Predictors of cervical cancer screening for Chinese American women.

Research on Chinese American women's cervical cancer screening behaviours is limited and there are few studies that examine factors associated with obtaining regular Pap tests. The purpose of this study was to use the transtheoretical model (TTM) as a framework to examine correlates of Pap testing and stages of change. Chinese American women (N = 121) were recruited to complete a cross-sectional, self-report survey. Survey items assessed stages of change, self-efficacy, perceived benefits and barriers, and demographic variables including screening and family history for cervical cancer. Eighty-one per cent of women reported that they had ever had a Pap test. Most participants were in the maintenance stage (55%), with 10% in each action and pre-contemplation, 8% in contemplation, 1% in preparation and 16% in the relapse stage. Women in the action/maintenance stage were more likely to be older, married and have a higher education level. Women in the action/maintenance stage had significantly lower perceived barrier scores compared to women in both the contemplation/preparation and pre-contemplation/relapse stages. Findings partially support the use of TTM for cervical cancer screening among this population and indicate the importance of perceived barriers. Results may inform interventions to increase screening rates among Chinese American women.

HIV knowledge and condom intention among sexually abstinent Chinese students.

AIMS: To (a) assess the HIV/AIDS knowledge and sources of HIV/sexually transmitted infection (STI) information among sexually abstinent college students in China; (b) examine whether constructs from the transtheoretical model (TTM) are applicable to this study population regarding condom use intention; and (c) evaluate the association between genders and TTM constructs, and HIV/AIDS knowledge. BACKGROUND: Chinese college students are vulnerable to HIV and other STIs. Strategies targeting abstinent students are more cost-effective than providing treatment for diseases. METHODS: We surveyed 390 students enrolled in two universities in China. Data were collected from June 2009 to March 2010. RESULTS: Only 11% and 24% were aware of HIV spread by infected semen and of the protective effects of condom use against HIV. The mass media were major sources of HIV/STI information. Individuals who had higher levels of self-efficacy and reported more perceived benefits and fewer perceived barriers were more likely to be in TTM contemplation stage of condom use than those in precontemplation. Females were less likely to discuss HIV/STIs through online chat or email with strangers than males. Individuals who had higher levels of self-efficacy and reported more perceived benefits and fewer perceived barriers were more likely to be in TTM contemplation stage of condom use than those in precontemplation. CONCLUSION: Sexually abstinent college students in China may be more likely to transition from precontemplation to contemplation if they know the benefits of condom use for the prevention of HIV/STIs and if they learn to successfully minimize potential barriers related to condom use.

Stages of condom use and decisional balance among college students.

AIMS: To explore sexual behaviours and condom use and differences in specific items of perceived benefits and barriers to condoms using the Transtheoretical Model (TTM) stages among college students in southern Taiwan. BACKGROUND: The TTM suggests that individuals in the action or maintenance stage exhibit higher levels of perceived benefits and lower levels of perceived barriers related to condom use than people in the precontemplation, contemplation or preparation stage. METHODS: This was a descriptive, cross-sectional design with cluster sampling among college students from two universities in southern Taiwan. Participants completed self-administered questionnaires, including demographic data, Sexual History and Condom Use Scale and Condom Use Decisional Balance Scale. RESULTS: Of the 279 participants, 57% were sexually active, of these only 11.9% used condoms consistently. Respondents in the TTM stage of action/maintenance perceived greater benefits in relation to feeling more responsible (P = 0.031) and protecting their partners as well as themselves (P = 0.028), and perceived more barriers in believing that using condom needs to rely on partner's cooperation (P = 0.046) than participants in precontemplation. Participants in precontemplation and contemplation perceived more barriers related to worry about making their partner angry if condoms were used than those in action/maintenance (P = 0.008). CONCLUSION: Low levels of condom use among Taiwanese college students remain a significant public health concern. HIV prevention programmes for college students in Taiwan may be enhanced if they incorporate readiness to change and perceived benefits and barriers. Future research should include a larger sample with diverse groups.

Applying the transtheoretical model to cervical cancer screening in Vietnamese-American women.

