Prediction of cervical cancer screening: application of the information-motivation-behavioral skills model

INTRODUCTION

Screening is an effective method for preventing cervical cancer. The present study aimed to determine the predictability of cervical cancer screening using the information-motivation-behavioral skills (IMB) model, as this model can help understand the factors that influence health-related behaviors.

METHOD

The present cross-sectional study examined 310 women aged 20 to 60 in Isfahan, Iran, between 2020 and 2021. To this end, comprehensive health centers and gynecology clinics of hospitals were randomly selected by lot. Women who met the study's inclusion criteria were selected via convenience sampling. An IMB skills questionnaire developed by researchers comprised the data collection tool. The data were analyzed using SPSS 22 software, descriptive and regression tests, and AMOS 24.0 software.

FINDINGS

Approximately 18.1% of the participants had never undergone routine cervical cancer screening. The regression model results indicated that the model components accurately predicted regular cervical cancer screening (P < 0.00). Path analysis revealed that information (β = 0.05, P = 0.002), motivation (β = 0.187, P = 0.026), and behavioral skills (β = 0.95, P < 0.001) were directly associated with regular cervical cancer screening. Furthermore, behavioral skills had the greatest direct effect on regular cervical cancer screening.

DISCUSSION AND CONCLUSION

The results demonstrated that the IMB model accurately predicted cervical cancer screening. Therefore, it is possible to improve cervical cancer screening in women by designing and implementing interventions based on this model's components, particularly those that improve behavioral skills.

Development of mobile application for cervical cancer screening in women: Protocol of a multi-phase study

BACKGROUND

Cervical cancer is one of the most common cancers in women. It is considered preventable due to the possibility of screening. The common barriers to cervical cancer screening include lack of knowledge, lack of time, and wrong beliefs. The use of e-Health technologies is one of the approaches for health promotion. The present study is aimed to the development of a mobile application for cervical cancer screening in women.

MATERIALS AND METHOD

This is a multi-phase study. In the first step, a literature review will be conducted to examine factors related to cervical cancer screening and existing applications related to cervical cancer and its screening. Then, in the second step, a cross-sectional study will be conducted to investigate the factors related to cervical cancer screening in 246 women referred to comprehensive health centers and women's clinics in teaching hospitals in Isfahan, Iran. The comprehensive health centers and women's clinics in teaching hospitals will be randomly selected using a lottery method. Using convenience sampling, women who meet the inclusion criteria will be included in the study, provided they provide informed consent. The data will be collected using a questionnaire, and then the descriptive and inferential statistical tests and SPSS18 software will be used to analyze the data. In the third step, specialists (gynecologists, reproductive health specialists, and midwives) will prioritize the application content by filling out a questionnaire. Then, the research team will compile the application content draft, and this draft will be reviewed and approved by experts on the expert panel. The prototype of the application will be prepared, and experts will evaluate it in the fifth step.

DISCUSSION

The results of this study will result in the development of applications for cervical cancer screening. The use of mobile applications can be useful in lifting some of the barriers to screening. Therefore, developing such applications may help improve cervical cancer screening.

Effectiveness of online sexual education based on the extended PLISSIT model on sexual function and sexual satisfaction in women undergoing breast cancer treatment

BACKGROUND

Despite therapeutic interventions having increased the survival rate of women with breast cancer, sexual dysfunction occurs in cancer survivors due to treatment. The aim of this study is to determine the effect of online sexual education, based on the Ex-PLISSIT model on sexual function and satisfaction, on women undergoing breast cancer treatment.

MATERIALS AND METHODS

The present study was a quasi-experimental and interventional control study. It was conducted with a pretest-posttest design between April and July 2022 in Isfahan, Iran. The participants were divided into an intervention (n = 40) and a control group (n = 40). The intervention group received sexual education based on the Ex-PLISSIT model that consisted of four levels of intervention, namely, permission (P), limited information (LI), specific suggestions (SS), and intensive therapy (IT), presented in four sessions. The Female Sexual Function Index (FSFI) and Larson's Sexual Satisfaction Questionnaire were used to measure the sexual function and sexual satisfaction of the participants. Data were analyzed using the Statistical Package for the Social Sciences (SPSS) version 21. P values below 0.05 were considered statistically significant.

RESULTS

The results showed that the mean of sexual satisfaction and function scores in the intervention group significantly increased after intervention. Moreover, the results showed a statistically significant difference in the mean of sexual satisfaction scores between the intervention and control groups after intervention (P = 0.020). Although there was a difference between the mean of sexual function scores in the intervention and control groups after the intervention, the t-test showed no statistically significant difference (P = 0.176).

