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Kim, Yeom, and Shin: Factors Affecting on Cancer Prevention Behaviors in Adult Women
Original Article

Korean J Adult Nurs 2014;26(4):455-465.

Published online: NaN August 2014

DOI: https://doi.org/10.7469/kjan.2014.26.4.455

Factors Affecting on Cancer Prevention Behaviors in Adult Women

II Ok Kim1, Gye Jeong Yeom2, Sun Hwa Shin3,

1Department of Nursing, Sahmyook University, Seoul

2Graduate School of Health Science & Social Welfare, Sahmyook University, Seoul

3Graduate School, Ewha Womans University, Seoul, Korea

Corresponding author: Shin, Sun Hwa Department of Nursing, Sahmyook University, 815 Hwarangro, Nowon-gu, Seoul 139-742, Korea. Tel: +82-2-3399-1593, Fax: +82-2-3399-1594, E-mail: ffssh@hanmail.net

Received 18 June 201428 July 2014       Accepted 4 August 2014

Copyright © 2014 Korean Society of Adult Nursing

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

This study was to identify relationships between the levels of perceived stress, cancer-related knowledge, attitude and prevention behaviors, and to explore factors influencing cancer prevention behaviors of adult women in Korea.

Methods

This study was a descriptive research, using a cross-sectional survey. A convenience sample of 314 women aged 20 to 64 was selected. A self-administered questionnaire was used to measure perceived stress, cancer-related knowledge, cancer-related attitude, and cancer prevention behaviors. The data were analyzed with the SPSS/WIN 21.0 program.

Results

Cancer-related knowledge significantly differed according to age, marital status, education level, and occupation. While correlations between cancer-related knowledge, cancer-related attitude, and cancer prevention behaviors were positive, correlations between perceived stress and cancer prevention behaviors were negative. The hierarchical regression analyses revealed significant positive relations between cancer prevention behaviors and age (β=.18, p=.003), perceived health status (β=.22, p<.001), periodic checkup (β=.21, p=.002), and cancer-related attitude (β=.25, p<.001). Perceived stress on the other hand was negatively related to cancer prevention behaviors (β=-.23, p<.001).

Conclusion

Interventions targeting women, especially young adults should focus on enhancing cancer-related attitude in order to improve cancer prevention behaviors. Thus, there continues to be a need to reduce perceived stress in adult women.

