Sağlık okuryazarlığı düzeyi kadınların meme kanseri bilgisi ve tarama davranışını etkiliyor: Türkiye’den bir kesitsel çalışma

Abstract

Amaç: Meme kanserine bağlı 50 yaş ve altı ölüm hızı azalmakta ve sağlık okuryazarlığı kanser farkındalığı ve tarama davranışı açısından önem kazanmaktadır. Çalışmanın amacı, kadınların sağlık okuryazarlığı seviyesi ve meme kanseri bilgi ve tarama davranışı arasındaki ilişkiyi göstermektir. Yöntem: Çalışma kesitsel bir çalışma olup, Türkiye’de iki birinci basamak sağlık merkezinde uygulanmıştır. Sağlık okuryazarlığı seviyesi değerlendirmesi için; REALM ve AHLS ölçekleri kullanılmıştır. Bulgular: Kadınaların ortalama yaşı 49±8.42’ydi. Kadınların REALM ortalama skoru 61±4.97 (min-max=0-65) olup, ortalama AHLS skoru 19±2.64 (min-max=0-23) olarak değerlendirildi. Yetersiz sağlık okuryazarlığı seviyesine sahip kadınlar en düşük meme kanseri bilgi skoruna sahipti (6±2.82, min-maks=0-15). Kadınların %38,2’si (n=191) meme kanseri bilgisini televizyondan edindiğini belirtirken, %31,7’si (n=102) doktorundan edindiğini bildirdi. Sonuç: Düşük sağlık okuryazarlığı düzeyi kadınların meme kanseri tarama davranışı ile bilgi kaynaklarını etkileyerek meme kanseri bilgisinde önemli bir bariyer olarak görünüyor. 

Keywords

• meme kanseri
• sağlık okuryazarlığı
• sağlığın geliştirilmesi
• birinci basamak

Health literacy levels affect breast cancer knowledge and screening attitudes of women in Turkey: A descriptive study

Abstract

Objective: The mortality rate for breast cancer for people under the age of 50 is decreasing, and health literacy is increasingly understood as important for cancer awareness and screening behavior. The aim of this study was to address the relationship between health literacy levels and breast cancer knowledge and screening attitudes of women. Method: The study was cross-sectional, and conducted in two primary healthcare centers in Turkey. The Rapid Estimate of Adult Literacy Measurement (REALM) and Adult Health Literacy Scale (AHLS) were used for health literacy level assessment. Results: The mean age of the participants was 49.62±8.43 years. The mean score of the women for REALM was 61.59±4.97 and the mean AHLS score of women was 19.55±2.64 (min-max=0-23). The women who had inadequate health literacy levels had the lowest Breast cancer knowledge score (BCKS) (6.00±2.82). Of the women, 38.2% (n=191) reported that they received breast cancer information from TV, whereas 31.7% (n=102) received information from their doctors. Conclusion: Low health literacy levels seem to be an important barrier for breast cancer knowledge, affecting screening attitudes and the source of knowledge among women.

Keywords

• breast cancer
• health literacy
• health promotion
• primary care

References

1. Ozmen V. Breast cancer in Turkey: Clinical and histopathological characteristics (analysis of 13.240 patients). J Breast Health. 2014;10(2):98.
2. Fact Sheets by Cancer—Breast Cancer: Estimated Incidence, Mortality and Prevalence Worldwide in 2012. International Agency for Research on Cancer, and World Health Organization (WHO); 2012.
3. Brennan ME. The role of clinical breast examination in cancer screening for women at average risk: A mini review. Maturitas. 2016;92:61-63.
4. Nelson HD, Tyne K, Naik A, et al. Screening for breast cancer: an update for the U.S. Preventive Services Task Force. Ann Intern Med. 2009;151(10):727-737, W237-242. doi:10.7326/0003-4819-151-10-200911170-00009.
5. Ozmen V, Fidaner C, Aksaz E, et al. The report of breast cancer early detection and screening sub-committee, national cancer advisory board, the ministry of health of Turkey. J Breast Health. 2009;5:125-134.
6. Davis TC, Arnold C, Berkel HJ, Nandy I, Jackson RH, Glass J. Knowledge and attitude on screening mammography among low-literate, low-income women. Cancer. 1996;78(9):1912-1920.
7. Davis TC, Williams MV, Marin E, Parker RM, Glass J. Health Literacy and Cancer Communication. CA Cancer J Clin. 2002;52(3):134-149. doi:10.3322/canjclin.52.3.134.
8. Cox N, Bowmer C, Ring A. Health Literacy and the Provision of Information to Women with Breast Cancer. Clin Oncol. 2011;23(3):223-227. doi:10.1016/j.clon.2010.11.010.

