Malekzadeh Elnaz, Nourizadeh Roghaiyeh, Farshbaf-Khalili Azizeh, Mehrabi Esmat, Hakimi Sevil
Department of Midwifery, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran.
Physical Medicine and Rehabilitation Research Centre, Aging Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran.
J Educ Health Promot. 2022 Jun 30;11:205. doi: 10.4103/jehp.jehp_714_21. eCollection 2022.
Performing appropriate and regular screening can effectively reduce cervical cancer and mortality rate, however, the available evidence suggests that women's participation in cervical cancer screening remains low in middle- and low-income countries, and that it is necessary to identify appropriate intervention methods to change behavior. The present study was designed to determine the effect of decision-aid-based counseling on cervical cancer screening behavior among women.
This trial study was conducted on 154 women with no history of Pap smear during the past 3 years and refers to Tabriz health care centers. The participants were assigned to the intervention (decision aid based counseling) and control (routine health education) groups through randomized block design with block sizes of 4 and 6 and a 1:1 allocation ratio. The data were collected using the sociodemographic and fertility characteristics, stages of change checklist, and shared decision-making (SDM) and decisional conflict (DC) questionnaire before and 6 months after the intervention by interview and then, analyzed by SPSS24 software. The independent -test, ANCOVA tests were used.
A significant difference was observed between the two groups in terms of changing the stages of cervical cancer screening behavior 6 months after the intervention. As after the intervention, the frequency of individuals entered the preparation or action stage was more than the control group ( = 0.001). The mean score of SDM in the intervention group was significantly higher than the control group after intervention ([45.49 ± 1.18] vs. [27.56 ± 1.18] [Mean Difference (MD): 17.92; 95% confidence interval [CI]: 14.59-21.25; < 0.001]). The mean score of DC in the intervention group was significantly lower than the control group after intervention ([29.16 ± 1.09] vs. [34.14 ± 1.09] [MD: -4.97; 95% CI: 1.09-8.04; < 0.002]).
This study revealed that evidence-based information communicated between clients and clinicians has very important role in clients' health-related behavior. It is recommended, health care providers apply decision-aid-based counseling for promoting the cervical cancer screening behavior among women.
进行适当且定期的筛查可有效降低宫颈癌发病率和死亡率，然而，现有证据表明，中低收入国家女性参与宫颈癌筛查的比例仍然较低，因此有必要确定合适的干预方法来改变行为。本研究旨在确定基于决策辅助的咨询对女性宫颈癌筛查行为的影响。
本试验研究对154名在过去3年中无巴氏涂片检查史的女性进行，这些女性来自大不里士的医疗保健中心。通过随机区组设计，将参与者分为干预组（基于决策辅助的咨询）和对照组（常规健康教育），区组大小为4和6，分配比例为1:1。通过访谈在干预前和干预后6个月收集社会人口学和生育特征、改变阶段清单、共同决策（SDM）和决策冲突（DC）问卷的数据，然后使用SPSS24软件进行分析。采用独立样本t检验、协方差分析。
干预6个月后，两组在宫颈癌筛查行为阶段改变方面存在显著差异。干预后，进入准备或行动阶段的个体频率高于对照组（P = 0.001）。干预组干预后的SDM平均得分显著高于对照组（[45.49 ± 1.18]对[27.56 ± 1.18] [平均差值（MD）：17.92；95%置信区间[CI]：14.59 - 21.25；P < 0.001]）。干预组干预后的DC平均得分显著低于对照组（[29.16 ± 1.09]对[34.14 ± 1.09] [MD：-4.97；95% CI：1.09 - 8.04；P < 0.002]）。
本研究表明，医患之间传递的循证信息在患者的健康相关行为中具有非常重要的作用。建议医疗保健提供者采用基于决策辅助的咨询来促进女性宫颈癌筛查行为。
