Knowledge, attitudes, and behaviours of primary health care workers regarding HPV infection and prevention: an example from Türkiye

İrem Akova; Nagehan Ekici Koşaroğlu; Esma Kılıç

doi:10.21763/tjfmpc.1310981

Araştırma Makalesi

Birinci basamak sağlık çalışanlarının HPV enfeksiyonu ve korunmaya ilişkin bilgi, tutum ve davranışları: Türkiye'den bir örnek

Yıl 2023, Cilt: 17 Sayı: 3 - Turkish Journal of Family Medicine and Primary Care, 407 - 415, 20.09.2023

İrem Akova Nagehan Ekici Koşaroğlu Esma Kılıç

https://doi.org/10.21763/tjfmpc.1310981

Öz

Giriş: Bu çalışma, Türk birinci basamak sağlık çalışanlarının human papillomavirus (HPV) enfeksiyonu, taramaları ve aşıları ile ilgili bilgi, tutum ve davranışlarını belirlemeyi amaçlamıştır.
Yöntem: Bu kesitsel araştırma, 1 Ocak 2023 ile 15 Şubat 2023 tarihleri arasında Türkiye'nin İç Anadolu Bölgesi'ndeki Sivas ilinde aile sağlığı merkezlerinde (ASM) çalışan aile hekimleri ve hemşire/ebelerle yapıldı. Sosyodemografik veri formu ve HPV Bilgi Ölçeği kullanıldı. Bağımsız örneklem t-testi, F testi (ANOVA) (post hoc Bonferroni testi) ve ki-kare testi uygulandı. Bulgular: Çalışma toplam 275 sağlık çalışanı ile yürütüldü. Sağlık çalışanlarının %57,5'i hemşire/ebe ve %69,8'i kadındı. Tüm sağlık çalışanları HPV'yi duymuştu, %97,8'i HPV testini duymuştu ve %84'ü HPV aşısını duymuştu. %79,3'ü ergenlik öncesi çocuklara ve %51,6'sı risk altındaki kişilere HPV aşısını önermemişti. Bunun en sık nedenleri, HPV aşıları hakkında bilgi eksikliği, bunların maliyeti ve devlet tarafından karşılanmamasıydı. HPV bilgisinin en düşük olduğu kısım HPV aşısı ile ilgiliydi. Ölçek toplam puanı erkeklerde, hekimlerde, adölesan oranı %10'un altında olan ASM çalışanlarında, HPV aşısını önerenlerde ve pahalı olduğu ve devlet tarafından karşılanmadığı için aşıyı önermeyenlerde daha yüksekti. Sonuç: Başta adölesan popülasyona hizmet veren sağlık çalışanları olmak üzere sağlık çalışanlarının HPV aşıları konusundaki bilgi eksikliğinin giderilmesi önerilmektedir. HPV aşılarının devlet tarafından karşılanması, sağlık çalışanlarının bu aşıları tavsiye etme oranını artırmada rol oynayabilir.

