چالش‌ها و موانع واکسیناسیون ویروس پاپیلومای انسانی در زنان سنین باروری بر مبنای مدل اعتقاد بهداشتی؛ مروری سیستماتیک

نوع مقاله : مروری

نویسندگان

1 دانشجوی دکتری تخصصی بهداشت باروری، کمیته تحقیقات و فناوری دانشجویی، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی شهید بهشتی، تهران، ایران.

2 استاد گروه مامایی و بهداشت باروری، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی شهید بهشتی، تهران، ایران.

3 دانشیار، گروه فیزیک و مهندسی پزشکی، دانشکده پزشکی، دانشگاه علوم پزشکی شهید بهشتی، تهران، ایران.

4 استادیار گروه پزشکی اجتماعی، دانشکده پزشکی، دانشگاه علوم پزشکی اردبیل، اردبیل، ایران.

10.22038/ijogi.2024.79736.6083

چکیده

مقدمه: ویروس پاپیلومای انسانی (HPV)، مهم‌ترین عامل آغازگر ابتلاء به سرطان دهانه رحم و مرگ ومیر ناشی از آن می ­باشد. علی‌رغم اثربخشی قابل توجه واکسن HPV در پیشگیری از این سرطان، میزان واکسیناسیون در بسیاری از جوامع همچنان پایین می­ باشد؛ مطالعه حاضر با هدف مرور چالش‌ها و موانع واکسیناسیون بر مبنای مدل اعتقاد بهداشتی در زنان سنین باروری انجام شد.
روش‌کار: در این مطالعه مروری، پایگاه‌های اطلاعاتی معتبر توسط دو محقق مستقل، طبق دستورالعمل PICO و با استفاده از واژه­های کلیدی Mesh شامل: Papillomavirus Infections، Human papillomavirus، Papillomavirus Vaccines، Health Belief Model، Self-Care، Patient Participation،Health Education، needs assessment و women مورد جستجو قرار گرفتند. روند انتخاب مقالات بر اساس پریسما و ارزیابی کیفیت مقالات برمبنای چک‌لیست NOS و CASP صورت گرفت.
یافته ­ها: بعد از بررسی و ارزیابی کیفی 2258 مقاله، 13 مقاله با 19061 مشارکت کننده زن وارد مرور یکپارچه شدند. بر اساس نتایج؛ چالش­ ها و موانع درک شده در سه گروه عمده فردی، روانی - اجتماعی و سازمانی قرار گرفت. مهم‌ترین موانع فردی، اطلاعات کم و یا غلط در مورد ویروس و آسیب‌ناپذیری درک شده در برابر بیماری‌زایی آن بوده و مهم‌ترین موانع روانی- اجتماعی، ترس و شرم زنان و تابو بودن بیماری‌های منتقله جنسی در جامعه بود. عدم دسترسی آسان به واکسن HPV، عدم برقراری ارتباط مؤثر توسط مراقبین سلامت و وجود شکاف‌های ارتباطی و مراقبتی نیز از عمده‌ترین موانع سازمانی بودند.
نتیجه ­گیری: طبق نتایج این مطالعه، استراتژی­ های راهبردی از جمله ارتقاء دانش افراد در زمینه HPV، ارائه خدمات مشاوره جنسی و واکسیناسیون روتین و رایگان HPV بایستی در الویت سیاست‌گذاری‌ها و برنامه‌ریزی ­های حوزه بهداشت جنسی قرار گرفته و توانمندسازی مراقبین سلامت در جهت برقراری ارتباط مؤثر و مداوم با مددجویان مدنظر قرار گیرد.

کلیدواژه‌ها

موضوعات

عنوان مقاله [English]

Challenges and Barriers to Human Papillomavirus Vaccination in Women of Reproductive Age Based on the Health Belief Model: A Systematic Review

نویسندگان [English]

  • Leila Alizadeh 1
  • Zohreh Keshavarz 2
  • Ahmad Shalbaf 3
  • Sohrab Iranpour 4
1 PhD Candidate of Reproductive Health, Student Research Committee, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
2 Professor, Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
3 Associate Professor, Department of Biomedical Engineering and Medical physics, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
4 Assistamt Professor, Department of Community Medicine, Faculty of Medicine, Ardabil University of Medical Sciences, Ardabil, Iran
چکیده [English]

Introduction: Human papillomavirus (HPV) is the most important initiator of cervical cancer and its mortality. Despite the significant effectiveness of the HPV vaccine in preventing this cancer, vaccination rates remain low in many communities. The present study was conducted with aim to review the challenges and barriers to vaccination based on the health belief model (HBM) in women of childbearing age.
Methods: In this review study, the reliable databases were searched by two independent researchers following PICO guidelines and using MESH keywords including: Papillomavirus Infections, Human papillomavirus, Papillomavirus Vaccines, Health Belief Model, Self-Care, Patient Participation, Health Education, needs assessment and women. The process of selecting articles was based on the PRISMA flowchart and quality assessment of articles was done using the NOS and CASP checklists.
Results: After reviewing and evaluating the quality of 2258 articles, 13 articles with 6030 women entered the review. According to the results, challenges and barriers were in three major categories: individual, psychosocial, and organizational. The most significant individual barriers included inadequate or incorrect information about the virus and perceived invulnerability against its pathogenicity. The most significant psychosocial barriers included fear and shame among women and the taboo of Sexually transmitted diseases. Unavailability of HPV vaccine, ineffective communication with clients, and communication and care gaps were also the major organizational barriers.
Conclusion: According to the results of this study, strategic approaches including enhancing women's knowledge of HPV, providing sexual counseling services, and implementing routine and free HPV vaccination should prioritize in national sexual health policies and programs. Furthermore, health care providers should be trained to establish effective and continuous communication with clients.

کلیدواژه‌ها [English]

  • Cervical Cancer
  • Health Belief Model
  • Human Papillomavirus
  • Human Papillomavirus Vaccine

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مجله زنان، مامایی و نازایی ایران
دوره 27، شماره 8
آبان 1403
صفحه 64-80

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