Knowledge and attitudes as predictors of cervical cancer screening among women in a Venezuelan urban area / Conocimientos y actitudes como predictores en la pesquisa del cuello uterino en mujeres en un área urbana venezolana

The purpose of this research was to investigate how the knowledge and attitudes have influence in Cervical Cancer (CC) screening among Venezuelan women, by realizing a cross-sectional descriptive study based on a structured non disguised questionnaire with closed ended questions: yes/no questions and multiple choices. The survey was performed on 691 volunteers, of which 595 were analyzed. Each patient was asked to fill in the questionnaire. Four hundred ninety three of 522 (94.4%) answered that they knew that Pap smear is for screening CC. Knowledge of Pap smear was statistically significant when it was compared to high educational level (p<0.0001) although 185 (76%) of 244 low educational level interviewees answered that they had the knowledge that the Pap smear is used for screening of CC. Four hundred four of 504 (84.7%; p<0.001) mentioned that they had a Pap smear at least once. One hundred ninety two (38.1%) of 504 women were adherent to an annual Pap smear test and more than half of the women (n=337, 67%) had the last Pap smear in the last 1-3 years. Women with a high educational level showed higher adherence to the annual Pap smear screening (68.2%). Two hundred fifty seven (87.4%) of 294 said that they remembered when they got the information about Pap smear. The conclusions of this investigation were that our women were aware about Pap smear, had a good attitude to have a Pap smear and to be adherent to a regularly performed screening.

El objetivo de este estudio fue investigar como el conocimiento y las actitudes que poseen las mujeres venezolanas son elementos que influencian la pesquisa del Cáncer del Cuello Uterino (CCU). La investigación consistió en un estudio descriptivo transversal basado en un cuestionario estructurado no disfrazado con preguntas cerradas, usando respuestas si/no y múltiple escogencia. Se entrevistaron 691 mujeres; 595 fueron analizadas. Cada paciente llenó el cuestionario. Cuatrocientos noventa y tres de 522 (94,4%) respondieron que sabía que la citología cervico-vaginal (CCV) es para la pesquisa del CCU. El conocimiento sobre la utilidad de la CCV fue estadísticamente significativo cuando se comparó el nivel educacional de las entrevistadas (p<0,0001), sin embargo, 185 (76%) de 244 mujeres con bajo nivel educacional respondieron que ellas tenían el conocimiento sobre la utilidad de la CCV en la pesquisa del CCU. Cuatrocientos cuatro de 595 (84,7%; p<0,001) mencionaron que ellas se había realizado al menos una CCV. Ciento noventa y dos de 504 entrevistadas (38,1%) se realizaban una CCV anual y más de la mitad (n=337, 67%) de ellas se practicaban la CCV entre 1-3 años. Las mujeres con un nivel educacional elevado fueron más inclinadas a realizarse su CCV anual (68,2%). Doscientos cincuenta y siete (87,4%) de 294 entrevistadas mencionaron que ellas recordaban cuando se enteraron de la utilidad de la CCV. Las conclusiones de esta investigación fueron que nuestras mujeres están concientes de la utilidad de la CCV, tienen una buena actitud a realizársela, así mismo de practicársela regularmente.

Perceptions and concerns of women undergoing Pap smear examination in a tertiary care hospital of India.

