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Current Women`s Health Reviews

Editor-in-Chief

ISSN (Print): 1573-4048
ISSN (Online): 1875-6581

Research Article

Perspectives of Married Women Related to Cervical Cancer Screening Test: A Theory-Based Qualitative Study in Iran

Author(s): Mona Khalednejad, Leili Salehi*, Sara Pashang, Abbas Moghimbeigi and Atefeh Nezhad Mohamad Nameghi

Volume 19, Issue 1, 2023

Published on: 19 April, 2022

Article ID: e040322201708 Pages: 8

DOI: 10.2174/1573404818666220304104128

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Abstract

Background: Cervical cancer (CC) is one of the treatable forms of cancer that can be prevented in its long precancerous conditions and good screening programs.

Aims: Using directed content analysis, the present study, as qualitative research, aimed to investigate married women’s perspectives on screening for CC based on the protection motivation theory (PMT).

Methods: To this end, a total number of 20 married women, considering maximum variation in sampling in terms of age and level of education, were interviewed. Therefore, an in-depth semistructured interview was used for data collection until saturation was reached. The PMT was also applied as the main framework to develop the interview items.

Results: Eight categories, namely, intention, fear, perceived susceptibility, perceived severity, response efficacy, self-efficacy, response cost, and social support, were identified based on data classification. The majority of the participants intended to have a Pap smear. Moreover, they believed that if women knew more about screening for cervical cancer, they would definitely do so. Most of the participants, 60 %, had a high level of perceived susceptibility, and 100 % of them had self-efficacy related to doing a Pap smear. Almost all the interviewees acknowledged the effectiveness of a Pap smear and its consequences, but 80 % of the participants reported that they could not follow regular tests due to response cost despite their self-efficacy and knowledge about the effectiveness and the benefits of this type of screening. All the study participants also put more emphasis on the role of social support to push them to get a Pap smear.

Conclusion: The cost of a Pap smear and social support should be considered when encouraging married women to participate in screening programs.

Keywords: Cervical cancer, protection motivation theory, pap smear test, screening, qualitative study, perspective.

