EVALUATION OF WOMEN’S BELIEFS ABOUT PAP SMEAR SCREENING USING THE HEALTH BELIEF MODEL SCALE

Abstract

Objective: To evaluate women’s beliefs about screening Pap smear test. Material and Method: The survey has been conducted through a questionnaire prepared by researchers, based on the Health Belief Model Scale for the Pap smear test. The participants consisted of 266 women between 18-70 years of age registered at a Family Health Center in Izmir. Their beliefs about screening Pap smear test were evaluated using the Health Belief Model Scale. Results: The mean age of first sexual intercourse was 21.67±4.5 (min:13--max:45 years), 86.5% reported a single partner and 41.0% of them (n=109) had never undergone a Pap smear test. Women who previously had a Pap smear test had high scores of sensitivity, seriousness, advantage and motivation, health motivation subscales, but the mean scores for obstacles were low. There was a difference between seriousness, health motivation subscales and taking the Pap smear test (p=0.021, p=0.006). The Mean scores of seriousness and health motivation of Health Belief Model Scale were higher. There was no difference between education level, working status and undergoing a Pap test (p>0.05). Conclusion: Having a Pap smear test is still moderately frequent and there are obstacles. Planning the interventions to eliminate Pap smear test barriers is an important issue for family physicians.

Keywords

• Health behaviour
• health belief
• cervical smear

KADINLARIN PAP SMEAR TARAMASINA İLİŞKİN İNANÇLARININ SAĞLIK İNANÇ MODELİ ÖLÇEĞİ İLE DEĞERLENDİRİLMESİ

Abstract

Amaç: Bu çalışmanın amacı kadınların Pap smear test taramasına ilişkin inançlarını değerlendirmektir. Gereç ve Yöntem: Araştırma, araştırmacı tarafından geliştirilen Pap smear testi için Sağlık İnanç Modeli Ölçeğini içeren bir anket aracılığıyla gerçekleştirilmiştir. Katılımcılar, İzmir’de bir Aile Sağlığı Merkezi’ne kayıtlı 18-70 yaş arası 266 kadındı. Pap smear testi taramasına ilişkin inançları Sağlık İnanç Modeli Ölçeği kullanılarak değerlendirildi. Bulgular: Ortalama ilk cinsel ilişki yaşı 21,67±4,5 (min:13-maks:45 yıl) idi, %86,5’i tek partner olduğunu ve %41,0’ı (n=109) hiç Pap smear testi yaptırmadığını ifade etti. Daha önce Pap smear testi yapılmış kadınların hassasiyet, ciddiyet, avantaj ve motivasyon, sağlık motivasyonu alt ölçek puanları yüksekti, ancak engeller ortalama puanları düşüktü. Ciddilik, sağlık motivasyonu alt ölçekleri ile Pap smear testi yapılması arasında fark vardı (p=0,021, p=0,006), Sağlık İnanç Modeli Ölçeği’nin ciddiyet ve sağlık motivasyonu puanları ortalamaları daha yüksekti (p<0,05). Eğitim düzeyi, çalışma durumu ve Pap testi yaptırmak arasında fark yoktu (p>0,05). Sonuç: Pap smear testi yaptırma durumu halen orta düzeydedir ve engeller bulunmaktadır. Aile hekimleri için Pap smear testini engelleyen nedenlerin ortadan kaldırılması için girişimlerin planlanması önemli bir konudur.

Keywords

• Sağlık davranışı
• sağlık inanışları
• servikal smear

References

1. 1. Latest world cancer statistics - GLOBOCAN 2012: Estimated Cancer Incidence, Mortality and Prevalence Worldwide in 2012. The International Agency for Research on Cancer (IARC). WHO 2013. Press Release No:223. https://www.iarc. fr/wp-content/uploads/2018/07/pr223_E.pdf
2. 2. The Ministry of Health of Turkey Health Statistics Yearbook 2014. Republic of Turkey Ministry of Health, General Directorate of Health Research: Ankara, 2015. Report No: 1009.
3. 3. Güner H, Taşkıran Ç. Epidemiology of cervical cancer and the role of Human Papilloma Virus Turk J Obstet Gynecol 2007;4(1):11-9.
4. 4. Gökaslan H, Uyar EE. Screening Cervical Cancer with Pap Smear. Turkish Journal of Family Practice 2004;8(3):105-10.
5. 5. Periodic Health Examinations and Screening Tests Recommended in Family Medicine Practice. Republic of Turkey Ministry of Health Turkey, Public Health Institution: Ankara, 2015. Report No: 991.
6. 6. Erkoç Y, Yardım N. Policies for Tackling Non-Communicable Diseases and Risk Factors in Turkey. Republic of Turkey Ministry of Health, Directorate General Primary Health Care: Ankara, 2011. Report No:809 Available from: https://www. saglikaktuel.com/d/file/ulke_raporu_baski_hali_en.pdf
7. 7. Bebis H, Reis N, Yavan T, Bayrak D, Unal 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):1407-12. [CrossRef]
8. 8. National Cancer Control Plan 2013 - 2018. Republic of Turkey Ministry of Health Turkey Public Health Institution Cancer Control Department. (Online) Available from: https://www.iccp-portal.org/system/files/plans/Ulusal_ Kanser_Kontrol_Plani_2013_2018.pdf

