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Gynecological Cancer Screening Knowledge, Practice, and Stage of Precaution Adoption Among Rural Elderly Women

Sunday, June 26, 2011
Leigh Anne Minchew, DNP, WHNP-BC , Maternal-Child Nursing, University of South Alabama, Mobile, AL

Discipline: Women’s Health (WH), Advanced Practice (AP)

Learning Objectives:
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Submission Description:
Objective:   To assess the knowledge rural elderly women possess for gynecological cancers, to examine gynecological cancer screening behaviors undertaken by rural elderly women, and to identify rural elderly women's stage of precaution adoption for gynecological cancer screening.

Design: Qualitative descriptive study using a one group design

Setting: A daily senior center within the Southeastern Alabama Regional Council on Aging (SARCOA)

Patients/Participants: Forty-four (44) elderly women (ages 60-94) 

Methods:  Institutional Review Board approval was obtained from Case Western Reserve University.  After controlling for cognitive impairment using the Short Portable Mental Status Questionnaire (SPMSQ), an investigator-developed survey tool, the Gynecological Cancer Screening Precaution Adoption Survey (GCSPAS) was used to identify gynecological cancer knowledge and stage of precaution adoption for gynecological cancer screening according to the Precaution Adoption Process Model (Weinstein & Sandman, 1992) while demograhic information was used to determine gynecological cancer screening practice behavior.  Data was collected during one on one interviews with participants.

Results:   Data from forty-one (N=41) participants were deemed valid.   Gynecological cancer knowledge was noted highest for cancers of the ovary (78%), uterus (65.9%), and cervix (61%) while cancers of the vagina, vulva and fallopian tube were less familiar.  Elderly women incorrectly identified ovarian cancer (29.3%) as the most common gynecological cancer while 24.4% of women stated they did not know which type of gynecological cancer was the most common among women their age.  Variation in gynecological cancer screening practices were noted among the participants as well with 63.4% of women participating in gynecological cancer screening by Pap smear or pelvic exam as directed by their provider, though many women verbalized participation in Pap smear screening even when they had not had a pelvic exam. Data indicated rural elderly women were noted within five of the six stages of the PAPM with the majority in stage seven, Maintenance, indicating they were actively participating in gynecological cancer screening within the previous three year period. 

Conclusion/Implications for nursing practice: The anticipation of rural elderly women living longer lives presents opportunity for women's health providers to educate women on the importance of gynecological health throughout the lifespan.  The PAPM may be used by health care providers to assess rural elderly women's gynecological health literacy and understanding of national gynecological cancer screening guidelines. The findings of this study may be used to guide gynecological health counseling including age-appropriate, evidence-based screening practice recommendations to all women.  

Keywords:  rural women, elderly women, gynecological cancer, knowledge, gynecological cancer screening, stages of precaution adoption, Precaution Adoption Process Model