CONCLUSIONS

According to the results of the study, sexual education based on the Ex-PLISSIT model could effectively enhance sexual satisfaction of women undergoing breast cancer treatment. It seems that this model can help health care providers evaluate the sexual needs of the patients and provide appropriate suggestions in order to decrease sexual problems.

A silence full of words: sociocultural beliefs behind the sexual health of Iranian women undergoing breast cancer treatment, a qualitative study

PURPOSE

Therapeutic interventions lead to impaired sexual health in women undergoing breast cancer treatment. There are some problem such as vaginal dryness, decreased libido, decreased sexual satisfaction, and decreased frequency of sexual intercourse among breast cancer survivors. This study was conducted to discover the sexual experiences of women undergoing breast cancer treatment.

METHODS

A total of 39 semi-structured interviews were held with the women undergoing breast cancer treatment, husbands, and health care providers. Recorded interviews were transcribed and analyzed using qualitative content analysis.

RESULTS

Three categories of cultural and gender taboos, adherence to subjective norms, and hidden values in sexuality were revealed. The cultural and gender taboos category consisted of subcategories of learned sexual shame, fear of judgment, sexual schemas, and gender stereotypes. The adherence to subjective norms category consisted of subcategories of sexual socialization, being labeled as a disabled woman and the priority of being alive to sexuality. The hidden values in sexuality category consist of subcategories of Task-based sexuality, Tamkin, and Sexuality prevents infidelity.

CONCLUSIONS

Socio-cultural beliefs affect the sexual health of women undergoing breast cancer treatment, so paying attention to this issue can improve the quality of sexual health services.

The Protective Effect of Breastfeeding and Ingesting Human Breast Milk on Subsequent Risk of Endometriosis in Mother and Child: A Systematic Review and Meta-Analysis

Background: Endometriosis is a chronic and debilitating disease characterized by ectopic, endometrium-like tissue outside the uterine cavity. Objective: The current meta-analysis was conducted to evaluate the effect of breastfeeding and ingesting human breast milk on the subsequent risk of endometriosis. Materials and Methods: The English and Persian databases were systematically searched in accordance with the Mesh browser keywords and free-text words until March 12, 2022. The Newcastle-Ottawa was used to evaluate the quality of the included studies. Publication bias was assessed using Begg's and Egger's tests, and funnel plot. The heterogeneity of studies was evaluated using I² statistics. Results of the random-effects meta-analysis were presented using odds ratios (ORs) and 95% confidence intervals (CIs). Results: In total, 18 articles with 10,994 subjects were included in the meta-analysis. Overall, the pool estimates show that breastfeeding (OR = 0.79, 95% CI: 0.71-0.88, I² = 89%) and ingesting human breast milk (OR = 0.67, 95% CI: 0.50-0.83, I² = 84.5%) have significantly a protective effect on the risk of endometriosis. Conclusion: Our findings confirm an inverse association between endometriosis risk and ingesting human breast milk, and breastfeeding. Therefore, the importance of breastfeeding for both mother and child should be considered by policymakers and health care providers.

Design, implementation, and evaluation of self-care program in the prevention of breast cancer among women in Isfahan: a community-based participatory action research protocol

Introduction

Breast cancer is one of the most prevalent cancers among women in Isfahan, Iran; however, its prevention is not desirable in this city. This disease poses several health, social and economic challenges for women. To promote women's self-care in breast cancer prevention, this study aims to design, implement and evaluate a self-care program among women in Isfahan through using a community-based participatory action research method.

Methods

The present study is based on a community-based participatory action research approach. In this study, the participatory action research includes four general phases of organizing, action planning, action, and rethinking. These phases are summarized as follows: In the organizing phase, the needs of the participants and the action research settings are examined. This means that the current situation is identified and the views of the process owners are assessed. In the action planning phase, using the results of the first phase, some strategies are designed to promote self-care behaviors in the prevention of breast cancer among women in Isfahan. In the implementation phase, the selected strategies are implemented with the help of the process owners. Finally, in the rethinking phase, the results of the implementation of the strategies are monitored and evaluated. This cycle continues until the intended results are achieved.

Discussion

Changing the role of individuals from a passive status to an aware and active status in the care process requires motivation, responsibility, and active participation of individuals in the disease control process. Moreover, many cultural and social factors affect the active participation of Iranian women. Therefore, individuals can be involved in promoting their health using a community-based participatory action research approach.

Supplementary Information

The online version contains supplementary material available at 10.1186/s40695-022-00077-8.

