Kadınların Pap Smear Testi Yaptırma Durumlarının Sağlık İnanç Modeli Ölçeği ile Değerlendirilmesi

Amaç: Bu çalışmada, kadınların Pap Smear testi yaptırmaya ilişkin inançlarının değerlendirilmesi amaçlanmıştır.Yöntem: Bu çalışma tanımlayıcı bir araştırma olarak, Ekim ve Aralık 2013 tarihleri arasında, Karaman Halk Eğitim Merkezinde, çalışmaya katılmayı kabul eden 485 kadın ile yürütülmüştür. Veriler “Veri Toplama Formu” ve “Sağlık İnanç Modeli Ölçeği” kullanılarak toplanmıştır.Bulgular: Kadınların %30.3’ünün Pap Smear testi yaptırdığı saptanmıştır. Pap Smear testi yaptırma ile eğitim düzeyi ve çalışma durumu arasında anlamlı ilişki bulunmuştur (p<0.05). Pap Smear testi yaptıran kadınlarda Sağlık İnanç Modeli Ölçeği alt gruplarından ciddiyet, yarar/motivasyon, sağlık motivasyon puan ortalamaları yüksek iken, engel puan ortalamalarının düşük olduğu belirlenmiştir (p<0.05). Katılımcıların %92’si servikal kansere yakalanma risklerinin olmadığını, %77.5’i ise Pap Smear testi yaptırmasını gerektirecek herhangi bir şikayetinin olmadığını belirtmiştir. Testin yapılmasına ilişkin en önemli engel ise utanma (%48.4) ve kadın hekim isteği (%64.4) olarak saptanmıştır. Sonuç: Bu çalışmada katılımcıların Pap Smear testi yaptırma deneyimlerinin sınırlı olduğu ve orta düzeyde engellerinin bulunduğu belirlenmiştir. Bu nedenle, bu çalışma bulgularının, kadınların Pap Smear testi yaptırmaya ilişkin engellerinin giderilmesine yönelik girişimlerin planlanması açısından değerli olduğu düşünülmektedir.

Anahtar Kelimeler:

Pap Smear test, servikal kanser, Sağlık İnanç Modeli

Evaluation of Women Having Pap Smear Test by Health Belief Model Scale

Objective: The aim of this study was to evaluate the women’s beliefs about having Pap Smear test.Method: This study was planned as a descriptive cross-sectional research. This study was conducted between the dates of October 2013 and December 2013 at a Public Education Center in Karaman city. The survey has been carried out by 485 women who accepted to participate in the survey. The data were collected with a “Data collection form” developed by the researcher and with the Health Belief Model Scale for Pap Smear Test.Results: About thirty percent of the women reported to have a Pap test. There was a relation between the education level, working status and having a Pap test (p<0.05). It was found that while the average points of subgroups (seriousness, usefulness/motivation, health motivation) of Health Belief Model Scale were higher, the average values of barrier points were lower (p<0.05). 92% of participants said that they had no risk on cervical cancer and 77.5% said no complain to have a Pap Smear test. The major frequent barriers were embarrassment (48.4%) and desire for female doctor (64.4%).Conclusion: The rate of making Pap Smear test has been still in a very low level. There are middle level barriers. This survey is important to plan to do the things to reduce the barriers about Pap Smear test.

Keywords:

