Cervical Cancer Screening Among Taiwanese Women: A Transtheoretical Approach

Purpose/Objectives: To assess Papanicolaou (Pap) test screening behaviors of Taiwanese women, to explore factors affecting stages of change, and to determine whether constructs from the transtheoretical model are applicable to Taiwanese women with regard to Pap screening.

Design: Descriptive, cross-sectional.

Setting: A hospital in Taiwan.

Sample: 222 female hospital workers.

Methods: Data were collected with a questionnaire.

Main Research Variables: Cervical screening behavior, perceived barriers and benefits, self-efficacy, and stages of change.

Findings: Fifty-six percent of participants reported engaging in regular screening practice. The stage of respondents' cervical cancer screening was significantly associated with age, marital status, and history of human papilloma virus-positive and abnormal tests. Self-efficacy scores were significantly higher for women who were in action or maintenance than those in precontemplation or relapse (p < 0.0001). Women in relapse reported significantly more perceived barriers than those in action-maintenance (p = 0.005). No significant differences were found in the level of perceived benefits (p = 0.702) to regular Pap screening among women in the various stages.

Conclusions: Pap screening was low among the entire sample and nonexistent among women younger than age 30. The transtheoretical model only was partially applicable to the Taiwanese women in this study.

Implications for Nursing: Reinforcement of self-efficacy was more important for women in the sample than emphasizing the benefits of or decreasing the barriers to regular Pap screening. Strategies for younger unmarried women might include education programs emphasizing the importance of routine annual screening and enhancing women's understanding of the relationship between Pap tests and cervical cancer.