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Knowledge of cervical cancer and acceptance of HPV vaccination among secondary school students in Sarawak, Malaysia

Rashwan H, Lubis SH, Ni KA

Asian Pac J Cancer Prev, 2011;12(7):1837-41.
PMID: 22126576

Cervical cancer is the third most common cancer in women in peninsular Malaysia and very prevalent worldwide. HPV vaccination and routine Pap smear testing are the best preventive measures. The objective of this study was to determine the knowledge level of secondary school students from Sarawak, East Malaysia regarding cervical cancer and its prevention. Multistage random sampling with various methods in each step was employed to select the sample of 76 students. Results showed that 61.8% had poor knowledge level of cervical cancer and its prevention. There were 60.5% of students who were aware of cervical cancer with Chinese and form four students showing significantly the highest awareness (p<0.05). The main source of cervical cancer information was from their parents (25.9%). HPV vaccination acceptance among students was 22.3% and an association was found between knowledge of cervical cancer with race and HPV vaccination acceptance (p<0.05). In conclusion, the students had poor knowledge level of cervical cancer, its prevention and HPV vaccination acceptance. More efforts should be made to improve cervical cancer knowledge and awareness of the public especially secondary school students in Sarawak. This in turn will enhance the practice of prevention against cervical cancer among students.

Matched MeSH terms: Health Knowledge, Attitudes, Practice*
Fulltext Practice and barriers toward breast self-examination among young Malaysian women

Al-Naggar RA, Al-Naggar DH, Bobryshev YV, Chen R, Assabri A

Asian Pac J Cancer Prev, 2011;12(5):1173-8.
PMID: 21875261

INTRODUCTION: The etiology of breast cancer is still unknown and adequate primary prevention strategies or interventions are still not possible. Therefore, early detection remains the first priority and regular practice of breast self-examination (BSE) influences treatment, quality of life, survival, and prognosis of breast cancer patients.
OBJECTIVES: The objective of this study was to determine the practices and barriers towards breast self-examination among young Malaysian women.
METHODOLOGY: Cross-sectional study was conducted among 251 female students at the Management and Science University, Shah Alam, Selangor, Malaysia. Questionnaires were distributed at gathering places such as the university cafeteria, the university plaza, the Islamic center, and at the library. In addition, questionnaires were distributed in the lecture halls. The proposal of this study was approved by the Ethics and Research Committee of Management and Science University. Data was analysis using SPSS version 13, t-test was used to analyze the associated factors toward the practice of BSE.
RESULTS: A total number of 251 students participated in this study. The majority of them were older than 20 years old,of Malay racial origin, single and from urban areas (66.5%; 63.7%; 96%; 70.9% respectively). Regarding their lifestyle practices, the majority of participants do exercise, are non-smokers and do not drink alcohol (71.3%; 98.4%; 94.4% respectively). More than half of the study participants mentioned that they have practiced BSE (55.4%). Regarding the sources of information about BSE, the majority mentioned that radio and TV were their main sources of information (38.2%). Age, exercise and family history of cancer significantly influenced the practice of BSE (p = 0.045; p=0.002; p=0.017 respectively). Regarding the barriers to BSE, the majority who never practiced BSE mentioned that lack of knowledge, not having any symptoms, and being afraid of being diagnosed with breast cancer were the main barriers to practicing BSE (20.3%; 14.3%; 4.4% respectively).
CONCLUSION: More than half of the participants practiced BSE. Age, exercise and family history of cancer significantly influenced the practice of the BSE. Lack of knowledge, not having any symptoms and being afraid of being diagnosed with breast cancer were the main barriers to practicing BSE. There is an urgent need to develop a continuous awareness campaign among university students on the importance of performing BSE.

Matched MeSH terms: Health Knowledge, Attitudes, Practice*
Fulltext Awareness and practice of breast self examination among Malaysian women with breast cancer

