Developing and Psychometric Testing of Cervical Cancer Screening Behavior Scale (CCSBS)

Besharat, Mohammad Ali; Zarani, Fariba; Mazaheri Nejad Fard, Golnaz; Sarrami Foroushani, Gholamreza; Haji SeyedSadeghi, Maryam

doi:10.30473/ijohp.2023.62961.1233

Document Type : research

Authors

¹ Faculty of Psychology and Educational Sciences, University of Tehran

² Assistant Professor, Department of Psychology, Faculty of Educational Sciences and Psychology, Shahid Beheshti University, Tehran, Iran.

³ Faculty of psychology and educational sciences, Shahid Beheshti University, Tehran, Iran.

⁴ Assistant Professor of the Department of Educational Psychology, Faculty of Psychology and Educational Sciences, Khwarazmi University

⁵ MA of psychology, Faculty of psychology and educational sciences, Shahid Beheshti University, Tehran, Iran

https://doi.org/10.30473/ijohp.2023.62961.1233

Abstract

Objective: Given the importance of screening as one of the health behaviors in cervical cancer, this study aims to develop and evaluate the psychometric characteristics of the Cervical Cancer Screening Behavior Scale (CCSBS).
Methods: In this cross-sectional study, 376 women referred to Javaheri Health Center during the study period were selected through convenience sampling. Then, the scale was developed, and its content and face validities were examined. To ensure divergent and convergent validity, Depression Anxiety Stress Scale (DASS-21) was used. The internal consistency method (Cronbach's alpha) was used to determine the reliability of the questionnaire. Finally, confirmatory factor analysis was used to assess the construct validity of the CCSBS, and SPSS and LISREL software were applied to analyze the data.
Results: The findings of this study provided strong support, which confirmed the content and face validities. Regarding the convergent and divergent validity, perceived vulnerability, perceived severity and deterioration, and perceived barriers have a direct and significant relationship with the three variables of depression, anxiety, and stress. On the other hand, perceived motivation had a significant inverse correlation with all three variables of depression, anxiety, and stress. Additionally, perceived self-efficacy had a significant inverse correlation with depression. The results of Cronbach's alpha indicated the appropriate internal consistency of the whole questionnaire and its components. Cronbach's alpha for the whole questionnaire was 0.78. According to confirmatory factor analysis, the goodness of fit indicators of the proposed model was confirmed and the paths were significant.
Conclusion: CCSBS is a reliable and valid tool for measuring the screening behavior of cervical cancer in Iranian women and it appears to be a comprehensive and useful tool for assessing women's beliefs related to cervical cancer and cervical cancer screening.

Keywords

Article Title [Persian]

طراحی، ساخت و آزمون ویژگی های روانسنجی مقیاس رفتار غربالگری سرطان دهانه رحم

Authors [Persian]

محمد علی بشارت ¹
فریبا زرانی ²
گلناز مظاهری نژاد فرد ³
غلامرضا صرامی فروشانی ⁴
مریم حاجی سید صادقی ⁵

¹ دانشگاه تهران-دانشکده روانشناسی و علوم تربیتی

² استادیار گروه روانشناسی، دانشکده علوم تربیتی و روانشناسی، دانشگاه شهید بهشتی، تهران، ایران.

³ گروه روانشناسی و علوم تربیتی، دانشگاه شهید بهشتی، تهران، ایران.

⁴ استادیار گروه آموزشی روانشناسی تربیتی دانشکده روانشناسی و علوم تربیتی دانشگاه خوارزمی

⁵ کارشناسی ارشد روانشناسی دانشگاه شهید بهشتی

Abstract [Persian]

