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Hilverda F, Fissers K, van den Broek T. Turkish and Moroccan Dutch women’s views of using a self-sampling kit for human papillomavirus testing as a tool for cervical cancer screening: What are the barriers and the motivators? WOMEN'S HEALTH 2021; 17:17455065211065873. [PMID: 34903110 PMCID: PMC8679022 DOI: 10.1177/17455065211065873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Objective: This study explores barriers and motivators to use self-sampling kits for
human papillomavirus testing for cervical cancer screening as perceived by
Dutch women of Turkish and Moroccan origin living in the Netherlands. Methods: A total of 11 in-depth semi-structured interviews were conducted and
structured according to the theory of planned behavior. Results: Findings suggest that self-sampling may lift important barriers hampering
traditional cervical cancer screening, such as those related to shame and
chastity. However, self-sampling raises its own barriers too. Most
importantly, some women fear that self-sampling may harm virginity. Some
women also do not feel confident about their ability to properly use the
self-sampling kit, but fears about the inability to properly use it often
fade away upon having seen the self-sampling kit. Moreover, results show
that knowledge about cervical cancer and its origin is limited, which may
undermine women’s willingness to participate in a screening program. Conclusions: These results suggest that communication strategies to encourage using
self-sampling kits among women of Turkish and Moroccan origin could benefit
from culturally sensitive approaches, for example, by placing emphasis on
issues such as virginity and chastity. Consistent with a recent advice of
the Health Council of the Netherlands, the kit could furthermore be sent to
eligible women as a standard procedure, rather than upon request. This could
reduce hassle and doubts about women’s ability to use the self-sampling kit.
Finally, educating women about the importance of screening to prevent
cervical cancer is needed to foster informed decision-making.
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Affiliation(s)
- Femke Hilverda
- Department of Socio-Medical Sciences, Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - Katleen Fissers
- Department of Socio-Medical Sciences, Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - Thijs van den Broek
- Department of Socio-Medical Sciences, Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, The Netherlands
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Shahid S, Teng THK, Bessarab D, Aoun S, Baxi S, Thompson SC. Factors contributing to delayed diagnosis of cancer among Aboriginal people in Australia: a qualitative study. BMJ Open 2016; 6:e010909. [PMID: 27259526 PMCID: PMC4893856 DOI: 10.1136/bmjopen-2015-010909] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND/OBJECTIVES Delayed presentation of symptomatic cancer is associated with poorer survival. Aboriginal patients with cancer have higher rates of distant metastases at diagnosis compared with non-Aboriginal Australians. This paper examined factors contributing to delayed diagnosis of cancer among Aboriginal Australians from patient and service providers' perspectives. METHODS In-depth, open-ended interviews were conducted in two stages (2006-2007 and 2011). Inductive thematic analysis was assisted by use of NVivo looking around delays in presentation, diagnosis and referral for cancer. PARTICIPANTS Aboriginal patients with cancer/family members (n=30) and health service providers (n=62) were recruited from metropolitan Perth and six rural/remote regions of Western Australia. RESULTS Three broad themes of factors were identified: (1) Contextual factors such as intergenerational impact of colonisation and racism and socioeconomic deprivation have negatively impacted on Aboriginal Australians' trust of the healthcare professionals; (2) health service-related factors included low accessibility to health services, long waiting periods, inadequate numbers of Aboriginal professionals and high staff turnover; (3) patient appraisal of symptoms and decision-making, fear of cancer and denial of symptoms were key reasons patients procrastinated in seeking help. Elements of shame, embarrassment, shyness of seeing the doctor, psychological 'fear of the whole health system', attachment to the land and 'fear of leaving home' for cancer treatment in metropolitan cities were other deterrents for Aboriginal people. Manifestation of masculinity and the belief that 'health is women's domain' emerged as a reason why Aboriginal men were reluctant to receive health checks. CONCLUSIONS Solutions to improved Aboriginal cancer outcomes include focusing on the primary care sector encouraging general practitioners to be proactive to suspicion of symptoms with appropriate investigations to facilitate earlier diagnosis and the need to improve Aboriginal health literacy regarding cancer. Access to health services remains a critical problem affecting timely diagnosis.
