Purpose: Health literacy is a significant determinant of health and health behaviors such as cancer screening. Despite its significance, there are limited instruments available to assess health literacy targeting Koreans. The purpose of this study was to test the psychometric properties of Korean translation of a validated health literacy instrument in cancer screening-Korean version of assessment of health literacy in breast and cervical cancer screening (K-AHL-C). Methods: A total of 555 women aged 20~65 participated in the online survey study. Of 52 items addressing five domains included in the original version, we focused on 36 items addressing three key domains closely associated with cancer screening: familiarity, health navigation, and comprehension. Results: During content validation, two items from the health navigation domain were removed, yielding 34 items. Using Rasch analysis and confirmatory factor analysis, we found the evidence of construct validity of K-AHL-C. The Korean version was also significantly correlated with measures of Functional Health Literacy scale, cancer prevention behaviors, and subjective health status, suggesting convergent validities respectively. Finally, K-AHL-C had acceptable reliability coefficients (α) ranging from 0.71 to 0.92 for each domain and the total scale. Conclusion: These psychometric properties support the K-AHL-C is a valid and reliable instrument for measuring Koreans' health literacy in cancer screening. Also it is expected to use the instrument to detect breast and cervical cancer early and improve the screening rate, and ultimately to contribute to the promotion of women's health and women's health nursing practice.
Abu-Helalah, Munir Ahmad;Alshraideh, Hussam Ahmad;Al-Serhan, Ala-Aldeen Ahmad;Kawaleet, Mariana;Nesheiwat, Adel Issa
Asian Pacific Journal of Cancer Prevention
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제16권9호
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pp.3981-3990
/
2015
Background: Breast cancer is the most common type of cancer in Jordan. Current efforts are focused on annual campaigns aimed at increasing awareness about breast cancer and encouraging women to conduct mammogram screening. In the absence of regular systematic screening for breast cancer in Jordan, there is a need to evaluate current mammography screening uptake and its predictors, assess women's knowledge and attitudes towards breast cancer and screening mammograms and to identify barriers to this preventive service. Materials and Methods: This cross-sectional study was conducted in six governorates in Jordan through face-to-face interviews on a random sample of women aged 40 to 69 years. Results: A total of 507 participants with mean age of $46.8{\pm}7.8$ years were interviewed. There was low participation rate in early detection of breast cancer practices. Breast self-examination, doctor examination and periodic mammography screening were reported by 34.9%, 16.8% and 8.6% of study participants, respectively. Additionally 3.8% underwent breast cancer screening at least once but not periodically, while 87.6% had never undergone mammography screening. Reported reasons for conducting the screening were: perceived benefit (50%); family history of breast cancer (23.1%); perceived severity (21.2%); and advice from friend or family member (5.8%). City residents have shown higher probability of undergoing mammogram than those who live in towns or villages. Results revealed negative perceptions and limited knowledge of study participants on breast cancer and breast cancer screening. The most commonly reported barriers for women who never underwent screening were: fear of results (63.8%); no support from surrounding environment (59.7); cost of the test (53.4%); and religious belief, i.e. Qadaa Wa Qadar (51.1%). Conclusions: In the absence of regular systematic screening for breast cancer in Jordan, the uptake of this preventive service is very low. It is essential for the country of Jordan to work on applying regular systematic mammography screening for breast cancer. Additionally, there is a need for improvement in the current health promotion programmes targeting breast cancer screening. Other areas that could be targeted in future initiatives in this field include access to screening in rural areas and removal of current barriers.
Purpose: The purpose of the study was to find the strategies of mental health screening in school. Based on the literature review, we discuss the importance of screening students in schools for mental health problems. Methods: Data from the 2008 Korean Mental Health Screening in Schools(2008-KMHSS) are used to estimate the outline of this screening. We administered the questionnaire for satisfaction of 2008-KMHSS for students(N=1,280), parents(N=2,672), school nurses(N=75), teachers(N=685), district personnels(N=6), and mental health center staffs(N=37). Also we interviewed a part of them by telephone and e-mail. And we reviewed the tools and methods for screening students for emotional/behavioral problems. Results: Mental health screening in schools is a very important, yet worrisome, agenda that is in its very early stages. From the 2008 Korean Mental Health Screening in Schools, 9,588 students(12.9%) needed more evaluation in the first stage. Of these, 6,910(72.1%) completed the second stage screening. In this sample, 1,975(28.6%) utilized the mental health services in school or community. 38.3% of students and 43.7% of their parents notified the 2008-KMHSS. But only 12.1% of students and 10.9% of their parents dissatisfied with the screening. 9.9% of teachers and 22.7% of school nurses dissatisfied with the screening. Among them the school nurses were mostly dissatisfied, and they complained work burden from KMHSS. Mental health center staffs complained similar issues. The Children's Problem-behavior Screening Questionnaire(CPSQ) and Adolescents' Mental-health & Problem-behavior Screening Questionnaire(AMPQ) were compatible to screen students in schools for mental health problems in first stage. Conclusion: Mental health screening in schools needs careful planning and implementation. For successful mental health screening in schools, several elements need to be considered: careful planning, collaboration, staff training, and integrative mental health programs and services in community or schools.
