上海市社区宫颈癌筛查服务利用影响因素研究

目的:了解上海市社区妇女宫颈癌筛查服务利用情况,并探讨影响社区妇女宫颈癌筛查服务利用的因素。方法:通过整群抽样方法选取社区妇女,采用结构式问卷调查共4 703名社区妇女,采用单因素和非条件logistic多因素方法分析服务利用影响因素。结果:社区妇女宫颈癌筛查既往参加率为44.6%,3年内参加率仅为25.4%。影响因素包括年龄、文化程度、家庭年收入、单位曾提供筛查服务、社区曾提供筛查服务、医生推荐、周围人影响、亲戚肿瘤病史。结论:构建社区宫颈癌筛查的环境氛围是提高社区妇女利用宫颈癌筛查服务,降低宫颈癌发生的关键。     

城市社区妇女参加宫颈癌筛查行为意向结构方程模型分析

目的建构具有态度、主观行为准则等概念的"城市社区妇女接受宫颈癌筛查行为意向整合模型",探讨影响城市社区妇女接受宫颈癌筛查(宫颈涂片检查)行为的因素。方法用结构式问卷调查1591名上海某社区妇女参加宫颈癌筛查相关知识、态度和行为意向。验证性因子分析建立测量模型,再构建结构方程模型。最大似然法(ML)估计参数,通过评价修正来确定最佳结构模型。结果社区妇女既往参加过宫颈癌筛查的占42.1%,其中三年内参加过宫颈癌筛查的占56.7%。结构方程模型拟合较好,正向影响参加筛查行为意向的因素包括对象个体主观行为准则、对家庭社会责任的感知、对筛查促进因素的感知、参与筛查的自我效能和对宫颈涂片的态度。宫颈癌相关知识对行为意向无影响。对象对行为改变障碍的感知对参与筛查行为意向的作用是负向的。结论要提高社区妇女宫颈癌筛查项目的覆盖率,不能仅提供免费筛查服务和健康知识的培训,还需要构建筛查环境,包括家属的动员,社区妇女较易接受的女性筛查医师的配备、医师检查技能的提高等,同时筛查对象本身信念层面对筛查必要性的感知和改变也是重要的。     

成都市608名社区妇女宫颈癌认知、态度、行为调查

目的了解成都市部分社区妇女对于宫颈癌知识的认知、态度、行为(KAP)及相关影响因素,为成都市社区妇女宫颈癌健康教育提供依据。方法抽取成都市6个社区妇女共计654例,采用自制问卷进行调查,有效问卷608例,应用SPSS13.0软件统计处理。结果 608例调查对象中仅有27.3%知晓HPV(人类乳头瘤病毒)感染是宫颈癌的高危因素,87.3%认为宫颈癌可以预防;85.2%认为有性生活的妇女应该每年做妇科检查;66.6%曾主动了解过宫颈癌相关知识;22.2%参加过宫颈癌筛查。调查对象宫颈癌知识得分偏低,为(13.82±3.401)(-8～10)分;单因素分析显示不同经济状况、文化程度、年龄、职业、单位体检是否包括宫颈癌筛查以及是否参加过宫颈癌筛查等组间得分差异有统计学意义(P﹤0.05);多元线性回归显示,对得分影响最大的变量从大到小依次为:单位体检中是否包括妇科检查、务农、经济状况、是否参加过宫颈癌筛查、文化程度、企事业单位员工及年龄。结论调查对象对宫颈癌的认知程度偏低,特别是对宫颈癌筛查相关知识、HPV与宫颈癌的关系了解不全面;有预防宫颈癌的意识,但缺乏实际行动。     

农村适龄妇女宫颈癌筛查服务利用行为现状及其影响因素分析

摘要:目的　调查农村适龄妇女宫颈癌筛查服务利用现状及其影响因素,为进一步完善农村宫颈癌筛查服务实施策略提供依据。方法　采用分层抽样方法,选取1 013名农村适龄妇女为研究对象,采用自制问卷进行入户调查获取宫颈癌筛查服务利用相关情况 结果　宫颈癌筛查服务利用率为28.8%;年龄、经济收入、医疗保障状况及宫颈癌筛查意识对宫颈癌筛查服务利用率有明显影响（P＜0.05）结论　农村宫颈癌筛查服务利用率较低;人口学因素及宫颈癌筛查意识是农村适龄妇女利用宫颈癌筛查服务的重要影响因素。     

