IntroductionExfoliative cytology, o

Introduction
Exfoliative cytology, or Papanicolaou (Pap) is a method
capable of detecting abnormal cells in the cervical epithelial
[1]. The Pap is attributed to a 70 %decrease in mortality from
cervical uterine cancer (CUC) worldwide [2]. Unfortunately,
in Mexico, this test is more sensitive for detecting invasive
cancer than pre-invasive cancer [3]. CUC is preventable as
long as the diagnosis and treatment is early [4–6], and is curable
if diagnosed in time [7]. Meanwhile, 10 %of new cancer
cases in theworld are CUC [8]. In Latin America, one in 1,000
womenbetween 35 and 55 years of age have this cancer, and in
Mexico, a woman dies from this every 2 h [7, 9].
Although the Pap test alone is not sufficient for preventing
CUC, it is an important element in a set of
screening tests that have been effective in developed
countries [4, 10]. The Pap provides a protective effect if
performed spontaneously and in the absence of symptoms
[11]. The known reasons why Mexican women do not have
a Pap performed are: stoic attitude towards problems [7],
ignorance about CUC and the Pap test [12, 13], lack of
social support, frightening images associated with CUC
[12], scarce resources and/or limited access to health services
[14, 15], negative experiences with the doctor [14],
modesty, lack of symptoms, ‘‘do it later’’ (neglect) [16],problems with the health system itself [8, 17], among
others. All these barriers had been reported at the individual-
level. In Morelos, Mexico, CUC is reported at a rate
of 18.2 per 100,000 women in 2006. This rate is above the
national, which was 16.4 [18]. The Health Center of Santa
Maria Ahuacatitla´n (neighborhood belonging to Cuernavaca,
Morelos) referred only 5 CUC cases detected last
year, but this figure cannot be real because few 25–40 year
old women living in Santa Maria Ahuacatitla´n went to
screening at the local health care center [19].
Fernandez et al. [20] addressed this problem through
increasing women’s self-efficacy to undergo a Pap and
mammogram through ‘‘Cultivando la Salud’’ intervention.
That intervention was conducted in 2004 with 243 Hispanic
women (including Mexicans) 50 years of age or
older who resided in two cities on the Mexico-U.S. border
and two in the Central Valley of California. Regarding the
Pap, a significant increase was achieved in self-efficacy,
perceived benefits, subjective norms and perceived cancer
survival. Besides, Byrd et al. [21, 22], through ‘‘Helping
Women with Information, Guidance and Love for their
Health’’ (AMIGAS, Spanish acronym) increased cervical
cancer screening in US women of Mexican origin aged
C21, and self-efficacy was one of the predisposing factors
of screened behavior that was studied and intervened.
Through Intervention Mapping, they designed AMIGAS
materials and guided intervention development using theoretical
constructs from Social cognitive theory, the Health
Belief Model, the Transtheoretical Model and the Theory
of Reasoned Action. In addition, another intervention by
Byrd et al. [23] with 84 Hispanic women residing in El
Paso, Texas was conducted to identify the barriers to and
facilitators of the use of Pap. Through the Health Belief
Model and focus groups, they found that an important
facilitator is educating women about the need to have a Pap
performed and the procedure itself.
The present intervention also involved the issue of selfefficacy,
through the Integrative Behavior Prediction
Model [24], which uses elements from 3 theories:
(a) Health Belief Model: for a person to engage in a health
behavior, first he or she must believe that they are at risk
and that the benefits outweigh the costs [24]; (b) Theory of
Reasoned Action; behavior is determined by the strength of
the person’s determination to perform it [24]; and
(c) Cognitive Social Theory: two factors exist that determine
the probability that a person will execute a health
behavior, the person believes that the benefits outweigh the
costs and the person believes he or she is able to perform
the behavior even with obstacles (has a sense of self-efficacy)
[25]. Self-efficacy largely influences how people
feel, think and act [25, 26]. Four ways to stimulate selfefficacy
exist [27, 28]: (a) successful experiences,
(b) social persuasion, (c) highlighting strengths and
(d) vicarious learning. While self-efficacy alone does not
determine the implementation of behavior (in this case,
have a Pap) it is an element involved in it. Given the scope
of this intervention in terms of time and resources, it was
decided to intervene on self-efficacy as it had theoretical
and practical support [20, 27] and could be expected to
change quickly. For the purpose of this study, self-efficacy
in terms of the Pap will be understood as the confidence/
belief in the personal ability to schedule and undergo a
Pap test [20, 27]. Results of the present intervention are
aimed at the scientific community interested in CUC prevention
and the health system responsible for carrying out
such preventive measures in the target population.
Previous studies suggest that interventions at the individual
level are not very effective for promoting the
detection of CUC because they do not take into account
cultural factors [29]. Therefore, the objective of this study
was to evaluate the effectiveness of a culturally adapted
educational intervention, at the individual and community
levels for semi-urban Mexican women. The corresponding
elements are found in the principal statements for the new
paradigm for the advancement of science in community
interventions [30].

