Aygül Akyüz

Health Belief Model Scale for Cervical Cancer and Pap Smear Test: psychometric testing

AIM This study is a report of the development and psychometric testing of the Health Belief Model Scale for Cervical Cancer and the Pap Smear Test. BACKGROUND While the Champion Health Belief Model scales have been tested extensively for breast cancer and screening for this, evaluation of these scales in explaining the beliefs of women with regard to cervical cancer and the Pap Smear Test has only received limited attention. METHODS This methodological research was carried out in Turkey in 2007. The data were collected with 237 randomly selected women who met the criteria for inclusion and agreed to participate in this study. The Champion Health Belief Model scales were translated into Turkish, adapted for cervical cancer, validated by professional experts, translated back into English and pilot-tested. FINDINGS Factor analysis yielded five factors: Pap smear benefits and health motivation, Pap smear barriers, seriousness, susceptibility and health motivation. Cronbachs alpha reliability coefficients for the five subscales ranged from 0·62 to 0·86, and test-retest reliability coefficients ranged from 0·79 to 0·87 for the subscales. CONCLUSION The Health Belief Model Scale for Cervical Cancer and the Pap Smear Test was found to be a valid and reliable tool in assessing the womens health beliefs. Understanding the beliefs of women in respect of cervical cancer and the Pap Smear Test will help healthcare professionals to develop more effective cervical cancer screening programmes.

Comparison of maternal–and paternal–fetal attachment in Turkish couples

OBJECTIVE to compare maternal-fetal attachment (MFA) and paternal-fetal attachment (PFA) in terms of selected variables. DESIGN cross-sectional study. SETTING three training hospitals in Ankara, Turkey. The study was performed between December 2005 and March 2006. PARTICIPANTS a total of 144 pregnant women and 144 partners participated in the study; the response rate was 98%. FINDINGS there was a statistically significant difference between MFA and PFA scores (p<0.001). A comparison of MFA and PFA scores according to the selected variables (education, employment status, planning of pregnancy, pregnancy risk status) revealed that the MFA scores for pregnant women were significantly higher than the PFA scores of their partners, except for unemployed partners. The MFA (rho=-0.24, p<0.004) and PFA (rho=-0.32, p<0.001) scores decreased with increasing age of both pregnant women and their partners. KEY CONCLUSIONS AND IMPLICATIONS FOR PRACTICE although partners have lower fetal attachment scores than pregnant women, it is important to recognise factors influencing the attachment of the mother and father towards their fetus. Prenatal midwives and nurses are in a unique position to assess attachment and to intervene to promote attachment behaviours.

Association of depression and anxiety with oocyte and sperm numbers and pregnancy outcomes during in vitro fertilization treatment.

To estimate association of depression and anxiety scores with oocyte and sperm numbers and pregnancy rates during in vitro fertilization (IVF) treatment, 80 Turkish couples were administered the Spielberger State and Trait Anxiety and Beck Depression Inventories. A significant correlation (r= -.25) obtained between Depression and womens oocyte pickup data and number of oocytes, showed that low oocyte numbers were associated with higher Depression. No significant relation was found for sperm counts with Anxiety and Depression scores on the day of oocyte pickup and sperm collection, but sperm motility was weakly and inversely correlated with Depression scores. Women with high State Anxiety score on the oocyte pickup day had significant lower pregnancy rates, as did those with higher Depression. Counseling of couples by health professionals on fertility-related issues to be implemented in IVF units is advisable.

Evaluating Dysmenorrhea in a Sample of Turkish Nursing Students

The aim of this study was to determine the prevalence and symptoms of dysmenorrhea, its relevant factors, and the rate of seeking medical help in a group of nursing students. A total of 380 students were included in the study. The demographic data questionnaire, a Daily Menstrual Symptom Rating Scale (DMSR), and the Visual Analog Scale for pain (VASP) were used as tools for data collection. The mean age of the participants was 20.31 ± 1.10 years. Most students had experienced dysmenorrhea (84.9%). Menstrual pain was frequently initiated on the first day of menstruation (77.8%). The most commonly reported menstrual problems were irregular menstrual cycles (27.2%) and oligomenorrhea (15.1%). Only 24.1% of students consulted their physicians for dysmenorrhea. The participants who had dysmenorrhea had significantly higher symptom scores than the participants who had not had dysmenorrhea, in terms of decreased activities, tension, hip and abdominal pain, backache, headache, and fatigue. Also, having a sister with dysmenorrhea increased the risk of dysmenorrhea. Although dysmenorrhea is a gynecological problem that is commonly seen in young women and that negatively affects daily activities and school life, the rate of seeking medical help is low. Adolescents should, therefore, be educated and counseled to determine the underlying cause and to increase the use of an effective treatment method. Considering that nurses should be better informed about dysmenorrhea causes and treatment options, a study of nursing students was undertaken.

Identifying women's knowledge about risk factors of breast cancer and reasons for having mammography.

The aim of this study was to identify breast cancer risk factors and reasons for having mammography of the women who applied for mammography, as well as to determine their level of knowledge about risk factors and level of risk perception, and anxiety concerning breast cancer. This cross-sectional descriptive study was conducted from June 15, 2010 through September 10, 2010, in a university hospital in Ankara, Turkey. A questionnaire prepared by the researchers was used to collect the data. The mean age of the women was 52.1 ± 9.98 years. Sixteen percent of the women had a family history of breast cancer. The majority of participants had mammograms (75.8%) before and had gained knowledge about breast cancer and its screening (73.7%). The leading source of information about breast cancer was physicians (46.2%). Physician recommendations, having breast-related complaints, and family history of breast cancer were important reasons to obtain mammography. The mean knowledge score about risk factors of breast cancer was 4.15 ± 2.73 and the mean anxiety score was 1.65 ± 1.61. It was found that some socio-demographic and obstetrical characteristics of women, their family history, and risk perceptions about breast cancer affect their knowledge and anxiety scores about breast cancer. In conclusion, the present study identified a number of factors affecting mammography participation for women. The results of this study can be helpful in promoting screening for breast cancer.

