Assessment of women s knowledge regarding. infectious risk factors for cervical cancer.

Transkrypt

1 JOURNAL JOURNAL OF PUBLIC OF PUBLIC HEALTH, HEALTH, NURSING NURSING AND MEDICAL AND MEDICAL RESCUE RESCUE No. No.2/2015 (59-64) JOURNAL OF PUBLIC HEALTH, NURSING AND MEDICAL RESCUE 2/ Assessmet of wome s kowledge regardig ifectious risk for cervical cacer (Ocea wiedzy kobiet a temat ifekcyjych czyików ryzyka raka szyjki macicy) M Sulima 1,A,D, M Lewicka 1,F, K Wiktor 2,E, G Bakalczuk 1,B, H Wiktor 1,C Abstract - Itroductio. Literature o the subject provides that 5 Polish wome die every day as a result of cervical cacer. Purpose of the study. Assessmet of wome s kowledge regardig ifectious risk for cervical cacer. Materials ad methods. wome formed the study group they came from the cities of Lubli ad Radom ad from the village of Jabłoa. The study was coducted usig the diagostic survey method with the authors ow survey questioaire made especially for this study. Results. A statistically sigificat relatioship has bee foud betwee the studied wome s kowledge about HPV as a risk factor for cervical cacer ad age (p=0.007), civil status (p=0.002), educatio () as well as the form of professioal activity (p= ). A statistically sigificat relatioship has bee foud betwee the respodets kowledge about geital herpes as a risk factor for cervical cacer ad age (), civil status (p=0.001), place of residece (p=0.004) ad the form of professioal activity (p= ). However, o statistically sigificat relatioship has bee foud betwee the respodets kowledge about the huma immuodeficiecy virus (HIV) as a risk factor for cervical cacer ad age (p=0.17) or educatio (p=0.13). Coclusios. Wome do ot possess a suitable kowledge regardig the ifectious risk for cervical cacer. Wome over 40 years of age, married wome, the oes with elemetary ad vocatioal educatio as well as ihabitats of villages should be offered a special educatioal programme because they have the least kowledge cocerig the ifectious risk for cervical cacer. Key words - cacer, cervix, huma paillomavirus, geital herpes virus, huma immuodeficiecy virus. Streszczeie Wprowadzeie. Literatura przedmiotu podaje, że z powodu raka szyjki macicy umiera dzieie 5 polskich kobiet. Cel pracy. Ocea wiedzy kobiet a temat ifekcyjych czyików raka szyjki macicy. Materiał i metoda. Badaiami objęto kobiet pochodzących z Lublia i Radomia oraz wsi Jabłoa. Badaia przeprowadzoo metodą sodażu diagostyczego z zastosowaiem kwestioariusza akiety własego autorstwa opracowaego dla potrzeb iiejszej pracy. Wyiki. Stwierdzoo istotą statystyczie zależość pomiędzy wiedzą badaych kobiet a temat HPV, jako czyika ryzyka raka szyjki macicy a wiekiem (p=0,007), staem cywilym (p=0,002), wykształceiem (p=0,02) oraz formą aktywości zawodowej (p=0,00001). Stwierdzoo istotą statystyczie zależość pomiędzy wiedzą badaych kobiet a temat opryszczki płciowej, jako czyika ryzyka raka szyjki macicy a wiekiem (p=0,02), staem cywilym (p=0,001), miejscem zamieszkaia (p=0,004) oraz formą aktywości zawodowej (p=0,00005). Nie stwierdzoo atomiast statystyczie istotej zależości pomiędzy wiedzą badaych kobiet a temat wirus upośledzeia ludzkiej odporości (HIV), jako czyika ryzyka raka szyjki macicy a wiekiem (p=0,17) oraz wykształceiem (p=0,13). Wioski. Kobiety ie posiadają odpowiediego zakresu wiedzy odośie ifekcyjych czyików ryzyka raka szyjki macicy. Kobiety: po 40 roku życia, mężatki, posiadające wykształceie podstawowe lub zawodowe, mieszkaki wsi powiy być objęte szczególymi działaiami edukacyjymi z powodu posiadaia ajmiejszego zakresu wiedzy odośie ifekcyjych czyików ryzyka raka szyjki macicy. Słowa kluczowe - rak, szyjka macicy, wirus brodawczaka ludzkiego, wirus opryszczki płciowej, wirus upośledzeia ludzkiej odporości. Author Affiliatios: 1. Departmet of Obstetrics, Gyaecology ad Obstetrical - Gyaecological Nursig Faculty of Nursig ad Health Scieces, Medical Uiversity, Lubli. 2. Departmet of Gyaecology ad Gyaecological Edocriology Faculty of Nursig ad Health Scieces, Medical Uiversity, Lubli Authors cotributios to the article: A. The idea ad the plaig of the study B. Gatherig ad listig data C. The data aalysis ad iterpretatio