Sexual health promotion interventional program for women undergoing breast cancer treatment: Protocol for a mix-methods study

BACKGROUND

Women undergoing breast cancer treatment, especially those of reproductive age, experience sexual health challenges. The aim of this study is to design an interventional program for promoting the sexual health of women undergoing breast cancer treatment.

MATERIALS AND METHODS

This is a mixed qualitative-quantitative exploratory study consisting of four phases. In the first phase, the needs and strategies for promoting sexual health of Iranian women with breast cancer in Isfahan city will be identified through a qualitative study. The patients will be selected using purposive sampling method and the data will be collected through semi-structured interviews. In the second phase of the study, the relevant literature will be reviewed. In the third phase, the initial version of the program will be designed based on the results of qualitative study and review of literature, the appropriate strategies are prioritized by the members of the panel of experts, and then, the final interventional program is prepared. In the fourth phase, the designed interventional program will be conducted as a quasi-experimental study in two groups of intervention and control and the effectiveness of the program on sexual quality of life, sexual satisfaction, and sexual function of women undergoing breast cancer treatment will be evaluated. The type of the intervention will be selected based on the results of the previous phases and the opinion of the expert panel.

CONCLUSIONS

The results of this study are expected to contribute to the design of an interventional program based on the needs of women undergoing breast cancer treatment and promote health and meet the sexual health needs of breast cancer patients.

The relationship between maternal perception of social support and breastfeeding patterns

BACKGROUND

Breastfeeding is beneficial for the health of infants and mothers. It is a complex social behavior that may be influenced by social support. The study aimed to determine the relationship between perceived social support of breastfeeding women and their breastfeeding patterns.

MATERIALS AND METHODS

The research was a cross-sectional study on 300 mothers with 6-month infants or younger who were selected randomly. The data collection tool consisted standard social support and breastfeeding patterns questionnaires. We analyzed data using descriptive and analytical tests and SPSS 18 at a significance level of < 0.05.

RESULTS

The results indicated that 85%, 82.2%, and 38% of the infants were exclusively breastfed at 1 week, 4, and 6 months after delivery, respectively. The result of post hoc LSD test indicated that the mean number of supporters for mothers, who were in the 6^th month of delivery, was significantly lower than other times (P = 0.001). The one-way analysis of variance indicated no significant difference between perceived satisfaction of social support at different periods after delivery (P = 0.92). Despite the present results, which indicated that the number of supporters and scores of satisfaction with support in exclusive breastfeeding were higher than other groups, the differences were not statistically significant.

CONCLUSIONS

The mean number of supporters was less in women, who had 6-month-old infants, than mothers who had just given birth. It seems mothers with supplements and formula feeding patterns, such as breastfeeding mothers, may be supported to use these methods. Therefore, more studies are suggested on this field.

Comparing the Fertility Desire and Related Factors in Mothers with Intellectually Disabled Children and Mothers with Healthy Children

Background

The birth of a child with an intellectual disability is a common event. The fertility desire plays an important role in healthy reproductive programs. This study was conducted to compare the fertility desire and related factors in mothers with intellectually disabled and healthy children.

Materials and Methods

The present study was a descriptive, cross-sectional study. The sample size consisted of 348 mothers with healthy and intellectually disabled children (174 per group). Sampling was performed at normal (six schools) and special primary schools (twelve schools) in Isfahan, Iran using stratified random sampling method. Attitude, subjective norms, perceived behavior control, and gender preference were assessed using a researcher-made questionnaire and psychological well-being using Ryff questionnaire. Data were analyzed by descriptive statistics, Independent t-test, Mann-Whitney U test, Chi-square test, and Logistic regression using SPSS 24.

Results

In this study, 21.84% of mothers with healthy children and 13.79% of mothers with intellectually disabled children were willing to have other children. The fertility desire in mothers with intellectually disabled and healthy children decreased as their numbers of children (CI 95% =0.14-0.42) and age increased (CI 95% =0.80-0.93) by 0.87 and 0.24, respectively. There was statistically significant difference in mean score of psychological well-being between the two groups of mothers with fertility desire (p = 0.017). There was no statistically significant difference in mean score of attitude, subjective norms, perceived behavior control, and gender preference (p > 0.05).

Conclusions

Apparently the awareness of fertility desire and related factors in mothers with healthy and intellectually disabled children may be helpful in healthy fertility counseling.

