Path Analysis on the Biopsychosocial Determinants and Genital Hygiene on Cervical Cancer at Dr. Moewardi Hospital, Surakarta, Central Java

Background: Cervical cancer is the fourth most common cancer in women worldwide and the second most common cancer in women in developing countries after breast cancer. The prevalence of cervical cancer in Indonesia was 0.8‰ with an estimated 98.692 cases. This study aimed to determine the biopsychosocial and genital hygiene factors for cervical cancer.Subjects and Method: This was an analytic observational study with a case-control design, conducted at Dr. Moewardi Hospital, Surakarta, from December 2017 to February 2018. A total of 178 study subjects including 95 women with cervical cancer (case) and 83 women without cervical cancer (control) were selected by fixed disease sampling. The dependent variable was cervical cancer. The independent variables were the age at first sexual intercourse, a number of sexual partners, body mass index (BMI), stress, education, income, and genital hygiene. Cervical cancer data was collected by medical record. The other data were collected by questionnaire. The data were analyzed by path analysis model.Results: The risk of cervical cancer increased with the number of sexual partner >1 (b=1.91; 95% CI= 0.31 to 3.49; p=0.019), BMI ≥25 (b= 0.98; 95% CI= -0.06 to 2.04; p=0.067), and stress (b= 1.59; 95% CI= 0.39 to 2.80; p=0.009). The risk of cervical cancer decreased with higher education (b= -3.58; 95% CI= -4.77 to -2.39; p1 (b= 1.36; 95% CI= 0.12 to 2.61; p=0.032).Conclusion: The risk of cervical cancer increases with the number of sexual partners, BMI, and stress, but decreases with higher education, higher income, age at first sexual intercourse, and genital hygiene.Keywords: cervical cancer, biopsychosocial determinants, genital hygiene, path analysisCorrespondence: Afriza Umami. Masters Program in Public Health, Sebelas Maret University, Jl. Ir. Sutami 36 A, Surakarta, Indonesia. Email: [email protected]. Mobile : +6282254348041Journal of Epidemiology and Public Health (2018), 3(2): 277-291https://doi.org/10.26911/jepublichealth.2018.03.02.0

Relationship between Demographic Factors, Knowledge, and Injection Contraceptive Acceptors’ Visit Compliance

BACKGROUND: The population of Indonesia continues to increase every year. Family planning is an effort to create a guaranteed or qualified family by regulating the number of children, birth spacing, and the age of delivered women, allowing pregnancy to occur to create a healthy and prosperous Indonesia. The total fertility rate (TFR) in 2017 was 2.4, but to create a qualified family and a balanced population, the TFR must be based on a decrease in 2020–2021.AIM: The aim of the study was to analyze the relationship between ages, education, knowledge, work status, and support from husbands with injection contraceptive acceptors.METHOD: This study used the analytical observational cross-sectional design. The sampling technique was non-random purposive sampling, with a sample size of 96 people; a questionnaire was used to collect data and data were analyzed using the Chi-squared test with IBM SPSS Statistics 21.RESULTS: The percentage of respondents who were injection contraceptive acceptors was 57.3%. The results showed that the variables associated with injection visit compliance were age (p = 0.022), knowledge (p = 0.005), and work status (p = 0.017). Meanwhile, the variables not related to compliance with injection visits were education (p = 0.172), husband’s support (p = 0.833), number of children (p = 0.167), and house distance (p = 0.054).CONCLUSION: The factor that most influenced acceptors’ compliance with injection visits was knowledge of contraception

Path Analysis on the Biopsychosocial Determinants and Genital Hygiene on Cervical Cancer at Dr. Moewardi Hospital, Surakarta, Central Java