Background: Cervical cancer is one of the major causes of deaths due to cancer among women in India. Pap smear is one of the best methods to detect early changes in cervix. However, there is lack of data on awareness level of women about Pap smear and various risk factors for cervical cancer. Objectives: To study the awareness about various risk factors for cervical cancer, health-seeking behavior and hygienic practices among women and to assess the distress experienced by these women before the Pap smear examination. Materials and Methods: This cross-sectional study was carried out on women coming for a Pap smear examination in a tertiary teaching hospital in New Delhi. A pretested interview schedule was used to get information after obtaining their informed consent. Results: Fifty-seven percent stated that they did not consult a doctor when they noticed the symptoms the first time. Sixty-one percent did not know what a cervical cancer is and a same percentage of women did not know what a Pap smear examination was. Older age group, Muslim and literate women had higher number of abnormal Pap smear results. Women who reported being stressed in their lives had higher number of abnormal smears as compared to women who claimed to lead a stress free life. Poor hygienic practices among these women from urban areas were also associated with abnormal Pap smear results. Conclusion: The study concluded that factors such as poor awareness, shyness, poor hygiene, and old age could be responsible for abnormal Pap smears and this needs special attention in cancer prevention activities of the government.

Exame Papanicolaou: sentimentos relatados por profissionais de enfermagem ao se submeterem a esse exame / Pap smear screening: sensations reported by nursing professionals when submitted to this test

Objetivou-se conhecer os sentimentos de auxiliares e técnicas de enfermagem ao se submeterem ao exame Papanicolaou. Trata-se de um estudo descritivo com abordagem qualitativa realizado nos meses de setembro a outubro de 2006, com 35 servidoras de uma instituição governamental referência em ginecologia na cidade de Fortaleza (CE). Os dados foram coletados através de entrevista semiestruturada, contendo uma questão norteadora gravada e analisada de acordo com referencial teórico metodológico da fenomenologia social. Os relatos foram agrupados em três temáticas: um exame que causa incômodo, medo e vergonha; um exame que gera ansiedade quanto aos resultados; e um exame que "me deixa calma e tranquila". Apesar de as entrevistadas pertencerem a uma instituição que cuida de mulheres na prevenção do câncer cérvico-uterino, elas não deixaram de emitir sentimentos negativos relacionados ao exame. Concluiu-se a importância de realizar projetos educativos, enfatizando a importância do empoderamento das usuárias a fim de minimizar essas questões.

This work sought to record the impressions of nursing assistants and technicians after submitting to Pap smear screening. This is a descriptive study using a qualitative approach conducted in September and October of 2006 with 35 employees of a public institution, which is a benchmark in gynecology in Fortaleza in the State of Ceará (Brazil). The data was collected through semi-structured interviews containing a recorded leading question and analyzed according to the methodological-theoretical reference of social phenomenology. The testimonials were separated in three groups: an exam that causes discomfort, fear and shame; an exam that causes anxiety about the results; and an exam that "makes me calm and relaxed". Despite the interviewees being part of an institution that cares for the prevention of cervical-uterine cancer in women, negative feelings about the Pap smear test were nonetheless reported. The conclusion reached is that it is important to stage educational campaigns emphasizing the importance of empowerment of patients in order to minimize these aspects.

Por qué las mujeres no se toman el papanicolaou? respuestas entregadas por los profesionales del programa cáncer cervicouterino - AUGE del Servicio de Salud Metropolitano Sur Oriente / Why women do not have the Pap smear?

Antecedentes: Los beneficios del test de Papanicolaou (Pap) en reducir la mortalidad de cáncer cervicouterino han sido bien documentados a nivel mundial y nacional. Sin embargo, aún persisten mujeres que no se realizan el Pap rutinariamente. Objetivo: Conocer la percepción que tienen los profesionales de la salud en relación a las causas por las cuales las mujeres no se toman la prueba del Pap. Método: Estudio descriptivo transversal, con una muestra de 59 profesionales del Servicio de Salud Metropolitano Sur-Oriente de la ciudad de Santiago, provenientes de los tres niveles de atención del programa cáncer cervicouterino AUGE. Resultados: Promedio de edad de los profesionales fue de 39,2 +/- 10,3 años. El tiempo promedio en el cargo es de 7,7 +/- 7,4 años. Un 41 por ciento de los profesionales de la salud tienen la percepción que las mujeres tienen un conocimiento parcial sobre la importancia de realizarse el Pap, mientras que un 48,3 por ciento refiere que las mujeres no tienen conocimiento sobres las normas de control de Pap. Falta de conocimiento, miedo, dejación y la falta de tiempo por parte de las mujeres surgen como las principales razones que los profesionales atribuyen a que las mujeres no se realicen el Pap. Conclusiones: Los resultados de este estudio pueden servir para diseñar y/o actualizar los contenidos educativos entregados a las mujeres con el propósito de aumentar el conocimiento y el nivel de conciencia sobre la importancia de la toma de esta prueba.