2 JOURNAL OF OF PUBLIC HEALTH, NURSING AND MEDICAL RESCUE No.2/2015 2/ D. Writig the article E. Critical review of the article F. Fial approval of the article Correspodece to: Magdalea Sulima MD, PhD Departmet of Obstetrics, Gyecology ad Obstetrical - Gyecological Nursig, Faculty of Nursig ad Health Scieces, Medical Uiversity, Chodźki 6 Str., PL Lubli, Polad, msulima13@wp.pl Accepted for publicatio: March 6, I I. INTRODUCTION Polad, cacer of the female reproductive orgas is a serious problem of both medical ad social ature. Cervical cacer is the secod most frequet, after breast cacer, maligat eoplasm affectig the female geitals [1,2]. Every day, 5 Polish wome die of cervical cacer. Cervical cacer morbidity ad mortality rates i Polad are amog the highest i Europe maily due to the icosiderable participatio of wome i periodic medical examiatios ad late diagosis at a advaced stage of the disease [3,4]. Viral ifectios are the mai aetiopathogeetic factor for cervical factor. The huma papillomavirus (HPV), especially types 16, 18 ad 45, is the mai aetiological factor of over 70 of squamous cell cervical cacer cases ad 90 of cervical adeocarcioma cases [5-7]. Herpes simplex virus type II is also a risk factor for cervical cacer. Moreover, a relatioship has bee foud betwee ifectio with the huma immuodeficiecy virus (HIV) ad the developmet of cervical dysplasia [8,9]. A appropriate level of kowledge amog wome regardig the ifectious risk for cervical cacer as well as regular prophylactic examiatios are the essetial reducig the risk of developig this type of cacer [10-13]. The purpose of the study was to evaluate the wome s kowledge regardig the ifectious for cervical cacer. II. MATERIALS AND METHODS wome comig from the cities of Lubli ad Radom as well as from the village of Jabłoa were examied. The study was coducted usig the diagostic survey method with the authors ow survey questioaire made especially for this study. Participatio i the study was of a volutary ad aoymous ature. The results obtaied were subjected to statistical aalysis. The risk of iferece error was adopted at 5 ad the value of p<0.05 was cosidered statistically sigificat. The respodets age raged from 20 to 66. Withi the study group, 92 wome (46.0) were aged 20-30, 22 (11.0) were aged 31-40, 57 (28.50) were aged 41-50, 21 (10.50) from 51 to 60 ad 8 (4.0) were over 60 years of age. I the study group, 108 wome (54.0) had obtaied higher educatio, 65 (32.50) secodary educatio, 19 (9.50) vocatioal educatio, whereas 8 wome (4.0) had elemetary educatio. 53 wome (26.50) lived i the of the provice, 94 (47.0) respodets lived i the district ad 53 wome (26.50) lived i the coutryside. Amog the wome studied, 92 (46) were married, 82 (41.0) were sigle, 18 (9.0) were divorced ad 8 (4.0) were widowed. Professioally active were 97 wome (48.50), 14 (7.0) remaied uemployed, 24 respodets (12.0) were pesioers ad 65 (32.50) were studets. III. RESULTS Table 1 presets the correlatio betwee the kowledge of the wome examied about the huma papillomavirus as a risk factor for cervical cacer ad the socio-demographic. The highest percetage of respodets aware of the fact that the huma papillomavirus is a risk factor for cervical cacer was formed by wome aged years (=49, 53.26), sigle wome (=47, 57.32), wome with higher educatio diplomas (=47, 43.52), ihabitats of the voivevodship (=27, 50.94) ad studets (=, 67.69). I tur, the highest percetage of respodets who did ot kow that the huma papillomavirus was a risk factor for cervical cacer was formed by wome aged years (=38, 66.67), married wome (=61, 66.30), wome with vocatioal educatio (=13, 68.42), ihabitats of villages (=33, 59.66) ad pesioers (=16, 66.67). A statistically sigificat relatioship has bee foud betwee the respodets kowledge regardig HPV as a risk factor for cervical cacer ad age (p=0.007), civil status (p=0.002), educatio () ad the form of professioal activity (p= ). Nevertheless, o statistically sigificat relatioship has bee foud betwee the respodets kowledge

3 Form of professioal activity Chi 2 =34.05 p= Place of residece Chi 2 =8.00 p=0.09 Educatio Chi 2 =15.48 Civil status Chi 2 =26.52 p=0.002 Age Chi 2 =21.01 p=0.007 Statistical aalysis JOURNAL OF OF PUBLIC HEALTH, NURSING AND MEDICAL RESCUE No.2/2015 2/ about HPV as a risk factor for cervical cacer ad their place of residece (p=0.09). Table 2 presets the correlatio betwee the kowledge of the wome surveyed regardig the geital herpes virus as a risk factor for cervical cacer ad the socio-demographic. The highest percetage of respodets aware of the fact that the geital herpes virus is a risk factor for cervical cacer were wome aged (=33, 35.87), divorcées (=7, 38.88), wome with elemetary educatio (=3, 37.50), dwellers of the provice (=20, 37.74), ad studets (=30, 46.15). I tur, the highest percetage of respodets who did ot kow that the geital herpes virus was a risk factor for cervical cacer were wome aged years (=38, 66.67), married wome (=60, 65.22), wome with vocatioal educatio (=12, 63.16), uemployed wome (=11, 78.57), ad ihabitats of the coutryside (=33, 62.26). The study has show a statistically sigificat relatioship betwee the respodets kowledge regardig the geital herpes virus as a risk factor for cervical cacer ad age (), civil status (p=0.001), place of residece (p=0.004) ad the form of professioal activity (p= ). However, o statistically sigificat relatioship has bee foud betwee the kowledge of the wome surveyed cocerig the geital herpes virus as a risk factor for cervical cacer ad their educatio (p=0.63). Table 3 presets the correlatio betwee the respodets kowledge regardig the huma immuodeficiecy virus (HIV) as a risk factor for cervical cacer ad the socio-demographic. The highest percetage of respodets aware of the fact that the huma immuodeficiecy virus (HIV) is a risk factor for cervical cacer was formed by wome aged over 60 (=3, 37.50), widows (=5, 62.50), wome with secodary educatio (=20, 30.77), studets (=21, 32.30) ad wome ihabitig the of the provice (=21, 39.62). I tur, the highest percetage of respodets who did ot kow that the huma immuodeficiecy virus (HIV) was a risk factor for cervical cacer was formed by wome betwee 51 ad 60 years of age (=13, 61.90), married wome (=57, 61.96), wome with elemetary educatio (=7, 87.50), uemployed wome (=9, 64.29), ad ihabitats of the coutryside (=36, 67.92). A statistically sigificat relatioship has bee foud betwee the kowledge of the wome surveyed regardig the huma immuodeficiecy virus (HIV) as a risk factor for cervical cacer ad the place of residece (), civil status (p=0.0003) ad the form of professioal activity (). However, o statistically sigificat relatioship has bee foud betwee the respodets kowledge regardig the huma immuodeficiecy virus (HIV) as a risk factor for cervical cacer ad age (p=0.17) or educatio (p=0.13). Table 1. Correlatio betwee the respodets kowledge about the huma papillomavirus as a risk factor for cervical cacer ad the socio-demographic HPV as a risk factor for the developmet of Socio-demographic cervical cacer I do t Yes No kow years years years years Over years (40.00) 18 (9.00) (51.00) Sigle Married Divorced Widowed (40.00) 18 (9.00) (51.00) Elemetary Vocatioal Secodary Higher Provice District 80 (40.00) 18 (9.00) (51.00) Coutryside (40.00) 18 (9.00) (51.00) Employed Uemployed Pesioer Studet (40.00) 18 (9.00) (51.00)