مقدمه: با توجه به اهمیت غربالگری به عنوان یکی از رفتارهای بهداشتی در سرطان دهانه رحم، هدف از این مطالعه ساخت و ارزیابی ویژگی های روانسنجی مقیاس رفتارغربالگری سرطان دهانه رحم است.
روش: در این مطالعه توصیفی-مقطعی 376 نفر از زنان مراجعه کننده به مرکز بهداشت جواهری (در طول مدت مطالعه) با روش نمونه گیری در دسترس انتخاب شدند. سپس، مقیاس تدوین شد و روایی محتوایی و صوری آن بررسی گردید. برای اطمینان از روایی واگرا و همگرا، از مقیاس DASS-21 استفاده شد. برای تعیین پایایی پرسشنامه نیزروش همسانی درونی (آلفای کرونباخ) مورد استفاده قرار گرفت. درنهایت، برای ارزیابی روایی سازه CCSBS از روش تحلیل عاملی تاییدی و از نرم افزارSPSS و LISREL استفاده شد.
یافته‌ها: یافته‌های پژوهش، اعتبار محتوایی و صوری مقیاس را تأیید کرد. از نظر روایی همگرا و واگرا، آسیب پذیری ادراک شده، شدت و وخامت ادراک شده و موانع ادراک شده با سه متغیر افسردگی، اضطراب و استرس رابطه مستقیم و معناداری داشتند. ازسوی دیگر، انگیزش ادراک شده با متغیرهای افسردگی، اضطراب و استرس همبستگی معکوس معنادار داشت. علاوه براین، خودکارآمدی ادراک شده با افسردگی همبستگی معکوس معنی‌داری داشت. نتایج آلفای کرونباخ بیانگر همسانی درونی مناسب کل پرسشنامه و مولفه های آن بود. بر اساس تحلیل عاملی تاییدی، شاخص‌های نیکویی برازش مدل پیشنهادی تایید شد و مسیرها معنی‌دار بودند.
نتیجه‌گیری: CCSBS ابزارمعتبر و پایایی برای سنجش رفتار غربالگری سرطان رحم در زنان ایرانی است و به نظر می‌رسد ابزاری جامع و مفید برای ارزیابی باورهای مرتبط با سرطان دهانه رحم و غربالگری آن در زنان باشد.

Keywords [Persian]

سرطان
سرطان دهانه رحم
رفتارهای بهداشتی
آزمون ویژگی های روانسنجی
غربالگری

References

Abedzadeh, M., Taebi, M., Saberi, F., & Sadat, Z. (2009). Quality of life and related factors in Menopausal women in Kashan city. ISMJ, 12(1), 81–88.

Ajzen, I., & Madden, T. J. (1986). Prediction of goal-directed behavior: Attitudes, intentions, and perceived behavioral control. Journal of Experimental Social Psychology, 22(5), 453–474.

Allahverdipour, H., & Emami, A. (2008). Perceptions of cervical cancer threat, benefits, and barriers of Papanicolaou smear screening programs for women in Iran. Women & Health, 47(3), 23–37.

Arbyn, M., Weiderpass, E., Bruni, L., de Sanjosé, S., Saraiya, M., Ferlay, J., & Bray, F. (2020). Estimates of incidence and mortality of cervical cancer in 2018: A worldwide analysis. The Lancet Global Health, 8(2), e191–e203.

Asl, R. T., Van Osch, L., De Vries, N., Zendehdel, K., Shams, M., Zarei, F., & De Vries, H. (2020). The role of knowledge, risk perceptions, and cues to action among Iranian women concerning cervical cancer and screening: A qualitative exploration. BMC Public Health, 20(1), 1–12.

Bandura, A. (1986). The explanatory and predictive scope of self-efficacy theory. Journal of Social and Clinical Psychology, 4(3), 359–373.

Bouvard, V., Wentzensen, N., Mackie, A., Berkhof, J., Brotherton, J., Giorgi-Rossi, P., Kupets, R., Smith, R., Arrossi, S., & Bendahhou, K. (2021). The IARC perspective on cervical cancer screening. New England Journal of Medicine, 385(20), 1908–1918.

Care, C. T. F. on P. H. (2013). Recommendations on screening for cervical cancer. Cmaj, 185(1), 35–45.

Champion, V. L. (1999). Revised susceptibility, benefits, and barriers scale for mammography screening. Research in Nursing & Health, 22(4), 341–348.

Chan, C. W., Yang, S.-B., Gu, C., Wang, X., & Tao, L. (2015). Perception of cervical cancer risk and screening behavior: A literature review. International Journal of Nursing Knowledge, 26(1), 2–18.

