A cross-sectional study of knowledge, attitudes, barriers and practices of cervical cancer screening among nurses in selected hospitals in the Eastern Cape Province, South Africa

Abstract

Background Cervical cancer is a preventable but highly prevalent cancer in many low -and middle-income countries including South Africa. Cervical cancer outcomes can be improved with improved vaccination, a well-coordinated and efficient screening programme, increased community awareness and uptake, and increased knowledge and advocacy of health professionals. This study therefore aimed to ascertain the knowledge, attitudes, practices and barriers of cervical cancer screening among nurses of selected rural hospitals in South Africa. Methods A quantitative cross-sectional study was conducted in five hospitals in the Eastern Cape Province of South Africa between October and December 2021. A self-administered questionnaire was used to assess demographic characteristics of nurses and cervical cancer knowledge, attitudes, barriers and practices. A knowledge score of 65% was deemed adequate. Data were captured in Microsoft Excel Office 2016 and exported to STATA version 17.0 for analysis. Descriptive data analyses were used to report the results. Results A total of 119 nurses participated in the study with just under two thirds (77/119, 64.7%) being professional nurses. Only 15.1% (18/119) of participants were assessed as having obtained a good knowledge score of ≥ 65%. The majority of these (16/18, 88.9%) were professional nurses. Of the participants with a good knowledge score, 61.1% (11/18) were from Nelson Mandela Academic Hospital, the only teaching hospital studied. Cervical cancer was deemed to be a disease of public health importance by 74.0% (88/119). However, only 27.7% (33/119) performed cervical cancer screening. Most of the participants (116/119, 97.5%) had an interest of attending more cervical cancer training. Conclusion The majority of nurse participants did not have adequate knowledge about cervical cancer and screening, and few performed screening tests. Despite this, there is a high level of interest in being trained. Meeting these training needs is of utmost importance to implementing a comprehensive cervical cancer screening programme in South Africa.

Role and knowledge of nurses in the management of non-communicable diseases in Africa: A scoping review

“…Among the 36 studies which focused on cancer, 12 were on breast cancer [ 26 – 36 ], 22 on cervical cancer [ 37 – 57 ], one on cancer generally [ 58 ] and one on oral cancer [ 59 ]. Studies on cervical cancer were focused on nurse-led screening and treatment of human papillomavirus.…”

Cost-effectiveness of single-visit cervical cancer screening in KwaZulu-Natal, South Africa: a model-based analysis accounting for the HIV epidemic

“…Coverage of cervical cancer prevention programs in South Africa remains low, reflecting challenges with resource allocation for screening, diagnosis, and access to adequate care ( 17 , 18 ), in addition to individual and societal barriers such as lack of awareness and misconceptions of cervical cancer ( 19 – 21 ). Barriers to effective scale-up persist at each step of the current South African multi-visit standard of care, in which women undergo cytology screening and are required to return to the clinic multiple times for results, triage, and pre-cancer treatment, if necessary.…”

“…Barriers to effective scale-up persist at each step of the current South African multi-visit standard of care, in which women undergo cytology screening and are required to return to the clinic multiple times for results, triage, and pre-cancer treatment, if necessary. First, widespread implementation of cytology and triage demands critical infrastructure, equipment, and adequately trained personnel in clinics and laboratories, all of which are lean in-country in the public-sector healthcare network ( 1 , 2 , 21 , 22 ). Meeting supply and cold chain requirements for cryotherapy treatment of cervical lesions proves challenging ( 23 ), and the need for multiple clinic visits results in notable loss to follow-up ( 23 , 24 ).…”

Poor Cervical Cancer Knowledge and Awareness among Women and Men in the Eastern Cape Province Rural Community

“…Among the general South African population, limited awareness and knowledge about cervical cancer, its risk factors, and the available prevention measures contribute to low screening coverage and high cervical cancer burden [13][14][15][16][17][18][19][20][21][22]. This is not only limited to the South African population but seems to be the norm in other sub-Saharan countries where knowledge about cervical cancer has similarly been reported to be poor [23,24].…”

“…It is common for men to have poor knowledge of and misperceptions about cervical cancer prevention and other women's health issues; yet, men in sub-Saharan Africa control the economic resources and make most health-related decisions for their families and population [25][26][27][28]. South African primary healthcare workers have been reported to have inadequate knowledge about cervical cancer prevention and treatment services, which may result in them giving low-quality health education to individual patients and communities around public health facilities [14][15][16].…”