• Asian Pacific Journal of Cancer Prevention
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• v.13 no.12
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• pp.5985-5987
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• 2012

A cross-sectional study was conducted among nursing staff of a missionary hospital of Delhi in June 2009. All the nurses were invited to participate in the training programme on breast cancer and techniques of breast self examination (BSE). A questionnaire was administered to all 259 participants seeking information on their level of awareness regarding breast cancer and relevant screening guidelines. With the help of 5 training workshops all the nurses were imparted training regarding the most appropriate technique of doing breast self exams. The mean age of the participants was 35.8 years. Out of a total of 259 nursing staff members 77.2% correctly answered all the 10 questions regarding high risk factors for breast cancer and after the training programme this increased to 100% (p<0.05). Only 65.2% of the participants gave correct responses to all the 8 questions regarding correct technique of performing a BSE, which after the training programme increased to 99.3% (p<0.05). At the baseline only 56.8% knew all the three screening methods correctly and after the intervention 98.7% could correctly mark the responses regarding screening (p<0.05). The actual practice of following the screening guidelines amongst the nursing staff was poor. Only 26 (10.03%) had ever done a BSE, none performed it monthly, 58 (22.4%) had ever gone themselves for a CBE and 18 (6. 94%) had ever undergone mammography.

• Journal of Korean Academy of Nursing
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• v.34 no.1
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• pp.141-149
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• 2004

Purpose: To identify the status of regular cervical cancer screening practices among middle-aged women, the associations between regular practice and research factors, and the predictive model and factors effecting such behavior was studied. Method: Two hundred women, aged 40 to 60, were selected by convenience in one urban area of Seoul. They were asked about their regular attendance for screening, knowledge of cancer and screening, health belief, health self-determination index and certain personal factors. Result: Approximately 54.5% of the women had periodic screening tests every 6 months to 2 years. Their knowledge of cervical cancer and health belief were at the medium level of each scale, but their health self-determination scores (HSDI) were low. Some influencing factors, and their cancer odds ratio were identified through univariate regression analysis. These variables were included in a predictive model, and this model proved to have enough fit and classification power (83.5%). In this model, the financial state, self-belief and self-determination scores were found to be significant. Conclusion: Middle-age women's intrinsic motivation for healthy behavior was found to be low in those who felt to be in a poor financial state, had higher perceived barriers, lower perceived benefits and a lower prevalence of undergoing regular screening test.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.18
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• pp.8541-8551
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• 2016

Background: The coverage of breast and cervical cancer screening has only slightly increased in the past decade in Thailand, and these cancers remain leading causes of death among women. This study identified socioeconomic and contextual factors contributing to the variation in screening uptake and coverage. Materials and Methods: Secondary data from two nationally representative household surveys, the Health and Welfare Survey (HWS) 2007 and the Reproductive Health Survey (RHS) 2009 conducted by the National Statistical Office were used. The study samples comprised 26,951 women aged 30-59 in the 2009 RHS, and 14,619 women aged 35 years and older in the 2007 HWS were analyzed. Households of women were grouped into wealth quintiles, by asset index derived from Principal components analysis. Descriptive and logistic regression analyses were performed. Results: Screening rates for cervical and breast cancers increased between 2007 and 2009. Education and health insurance coverage including wealth were factors contributing to screening uptake. Lower or non-educated and poor women had lower uptake of screenings, as were young, unmarried, and non-Buddhist women. Coverage of the Civil Servant Medical Benefit Scheme increased the propensity of having both screenings, while the universal coverage scheme increased the probability of cervical screening among the poor. Lack of awareness and knowledge contributed to non-use of both screenings. Women were put off from screening, especially Muslim women on cervical screening, because of embarrassment, fear of pain and other reasons. Conclusions: Although cervical screening is covered by the benefit package of three main public health insurance schemes, free of charge to all eligible women, the low coverage of cervical screening should be addressed by increasing awareness and strengthening the supply side. As mammography was not cost effective and not covered by any scheme, awareness and practice of breast self examination and effective clinical breast examination are recommended. Removal of cultural barriers is essential.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.15
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• pp.6605-6608
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• 2015