9. 9. Denizli R, Sakin O, Angin AD, Cikman MS, Pirimoglu ZM. Colposcopic examination in cytology negative women who tested positive for non-16/18 HPV types. J Ist Faculty Med 2019;82(4):212-8. [CrossRef]
10. 10. Turkey Cancer Control Programme. Republic of Turkey Ministry of Health Turkey Public Health Institution Cancer Control Department. (Online) Available from: https://www. iccp-portal.org/system/files/plans/Turkiye_Kanser_Kontrol_ Program_English.pdf
11. 11. Guvenc G, Akyuz A, Açikel CH. Health belief model scale for cervical cancer and Pap smear test: psychometric testing. J Adv Nurs 2011;67(2):428-37. [CrossRef]
12. 12. Champion VL. Instrument refinement for breast cancer screening behaviors. Nurs Res 1993;42(3):139-43. [CrossRef]
13. 13. Kesic V, Markovic M, Matejic B, Topic L. Awareness of cervical cancer screening among women in Serbia. Gynecol Oncol 2005;99(3 Suppl 1):S222-S225. [CrossRef]
14. 14. Sirovich BE, Woloshin S, Schwartz LM. Screening for cervical cancer: will women accept less? Am J Med 2005;118(2):151- 8. [CrossRef]
15. 15. Bal MD. Evaluation of women having Pap smear test by Health Belief Model scale. Journal of Marmara University Institute of Health Sciences MÜSBED 2014;4(3):133-8. [CrossRef]
16. 16. Karabulutlu O. Evaluation of the Pap smear test status of Turkish women and related factors. Asian Pac J Cancer Prev 2013;14(2):981-986.
17. 17. Akyüz A, Güvenç G, Yavan T, Çetintürk A, Kök G. Evaluation of the Pap smear test status of women and of the factors affecting this status. Gulhane Med J 2006;48:25-29.
18. 18. Cenesiz E, Atak N. The evaluation of the researches in the health belief model in Turkey. TAF Preventive Medicine Bulletin 2007;6(6):427-34.
19. 19. Burak LJ, Meyer M. Using the Health Belief Model to examine and predict college women’s cervical cancer screening beliefs and behavior. Health Care Women Int 1997;18(3):251-62. [CrossRef]
20. 20. Esin MN, Bulduk S, Ardic A. Beliefs about cervical cancer screening among Turkish married women. J Cancer Educ 2011;26(3):510-5. [CrossRef]
21. 21. Duman NB, Koçak DY, Albayrak SA, Topuz Ş, Yılmazel G. Knowledge and practices breast and cervical cancer screening among womens over age of 40. Journal of Academic Research in Nursing 2015;1(1):30-8.
22. 22. Gökgöz N, Aktaş D. Determination of women awareness level of cervical cancer & conducting pap-smear test. Yıldırım Beyazıt University Journal of Nursing 2015;3(2):11-23.
23. 23. Esencan TY. The evaluation of the behavior of women on gynecological diagnostic methods. Medical Bulletin of Zeynep Kamil 2009;40(2):63-6.
24. 24. Markovic M, Kesic V, Topic L, Matejic B. Barriers to cervical cancer screening: a qualitative study with women in Serbia. Soc Sci Med 2005;61(12):2528-35. [CrossRef]
25. 25. Reis N, Bebis H, Kose 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):1463-70. [CrossRef]
26. 26. Karaca M, Palancı Y, Aksu SR. How common is pap smear test known and performed. J Clin Obstet Gynecol 2008;18(1):22- 8.
27. 27. Abadi MMM, Vakilian K, Safari V. Motivational interview on having Pap test among middle-aged women - a counseling service in primary care. Fam Med Prim Care Rev 2018;2: 101-5.