Sedrak, Amal Samir;Galal, Yasmine Samir;Amin, Tarek Tawfik
Asian Pacific Journal of Cancer Prevention
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제17권8호
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pp.3809-3816
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2016
Background: Increasing knowledge and awareness of cancer screening significantly influence health promotion behavior which could markedly reduce incidence rates. In many countries, health care providers are the principal source of information concerning cancer screening. This study was carried out to assess the level of knowledge concerning cancer screening among medical students, house officers and residents and to explore their attitude towards cancer screening practices. Materials and Methods: This cross-sectional study was conducted in Kasr Al Ainy Medical School at Cairo University in Egypt, with 300 undergraduate medical students and 150 postgraduates (interns and residents) enrolled. A pre-tested self-administered questionnaire was used to collect data from the study participants regarding personal and education-related information, knowledge about cancer screening and its sources, and attitude towards cancer screening. Results: More than 64% of participants had knowledge scores of ${\leq}10$ points (out of 24). The total knowledge score (out of 6 points) for breast cancer screening increased from $1.9{\pm}1.0$ to $2.3{\pm}1.2$ and $2.4{\pm}1.1$ for $4^{th}$, $5^{th}$ and $6^{th}$ year respectively, interns showed the highest score of $2.6{\pm}1.1$, P= 0.001. Year of enrollment at medical school was a significant positive predictor of acquiring knowledge about cancer screening (post graduate vs. undergraduate students) (OR= 1.30, C.I =1.01-1.63), lack of or none receiving of orientation/training about cancer screening was the sole negative significant predictor for proper knowledge about cancer screening (OR=0.50, C.I=0.31-0.82). Over 92% of students agreed that they had insufficient knowledge about cancer screening, 88.2% appraised the need to have enough knowledge in order to direct/advice patients, relatives and friends, and 93.7% required that the faculty should emphasize the importance of cancer screening in the delivered curricula at medical school. Conclusions: A relatively low to moderate level of knowledge about cancer screening was detected among the selected medical students regardless of their year of enrollment at medical school or their graduation status, which may implicate a negative impact on early cancer detection especially in a low resource country like Egypt.
Retinopathy of prematurity (ROP) is a major cause of blindness that affects premature infants. With advances in neonatology, ROP is likely to emerge as the most serious problem of vision loss in children even in developed countries; such a situation could be called the third epidemic of ROP. However, controversy and uncertainty still surround favorable outcomes of ROP. For successfully controlling ROP, timely and accurate screening is crucial because early treatment leads to favorable outcomes. Standard guidelines, including ROP classification, have provided satisfactory instructions for the screening and treatment of ROP. To improve the structural and functional outcomes of ROP, optimizing the timing of surgical interventions including cryotherapy, laser-photocoagulation, encircling, and vitrectomy is essential; these interventions can prevent the sequelae of ROP. It is essential for the neonatologist and the ophthalmologist to cooperate extensively for the successful treatment of ROP.
Kharameh, Zahra Taheri;Foroozanfar, Sahar;Zamanian, Hadi
Asian Pacific Journal of Cancer Prevention
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제15권11호
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pp.4595-4599
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2014
Background: Colorectal cancer is a serious health problem. Early detection of colorectal cancer is crucial for treatment and reducing mortality. Beliefs related to colorectal cancer have been found to be a factor in a person's decision about colorectal cancer screening programs. To determine such beliefs, a valid and reliable instrument is necessary. Objective:The aim of this study was to adapt and determine the psychometric properties of the Persian version of Champion's Health Belief Model Scale of breast cancer screening in the measurement of beliefs toward colorectal cancer (CRC) screening. Materials and Methods: The 'forward-backward' procedure was applied to translate the instrument from English into Persian. This study was conducted in Iran from June 2012 to May 2013. A convenience sample of 200 individuals aged 50 years and older was recruited from the population at the outpatient clinics in the three teaching hospitals. Validity was assessed using content, face and construct validity. To test reliability, the internal consistency was assessed by using Cronbach's alpha coefficient and test-retest (intraclass correlation coefficient) analyses. Exploratory factor analysis was used to assess the construct validity and determine the factors of adapted Champion's Health Belief Model Scale. Results: The mean age of the participants were 62.5 years (SD=10.8 years) and the majority of them (75.5 percent) were female. The results of exploratory factor analysis indicated a six-factor solution for the questionnaire (benefits, motivation and confidence, seriousness, susceptibility, emotional barriers and background barriers) that jointly accounted for 55.52% of variance observed. Cronbach's alpha of the subscales ranged from 0.57 to 0.89 and test-retest reliability ranged from 0.81 to 0.93 indicating a good range of reliability. Conclusions: The findings of this study suggest that the Persian version of Champion's Health Belief Model Scale of CRC screening has good psychometric properties and could be an appropriate measure for health beliefs related to CRC screening in national and international studies.
