ارتباط بین عوامل دموگرافیک، اجتماعی و مامایی با تأخیر در کمک‌جویی بیماران مبتلا به زگیل تناسلی

نوع مقاله : اصیل پژوهشی

نویسندگان

1 کارشناس ارشد مامایی، مرکز تحقیقات بهداشت باروری، دانشکده پزشکی، دانشگاه علوم پزشکی گیلان، رشت، ایران.

2 دانشیار گروه پوست، مرکز تحقیقات پوست، دانشکده پزشکی، دانشگاه علوم پزشکی گیلان، رشت، ایران.

3 استاد گروه زنان و مامایی، مرکز تحقیقات بهداشت باروری، دانشکده پزشکی، دانشگاه علوم پزشکی گیلان، رشت، ایران.

4 استادیار گروه زنان و مامایی، مرکز تحقیقات بهداشت باروری، دانشکده پزشکی، دانشگاه علوم پزشکی گیلان، رشت، ایران.

5 کارشناس ارشد اپیدمیولوژی، واحد توسعه تحقیقات بالینی رازی، دانشکده پزشکی، دانشگاه علوم پزشکی گیلان، رشت، ایران.

چکیده

مقدمه: مراجعه­ به‌موقع جهت تشخیص و درمان زگیل تناسلی در جلوگیری از انتقال بیماری اهمیت دارد، لذا شناسایی عوامل تأثیرگذار دموگرافیک- اجتماعی و مامایی بر تأخیر در کمک جویی بیمار حائز اهمیت است. مطالعه حاضر با هدف بررسی ارتباط بین عوامل دموگرافیک، اجتماعی و مامایی با تأخیر در کمک‌جویی بیماران مبتلا به زگیل تناسلی انجام شد.
روش‌کار: این مطالعه توصیفی- تحلیلی در سال 1398 بر روی 130 نفر از زنان مبتلا به زگیل تناسلی مراجعه‌کننده به درمانگاه زنان بیمارستان الزهراء (س) شهر رشت انجام شد. معیارهای ورود به مطالعه شامل: تأیید تشخیص زگیل تناسلی بر اساس معاینه بالینی و بررسی­های آزمایشگاهی و گذشتن حداکثر 6 ماه از تشخیص بیماری بود. ابزار گردآوری داده­ها شامل: فرم مشخصات دموگرافیک- اجتماعی، مامایی و پرسشنامه محقق‌ساخته برای ارزیابی تأخیر بیمار بود. تأخیر بیشتر از 7 روز در مراجعه جهت تشخیص قطعی و درمان، به‌عنوان تأخیر در کمک­جویی بیمار در نظر گرفته­ شد. تجزیه و تحلیل داده­ها با استفاده از نرم‌افزار SPSS (نسخه21) و آزمون­های کای دو، فیشر، من‌ویتنی و رگرسیون لجستیک انجام شد. میزان p کمتر از 05/0 معنی‌دار در نظر گرفته شد.
یافته­ها: از 130 فرد شرکت‌کننده، 94 نفر (72%) با تأخیر در کمک‌جویی بیشتر از 7 روز مراجعه کرده بودند. در متغیرهای سابقه سقط، نوع اولین علامت تشخیصی و درمان دریافت شده، اختلاف آماری معناداری بین دو گروه مشاهده شد (05/0>p). بر اساس نتایج آنالیز رگرسیون لوجستیک، متغیرهای سابقه عفونت زنان (40/9-08/1، 95%:CI، 187/3=OR)، نوع محل سکونت (وضعیت اقتصادی) (31/9-02/1، 95%:CI، 08/3=OR) و سابقه سقط بر تأخیر در کمک­جویی (63/15-30/1، 95%:CI، 51/4=OR) نقش پیشگویی‌کننده داشت.
نتیجه‌گیری: بین متغیرهای سابقه عفونت زنان، وضعیت اقتصادی و سابقه سقط با تأخیر در کمک‌جویی جهت تشخیص و درمان زگیل تناسلی ارتباط وجود دارد. لذا ارائه‌دهندگان خدمت بایستی در برخورد و آموزش زنان با وضعیت اجتماعی اقتصادی پایین، دارای سابقه عفونت زنان و زنان بدون تجربه سقط و نولی‌پار دقت بیشتری داشته باشند.