Loh SY, Chew SL

Asian Pac J Cancer Prev, 2011;12(1):199-202.
PMID: 21517257

Breast self-examination (BSE) is a self-generated, non-invasive and non-irradiative method of breast cancer detection. This paper documents Malaysian women's awareness and practice of regular BSE as a potent breast cancer detection tool. A pre-test post-test questionnaire survey on women diagnosed with breast cancer (n=66) was conducted. Descriptive statistics and Chi-square tests were performed to correlate demographic variables, knowledge and regular practice of BSE. Findings showed that 80% of the breast cancer survivors self-detected the breast lumps, despite a high 85% of these women reporting they were never taught about BSE. More than 70% of the women maintained that lack of knowledge/skill on the proper practice of BSE was the key barrier to a more regular BSE practice. After an educational intervention on BSE and breast awareness, we found an increase report from 17% (at pre-test) to 67% (at post-test) of self reported monthly BSE practices. Provision of self-management education incorporating BSE, a readily available cheap method, should be introduced at primary care and breast clinics. This strategy promotes women's self-efficacy which contributes towards cancer control agenda in less resource available countries around Asia Pacific. Longer follow up may be crucial to examine the adherence to positive BSE behaviour.

Matched MeSH terms: Health Knowledge, Attitudes, Practice*
Premenstrual syndrome and dysmenorrhea: urban-rural and multiethnic differences in perception, impacts, and treatment seeking

Wong LP

J Pediatr Adolesc Gynecol, 2011 Oct;24(5):272-7.
PMID: 21600811 DOI: 10.1016/j.jpag.2011.03.009

Attitudes toward menarche and menstruation are largely influenced by sociological, cultural, and family environmental factors. Recognizing the influential effects that these factors might have on shaping adolescents' attitudes is crucial in designing a more effective means of transmitting health information.

Matched MeSH terms: Health Knowledge, Attitudes, Practice*
Fulltext Randomised-controlled trial of a web-based dietary intervention for patients with type 2 diabetes mellitus: study protocol of myDIDeA

Ramadas A, Quek KF, Chan CK, Oldenburg B, Hussein Z

BMC Public Health, 2011;11:359.
PMID: 21599990 DOI: 10.1186/1471-2458-11-359

The potential of web-based interventions in dietary behaviour modification of the diabetics has not been fully explored. We describe the protocol of a 12-month match-design randomised controlled trial of a web-based dietary intervention for type 2 diabetic patients with primary aim to evaluate the effect of the intervention on their dietary knowledge, attitude and behaviour (KAB). The secondary objective of this study is to improve the participants' dietary practices, physical measurements and biomarkers.

Matched MeSH terms: Health Knowledge, Attitudes, Practice*
Fulltext Public knowledge and attitudes towards antibiotic usage: a cross-sectional study among the general public in the state of Penang, Malaysia

Oh AL, Hassali MA, Al-Haddad MS, Syed Sulaiman SA, Shafie AA, Awaisu A

J Infect Dev Ctries, 2011 May;5(5):338-47.
PMID: 21628809

INTRODUCTION: Public knowledge and attitudes towards antibiotics play a vital role in the success of the treatment process. This study aimed to assess public knowledge and attitudes toward antibiotic usage which could serve as baseline data for future studies within a government hospital setting in Malaysia.
METHODOLOGY: A self-administered cross-sectional survey involving 408 respondents was conducted using a validated questionnaire at an outpatient pharmacy department in Penang Hospital, Malaysia, from February to March 2009.
RESULTS: Nearly 55% of the respondents had a moderate level of knowledge. Three quarters of the respondents (76.7%) could correctly identify that antibiotics are indicated for the treatment of bacterial infections. However, 67.2% incorrectly thought that antibiotics are also used to treat viral infections. About 59.1% of the respondents were aware of antibiotic resistance phenomena in relation to overuse of antibiotics. With regard to attitudes, 38% believed that taking antibiotics when having cold symptoms could help them to recover faster, while 47.3% expected antibiotics to be prescribed for common cold symptoms. Age, race and educational level were among the demographic characteristics significantly associated with knowledge and attitudes toward antibiotic use. Poor level of knowledge was found in less than one-third of the respondents whereas more than one-third of the respondents wrongly self-medicate themselves with antibiotics once they have a cold.
CONCLUSION: Educational interventions are needed to promote prudent use of antibiotics among the public.
Study site: outpatient pharmacy, Hospital Pulau Pinang, Malaysia

Matched MeSH terms: Health Knowledge, Attitudes, Practice*
Is breast self examination (BSE) still relevant? A study on BSE performance among female staff of University of Malaya

