A nursing investigation of factors identified by Newfoundland women that may influence screening for cancer of the cervix

Kelly, Colleen M. E. (1993) A nursing investigation of factors identified by Newfoundland women that may influence screening for cancer of the cervix. Masters thesis, Memorial University of Newfoundland.

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Abstract

A descriptive, correlational investigation was conducted in two physicians' clinics in an urban setting in Newfoundland. The investigation sought to document pap smear frequency and identify factors that may influence a woman's decision to have a pap smear. Cancer of the cervix is considered preventable and amenable to successful treatment when detected early. In order to be successful in primary and secondary prevention strategies for this cancer, nurses need to be aware of factors that may influence a woman's decision to have a pap smear according to recommended intervals. -- The conceptual framework used in this investigation was the Health Belief Model (HBM). The major elements included: individual perceptions, modifying factors, and likelihood of action. Data were collected using the Pap Test Questionnaire. Ninety-two women comprised the sample population. -- The sample consisted of women who were younger and well educated and was not representative of the general population. Most were screened within a five year interval, with two thirds screened less than one year ago. Most of the women of childbearing age were screened less than one year ago as compared to one half of those past childbearing. -- The major elements of the HBM were not found to influence screening practice. Only one third of the sample perceived themselves to be susceptible for cancer of the cervix. The majority reported their husband or boyfriend influenced their decision to have a pap smear. Mother, close friends, and sister were also reported to be influential. The majority believed the recommended screening interval was annually. This has implications for education programs prior to the implementation of the revised screening guidelines which recommend screening every three years regardless of age or risk. Subjects were not knowledgable of risk factors for cancer of the cervix and of particular concern over two thirds of the youngest age group reported early onset of sexual intercourse was not high risk. Cues to action variables, the doctor and the media, were perceived to be highly influential and greater than that reported for individuals in a woman's family and social network. The majority indicated they should remember when to have a pap smear, yet two thirds indicated the doctor should remind them. Many of the women who had a pap smear less than one year ago were reminded by the doctor. Almost all of the women reported they felt relieved to have a pap smear and that changes would be found early. The barrier most frequently reported was unpleasantness. -- The findings of this investigation suggest replication for various subsets of the Newfoundland population including older women, women considered to be disadvantaged, and aboriginal peoples. It is recommended nurses take an active role in prevention activities for cancer of the cervix and offer pap smear screening as a part of Well Womens' Clinics.

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