Subramanian, Pathmawathi;Oranye, Nelson Ositadimma;Masri, Azimah Mohd;Taib, Nur Aishah;Ahmad, Nora
Asian Pacific Journal of Cancer Prevention
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제14권11호
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pp.6783-6790
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2013
Background: Breast cancer is the commonest type of cancer among women, and in Malaysia 50-60% of the new cases are being detected at late stages. Do age, education level, income, ethnicity, relationship with breast cancer patients and knowledge of breast cancer risk factors influence breast screening practices? This study revealed interesting but significant differences. Objectives: To assess the knowledge of breast cancer risk factors and early detection measures among women in a high risk group. Materials and Methods: A cross sectional survey of one hundred and thirty one women relatives of breast cancer patients was carried out. Participants were selected through purposive sampling, during hospital visits. A self-administered questionnaire was used for data collection. Results: The majority of the respondents (71%) had poor knowledge of the risk factors for breast cancer. Income, relationship with a patient and practise of breast cancer screening predicted performance of mammography, $R^2$=0.467, F=12.568, p<0.0001. Conclusions: The finding shows inadequate knowledge of breast cancer risk factors and poor cancer screening practise among women with family history of breast cancer. Poor knowledge and practise of breast screening are likely to lead to late stage presentation of breast cancer disease. Some important predictors of breast cancer screening behaviour among women with positive family history of breast cancer were identified. An understanding of the strengths and significance of the association between these factors and breast screening behaviour is vital for developing more targeted breast health promotion.
In view of funding crunches and inadequate manpower in cytology in developing countries like India, single lifetime screening for cervical cancer has been suggested. In this study, an attempt was made to cscreening to make it more effective for early detection. Cytological data were derived from the ongoing routine cervical cytology screening program for women attending Gynaecology Out Patient Department of Queen Mary's Hospital of K.G.Medical University, Lucknow, India during a span of 35 years (April 1971 - December 2005). Cervical smears in a total of 38,256 women were cytologically evaluated. The frequencies of squamous intraepithelial lesions of cervix (SIL) and carcinoma cervix were found to be 7.0% and 0.6%, respectively, in the series. Predisposing factors related to cervical carcinogenesis were analyzed in detail to establish the most vulnerable groups of women for single life time screening. The incidence of SIL and carcinoma cervix was found to be maximal in women above the age of 40 years irrespective of parity and in multiparous women (with three or more children) irrespective of age. The incidence of cervical cytopathologies was significantly higher in symptomatic women, the frequency of SIL being alarmingly higher in women complaining of contact bleeding and that of carcinoma cervix in older women with postmenopausal bleeding. It is consequently felt that single life time screening must include the three groups of women delineated above. Such selective screening appears to be the most economical, cost effective and feasible approach to affordably control the menace of cervical cancer in developing countries like India.
Several studies about hospital malnutrition have been reported that about more than 40% of hospitalized patients are having nutritional risk factors and hospital malnutrition presents a high prevalence. People in a more severe nutritional status ended up with a longer length of hospital stay and higher hospital cost. Nutrition screening tools identify individuals who are malnourished or at risk of becoming malnourished and who may benefit from nutritional support. For the early detection and treatment of malnourished hospital patients , few valid screening instruments fur Koreans exist. Therefore, the aim of this study was to develop a simple, reliable and valid malnutrition screening tool that could be used at hospital admission to identify adult patients at risk of malnutrition using medical electrical record data. Two hundred and one patients of the university affiliated medical center were assessed on nutritional status and classified as well nourished, moderately or severely malnourished by a Patient-Generated subjective global assessment (PG-SGA) being chosen as the 'gold standard' for defining malnutrition. The combination of nutrition screening questions with the highest sensitivity and specificity at prediction PG-SGA was termed the nutrition screening index (NSI). Odd ratio, and binary logistic regression were used to predict the best nutritional status predictors. Based on regression coefficient score, albumin less than 3.5 g/dl, body mass index (BMI) less than $18.5kg/m^2$, total lymphocyte count less than 900 and age over 65 were determined as the best set of NSI. By using best nutritional predictors receiver operating characteristic curve with the area under the curve, sensitivity and 1-specificity were analyzed to determine the best optimal cut-off point to decide normal or abnormal in nutritional status. Therefore simple and beneficial NSI was developed for identifying patients with severe malnutrition. Using NSI, nutritional information of the severe malnutrition patient should be shared with physicians and they should be cared for by clinical dietitians to improve their nutritional status.
The geriatric patients with chronic physical diseases are frequently associated with the continuous clusters of depression including nonpathological sadness, subsyndromal depression, minor depressive disorder, and major depressive disorder. Because of the complex and reciprocal relationships among depression, elderly, and chronic physical diseases, screening approaches with specific nosological methods should be needed in the realm of early detection of depression. Cognitive decline is frequently manifested in geriatric depression with medical or neurological diseases. Also, somatic symptoms of depression or emotional symptoms of physical diseases can play a role as a hampering factor in the early detection of depression. Furthermore, after-care has been regarded as an essential factor of depression screening in the geriatric patients with chronic physical diseases. We reviewed the most popular examples of integrated medicine for depression in primary care. Thus, we propose a general hospital-based model for early detection of depression which includes favorable response loop between screening and therapeutic intervention. Our model can be a basis for evidence-based detection and after-care for depression in the geriatric patients with chronic medical diseases.
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