ผลลัพธ์ (ไทย) 1:

แนะนำเซลล์วิทยา exfoliative หรือ Papanicolaou (บ) เป็นวิธีการความสามารถในการตรวจหาความผิดปกติเซลล์ปากมดลูก epithelial[1] . บมีบันทึกลดลง 70% ตายจากมะเร็งปากมดลูกมดลูก (คุก) ทั่วโลก [2] อับในประเทศเม็กซิโก การทดสอบนี้จะสำคัญมากสำหรับการตรวจสอบการรุกรานมะเร็งมากกว่าโรคมะเร็งก่อนลุกลาม [3] คุกเป็น preventable เป็นจึงเป็นการวินิจฉัยและรักษาเป็นต้น [4-6], และรักษาถ้าวินิจฉัยในเวลา [7] ในขณะเดียวกัน 10% ของมะเร็งใหม่กรณีใน theworld คัค [8] ในสหรัฐอเมริกา หนึ่งใน 1000womenbetween 35 และ 55 ปีมีมะเร็งนี้ และในเม็กซิโก ผู้หญิงตายจากนี้ ทุก 2 h [7, 9]แม้ว่าการทดสอบเพียงอย่างเดียวไม่เพียงพอสำหรับการป้องกันคุก เป็นองค์ประกอบสำคัญในชุดของการตรวจทดสอบที่มีประสิทธิภาพในการพัฒนาประเทศ [4, 10] บมีผลป้องกันดำเนินการ และธรรมชาติของอาการ[11] ทราบเหตุผลทำไมผู้หญิงเม็กซิโกไม่มีบที่ทำอยู่: ใจทัศนคติต่อปัญหา [7],ไม่รู้เกี่ยวกับคุกและทดสอบ [12, 13], ขาดสนับสนุนทางสังคม น่ากลัวภาพที่เชื่อมโยงกับคุก[12], ขาดแคลนทรัพยากรและ/หรือจำกัดการเข้าถึงบริการสุขภาพ[14, 15], ลบประสบการณ์กับแพทย์ [14],โมเดสตี้ ขาดอาการ นิ้วทำในภายหลัง '' (ละเลย) [16], ปัญหาระบบสุขภาพเอง [8, 17], ระหว่างผู้อื่น อุปสรรคเหล่านี้มีรายงานที่บุคคล-level. In Morelos, Mexico, CUC is reported at a rateof 18.2 per 100,000 women in 2006. This rate is above thenational, which was 16.4 [18]. The Health Center of SantaMaria Ahuacatitla´n (neighborhood belonging to Cuernavaca,Morelos) referred only 5 CUC cases detected lastyear, but this figure cannot be real because few 25–40 yearold women living in Santa Maria Ahuacatitla´n went toscreening at the local health care center [19].Fernandez et al. [20] addressed this problem throughincreasing women’s self-efficacy to undergo a Pap andmammogram through ‘‘Cultivando la Salud’’ intervention.That intervention was conducted in 2004 with 243 Hispanicwomen (including Mexicans) 50 years of age orolder who resided in two cities on the Mexico-U.S. borderand two in the Central Valley of California. Regarding thePap, a significant increase was achieved in self-efficacy,perceived benefits, subjective norms and perceived cancersurvival. Besides, Byrd et al. [21, 22], through ‘‘HelpingWomen with Information, Guidance and Love for theirHealth’’ (AMIGAS, Spanish acronym) increased cervicalcancer screening in US women of Mexican origin agedC21, and self-efficacy was one of the predisposing factorsof screened behavior that was studied and intervened.Through Intervention Mapping, they designed AMIGASmaterials and guided intervention development using theoreticalconstructs from Social cognitive theory, the HealthBelief Model, the Transtheoretical Model and the Theoryof Reasoned Action. In addition, another intervention byByrd et al. [23] with 84 Hispanic women residing in ElPaso, Texas was conducted to identify the barriers to andfacilitators of the use of Pap. Through the Health BeliefModel and focus groups, they found that an importantfacilitator is educating women about the need to have a Papperformed and the procedure itself.The present intervention also involved the issue of selfefficacy,through the Integrative Behavior PredictionModel [24], which uses elements from 3 theories:(a) Health Belief Model: for a person to engage in a healthbehavior, first he or she must believe that they are at riskand that the benefits outweigh the costs [24]; (b) Theory ofReasoned Action; behavior is determined by the strength ofthe person’s determination to perform it [24]; and(c) Cognitive Social Theory: two factors exist that determinethe probability that a person will execute a healthbehavior, the person believes that the benefits outweigh thecosts and the person believes he or she is able to performthe behavior even with obstacles (has a sense of self-efficacy)[25]. Self-efficacy largely influences how peoplefeel, think and act [25, 26]. Four ways to stimulate selfefficacyexist [27, 28]: (a) successful experiences,(b) social persuasion, (c) highlighting strengths and(d) vicarious learning. While self-efficacy alone does notdetermine the implementation of behavior (in this case,have a Pap) it is an element involved in it. Given the scopeof this intervention in terms of time and resources, it wasdecided to intervene on self-efficacy as it had theoreticaland practical support [20, 27] and could be expected tochange quickly. For the purpose of this study, self-efficacyin terms of the Pap will be understood as the confidence/belief in the personal ability to schedule and undergo aPap test [20, 27]. Results of the present intervention areaimed at the scientific community interested in CUC preventionand the health system responsible for carrying outsuch preventive measures in the target population.Previous studies suggest that interventions at the individuallevel are not very effective for promoting thedetection of CUC because they do not take into accountcultural factors [29]. Therefore, the objective of this studywas to evaluate the effectiveness of a culturally adaptededucational intervention, at the individual and communitylevels for semi-urban Mexican women. The correspondingelements are found in the principal statements for the newparadigm for the advancement of science in communityinterventions [30].