Background: Benefts of screening programs using Papanicolaou test (Pap test) reducing cervical cancer related mortality has been documented worldwide and at national level, in Chile. However, there are women who do not have a Pap test routinely. Objective: To know the perception of health care providers about the reasons why some women do not have a Pap smear. Method: Cross sectional study with a sample of 59 health care providers from the Servicio de Salud Metropolitano Sur-Oriente in Santiago, Chile; representing all the three different levels of care of the national health program called AUGE. Results: Health care providers were in average 39 +/- 10 years old, with an average of 7.7 +/- 7 years working in the health service. A 41 percent of the health care providers have the perception that women had a partial knowledge about the importance of having a Pap smear; while a 48.3 percent of them refer that women do not have knowledge related to the Pap. smear guidelines. Lack of knowledge, fear, neglect by women, and lack of time emerged as the principal reasons why women do not have a Pap smear based on health care provider's perception. Conclusions: The results from this research can help in designing and/or actualizing educative contents for women with the objective of increase the level of knowledge and the awareness about the importance in have a Pap smear.

Conhecimentos, atitudes e prática do exame de Papanicolaou por mulheres, Nordeste do Brasil / Knowledge, attitudes, and practices related to Pap test by women, Northeastern Brazil

OBJETIVO: Analisar conhecimentos, atitudes e práticas das mulheres em relação ao exame citológico de Papanicolaou e a associação entre esses comportamentos e características sociodemográficas MÉTODOS: Inquérito domiciliar com abordagem quantitativa. Foram entrevistadas 267 mulheres com idade de 15 a 69 anos, selecionadas de forma estratificada aleatória, residentes no município de São José do Mipibu, RN, em 2007. Utilizou-se questionário com perguntas pré-codificadas e abertas, cujas respostas foram descritas e analisadas quanto à adequação dos conhecimentos, atitudes e prática das mulheres em relação ao exame preventivo de Papanicolaou. Foram realizados testes de associação entre as características sociodemográficas e os comportamentos estudados, com nível de significância de 5%. RESULTADOS: Apesar de 46,1% das mulheres entrevistadas terem mostrado conhecimento adequado, proporções de adequação significativamente maiores foram observadas em relação às atitudes e prática quanto ao exame: 63,3% e 64,4%, respectivamente. O maior grau de escolaridade apresentou associação com adequação dos conhecimentos, atitudes e prática, enquanto as principais barreiras para a realização do exame relatadas foram descuido, falta de solicitação do exame pelo médico e vergonha. CONCLUSÕES: O médico é a principal fonte de informação sobre o exame de Papanicolau. Entretanto, mulheres que vão a consultas com maior freqüência, embora apresentem prática mais adequada do exame, possuem baixa adequação de conhecimento e atitude frente ao procedimento, sugerindo que não estejam recebendo as informações adequadas sobre o objetivo do exame, suas vantagens e benefícios para sua saúde.