[1]
Arbyn, M.; Weiderpass, E.; Bruni, L.; de Sanjosé, S.; Saraiya, M.; Ferlay, J.; Bray, F. Estimates of incidence and mortality of cervical cancer in 2018: A worldwide analysis. Lancet Glob. Health, 2020, 8(2), e191-e203.
[http://dx.doi.org/10.1016/S2214-109X(19)30482-6] [PMID: 31812369]
[2]
de Martel, C.; Plummer, M.; Vignat, J.; Franceschi, S. Worldwide burden of cancer attributable to HPV by site, country and HPV type. Int. J. Cancer, 2017, 141(4), 664-670.
[http://dx.doi.org/10.1002/ijc.30716] [PMID: 28369882]
[3]
Mupepi, S.C.; Sampselle, C.M.; Johnson, T.R.B. Knowledge, attitudes, and demographic factors influencing cervical cancer screening behavior of Zimbabwean women. J. Womens Health (Larchmt.), 2011, 20(6), 943-952.
[http://dx.doi.org/10.1089/jwh.2010.2062] [PMID: 21671779]
[4]
Momenimovahed, Z.; Salehiniya, H. Cervical cancer in Iran: Integrative insights of epidemiological analysis. Biomedicine (Taipei), 2018, 8(3), 18.
[http://dx.doi.org/10.1051/bmdcn/2018080318] [PMID: 30141405]
[5]
Siegel, R.; Naishadham, D.; Jemal, A. Cancer statistics, 2012. CA Cancer J. Clin., 2012, 62(1), 10-29.
[http://dx.doi.org/10.3322/caac.20138] [PMID: 22237781]
[6]
Mishra, G.A.; Pimple, S.A.; Shastri, S.S. An overview of prevention and early detection of cervical cancers. Indian J. Med. Paediatr. Oncol., 2011, 32(3), 125-132.
[http://dx.doi.org/10.4103/0971-5851.92808] [PMID: 22557777]
[7]
Sharma, P.; Rahi, M.; Lal, P.A. Community-based cervical cancer-screening program among women of Delhi using camp approach. Indian J. Community Med., 2010, 35(1), 86-88.
[http://dx.doi.org/10.4103/0970-0218.62576]
[8]
Ibekwe, C.M.; Hoque, M.E.; Ntuli–Ngcobo, B. Perceived barriers of cervical cancer screening among women attending Mahalapye district hospital, Botswana. Arch. Clin. Microbiol., 2011, 2(1), 4.
[9]
Khodakarami, N.; Farzaneh, F.; Yavari, P.; Khayamzadeh, M.; Taheripanah, R.; Esmaeil Akbari, M. The new guideline for cervical cancer screening in low risk Iranian women. Majallah-i Zanan, Mamai va Nazai-i Iran, 2014, 17(95), 8-17.
[10]
Jamdar, F.; Farzaneh, F.; Navidpour, F.; Younesi, S.; Balvayeh, P.; Hosseini, M.; Ghodssi-Ghasemabadi, R. Prevalence of human papillomavirus infection among Iranian women using COBAS HPV DNA testing. Infect. Agent. Cancer, 2018, 13(1), 6.
[http://dx.doi.org/10.1186/s13027-018-0178-5] [PMID: 29416557]
[11]
Akbari, H.; Jaddi Arani, T.S.; Gilasi, H.R.; Moazeni Godarzi, A.; Ghazi Poor, Z.; Naghi Poor, A.; Tol A Abdar, T. Study of motivational factors and causes of nonparticipation to breast and cervical cancer screening tests among women attending health centers in Kashan city. Sci. J. Ilam Univ. Med. Sci., 2013, 22(3), 137-148.
[12]
Masoumi, S.Z.; Khani, S.; Gharosian, M.; Farhadi, M.; Shayan, A. The prevalence of abnormal pap smears in female referred to health centers affiliated to medical sciences during the years 2012-2016. J. Educ. Community Health, 2016, 3(10), 16-23.
[13]
Hami, M.Y.; Ehlers, V.J.; van der Wal, D.M.; Ehlers, V.J. Women’s perceived susceptibility to and utilisation of cervical cancer screening services in Malawi. Health SA Gesondheid, 2014, 19(1), 1-8.
[http://dx.doi.org/10.4102/hsag.v19i1.787]
[14]
Blomberg, K.; Ternestedt, B.M.; Törnberg, S.; Tishelman, C. How do women who choose not to participate in population-based cervical cancer screening reason about their decision? Psychooncology, 2008, 17(6), 561-569.
[http://dx.doi.org/10.1002/pon.1270] [PMID: 17886262]
[15]
Al-Naggar, R.A.; Chen, R. Practice towards cervical cancer screening among university staff at a Malaysian university. J. Community Med. Health Educ., 2012, 2(1), 120.
[http://dx.doi.org/10.4172/jcmhe.1000120]
[16]
Oscarsson, M.G.; Benzein, E.G.; Wijma, B.E. Reasons for non-attendance at cervical screening as reported by non-attendees in Sweden. J. Psychosom. Obstet. Gynaecol., 2008, 29(1), 23-31.
[http://dx.doi.org/10.1080/01674820701504619] [PMID: 18266164]
[17]
Adolfsson, A.; Granevik, K.; Paulson, K. The reasons why women do not participate in Pap smear screening and testing program in Sweden. Adv. Sexual Med., 2012, 2, 31-37.
[http://dx.doi.org/10.4236/asm.2012.23006]
[18]
Keshavarz, Z.; Simbar, M.; Ramezankhani, A. Factors for performing breast and cervix cancer screening by Iranian female workers: A qualitative-model study. Asian Pac. J. Cancer Prev., 2011, 12(6), 1517-1522.
[PMID: 22126491]
[19]
Grigore, M.; Popovici, R.; Pristavu, A.; Grigore, A.M.; Matei, M.; Gafitanu, D. Perception and use of Pap smear screening among rural and urban women in Romania. Eur. J. Public Health, 2017, 27(6), 1084-1088.
[http://dx.doi.org/10.1093/eurpub/ckx112] [PMID: 29020396]
[20]
