Health Education of Mothers About Their Girls’ Vaccination

Procedia - Social and Behavioral Sciences 46 ( 2012 ) 5330 – 5334

1877-0428 © 2012 Published by Elsevier Ltd. Selection and/or peer review under responsibility of Prof. Dr. Hüseyin Uzunboylu doi: 10.1016/j.sbspro.2012.06.433

WCES 2012

Health education of mothers about their girls` vaccination Zoltan Abram*, Gyongyi Tar

University of Medicine and Pharmacy from Targu Mures, Dpt.of Hygiene, 38 Gh Marinescu, 540139 Targu Mures, Romania

Abstract

Human papilloma virus is the main cause of cervical cancer around the world. In November 2008 the Romanian Health Ministry has started the national health program organizing the anti-HPV vaccination of girls aged 12-14. In our study we tried to answer why the participation was so low and we analysed the information level of mothers about cervical cancer, the efficiency and the secondary effects of anti-HPV vaccine. The majority of mothers of 12-14 aged girls from some schools from Targu Mureş have insufficient knowledge about the relationship between HPV and cervical cancer, and more than two-third of them have irrational fear because of secondary effects and are distrustful regarding the efficiency of vaccination. The study shows that the participation in screening was of a higher percentage at the women with a higher educational level than at the mothers with a lower educational level. In conclusion it is underlined the role of right information offered by specialists and mass media. Keywords: cervical cancer, vaccine against HPV, national program, mothers’ knowledge and attitude.

1. Introduction

Human Papilloma Virus (HPV) is one – but not the only one - reason of getting infected with cervical cancer. Approximately 40 HPV types cause infections of the mucous membrane of the genital organs. After breast cancer, cervical cancer is the second cause of mortality among women suffering of cancer. There are in the world about 630 million people infected with HPV who can spread this disease unconsciously having no symptoms at all. The Free National Vaccination Campaign reduces the risk that future generations will develop cervical cancer. Vaccination is one of the most successful and less expensive methods of intervention in public health programs.

2. Materials and methods

In November 2008, the Ministry of Health in Romania started a national health program concerning the free vaccination of HPV for primary schoolgirls (aged 12-14). 110.000 doses of vaccine were bought, costing approximately 23 million Euros, but due the controversial information concerning the safety of vaccination, side-effects and complications, according to the statistical data of the first trimester of the year 2009, only 2.57% of the target population received the vaccination. After the first unsuccessful phase of the vaccination, in November 2009 a new campaign was started. Until 17th February 2010, 11731 girls aged 12-14 years were vaccinated, approximately 10 percent of the target population.

* Zoltan Abram. Tel.: +0-36-745-764297 [email protected]

Available online at www.sciencedirect.com

5331 Zoltan Abram and Gyongyi Tar / Procedia - Social and Behavioral Sciences 46 ( 2012 ) 5330 – 5334

In our study we are looking for answers concerning the causes of low participation in the vaccination program and we are trying to analyze how informed were the parents about cervical cancer and HPV vaccine efficiency and eventual side-effects of the vaccine. Since 1st October until 1st April 2010 we surveyed the parent using a questionnaire about cervical cancer and HPV vaccine. The total sample consists of N=206 mothers with daughters aged 12-14 years, schoolgirls in two secondary schools in Targu Mures.

3. Results and discussions

In Romania cervical cancer is the most frequent form of cancer among women aged 15-44 years. After statistics, 6 women die daily because of this disease and 9 are diagnosed with cervical cancer. The incidence of cervical cancer is the highest in Central Africa, Central America, South America, Central Asia, followed by Eastern Europe. The lowest statistical values can be found in Western Asia and North America (Figure 1.).

Figure 1. Worldwide incidence of cervical cancer

In our study the majority of the interviewed mothers were between 33-36 years, with a medium age of 35.21 year, standard deviation 2.65. Our results show insufficient knowledge. The high majority of the interviewed women (73.74 %) have never heard about the causative relationship between Human Papilloma Virus and cervical cancer. So that, our survey confirms that the information. Among those persons who have already heard about the causative relationship between HPV and cervical cancer we studied the source of information in terms of education (Figure 2).

