آگاهي، نگرش و عملكرد دانشجويان پزشكي درباره روش غربالگري سرطان دهانه رحم

Medical Students’ Knowledge, Attitude and Practice about Cervical Cancer Screening Method

ﻪ و ﻫﺪف: آﮔﺎﻫﯽ و ﻧﮕﺮش از ﻣﻬﻤﺘﺮﯾﻦ ﻋﻮاﻣﻞ ﭘﯿﺶﺑﯿﻨﯽ ﮐﻨﻨﺪه رﻓﺘﺎرﻫﺎي ﺑﻬﺪاﺷﺘﯽ ﻫﺴﺘﻨﺪ. ﻫﻤﭽﻨﯿﻦ، آﻧﻬﺎ ﻋﺎﻣﻠﯽ ﻣﺆﺛﺮ در اﻧﺠﺎم روشﻫﺎي ﻏﺮﺑﺎﻟﮕﺮي ﻣﯽﺑﺎﺷﻨﺪ. اﯾﻦ ﻣﻄﺎﻟﻌﻪ ﺑﺎ ﻫﺪف ﺑﺮرﺳﯽ آﮔﺎﻫﯽ و ﻧﮕﺮش و ﻋﻤﻠﮑﺮد داﻧﺸﺠﻮﯾﺎن ﭘﺰﺷﮑﯽ در ﻣﻮرد روش ﻏﺮﺑﺎﻟﮕﺮي ﺳﺮﻃﺎن دﻫﺎﻧﻪ رﺣﻢ اﻧﺠﺎم ﮔﺮﻓﺖ. ﻣﻮاد و روش ﻫﺎ: در اﯾﻦ ﻣﻄﺎﻟﻌﻪ ﺗﺤﻠﯿﻠﯽ ﻣﻘﻄﻌﯽ، 368 ﻧﻔﺮ از داﻧﺸﺠﻮﯾﺎن ﭘﺰﺷﮑﯽ ﻣﻮرد ﺑﺮرﺳﯽ ﻗﺮار ﮔﺮﻓﺘﻨﺪ. ﺟﻤﻊآوري اﻃﻼﻋﺎت از ﻃﺮﯾﻖ ﭘﺮﺳﺸﻨﺎﻣﻪاي ﺷﺎﻣﻞ وﯾﮋﮔﯽﻫﺎي دﻣﻮﮔﺮاﻓﯿﮏ، آﮔﺎﻫﯽ ﺳﻨﺠﯽ، ﻧﮕﺮش ﺳﻨﺠﯽ و ﻋﻤﻠﮑﺮد ﺳﻨﺠﯽ ﺑﻮد. ﺳﭙﺲ ﺑﺮ اﺳﺎس ﻧﻤﺮه ﮐﺴﺐ ﺷﺪه اﻓﺮاد ﺑﻪ ﺳﻪ ﮔﺮوه ﺑﺎ آﮔﺎﻫﯽ ﺿﻌﯿﻒ )ﻧﻤﺮه ﮐﻤﺘﺮ از 20( ﺑﺎ آﮔﺎﻫﯽ ﻣﺘﻮﺳﻂ )ﻧﻤﺮه ﺑﯿﻦ 20 ﺗﺎ 30( و ﺑﺎ آﮔﺎﻫﯽ ﺧﻮب )ﻧﻤﺮه ﺑﺎﻻي 30( ﺗﻘﺴﯿﻢ ﻣﯽﺷﺪﻧﺪ. ﺳﺌﻮاﻻت ﻧﮕﺮشﺳﻨﺠﯽ ﺑﻪ ﺻﻮرت ﻣﻘﯿﺎس ﻟﯿﮑﺮت 5 درﺟﻪاي ﻃﺮاﺣﯽ ﺷﺪ. دادهﻫﺎ ﺑﺎ آزﻣﻮنﻫﺎي آﻣﺎري ﮐﺎي دو و ﺿﺮﯾﺐ ﻫﻤﺒﺴﺘﮕﯽ ﭘﯿﺮﺳﻮن در ﻧﺮم اﻓﺰار SPSS ﻧﺴﺨﻪ21 ﻣﻮرد ﺗﺠﺰﯾﻪ و ﺗﺤﻠﯿﻞ ﻗﺮار ﮔﺮﻓﺖ. ﯾﺎﻓﺘﻪ ﻫﺎ: 16/6% داﻧﺸﺠﻮﯾﺎن داراي آﮔﺎﻫﯽ ﺧﻮب، 28% داراي آﮔﺎﻫﯽ ﺿﻌﯿﻒ و 55/4% داراي آﮔﺎﻫﯽ ﻣﺘﻮﺳﻂ ﺑﻮدﻧﺪ. ﺑﯿﺸﺘﺮﯾﻦ ﻧﮕﺮش ﻣﻨﻔﯽ ﻣﺮﺑﻮط ﺑﻪ ﻋﺒﺎرت "آﯾﺎ ﺗﺴﺖ ﭘﺎپ اﺳﻤﯿﺮ ﻓﻘﻂ ﺑﺮاي ﮐﺴﺎﻧﯽ ﮐﻪ ﺗﻤﺎس ﺟﻨﺴﯽ دارﻧﺪ، ﻻزم اﺳﺖ" )64/3%( و ﺑﯿﺸﺘﺮﯾﻦ درﺻﺪ ﻣﻮاﻓﻖ ﻣﺮﺑﻮط ﺑﻪ ﻋﺒﺎرت "ﺗﺸﻮﯾﻖ ﺧﺎﻧﻮاده ﺑﻪ اﻧﺠﺎم ﺗﺴﺖ ﭘﺎپ اﺳﻤﯿﺮ" )82/2%( ﺑﻮد. 100% داﻧﺸﺠﻮﯾﺎن ﻣﺘﺄﻫﻞ در ﮐﻤﺘﺮ از 2 ﺳﺎل ﭘﯿﺶ ﺑﻪ ﭘﺰﺷﮏ زﻧﺎن ﻣﺮاﺟﻌﻪ ﻧﻤﻮده ﺑﻮدﻧﺪ و ﻫﯿﭻ ﮐﺪام ﺗﺎﮐﻨﻮن ﺗﺴﺖ ﭘﺎپ اﺳﻤﯿﺮ ﺑﺮاي ﺧﻮدﺷﺎن اﻧﺠﺎم ﻧﺪاده ﺑﻮدﻧﺪ. ﻫﻤﺒﺴﺘﮕﯽ ﻣﻌﻨﯽدار ﺑﯿﻦ ﻧﻤﺮه آﮔﺎﻫﯽ و ﺳﻦ داﻧﺸﺠﻮﯾﺎن وﺟﻮد داﺷﺖ )0/368=P< 0/0001 ،r(. در ﮔﺮوه داﻧﺸﺠﻮﯾﺎن دﺧﺘﺮ 24/5 آﮔﺎﻫﯽ ﺧﻮب داﺷﺘﻨﺪ، وﻟﯽ در ﮔﺮوه ﭘﺴﺮان ﻫﯿﭻ ﯾﮏ از داﻧﺸﺠﻮﯾﺎن آﮔﺎﻫﯽ ﺧﻮب ﻧﺪاﺷﺘﻨﺪ )0/0001=P(. در 12 ﻋﺒﺎرت از 14 ﻋﺒﺎرت ﻧﮕﺮشﺳﻨﺠﯽ ﺗﻔﺎوت ﺑﯿﻦ دو ﮔﺮوه ﺟﻨﺴﯽ از ﻟﺤﺎظ آﻣﺎري ﻣﻌﻨﯽدار ﺑﻮد )0/01 < P(. 