Pap Smear test, cervical cancer, Health Belief Model,

PDF

___

World Health Organization. (2012). Cancer. Available at: http://www. who.int/mediacentre/ factsheets/fs297/en/index.html. Erişim Tarihi: Ekim 2013.
WHO/ICO (2010) Fact Sheet 2010 Available at: http://apps.who. int/hpvcentre/statistics/dynamic/ico/country_pdf/tur_fs.pdf. Erişim Tarihi: Temmuz 2010.
Bebiş H, Reis N, Yavan T, Bayrak D, Ünal A, Bodur S. Effect of health education about cervical cancer and papanicolaou testing on the behavior, knowledge and beliefs of Turkish women. Int J Gynecol Cancer. 2012;22(8):1407-1412.
Gokaslan H, Uyar EE. Pap Smear ile servikal kanser taraması. Türk Aile Hek Der. 2004;8(3):105-110.
Guner H, Taskıran C. Serviks kanseri epidemiyolojisi ve human papilloma virus. J Turk Soc Obstet Gynecol. 2007;4(1):11-19.
ACOG Committee Opinion. Recommendations on frequency of Pap test screening. Committee on Gynecologic Practice. American College of Obstetricians and Gynecologists. Int J Gynaecol Obstet. 1995; 49(2):210-211.
Canavan TP, Doshi NR. Cervical cancer. Am Fam Physician. 2000;61(5):1369-1176.
Brotto LA, Chou AY, Singh T, Woo JS. Reproductive health practices among Indian, Indo-Canadian, Canadian East Asian, and Euro- Canadian women: the role of acculturation. J Obstet Gynaecol Can. 2008;30(3):229-238.
Parkin DM, Bray F, Ferlay J, Pisani P. Global cancer statistics. CA Cancer J Clin. 2002; 55(2):74-108.
Waxman AG. Guidelines for cervical cancer screening: history and scientific rationale. Clin Obstet Gynecol. 2005;48(1):77-97.
Sawaya GF, Brown AD, Washington AE, Garber AM. Clinical practice: current approaches to cervical-cancer screening. N Engl J Med. 2001;344(21):1603-1607.
McGovern PG, Lurie N, Margolis KL, Slater JS. Accuracy of self-report of mammography and Pap Smear in a low-income urban population. Am J Prev Med. 1998;14(3):201-208.
Güvenç G, Akyüz A, Açıkel CH. Health belief model scale for cervical cancer and Pap Smear test: psychometric testing. J Adv Nurs. 2010;67(2):428-437.
Paskett ED, Tatum C, Rushing J, Michielutte R, Bell R, Foley KL, Bittoni M, Dickinson S. Racial differences in knowledge, attitudes, and cancer screening practices among a triracial rural population. Cancer. 2004;101(11):2650-2659.
McMullin JM, De Alba I, Cha’vez LR, Hubbell FA. Influence of beliefs about cervical cancer etiology on Pap Smear use among Latina immigrants. Ethn Health. 2005;10(1):3-18.
Lee EE, Tripp-Reimer T, Miller AM, Sadler GR, Lee SY. Korean American women’s beliefs about breast and cervical cancer and associated symbolic meanings. Oncol Nurs Forum. 2007;34(3):713-720.
McFarland DM. Beliefs about the causes of cervical cancer in Botswana: implications for nursing. Int Nurs Rev. 2009;56(4):426-432.
Glanz K, Rimer KR, Viswanath K. Health behavior and health education; Theory, Research and Practice. 4th edition. San Francisco, USA: Jossey- Bass. 2008, p.45-62.
Birhanu Z, Abdissa A, Belachew T, Deribew A, Segni, H., Tsu V, Mulholland K, Russell FM. Health seeking behavior for cervical cancer in Ethiopia: a qualitative study. Int J Equity Health. 2012;29:11,83.
Pender NJ. Health promotion in nursing practice. 2nd ed. Norwalk, CT:Appleton&Lange 2008, p.25-50.
Akyuz A, Guvenc G, Yavan T, Çetintürk A, Kök G. Kadınların Pap Smear yaptırma durumları ile bunu etkileyen faktörlerin belirlenmesi. Gulhane Med J. 2006;48:25-29.
Aydoğdu NG, Bahar Z. Yoksul kadınlarda Sağlık İnanç Modeli ve Sağlığı Geliştirme Modeli kullanımının meme ve serviks kanseri erken tanı davranışlarındaki değişime etkisi. DEUHYO e.d. 2011;4(1):34-40.