Eze, G.U.; Irikefe, P.; ObiebiIbiyemi, J. Umuago Perspectives of cervical cancer and screening practices among staff of a teaching hospital in South-South Nigeria. J. Cancer Res. Pract., 2018, 2(5), 67-73.
[http://dx.doi.org/10.1016/j.jcrpr.2018.01.001]
[21]
Maar, M.; Burchell, A.; Little, J.; Ogilvie, G.; Severini, A.; Yang, J.M.; Zehbe, I. A qualitative study of provider perspectives of structural barriers to cervical cancer screening among first nations women. Womens Health Issues, 2013, 23(5), e319-e325.
[http://dx.doi.org/10.1016/j.whi.2013.06.005] [PMID: 23993479]
[22]
Collins, C.S.; Stockton, C.M. The central role of theory in qualitative research. Int. J. Qual. Methods, 2018, 17, 1-10.
[http://dx.doi.org/10.1177/1609406918797475]
[23]
Rogers, R.W. A protection motivation theory of fear appeals and attitude change. J. Psychol., 1975, 91(1), 93-114.
[http://dx.doi.org/10.1080/00223980.1975.9915803] [PMID: 28136248]
[24]
Hsieh, H.F.; Shannon, S.E. Three approaches to qualitative content analysis. Qual. Health Res., 2005, 15(9), 1277-1288.
[http://dx.doi.org/10.1177/1049732305276687] [PMID: 16204405]
[25]
Saunders, B.; Sim, J.; Kingstone, T.; Baker, S.; Waterfield, J.; Bartlam, B.; Burroughs, H.; Jinks, C. Saturation in qualitative research: Exploring its conceptualization and operationalization. Qual. Quant., 2018, 52(4), 1893-1907.
[http://dx.doi.org/10.1007/s11135-017-0574-8] [PMID: 29937585]
[26]
Clubb, A.C.; Hinkle, J.C. Protection motivation theory as a theoretical framework for understanding the use of protective measures. Crim. Justice Stud., 2015, 28(3), 336-355.
[http://dx.doi.org/10.1080/1478601X.2015.1050590]
[27]
Ferguson, B.D.; Tandon, A.; Gakidou, E.; Murray, C.J.L. Estimating permanent income using indicator variables. Murray, C.J.L.; Evans, D.B. In: Health Systems Performance Assessment: Debates, Methods and Empiricism; WHO: Geneva, Switzerland, 2003; pp. 747-760.31.
[28]
Chatterji, S.; Kowal, P.; Mathers, C.; Naidoo, N.; Verdes, E.; Smith, J.P.; Suzman, R. The health of aging populations in China and India. Health Aff. (Millwood), 2008, 27(4), 1052-1063.
[http://dx.doi.org/10.1377/hlthaff.27.4.1052] [PMID: 18607041]
[29]
Maddux, J.E.; Rogers, R.W. Protection motivation and self-efficacy: A revised theory of fear appeals and attitude change. J. Exp. Soc. Psychol., 1983, 19(5), 469-479.
[http://dx.doi.org/10.1016/0022-1031(83)90023-9]
[30]
Li, Q.; Liu, Q.; Chen, X.; Tan, X.; Zhang, M.; Tuo, J.; Xiang, Q.; Yu, Q.; Zhu, Z. Protection motivation theory in predicting cervical cancer screening participation: A longitudinal study in rural Chinese women. Psychooncology, 2020, 29(3), 564-571.
[http://dx.doi.org/10.1002/pon.5307] [PMID: 31823462]
[31]
Oketch, S.Y.; Kwena, Z.K.; Adewumi, K.; Moghadassi, M.; Bukui, E.A.; Hucko, M.J. Perspectives of women participating in a cervical cancer screening campaign with community-based HPV self-sampling in rural western Kenya: A qualitative study. BMC Women's Health Volume, 2019, 19(1), 75.
[http://dx.doi.org/10.1186/s12905-019-0778-2]
[32]
Abdulmalek, Y.I.; Mohamood Kalary, K. Knowledge, attitude and practice about pap smear among married women attending primary health care centers in Duhok city. Int. J. Med. Sci., 2019, 8(1), 139-153.
[http://dx.doi.org/10.31386/dmj.2020.4.1.9]
[33]
El-Hammasi, K.; Samir, O.; Kettaneh, S.; Al-Fadli, A.; Thalib, L. Use of and attitudes and knowledge about pap smears among women in Kuwait. J. Womens Health (Larchmt.), 2009, 18(11), 1825-1832.
[http://dx.doi.org/10.1089/jwh.2008.1227] [PMID: 19951218]
[34]
Jalilian, F.; Emdadi, S. Factors related to regular undergoing papsmear test: Application of theory of planned behavior. J. Res. Health Sci., 2011, 11(2), 103-108.
[http://dx.doi.org/10.7314/APJCP.2016.17.S3.263] [PMID: 22911960]
[35]
Majdfar, Z.; Khodadost, M.; Majlesi, F.; Rahimi, A.; Shams, M. Relationships between self-efficacy and pap smear screening in Iranian women. Asian Pac. J. Cancer Prev., 2016, 17(S3), 263-268.
[http://dx.doi.org/10.7314/APJCP.2016.17.S3.263]
[36]
Marashi, T.; Irandoost, S.F.; Yoosefi Lebni, J.; Soofizad, G. Exploring the barriers to Pap smear test in Iranian women: A qualitative study. BMC Womens Health, 2021, 21(1), 287.
[http://dx.doi.org/10.1186/s12905-021-01428-9] [PMID: 34362366]
[37]
Lin, T.; Chen, J. Effect of physician gender on demand for pap tests. Econ. Res. Int., 2014, 2014, 647169.
[38]
Al-Naggar, R.A.; Isa, Z.M. Perception and opinion of medical students about Pap smear test: A qualitative study. Asian Pac. J. Cancer Prev., 2010, 11(2), 435-440.
[PMID: 20843130]
[39]
Akbari, F.; Shakibazadeh, E.; Pourreza, A.; Tavafian, S.S. Barriers and facilitating factors for cervical cancer screening: A qualitative study from Iran. Int. J. Cancer Manage., 2010, 3(4), e80714.

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