Exploring Potential Achievements and Barriers to Provide Homecare for Women with Preeclampsia: A Qualitative Study

BACKGROUND

Preeclampsia (PE) is one of the leading causes of mortality and complications during pregnancy. It seems that usual prenatal care is not enough for these patients. They require more assistance, support, and guidance from health professionals, and home care is an effective strategy in this regard. Also, Iran has no official or compiled program for home care in high-risk pregnancy. This study was designed to explore the potential achievements and barriers of home care for mothers with PE.

METHODS

In this qualitative study with conventional content analysis, twenty-eight participants (mothers with PE, maternal health policy-makers, and health care providers) were selected through purposeful sampling with maximum variation. Data were collected through semi-structured interviews until saturation was achieved. Simultaneously, data analysis was performed using MXQDA software. Finally, the main categories were extracted.

RESULTS

Seven main categories were extracted. Three main categories for the potential achievement included "family involvement in maternal care", "holistic maternal health promotion", and "improving utility of services". The other four categories emerged for barriers included: "more willingness to provide in-hospital medical care", "clients' concerns about cultural issues", "providers` unwillingness to delivery home care", and "insufficiency of infrastructures for home care".

CONCLUSION

Paying attention to home care advantages, based on the socio-cultural context of the community, making effort to remove the barriers, and organizing home care infrastructures contribute to improvement in the quality of care in women with PE.

The association of psychological well-being and fertility intention in parents of children with intellectual disability: A foundation for reproductive education

INTRODUCTION

Childbearing is an important event in a couple's life. The parents might have children with disability that affected on their well-being after the children's birth. Well-being considered as an important aspect of a couple's quality of life which may alter the future of their fertility. The present study was conducted to the association of psychological well-being and fertility intention in parents with educable intellectually disabled children.

METHODS

The study was a cross-sectional descriptive research conducted on parents of children with intellectual disability (n = 386). Parents were selected randomly of schools of exceptional education and welfare. The data were collected using Ryff's scale of psychological well-being, demographic information, and fertility intention questionnaire. Data were analyzed using descriptive and analytical tests including independent t-test, Chi-square test, Mann-Whitney U-test, and Logistic regression.

RESULTS

The majority of parents (83.9%) reported the negative infertility intention. Despite the mean score of well-being in parents without fertility intention (75.71 ± 11.67) was lower than parents with fertility intention (76.90 ± 11.27), the difference was not statistically significant (P > 0.05). The logistic regression analysis indicated that the parents' age and number of children with intellectual disability were predictors of fertility intention (P < 0.05), and their increase decreased the fertility intention.

CONCLUSION

It seems that the lack of difference in psychological well-being scores between the two groups of parents might be due to the equal severity of disability in children. The results also indicated parents' age and the number of children correlated with fertility intention. The findings can be used to advance counseling programs in the field of healthy reproduction for this group of parents.

Fatalism in breast cancer and performing mammography on women with or without a family history of breast cancer

Background

Breast cancer is the most prevalent cancer in women, and in those with a positive family history, it is important to perform mammography. One of the probable barriers in doing mammography is fatalism.

Methods

This is a descriptive/cross-sectional study conducted on 400 women residing in Isfahan, Iran, randomly selected in 2017. Sampling was done randomly among the enrolled women in Health Integrity System. The data collection tool was a questionnaire regarding the demographic-fertility information and fatalism. The data analysis was done by SPSS software. A P-value < 0.05 was considered statistically significant.

Results

The results showed that the mean rate of fatalism was 59.5 ± 23.2 in women with the experience of mammography, and 65.9±18.7 in women without the experience. Moreover, the mean rate of fatalism was 73.1±15.2 in subjects with a family history of breast cancer, and 59.3 ± 22.5 in those no family history related to this condition. Accordingly, fatalism was statistically significant associated (P < 0.001) with a family history of breast cancer and experience of mammography. There was no significant relationship between demographic information and fatalism (P > 0.05).

Conclusion

The results indicated that fatalism in women with no experience of mammography was higher than in those with a positive history. Regarding the necessity of mammography in women with a family history of breast cancer, the required interventions seem to be essential to changing the viewpoints of women regarding the importance and effect of mammography as a screening method for breast cancer.

Electronic supplementary material

The online version of this article (10.1186/s12905-019-0810-6) contains supplementary material, which is available to authorized users.

Comparing individual and peer education on the constructs of theory of planned behavior in mammography

INTRODUCTION

Breast cancer is the most common cancer in women. It can be diagnosed in the first stage by screening. One of the methods for screening breast cancer is mammography. Mammography as a health behavior needs education. The theory of planned behavior examines the factors associated with the behavior.