Anahtar Kelimeler

Human papillomavirüsü, HPV aşıları, Sağlık bilgisi, tutum, uygulama

Kaynakça

1. Forman D, de Martel C, Lacey CJ, Soerjomataram I, Lortet-Tieulent J, Bruni L, et al. Global burden of human papillomavirus and related diseases. Vaccine 2012;30:F12–23. Doi:10.1016/j.vaccine.2012.07.055.
2. Giuliano AR, Nyitray AG, Kreimer AR, Pierce Campbell CM, Goodman MT, Sudenga SL, et al. EUROGIN 2014 roadmap: Differences in human papillomavirus infection natural history, transmission and human papillomavirus-related cancer incidence by gender and anatomic site of infection. Int J Cancer 2015;136:2752–60. Doi: 10.1002/ijc.29082.
3. World Health Organization. Human Papillomavirus (HPV) and Cervical Cancer 2022. Access date: 14.04.2023 https://www.who.int/en/news-room/fact-sheets/detail/human-papillomavirus-(hpv)-and-cervical-cancer.
4. Zandberg DP, Bhargava R, Badin S, Cullen KJ. The role of human papillomavirus in nongenital cancers. CA Cancer J Clin 2013;63:57–81. https://doi.org/10.3322/caac.21167.
5. Viens LJ, Henley SJ, Watson M, Markowitz LE, Thomas CC, Thompson TD, et al. Human Papillomavirus-Associated Cancers - United States, 2008-2012. MMWR Morb Mortal Wkly Rep 2016;65:661–6. Doi: 10.15585/mmwr.mm6526a1.
6. Başara Bora B, Soytutan Çağlar İ, Aygün A, Özdemir TA, Kulali B, Yentür GK, et al. T.C. Sağlık Bakanlığı Sağlık İstatistikleri Yıllığı 2020. Ankara: Sağlık Bilgi Sistemleri Genel Müdürlüğü, Sağlık Bakanlığı; 2022: 41.
7. Halk Sağlığı Genel Müdürlüğü Yayın Komisyonu. Türkiye Kanser Kontrol Programı. Ankara: T.C. Sağlık Bakanlığı Halk Sağlığı Genel Müdürlüğü; 2021: 344.
8. Schiller JT, Castellsagué X, Garland SM. A Review of Clinical Trials of Human Papillomavirus Prophylactic Vaccines. Vaccine 2012;30:F123–38. Doi: 10.1016/j.vaccine.2012.04.108.
9. Dorleans F, Giambi C, Dematte L, Cotter S, Stefanoff P, Mereckiene J, et al, Group on behalf of the V 2 project gatekeepers. The current state of introduction of human papillomavirus vaccination into national immunisation schedules in Europe: first results of the VENICE2 2010 survey. Euro Surveill 2010;15:pii=19730.
10. T.C. Sağlık Bakanlığı Halk Sağlığı Genel Müdürlüğü. Aşı portalı. Access date: 10.04.2023 https://asi.saglik.gov.tr/asi-takvimi2
11. Sherris J, Friedman A, Wittet S, Davies P, Steben M, Saraiya M. Chapter 25: Education, training, and communication for HPV vaccines. Vaccine 2006;24:S210–8. Doi: 10.1016/j.vaccine.2006.05.124.
12. Anfinan NM. Physician’s knowledge and opinions on human papillomavirus vaccination: a cross-sectional study, Saudi Arabia. BMC Health Serv Res 2019;19:963. Doi: 10.1186/s12913-019-4756-z.
13. Waller J, Ostini R, Marlow LAV, McCaffery K, Zimet G. Validation of a measure of knowledge about human papillomavirus (HPV) using item response theory and classical test theory. Prev Med (Baltim) 2013;56:35–40. Doi: 10.1016/j.ypmed.2012.10.028.
14. Demir F. Human Papilloma Virüsü (Hpv) Bilgi Ölçeği’nin Türkçe Geçerlik ve Güvenirliği (Yüksek lisans tezi). Sağlık Bilimleri Üniversitesi, İstanbul, 2019.
15. Huck SW. Reading statistics and research. 6th ed. Boston: Pearson: 2012: 103-112.
16. Coskun S, Can H, Turan S. Knowledge about Cervical Cancer Risk Factors and Pap Smear Testing Behavior among Female Primary Health Care Workers: A Study from South Turkey. Asian Pacific J Cancer Prev 2013;14:6389–92. Doi: 10.7314/APJCP.2013.14.11.6389.