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Affiliation(s)
- Shaouli Shahid
- Centre for Aboriginal Studies, Curtin University
- Western Australian Centre for Rural Health, University of Western Australia
| | | | - Dawn Bessarab
- Centre for Aboriginal Medical and Dental Health, University of Western Australia
| | - Samar Aoun
- School of Nursing, Midwifery and Paramedicine, Curtin University
| | | | - Sandra C Thompson
- Western Australian Centre for Rural Health, University of Western Australia
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3
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Banning M. Perceptions of breast health awareness in Black British women. Eur J Oncol Nurs 2011; 15:173-7. [DOI: 10.1016/j.ejon.2010.07.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2010] [Revised: 07/09/2010] [Accepted: 07/16/2010] [Indexed: 11/30/2022]
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Banning M, Hafeez H. A two-center study of Muslim women's views of breast cancer and breast health practices in Pakistan and the UK. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2010; 25:349-353. [PMID: 20146040 DOI: 10.1007/s13187-010-0051-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/23/2009] [Accepted: 01/08/2010] [Indexed: 05/26/2023]
Abstract
Breast health awareness practices of Pakistani Muslim women in the UK and Pakistan is unknown. Focus group interviews were used to investigate the impact of culture and psychosocial issues on breast health awareness involving 44 women in Lahore and London. Women based in Lahore were more inquisitive about breast cancer and held more developed views compared with British Pakistani Muslim women. Women concurred that concise and relevant breast health education is needed irrespective of faith to improve cultural sensitivity and awareness in both Pakistani communities (both men and women).
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Affiliation(s)
- Maggie Banning
- School of Health Studies and Social Care, Brunel University, Uxbridge, Middlesex, UK,
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5
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Banning M. Black women and breast health: a review of the literature. Eur J Oncol Nurs 2010; 15:16-22. [PMID: 20591734 DOI: 10.1016/j.ejon.2010.05.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2009] [Revised: 04/26/2010] [Accepted: 05/08/2010] [Indexed: 11/18/2022]
Abstract
AIM In the UK, it is known that screening inequalities exist involving ethnic minority groups such as Black women (Patnick, 2009). To date, there is limited UK data on Black British women and breast health awareness. Black British women appear to be an underrepresented group in breast cancer studies (Breast Cancer Care, 2004, 2005). This literature review aimed to explore Black women's perceptions of breast health and factors that influence breast cancer screening practices. METHODS A literature search for the period 1994 to September 2009 was undertaken using BNI, CINAHL, PubMed, OSH-ROM, PsyInfo, Google scholar, and Scopus databases. Key words used included: breast cancer, breast health, African American women, Black British women, black women, breast cancer screening, qualitative studies. Hand-searching was also done, and reference lists of papers were examined for relevant studies. RESULTS Black women hold a variety of views and perceptions on the risk that breast cancer poses. These perceptions are strongly related to existing knowledge, related stigmatization, spiritual and religious beliefs, all of which can adversely influence motivation to engage in self-breast examination and breast cancer screening. CONCLUSION US based studies identified several influential factors: religion, educational awareness of breast cancer screening, breast health awareness. Breast health interventions and research are needed to increase breast health awareness in Black British women.
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Affiliation(s)
- Maggi Banning
- School of Health Sciences and Social Care, Brunel University-Uxbridge, Middlesex, UK.