Background: Colorectal cancer is a major cause of morbidity and mortality throughout the world. Colorectal cancer screening is an optimal way for reducing of morbidity and mortality and a clinical decision support system (CDSS) plays an important role in predicting success of screening processes. DSS is a computer-based information system that improves the delivery of preventive care services. The aim of this article was to detail engineering of information requirements and work flow design of CDSS for a colorectal cancer screening program. Materials and Methods: In the first stage a screening minimum data set was determined. Developed and developing countries were analyzed for identifying this data set. Then information deficiencies and gaps were determined by check list. The second stage was a qualitative survey with a semi-structured interview as the study tool. A total of 15 users and stakeholders' perspectives about workflow of CDSS were studied. Finally workflow of DSS of control program was designed by standard clinical practice guidelines and perspectives. Results: Screening minimum data set of national colorectal cancer screening program was defined in five sections, including colonoscopy data set, surgery, pathology, genetics and pedigree data set. Deficiencies and information gaps were analyzed. Then we designed a work process standard of screening. Finally workflow of DSS and entry stage were determined. Conclusions: A CDSS facilitates complex decision making for screening and has key roles in designing optimal interactions between colonoscopy, pathology and laboratory departments. Also workflow analysis is useful to identify data reconciliation strategies to address documentation gaps. Following recommendations of CDSS should improve quality of colorectal cancer screening.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.1
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• pp.229-237
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• 2014

Background: Dentists are typically the first professionals who are approached to treat ailments within the oral cavity. Therefore they should be well-equipped in detecting suspicious lesions during routine clinical practice. This study determined the levels of knowledge on early signs and risk factors associated with oral cancer and identified which factors influenced dentist participation in prevention and early detection of oral cancer. Materials and Methods: A survey on dentists' knowledge and their practices in prevention and early detection of oral cancer was conducted using a 26-item self-administered questionnaire. Results and Conclusions: A response rate of 41.7% was achieved. The level of knowledge on early signs and risk habits associated with oral cancer was high and the majority reported to have conducted opportunistic screening and advised patients on risk habit cessation. Factors that influenced the dentist in practising prevention and early detection of oral cancer were continuous education on oral cancer, age, nature of practice and recent graduation. Notably, dentists were receptive to further training in the area of oral cancer detection and cessation of risk habits. Taken together, the study demonstrated that the dental clinic is a good avenue to conduct programs on opportunistic screening, and continuous education in these areas is necessary to adequately equip dentists in running these programs. Further, this study also highlighted knowledge deficits and practice shortcomings which will help in planning and developing programs that further encourage better participation of dentists in prevention and early detection of oral cancer.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.15
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• pp.6095-6098
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• 2014

Background:Cervical cancer is potentially the most preventable and treatable cancer. Despite the known efficacy of cervical screening, a significant number of women do not avail themselves of the procedure due to lack of awareness. Objectives: This study was conducted to elicit information on the knowledge, attitude and practice (KAP) regarding screening (Pap test) and vaccination for carcinoma cervix among female doctors and nurses in a tertiary care hospital in Bangalore and to assess barriers to acceptance of the Pap test. Materials and Methods: A cross-sectional, descriptive study was conducted with semi-structured, self-administered questionnaire among female health professionals. The study subjects were interviewed for KAP regarding risk factors for cancer cervix, Pap test and HPV vaccination for protection against carcinoma cervix. Results: Higher proportion of doctors 45 (78.9%) had very good knowledge as compared to only 13 (13.3%) of the nurses, about risk factors for cancer cervix and Pap test (p=0.001). As many as 138(89.6%) of the study subjects had favorable attitude towards Pap test and vaccination, but 114 (73.6%) of the study subjects never had a Pap test and the most common reason 35 (31%) for not practicing was absence of disease symptoms. Conclusions: In spite of good knowledge and attitudes towards cancer cervix and Pap test being good, practice remained low among the study subjects and most common reasons for not undergoing Pap test was absence of disease symptoms. The independent predictors of ever having a Pap test done was found to be the occupation and duration of married life above 9yrs. Hence there is a strong need to improve uptake of Pap test by health professionals by demystifying the barriers.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.18
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• pp.8595-8598
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• 2016