17. Yakşi N, Topaktaş B. Knowledge Beliefs and Barriers of Healthcare Workers about Human Papilloma Virus (HPV) and HPV Vaccination. Acibadem Univ Saglik Bilim Derg 2023;14:183–9. Doi: 10.31067/acusaglik.1240702.
18. Güven SE, Sağlam ZA, İnci A. A case-control study to evaluate awareness level of human papillomavirus among women healthcare professionals in tertiary health care facility. Ann Clin Anal Med 2021;12:1427–31. Doi: 10.4328/ACAM.20901.
19. Trucchi C, Restivo V, Amicizia D, Fortunato F, Manca A, Martinelli D, et al. Italian Health Care Workers’ Knowledge, Attitudes, and Practices Regarding Human Papillomavirus Infection and Prevention. Int J Environ Res Public Health 2020;17:5278. Doi: 10.3390/ijerph17155278.
20. Nilsen K, Aasland OG, Klouman E. The HPV vaccine: knowledge and attitudes among public health nurses and general practitioners in Northern Norway after introduction of the vaccine in the school-based vaccination programme. Scand J Prim Health Care 2017;35:387–95. Doi: 10.1080/02813432.2017.1358433.
21. Tubaş F, Dulkadir R, Taplak AŞ, Ünlü E. Knowledge and Attitudes of Physicians and Nurses in Turkey Regarding Human Papillomavirus Vaccination of Their Children. J Community Health 2023;48:99–103. Doi: 10.1007/s10900-022-01141-0.
22. Christodoulou A, Ajzajian J, Su D, Wang H, Roupa Z, Farazi PA. Awareness of human papilloma virus and cervical cancer prevention among Cypriot female healthcare workers. Ecancermedicalscience 2019;13:978. Doi: 10.3332/ecancer.2019.978.
23. Bruni L, Albero G, Serrano B, Mena M, Collado J, Gómez D, et al. ICO/IARC Information Centre on HPV and Cancer (HPV Information Centre). Human Papillomavirus and Related Diseases in the World. Summary Report 10 March 2023. Access date: 20.04.2023 https://hpvcentre.net/statistics/reports/XWX.pdf
24. Aydemir Ö, Terzi HA, Köroğlu M, Turan G, Altındiş M, Karakeçe E. Evaluation of HPV-DNA Positivity Rate and Cytopathologic Results in Cervical Specimens. Turkish Bull Hyg Exp Biol 2020;77:33–40. Doi: 10.5505/TurkHijyen.2019.68984.
25. Akova İ, Hasdemir Ö. Evaluatıon of cervıcal cancer screenıng rates and results ın 30-65 years women. Int Ref Acad J Sport 2018;3:63–77. Doi: 10.17363/SSTB.2018.29.3.
26. Daley EM, Vamos CA, Thompson EL, Zimet GD, Rosberger Z, Merrell L, et al. The feminization of HPV: How science, politics, economics and gender norms shaped U.S. HPV vaccine implementation. Papillomavirus Res 2017;3:142–8. Doi: 10.1016/j.pvr.2017.04.004.
27. Hilton S, Hunt K, Bedford H, Petticrew M. School nurses’ experiences of delivering the UK HPV vaccination programme in its first year. BMC Infect Dis 2011;11:226. Doi: 10.1186/1471-2334-11-226.
28. Rosen BL, Goodson P, Thompson B, Wilson KL. School Nurses’ Knowledge, Attitudes, Perceptions of Role as Opinion Leader, and Professional Practice Regarding Human Papillomavirus Vaccine for Youth. J Sch Health 2015;85:73–81. Doi: 10.1111/josh.12229.
29. Szarewski A. Raising awareness of human papillomavirus and cervical cancer prevention: the need for clinical education. Future Virol 2009;4:431–6. Doi: 10.2217/fvl.09.46.
30. Karamanidou C, Dimopoulos K. Greek health professionals’ perceptions of the HPV vaccine, state policy recommendations and their own role with regards to communication of relevant health information. BMC Public Health 2016;16:467. Doi: 10.1186/s12889-016-2831-5.