Dahlui M, Ng C, Al-Sadat N, Ismail S, Bulgiba A

Asian Pac J Cancer Prev, 2011;12(2):369-72.
PMID: 21545196

OBJECTIVES: This study aimed to determine the rate of breast self examination (BSE) among the female staff of University of Malaya and to determine the role of BSE in detecting breast abnormalities.
METHODS: A total of 1598 questionnaires were posted to all female staff, aged 35 years and above. Their knowledge on breast cancer, practice of BSE and detection rate of breast abnormality as confirmed by CBE was determined.
RESULTS: The response rate for this study was 45 percent (714 respondents). The rate of respondents having awareness on breast cancer was 98.7 percent. Eighty four percent (598) of the respondents had performed BSE in their lifetime. However, in only 41% was it regular at the recommended time. Forty seven percent (334) had undergone CBE at least once in a lifetime but only 26% (185) had CBE at least once in the past 3 years, while 23% (165) had had a mammogram. There was a significant relationship between CBE and BSE whereby those who had CBE were twice more likely to do BSE. Nineteen percent (84 respondents) of those who did BSE claimed they had detected a breast lump. Of these, 87% (73) had gone for CBE and all were confirmed as such.
CONCLUSION: BSE is still relevant as a screening tool of breast cancer since those who detect breast lump by BSE will most probably go for further check up. CBE should be done to all women, especially those at highest risk of breast cancer, to encourage and train for BSE.

Matched MeSH terms: Health Knowledge, Attitudes, Practice*
Prevalence of vitamin-mineral supplements use and associated factors among young Malaysians

Al-Naggar RA, Chen R

Asian Pac J Cancer Prev, 2011;12(4):1023-9.
PMID: 21790245

The objective of this study is to determine the prevalence and associated factors of vitamin-mineral supplements use among Management and Science University students. The cross-sectional study protocol was approved by the Ethics and Research Committee and questionnaires were distributed randomly using simple random sampling to students from all faculties and consent was obtained. The data were analyzed using the SPSS version 13. Total number of the participants in this study is 105. More than half of them were female, older than 20 years of age and Malay (58.1%, 61.9 and 61.9% respectively). The prevalence of vitamin-mineral supplement use was 43%, the main reasons being 'to maintain good health' 80%, followed by 'to ensure adequate nutrition' (10.5%). There was a significant positive association with monthly household income and BMI (P=0.039; P=0.048), with significant dependence on race and knowledge about vitamin-mineral supplements (P=0.002). There was a significant difference between medical and health sciences as compared to non-medical and health science faculties (p =0.05). The conclusion is that although the prevalence of vitamin-mineral supplement use among university students is relatively high, many of them do not have accurate information about supplements. Therefore, there is a need to provide them with education and access to scientific and unbiased information.

Matched MeSH terms: Health Knowledge, Attitudes, Practice*
Awareness, knowledge, and attitudes with respect to epilepsy: an investigation in relation to health-related quality of life within a Malaysian setting

Lua PL, Neni WS

Epilepsy Behav, 2011 Jul;21(3):248-54.
PMID: 21576038 DOI: 10.1016/j.yebeh.2011.03.039

The influence of awareness, knowledge, and attitudes (AKA) on the health-related quality of life (HRQoL) of patients with epilepsy has not been widely established. The aims of this preliminary study were to (1) assess general AKA and HRQoL levels, (2) correlate AKA and HRQoL levels, and (3) compare the HRQoL of patients with epilepsy with different AKA levels. A cross-sectional sample of outpatients with epilepsy were recruited from the Neurology Clinic, Hospital Sultanah Nur Zahirah, Kuala Terengganu, Malaysia. Data analysis was carried out using the Statistical Package for Social Sciences Version 15 employing descriptive and nonparametric statistics. On written consent, included patients completed the Malay AKA Epilepsy and the Malay Quality of Life in Epilepsy-30 (MQOLIE-30) instruments. Across all patients, both AKA levels (median: 80.0, range: 0-170) and overall HRQoL (median 51.5; range 15-97) were moderate. Awareness was significantly correlated only with Seizure Worry (r(s)=+0.29, p<0.05), whereas Knowledge was not significantly linked to any domain. However, Attitudes was significantly correlated with all domains (r(s)=+0.35 to +0.47, p<0.01) except Medication Effects and Seizure Worry. Patients with good AKA levels (Total Score ≥ median) experienced significantly better Overall Quality of Life and Cognitive Functioning (p<0.05). Findings showed that AKA may play an important role in influencing patients' HRQoL, suggesting that epilepsy treatment efforts should also focus on enhancing AKA through epilepsy awareness to improve health outcomes.