Background: Decision making modalities for screening for many cancer conditions and different stages have become increasingly complex. Computer-based risk assessment systems facilitate scheduling and decision making and support the delivery of cancer screening services. The aim of this article was to survey electronic risk assessment system as an appropriate tool for the prevention of cancer. Materials and Methods: A qualitative design was used involving 21 face-to-face interviews. Interviewing involved asking questions and getting answers from exclusive managers of cancer screening. Of the participants 6 were female and 15 were male, and ages ranged from 32 to 78 years. The study was based on a grounded theory approach and the tool was a semi-structured interview. Results: Researchers studied 5 dimensions, comprising electronic guideline standards of colorectal cancer screening, work flow of clinical and genetic activities, pathways of colorectal cancer screening and functionality of computer based guidelines and barriers. Electronic guideline standards of colorectal cancer screening were described in the s3 categories of content standard, telecommunications and technical standards and nomenclature and classification standards. According to the participations' views, workflow and genetic pathways of colorectal cancer screening were identified. Conclusions: The study demonstrated an effective role of computer-guided consultation for screening management. Electronic based systems facilitate real-time decision making during a clinical interaction. Electronic pathways have been applied for clinical and genetic decision support, workflow management, update recommendation and resource estimates. A suitable technical and clinical infrastructure is an integral part of clinical practice guidline of screening. As a conclusion, it is recommended to consider the necessity of architecture assessment and also integration standards.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.8
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• pp.4169-4172
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• 2012

Background: The majority of women in rural India have poor or no access to cervical cancer screening services, although one.quarter of all cervical cancers in the world occur there. Several large trials have proven the efficacy of low-tech cervical cancer screening methods in the Indian context but none have documented the necessary components and processes of implementing this evidence in a low-resource setting. Methods: This paper discusses a feasible model of implementation of cervical cancer screening programme in low-resource settings developed through a pilot research project carried out in rural Tamilnadu, India. The programme used visual inspection of cervix after acetic acid application (VIA) as a screening tool, nurses in the primary care centres as the primary screeners and peer educators within Self-Help Women groups to raise community awareness. Results: The uptake of screening was initially low despite the access to a screening programme. However, the programme witnessed an incremental increase in the number of women accessing screening with increasing community awareness. Conclusions: The investigators recommend 4 key components to programme implementation in low-resource setting: 1) Evidence-based, cost-effective test and treatment available within the reach of the community; 2) Appropriate referral pathways; 3) Skilled health workers and necessary equipment; and 4) Optimisation of health literacy, beliefs, attitudes of the community.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.4
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• pp.1565-1570
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• 2015

Background: In Aotearoa/New Zealand cervical screening programmes have reduced cervical cancer; however, half of cervical cancer cases among Pacific women are found among clients who had not attended cervical screening. Hence, we set out to determine health provider perspectives on barriers that prevent their services reaching Pacific women within Aotearoa/New Zealand. Materials and Methods: Twenty semi-structured interviews were conducted with health care providers, Pap smear takers and community workers in the Wellington region. Participants were asked their views on factors that enabled and/or constrained the participation of Pacific women in their cervical screening services. Results: Six interrelated themes influencing participation in cervical screening among Pacific women in the Wellington region were apparent: the funding and practice of service delivery; family always coming first; the cost of screening services; type of employment; the appropriateness of information; and attitudes to self and screening. Conclusions: Determining specific ethnic group actual health needs and meeting them contributes to overall improvement in New Zealand's health status. The results identified the need for improvements to the delivery of screening services including adapting cervical screening services to the requirements of Pacific women through more outreach services at alternate clinic hours; culturally appropriate practitioners; the ability to take up opportunities for health checks and foster long-term relationships; as well as appropriate monitoring and evaluation of approaches. Funding and reporting relationships also need to be compatible with the goal of improving outcomes for Pacific women. Further research into client voices for their particular needs to compliment the service provider perspective as well as minority groups is called for.

• Korean Journal of Adult Nursing
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• v.25 no.6
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• pp.655-664
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• 2013

Purpose: This study was undertaken to identify which delirium screening instrument would be more useful in clinical practice. Methods: Data were collected from 118 nurses from six hospitals in five provinces in Korea. For the delirium screening three instruments were compared: NEECHAM Confusion Scale (NEECHAM), Nursing Delirium Screening Scale (Nu-DESC), Delirium Observation Scale (DOS). The MMSE-K was used for concurrent validity. The nurse subjects were surveyed as to the practical clinical value of each instrument. Cronbach's ${\alpha}$ coefficient and Kuder-Richardson 20 were used to confirm the reliability. Results: The range of three scales reliability was .70~.82 and the range of correlation coefficient was .63~.82 with MMSE-K. For sensitivity of NEECHAM, Nu-DESC and DOS was 1.00, 1.00 and 0.81 respectively and specificity NEECHAM, Nu-DESC and DOS was 0.88, 0.89 and 0.89 respectively. Nurses rated the practical use of the DOS scale as significantly easier to use than the NEECHAM and Nu-DESC. Conclusion: NEECHAM, Nu-DESC and DOS scales were acceptable in terms of reliability, validity, sensitivity and specificity. However, nurses rated the DOS scale as easier scale to use and had more relevance to their practice.