埃塞俄比亚南部妇幼保健服务机构就诊妇女使用宫颈癌筛查服务意向的心理预测因素：计划行为理论（TPB）视角。
Psychographic predictors of intention to use cervical cancer screening services among women attending maternal and child health services in Southern Ethiopia: the theory of planned behavior (TPB) perspective.
机构信息
Department of Health, Behavior and Society, Institute of Health, Faculty of Public Health, Jimma University, Ethiopia, PO Box 378, Jimma, Ethiopia.
Sidama Zone Health Department, SNNPR, Hawassa, Ethiopia.
出版信息
BMC Public Health. 2019 Apr 25;19(1):434. doi: 10.1186/s12889-019-6745-x.
BACKGROUND
Detection of the premalignant forms cervical cancer through screening in the target age group is one of the effective strategies in the prevention of the disease. Nevertheless, the cervical cancer screening service use remains considerably low in Ethiopia. Indeed; promoting screening behaviors requires understanding the factors influencing women's motivation towards the service. Our study has explored the psycho-graphic factors associated to intention to use cervical cancer screening among women visiting maternal and child health services in Southern Ethiopia, 2017.
METHODS
Institution based cross-sectional study was used employing 422 women's age between 30 and 49 years old. A structured questionnaire was used to collect data on interviewer-administered basis. All assumptions of theory of planned behavior (TPB) were considered to measure intention, attitude, perceived social pressure and perceived ability to control circumstances against cervical cancer screening. Data were analyzed using statistical package for social sciences version 21.0. Multiple linear regression models were conducted to identify factors associated to intention to use cervical cancer screening. P-value less than 5% was considered to indicate significant association.
RESULT
Four hundred and two (95%) of the respondents completed the interview. Knowledge of the disease signs, symptoms, risk factors and prevention methods was 162(41.4%). Knowledge about the disease and past screening experience were positively associated with intention to use cervical cancer screening (β = 0.145, 95% CI = [0.047, 0.170]) and (β = 0.098, 95% CI = [0.093, 1.001]) respectively. Further; standardized regression coefficient showed that all dimensions of TPB were positively associated to intention to use the services with perceived behavioral control (β = 0.297, 95% CI = [0.172, 0.343]), perceived social pressure (β = 0.248, 95% CI = [0.131, 0.301]) and attitude towards screening (β = 0.110, CI = [0.018, 0.158]).
CONCLUSION
Overall; the intention to use cervical cancer screening was a function of attitude, perceived social pressure and perceived behavioral control confirming the hypothesis of the study. None of the socio-demographic variables were associated to intention. Health behavior change interventions should focus on increasing knowledge and empowering women that enable them to evaluate their control beliefs and develop ability against social norms and circumstances that compete with the use of cervical cancer screening services.
背景
通过在目标年龄段进行筛查来检测宫颈癌的癌前病变形式是预防该疾病的有效策略之一。然而，在埃塞俄比亚，宫颈癌筛查服务的使用率仍然相当低。事实上，要促进筛查行为，就需要了解影响妇女对该服务积极性的因素。我们的研究探讨了 2017 年在埃塞俄比亚南部接受母婴保健服务的妇女中与使用宫颈癌筛查意愿相关的心理因素。
方法
采用基于机构的横断面研究，纳入年龄在 30-49 岁之间的 422 名妇女。使用结构化问卷，通过访谈员进行数据收集。考虑了计划行为理论（TPB）的所有假设来衡量对宫颈癌筛查的意图、态度、感知社会压力和感知控制环境的能力。使用社会科学统计软件包 21.0 进行数据分析。采用多元线性回归模型来确定与使用宫颈癌筛查意愿相关的因素。P 值小于 0.05 被认为具有显著相关性。
结果
402 名（95%）受访者完成了访谈。有 162 名（41.4%）受访者了解疾病的体征、症状、风险因素和预防方法。对疾病的了解和过去的筛查经验与使用宫颈癌筛查的意愿呈正相关（β=0.145，95%CI=[0.047，0.170]）和（β=0.098，95%CI=[0.093，1.001]）。进一步，标准化回归系数显示，TPB 的所有维度与使用服务的意愿均呈正相关，包括感知行为控制（β=0.297，95%CI=[0.172，0.343]）、感知社会压力（β=0.248，95%CI=[0.131，0.301]）和对筛查的态度（β=0.110，CI=[0.018，0.158]）。
结论
总体而言，使用宫颈癌筛查的意愿是态度、感知社会压力和感知行为控制的函数，这证实了研究的假设。社会人口统计学变量均与意愿无关。健康行为改变干预措施应侧重于增加知识和增强妇女的能力，使她们能够评估自己的控制信念，并培养针对与使用宫颈癌筛查服务竞争的社会规范和环境的能力。
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