39/6 درﺻﺪ داﻧﺸﺠﻮﯾﺎن ﮐﺎرورز آﮔﺎﻫﯽ ﺧﻮب داﺷﺘﻨﺪ و در ﺳﺎﯾﺮ ﻣﻘﺎﻃﻊ ﻫﯿﭻ ﯾﮏ از داﻧﺸﺠﻮﯾﺎن آﮔﺎﻫﯽ ﺧﻮب ﻧﺪاﺷﺘﻨﺪ ﮐﻪ ﺗﻮزﯾﻊ ﻓﺮاواﻧﯽ ﺳﻄﺢ آﮔﺎﻫﯽ ﺑﯿﻦ ﺳﻪ ﮔﺮوه ﻣﻘﻄﻊ ﺗﺤﺼﯿﻠﯽ از ﻧﻈﺮ آﻣﺎري ﻣﻌﻨﯽدار ﺑﻮد )0/0001=P(. ﻫﻤﭽﻨﯿﻦ ﺗﻔﺎوت ﺗﻮزﯾﻊ ﻧﮕﺮش داﻧﺸﺠﻮﯾﺎن ﺑﺮاﺳﺎس ﻣﻘﻄﻊ ﺗﺤﺼﯿﻠﯽ در ﻫﻤﻪ ﻋﺒﺎرات ﻧﮕﺮشﺳﻨـﺠﯽ از ﻟﺤـﺎظ آﻣﺎري ﻣﻌﻨﯽدار ﺑﻮد )0/05˂P(. ﻧﺘﯿﺠﻪ ﮔﯿـﺮي: اﯾﻦ ﻣﻄﺎﻟﻌﻪ ﻧﺸﺎن داد ﮐﻪ آﮔﺎﻫﯽ داﻧﺸﺠﻮﯾﺎن ﻧﺴﺒﺖ ﺑﻪ ﺗﺴﺖ ﻏﺮﺑﺎﻟﮕﺮي ﺳﺮﻃﺎن ﺳﺮوﯾﮑﺲ ﻧﺴﺒﺘﺎً ﺿﻌﯿﻒ اﺳﺖ، اﻣﺎ اﮐﺜﺮﯾﺖ اﻓﺮاد ﻧﮕﺮش ﻣﻨﺎﺳﺒﯽ دارﻧﺪ. ﻫﻤﭽﻨﯿﻦ ﻋﻤﻠﮑﺮد آﻧﺎن ﻧﯿﺰ ﻧﺴﺒﺘﺎً ﺿﻌﯿﻒ ﻣﯽﺑﺎﺷﺪ، ﺑﻨﺎﺑﺮاﯾﻦ ﺑﺮﮔﺰاري ﺑﺮﻧﺎﻣﻪﻫﺎي آﻣﻮزﺷﯽ ﺑﯿﺸﺘﺮ ﺗﻮﺻﯿﻪ ﻣﯽﮔﺮدد.

Introduction & Objective: Knowledge and attitude are important factors in predicting health behaviors. Also, they are effective factors in performing screening procedures. We aimed to investigate medical students’ knowledge, attitude and practice about cervical cancer screening method. Materials & Methods: In this analytic cross sectional study, 368 undergraduate medical students were assessed. Data were collected through a questionnaire consisted demographic characteristics, knowledge assessment (20 questions), attitude assessment (14 questions) and performance assessment (6 questions). Patients were divided in 3 groups based on the acquired score in knowledge assessment: poor knowledge (< 20), moderate knowledge (20-30) and good knowledge (> 30). The attitude questions were designed as 5 degree likert index. Data were analyzed by chi-square test and Pearson correlation coefficient in SPSS software (version 21). Results: 16.6%, 28% and 55.4% of the students had respectively good, poor and moderate knowledge. The most negative attitude was about the necessity of pap smear in those women who had sexual contacts (64.3%) and the most positive attitude was about encouraging family to do the test (82.2%). 100% of married students had referred to a gynecologist in the past 2 years and none of them had Pap smear. There was significant Correlation between knowledge score and age (r = 0.368, P = 0.0001). In the female students, 24.5% had good knowledge, but none of male students had good knowledge (P = 0.0001). There were significant differences between the two gender groups in 12 sentences out of 14 of attitude sentences. 39.6% of intern students had good knowledge, but in other educational levels none of the students had good knowledge (P = 0.0001). Also, there was significant difference between all attitude questions in the three educational levels (P < 0.05). Conclusions: Our study showed that students' knowledge regarding cervical cancer screening test was relatively low, but most people had a good attitude toward it. Also, their performance was relatively poor. So, it is suggested to have more educational programs.