4 Form of professioal activity Chi 2 =29.49 p= Form of professioal activity Chi 2 =15.14 Place of residece Chi 2 =15.48 p=0.004 Place of residece Chi 2 =12.25 Educatio Chi 2 =4.36 p=0.63 Educatio Chi 2 =9.96 p=0.13 Civil status Chi 2 =21.84 p=0.001 Civil status Chi 2 = p= Age Chi 2 =18.31 Age Chi 2 =11.63, p=0.17 Statistical aalysis Statistical aalysis JOURNAL OF OF PUBLIC HEALTH, NURSING AND MEDICAL RESCUE No.2/2015 2/ Table 2. Correlatio betwee the respodets kowledge about the geital herpes virus as a risk factor for cervical cacer ad the socio-demographic Table 3. Correlatio betwee the respodets kowledge about the huma immuodeficiecy virus (HIV) as a risk factor for cervical cacer ad the sociodemographic Socio-demographic Geital herpes virus as a risk factor for developig cervical cacer Yes No I do t kow Sociodemographic Huma immuodeficiecy virus (HIV) as a risk factor for developig cervical cacer Yes No I do t kow years years years years Over 60 years Sigle Married Divorced Widow Elemetary Vocatioal Secodary Higher Provice District Coutryside Employed Uemployed Pesioer Studet (27.50) (22.00) (50.50) (27.50) (22.00) (50.50) (27.50) (22.00) (50.50) (27.50) (22.00) (50.50) (27.50) (22.00) (50.50) years years years years Over years (29.50) (20.00) (50.50) Sigle Married Divorced Widow (29.50) 40 (20.00) (50.50) Elemetary Vocatioal Secodary Higher (29.50) 40 (20.00) (50.50) (29.50) 40 (20.00) (50.50) Provice District Coutryside Employed Uemployed Pesioer Studet (29.50) (20.00) (50.50)

5 JOURNAL OF OF PUBLIC HEALTH, NURSING AND MEDICAL RESCUE No.2/2015 2/ IV. DISCUSSION The huma papillomavirus (HPV) belogs to the Papillomaviridae family ad it is cosidered to be the mai aetiological factor for cervical cacer. The period i which the viral ifectio leads to eoplasm i the cervix depeds o the HPV geotype. Types 16 ad 18 are highly ocogeic. The medium-risk group is formed by types: 31, 33, 35, 39, 45, 51, 52, 56, 58, 59 ad 68, whereas types 6, 11, 42, 43 ad belog to the low-risk group. [ Chi et al. have discovered that, i the group of 43 patiets hospitalized for cervical cacer, 98 had the HPV DNA i pap smear. Also, i aother study coducted by the above-metioed authors i a group of 98 wome treated for cervical cacer, the HPV DNA was foud i 97.0 of pap smears. Research by Makwe ad Aorlu [19] coducted i a group of 178 urses has show that 70.1 of the respodets did ot kow that the huma papillomavirus was a aetiopathogeetic factor for cervical cacer. I tur, research by Ezewa et al [20] i a group of 290 wome mothers of adolescet girls has show that 27.9 of the wome surveyed did ot have kowledge regardig HPV ifectios, whereas 34.5 of the respodets kew that HPV was a risk factor for cervical cacer. Moreover, research coducted by Czechowska [21] i a group of 120 wome from Jeleia Góra district demostrated that.0 of wome had kowledge that the huma papillomavirus was a factor for cervical cacer. Furthermore, Cichońska et al [12] foud that 66 of the respodets kew that HPV ifectio was a risk factor for cervical cacer. Krajewska et al [22] foud that 26.0 of female respodets aged 20-30, 36.0 of wome aged ad 20 of wome aged did ot kow that HPV ifectio was a risk factor for cervical cacer. Fially, a study coducted i a group of 100 wome by Pacewicz et al [3] revealed