Cervical cancer: knowledge, attitude and practice on the prevention examination

to evaluate the knowledge, attitude and practice of women on the cervical-uterine cancer screening and to investigate their association with sociodemographic variables.

Method:

a cross-sectional study, carried out from July to September 2015, with 500 women enrolled in the Basic Health Units of the Health District V, of the city of Recife-PE. For data collection, a semi-structured form was used. In statistical analysis, the Chi-square test and Fisher’s Exact Test were applied and, in the multivariate analysis, the Poisson model and Wald statistic.

Results:

the prevalence of adequate knowledge, attitude and practice was 35.2%, 98% and 70.6%, respectively. Adequate knowledge was associated with having no children, having a family income of two minimum wages and Spiritist/Afro-Brazilian religion.

Conclusion:

women carry out the examination, deem it necessary, but do not have adequate knowledge, which demonstrates the need for educational actions by nurses and other health professionals.

Descriptors:
Nursing; Women’s Health; Uterine Cervical Neoplasms; Papanicolaou Test; Knowledge, Attitudes and Practice in Health

Factor assessed	n	%
Age (years)
25-39	188	37.6
40- 59	268	53.6
≥60	44	8.8
Minimum	25
Maximum	64
Mean ± Standard Deviation	43.7±11.2
Number of children
0	59	11.8
1	113	22.6
2	160	32.0
≥3	168	33.6
Marital Status
Single	160	32.0
Married	195	39.0
Stable Union	97	19.4
Divorced	22	4.4
Widow	26	5.2
Work
Yes	199	39.8
No	301	60.2
Schooling
Illiterate/Literate	16	3.2
Complete/incomplete elementary and middle school	230	46.0
Complete/incomplete High School	220	44.0
Complete/incomplete Higher Education	34	6.8
Family income (minimum wage)^a a Minimum wage in force: R$ 788.00 (about 215 US dollars).
No income/ <1	74	14.8
1	215	43.1
2	158	31.7
≥3	52	10.4
Religion
Catholic	254	50.8
Protestant	179	35.8
Others	21	4.2
No religion	46	9.2
Color
White	95	19.0
Black	75	15.0
Brown/mulatto	330	66.0

Domains assessment	Domain assessed			p value^a a P value of the Chi-Square Test for homogeneity;
Domains assessment	Knowledge	Attitude	Practice	p value^a a P value of the Chi-Square Test for homogeneity;
Adequate	176(35.2%)	490(98.0%)	353(70.6%)	<0.001
Inadequate	324(64.8%)	10(2.0%)	147(29.4%)	<0.001
p value^b b P value of Chi-Square Test for proportion comparison.	<0.001	<0.001	<0.001	-

Factor assessed	Domain assessed
	Knowledge		Attitude		Practice
	Adequate	p value	Adequate	p value	Adequate	p value
Age		0.509^a a P value of the Chi-Square Test for independence;		0.801^b b P value of the Fisher's Exact Test.		0.259^a a P value of the Chi-Square Test for independence;
20 to 39 years	65(34.6%)		185(98.4%)		140(74.5%)
40 to 59 years	92(34.3%)		262(97.8%)		185(69.0%)
60 or over	19(43.2%)		43(97.7%)		28(63.6%)
Númber of children		0.044^a a P value of the Chi-Square Test for independence;		0.936^b b P value of the Fisher's Exact Test.		0.901^a a P value of the Chi-Square Test for independence;
None	30(50.8%)		58(98.3%)		43(72.9%)
1 child	41(36.3%)		110(97.3%)		82(72.6%)
2 children	49(30.6%)		157(98.1%)		112(70.0%)
3 or more	56(33.3%)		165(98.2%)		116(69.0%)
Marital Status		0.073^a a P value of the Chi-Square Test for independence;		0.055^b b P value of the Fisher's Exact Test.		0.123^a a P value of the Chi-Square Test for independence;
Single	54(33.8%)		155(96.9%)		104(65.0%)
Married	81(41.5%)		194(99.5%)		140(71.8%)
Stable Union	26(26.8%)		95(97.9%)		71(73.2%)
Divorced	9(40.9%)		20(90.9%)		20(90.9%)
Widow	6(23.1%)		26(100.0%)		18(69.2%)
Work		0.450^a a P value of the Chi-Square Test for independence;		1.000^b b P value of the Fisher's Exact Test.		0.764^a a P value of the Chi-Square Test for independence;
Yes	74(37.2%)		195(98.0%)		139(69.8%)
No	102(33.9%)		295(98.0%)		214(71.1%)
Escolaridade		0.066^b b P value of the Fisher's Exact Test.		0.594^b b P value of the Fisher's Exact Test.		0.238^a a P value of the Chi-Square Test for independence;
No illiterate/Literate	2(12.5%)		16(100.0%)		10(62.5%)
Elementary and Middle school	73(31.7%)		223(97.0%)		154(67.0%)
High School	87(39.5%)		217(98.6%)		162(73.6%)
Higher Education	14(41.2%)		34(100.0%)		27(79.4%)
Family income		0.011^a a P value of the Chi-Square Test for independence;		0.867^b b P value of the Fisher's Exact Test.		0.698^a a P value of the Chi-Square Test for independence;
No income/< 1 MW^c c Minimum wage in force: R$ 788.00 (about 215 US dollars).	14(18.9%)		72(97.3%)		49(66.2%)
1 MW	78(36.3%)		210(97.7%)		156(72.6%)
2 MW	65(41.1%)		155(98.1%)		109(69.0%)
3 or more MW	19(36.5%)		52(100.0%)		38(73.1%)
Religion		0.018^b b P value of the Fisher's Exact Test.		0.399^b b P value of the Fisher's Exact Test.		0.886^b b P value of the Fisher's Exact Test.
Catholic	88(34.6%)		248(97.6%)		183(72.0%)
Protestant	69(38.5%)		177(98.9%)		124(69.3%)
Others	11(52.4%)		21(100.0%)		15(71.4%)
No religion	8(17.4%)		44(95.7%)		31(67.4%)
Color		0.884^a a P value of the Chi-Square Test for independence;		0.314^b b P value of the Fisher's Exact Test.		0.804^a a P value of the Chi-Square Test for independence;
White	32(33.7%)		93(97.9%)		66(69.5%)
Black	28(37.3%)		72(96.0%)		51(68.0%)
Brown/Mulatto	116(35.2%)		325(98.5%)		236(71.5%)

Factor assessed	Adequate knowledge
Factor assessed	RP	(95%)CI	p value^a a P value of the Wald tests;
Number of children
None	1.52	1.11 - 2.08	0.009
1 child	1.04	0.76 - 1.44	0.789
2 children	0.90	0.66 - 1.24	0.523
3 or more	1.00	-	-
Family income (minimum wage)^b b Minimum wage in force: R$ 788.00 (about 215 US dollars).
No income/<1	1.00	-	-
1	1.79	1.08 - 2.96	0.025
2	2.07	1.24 - 3.47	0.005
≥ 3	1.94	1.08 - 3.50	0.027
Religion
Catholic	1.92	0.99 - 3.73	0.053
Protestant	2.20	1.13 - 4.27	0.020
Others	2.66	1.25 - 5.64	0.011
No religion	1.00	-	-

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[1] Corresponding Author: Ester Marcele Ferreira de Melo. E-mail: ester_mfm@hotmail.com