Knowledge, attitudes, and behaviours of primary health care workers regarding HPV infection and prevention: an example from Türkiye

Yıl 2023, Cilt: 17 Sayı: 3 - Turkish Journal of Family Medicine and Primary Care, 407 - 415, 20.09.2023

İrem Akova Nagehan Ekici Koşaroğlu Esma Kılıç

https://doi.org/10.21763/tjfmpc.1310981

Öz

Introduction: This study aimed to determine the knowledge, attitudes, and behaviors of Turkish primary health care workers (HCWs) regarding human papillomavirus (HPV) infection, screening, and vaccines.
Methods: This cross-sectional study was conducted with family physicians and nurses/midwives working in family health centers (FHC) in Sivas province in the Central Anatolia Region of Türkiye between January 1, 2023 and February 15, 2023. The sociodemographic data form and HPV Knowledge Scale were used. The independent sample t-test, the F test (ANOVA) (post hoc Bonferroni test), and the chi-squared test were performed.
Results: The study was conducted with a total of 275 HCWs. Of the HCWs, 57.5% were nurses/midwives and 69.8% were female. All HCWs had heard of HPV, 97.8% had heard of the HPV test, and 84% had heard of the HPV vaccine. 79.3% had not recommended the HPV vaccine to pre-adolescents and 51.6% to people at risk. The most common reasons for this were the lack of information about HPV vaccines, their expense, and the lack of coverage by the government. The part with the lowest level of HPV knowledge was about the HPV vaccine. The total score of the scale was higher in males, physicians, and those who were working in the FHC unit where the adolescent rate was below 10%, in those who recommended the HPV vaccine, and in those who had not recommended the vaccine because it is expensive and not covered by the government. Conclusion: It is recommended to improve the lack of knowledge among HCWs, mainly those serving the adolescent population, about HPV vaccines. Government coverage of HPV vaccines may play a role in increasing the rate at which HCWs recommend these vaccines.