ผลลัพธ์ (ไทย) 3:

บทนำ
บู้บี้ หรือพานิโคเลาว์ ( PAP ) เป็นวิธีการ
สามารถตรวจสอบเซลล์ที่ผิดปกติในเยื่อบุปากมดลูก
[ 1 ] ส่วนเรื่องราคาลด 70% ในการตายจากโรคมะเร็งปากมดลูกมดลูก
( cuc ) ทั่วโลก [ 2 ] แต่น่าเสียดายที่
ในเม็กซิโก การทดสอบนี้มีความไวในการตรวจหามะเร็งแพร่กระจาย
กว่าก่อนแพร่กระจายมะเร็ง [ 3 ] cuc เป็น preventable โดย
ถ้าการวินิจฉัยและการรักษา เป็นต้น [ 4 – 6 ] และรักษาได้
ถ้าวินิจฉัยในเวลา [ 7 ] โดยร้อยละ 10 ของผู้ป่วยโรคมะเร็ง
ใหม่ใน theworld เป็น cuc [ 8 ] ในละตินอเมริกา , หนึ่งใน 1000
womenbetween 35 และ 55 ปี เป็นมะเร็ง และใน
เม็กซิโก , ผู้หญิงตายจากทุก 2 ชั่วโมง [ 7 , 9 ] .
แม้ว่าการตรวจสอบเพียงอย่างเดียวนั้นไม่เพียงพอสำหรับการป้องกัน cuc
,มันเป็นองค์ประกอบที่สำคัญในชุดของการทดสอบการคัดกรองที่ได้รับ

ที่มีประสิทธิภาพในการพัฒนาประเทศ [ 4 / 10 ] อาหารเหลวให้ผลป้องกันถ้า
ดำเนินการคล่อง และในกรณีที่ไม่มีอาการ
[ 11 ] รู้จักเหตุผลทำไมผู้หญิงเม็กซิกันไม่ได้
การตรวจปฏิบัติ : ทัศนคติ ความอดกลั้นต่อปัญหา [ 7 ] ,
ไม่รู้เกี่ยวกับ cuc และการตรวจสอบ [ 12 , 13 ] ขาด
การสนับสนุนทางสังคม