Keywords
Screening barriers
Cervical cancer
Abstract
Objectives. Despite advances in screening and treatment during past several Decades, cervical cancer remains a major health problem for Iranian women. Recent researches have focused on factors related to development of health behavior in an effort to design effective early interventions. The current study aimed to investigate the role of attachment styles on cervix cancer screen- ing barriers among women of BandarAbbas-Iran. Methods. In an analytic-cross sectional study, 681 women aged 21-65 referring to health centers were selected randomly and after completing written informed consents were investigated by Revised Adult Attachment Scale (RAAS) (Collins and Read), Pap smear screening barriers and demographic data questionnaire. The data were analyzed by Pearson correlation coefficient, linear regressions and chi-square test. Results. The results showed significant association between attachment styles and screening barriers. There was a negative significant relation between secure attachment style and screening barriers and there was a positive significant association between insecure attachment style (anxiety and avoidant) and screening barriers. The regression analysis indicated that insecure attachment style (avoid- ant) were predictors of barriers to the Pap smear screening test in this regard. There was a significant association between age and residential area and participation in Pap smear test. Conclusions. Insecure attachment style is associated with hazardous risk behaviors and these results can be useful for health service providers in preventive planning of screening and identi- fication of people susceptible to risk and the design of the inter- vention.References
Maree JE, Wright SCD. Cervical cancer: does our message promote screening? A pilot study in a South African context. European Journal of Oncology Nursing. 2011;15:118–123.
Center for Disease Control Non Communicable Deputy Cancer Control Office , author. Iranian Annual of National Cancer Registration Report. Tehran: Ministry of Health and Medical Education; 2008. pp. 26–34.
Fakour F, Atrkar Roshan Z, Shaef SP, et al. Sensitiveity and features of visual inspection of cervix with acetic acid, as a screening test for cervical cancer. Journal of Guilan University of Medical Sciences. 2011;79:49–55.
Saslow D, Solomon D, Lawson HW, et al. American Cancer Society, American Society for Colposcopy and Cervical Pathology, and American Society for Clinical Pathology screening guidelines for the prevention and early detection of cervical cancer. CA Cancer J Clin. 2012;62:147–172.
Wright TC, Cox JT, Massad LS, et al. Guidelines for the management of women with cervical cytological abnormality. JAMA J Am Med Assoc. 2004;287:2120–2129.
Leganger A, Kraft P. Control constructs: do they mediate the relation between educational attainment and health behaviour? Journal of Health Psychology. 2003;8:361–372.
Huurre T, Aro H, Rahkonen H. Well-being and health behavior by parental socioeconomic status: a follow-up study of adolescents aged 16 until age 32 years. Soc Psychiatry Psychiatr Epidemiol. 2003;38:249–255.
Ciechanowski PS, Walker EA, Katon WJ, et al. Attachment theory: A model for health care utilization and somatization. Psychosom Med. 2002;64:660–667.
Feeney JA. Adult attachment, coping style and health locus of control as predictors of health behavior. Aust J Psychol. 1995;47:171–177.
Hunter JJ, Maunder RG. Using attachment theory to understand illness behavior. Gen Hosp Psychiatry. 2001;23:177–182.
Maunder RG, Hunter JJ. Attachment and psychosomatic medicine: Developmental contributions to stress and disease. Psychosom Med. 2001;63:556–567.
Maunder RG, Lancee WJ, Nolan RP, et al. The relationship of attachment insecurity to subjective stress and autonomic function during standardized acute stress in healthy adults. J Psychosom Res. 2006;60:283–290.
Taylor RE, Mann AH, White NJ, et al. Attachment style in patients with unexplained physical complaints. Psychol Med. 2000;30:931–941.
Berry K, Barrowclough C, Wearden A. A review of the role of adult attachment style in psychosis: unexplored issues and questions for further research. Clin Psychol Rev. 2007;27:458–475.
Platts H, Tyson M, Mason O. Adult attachment style and core beliefs: are they linked? Clin Psychol Psychother. 2002;9:332–348.
