EFFECTS OF EDUCATIONAL INTERVENTION FOR NURSES ON WOMEN'S KNOWLEDGE AND WILLINGNESS TO UPTAKE CERVICAL SCREENING SERVICES IN SELECTED HEALTH FACILITIES IN IBADAN

Abstract

Cervical cancer (CC) is a major cause of cancer mortality among women especially in developing nations. Low uptake of Cervical Cancer Screening (CCS) has been implicated. Countries with established screening programmes have recorded reduction in CC. Uptake of CCS depends largely on information available to women and nurse are in vantage position to provide this information. Few CCS pregames have been developed in Nigeria: however, the effects of educational interventions directed at nurses on women's uptake of screening have not been assessed. This study evaluated the effects of an educational intervention (EI) for nurses on women's knowledge and willingness to uptake CCS services. This quasi experimental study was conducted in purposively selected four primary and four secondary health facilities in Ibadan. These were randomly divided into four different facilities each in intervention and control groups. A total of 133 consented nurses who had more than a year experience [60 in the Intervention Group (IG) and 73 in the Control Group (CG) participated. Nine hundred and four women attending antenatal clinics in the facilities were also selected using systematic random sampling as baseline and same number at Post-Intervention (PI). Baseline data were collected from nurses and women using different validated structured questionnaires. Five modules El were conducted for the four in the IG at weekly intervals for three weeks. The nurses were followed up monthly, for six months and activities related to information dissemination for women were observed. Post-test questionnaires were administered to the nurses and women in IG and CG. Data were analysed using Chi square, t-test and logistic regression at p=0.05. Nurses' mean age was 41.6± 9.1 years while those of the women were 27.9±5.8 years at baseline and 28.0±5.3 )ears at PI. Majority of the women, IG; 94.9%; CG: 94.6% were married at baseline. The nurses' knowledge scores for the IG (11.8±3.3) and CG ( 11.7±3.3) were comparable at baseline. Post intervention knowledge score was significantly higher among nurses in the IG (14.6±3.1) than those in CG (12.7±3.5). The women's mean knowledge score was comparable at baseline IG (2.9±1.3) and CG (2.9±1.9). Post intervention knowledge score was significantly higher among women in the IG (3.4±3.2) than CG (2.0±3.1). Willingness to utilise CCS services also significantly increased from 75.0% (IG) and 70.0% (CG) bawline to 90.0% (IG) and 85.3% (CG) at PI. Uptake of CCS increased from 1.4% at baseline to 3.6% in the IG and 2.1% to 2.3% in the CG. The major factors that influenced uptake among women despite their willingness at PI were non-availability of CCS services (OR=0.481, CI=0.353-0.659) and lack of information on CCS (OR=1.919, CI=1.149-2.477). Cervical cancer screening uptake was low but improved slightly with the intervention. Educational intervention is a useful tool for improving knowledge and uptake of Cervical Cancer Screening. Nurses at all levels of healthcare should be trained to provide this information to women. Government and health related agencies should provide information and empower nurses to render cervical cancer services at all levels.