基于健康信念模型的济南市妇女宫颈癌筛查行为影响因素研究

目的 以健康信念模型（health belief model,HBM）为理论基础,探索济南市妇女宫颈癌筛查行为的影响因素。 方法 基于济南市“两癌筛查”项目,对济南市9个区进行方便抽样,使用基于HBM理论的宫颈癌筛查问卷进行调查,对曾做过宫颈癌筛查和从未做过此筛查的人群进行对比,分析济南市妇女宫颈癌筛查行为的影响因素。 结果 共收回有效问卷1441份,有效率为79.0 %,其中942（65.5%）份为曾筛查组问卷,499（34.5 %）份为未筛查组问卷。曾筛查组在筛查自我效能、筛查益处、筛查障碍等维度的平均得分均高于未筛查组但在宫颈癌易感性和严重性的平均得分低于未筛查组（P＜0.05）。Logistic回归分析显示居住地（OR=1.327, 95%CI:1.007~1.749）、文化程度（OR=1.414, 95%CI:1.079~1.853）、筛查益处认知（OR=2.061, 95%CI:1.56 ~2.72）和筛查障碍认知（OR=1.466, 95%CI:1.22~1.763）是济南市妇女宫颈筛查的独立影响因素。结论 济南市女性宫颈癌筛查信念较好。优化农村贫困人群筛查策略、加强宫颈癌筛查科普、减少筛查障碍是提高济南妇女筛查率的可行措施。     

广州市妇女参加宫颈癌筛查影响因素的结构方程模型分析

目的 探讨影响城市社区妇女参加宫颈癌筛查的因素,为有效开展宫颈癌筛查提供依据.方法 采用整群随机抽样方法,自行设计宫颈癌认知、参与筛查的态度和行为调查问卷对广州市基层社区的813名妇女进行调查.采用结构方程模型对调查数据进行统计分析 结果 被调查的813名妇女近3年宫颈癌筛查率为48.3％.结构方程模型分析结果表明,“客观因素”、“危险因素认知”、“防治知识”及“筛查支持感知”等4个外生潜变量对内生潜变量“筛查积极态度”有正向影响作用,其标准化路径系数分别为0.21、0.13、0.21、0.22,均有统计学意义(均有P＜0.05);“筛查积极态度”进而影响妇女参加宫颈癌筛查的时间间隔,其标准化路径系数为0.16(P=0.001),即态度积极者参加筛查的时间间隔较短.外生潜变量“筛查支持感知”还直接影响筛查的时间间隔,是妇女参加宫颈癌筛查的重要促进因素.模型的拟合效果良好,其卡方自由度比(x2/df)为2.99、拟合优度指数(GFI)为0.914、近似误差均方根(RMSEA)为0.057.结论 提高妇女参加宫颈癌筛查的积极性,除了要加强对妇女自身的健康教育外,还要提高其对筛查支持的感知度,比如同时也对其家庭、所在社区或工作单位普及宫颈癌防治知识.     

石家庄市900例妇女宫颈癌认知及影响因素调查

目的调查河北省石家庄市妇女宫颈癌认知情况及影响因素,为当地宫颈癌的防治提供借鉴和参考。方法选取2012年1月-2014年12月河北省石家庄市进行健康体检的妇女900例为研究对象。调查问卷了解研究对象对宫颈癌防治知识的知晓情况,统计研究对象答对宫颈癌防治知识的数量,比较不同特征妇女对宫颈癌防治知识的知晓情况。Logistic回归分析影响妇女宫颈癌防治知识的影响因素,调查妇女未参加宫颈癌筛查的原因。结果 900例妇女对宫颈癌防治知识中的一般知识、危险因素及预防措施的知晓率普遍较低,9道宫颈癌防治知识中仅有10例(1.1%)全部答对,36.1%答对3～4题。单因素分析显示,妇女的年龄、居住区域、文化程度、家庭人均收入、生殖道病史、5年内参加宫颈癌筛查是影响妇女宫颈癌防治知识知晓率的因素。Logistic多因素回归分析显示,居住区域、文化程度、家庭人均收入、5年内参加宫颈癌筛查是影响妇女宫颈癌防治知识知晓率的因素。妇女未参加宫颈癌筛查的原因众多,未出现症状占53.6%;担心有心理负担占43.1%;做妇科检查难受占21.0%。结论河北省石家庄市妇女对宫颈癌防治知识的知晓率较低,针对宫颈癌高发人群展开有效的健康教育,定期展开宫颈癌的筛查工作,促进宫颈癌及宫颈癌癌前病变的早期诊治具有重要意义。     