Study site: Neurology Clinic, Hospital Sultanah Nur Zahirah

Matched MeSH terms: Health Knowledge, Attitudes, Practice*
Fulltext Knowledge, attitudes and practice of breast self-examination among women in a suburban area in Terengganu, Malaysia

Rosmawati NH

Asian Pac J Cancer Prev, 2010;11(6):1503-8.
PMID: 21338188

INTRODUCTION: Breast cancer is the most frequently diagnosed cancer in Malaysian women, irrespective of age group and ethnicity. The observed low survival rates are related to late stage at presentation despite the availability of breast self examination (BSE) as a reliable screening method for early detection.

MATERIALS AND METHODS: This cross-sectional study was designed to determine the knowledge, attitude and practice towards BSE amongst women aged 15 years old and above. Systemic random sampling was applied and information gathered through guided interview by using a structured questionnaire.

RESULTS: A total of 86 respondents were recruited, with a mean age of 40.5 years (SD: 15.51), more than 80% having a secondary or tertiary level of education. The total score was 16.9 (total mean percent: 60.4%) for knowledge, 37.1 (77.3%) for attitude and 9.56 (34.1%) for practice. The proportions of respondents with good score for knowledge, attitude and practice were 38.4%, 73.3% and 7.0%, respectively. Not knowing the correct method of BSE, lack of knowledge on cancer signs and lack of motivational support from parents, spouse or friends appeared to be related with the poor practices.

CONCLUSION: Enhancement of breast cancer awareness and focusing on recognized barriers by health care professionals with the involvement of spouses, family and community would have a substantial beneficial impact on BSE practice.

Matched MeSH terms: Health Knowledge, Attitudes, Practice*
Eye donation - awareness and willingness among attendants of patients at various clinics in Melaka, Malaysia

Bhandary S, Khanna R, Rao KA, Rao LG, Lingam KD, Binu V

Indian J Ophthalmol, 2010 12 16;59(1):41-5.
PMID: 21157071

AIM: Corneal blindness accounts for 3.42% of blindness in Malaysia; the rate of eye donation is low. The aim of the study was to assess the awareness about eye donation and willingness to donate eyes among attendants of patients at various clinics in Melaka, Malaysia.
MATERIALS AND METHODS: This observational study was conducted on attendants who accompanied patients (n = 400) visiting various outpatient departments of the General Hospital and two peripheral clinics in Melaka between August and October 2007. The participants answered a questionnaire (Malay and English versions) which included demographic profile, awareness of eye donation, knowledge regarding facts of eye donation, and willingness to donate eyes. Univariate and multivariate logistic regression was performed at 5% level of significance.
RESULTS: Awareness of eye donation was observed in 276 (69%) participants. Multivariate analysis showed that awareness was more among females when compared to males (P = 0.009). Of the 276 participants who were aware of eye donation, only 34.42% were willing to donate eyes. Willingness was more among the Indian race (P = 0.02) and males (P = 0.02). Educational status did not influence the willingness to donate eyes.
CONCLUSIONS: Although majority of participants were aware of eye donation, willingness to donate eyes was poor.

Matched MeSH terms: Health Knowledge, Attitudes, Practice*
Fulltext The usage and knowledge of mammography among women in sub-urban area in Terengganu, Malaysia

Rosmawati NH

Asian Pac J Cancer Prev, 2010;11(3):767-71.
PMID: 21039051

INTRODUCTION: Breast cancer is the leading cancer in women today and the major challenge is late presentation then later contributes to poor outcome and high fatality rate. Mammography is effective in early detection of breast cancer and consequently significantly improves the breast cancer survival.

MATERIALS AND METHODS: This cross-sectional study was used to study the knowledge and awareness towards mammogram amongst women aged 15 years old and above. A systemic random sampling was applied and information gathered through guided interview by using a structured questionnaire.

RESULTS: Eighty-six respondents were recruited. The mean age of respondents was 40.5 years (SD: 15.51) and more than 80% had secondary and tertiary level of education. The percentage of respondents ever performed mammogram was 10.5% (95% CI: 4.0%-17.0%). The rate of correct answers was between 8.1% and 48.8%. Most of the respondents do not sure the answer (45.3%-61.6%) rather than wrongly answer (4.7%-43.0%). Only about 8% truly answer that mammogram should be done once in a life. There are 10.5% of women claimed that mammogram had no serious side effect and not a painful procedure. Nearly half of respondents (48.8%) correctly mentioned that Mammogram can detect breast cancer in early stage.