De Groot, J. M., Mah, K., Fyles, A., Winton, S., Greenwood, S., DePetrillo, A. D., & Devins, G. M. (2005). The psychosocial impact of cervical cancer among affected women and their partners. International Journal of Gynecologic Cancer, 15(5), 918–925.

Farajzadegan, Z., Nourbakhsh, S. F., Mostajeran, M., & Loghmani, A. (2012). Cervical Cancer Screening Status in 35 to 60 Year-old Women in Isfahan, Iran. Journal of Isfahan Medical School, 30(208).

Farajzadegan, Z., Tavakoli Moghadam, N., Naderolasli, M., Aahmadloo, H., Boroumand, M. A., & Motamed, N. (2021). Correlation between sense of coherence (SOC) and quality of life (QOL) in cancer patients; A systematic review. Iranian Journal of Health Psychology, 4(1), 9–18.

Fishbein, M., & Ajzen, I. (1980). Predicting and understanding consumer behavior: Attitude-behavior correspondence. Understanding Attitudes and Predicting Social Behavior, 148–172.

Guvenc, G., Akyuz, A., & Açikel, C. H. (2011). Health belief model scale for cervical cancer and Pap smear test: Psychometric testing. Journal of Advanced Nursing, 67(2), 428–437.

Hajializadeh, K., Ahadi, H., Jomehri, F., & Rahgozar, M. (2013). Health beliefs and screening behavior of cervical cancer among the women of Bandar Abbas. Life Sci J, 10(1), 545–551.

Henry, J. D., & Crawford, J. R. (2005). The short-form version of the Depression Anxiety Stress Scales (DASS-21): Construct validity and normative data in a large non-clinical sample. British Journal of Clinical Psychology, 44(2), 227–239.

Hooman, H. A. (2006). Multivariate data analysis in behavioral research. peyk farhang.

Isaka, Y., Inada, H., Hiranuma, Y., & Ichikawa, M. (2017). Psychological impact of positive cervical cancer screening results among Japanese women. International Journal of Clinical Oncology, 22(1), 102–106.

Jentschke, M., Lehmann, R., Drews, N., Hansel, A., Schmitz, M., & Hillemanns, P. (2020). Psychological distress in cervical cancer screening: Results from a German online survey. Archives of Gynecology and Obstetrics, 302(3), 699–705.

Kessler: Cervical cancer: Prevention and early detection—Google Scholar. (n.d.). Retrieved February 11, 2021, from https://scholar.google.com/scholar_lookuptitle=Cervical%20Cancer%20prevention%20and%20early%20detection&publication_year=2018#d=gs_cit&u=%2Fscholar%3Fq%3Dinfo%3AUZRGYhqZS6EJ%3Ascholar.google.com%2F%26output%3Dcite%26scirp%3D0%26hl%3Den

Khalil, J., Bellefqih, S., Sahli, N., Afif, M., Elkacemi, H., Elmajjaoui, S., Kebdani, T., & Benjaafar, N. (2015). Impact of cervical cancer on quality of life: Beyond the short term (Results from a single institution). Gynecologic Oncology Research and Practice, 2(1), 7.

Kim, J., Han, J. Y., Shaw, B., McTavish, F., & Gustafson, D. (2010). The roles of social support and coping strategies in predicting breast cancer patients’ emotional well-being: Testing mediation and moderation models. Journal of Health Psychology, 15(4), 543–552.

Kline, R. B. (2015). Principles and practice of structural equation modeling. Guilford publications.

Logan, L., & McIlfatrick, S. (2011). Exploring women’s knowledge, experiences and perceptions of cervical cancer screening in an area of social deprivation. European Journal of Cancer Care, 20(6), 720–727.

Lovibond, P. F., & Lovibond, S. H. (1995). The structure of negative emotional states: Comparison of the Depression Anxiety Stress Scales (DASS) with the Beck Depression and Anxiety Inventories. Behaviour Research and Therapy, 33(3), 335–343.

Maiman, L. A., & Becker, M. H. (1974). The health belief model: Origins and correlates in psychological theory. Health Education Monographs, 2(4), 336–353.