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6
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Liang W, Wang JH, Chen MY, Mandelblatt JS. Language use and the receipt of cancer screening recommendations by immigrant Chinese American women. J Womens Health (Larchmt) 2009; 18:201-7. [PMID: 19183091 DOI: 10.1089/jwh.2007.0709] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Cancer screening rates are low among Chinese American women, a mostly immigrant minority population. This is possibly because they do not receive cancer screening recommendations from their physicians. The objective of this study was to determine if the rate at which physicians recommend cancer screening to older Chinese American women differs according to the language used during visits. METHODS Data for the cross-sectional study were collected from a telephone survey of older Chinese American women residing in the Washington, DC, area. A total of 507 asymptomatic Chinese American women aged > or =50 who had a regular physician participated in this study. The main outcome was women's self-reported perception of having received a recommendation from their physician for mammography, Pap tests, or colorectal cancer screening in the past 2 years. The main independent variable was the language used during visits (English vs. Chinese). Patient age, educational level, employment status, cultural views, physician specialty, physician gender, and length of relationship with the physician were included in the multiple logistic regression analyses. RESULTS Chinese women who communicated with their physicians in English were 1.71 (95% CI 1.00-2.96) and 1.73 (95% CI 1.00-3.00) times more likely to report having received mammography and colorectal cancer screening recommendations, respectively (p < 0.05). Physicians in family medicine or general practice were 2.11 (95% CI 1.31-3.40) and 1.70 (95% CI 1.06-2.48) times more likely to recommend cancer screening than those in other specialties. CONCLUSIONS Chinese American women who conversed with their physicians in Chinese were less likely to perceive receiving cancer screening recommendations. Future research is needed to identify physician-specific knowledge, attitude, and cultural barriers to recommending cancer screening.
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Affiliation(s)
- Wenchi Liang
- Cancer Control Program, Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC, USA.
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Wang JH, Sheppard VB, Schwartz MD, Liang W, Mandelblatt JS. Disparities in cervical cancer screening between Asian American and Non-Hispanic white women. Cancer Epidemiol Biomarkers Prev 2008; 17:1968-73. [PMID: 18708386 DOI: 10.1158/1055-9965.epi-08-0078] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Asian American women have higher cervical cancer mortality rates than non-Hispanic White women, yet have lower Pap screening rates than their White counterparts. This study examined whether ethnic differences in the use of Pap screening were associated with differences in cultural views, controlling for demographic and access factors. METHODS Cross-sectional survey data from the Commonwealth 2001 Health Care Quality Survey were used. Non-Hispanic White (n = 2,146) and Asian American women (including Chinese, Vietnamese, Korean, Filipino, and Japanese; n = 259) were included in this study. Eastern cultural views were measured by beliefs in the role of self-care and luck. Access factors (having health insurance, regular providers, and communication with providers) and demographics of patients and providers were measured. The outcome was receipt of a Pap test in the past 2 years. RESULTS Asian American women had a lower rate of obtaining a recent Pap test (70%) than non-Hispanic White women (81%; P = 0.001). More Asians believed in the role of luck and self-care and experienced access barriers than Whites (P < 0.0001). Women with less Eastern cultural views are more likely to be recently screened than women with more (odds ratio, 1.08; 95% confidence interval, 1.00-1.16; P < 0.05). All access factors and provider gender types predicted the outcome. Within the Asian subgroups, Vietnamese women had lower screening rates (55%) and greater Eastern cultural views than their Asian counterparts. CONCLUSION More research is needed to understand cultural and other barriers to Pap screening in high-risk Asian women, and attention should be paid to within-group differences.
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Affiliation(s)
- Judy H Wang
- Department of Oncology, Georgetown University School of Medicine, and Cancer Control Program, Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC 20007, USA.
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Wang JH, Liang W, Schwartz MD, Lee MM, Kreling B, Mandelblatt JS. Development and evaluation of a culturally tailored educational video: changing breast cancer-related behaviors in Chinese women. HEALTH EDUCATION & BEHAVIOR 2007; 35:806-20. [PMID: 17602099 DOI: 10.1177/1090198106296768] [Citation(s) in RCA: 59] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This study developed and evaluated a culturally tailored video guided by the health belief model to improve Chinese women's low rate of mammography use. Focus-group discussions and an advisory board meeting guided the video development. A 17-min video, including a soap opera and physician-recommendation segment, was made in Chinese languages. A pretest/posttest pilot was conducted to evaluate the efficacy of the video in changing knowledge, beliefs, and screening intentions among Chinese women (age >or= 40) who were nonadherent to current National Cancer Institute's mammography guidelines (n=52). The results showed that the video significantly increased these women's screening intentions, knowledge, perceived risk for breast cancer, and perceived benefits of mammography. Chinese immigrant women were less likely to hold an Eastern view of health care and report barriers to screening after viewing the video. This video might have the potential to increase adherence to mammography screening in Chinese women.
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Affiliation(s)
- Judy H Wang
- Cancer Control Program, Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC 20007, USA.