38,3

26,2

12,1

30,6

5,8

14,5

28,6

9

10

7,7

0 5 10 15 20 25 30 35 40 45

Central Africa

Central Asia

North Africa

Central America

Western Asia

Eastern Europe

South America

Northern Europe

Western Europe

North America

100.000 inhabitants per year

Incidence


Figure 2. Source of information and education

The results show that among mothers with a higher education 34.8% received the information through health education, while among those with lower studies only 8.6 % was informed in this way about HPV and cervical cancer (p<0,001). In this category the majority of information is provided by friends and then by the family doctor. Analysing the studied sample, it is concluded that only 7.6% of mothers have been participated at anti-HPV screening, while the high majority (92.4%) have not participated because of various causes. The study of the relationship between the participation in screening and the educational level shows that the participation in screening was of a higher percentage at women with a higher educational level than at mothers with a lower educational level: n=196, Chi-square test, p<0,001 (Figure 3).

Figure 3. The study of relationship between the participation in screening and educational level

The analysis of relationship between the participation in screening and HPV vaccine acceptance shows significant results. The acceptance of vaccine was of a higher rate when the mothers were personally present in screening. The results show that among mothers who accepted the HPV vaccine above 30% were present in screening and among those who refused to accept it only 3.2%: n=196, Chi-square test, p<0,0001 (Figure 4).

0%10%20%30%40%50%60%70%80%90%

100%

superior studies medium studies elementary studies

friend

family doctor

health education

media

75%

80%

85%

90%

95%

100%

elementary studies medium studies superior stadies

went to screening (7,6%)

didn't go to screening (92,4%)


Figure 4. The relationship between screening and acceptance of vaccination

At the refusal of HPV vaccine the following things play an important role: non acceptance of the vaccine by the relatives, fear of the adverse reactions, contradictory opinions of the specialists, contradictory opinions supplied by the mass media (Figure 5).

Figure 5. Reasons for non acceptance of HPV vaccine

4. Conclusions

Cervical cancer is frequent in Romania, it is the number one cause of cancer death among women aged 15-44 years. The high rates are due to the fact that women in Romania have a very poor knowledge about the causes that lead to this kind of cancer and about preventive measures like the Free National Vaccine Campaign.

adequate information about cervical cancer. Neither do they have adequate information about HPV vaccine for preventing cancer.

al level and participation in screening. The mothers who previously participated in screening accepted in a higher percentage the vaccination of their daughter. We propose to increase the role of specialists and mass media offering right information, to organize health education courses at school level and to involve civil organizations in health promotion activities. We suggest the necessity of organizing in the future a new and more successful screening program for cervical cancer with the aim of detecting cancer as soon as possible.

0%

20%

40%

60%

80%

100%

acceptence of HPV vaccinationfor their daughters

vaccination refuse

went to screening (7,6%)

didn't go to screening (92,4%)

0

20

40

60

80

100

my aquaintancesdidn't accept thevaccine either

contradictoryopinion of the

specialists

it can have seriousside effects

I am not vaccinatedand I am not sick


References

Alexandru, F.A. (2004). , : Editura Amaltea, 156. Kahn, J.A., Hillard, P.J. (2003). Cervical cytology screening and management of abnormal cytology in adolescent girls. J Pediatr Adolesc Gynecol, 16, 167-170. Lupsa, R., Demian, R., Csiki, Cs. (2009). : 62-64. Miller, M.G., Sung, H.Y., & Sawaya, G.F. (2003). Screening interval and risk of invasive squamous cell cervical cancer. Obstet Gynecol, 101, 29-33. Rose, P.G. (2003). Combined-modality therapy of locally advanced cervical cancer. J Clin Oncol, 21, 211-217. Szarewski, A., & Sasieni, P. (2004). Cervical screening in adolescents - at least do no harm. Lancet, 364, 1642. Farkas, E. (2005). , (2nd ed.) : Univer (Chapter 5). *** (2009). Cancerul de col uterin Ac ioneaz ast zi pentru a schimba viitorul genera iei urm toare!, Bucure ti: Info-press.

, M., Golea, C., & , V. (2005). , *** (2009). , Nagy, V., Rancea ,A.C., Peltecu, G., Anghel, R., Ghilezan, N. (2006). Cancerul de col uterin: ghid de diagnostic si tratament. Simona, S. (2004). Patologia colului si a corpului uterin Editura Polirom (Chapter 5).

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Health Education of Mothers About Their Girls’ Vaccination