CONCLUSION: Only a small percentage of women ever performed mammogram and there are seriously unaware and poor knowledge pertaining to mammography screening for breast cancer among women in sub urban area. A massive health education campaign through multiple methods and agencies are needed to enhance the knowledge and awareness on mammogram.

Matched MeSH terms: Health Knowledge, Attitudes, Practice*
Consumer perception on generic medicines in Basrah, Iraq: preliminary findings from a qualitative study

Sharrad AK, Hassali MA

Res Social Adm Pharm, 2011 Mar;7(1):108-12.
PMID: 21397885 DOI: 10.1016/j.sapharm.2009.12.003

BACKGROUND: The use of generic medicines has been increasing steadily internationally, primarily because of cost concerns. Knowledge and use patterns of generic medicines in Iraq have not yet been measured.
OBJECTIVE: This study aimed to explore consumers' perception and knowledge on issues relating to generic medicine use in Basrah, Iraq.
METHODS: A qualitative approach was used to gather information from consumers in Basrah, Iraq. A purposive sample of 14 consumers in Basrah was interviewed face-to-face using a semistructured interview guide.
RESULTS: Thematic analysis of the interviews identified 5 major themes: understanding of the term "generic medicine," preference for generic medicine, refusal of generic medicine, generic substitution, and education on the use of generic medicines. Not all the consumers were familiar with the term "generic medicine;" they were familiar with the term "commercial medicine." Most of the participants understood that generics cost less compared with their branded counterparts. Most of the consumers said that their physicians and pharmacists had given them information on generics.
CONCLUSION: Knowledge of generic medicines may be lacking among consumers in Iraq. Development of consumer education on generics by health care providers is required to support the implementation of the policy on generic medicines in Iraq.

Matched MeSH terms: Health Knowledge, Attitudes, Practice*
Fulltext Knowledge, attitudes and barriers for human papilloma virus (HPV) vaccines among Malaysian women

Al-Dubai SA, Alshagga MA, Al-Naggar RA, Al-Jashamy K, Baobaid MF, Tuang CP, et al.

Asian Pac J Cancer Prev, 2010;11(4):887-92.
PMID: 21133596

A cross-sectional study was conducted among 300 Malaysian women in the obstetrics and gynecology outpatient clinic in a selected hospital in Bangi, Selangor to determine the level of knowledge of HPV and HPV vaccines, attitudes toward HPV vaccination and barriers of being vaccinated. Factors associated with knowledge and attitudes were also addressed with a questionnaire. Seventy eight women (26%) had heard about the HPV virus and 65 about HPV vaccines (21.7%). Marital status was associated significantly with awareness of HPV and HPV vaccine (p=0.002, p=0.002; respectively), in addition to level of education (p=0.042). The percentages of women who reported correct answers for the questions on knowledge of HPV and HPV vaccine ranged from 12% to 25%. One hundred fifty nine respondents (53%) had a positive attitude toward HPV vaccination. Age, marital status, and level of education were associated significantly with attitude (p<0.001, p<0.001, p=0.002; respectively). The most important barriers reported were 'unawareness of the vaccine' 'concerned about side effects' and 'afraid of needles'. This study found a very low level of knowledge of HPV and HPV vaccine. Education of population is highly recommended and barriers to being vaccinated should be dealt with seriously.
Study site: Hospital, Bangi, Selangor, Malaysia

Matched MeSH terms: Health Knowledge, Attitudes, Practice*
Fulltext Student perceptions regarding the usefulness of explicit discussion of "Structure of the Observed Learning Outcome" taxonomy

Prakash ES, Narayan KA, Sethuraman KR

Adv Physiol Educ, 2010 Sep;34(3):145-9.
PMID: 20826769 DOI: 10.1152/advan.00026.2010

