219759 Papanicolaou Screening: Perceived Barriers and Self-Efficacy in Taiwan

Tuesday, November 9, 2010 : 11:30 AM - 11:50 AM

Wei-Chen Tung, PhD, RN , School of Nursing, University of Nevada-Reno, Reno, NV
Daniel Cook, PhD , School of Community Health Sciences, University of Nevada Reno, Reno, NV
Minggen Lu, PhD , School of Community Health Sciences, University of Nevada, Reno, Reno, NV
Background: Cervical cancer remains a leading cause of death in Taiwan, and 30-50% of Taiwanese women have never had a Papanicolaou test. The transtheoretical model (TTM) suggests that individuals in earlier stages of the TTM (precontemplation, relapse) report greater perceived barriers and lower levels of self-efficacy than people in later stages (action, maintenance). This study explored differences in specific items of perceived barriers and self-efficacy to obtaining Papanicolaou smears within the framework of the TTM stages among Taiwanese women.

Methods: A descriptive, cross-sectional survey design was used to collect data from a convenience sample of 222 women in Taiwan. The survey measured demographics, 12 perceived barriers, and seven self-efficacy items. Data were analyzed descriptively and with multiple linear regression.

Results: Relapsers perceived more barriers related to worry (p = .0002), embarrassment (p = .002), stigma (p = .002), and the lack of female physicians (p = .005) than those in action/maintenance. Relapsers reported significantly lower self-efficacy scores than those in action/maintenance, including less confidence in obtaining the test if it: requires long travel (p < .0001); is anticipated to be painful (p = .002), stressful (p < .0001), time-inconvenient (p = .0002) or expensive (p = .0004); has no family support (p = .005).

Conclusions: Specific perceived barriers and self-efficacy may play important roles in moving Taiwanese women through the TTM stages for Pap screening practice. This has important implications for public health nurses in the development of educational programs. Interventions for relapsers should teach overcoming identified barrier skills (e.g., asking for female physicians), and how to increase self-efficacy to carry out those skills. The barriers themselves (e.g., cost) may also be a target.

Learning Areas:
Planning of health education strategies, interventions, and programs
Program planning
Public health or related education
Public health or related nursing
Public health or related research
Social and behavioral sciences

Learning Objectives:
1. Describe the differences in three specific items of perceived barriers to obtaining papanicolaou smears between Taiwanese women in action/maintenance and relapse. 2. List the differences in three specific self-efficacy items to obtaining papanicolaou smears between Taiwanese women in action/maintenance and relapse.

Keywords: Asian Women, Cervical Cancer

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I conduct university research and teaching as a faculty member in public health policy.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.