Pickering L, Simpson J, Bentall RP. Insecure attachment predicts proneness to paranoia but not hallucinations. Pers Individ Dif. 2008;44:1212–1224.
Ciechanowski P, Sullivan M, Jensen M, et al. The relationship of attachment style to depression, catastrophizing and health care utilization in patients with chronic pain. Pain. 2003;104:627–637.
Bettman EJ, Jasperson RA. Adults in wilderness treatment: a unique application of attachment theory and research. Clinical Social Work Journal. 2008;36:51–61.
Maunder RG, Hunter JJ. Attachment relationships as determinants of physical health. J Am Acad Psychoanal Dyn Psychiatry. 2008;36:11–32.
Huntsinger ET, Luecken LJ. Attachment relationships and health behavior: The meditational role of self-esteem. Psychology & Health. 2004;19:515–526.
Scharfe E, Eldredge D. Associations between attachment representations and health behaviors in late adolescence. J Health Psychol. 2001;6:295–307.
Collins NL, Read SJ. Adult attachment, working models, and relationship quality in dating couples. J Pers Soc Psychol. 1990;58:644–663.
Collins NL. Working models of attachment: implications for explanation, emotion, and behavior. J Pers Soc Psychol. 1996;71:810–832.
Hill EM, Gick ML. The big five and cervical screening barriers: Evidence for the influence of conscientiousness, extraversion and openness. Pers Individ Dif. 2011;50:662–667.
Hill EM, Gick ML. Attachment and barriers to cervical screening. J Health Psychol. 2012;0:1–10.
Cooper ML, Shaver PR, Collins NL. Attachment styles, emotion regulation, and adjustment in adolescence. J Pers Soc Psychol. 1998;74:1380–1397.
Gentzler AL, Kerns KA. Associations between insecure attachment and sexual experiences. Pers Relat. 2004;11:249–265.
Bogaert AF, Sadava S. Adult attachment and sexual behavior. Pers Relat. 2002;9:191–204.
Clifford GM, Smith JS, Munoz N, et al. Human papillomavirus types in invasive cervical cancer worldwide: a meta-analysis. Br J Cancer. 2003;88:63–73.
Xu J, Kochanek MA, Murphy SL, et al. Deaths: final data for 2007. National Vital Statistics Reports. 2010;58
Cates JR, Herndon NL, Schulz SL, et al. Our voices, our lives, our futures: youth and sexually transmitted diseases. Chapel Hill, NC: School of Journalism and Mass Communication. University of North Carolina: Chapel Hill; 2004.
Ciechanowski PS. As fundamental as nouns and verbs? Towards an integration of attachment theory in medical training. Med Educ. 2010;44:122–124.
Larose S, Bernier A, Soucy N, et al. Attachment style dimensions, network orientation, and the process of seeking help from college teachers. J Soc Pers Relat. 1999;16:225–247.
Schmidt S, Blank T, Bellizzi K, et al. The relationship of coping strategies, social support, and attachment style with posttraumatic growth in cancer survivors. J Health. 2012;17:1033–1040.
Mikulincer M, Florian V. The relationship between adult attachment styles and emotional and cognitive reactions to stressful events. In: Simpson JA, Rholes WS, editors. Attachment Theory and Close Relationships. New York: Guilford Press; 1998. pp. 143–165.
Mikulincer M, Florian V. Appraisal of and coping with a reallife stressful situation: the contribution of attachment styles. Pers Soc Psychol Bull. 1995;21:406–414.
Yi JK. Factors associated with cervical cancer screening behavior among Vietnamese women. J Community Health. 1994;19:189–200.
Borras JM, Guillen M, Sanchez V, et al. Educational level, voluntary private health insurance and opportunistic cancer screening among women in Catalonia (Spain) Eur J Cancer Prev. 1999;8:427–434.
Ho IK, Dinh KT. Cervical cancer screening among Southeast Asian American women. J Immigr Minor Health. 2011;13:49–60.
Cesar J, Horta B, Gomes G, et al. Factors associated with nonparticipation in screening for cervical cancer in Southern Brazil. Cad Saúde Pública. 2002;19:1365–1372.