One method of grading responses of the descriptive type is by using Structure of Observed Learning Outcomes (SOLO) taxonomy. The basis of this study was the expectation that if students were oriented to SOLO taxonomy, it would provide them an opportunity to understand some of the factors that teachers consider while grading descriptive responses and possibly develop strategies to improve scores. We first sampled the perceptions of 68 second-year undergraduate medical students doing the Respiratory System course regarding the usefulness of explicit discussion of SOLO taxonomy. Subsequently, in a distinct cohort of 20 second-year medical students doing the Central Nervous System course, we sought to determine whether explicit illustration of SOLO taxonomy combined with some advice on better answering descriptive test questions (to an experimental group) resulted in better student scores in a continuous assessment test compared with providing advice for better answering test questions but without any reference to SOLO taxonomy (the control group). Student ratings of the clarity of the presentation on SOLO taxonomy appeared satisfactory to the authors, as was student understanding of our presentation. The majority of participants indicated that knowledge of SOLO taxonomy would help them study and prepare better answers for questions of the descriptive type. Although scores in the experimental and control group were comparable, this experience nonetheless provided us with the motivation to orient students to SOLO taxonomy early on in the medical program and further research factors that affect students' development of strategies based on knowledge of SOLO taxonomy.

Matched MeSH terms: Health Knowledge, Attitudes, Practice*
Behavioral responses to the influenza A(H1N1) outbreak in Malaysia

Wong LP, Sam IC

J Behav Med, 2011 Feb;34(1):23-31.
PMID: 20680674 DOI: 10.1007/s10865-010-9283-7

In the setting of the new A(H1N1) outbreak, the study was conducted to assess: (1) fear of the A(H1N1) pandemic; (2) risk avoidance behavior; (3) health-protective behavior; and (4) psychosocial impact in the ethnically diverse population of Malaysia. A cross-sectional, computer-assisted telephone interview was conducted between July 11 and September 12, 2009. A total of 1,050 respondents were interviewed. Fear about the pandemic was high, with 73.2% of respondents reporting themselves as Slightly fearful/Fearful. High risk avoidance and health protective behavior were reported, with 78.0 and 99.0% reporting at least one avoidance and protective behavior respectively. Knowledge was a significant predictor for practice of healthprotective behavior across the three ethnic groups. Level of fear was significantly correlated with number of protective and avoidance behaviors. The study highlights the need for provision of accurate information that increases risk avoidance and health protective behaviors, while at the same time decreases fear or panic in the general public.

Matched MeSH terms: Health Knowledge, Attitudes, Practice*
Knowledge and attitudes about HPV infection, HPV vaccination, and cervical cancer among rural southeast Asian women

Wong LP

Int J Behav Med, 2011 Jun;18(2):105-11.
PMID: 20524163 DOI: 10.1007/s12529-010-9104-y

BACKGROUND: The incidence of cervical cancer in developing countries is high and even higher among women in rural areas in these countries.
PURPOSE: The purpose of this study is to assess the knowledge and attitudes towards human papillomavirus (HPV), HPV vaccination, and cervical cancer among young women in rural settings in a Southeast Asia country.
METHODS: A convenience sample of ethnically diverse young rural women in Malaysia was surveyed. Participants were interviewed using a standard questionnaire.
RESULTS: Among the participants (N = 449), knowledge of HPV, HPV vaccination, cervical screening, and cervical cancer risk factors was extremely poor. The mean total knowledge score (14 items) was 2.37 (SD ± 1.97). Although many had never heard of the newly released HPV vaccine, two-thirds professed an intention to receive the HPV vaccine. Intention to receive the vaccine was significantly associated with knowledge of cervical screening and cervical cancer risk factors (OR 1.17; 95% CI 1.03-1.33; P = 0.013). Reasons for vaccine refusal were doubts about safety and efficacy of the new vaccine (27.4%), perceived embarrassment at receiving an STI vaccine (20.7%), and perception of not being at risk of HPV infection (20.0%).
CONCLUSIONS: Providing HPV education to the rural residents is a high priority.

Matched MeSH terms: Health Knowledge, Attitudes, Practice*
Fulltext Perception and opinion of medical students about Pap smear test: a qualitative study

Al-Naggar RA, Isa ZM

Asian Pac J Cancer Prev, 2010;11(2):435-40.
PMID: 20843130

OBJECTIVE: the objective of this study is to explore the perceptions of medical students regarding the Pap smear test.

METHODOLOGY: Focus group discussion was held with twenty three medical students. The students were divided into three focus groups; two groups of female participants consisting of 9 and 8 students; respectively. The third group consisted of 6 male students. Questions regarding Pap smear testing included barriers that prevented women from taking the test, gender preference for the physician to conduct the cervical screening test, willingness to suggest Pap smear test to the family or friends. The data obtained were classified into various categories and analyzed manually.