Self-Application of Complementary and Alternative Medicine by Patients with Gynecologic Cancer

Objectives: In this study we aimed to determine the epidemiology and demographic data on complementary and alternative medicine (CAM) use along with the medical/surgical treatment modalities in patients with gynecologic cancers in Turkey. Materials and Methods: A cross-sectional study was designed to determine demographic data on CAM use of patients with gynecologic cancers who had medical and/or surgical treatments. Semistructured questionnaires were used for collecting data from 126 patients. Results: When the CAM use ratio of patients was evaluated with respect to demographic characteristics, patients using any type of CAM were younger and more educated, and there were no significant differences between the patients who used and who did not use any type of CAM with respect to geographical region. There were no significant correlations between the use of CAM and the type of malignancy, treatment modality and time period after diagnosis. Conclusion: There is critical concern about the probable serious risks associated with non-educated CAM practitioners. Therefore, informed and educated healthcare professionals should inform and help in relieving patients in a more professional and multidisciplinary way.

Premenstrual syndrome and attitudes toward menstruation in a sample of nursing students.

Objective: The aim of this study was to evaluate baccalaureate nursing students’ attitudes toward menstruation, and to analyze the frequency of premenstrual syndrome (PMS) symptoms, as well as the relationship between attitudes toward menstruation and PMS symptoms. Methods: This cross-sectional study was carried out between February 15 and March 10, 2009, in Ankara Turkey. The study participants were 250 undergraduate nursing student volunteers. Data were collected using a demographic questionnaire, the validated Turkish version of the Menstrual Attitude Questionnaire (MAQ), and the validated Turkish Premenstrual Syndrome (PMS) Scale. Obtained data were analyzed using SPSS version 15.0. Findings: The average age of participants was 19.89 ± 1.43. The MAQ’s five subscales’ mean scores ranged from 2.67 ± 0.58 to 3.37 ± 0.52, indicating natural to moderate attitudes toward menstruation. The mean PMS score was 114.86 ± 35.15, indicating moderate PMS symptoms. PMS symptoms were detected in 36.4% of the nursing students. Thirty one percent of the students reported having dysmenorrhoea during every menstrual cycle. Students who had PMS symptoms scored significantly higher on the debilitation subscale and scored significantly lower on the denial subscale of the MAQ (p < 0.05). Conclusions: The findings of this research showed that menstruation was considered to be a natural event by most of the nursing students. In addition, dysmenorrhea was found to be the most common menstrual problem and the rate of PMS was found lower than that found in previous researches conducted in Turkey.

Women's Breast Cancer Risk Perception and Attitudes Toward Screening Tests

This studys objective is to identify womens breast cancer risk perceptions and their attitudes and knowledge on screening tests. The cross-sectional research. Gulhane Military Medical Academy, Ankara, Turkey. The population of 188 females who applied for gynecological examination. The study employed a semistructured questionnaire form. Questions such as females demographic data, attitudes based on screening tests of breast cancer, family history, perceived risk breast cancer, and questions with regard to patients’ fear of breast cancer were included in the survey. In this study, it is determined that the rates of the women, who conduct breast self-examination (BSE), clinical breast examination (CBE) and mammography at least once, are very low. The reason for not performing the BSE was declared with a rate of 50.8% as “Do not know how to perform.” Of the women 20.2% were fully acknowledged about BSE. Nearly half of the women perceived 50% or more risk of developing breast cancer, and this rate increases as they get older. The risk perception and educational status increased CBE and mammography rates and BSE knowledge positively, but because of insufficient BSE application abilities BSE rate cannot increase as expected. It is recommended that nurses put forward the initiatives in training programs to increase womens BSE abilities. In planning such an education program risk perception and information of women about breast cancer should be considered.

Marital Violence: Is it a Factor Affecting the Reproductive Health Status of Women?

The aim of this study is to determine the effects of violence on the reproductive health of women and utilization of reproductive health services. The study population consisted of 250 married women aged 15 to 49, selected from patients at two different hospitals’ obstetrics and gynecology clinics in Ankara, Turkey. A data collection form and the “Scale of Marital Violence Against Women” were used to obtain data. According to the study, women who have lower education levels and who first experience marriage and sexual intercourse at a younger age suffer from violence more frequently. Women experiencing violence have higher gravida and para numbers. The majority of these women has not undergone appropriate prenatal care and delivered their babies under the supervision of a health care professional. These women have been using traditional and ineffective contraceptive methods. Marital violence has led to unfavorable effects on these women’s reproductive health and utilization of reproductive health services.

Effectiveness of nursing counseling on coping and depression in women undergoing in vitro fertilization.

The purpose of present study was to evaluate the effectiveness of counseling provided by nurses on depression and coping strategies of infertile women undergoing in vitro fertilization (N = 67). Of the 84 women who were interviewed, 30 were accepted as a comparison group, and 37 were included in the study group. The study group women were given counseling in addition to routine nursing care services, including group education and individual interviews about treatment and coping strategies. The nurses also provided support by accompanying the women during the invasive procedures. The Beck Depression Inventory and Jalowiecs Coping Strategies Form were used for measurements. All the women were using emotional coping and had moderate depression prior to the study. There was no statistically significant difference between the comparison and study groups before or after the counseling with respect to depression and coping strategies. Parameters to evaluate the efficacy of counseling are discussed.