Karaca M, Palancı, Y, Aksu SR. Pap Smear ne kadar biliniyor, ne kadar uygulanıyor? Turk Klin Obstet Jin. 2008;18(1):22-28.
Reis N, Bebis H, Köse S, Sis A, Engin R, Yavan T. Knowledge, behavior and beliefs related to cervical cancer and screening among Turkish women. Asian Pac J Cancer Prev. 2012;13(4):1463-1470.
Esin MN, Bulduk S, Ardıç A. Beliefs about cervical cancer screening among Turkish married women. J Cancer Educ. 2011;26(3):510-515.
Champion VL. Instrument refinement for breast cancer screening behaviors. Nurs Res. 1993;42(3):139-143.
Byrd TL, Peterson SK, Chavez R, Heckert A. Cervical cancer screening beliefs among young Hispanic women. Prev Med. 2004;38:192-197.
Nguyen TT, McPhee SJ, Nguyen T, Lam T, Mock J. Predictors of cervical Pap Smear screening awareness, intention, and receipt among Vietnamese-American women. Am J Prev Med. 2002;23(3):207-214.
Juon HS, Seung-Lee C, Klassen AC. Predictors of regular Pap Smear’s among Korean-American women. Prev Med. 2003;37(1):585-592.
Sirowich BE, Woloshin S, Schwartz LM. Screening for cervical cancer: will women accept less? Am J Med. 2005;118(2):151-158.
Kesic V, Markovic M, Matejic B, Topic L. Awareness of cervical cancer screening among women in Serbia. Gynecol Oncol. 2005;99(1):222- 225.
Özmen D. Developing a scale to examine attitudes toward early diagnosis of cervical cancer by using Health Belief Model as a theoretical framework. Doctorate Dissertation, Ege University Health Science Institution. Izmir, Turkey. 2004.
Yücel U. Evaluating the effectiveness of training given to women concerning the risk factors of and prevention from the cervical cancer. Master Dissertation, Ege University Health Science Institution. İzmir, Turkey. 2006
Matin M, LeBaron S. Attitudes toward cervical cancer screening among Muslim women: a pilot study. Women Health. 2004;39(3):63- 77.
Markovic M, Kesic V, Topic L, Matejic B. Barriers to cervical cancer screenings: a qualitative study with women in Serbia. Soc Sci Med. 2005;61(12):2528-2535.
Ackerson K, Gretebeck K. Factors influencing cancer screening practices of underserved women. J Am Acad Nurse Pract. 2007;19(11):591-60.
Jirojwong S, Maclennan R, Manderson L. Health beliefs and Pap Smear’s among Thai Women in Brisbane, Australia. Asia Pac J Public Health. 2001;13(1):20-23.
Agurto I, Bishop A, Sanchez G, Betancourt Z, Robles S. Perceived barriers and benefits to cervical cancer screenings in Latin America. Prev Med. 2004;39(1):91-98.
Güvenç G, Akyüz A, Yenen MC. Effectiveness of nursing interventions to increase Pap Smear test screening. Res Nurs Health. 2013;36(2):146- 157.
Ersin F, Bahar Z. Barriers and facilitating factors perceived in Turkish women’s behaviors towards early cervical cancer detection: A qualitative approach. Asian Pac J Cancer Prev. 2013;14(9):4977-4982.
Kwok CK, Roydhouse JK. Chinese-Australian women’s knowledge, facilitators and barriers related to cervical cancer screening: A qualitative study. J Immigr Minor Health. 2011;13(6):1076-1083.
Rajaram SS, Rashidi A. Asian-Islamic women and breast cancer screening: a socio-cultural analysis. Women Health. 1999;28(3):45-58.
Wong LP, Wong YL, Low WY, Khoo EM, Shuib R. Knowledge and awareness of cervical cancer and screening among Malaysian women who have never had a Pap Smear: a qualitative study. Singapore Med J. 2009;50(1):49-53.
Hewitt M, Devesa SS, Breen N. Cervical cancer screening among us women: Analyses of the 2000 national health interview survey. Prev Med. 2004;39(2):270-278.