Getahun Tomas, Kaba Mirgissa, Derseh Behailu Tariku
School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
Department of Public Health, College of Health Sciences, Debre Berhan University, Debre Berhan, Ethiopia.
J Cancer Epidemiol. 2020 Mar 19;2020:3024578. doi: 10.1155/2020/3024578. eCollection 2020.
Cervical cancer is a major public health problem in many developing countries. Despite the value of screening to prevent morbidity and mortality from cervical cancer, little available literature shows early detection and treatment to be limited in Ethiopia. The aim of this study was to determine the magnitude of and identify factors associated with women's intention to screen for cervical cancer using the theory of planned behavior.
A community-based cross-sectional study design supplemented with a qualitative approach was employed. Using multistage sampling, a total of 821 women were used in the study. An interviewer-administered survey questionnaire was used to collect quantitative data, whereas purposively selected 12 female health care providers were included in in-depth interviews. Descriptive statistics and simple and multiple binary logistic regression analysis were used to determine the magnitude of women's intention, identify associated factors, and explore barriers for intention to cervical cancer screening among Debre Berhan women, Ethiopia. The statistical association was determined at a value of less than 0.05. Moreover, thematic analysis was used to search the hindrances of women's intention to screen for cervical cancer.
The median age of women who participated in this study was 39 years with IQR of 35 to 42 years. Three hundred sixty-one (361, 45.3%) of women had an intention to screen for cervical cancer within three months from the date of the interview. Positive attitude towards cervical cancer screening (AOR = 6.164; 95% CI: 4.048, 9.387), positive subjective norm (AOR = 2.001; 95% CI: 1.342, 2.982), and higher perceived behavioral control (AOR = 7.105; 95% CI: 4.671, 10.807) were predictors of the women's intention to screen for cervical cancer. The qualitative finding revealed that women did not like to be screened for cervical cancer because they thought that procedure pinch the cervix and it may result in perforating the uterus that would expose them for infertility. In addition, the qualitative findings supported quantitative results, where the constructs of the theory of planned behavior play an essential role in the betterment of women's intention.
This study showed that women's intention to screen for cervical cancer was low. Positive attitudes towards cervical cancer screening (CCS), subjective norms, and perceived behavioral control were predictors of women's intention to screen for cervical cancer. Thus, efforts should be exerted to improve the attitude of women involving influential people, which could improve women's intention for cervical cancer screening. Moreover, behavioral change communication focusing on the constructs of the theory of planned behavior is crucial.
宫颈癌是许多发展中国家的一个主要公共卫生问题。尽管筛查对于预防宫颈癌的发病和死亡具有重要价值，但在埃塞俄比亚，鲜有文献表明早期检测和治疗是有限的。本研究的目的是运用计划行为理论来确定女性进行宫颈癌筛查意愿的程度，并识别与之相关的因素。
采用基于社区的横断面研究设计，并辅以定性方法。通过多阶段抽样，本研究共纳入了821名女性。采用访谈式调查问卷收集定量数据，同时有目的地选取了12名女性医疗保健提供者进行深入访谈。描述性统计以及简单和多元二元逻辑回归分析被用于确定女性意愿的程度、识别相关因素，并探讨埃塞俄比亚德布雷伯汉女性进行宫颈癌筛查意愿的障碍。统计学关联以P值小于0.05来确定。此外，采用主题分析来探寻女性进行宫颈癌筛查意愿的阻碍因素。
参与本研究的女性的中位年龄为39岁，四分位间距为35至42岁。361名（361名，45.3%）女性表示有意愿在访谈之日起三个月内进行宫颈癌筛查。对宫颈癌筛查持积极态度（优势比[AOR]=6.164；95%置信区间[CI]：4.048，9.387）、积极的主观规范（AOR=2.001；95%CI：1.342，2.982）以及较高的感知行为控制（AOR=7.105；95%CI：4.671，10.807）是女性进行宫颈癌筛查意愿的预测因素。定性研究结果显示，女性不喜欢进行宫颈癌筛查，因为她们认为该检查会挤压宫颈，可能导致子宫穿孔，进而使她们面临不孕风险。此外，定性研究结果支持了定量研究结果，即计划行为理论的各个构念在改善女性意愿方面发挥着重要作用。
本研究表明，女性进行宫颈癌筛查的意愿较低。对宫颈癌筛查的积极态度、主观规范以及感知行为控制是女性进行宫颈癌筛查意愿的预测因素。因此，应努力改善女性的态度，包括有影响力的人群，这可能会提高女性进行宫颈癌筛查的意愿。此外，聚焦于计划行为理论构念的行为改变沟通至关重要。
