Hogenmiller Jette R, Atwood Jan R, Lindsey Ada M, Johnson David R, Hertzog Melody, Scott Joseph C
Health, Innovation, and Research, 8687 Tranquility Loop, Ft. Calhoun, NE 68023, USA.
Nurs Res. 2007 Nov-Dec;56(6):369-77. doi: 10.1097/01.NNR.0000299848.21935.8d.
Sheltered, homeless women disproportionately experience cervical dysplasia and cervical cancer. Low rates of Pap smear screening contribute to late diagnosis with accompanying increased morbidity and mortality. Self-efficacy (SE) has been demonstrated to be predictive of several health behaviors, but limited evidence about SE for Pap smear screening exists.
To develop, test, and refine the conceptually based Self-Efficacy Scale for Pap Smear Screening Participation (SES-PSSP).
This correlational, descriptive study included a purposive sampling of sheltered women (N = 161).
The 20-item SES-PSSP demonstrated acceptable initial validity and reliability. Reliability estimates of stability (>or=84%) and internal consistency (alpha = .95) exceeded criteria. Content validity and construct validity were supported (e.g., common factor analysis and predictive model testing that included SE, decisional balance, knowledge regarding Pap smear screening, demographics, health-related behaviors, health status, and personal beliefs about risks for cervical cancer and dysplasia). Self-efficacy, decisional balance, illicit drug usage, and age predicted 28% of the variance in stages of change (precontemplation, contemplation, preparation, action, and maintenance) for Pap smear screening participation.
The SES-PSSP provides a new scale for measuring SE pertinent to Pap smear screening participation in a vulnerable, ethnically diverse sample of sheltered, inner-city women. Validity testing demonstrated that the SE concept was predictive of Pap smear screening behavior, suggesting that SE-based interventions tailored to the SES-PSSP subscale or total scores could increase screening. A 10-minute completion time supports feasibility for use in the clinic setting.
受庇护的无家可归女性患宫颈发育异常和宫颈癌的比例过高。巴氏涂片筛查率低导致诊断延迟，随之而来的是发病率和死亡率增加。自我效能感（SE）已被证明可预测多种健康行为，但关于巴氏涂片筛查的自我效能感的证据有限。
开发、测试和完善基于概念的巴氏涂片筛查参与自我效能量表（SES-PSSP）。
这项相关性描述性研究包括对受庇护女性（N = 161）进行的目的抽样。
20项的SES-PSSP显示出可接受的初始效度和信度。稳定性（≥84%）和内部一致性（α = 0.95）的信度估计超过标准。内容效度和结构效度得到支持（例如，共同因素分析和预测模型测试，包括自我效能感、决策平衡、关于巴氏涂片筛查的知识、人口统计学、健康相关行为、健康状况以及对宫颈癌和发育异常风险的个人信念）。自我效能感、决策平衡、非法药物使用和年龄预测了巴氏涂片筛查参与的改变阶段（前意向、意向、准备、行动和维持）中28%的变异。
SES-PSSP为测量与受庇护的市中心弱势、种族多样的女性参与巴氏涂片筛查相关的自我效能感提供了一个新量表。效度测试表明，自我效能感概念可预测巴氏涂片筛查行为，这表明针对SES-PSSP子量表或总分量身定制的基于自我效能感的干预措施可能会增加筛查。10分钟的完成时间支持了在临床环境中使用的可行性。