Maree, J. E., & Wright, S. C. (2011). Cervical cancer: Does our message promote screening? A pilot study in a South African context. European Journal of Oncology Nursing, 15(2), 118–123.

Meissner, H. I., Yabroff, K. R., Dodd, K. W., Leader, A. E., Ballard-Barbash, R., & Berrigan, D. (2009). Are patterns of health behavior associated with cancer screening? American Journal of Health Promotion, 23(3), 168–175.

Noar, S. M., & Zimmerman, R. S. (2005). Health Behavior Theory and cumulative knowledge regarding health behaviors: Are we moving in the right direction? Health Education Research, 20(3), 275–290.

Ping, W., Cao, W., Tan, H., Guo, C., Dou, Z., & Yang, J. (2018). Health protective behavior scale: Development and psychometric evaluation. PloS One, 13(1), e0190390.

Rafiepoor, A. (2019). The Effectiveness of Mindfulness-Based Cognitive Group Therapy (MBCT) In Improving Quality of Life Among Patients with Cancer. Iranian Journal of Health Psychology, 2(1), 125–134.

RAMEZANI, T. F., Mohammad, K., RAHGOZAR, M., & BAROUTI, E. (2001). Knowledge, attitude, and practice of 20-49 years old Iranian women about breast cancer.

Raykov, T., & Marcoulides, G. A. (2012). A first course in structural equation modeling. Routledge.

Redding, C. A., Rossi, J. S., Rossi, S. R., Velicer, W. F., & Prochaska, J. O. (2000). Health behavior models. International Electronic Journal of Health Education.

Refaei, M., Khakbazan, Z., & Dehghan Nayeri, N. (2020). Regular Cervical Cancer Screening for Iranian Women: Facilitators and Barriers. Journal of Qualitative Research in Health Sciences, 9(2), 155–165.

Rosenstock, I. M., Strecher, V. J., & Becker, M. H. (1988). Social learning theory and the health belief model. Health Education Quarterly, 15(2), 175–183.

Rutherford, C., Mercieca-Bebber, R., Tait, M., Mileshkin, L., & King, M. T. (2019). Quality of Life in Women with Cervical Cancer. In Uterine Cervical Cancer (pp. 267–289). Springer.

Shojaeizadeh, D., Hashemi, S. Z., Moeini, B., & Poorolajal, J. (2011). The effect of educational program on increasing cervical cancer screening behavior among women in Hamadan, Iran: Applying health belief model. Journal of Research in Health Sciences, 1(1), 20–25.

St-Pierre, M., Sinclair, I., Elgbeili, G., Bernard, P., & Dancause, K. N. (2019). Relationships between psychological distress and health behaviors among Canadian adults: Differences based on gender, income, education, immigrant status, and ethnicity. SSM-Population Health, 7, 100385.

Sutton, S. (2005). Stage theories of health behaviour. Predicting Health Behaviour: Research and Practice with Social Cognition Models, 2, 223–275.

Tanaka, S., Palmer, M., & Katanoda, K. (2022). Trends in cervical cancer incidence and mortality of young and middle adults in Japan. Cancer Science, 113(5), 1801–1807.

Tennant, R., Hiller, L., Fishwick, R., Platt, S., Joseph, S., Weich, S., Parkinson, J., Secker, J., & Stewart-Brown, S. (2007). The Warwick-Edinburgh mental well-being scale (WEMWBS): Development and UK validation. Health and Quality of Life Outcomes, 5(1), 1–13.

Trafimow, D. (1999). A theory of attitudes, subjective norms, and private versus collective self-concepts. In Attitudes, behavior, and social context (pp. 47–66). Psychology Press.

Weinstein, N. D. (1993). Testing four competing theories of health-protective behavior. Health Psychology, 12(4), 324.

Developing and Psychometric Testing of Cervical Cancer Screening Behavior Scale (CCSBS)

References

References

Volume 6, Issue 3 - Serial Number 17September 2023Pages 9-20

Volume 6, Issue 3 - Serial Number 17
September 2023
Pages 9-20