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Abstract
PURPOSE/OBJECTIVES To examine the delay in seeking treatment and worry experiences of African American women with breast cancer. DESIGN Descriptive, correlational. SETTING Urban northeastern United States. SAMPLE 60 African American women diagnosed with breast cancer. METHODS Consenting participants completed the worry subscale of the Ware Health Perception questionnaire and a Demographic and Illness-Related Information Sheet during a one-hour personal interview. Data analysis consisted of descriptive statistics and Pearson correlations. MAIN RESEARCH VARIABLES Delay in seeking treatment, worry about breast cancer and symptoms, and sociodemographic characteristics. FINDINGS Contrary to the literature, participants reported short patient and provider delay. As a result of little variability in delay, predicting those for whom worry was a deterrent or a motivator to seek prompt treatment was not possible. CONCLUSIONS Although delay does exist, African American women with sociodemographic characteristics similar to white women who do not delay are likely to have similarly short symptom durations. Further study to determine who is helped and who is hurt by worry and other possible intervening factors would be useful. Including biologic characteristics such as tumor staging and hormone receptor information in future studies would allow for a closer examination of stage at diagnosis and biologic influence. IMPLICATIONS FOR NURSING Interventions with African American women cannot assume that delay exists. Strategies that consider both individual and cultural group differences are essential to the early seeking of a diagnosis and treatment for breast cancer symptoms among African American women.
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Russell KM, Monahan P, Wagle A, Champion V. Differences in health and cultural beliefs by stage of mammography screening adoption in African American women. Cancer 2007; 109:386-95. [PMID: 17133417 DOI: 10.1002/cncr.22359] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Behavioral studies show that women's stage of readiness to adopt mammography screening affects their screening rates and that beliefs about breast cancer and screening affect stages of screening. The purposes of this study were to determine, first, the relationship between particular health and cultural beliefs and stage of mammography screening adoption in urban African American women, and second, whether demographic and experiential characteristics differed by stage. Data were analyzed from 344 low-income African American women nonadherent to mammography screening who participated in a 21-month trial to increase screening. At baseline, these women were randomized into 1 of 3 groups: tailored interactive computer instruction, targeted video, or usual care. Participants were categorized by stage of mammography screening adoption at 6 months as precontemplators (not planning to have a mammogram), contemplators (planning to have a mammogram), or actors (had received a mammogram). Although demographic and experiential variables did not differentiate stages of screening adoption at 6 months postintervention, some health and cultural beliefs were significantly different among groups. Actors were more preventive-health-oriented than precontemplators and had fewer barriers to screening than did contemplators. Precontemplators had more barriers, less self-efficacy, and greater discomfort with the mammography screening environment than did contemplators or actors. These results will be useful, not to change cultural beliefs, but to guide the design of health education messages appropriate to an individual's culture and health belief system. Cancer 2007. (c) 2006 American Cancer Society.
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Affiliation(s)
- Kathleen M Russell
- Department of Environments for Health, School of Nursing, Indiana University, Indianapolis, Indiana 46202, USA.
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Russell KM, Perkins SM, Zollinger TW, Champion VL. Sociocultural context of mammography screening use. Oncol Nurs Forum 2006; 33:105-12. [PMID: 16470238 DOI: 10.1188/06.onf.105-112] [Citation(s) in RCA: 60] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE/OBJECTIVES To examine variations in cultural and health beliefs about mammography screening among a socioeconomically diverse sample of African American and Caucasian women and to identify which set of beliefs predicted mammography screening adherence. DESIGN Descriptive, retrospective, cross-sectional study. SETTING Community-based organizations and public housing. SAMPLE 111 African American women and 64 Caucasian women, aged 40 years or older, with no history of breast cancer. METHODS Telephone and in-person structured interviews were conducted. Items used previously validated scales based on the Cultural Assessment Model for Health and the Health Belief Model. MAIN RESEARCH VARIABLES Race or ethnicity, education, income, personal space, health temporal orientation, personal control, fatalism, susceptibility, benefits, barriers, self-efficacy, and mammography screening adherence. FINDINGS African American women were more fatalistic about breast cancer and perceived fewer benefits to screening. Mammography screening-adherent women were more future oriented, believed that they had less control over finding health problems early, had fewer barriers to screening, and experienced more physical spatial discomfort during the screening procedure than nonadherent women. CONCLUSIONS Several of the cultural beliefs were not significantly different by race or ethnicity. However, cultural and health beliefs were significant predictors of mammography screening. IMPLICATIONS FOR NURSING Theoretically based cultural beliefs are important to consider for behavioral interventions to increase mammography screening in African American and Caucasian women.