Anahtar Kelimeler

Human papillomavirus, HPV vaccines, Health knowledge, attitudes, practice

Kaynakça

1. Forman D, de Martel C, Lacey CJ, Soerjomataram I, Lortet-Tieulent J, Bruni L, et al. Global burden of human papillomavirus and related diseases. Vaccine 2012;30:F12–23. Doi:10.1016/j.vaccine.2012.07.055.
2. Giuliano AR, Nyitray AG, Kreimer AR, Pierce Campbell CM, Goodman MT, Sudenga SL, et al. EUROGIN 2014 roadmap: Differences in human papillomavirus infection natural history, transmission and human papillomavirus-related cancer incidence by gender and anatomic site of infection. Int J Cancer 2015;136:2752–60. Doi: 10.1002/ijc.29082.
3. World Health Organization. Human Papillomavirus (HPV) and Cervical Cancer 2022. Access date: 14.04.2023 https://www.who.int/en/news-room/fact-sheets/detail/human-papillomavirus-(hpv)-and-cervical-cancer.
4. Zandberg DP, Bhargava R, Badin S, Cullen KJ. The role of human papillomavirus in nongenital cancers. CA Cancer J Clin 2013;63:57–81. https://doi.org/10.3322/caac.21167.
5. Viens LJ, Henley SJ, Watson M, Markowitz LE, Thomas CC, Thompson TD, et al. Human Papillomavirus-Associated Cancers - United States, 2008-2012. MMWR Morb Mortal Wkly Rep 2016;65:661–6. Doi: 10.15585/mmwr.mm6526a1.
6. Başara Bora B, Soytutan Çağlar İ, Aygün A, Özdemir TA, Kulali B, Yentür GK, et al. T.C. Sağlık Bakanlığı Sağlık İstatistikleri Yıllığı 2020. Ankara: Sağlık Bilgi Sistemleri Genel Müdürlüğü, Sağlık Bakanlığı; 2022: 41.
7. Halk Sağlığı Genel Müdürlüğü Yayın Komisyonu. Türkiye Kanser Kontrol Programı. Ankara: T.C. Sağlık Bakanlığı Halk Sağlığı Genel Müdürlüğü; 2021: 344.
8. Schiller JT, Castellsagué X, Garland SM. A Review of Clinical Trials of Human Papillomavirus Prophylactic Vaccines. Vaccine 2012;30:F123–38. Doi: 10.1016/j.vaccine.2012.04.108.
9. Dorleans F, Giambi C, Dematte L, Cotter S, Stefanoff P, Mereckiene J, et al, Group on behalf of the V 2 project gatekeepers. The current state of introduction of human papillomavirus vaccination into national immunisation schedules in Europe: first results of the VENICE2 2010 survey. Euro Surveill 2010;15:pii=19730.
10. T.C. Sağlık Bakanlığı Halk Sağlığı Genel Müdürlüğü. Aşı portalı. Access date: 10.04.2023 https://asi.saglik.gov.tr/asi-takvimi2
11. Sherris J, Friedman A, Wittet S, Davies P, Steben M, Saraiya M. Chapter 25: Education, training, and communication for HPV vaccines. Vaccine 2006;24:S210–8. Doi: 10.1016/j.vaccine.2006.05.124.
12. Anfinan NM. Physician’s knowledge and opinions on human papillomavirus vaccination: a cross-sectional study, Saudi Arabia. BMC Health Serv Res 2019;19:963. Doi: 10.1186/s12913-019-4756-z.
13. Waller J, Ostini R, Marlow LAV, McCaffery K, Zimet G. Validation of a measure of knowledge about human papillomavirus (HPV) using item response theory and classical test theory. Prev Med (Baltim) 2013;56:35–40. Doi: 10.1016/j.ypmed.2012.10.028.
14. Demir F. Human Papilloma Virüsü (Hpv) Bilgi Ölçeği’nin Türkçe Geçerlik ve Güvenirliği (Yüksek lisans tezi). Sağlık Bilimleri Üniversitesi, İstanbul, 2019.
15. Huck SW. Reading statistics and research. 6th ed. Boston: Pearson: 2012: 103-112.
16. Coskun S, Can H, Turan S. Knowledge about Cervical Cancer Risk Factors and Pap Smear Testing Behavior among Female Primary Health Care Workers: A Study from South Turkey. Asian Pacific J Cancer Prev 2013;14:6389–92. Doi: 10.7314/APJCP.2013.14.11.6389.
17. Yakşi N, Topaktaş B. Knowledge Beliefs and Barriers of Healthcare Workers about Human Papilloma Virus (HPV) and HPV Vaccination. Acibadem Univ Saglik Bilim Derg 2023;14:183–9. Doi: 10.31067/acusaglik.1240702.
18. Güven SE, Sağlam ZA, İnci A. A case-control study to evaluate awareness level of human papillomavirus among women healthcare professionals in tertiary health care facility. Ann Clin Anal Med 2021;12:1427–31. Doi: 10.4328/ACAM.20901.
