ABSTRACT
BACKGROUND Cervical cancer is the fourth most fatal and common disease globally among women of reproductive age in Kenya; it ranks the second most frequent type of cancer after breast cancer. Due to the high burden, cryotherapy treatment services, which are effective for the treatment of precancerous lesions are available in selected health facilities in Kenya, however, barriers to the treatment services are poorly understood. Nonetheless, understanding these barriers is critical for enhanced service delivery. MATERIALS AND METHODS :A descriptive facility-based cross-sectional study design was carried out to determine the barriers to cryotherapy treatment services among 60 women of reproductive age on a one-year therapy at Migosi Sub County Hospital in Western Kenya. The participants were selected purposively and interviewed via telephone calls using pre-coded semi-structured questionnaires. However, data from 5 nurses working in the cryotherapy section were collected through face-to-face interviews at the health facility. Data were entered in an excel sheet and then exported to SPSS version 23.0 for analysis. Both descriptive and inferential statistics (Chi-square) were used and data were presented in form of tables. RESULTS :Overall, 52 (85.4%) respondents adhered to post-care treatment instructions and reported no adverse reactions. However, 28 (46.7%) experienced unavailability of cryotherapy services at the time of the appointment and got the services later, 24 (40%) got the services at the time of the appointment but waited for a long time before being served, 37 (61.7%) did not know why they were being treated and 46 (76.7%) had misconceptions and myths about the therapy. In addition, there was a statistically significant association between knowing both the benefits of screening and cryotherapy [X 2 (1, N = 60) = 5.90, p = .02]. Also, the knowledge of the benefits of cryotherapy did not influence one's decision to wait for cryotherapy treatment services, [X 2(1, N = 60) = 3.98, p = .46]. CONCLUSION : The study shows very good adherence to post-treatment instruction but inadequate availability of cryotherapy treatment services. Also, the misconceptions and myths about cryotherapy are public health concerns. Therefore, the study recommends improved awareness campaigns and service delivery for the enhanced uptake of cryotherapy treatment services.
Subject(s)
Humans , Female , Precancerous Conditions , Attitude to Health , Uterine Cervical Neoplasms , Cryotherapy , Therapeutic Misconception , Treatment Adherence and ComplianceABSTRACT
@#Introduction: The elderly population are susceptible to malnutrition due to many factors. Hence, timely malnutrition identification through nutrition screening needs to be performed routinely in health clinics. However, the nutrition screening practice in health clinics need to be improvised for malnutrition identification among the elderly population. This study identifies barriers and opportunities for nutrition screening in elderly patients in health clinic settings. Method: A qualitative study was conducted among healthcare staff from urban and rural health clinics in Kuantan, Pahang, Malaysia. In-depth individual interviews were performed, audio-recorded and transcribed verbatim. Non-participant observations that act as triangulation were conducted among elderly patients (aged ≥60 years) attending the sampled health clinics. Both data from the interviews and observations were analysed thematically using NVivo software. Results: Twenty healthcare staff participated in the interviews were medical officers (n=6), medical assistants (n=8), staff nurses (n=4), and community nurses (n=2) with a mean age of 33.7±6.3 years. Twenty- one elderly patients were involved in non-participant observations. The four themes that emerged as barriers and opportunities were: time, patient factors, organisation factors and nutrition screening knowledge. Time constituted the main barrier, whilst incorporating a validated nutrition screening tool into current health screening practices was identified as the most practical approach to performing nutrition screening. Staff also highlighted the need for appropriate guidelines for implementing nutrition screening. Conclusion: This study identified appropriate approaches to implementing nutrition screening among elderly patients in health clinics. Developing a comprehensive nutrition screening guideline may facilitate healthcare staff in performing nutrition screening.
ABSTRACT
OBJETIVO: en Colombia el cáncer de cuello uterino (CaCu) es el segundo más común en las mujeres con una incidencia estandarizada de 21,5/100.000. En este estudio se examinaron el conocimiento y los factores percibidos asociados con el tamizaje de CaCu en mujeres de nivel socioeconómico bajo/ medio en Bogotá, Colombia. METODOLOGIA: 10 grupos focales segmentados por grupos de edad (18-33, 34-49 y 50-66). Dos investigadores realizaron análisis de contenido, identificando categorías emergentes. RESULTADOS: participaron 81 mujeres entre 18 y 66 años. Aunque se encontraron diferencias por grupos de edad, el inicio temprano de la actividad sexual, promiscuidad, infecciones vaginales, VPH, genética, abortos y falta de higiene, fueron identificados como los principales factores de riesgo para CaCu. Ellas reconocieron que esta enfermedad no siempre tiene síntomas, y que las citologías la detectan tempranamente. Sin embargo, mencionaron miedo a practicarse la citología, incomodidad/dolor, pena, mala atención, procrastinación y miedo al diagnóstico de cáncer como las principales barreras para el tamizaje rutinario. Las mujeres recomendaron campañas educativas y mejorar el servicio como estrategias para motivarlas. CONCLUSION: las participantes reportaron conocimientos básicos acerca del CaCu y el tamizaje. Las acciones para facilitar el tamizaje deben ser multifacéticas y acordes con las barreras y facilitadores reportados en cada grupo etario.
OBJECTIVE: in Colombia, cervical cancer (cc) is the second most common type of cancer among women. It has an agestandardized incidence of 21.5/100,000. The purpose of this study was to examine the knowledge and perceived factors associated with CC screening among women from low medium income status in Bogotá, Colombia. METHODOLOGY: the study was conducted with 10 focus groups segmented by age groups (18-33, 34-49, and 50-66). Two researchers conducted content analysis and identified the emerging categories. RESULTS: the sample consisted of 81 women whose ages ranged from 18 to 66. Early onset of sexual activity, promiscuity, vaginal infections, hpv, genetics, abortions, and lack of hygiene were identified as the most important risk factors for cc. Participants recognized that this disease does not always have symptoms, and that pap smears detect it early. However, they mentioned fear of undergoing a pap test, discomfort or pain, embarrassment, poor services, procrastination, and fear of a cancer diagnosis as the main barriers preventing regular screening. Women recommended educational campaigns and improved customer service as strategies to motivate them. CONCLUSION: participants reported basic knowledge about CC and screening. Actions to facilitate screening must be multifaceted and based on the barriers and facilitators mentioned by each age group.