Toronto, Ont

Objective

To see if refugee women at a community health centre (CHC) in Toronto, Ont, are appropriately screened for cervical cancer and if there are any demographic characteristics that affect whether they are screened.

Design

Chart review.

Setting

A CHC in downtown Toronto.

Participants

A total of 357 eligible refugee women attending the CHC.

Main outcome measures

Papanicolaou test received or documented reason for no Pap test.

Results

Ninety-two percent of women in the study sample were either appropriately screened for cervical cancer or had been approached for screening. Eighty percent of women were appropriately screened. Demographic variables including pregnancy, being uninsured, not speaking English, recent migration to Canada, and being a visible minority did not affect receipt of a Pap test after migration in multivariate analyses. Not speaking English was associated with a delay to receiving a first Pap test after migration.

Conclusion

The clients at our centre are demographically similar to women who are typically overlooked for Pap tests in the greater Toronto area. Despite belonging to a high-risk population, refugee women in this multidisciplinary CHC were screened for cervical cancer at a higher rate than the local population.     

The health-care practices of Vietnamese-Canadian women: cultural influences on breast and cervical cancer screening.

Breast and cervical cancer are major contributors to morbidity and mortality among Vietnamese-Canadian women. Vietnamese women are at risk due to their low participation rate in screening programs for these cancers. The purpose of this exploratory qualitative study, informed by Kleinman's Exploratory Model of Health and Illness, was to explore the participation of Vietnamese-Canadian women in screening for breast and cervical cancer; the appropriateness of current cancer-prevention services for Vietnamese women; and the influence of social, cultural, political, historical, and economic factors, shaped by race, gender, and class, on the screening practices of Vietnamese-Canadian women. Fifteen Vietnamese-Canadian women and 6 health-care providers were interviewed. Analysis revealed that several factors influenced the women's participation in cancer screening. This paper reports on the process by which cultural knowledge and beliefs contributed to the women's health-care practices. The study revealed that the following cultural factors influenced the women's level of participation in screening programs for breast and cervical cancer: cultural knowledge and values with regard to women's bodies, conceptualization of health and illness, and beliefs and values concerning the patient/health-care provider relationship. The author offers recommendations on the promotion of screening for breast and cervical cancer among Vietnamese-Canadian women.