کلیدواژه‌ها

عنوان مقاله [English]

The relationship between socio-demographic and midwifery factors with delay in seeking help for genital warts patients

نویسندگان [English]

  • Seyedeh Maryam Attari 1
  • Narges Alizadeh 2
  • Seyedeh Hajar Sharami 3
  • Seyedeh Fatemeh Dalil Heirati 1
  • Roya Kabodmehri 4
  • Elahe Rafiei 5
1 M.Sc. of Midwifery, Reproductive Health Research Center, Faculty of Medicine, Guilan University of Medical Sciences, Rasht, Iran.
2 Associate Professor, Department of Dermatology, Dermatology Research Center, Faculty of Medicine, Guilan University of Medical Sciences, Rasht, Iran.
3 Professor, Department of Obstetrics & Gynecology, Reproductive Health Research Center, Faculty of Medicine, Guilan University of Medical Sciences, Rasht, Iran.
4 Assistant Professor, Department of Obstetrics & Gynecology, Reproductive Health Research Center, Faculty of Medicine, Guilan University of Medical Sciences, Rasht, Iran.
5 M.Sc. of Epidemiology, Razi Clinical Research Development Unit, Faculty of Medicine, Guilan University of Medical Sciences, Rasht, Iran.
چکیده [English]

Introduction: It is important to timely refer in order to diagnosis and treatment of genital warts and preventing disease transmission. Therefore, identifying the socio-demographic and obstetric effective factors is important in the delay of patient's seeking-help. The present study was performed aimed to investigate the relationship between demographic, social and obstetric factors with seeking-help delay in patients with genital warts.
Methods: This descriptive-analytical study was performed in 2019 on 130 women with genital warts referred to the gynecology clinic of Al-Zahra Hospital in Rasht. Inclusion criteria were confirmation of the diagnosis of genital wart based on clinical examination and laboratory tests and a maximum of six months after diagnosis. Data collection tools included socio-demographic form, midwifery form and a researcher-made questionnaire to assess patient’s delay. A delay of more than 7 days in referral for definitive diagnosis and treatment was considered as a delay in patient's seeking help. Data were analyzed by SPSS software (version 21) and Chi-square, Fisher, Mann-Whitney tests and logistic regression. P<0.05 was considered statistically significant.
Results: Among 130 participant, 94 (72%) had more than 7 days delay. There was statistically significant difference between the two groups in the variables of history of abortion, type of first diagnostic symptom and type of treatment received (P<0.05). Logistic regression analysis showed that the variables of history of gynecological infection (CI 95%: 1.08-9.40, OR=3.187), type of residence place (economic status) (CI 95%: 1.02-9.31, OR=3.08) and history of abortion (CI 95%: 1.30-15.63, OR=4.51) have a predictive role in help-seeking delay.
Conclusion: There is a relationship between the variables of history of gynecological infection, economic status and history of abortion with delay in seeking help for diagnosis and treatment of genital warts. Therefore, health care providers should be more careful in dealing with and educating low socioeconomic status women, patients with a history of infection and women without experience of abortion and nulliparous.

کلیدواژه‌ها [English]

  • Abortion Rate
  • Delayed Treatment
  • Demographic Factors
  • Genital wart
  • Help Seeking Behavior
  • Social Factor