that 51.0 of the wome examied did ot posses kowledge cocerig the ifluece of HPV o developig cervical cacer. Herpes simplex virus type II is a persistet ad recurrig viral ifectio beig the most frequet cause of ulceratios affectig geitals. It also costitutes a risk factor for becomig ifected with other sexually trasmitted diseases as well as for the developmet of cervical cacer. I a group of wome foud to be ifected with HPV (type 16 or 18) ad HSV- 2, the risk of developig a ivasive form of cervical cacer is twice as high as i wome ifected with oly oe type of the virus [23,24]. Research carried out by Cichońska et al [12] has show that merely 36.0 of the respodets kew that the herpes virus was a risk factor for cervical cacer. I tur, research by Pacewicz et al [3] has demostrated that wome are aware of the fact that ifectio with HSV-2 is a risk factor for cervical cacer. The authors ow research has show that oly of the respodets kew that the herpes simplex virus was a risk factor for cervical cacer. Yet, of the wome surveyed did ot kow that HIV-2 was a risk factor for this type of cacer. Ifectio with the huma immuodeficiecy virus (HIV) ad the Acquired Immuodeficiecy Sydrome (AIDS) still poses a serious health problem to wome. A relatioship has bee foud betwee seropositivity for HIV ad the developmet of cervical dysplasia. The icidece of cervical dysplasia i HIV-positive wome is approx. 40. Also, the course of the disease has bee observed to be worse for HIV-positive wome i compariso to HIV-egative wome. [24-28]. The authors ow study has demostrated that of the female respodets did ot posses kowledge regardig the relatioship betwee HIV ad the risk of developig cervical cacer, of the respodets kew that ifectio with HIV could predispose to the developmet of cervical cacer ad of the wome surveyed believed that ifectio with HIV did ot cotribute to the risk of developig this disease. This study has made it possible to determie the group of wome with the least kowledge about the ifectious risk for cervical cacer. Educatioal programmes coducted i this group of wome may cotribute to icreasig the umber of wome participatig i prophylactic examiatios as well as to reducig the morbidity ad mortality rates amog wome as a result of cervical cacer. V. CONCLUSIONS 1. Wome do ot have a suitable kowledge regardig the ifectious risk for cervical cacer. 2. Wome over 40 years of age, married wome, wome with elemetary or vocatioal educatio ad ihabitats of the coutryside should be subjected to special educatioal programmes due to the fact that they possess the least kowledge regardig the ifectious risk for cervical cacer

6 JOURNAL OF OF PUBLIC HEALTH, NURSING AND MEDICAL RESCUE No.2/2015 2/ VI. REFERENCES [1] Bartczak A, Dziedziczak-Buczyńska M. Wybrae zagadie z epidemiologii, aatomii i terapii raka piersi. JPHNMR 2012; (2): [2] Łoś J. Skryig cytologiczy raka szyjki macicy. Giekol Prakt 6; 1: [3] Pacewicz M, Krajewska-Kułak E, Krajewska-Ferishah K. Profilaktyka raka szyjki macicy- poziom wiedzy kobiet i mężczyz. Med Paliat 2012, 4: [4] Krajewska M, Owłasiuk A, Litwiejko A. The state of kowledge ad health behaviors coected with cervical cacer prevetio of the wome i Sejy. Probl Med Rodz 2010; 1: [5] Chybicka A, Jackowska T, Dobrzańska A i wsp. Zaleceia grupy ekspertów dotyczące pierwotej profilaktyki raka szyjki macicy u dziewcząt i młodych kobiet. Pediatr Pol 2010; 4, 85: [6] Khaial FB, Bodalal Z, Elramli A, Elkhwsky F, Eltaguri A et al. Cervical cacer i North-easter Libya: 0-8. J Obstet Gyaecol 2014;2:1-4. [7] Chi V, Matarira T. Huma papillomavirus geotypem i cervical kacer ad vacciatio challeges i Zimbabwe. Ifect Agets Cacer 2014; 9:16. [8] Bara W, Koracka K, Szela S. Ocea wiedzy kobiet z Podkarpacia a temat profilaktyki raka szyjki macicy. Prz Med Uiw Rzesz. 