OBJECTIVE: To assess the knowledge, attitudes and practices of women related to the Pap test and the association between these behaviors and sociodemographic characteristics. METHODS: A household survey with quantitative approach was conducted. A total of 267 women aged 15 to 69 years, randomly selected in a stratified manner, living in the city of São José de Mipibu, Northeastern Brazil, were interviewed in 2007. A questionnaire consisting of pre-coded open questions was administered and answers were described and analyzed, as for adequacy of knowledge, attitudes, and practices of women regarding the Pap test. Tests of association were carried out between sociodemographic characteristics and behaviors studied at a 5% significance level. RESULTS: Although 46.1% of the women interviewed showed adequate knowledge about the Pap test, a significantly higher proportion of adequacy was seen regarding attitudes and practices, 63.3% and 64.4%, respectively. Higher schooling was associated with adequacy of knowledge, attitudes, and practices. The main barriers to the Pap test were negligence, non-requesting by their physicians, and shame. CONCLUSIONS: The physician is the main source of information about the Pap test. However, women who more often attend medical visits, despite their good practice, show low adequacy of knowledge and attitudes related to the Pap test, which indicates that they are not receiving appropriate information on the test's purpose, advantages and benefits to women's health.

Por qué las mujeres no se toman el papanicolau: barreras percibidas por un grupo de mujeres ingresadas al Programa de Cáncer Cervicouterino AUGE / Perceptions and barriers about the Papanicolau (PAP) test: perspectives of a Chilean women group with premalignant lesions

Antecedentes: A comienzos de los 70, se introdujo en Chile el examen de citología cervical para la pesquisa precoz de cáncer cérvico uterino. La adherencia a este examen ha demostrado su utilidad para la pesquisa oportuna de la patología y para la disminución de la mortalidad. Objetivo: Examinar las percepciones que tiene un grupo de mujeres chilenas con lesiones preinvasoras de cuello uterino, sobre el Papanicolau. Método: Estudio descriptivo, cualitativo, transversal. Se entrevista a un grupo de 237 mujeres ingresadas al programa AUGE del Servicio de Salud Metropolitano Sur-Oriente, Santiago, Chile. Resultados: Las principales razones para no hacerse el Papanicolau y no acudir a buscar el resultado fueron: la falta de preocupación; los problemas relacionados al procedimiento como miedo, vergüenza, incomodidad y falta de tiempo; y la falta de conocimiento. Conclusión: Todas las razones dadas por las mujeres chilenas en este estudio, han sido descritas en la literatura internacional. Los profesionales de la salud están en situación de cambiar la perspectiva que las mujeres tienen y por lo tanto para mejorar la educación y la práctica del screening en las mujeres. Resultados de este estudio pueden servir de guía para desarrollar programas educativos y posteriormente ser aplicados en la práctica clínica.

Background: At the beginning of the 70s, the exam of cervical cytology was introduced in Chile. The adherence to this exam has demonstrated its utility for the opportune search of the pathology and mortality decrease. Objective: To examine perceptions about the Papanicolau (PAP) test from the perspectives of Chilean women with premalignant lesions. Method: Descriptive, qualitative, and cross-sectional study in a group of 237 women from AUGE program in the Southeast Metropolitan Public Health Service, Santiago, Chile. Results: The principal reasons for not having had a PAP test were procrastination; the problems related to the PAP test procedure like fear, embarrassment, discomfort, and lack of time; and lack of knowledge. Conclusion: All the reasons given by the Chilean women in this study have been described in the international literature. Health professionals are in a position to change the perspective that the women have, and therefore for increasing the education and cervical cancer screening for women. Results of this study can serve as a guide for education programs and can be applied in clinical practice.

Sentimentos e expectativas das mulheres acerca da Citologia Oncótica / Feelings and expectations of the women concerning Oncotic Citology

Trata-se de um estudo qualitativo cujo objetivo foi discutir e descrever os sentimentos e as expectativas vivenciadas por 28 mulheres quanto à citologia oncótica em uma unidade do Programa de Saúde da Família em Parnaíba-PI, através de uma entrevista com roteiro de questões abertas. Os resultados foram apresentados em categorias e constatou-se que a maioria das mulheres não realiza o exame, embora todas afirmem a importância deste, principalmente para detecção de doenças. Observou-se ainda que durante o procedimento, os sentimentos mais recorrentes entre as mulheres foram: timidez, insegurança, medo, vergonha e dor. Quanto às expectativas, elas anseiam um melhor atendimento dos profissionais, e um resultado que não apresente alterações, em especial o câncer.