مراجع

  1. Maheswari SU, Kalaivani S. Pattern of sexual behavior in adolescents and young adults attending STD clinic in a tertiary care center in South India. Indian journal of sexually transmitted diseases and AIDS 2017; 38(2):171.
  2. Farahmand M, Shoja Z, Arashkia A, Salavatiha Z, Jalilvand S. Systematic review and meta-analysis of human papillomavirus prevalence and types among women with normal cervical cytology in the Eastern Mediterranean Region. Future Virology 2019; 14(11):761-77.
  3. Torrone EA, Morrison CS, Chen PL, Kwok C, Francis SC, Hayes RJ, et al. Prevalence of sexually transmitted infections and bacterial vaginosis among women in sub-Saharan Africa: an individual participant data meta-analysis of 18 HIV prevention studies. PLoS medicine 2018; 15(2):e1002511.
  4. Mansor N, Ahmad N, Rahman HA. Determinants of knowledge on sexually transmitted infections among students in public higher education institutions in Melaka state, Malaysia. Plos one 2020; 15(10):e0240842.
  5. Zizza A, Guido M, Recchia V, Grima P, Banchelli F, Tinelli A. Knowledge, Information Needs and Risk Perception about HIV and Sexually Transmitted Diseases after an Education Intervention on Italian High School and University Students. International journal of environmental research and public health 2021; 18(4):2069.
  6. Hosseinpouri P, Hejazi SH, Hadi F. Relationship between human papillomavirus and breast cancer in women with this cancer in Khuzestan province. Iran J Obstet Gynecol Infertil 2020; 23(8):66–74.
  7. World Health Organization. Assessment of country implementation of the WHO global health sector strategy for sexually transmitted infections (2016 –2021): results of a national survey; 2021.
  8. Mark H, Dhir A, Roth C. Sexually Transmitted Infections in the United States. The American journal of nursing 2015; 115(9):34-44.
  9. Khani Jeihooni A, Ghaedi R, Kashfi SM, Khiyali Z. Effect of education based on the health belief model in the prevention of sexually transmitted diseases in couples participating in premarriage training classes. J Educ Community Health 2018; 4(4):4-12.
  10. World Health Organization. Global health sector strategy on sexually transmitted infections 2016-2021: toward ending STIs. World Health Organization; 2016.
  11. Berek JS. Berek & Novak’s gynecology. 16nd Lippincott Williams & Wilkins; 2021.
  12. Denison H. Healthcare-seeking behaviour for sexually transmitted infection testing in New Zealand: A mixed methods study; 2017.
  13. Bish A, Ramirez A, Burgess C, Hunter M. Understanding why women delay in seeking help for breast cancer symptoms. Journal of psychosomatic research 2005; 58(4):321-6.
  14. Ireland JA, Reid M, Powell R, Petrie KJ. The role of illness perceptions: psychological distress and treatment-seeking delay in patients with genital warts. International journal of STD & AIDS 2005; 16(10):667-70.
  15. Hook III EW, Richey CM, Leone P, Bolan G, Spalding C, Henry K, et al. Delayed presentation to clinics for sexually transmitted diseases by symptomatic patients: a potential contributor to continuing STD morbidity. Sexually transmitted diseases 1997; 24(8):443-8.
  16. Grunfeld EA, Hunter MS, Ramirez AJ, Richards MA. Perceptions of breast cancer across the lifespan. Journal of psychosomatic research 2003; 54(2):141-6.
  17. Talley JO. The Impact of Social Stigmas on Sexual Health Seeking Behavior: A Review of Literature. McNair Scholars Research Journal 2020; 13(1):11.
  18. Scheinfeld E. Shame and STIs: An Exploration of Emerging Adult Students’ Felt Shame and Stigma towards Getting Tested for and Disclosing Sexually Transmitted Infections. International Journal of Environmental Research and Public Health 2021; 18(13):7179.
  19. Jayapalan S. Determinants of delay in the health care seeking behaviour of STD patients. Clin Epidemiol Glob Heal 2015; 3:S69–74.
  20. Cunningham SD, Kerrigan DL, Jennings JM, Ellen JM. Relationships between perceived STD‐related stigma, STD‐related shame and STD screening among a household sample of adolescents. Perspectives on sexual and reproductive health 2009; 41(4):225-30.
  21. Kops NL, Horvath JD, Bessel M, Souza FM, Benzaken AS, Pereira GF, et al. The impact of socioeconomic status on HPV infection among young Brazilians in a nationwide multicenter study. Preventive Medicine Reports 2021; 21:101301.
  22. Xu JJ, Yu YQ, Hu QH, Yan HJ, Wang Z, Lu L, et al. Treatment-seeking behaviour and barriers to service access for sexually transmitted diseases among men who have sex with men in China: a multicentre cross-sectional survey. Infectious diseases of poverty 2017; 6(1):1-10.
  23. Barua A, Kurz K. Reproductive health-seeking by married adolescent girls in Maharashtra, India. Reproductive health matters 2001; 9(17):53-62.
  24. Puthuchira Ravi R, Athimulam Kulasekaran R. Care seeking behaviour and barriers to accessing services for sexual health problems among women in rural areas of Tamilnadu state in India. Journal of sexually transmitted diseases 2014; 2014.
  25. Lin W, Chen B, Hu H, Yuan S, Wu B, Zhong C, et al. Joint effects of HPV-related knowledge and socio-demographic factors on HPV testing behaviour among females in Shenzhen. European Journal of Public Health 2021.
  26. Gordon T, Booysen F, Mbonigaba J. Socio-economic inequalities in the multiple dimensions of access to healthcare: the case of South Africa. BMC Public Health 2020; 20(1):1-13.
  27. Attari SM, Ozgoli G, Solhi M, Majd HA. Study of relationship between illness perception and delay in seeking help for breast cancer patients based on Leventhal's self-regulation model. Asian Pacific Journal of Cancer Prevention 2016; 17:167-74.
  28. Majadi Hezaveh M, Khademi M. Breast Cancer: A phenomenological study. Journal of Arak University of Medical Sciences 2009; 12(1):29-39.
  29. Chen SM, Van den Hoek A, Shao CG, Wang L, Liu DC, Zhou SJ, et al. Prevalence of and risk indicators for STIs among women seeking induced abortions in two urban family planning clinics in Shandong province, People's Republic of China. Sexually Transmitted Infections 2002; 78(3):e3-.
  30. Mercer CH, Sutcliffe L, Johnson AM, White PJ, Brook G, Ross JD, et al. How much do delayed healthcare seeking, delayed care provision, and diversion from primary care contribute to the transmission of STIs?. Sexually Transmitted Infections 2007; 83(5):400-5.
  31. Malakouti J, Mirghafourvand M, Gorbani M, Poormehr HS, Shahrak SP, Shabiri MJ. Incidence of Human Papilloma Virus (HPV) infection and its relevant factors among women referring to Alzahra Therapeutic-Educational Center of Tabriz, September 2013 to March 2014. Iran J Obstet Gynecol Infertil 2016; 18(185):16-22.
مجله زنان، مامایی و نازایی ایران
دوره 25، شماره 6
شهریور 1401
صفحه 71-78

فایل ها

هم رسانی

ارجاع به این مقاله

آمار