2013; 3: [9] Akarolo-Athoy S.N, Maso L.D, Igbioba F, Mbulaiteye S.M, Adebamowo A. Cacer burde amo HIV-positive persos i Nigeria: prelimiary fidigs from the Nigeria AIDS-cacer match study. Ifect Agets Cacer 2014; 9:1. [10] Stawarz B, Sulima M, Lewicka M, Brukwicka I, Wiktor H. Health ad determiats of health - a review of literature, p.i. JPHNMR 2014; (2):4-10. [11] Stawarz B, Sulima M, Lewicka M, Brukwicka I, Wiktor H. Health ad determiats of health - a review of literature, p.ii. JPHNMR 2014; (2): [12] Cichońska M, Borek M, Krawczyń W, Maciąg D. Wiedza kobiet w zakresie zapobiegaia owotoworom piersi i raka szyjki macicy. W: Nauki medycze, kultura fizycza i zdrowie. Zboia B, Doliwa-Klepacka A, Bakalarz- Kowalska B.(red.) Acta Sci Acad Ostroviesis. Sectio B. Sectio B 2012; 1:5-25. [13] Lipińska U, Atos E, Uracz W, Kopański Z, Bruchwicka I, Rowiński J. Rola pielęgiarki w profilaktyce i wczesym wykrywaiu raka piersi. JPHNMR 2011; (3): [14] Ciszek B, Heimrath J, Ciszek M. The applicatio of huma Papilloma Wirus Geotypig for the idetyficatio of eoplasm lesios i the cervix of wome with abormal cytology smears. Adv Cli Exp Med 2012; 21, 6: [15] Fraco E.L, Duarte Fraco E, Fereczy A. Cervical Cacer: epidemiology, prevetio ad the role of huma papillomavirus ifectio. CMAJ 2011; 164, 7:7 4. [16] Jaiecek M.F, Hervy MD, Averette E. Cervical cacer: prevetio, diagosis, ad therapeutics. Cacer J Cliic 7; 4: [17] Nawarra Karowicz D, Kowalska Koperek U, Karłowicz Bilińska A. Ocea wystąpieia czyików ryzyka zakażeia wirusem brodawczaka ludzkiego (HPV) oraz stopia jego okogeości wśród mieszkaek wsi. Prz Meopauz 5; 4, 4: [18] Wal M, Kuch A, Szkaradkiewicz A. Zakażeie wirusem brodawczaka ludzkiego (HPV) i ich rozpozawaie. Zakażeia 5; 3: [19] Makwe C.C, Aorlu R.I. Kowledge of ad attitude toward huma papillomavirus ifectio ad vaccies amog female urses at a tertiary hospital i Nigeria. IJWHRS 2011; 3: [20] Ezewa B.N, Balogu M.R, Okafor I.P. Mothers huma papilloma wirus kowledhe ad willigess to vacciate their adolescet daughters i Lagos, Nigeria. IJWHRS 2013; 5: [21] Czechowska K. Wiedza i zachowaia prozdrowote kobiet w zakresie profilaktyki raka szyjki macicy a podstawie badań pacjetek z powiatu jeleiogórskiego. W: Wiedza i doświadczeie pielęgiarki a jej działaia promocyjiedukacyje. Redakcja Pękała R. Wyższa Szkoła LDZ. w Legicy. Acta Scholie Superioris mediciae legicesis 8; 1:5-12. [22] Krajewska M, Owłasiuk A, Litwiejko A. The state of kowledge ad health behaviors coected with cervical kacer prevetio of the wome i Sejy. Prob Med Rodz 2010, 1, 30: [23] Wójcicki J. Współczese poglądy a rolę zakażeia HPV w procesie okogeezy raka szyjki macicy. Wiad Lek 6; 59, 5 6: [24] Majewska A, Krawczyk E, Łuczak M. Opryszczka arządów płciowych (geital herpes) obraz kliiczy i możliwe astępstwa zakażeia cz.ii. Zakażeia 5; 6: [25] Haisch Haiach.A, Chere SL, Sow PS, Wier RL, Hughes JP et al. Huma papillomavirus type 16 viral load i relatio to HIV ifectio, cervical eoplasia ad cacer i Seegal. Cacer Epidemiol 2014; httpl://dx.doi.org/ /j.caep [26] Rocha-Brischiliari SC, Gimees F, de Abreu A, Irie MMT, Souza RP et al. Risk for cervical HPV ifectio ad geotypes distributio i HIV- ifected South Brazilia wome. Ifectious Agets ad Cacer 2014; 9:6. [27] Kodey PD, Narigapalli BP. Covetioal pap smear screeig i HIV seropositive wome i South Idia. J Obstet Gyecol of Idia 2013; 63, 1:-58. [28] Ezechi OC, Ostergre PO, Nwaokorie FO, Ujah IAO, Pettersso KO. The burde, distributio ad risk for cervical ocogeic huma papilloma virus ifectio i HIV positive Nigeria wome. Virology Joural 2014;11:5. ccccccccccccccccccccccccc