Keywords: Women, Cancer, Attitude, Stress, Behaviors

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Table 1.
General Characteristics of the Study Participants (N=314)
Characteristics Categories n(%)
Age (year) 20~29 50 (15.9)
30~39 124 (39.5)
40~49 92 (29.3)
≥50 48 (15.3)
Marital status Unmarried 62 (19.8)
Married 252 (80.3)
Religion Yes 189 (60.2)
No 125 (39.8)
Education level ≤High school 67 (21.3)
University 226 (72.0)
≥Graduate school 21 (6.7)
Occupation Yes 274 (87.3)
No 40 (12.7)
Economic status Lower 104 (33.1)
Middle 172 (54.8)
Upper 38 (12.1)
Perceived health status Lower 39 (12.4)
Middle 146 (46.5)
Upper 129 (41.1)
Current disease Yes 18 (5.7)
No 296 (94.3)
Family history of cancer Yes 100 (31.9)
No 214 (68.2)
Periodic checkup No 64 (20.4)
Once a year 155 (49.4)
Once in two years 77 (24.5)
Once in three years 18 (5.8)
Table 2.
Mean Score of Perceived Stress, Cancer related Knowledge, Cancer related Attitude, and Cancer Prevention Behaviors (N=314)
Variables Range M±SD Min Max
Perceived stress 0~40 18.54±5.01 5 34
Cancer related knowledge 0~30 19.61±4.37 6 28
   Stomach cancer 0~5 3.73±0.91 1 5
   Lung cancer 0~5 3.08±1.13 0 5
   Liver cancer 0~5 2.98±1.40 0 5
   Colorectal cancer 0~5 3.36±1.21 0 5
   Breast cancer 0~5 3.37±0.95 0 5
   Cervical cancer 0~5 3.09±1.40 0 5
Cancer related attitude 14~70 55.31±5.84 41 70
Cancer prevention behaviors 20~100 71.45±9.87 41 100
Table 3.
Cancer related Knowledge, Cancer related Attitude, and Cancer Prevention Behavior according to General Characteristics (N=314)
Characteristics Categories Stomach cancer Lung cancer Liver cancer Colorectal cancer Breast cancer
M±SD t or F (p) M±SD t or F (p) M±SD t t or F (p) M±SD t or F (p) M±SD t or F (p)
Age (year) 20~29a 3.18±0.98 8.54 2.94±1.08 0.35 2.46±1.42 4.28 2.98±1.15 2.23 3.28±0.88 1.09
30~39b 3.77±0.84 (＜.001) 3.09±1.17 (.790) 2.90±1.38 (.006) 3.36±1.30 (.084) 3.29±0.99 (.353)
40~49c 3.93±0.78 a＜b, c, d† 3.14±1.20   3.30±1.45   3.52±1.15   3.50±0.93  
≥50d 3.83±1.02   3.06±0.95   3.08±1.20   3.42±1.11   3.44±0.94  
Marital status Unmarried 3.24±0.92 -4.93 3.13±1.12 0.41 2.44±1.42 -3.46 2.98±1.19 -2.72 3.31±0.95 -0.61
Married 3.85±0.86 (＜.001) 3.06±1.13 (.683) 3.11±1.37 (.001) 3.45±1.20 (.007) 3.39±0.95 (.542)
Religion Yes 3.67±0.96 -1.46 3.12±1.14 0.87 3.06±1.39 1.34 3.43±1.21 1.39 3.33±0.87 -0.86
No 3.82±0.82 (.146) 3.01±1.11 (.384) 2.85±1.41 (.183) 3.24±1.21 (.167) 3.43±1.07 (.389)
Education level ≤High schoola 3.73±0.73 2.96 2.99±1.09 1.55 2.61±1.40 3.50 3.12±1.33 2.11 3.10±0.97 3.52
Universityb 3.69±0.96 (.053) 3.07±1.15 (.215) 3.05±1.42 (.032) 3.40±1.19 (.123) 3.44±0.95 (.031)
≥Graduate schoolc 4.19±0.68   3.48±0.93   3.38±0.92   3.67±1.02   3.52±0.75 a＜b†
Occupation Yes 3.73±0.93 -0.39 3.11±1.15 1.51 3.06±1.41 2.70 3.39±1.17 1.08 3.42±0.93 2.31
No 3.78±0.70 (.696) 2.83±0.96 (.132) 2.42±1.20 (.007) 3.13±1.49 (.285) 3.05±1.04 (.021)
Economic status Lowera 3.70±0.90 0.94 2.92±1.18 1.62 2.84±1.42 2.37 3.20±1.29 1.40 3.28±1.03 1.21