南京社区妇女乳腺癌筛查知信行现状及影响因素

目的 了解江苏省南京市妇女乳腺癌筛查知信行现状并分析其影响因素,为制定合理有效的乳腺癌筛查干预模式提供依据.方法 采取随机整群抽样方法抽取南京市418名≥40岁社区妇女为调查对象,采用乳腺癌筛查知信行问卷进行调查.结果 调查对象乳腺癌筛查知识总知晓率为32.8％,主要影响因素有文化程度和职业(P＜0.05);乳腺钼钯筛查信念得分为(31.94±4.17)分,在不同社会人口学特征对象间差异无统计学意义;曾经做过乳腺自我检查和乳腺临床检查的妇女分别占57.1％和82.3％,其中在最近1年内做过的分别占47.0％和45.7％,年龄和职业是影响自我检查行为的因素(P＜0.05);有12.2％的女性曾经接受过乳腺钼钯检查,文化程度是实施乳腺钼钯检查的影响因素(P＜0.01).结论 南京市社区妇女乳腺癌筛查知识较为缺乏,筛查率有待提高,年龄、职业、文化程度是筛查行为的影响因素.     

龙泉山区妇女对宫颈癌筛查的认知、态度和行为状况调查

目的调查龙泉山区妇女对宫颈癌筛查的认知、态度和行为状况并探讨其相关影响因素,为临床宫颈癌防控措施的制定提供参考。方法随机选取自2014年6月-2015年6月龙泉山区288例妇女作为调查对象。采用自制的调查问卷进行调查,分析龙泉山区妇女对宫颈癌筛查的认知、态度和行为,并分析其相关影响因素。结果 93.75%的调查对象知道宫颈癌筛查,17.36%的调查对象认为有必要定期接受宫颈癌筛查;9.38%的调查对象知道宫颈癌筛查方法,认为宫颈癌筛查可发现早期宫颈病变的仅有17.36%,47.22%(136例)调查对象表示曾接受过宫颈癌筛查。年龄、婚姻状况、受教育程度、职业类别以及家庭月收入均是影响龙泉山区妇女对宫颈癌认知、态度和行为的因素。多元线性回归分析结果显示,宫颈癌筛查认知主要受调查对象教育程度的影响(β=3.041,t=5.092,P0.05);调查对象宫颈癌筛查态度主要受到周围人群筛查行为的影响(β=12.736,t=13.407,P0.05);调查对象宫颈癌筛查行为主要受到其态度的影响(β=0.598,t=0.259,P0.05)。Pearson相关分析结果显示,宫颈癌筛查的认知和态度、态度和行为、认知和行为之间均存在正相关关系(r=0.312、0.308、0.182,均P0.05)。结论妇女对宫颈癌筛查的认知、态度和行为三者呈正相关关系,应加强宫颈癌筛查相关知识的宣传,以进一步提高宫颈癌筛查的覆盖率。     

初诊宫颈癌妇女对宫颈癌认知和筛查现况分析

目的:调查海南省万宁市初诊宫颈癌妇女宫颈癌认知及筛查现状及可能影响原因。方法:选择2015年3月—2018年3月在本院初次确诊为宫颈癌患者400例作为调查对象,采用一般资料调查表、宫颈癌知识问卷对其认知水平和筛查情况进行现况调查,并分析其影响因素。结果:被调查妇女宫颈癌防治知识认知程度低者占21.0%,一般占57.0%,程度高占22.0%。从未进行过宫颈癌筛查占70.8%,1~3年进行过筛查的占26.0%,筛查已3年占3.2%。多因素分析显示年龄(31~45岁)、婚姻(已婚)、学历(高中/大专)、居住地(农村)是影响妇女认知程度的主要影响因素。结论:初诊宫颈癌妇女宫颈癌防治知识认知程度和筛查情况整体较低,特别居住在农村,学历为高中或大专,31~45岁的已婚妇女,亟待采取有效的措施来提高其认识水平和筛查力度,以提高妇女健康水平。     

上海市杨浦区退休与生活困难妇女乳腺癌和宫颈癌筛查结果

目的分析杨浦区退休与生活困难妇女常见病及肿瘤发病情况。方法统一使用上海市杨浦区卫生局、杨浦区妇女儿童工作委员会印发的《杨浦区退休与生活困难妇女免费妇科病、乳腺病筛查》表格,按照项目实施方案要求,于2013年3—9月对杨浦区控江、长白、殷行、新江湾城、延吉和五角场6个街道的13632名退休与生活困难妇女进行免费乳腺癌、宫颈癌项目筛查。结果杨浦区退休与生活困难妇女总患病率为57．02％,其中宫颈疾病（22．35％）、乳腺疾病（19．23％）和生殖道感染（6．71％）居前三位;查出乳腺癌7例,宫颈癌前病变97例,宫颈原位癌3例,浸润癌2例。结论杨浦区退休与生活困难妇女乳腺癌发病率居女性恶性肿瘤首位,宫颈癌居第二位,两种癌症都是可以通过早期发现、早期诊断、早期治疗而达到完全治愈。防治“两癌”最有效的方法是定期到医院进行健康检查,积极治疗宫颈疾病、乳腺增生和生殖道感染可以降低“两癌”的发病率。     

The urban church and cancer control: a source of social influence in minority communities.