9. Doak LG, Doak CC, Meade CD. Strategies to improve cancer education materials. Oncol Nurs Forum. 1996;23(8):1305-1312.
10. Sentell T, Braun KL, Davis J, Davis T. Health literacy and meeting breast and cervical cancer screening guidelines among Asians and whites in California. SpringerPlus. 2015;4(1):432. doi:10.1186/s40064-015-1225-y.
11. Yilmazel G. Health Literacy, Mammogram Awareness and Screening Among Tertiary Hospital Women Patients. J Cancer Educ Off J Am Assoc Cancer Educ. May 2016. doi:10.1007/s13187-016-1053-y.
12. Davis TC, Long SW, Jackson RH, et al. Rapid estimate of adult literacy in medicine: a shortened screening instrument. Fam Med. 1993;25(6):391-395.
13. Ozdemir H, Alper Z, Uncu Y, Bilgel N. Health literacy among adults: a study from Turkey. Health Educ Res. 2010;25(3):464-477. doi:10.1093/her/cyp068.
14. Sezer A, Kadıoğlu H. YETİŞKİN SAĞLIK OKURYAZARLIĞI ÖLÇEĞİ’NİN GELİŞTİRİLMESİ. J Anatolia Nurs Health Sci. 2014;17(3). doi:10.17049/ahsbd.51846.
15. Jovic-Vranes A, Bjegovic-Mikanovic V, Marinkovic J, Kocev N. Health literacy in a population of primary health-care patients in Belgrade, Serbia. Int J Public Health. 2011;56(2):201-207. doi:10.1007/s00038-010-0181-0.
16. Berens E-M, Vogt D, Messer M, Hurrelmann K, Schaeffer D. Health literacy among different age groups in Germany: results of a cross-sectional survey. BMC Public Health. 2016;16(1):1151.
17. DeWalt DA, Berkman ND, Sheridan S, Lohr KN, Pignone MP. Literacy and health outcomes. J Gen Intern Med. 2004;19(12):1228-1239.
18. Kindig DA, Panzer AM, Nielsen-Bohlman L. Health Literacy: A Prescription to End Confusion. National Academies Press; 2004.
19. Pagán JA, Brown CJ, Asch DA, Armstrong K, Bastida E, Guerra C. Health literacy and breast cancer screening among Mexican American women in South Texas. J Cancer Educ. 2012;27(1):132-137.
20. Komenaka IK, Nodora JN, Hsu C-H, et al. Association of health literacy with adherence to screening mammography guidelines. Obstet Gynecol. 2015;125(4):852-859.
21. Aslan A, Temiz M, Yiğit Y, Can R, Canbolant E, Yiğit F. Hemşirelik Yüksek Okulu öğrencilerinin meme kanseri hakkında bilgi, tutum ve davranışları. TSK Koruyucu Hekim Bül. 2007;6(3):193-198.
22. Guvenc I, Guvenc G, Tastan S, Akyuz A. Identifying women’s knowledge about risk factors of breast cancer and reasons for having mammography. Asian Pac J Cancer Prev. 2012;13(8):4191-4197.
23. Kartal M, Ozcakar N, Hatipoglu S, Tan MN, Guldal AD. The Importance of Family History in Breast Cancer Patients in Primary Care Setting: a Cross-sectional Study. J Cancer Educ. 2017:1-8.