BACKGROUND: Low levels of Papanicolaou (Pap) screening participation in Vietnamese-American women remain a significant public health problem. The transtheoretical model (TTM) suggests that individuals adopting Pap smear behaviour move through a series of stages of readiness to change. Determining a woman's level of readiness for regular Pap testing and identifying the screening behaviour that an individual already performs is important in the development of successful intervention programmes that address the specific needs of Vietnamese-American women in different stages. AIMS: To describe Pap smear screening behaviours of Vietnamese-American women, and to examine whether constructs (stages of change, self-efficacy and perceived benefits/barriers) from the TTM are applicable to Vietnamese-American women relative to Pap testing. METHODS: A descriptive, cross-sectional design with snowball sampling was used to recruit participants. A total of 80 Vietnamese-American women completed the self-administered questionnaire. RESULTS: Most respondents (62.5%) reported previous Pap testing and only 46.3% receiving regular Pap testing. Compared with those in the pre-contemplation stage of the TTM, participants in maintenance reported significantly less self-efficacy (F (3, 73) = 4.85, P = 0.00), a lower level of perceived barriers (F (3, 75) = 5.99, P = 0.00) and a higher level of perceived benefits (F (3, 76) = 3.91, P = 0.01) relative to Pap smear. CONCLUSIONS: The results support some of the assumptions of the TTM but raise questions about the predicted relationships between stages of change and self-efficacy. Continued research is needed to identify the most effective theory-based interventions for evidence-based nursing practice in this population.

Radiation therapy to non-iatrogenic subcutaneous metastasis in hepatocellular carcinoma: results of a case series.

Non-iatrogenic subcutaneous metastasis of hepatocellular carcinoma (HCC) is rare. The aim of this study was to determine the characteristics of such non-iatrogenic subcutaneous metastases and to review the results of radiation therapy. Patients with HCC who were referred for radiation therapy to a subcutaneous mass from 1 January 1998 to 31 December 2005 were reviewed. Iatrogenic cases were excluded. The patients' characteristics, the properties of the lesion, radiation treatment, treatment response, and survival were studied. 24 subcutaneous metastatic lesions in 21 patients were studied. The patients' mean age was 58.2 years. The average latency period for the occurrence of the metastases was 291 days. The scalp was the most frequent metastatic site. At least a partial response was achieved in 20 of 24 lesions (83.3%), with radiation doses ranging from 8 to 64 Gy. No severe sequelae were recorded. The overall 6-month survival was 43.4%. ECOG (Eastern Cooperative Oncology Group) performance status and radiation dose were statistically significant factors for local treatment response. Performance status was also an independent factor for survival. Radiation therapy of subcutaneous metastases of HCC can achieve satisfactory results, especially in patients with a good performance status.

Effects of an osteoporosis educational programme for men.

AIM: This paper reports an evaluation of the effects on knowledge, health beliefs and preventive behaviours of an osteoporosis educational programme for men. BACKGROUND: Osteoporosis is an increasing global health concern, and educational programmes have been identified as a crucial strategy in its prevention. However, the effectiveness of osteoporosis educational programmes has mainly been evaluated in women. METHODS: A randomized controlled trial was carried out to identify the effects of an osteoporosis educational programme for men. The study was conducted between September 2004 to February 2005, and 128 Hong Kong Chinese men were randomly assigned to an intervention or control group, with 64 in each group. The intervention group attended an osteoporosis educational programme. All participants completed pre- and post-test self-administered questionnaires: Osteoporosis Knowledge Test, Osteoporosis Health Belief Scale and Osteoporosis Self-Efficacy Scale. RESULTS: The intervention group showed a statistically significant increase in both knowledge (P < 0.0005) and health beliefs (P = 0.007) about osteoporosis and preventive behaviours in comparison with the control group. However, the difference in self-efficacy between the two groups was not statistically significant (P = 0.154). CONCLUSIONS: An osteoporosis educational programme can increase men's knowledge levels and change their health beliefs about osteoporosis and preventive behaviours. This approach should be more widely used in nursing practice to promoting the adoption of osteoporosis prevention behaviours in men.