A study was conducted to examine the efficacy of a church-based model of social influence in improving access to and participation of underserved minority women in a cervical cancer control program. The model expanded on strategies used in previous hypertension control and health promotion research. A total of 24 churches, stratified by faith tradition, were randomly selected to participate in the cancer control program from a pool of 63 churches in a defined geographic area of Los Angeles County, CA. Female parishioners ages 21 years and older were eligible to participate in cervical cancer education sessions, and screening was offered to adult women who had not had Papanicolaou tests within the last 2 years. Church participation rate was 96 percent. Thirty lay health leaders were selected by the clergy to serve as messengers, recruiters, and organizers for their respective congregations. Ninety-seven percent of these lay health leaders participated in two training sessions designed to prepare them for their leadership role. Social support structures such as child care, meals, or transportation for targeted women were organized by lay health leaders in 78 percent of the churches. A total of 1,012 women between the ages of 21 and 89 years attended educational sessions. Forty-four percent of the eligible women were targeted for screening because they had not had a Papanicolaou test within the last 2 years or had never been screened. Black women were 6.6 times more likely than Hispanics to have been screened in the past 2 years.(ABSTRACT TRUNCATED AT 250 WORDS)     

上海市虹口区社区妇女宫颈癌筛查现况调查

目的了解虹口区某社区女性宫颈癌筛查现况。方法采用随机整群抽样的方法,抽取虹口区某社区本市户籍女性为研究人群,采用自行设计的自填式表格进行问卷调查。结果该社区女性近3年宫颈癌平均筛查率为52．64％,筛查率在不同文化层次、不同职业、不同经济收入间差异有统计学意义（P〈0．01）。结论该社区宫颈癌筛查率较低,应首先在重点人群中广泛开展宫颈癌防治的宣传教育,提高主动参加筛查的自觉性。     

A qualitative study of cervical cancer and cervical cancer screening awareness among nurses in Ghana

Despite the availability of cervical cancer screening tools, including those that are appropriate for low resource settings, the rates of preventive cervical cancer screening remain extremely low among women in LMICS. Nurse-led education interventions have been proven to be effective at increasing participation in healthcare recommendations. However, there is a need to determine nurses' knowledge of cervical cancer and cervical cancer prevention in order to develop effective health education interventions. Our goal was to assess Ghanaian nurses' knowledge of cervical cancer and cervical cancer prevention. Interviews and small focus groups were conducted with 42 nurses at two hospitals in Ghana. Awareness of cervical cancer was very high among the nurses. However, the majority of the participants held negative perceptions about cervical cancer and lacked knowledge about cervical cancer risk factors and prevention. The results can be used to inform the development of culturally-relevant cervical cancer education interventions targeted towards women and healthcare providers in LMICs.     

Factors Associated with Self-Reported Cervical Cancer Screening Among Women Aged 18 Years and Older in the United States

In 2016, an estimated 4120 women will die as a result of cervical cancer. The objective of this study was to examine the factors associated with cervical cancer screening among women 18 years of age and older in the United States (U.S.). Using the 2012 Behavioral Risk Factor Surveillance System survey, women over the age of 18 in the U.S. were examined to assess factors associated with cervical cancer screening. Analyses were conducted using SAS 9.2. Of the 272,692 study participants, 258,496 (95 %) had obtained cervical cancer screening. After adjusting for demographic and socioeconomic factors, being non-Hispanic White, Hispanic or Latino, Asian, Native Hawaiian or Other Pacific Islander, in the age group 18–44 years and 75 years and above, having less than a high school education and an annual household income of less than a $25,000, having never married, and residing in the West region of the U.S. reduced the likelihood of participation in cervical cancer screening. Also, after adjusting for demographic and socioeconomic factors, being between the ages of 45–74 years of age, having more than a high school education, having a higher income, and residing in the South region of the U.S. increased the likelihood of participation in cervical cancer screening. The results of this study suggest that socio-demographic factors and region of residence are predictors of cervical cancer screening. These findings highlight the need to identify potential prevention strategies to promote cervical cancer screening among at-risk populations and groups.     