AIM

This research was conducted to compare the individual and peer education on the constructs of the theory of planned behavior in mammography.

METHODS

This study was a clinical trial. A total of 100 women who attending the selected health centers of Isfahan city were classified randomly into two groups: peer and individual education. Education was based on the constructs of the theory of planned behavior (attitude relative to the mammography behavior, subjective norms, perceived behavioral control, and behavioral intention). The data were collected using a researcher-made questionnaire. Data were analyzed using descriptive-analytical statistics.

RESULTS

The mean score of attitude toward behavior in the individual education group was significantly higher than peer education (P < 0.05). In addition, the average score of subjective norms in peer education group was significantly higher than individual education (P < 0.05). The mean scores of perceived behavioral control constructs and behavioral intention were not significantly different (P > 0.05).

DISCUSSION

The results of this study showed the effectiveness of education (individual and peer) based on the theory of planned behavior on attitude toward behavior, subjective norms, perceived behavioral control, and behavioral intention related to performing mammography in women. It seems that using educational intervention can be useful to promote the screening behaviors of breast cancer. In general, there were no significant differences between the two methods in changing theoretical constructs.

A qualitative exploration of personality factors in breast cancer screening behavior

Although the efficacy of breast cancer screening in Iran has improved, the participation of women is not yet at a satisfactory level. Some personality factors can prevent women from attending breast cancer screening and most tumors are still diagnosed at an advanced stage. We conducted a descriptive exploration study in which we recruited healthcare providers, policymakers, and clients in Iran as participants. We used conventional content analysis with an inductive approach and gathered data from 2 discussion groups and some semistructured interviews. Three main themes emerged from the analysis: selflessness, fatalistic beliefs, and emotional responses. These factors contributed to screening behavior as both inhibitors and facilitators. Theoretical and practical implications are discussed.

Role Playing for Improving Women’s Knowledge of Breast Cancer Screening and Performance of Breast Self-Examination

Background:

To enhance knowledge and performance of screening as a strategy to control breast cancer, use of effective teaching methods is necessary. The objective of this study was to determine the effect of role-playing on knowledge of breast cancer screening and performance of breast self-examination (BSE).

Methods:

A quasi experimental design was used. Women enrolled in community cultural centers (n=314) were randomly divided into two educational groups: role playing (intervention) and lecture (control). Data were collected using a structured questionnaire before and after intervention. Reliability of the questionnaire was determined as 0.80 by Cronbach’s alpha. The women were followed up regarding performance of BSE one month later.

Results:

Of the 314 women, 113 (36%) and 132 (42%) had low and medium levels of knowledge, respectively. More than a third (38.2%) reported that TV and radio were the most important information sources for breast cancer and screening. There were significant differences between mean scores of knowledge before and after the intervention in both groups, but change was greater with role playing (31.3±1.9 as compared to 23.5±1.3) (P=0.001). After a month of educational intervention, 75.7% and 69.8% of those in role playing and control groups had undergone BSE.

Conclusion:

It appears that application of a role playing method by providers improves women’s knowledge and behavior with respect to breast cancer screening.

Relationship between breastfeeding factors and breast cancer in women referred to Seyed Al-Shohada Hospital in Isfahan, Iran

Background:

Breast cancer is the most common malignancy and a major cause of cancer deaths among women. Breastfeeding is presented as a probable protective factor against breast cancer, however, the effect of different breastfeeding patterns and duration of breastfeeding on this factor is not well determined. Thus, the aim of this research was to evaluate factors related to breastfeeding and breast cancer.

Materials and Methods:

This case–control study was conducted on 98 women with breast cancer and 198 healthy women who were selected through systematic random sampling method. Studied variables included demographic characteristics, reproduction characteristics, duration of breastfeeding, and breastfeeding pattern. The study variables were measured using a researcher-made questionnaire through self-report method. The two groups were matched in terms of place of residence and age. The data analysis was performed using logistic regression.

Results:

A relationship was observed between breast cancer and marital status (P = 0.04), education level (P = 0.02), individuals’ perspectives of their economic status (P = 0.001), and lack of breastfeeding (P = 0.006). However, no relationship was found between breast cancer and reproductive factors. Moreover, multiple logistic regression analysis results showed that breast cancer only had a relationship with individuals’ perspectives of their economic status with OR of 0.31 (95% CI: 0.16–0.59).

Conclusions:

The results showed that there was no relationship between breast cancer and reproductive factors and breastfeeding pattern. Due to the difference between the findings of this research and other researches, genetic, epigenetic, and cultural differences must be considered in the evaluation of risk factors for breast cancer.