Qualitative study whose objective was to argue and to describe the feelings and the expectations lived deeply for 28 women about oncotic citology in a unit of the Family Health Program in Parnaíba-PI, through an interview with script of opened questions. The results were presented in categories and evidenced that the majority of the women does not carry through the examination, even so they all affirm the importance of this, mainly for detention of illnesses. It was observed despite during the procedure, the feelings most recurrent between the women were: shyness, unreliability, fear, shame and pain. Related to the expectations, they wish a better attendance of the professionals, and a result that does not present alterations, in special the cancer.

Estudio cualitativo cuyo objetivo fue discutir y describir las sensaciones y las expectativas vivenciadas por 28 mujeres cuánto a la citología del oncótica en una unidad del Programa de Salud de la Familia en Parnaíba-PI, con una entrevista con la estrutura de preguntas abiertas. Los resultados fueran presentados en categorías y evidenciados que la mayoría de las mujeres no hacen la examinación, sin embargo todas afirmen la importancia de esto, principalmente para la detención de enfermedades. Fueran observados aun que durante el procedimiento, las sensaciones más recurrentes entre las mujeres había sido: timidez, inseguridad, miedo, vergüenza y dolor. Cuánto a las expectativas, ellas anhelan para una atención mejor de los profesionales, y un resultado que no presente alteraciones, en especial el cáncer.

Análise dos aspectos psicossociais e culturais que permeiam a realização do exame de citologia oncótica / Analysis of psychosocial and cultural aspects that involve the accomplishment of the examination of cancer cytology

Objetivamos identificar e analisar os aspectos psicossociais e culturais envolvidos na realização da citologia oncótica. Utilizamos o método clínico-qualitativo e a técnica de entrevistas com roteiro de perguntas semi-estruturadas com dez usuárias de uma unidade básica de saúde. Por meio da análise de conteúdo e do processo de categorização não apriorística, foram criadas categorias: a percepção das mulheres quanto à citologia oncótica; a motivação para a realização do exame preventivo; a questão do gênero na escolha do profissional; aspectos psicossociais e culturais que infuenciaram a busca da prevenção. Concluimos que os aspectos psicossoais e culturais envolvidos na realização desse exame são inúmeros, diferindo de acordo com sua inserção social, escolaridade, tabus culturais.

Cervical Cancer Screening in Korean American Women : Findings from Focus Group Interviews / 간호학회지

PURPOSE: Korean American women have twice the rate of cervical cancer than white women and demonstrate low rates in participation in cervical cancer screening. This study was to describe the perceptions about cervical cancer and factors related to cervical cancer screening among Korean American women. METHOD: Focus group methods. RESULT: Five themes emerged. First, knowledge about cervical cancer; misconceptions about cervical cancer, its causes, reproductive anatomy and the treatment Second, perceived meanings of having cervical cancer; most of the women felt that cervical cancer represented a loss of femininity and existential value of womanhood. Third, knowledge about cervical cancer screening ; regular medical check-ups were necessary for early detection and prevention of cervical cancer. Forth, experiences and perceived meanings of cervical cancer screening; the participants expressed their feelings; embarrassment, fear, shame and shyness. Fifth, practices of cervical cancer screening; various intervals in participating in cervical cancer screening. But they mentioned several deterrents, language, insurance, time constraint, embarrassment, fear of the screening results, misbelief about susceptibility, lack of health prevention behavior, and lack of information written in Korean. CONCLUSION: Results emphasize the critical need for culturally appropriate health education to encourage participation of Korean American women in cervical cancer screening.

Prevention of carcinoma cervix: role of Pap smear screening.