Background: Cervical cancer is the fourth most common cancer in women worldwide and the second most common cancer in women in developing countries after breast cancer. The prevalence of cervical cancer in Indonesia was 0.8‰ with an estimated 98.692 cases. This study aimed to determine the biopsychosocial and genital hygiene factors for cervical cancer.Subjects and Method: This was an analytic observational study with a case-control design, conducted at Dr. Moewardi Hospital, Surakarta, from December 2017 to February 2018. A total of 178 study subjects including 95 women with cervical cancer (case) and 83 women without cervical cancer (control) were selected by fixed disease sampling. The dependent variable was cervical cancer. The independent variables were the age at first sexual intercourse, a number of sexual partners, body mass index (BMI), stress, education, income, and genital hygiene. Cervical cancer data was collected by medical record. The other data were collected by questionnaire. The data were analyzed by path analysis model.Results: The risk of cervical cancer increased with the number of sexual partner >1 (b=1.91; 95% CI= 0.31 to 3.49; p=0.019), BMI ≥25 (b= 0.98; 95% CI= -0.06 to 2.04; p=0.067), and stress (b= 1.59; 95% CI= 0.39 to 2.80; p=0.009). The risk of cervical cancer decreased with higher education (b= -3.58; 95% CI= -4.77 to -2.39; p1 (b= 1.36; 95% CI= 0.12 to 2.61; p=0.032).Conclusion: The risk of cervical cancer increases with the number of sexual partners, BMI, and stress, but decreases with higher education, higher income, age at first sexual intercourse, and genital hygiene.Keywords: cervical cancer, biopsychosocial determinants, genital hygiene, path analysisCorrespondence: Afriza Umami. Masters Program in Public Health, Sebelas Maret University, Jl. Ir. Sutami 36 A, Surakarta, Indonesia. Email: [email protected]. Mobile : +6282254348041Journal of Epidemiology and Public Health (2018), 3(2): 277-291https://doi.org/10.26911/jepublichealth.2018.03.02.0

Knowledge, Barriers, and Motivation Related to Breast and Cervical Cancer Screening Among Women in Bojonegoro, East Java: A Qualitative Study

Background: Breast and cervical cancer remain a major cause of morbidity and mortality for wo­men in Indonesia. Although this cancer can be de­tected early, women are still less active in self-detecting breast and cervical cancer, so both cancers are found at an advanced stage. This study aimed to explore how women's knowledge, barriers, and motivations are related to early detection of breast and cervical cancer.Subjects and Method: This was a qualitative study, with focus group discussions (FGDs) and interviews with key informants. Discussions and in­terviews were conducted in the community within Ledok Kulon village, Bojonegoro Regency, East Java, Indonesia. Participants: FGD partici­pants involved 20 women, 10 women underwent FDG about cervical cancer and 10 other women conducted FGD about breast cancer. Three key informants interviewed with health worker and administrator that allow triangulation of res­pon­ses thereby increasing the validity of the findings. Participants were aged 20 to ≥60 years, with no history of symptoms or previous diagnosis of breast or cervical cancer. The women were inter­viewed in October-November 2019. The trans­cri­bed data were analyzed using content analysis.Results: Participants' knowledge about under­stan­ding, risk factors, signs and symptoms of breast and cervical cancer was still lacking. Par­ticipants attributed the cause of cervical cancer to the vaginal wound resulting in cervical cancer and signs of symptoms such as heartburn. Whe­reas for breast cancer participants were not know the signs and symptoms, they only said there was a lump in the breast. Barriers to screening were ashamed to be examined by health workers, afraid of testing procedures, feeling healthy and there were no signs of cancer. Screening motiva­tion were experiencing signs and symptoms of can­cer, family history of the disease and aware­ness of the disease/screening service.Conclusion: The study participants' knowledge of breast and cervical cancer was still lacking. To improve breast and cervical cancer screening, efforts must focus on reducing identified barriers and increasing motivation.Keywords: knowledge, barriers, motivation, breast and cervical cancer screeningCorrespondence: Afriza Umami. Diploma III of Medical Records, School of Health Sciences Muhammadiyah Bojone­go­ro, Jl. A.Yani No.14, Bojonegoro, Indonesia. Email: [email protected]. Mobile: +62­8­225­4348041.Journal of Health Promotion and Behavior (2020), 5(1): 1-10 https://doi.org/10.26911/thejhpb.2020.05.01.01