TABLE OF CONTENTS
Title page – – – – – – – i
Approval page – – – – – – – ii
Certification page – – – – – – – iii
Dedication – – – — – – iv
Acknowledgement – – – – – – v
List of table – – – – – – vi
List of appendix – – – – – – vii
Abstract – – – – – – – viii
CHAPTER ONE: INTRODUCTION
Background to the Study – — – — – – – 1
Statement of Problem – – – – – – – – 4
Purpose – – – – – – – – – – 6
Objectives – – – – – – – – – – 6
Research questions – – – – – – – – 6
Significance of the Study — – – – – — – – 7
Scope of the Study – – – – – – – – 9
Operational definition – – – – — – – – 9
CHAPTER TWO: LITERATURE REVIEW
Conceptual Review – – — – – – – – 11
Development of Cancer – – – – – – – – 12
Cervical Cancer Development – – – – – – – 13
Cervical Cancer Staging – – – – – – – – 15
Incidence of Cervical cancer – – – – – – 16
Types of Screening, strengths and Weakness – – – – – 18
Theory Underlying the Study – – – – – – – 20
Application of the Model to the Study – – – – – – 21
Empirical Review – – – – – – – – – 25
Attitude and Practice of Health Care workers – – – – – 26
Summary of Literature Review — – – – – – – 29
CHAPTER THREE: RESEARCH METHOD
Research Design – – – – – – – – – 30
Area of Study – – – – – – – – – 30
Population of Study – – – – – — – – 31
Sample – – – – – – – – — 32
Sampling Techniques – – – – – – – – 32
Inclusion Criteria – – – – – – – – – 33
Instrument for Data Collection – – – – – – – 33
Validity of Instrument – – – – – – – – 34
Reliability of Instrument – – – – – – – – 34
Ethical Consideration – – – – – – – – 35
Procedure for Data Collection – – – – – – – 35
Method of Data Analysis – – – – – – – – 35
CHAPTER FOUR: PRESENTATION OF RESULTS
Introduction
Presentation Results – – – — – 34
Presentation of socio demographic data – – – – – 34
Summary Findings – – – – – — – 41
CHAPTER FIVE
Discussion, Conclusion and Recommendation
Discussion of major findings – – – – 42
Implications of findings – – – – – – – 49
Limitation of the Study – – – – – – – 50
Summary – – – – – – – – – 51
Conclusion – – – – – – – – 52
Recommendations — – – – – – – – 53
Suggestions for further Research – – – – – – 54
References – – – – – – – – – – 55
Appendices – – – – – – – – – 58
LIST OF TABLES
- Composition of sample for the study through proportionate
Stratified random sampling technique
- Distribution of respondents based on age
- Distribution of respondents based on duration of service
- Distribution of respondents based on qualification
- Mean, standard deviation and percentage responses on the attitude of female
health workers towards the uptake of cervical cancer screening
- Frequency and percentage responses on female heath workers practices of
cervical cancer screening
- Mean, standard deviation and ANOVA on the attitude of female health workers
towards the uptake of cervical cancer screening based on profession
- Frequency percentage and chi-square statistics on the relationship between
profession and practices of cervical cancer screening among female health
workers.
LIST OF APPENDICES
- Sample questionnaire on the attitude and practice of cervical cancer screening among female heath workers in the hospital studied and factors that influence uptake of screening.
- Letter of introduction from head of department of nursing UNEC.
- Letter of introduction from the director of clinical services and training of Braithwaite memorial specialist hospital (BMSH), rivers state.
- Calculation of reliability co-efficient.
- Calculation of sample size.
- Calculation of sample size from each stratum using proportional stratified random sampling technique.
- Staff description of female staff (January 2013).
- Approval letter from hospital (UPTH) ethical committee
ABSTRACT
The purpose of the study was to examine the attitude and practice of female health workers towards cervical cancer screening (CCS) in the university of Port Harcourt teaching hospital (UPTH), Rivers state. The descriptive survey design was adopted for the study. A sample size of 352 was used for the study. This sample size was approximately 40% of the target population. This sample was considered representative of the population with an accurate level of more than 97%. A self-structured questionnaire was the instrument used for data collection. The validity of the instrument was ascertained by the project supervisor and two (2) other senior lecturers one being a specialist in measurement and evaluation.The reliability indices were established using Test-retest. The scores obtained were correlated using Pearson’s product-moment coefficient of correlation to obtain the reliability co-efficient (r) of 0.94 which was consideredadequate. Data analysis was done using statistical software package, for Social Sciences (SPSS) version 20.0. Descriptive statistics of percentages, mean, standard deviation and mean cut-off criterion of 2.5 as well as inferential statistics (chi-square and Analysis of variance (ANOVA)) were used to analyse the data. Findings showed that the female health workers have negative attitude and poor practice of CCS. Profession has no influence on their attitude and practice.
CHAPTER ONE
INTRODUCTION
Background to the study
Cervical cancer remains the commonest genital tract cancer yet it is largely preventable by effective screening programmes. Considerable reduction in cervical cancer incidence and deaths has been achieved in developed nations with systematic cytological smear screening programmes.(Babatunde&Ikimalo,2010; Mutyaha,Mmiro& Weiderpass,2006).
One woman dies of cervical cancer in every two minutes worldwide, 80% of these deaths occur in developing nations.(Okunnu 2010 ).
For every two women who die of breast cancer, one dies from cervical cancer worldwide. It is 2nd most common cancer in women worldwide and most common in African women thus the most leading cause of cancer deaths in women in sub-Saharan Africa including Nigeria with a very poor 6-year survival rate.(Okunnu,2010; Obi,Ozumba& Onyebuchi,2008; Oguntayo Samaila,2008;Papadopoulos,Devaja,Cason &Raji,2000).
Most cervical cancers are caused by HPV infection with two prominent types, (16 and 18) which are responsible for about 70% of all cases. [National cancer institute, 2007]. They can both be prevented and detected early. Prevention can be achieved by immunizing young girls between the ages of 9-16 [before the age of sexual debut] while cervical screening is used for early detection. (Qiao, 2008, WHO, 2006).
Studies conducted in some parts of Africa, Nigeria inclusive reported that in Benin Nigeria, Carcinoma of the cervix constitute 74.6% of all malignant gynaecological tumors with stage IIb and above constituting 67.6%of all cases; in Zaria it accounted for 66.2% with advanced carcinoma of the cervix stage IIb and above making up 58.7% of the cases. In Kenya, 55% of patients presented with stage III diseases and beyond (stage iv-v).