This study was undertaken to evaluate the prevalence of Cervical precancerous and Cancer pick up by single pap smear test. A prospective study of pap smear test of three years duration 2000-2002 in Obstetrics and Gynecology department, NMCTH, Kathmandu. A total 800 cases were included Maximum number of patients are in the age group of active reproductive period (21-40 yr) with higher rate of an abnormal smear in Brahmin ethnic group. The main complaints are of lower abdominal pain and white discharge per vaginum. The main cervical pathology is cervicitis, cervical erosion and cervical hypertrophied with bleeding on touch. 4.8% of the patients had abnormal smear including three patients with invasive cervical squamous cell carcinoma detected on pap smear test. This study shows that routine pap smear screening in patients attending gynecological OPD is the good method of detecting precancerous cervical intraepithelial neoplasia (CIN) lesion and early cervical cancer, which would go undiagnosed otherwise with worst morbidity and mortality. We should try to cover 100% screening if possible in an institution at least to begin with.

A gente se sente um pouco constrangida mas é preciso: o exame colpocitológico sob a ótica da mulher que o vivencia / We fell shame but its's necessary: the smear test under the pont of view of the woman who has who has experienced it in her life

Esta pesquisa é fruto de minha experiência com mulheres que frequentam o Programa de Prevençäo do Câncer Cérvico-uterino do Ambulatório de Ginecologia e Obstetrícia do Hospital das Clínicas da UFMG. Queria compreender o que significa para as mulheres se submeterem ao exame colpocitológico. Para essa compreensäo, utilizei-me da pesquisa qualitativa, numa abordagem fenomenológica. Para coletar os dados utilizei uma entrevista aberta com a questäo norteadora: Conta para mim o que foi para você fazer o exame de prevençäo...

Loss to follow-up of patients with abnormal Pap smear: magnitude and reasons.

We studied the magnitude and reasons for loss to follow-up in cases of abnormal Pap smears. We studied 162 women whose Pap smear results were abnormal. The lost follow-up rate was 41.1 per cent (95% CI: 33.1 to 49.3). Reasons for not coming to receive treatment was mostly related to communication such as not receiving informed letters from the hospital (35.6%), not understanding the messages in the informed letters (10.2%), were informed from the hospital's letters that their results were normal (5.1%), and perceiving that the test result was not serious (13.6%). One third of them had traveling-related reasons. There were 25.4 per cent of patients who sought treatment at other hospitals and 8.5 per cent went to see a traditional healer for treatment. The results provide information to prevent such unnecessary loss after having a Pap smear screening test for cervical carcinoma.

Prevençäo do câncer cérvico-uterino: uma compreensäo fenomenológica / The prevention of cancer of uterine cervix

Este trabalho surgiu de uma inquietaçäo amadurecida ao longo de minha trajetória profissional, ao verificar que um número considerável de mulheres que realizam o exame de prevençäo do câncer cérvico-uterino, näo retornam à instituiçäo para conhecer o resultado. Procurei entäo, pela fenomenologia, compreender essas clientes. Optei por essa abordagem por buscar a compreensäo do fenômeno em sua essência, ou seja, na vivência dessas mulheres. Para isso, trabalhei com 12 delas, entrevistando-as em suas residências. Para que as clientes fizessem o relato do seu mundo-vida, pedi-lhes que me falassem o que significava para elas a prevençäo do câncer cérvico-uterino. Numa imersäo feita nas falas dos sujeitos, foi possível chegar à compreensäo do fenômeno, que convergi em oito categorias que traduzem o significado para as clientes, da prevençäo do câncer cérvico-uterino e jogam alguma luz à compreensäo do näo retorno das mesmas ao serviço, para tomar conhecimento do resultado de seus exames. A realizaçäo deste trabalho levou-me a refletir näo apenas sobre a vivência das mulheres, mas também sobre o contexto de atendimento à mulher e sobre a projeçäo do ensino em uma outra dimensäo.