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Bradley PK, Kash KM, Piccoli CW, Myers RE. Preparing African American women for breast biopsy. Cancer Control 2005; 12 Suppl 2:100-2. [PMID: 16327759 DOI: 10.1177/1073274805012004s16] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Hoyo C, Yarnall KSH, Skinner CS, Moorman PG, Sellers D, Reid L. Pain predicts non-adherence to pap smear screening among middle-aged African American women. Prev Med 2005; 41:439-45. [PMID: 15917039 DOI: 10.1016/j.ypmed.2004.11.021] [Citation(s) in RCA: 69] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2003] [Revised: 06/22/2004] [Accepted: 11/23/2004] [Indexed: 12/22/2022]
Abstract
BACKGROUND Middle-aged African American women have the highest incidence and mortality of invasive cervical cancer in the United States and the lowest adherence to pap smear screening. METHODS In 2001, we identified factors associated with non-adherence to screening recommendations using three focus group interviews and subsequently developed a questionnaire administered to 144 African American women aged 45 to 65 years. RESULTS The perception that the Pap test was painful was associated with non-adherence to screening recommendations (OR = 4.78; 95%CI: 1.67-13.7). Difficulty to pay for the office visit coupled with perceived pain was associated with a nearly sixfold increase in risk of non-adherence (OR = 5.8; 95%CI: 2.8-15.5). Previously identified barriers to screening including lower education and socioeconomic status, poor access to care, knowledge of and exposure to known risk factors of invasive cervical cancer, cancer fatalism, and perceived racism were not independently associated with non-adherence. CONCLUSIONS These data suggest that, among middle-aged African American women, future interventions addressing pain during a Pap test will likely increase acceptability of and adherence to cervical cancer screening. Pain could be addressed either by providing information during the pap test and/or using smaller lubricated speculums.
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Affiliation(s)
- Cathrine Hoyo
- Department of Community and Family Medicine, Duke University Medical Center, Box 2914, Durham, NC 27710, USA.
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Weissenberger C, Jonassen S, Beranek-Chiu J, Neumann M, Müller D, Bartelt S, Schulz S, Mönting JS, Henne K, Gitsch G, Witucki G. Breast cancer: patient information needs reflected in English and German web sites. Br J Cancer 2004; 91:1482-7. [PMID: 15467771 PMCID: PMC2410016 DOI: 10.1038/sj.bjc.6602168] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Individual belief and knowledge about cancer were shown to influence coping and compliance of patients. Supposing that the Internet information both has impact on patients and reflects patients' information needs, breast cancer web sites in English and German language were evaluated to assess the information quality and were compared with each other to identify intercultural differences. Search engines returned 10 616 hits related to breast cancer. Of these, 4590 relevant hits were analysed. In all, 1888 web pages belonged to 132 English-language web sites and 2702 to 65 German-language web sites. Results showed that palliative therapy (4.5 vs 16.7%; P=0.004), alternative medicine (18.2 vs 46.2%; P<0.001), and disease-related information (prognosis, cancer aftercare, self-help groups, and epidemiology) were significantly more often found on German-language web sites. Therapy-related information (including the side effects of therapy and new studies) was significantly more often given by English-language web sites: for example, details about surgery, chemotherapy, radiotherapy, hormone therapy, immune therapy, and stem cell transplantation. In conclusion, our results have implications for patient education by physicians and may help to improve patient support by tailoring information, considering the weak points in information provision by web sites and intercultural differences in patient needs.
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Affiliation(s)
- C Weissenberger
- Division of Radiotherapy, University Hospital of Freiburg, Hugstetter Strasse 55, D-79106 Freiburg, Germany.