19. Trucchi C, Restivo V, Amicizia D, Fortunato F, Manca A, Martinelli D, et al. Italian Health Care Workers’ Knowledge, Attitudes, and Practices Regarding Human Papillomavirus Infection and Prevention. Int J Environ Res Public Health 2020;17:5278. Doi: 10.3390/ijerph17155278.
20. Nilsen K, Aasland OG, Klouman E. The HPV vaccine: knowledge and attitudes among public health nurses and general practitioners in Northern Norway after introduction of the vaccine in the school-based vaccination programme. Scand J Prim Health Care 2017;35:387–95. Doi: 10.1080/02813432.2017.1358433.
21. Tubaş F, Dulkadir R, Taplak AŞ, Ünlü E. Knowledge and Attitudes of Physicians and Nurses in Turkey Regarding Human Papillomavirus Vaccination of Their Children. J Community Health 2023;48:99–103. Doi: 10.1007/s10900-022-01141-0.
22. Christodoulou A, Ajzajian J, Su D, Wang H, Roupa Z, Farazi PA. Awareness of human papilloma virus and cervical cancer prevention among Cypriot female healthcare workers. Ecancermedicalscience 2019;13:978. Doi: 10.3332/ecancer.2019.978.
23. Bruni L, Albero G, Serrano B, Mena M, Collado J, Gómez D, et al. ICO/IARC Information Centre on HPV and Cancer (HPV Information Centre). Human Papillomavirus and Related Diseases in the World. Summary Report 10 March 2023. Access date: 20.04.2023 https://hpvcentre.net/statistics/reports/XWX.pdf
24. Aydemir Ö, Terzi HA, Köroğlu M, Turan G, Altındiş M, Karakeçe E. Evaluation of HPV-DNA Positivity Rate and Cytopathologic Results in Cervical Specimens. Turkish Bull Hyg Exp Biol 2020;77:33–40. Doi: 10.5505/TurkHijyen.2019.68984.
25. Akova İ, Hasdemir Ö. Evaluatıon of cervıcal cancer screenıng rates and results ın 30-65 years women. Int Ref Acad J Sport 2018;3:63–77. Doi: 10.17363/SSTB.2018.29.3.
26. Daley EM, Vamos CA, Thompson EL, Zimet GD, Rosberger Z, Merrell L, et al. The feminization of HPV: How science, politics, economics and gender norms shaped U.S. HPV vaccine implementation. Papillomavirus Res 2017;3:142–8. Doi: 10.1016/j.pvr.2017.04.004.
27. Hilton S, Hunt K, Bedford H, Petticrew M. School nurses’ experiences of delivering the UK HPV vaccination programme in its first year. BMC Infect Dis 2011;11:226. Doi: 10.1186/1471-2334-11-226.
28. Rosen BL, Goodson P, Thompson B, Wilson KL. School Nurses’ Knowledge, Attitudes, Perceptions of Role as Opinion Leader, and Professional Practice Regarding Human Papillomavirus Vaccine for Youth. J Sch Health 2015;85:73–81. Doi: 10.1111/josh.12229.
29. Szarewski A. Raising awareness of human papillomavirus and cervical cancer prevention: the need for clinical education. Future Virol 2009;4:431–6. Doi: 10.2217/fvl.09.46.
30. Karamanidou C, Dimopoulos K. Greek health professionals’ perceptions of the HPV vaccine, state policy recommendations and their own role with regards to communication of relevant health information. BMC Public Health 2016;16:467. Doi: 10.1186/s12889-016-2831-5.

Toplam 30 adet kaynakça vardır.

Ayrıntılar

Birincil Dil	İngilizce
Konular	Aile Hekimliği
Bölüm	Orijinal Makaleler
Yazarlar	İrem Akova 0000-0002-2672-8863 Nagehan Ekici Koşaroğlu 0000-0001-9087-1317 Esma Kılıç 0000-0001-8503-4995
Erken Görünüm Tarihi	16 Eylül 2023
Yayımlanma Tarihi	20 Eylül 2023
Gönderilme Tarihi	7 Haziran 2023
Yayımlandığı Sayı	Yıl 2023 Cilt: 17 Sayı: 3 - Turkish Journal of Family Medicine and Primary Care

Kaynak Göster

Vancouver	Akova İ, Ekici Koşaroğlu N, Kılıç E. Knowledge, attitudes, and behaviours of primary health care workers regarding HPV infection and prevention: an example from Türkiye. TJFMPC. 2023;17(3):407-15.

Kapak Resmi İndir

Makale Dosyaları

Tam Metin

Sağlığın ve birinci basamak bakımın anlaşılmasına ve geliştirilmesine katkıda bulunacak yeni bilgilere sahip yazarların İngilizce veya Türkçe makaleleri memnuniyetle karşılanmaktadır.