RESULTS: Most of the study participants mentioned that the main barriers for women to not perform Pap smear test is lack of awareness 16 (70%), followed by shyness 12 (52%) and the cost of the test 12 (52%). Most agreed that the gender of the physician will affect the women decision to do Pap smear test. All mentioned that the advantage of a regular Pap smear test is to detect the abnormality at the early stage of cervical cancer. Some of the participants 9 (39%) mentioned that the disadvantages are expense, possible injury in the vagina due to the test procedures 8 (35%), associated infection 7(30.4%) and pain 7(30.4%) . The majority, 20 (87%) mentioned that the most effective prevention methods for cervical cancer are having sex only after getting married with the spouse only, HPV vaccination 15 (65%) and Pap smear 14 (61%).

CONCLUSION: The main barriers for women to not perform Pap smear test is lack of awareness, shyness and the cost of the test. Gender of the physician will affect the women decision to do Pap smear test.

Matched MeSH terms: Health Knowledge, Attitudes, Practice*
Fulltext Does performance of breast self-exams increase the probability of using mammography: evidence from Malaysia

Dunn RA, Tan A, Samad I

Asian Pac J Cancer Prev, 2010;11(2):417-21.
PMID: 20843127

OBJECTIVES: Breast self-examination (BSE) was evaluated to see if it is a significant predictor of mammography.

METHODS: The decisions of females above age 40 in Malaysia to test for breast cancer using BSE and mammography are jointly modeled using a bivariate probit so that unobserved attributes affecting mammography usage are also allowed to affect BSE. Data come from the Malaysia Non-Communicable Disease Surveillance-1, which was collected between September 2005 and February 2006.

RESULTS: Having ever performed BSE is positively associated with having ever undergone mammography among Malay (adjusted OR=7.343, CI=2.686, 20.079) and Chinese (adjusted OR=3.466, CI=1.330, 9.031) females after adjusting for household income, education, marital status and residential location. Neither relationship is affected by jointly modelling the decision problem. Although the association is also positive for Indian females when mammography is modelled separately (adjusted OR=5.959, CI=1.546 - 22.970), the relationship is reversed when both decisions are modelled separately.

CONCLUSIONS: De-emphasizing BSE in Malaysia may reduce mammography screening among a large proportion of the population. Previous work on the issue in developed countries may not apply to nations with limited resources.

Matched MeSH terms: Health Knowledge, Attitudes, Practice*
Fulltext Knowledge, attitude and practice (KAP) concerning cervical cancer and screening among rural and urban women in six provinces of the Democratic People's Republic of Korea

Tran NT, Choe SI, Taylor R, Ko WS, Pyo HS, So HC

Asian Pac J Cancer Prev, 2011;12(11):3029-33.
PMID: 22393985

BACKGROUND: This study assessed women from the Democratic People's Republic of Korea for: (i) their level of knowledge of cervical cancer and attitudes and practices concerning cervical screening (KAP); and (ii) differences in KAP between rural and urban groups.

METHODS: In a descriptive cross-sectional study, a purposive sample of 200 women in 6 provinces of DPRK (rural: n=99, urban: n=101) were interviewed using a standardized questionnaire. Differences between proportions were assessed using the χ2 test. Significance was defined as p<0.05.

RESULTS: 63% of rural and 60% of urban participants had heard of cervical cancer (p>0.05). 42% knew that it is the most common cancer of the female reproductive tract, 55% knew that all women are at risk, but only 36% were aware of cervical cancer's preventability. Some 13% of rural and 29% of urban respondents had heard of cervical cytology testing (p<0.001). Only 6% of participants had ever received a cervical cytology smear. Among the reasons for not screening, 48% mentioned a lack of awareness of cervical cytology; 47% their dislike of pelvic examinations; 17% of rural and 31% of urban interviewees reported the absence of symptoms (p<0.05); and 62% of rural and 0% of urban women mentioned travelling long distances to service delivery points (p<0.001).

CONCLUSIONS: There is a reasonable level of knowledge of cervical cancer among North Korean women; however, there are major gaps regarding awareness of its preventability and actual uptake of cytology screening services. There are no significant differences between rural and urban women with regard to their KAP. Large scale health promotion campaigns are needed to educate women and the community about cervical cancer and its preventability through screening. The national health care system needs to ensure that screening services are effective, accessible, feasible and acceptable to women.

Matched MeSH terms: Health Knowledge, Attitudes, Practice*

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