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Benard VB, Eheman CR, Lawson HW, Blackman DK, Anderson C, Helsel W, Thames SF, Lee NC. Cervical screening in the National Breast and Cervical Cancer Early Detection Program, 1995-2001. Obstet Gynecol 2004; 103:564-71. [PMID: 14990422 DOI: 10.1097/01.aog.0000115510.81613.f0] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To describe results of cervical cytology screening among low-income and uninsured women in the National Breast and Cervical Cancer Early Detection Program. METHODS We analyzed data from 750,591 women who received their first Papanicolaou (Pap) test in the program between July 1995 and March 2001. RESULTS Nearly 85% of the women were aged 40 years or older. Almost half were members of racial or ethnic minority groups. Overall, the percentage of abnormal Pap test results decreased with increasing age. The rates of cervical intraepithelial neoplasia (CIN) were highest in the younger age groups but the rate of invasive cancer increased with age. White women had the highest age-adjusted percentage of abnormal Pap test results and the highest rate of biopsy-confirmed CIN 2 or worse. CONCLUSIONS In this nationwide screening program, only 7% of all biopsy-confirmed high-grade cervical lesions (CIN 2 or worse) were invasive cancer. This underscores the success of Pap screening in identifying preinvasive disease and preventing cancer. LEVEL OF EVIDENCE II-3
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Affiliation(s)
- Vicki B Benard
- Epidemiology and Health Services Research Branch, Division of Cancer Prevention and Control, Centers for Disease Control and Prevention/NCCDPHP, 4770 Buford Highway NE, Atlanta, GA 30341, USA.
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Abstract
This study aimed to assess baseline knowledge about mammograms and Pap smears among Australian Deaf women, to investigate their participation in breast and cervical cancer screening services, and to explore, where relevant, their perceptions about their access to breast and cervical screening services. An interview schedule was developed, and a convenience sample of 13 Deaf women was interviewed face-to-face by the first researcher with an accredited Auslan interpreter. The Deaf women's knowledge about mammograms and Pap smears often was incomplete. However, most of the eligible women had undergone a mammogram and had been rescreened within the recommended time frame. Although most had received a Pap smear, some were not attending as recommended by the Cancer Council of Australia. This exploration into the experiences of Deaf women can prompt all nurses to consider the needs of particular minorities and the barriers they may face to participate fully in health services.
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Affiliation(s)
- Judy Wollin
- School of Nursing, Queensland University of Technology, Kevin Grove, Queensland, Australia
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Russell KM, Champion VL, Perkins SM. Development of cultural belief scales for mammography screening. Oncol Nurs Forum 2003; 30:633-40. [PMID: 12861323 DOI: 10.1188/03.onf.633-640] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE/OBJECTIVES To develop instruments to measure culturally related variables that may influence mammography screening behaviors in African American women. DESIGN Instrumentation methodology. SETTING Community organizations and public housing in the Indianapolis, IN, area. SAMPLE 111 African American women with a mean age of 60.2 years and 64 Caucasian women with a mean age of 60 years. METHODS After item development, scales were administered. Data were analyzed by factor analysis, item analysis via internal consistency reliability using Cronbach's alpha, and independent t tests and logistic regression analysis to test theoretical relationships. MAIN RESEARCH VARIABLES Personal space preferences, health temporal orientation, and perceived personal control. FINDINGS Space items were factored into interpersonal and physical scales. Temporal orientation items were loaded on one factor, creating a one-dimensional scale. Control items were factored into internal and external control scales. Cronbach's alpha coefficients for the scales ranged from 0.76-0.88. Interpersonal space preference, health temporal orientation, and perceived internal control scales each were predictive of mammography screening adherence. CONCLUSIONS The three tested scales were reliable and valid. Scales, on average, did not differ between African American and Caucasian populations. IMPLICATIONS FOR NURSING These scales may be useful in future investigations aimed at increasing mammography screening in African American and Caucasian women.
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Boyle DA, Sheridan A, McClary J, White J. A multifocal education strategy to enhance hospital-based Cultural competency in professional staff. Oncol Nurs Forum 2002; 29:764-8. [PMID: 12064324 DOI: 10.1188/02.onf.764-768] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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