Determinants of preventive health behavior in relation to cervical cancer screening among the female population of Belgrade

Identifying the factors that deter or stimulate the women to participate in screening activities is very important in order to design effective education and motivation strategies, particularly in the countries without an organized system. The study employed a case-control design. The participants were recruited in four primary health care institutions in Belgrade over a month. The study group comprised all women aged 18-70 years, who demonstrated an initiative for a PAP- smear. The controls were women with no Pap smears within the last 4 years, matched by age (±2 years), education and marital status with the study group participants. The study instrument was the 62-item self-administered questionnaire. According to multivariate analysis, adherence to cervical cancer screening practices is significantly related to better financial status [odds ratio (OR) = 10.8, P = 0.001], no gender preference for a gynecologist (OR = 3.1, P = 0.015), consultations with a gynecologist (OR = 4.7, P = 0.029), conversation with the women with cervical cancer about that disease (OR = 2.8, P = 0.029) and higher media exposure to information about cervical cancer prevention (OR = 5.0, P = 0.004). Open communication, social networks and improving social-economic status of women in our society are the most prominent factors, most of which are mainly outside the health services' domain and require multisectoral collaboration to improve women's reproductive health.     

宫颈癌筛查对农村妇女相关防治知识影响因素分析

目的了解北京市宫颈癌免费筛查前后对大兴区农村地区30～59岁妇女的宫颈癌防治知识知晓率的变化,探索其影响因素,以便制订相应防治策略。方法采用三阶段分层随机及按固定样本量分配样本数量选取研究对象,分别在北京市宫颈癌免费筛查启动的前一年（2008年）和启动年（2009年）对妇女宫颈癌防治知识进行横断面一对一方式的调查。结果单因素分析显示：在北京市宫颈癌免费筛查项目启动后,大兴区妇女宫颈癌总体知晓率显著提高,被调查的农村妇女宫颈癌相关知识总体知晓率有显著提高,答对5题以上的妇女比例从启动前的37．3％提高到51．0％（χ^2=62．06,P〈0．001）;在调整其他混杂因素后,多因素分析结果亦显示宫颈癌筛查有利于宫颈癌相关知识知晓率的提高（OR=1．853,95％CI：1．590～2．159）。此外,单因素分析显示,居住地、文化程度、家庭年人均收入、有否5年内筛查史是影响妇女知晓率的主要因素,且文化程度、家庭年人均收入等级越高,知晓率越高（DR值分别为1．766和2．580及OR值分别为1．350和1．676）。结论通过北京市免费筛查宫颈癌和健康教育宣传活动确实能够提高广大妇女宫颈癌防治知识水平,尤其是对于以往没有参加过筛查的群体,可以提高她们的参与意识。     

Participation in annual skin cancer screening among women seeking routine mammography

BACKGROUND: Early detection of skin cancer is associated with improved prognosis. The American Cancer Society's current skin cancer screening (SCS) recommendation states that adults over the age of 40 should receive an annual skin examination conducted by a health professional. However, little is known about the psychosocial factors related to participation in annual SCS, which remains relatively low among the general public. METHODS: Data were collected from women, aged 50 and older, seeking routine mammography at a large, urban, breast diagnostic facility. RESULTS: A total of 253 eligible women completed the survey. Overall, 20.2% of women reported receiving annual clinical SCS. Physician recommendation, self-efficacy, perceived susceptibility, and age were significantly associated with participation in annual skin screening. CONCLUSIONS: Similar to previously reported findings in the literature, our rates of participation in annual clinical skin screening were lower than reported rates for other types of cancer screening. Among older women, multiple covariates for participation in annual skin cancer screening were determined and may serve to guide future health education interventions to promote screening. Our findings suggest that participation could improve through increasing physician recommendation, screening self-efficacy, and individuals' sense of perceived susceptibility to skin cancer.     

Health beliefs and Pap smears among Thai women in Brisbane,Australia

Although a number of studies have assessed the use of Pap smear among Thai women in Thailand, little is known about factors influencing the use of this cervical cancer screening among potentially high risk Thai migrant women. We related health belief model (HBM) factors and sociodemographic variables to the use of Pap smears among migrant Thai women in Brisbane, Australia. A cross-sectional study was conducted in Brisbane, Queensland, Australia. A snowball sampling method was used to recruit 145 women. Thirty-nine percent reported regular Pap smears. Summary HBM index and self-efficacy index were positively associated with Pap smears. Barriers to screening were negatively associated. The HBM appears to be a useful framework for planning cervical cancer prevention. Strategies that reduce barriers to the screening and increase the confidence of women and their self-efficacy are likely to increase their participation.