Middleb 3.71±0.93 (.393) 3.17±1.11 (.200) 3.13±1.38 (.095) 3.41±1.18 (.248) 3.39±0.92 (.298)
Upperc 3.92±0.82   3.05±1.06   2.68±1.38   3.53±1.16   3.55±0.86  
Perceived health status Lowera 3.69±0.95 0.09 3.13±1.08 0.18 2.82±1.48 0.58 3.26±1.21 0.16 3.36±1.04 0.03
Middleb 3.75±0.95 (.917) 3.10±1.20 (.832) 3.06±1.37 (.561) 3.36±1.24 (.854) 3.36±0.94 (.973)
Upperc 3.72±0.85   3.03±1.07   2.93±1.42   3.38±1.19   3.39±0.95  
Current disease Yes 3.89±0.83 0.75 3.11±1.02 0.13 2.94±1.43 -0.10 3.61±1.14 0.91 3.78±0.65 1.87
No 3.72±0.91 (.452) 3.07±1.14 (.894) 2.98±1.40 (.918) 3.34±1.22 (.361) 3.35±0.96 (.063)
Family history of cancer Yes 3.68±0.96 -0.70 3.01±1.07 -0.73 3.03±1.44 0.45 3.54±1.12 1.83 3.38±0.89 0.09
No 3.76±0.88 (.484) 3.11±1.16 (.465) 2.95±1.39 (.652) 3.27±1.25 (.068) 3.37±0.98 (.925)
Periodic checkup Noa 3.81±0.89 0.44 2.89±1.07 1.16 2.70±1.31 2.08 3.09±1.37 1.45 3.27±1.06 0.73
Once a yearb 3.71±0.97 (.726) 3.15±1.17 (.325) 2.98±1.46 (.103) 3.38±1.17 (.229) 3.41±0.96 (.535)
Once in two yearsc 3.75±0.81   3.13±1.06   3.26±1.22   3.51±1.08   3.43±0.86  
Once in three yearsd 3.56±0.86   2.83±1.25   2.72±1.81   3.44±1.46   3.17±0.86  
Characteristics Categories Cervical cancer Cancer related knowledge Cancer related attitude Cancer prevention behaviors
M±SD t or F (p) M±SD t or F (p) M±SD t or F (p) M±SD t or F (p)
Age (year) 20~29a 2.82±1.40 1.43 17.66±4.45 5.64 53.84±5.60 1.36 65.78±9.77 12.42
  30~39b 3.03±1.45 (.233) 19.44±4.49 (.001) 55.55±5.89 (.256) 70.27±9.68 (＜.001)
  40~49c 3.16±1.34   20.57±4.09 a＜c, d† 55.82±5.58   73.72±8.30 a＜b, c, d†
  ≥50d 3.38±1.39   20.21±3.88   55.25±6.38   76.06±10.08 b＜d†
Marital Unmarried 2.73±1.42 -2.29 17.82±4.50 -3.66 53.55±5.18 -2.67 66.45±8.59 -4.60
status Married 3.18±1.39 (.023) 20.04±4.23 (＜.001) 55.74±5.93 (.008) 72.68±9.79 (＜.001)
Religion Yes 3.06±1.31 -0.38 19.69±4.20 0.41 55.33±5.74 0.09 72.06±9.37 1.35
  No 3.13±1.54 (.701) 19.48±4.63 (.681) 55.27±6.03 (.928) 70.53±10.57 (.178)
Education ≤High schoola 2.87±1.58 1.19 18.42±4.66 4.79 55.69±6.24 0.47 69.55±9.89 1.87
level Universityb 3.14±1.37 (.306) 19.78±4.34 (.009) 55.12±5.86 (.625) 71.82±9.83 (.155)
  ≥Graduate schoolc 3.29±1.10   21.52±2.46 a＜c† 56.14±4.30   73.52±9.89  
Occupation Yes 3.11±1.37 0.55 19.81±4.25 2.23 55.31±5.83 -0.02 71.59±9.81 0.67
  No 2.98±1.64 (.583) 18.18±4.93 (.026) 55.33±6.00 (.985) 70.47±10.35 (.504)
Economic Lowera 3.03±1.42 1.04 18.97±4.58 1.70 55.18±5.91 0.19 69.41±10.43 5.88
status Middleb 3.06±1.40 (.356) 19.87±4.23 (.184) 55.27±6.03 (.831) 71.76±9.62 (.003)
  Upperc 3.39±1.41   20.13±4.29   55.84±4.82   75.63±7.98 a＜c†
Perceived Lowera 2.97±1.51 0.42 19.23±4.53 0.35 54.97±5.98 0.26 64.51±9.69 17.44
health Middleb 3.16±1.37 (.657) 19.81±4.48 (.708) 55.56±6.03 (.768) 70.71±9.60 (＜.001)
status Upperc 3.04±1.42   19.49±4.21   55.12±5.62   74.40±9.06 a＜b＜c†
Current Yes 3.33±1.37 0.76 20.67±3.18 1.06 57.22±6.80 1.43 74.06±10.11 1.15
disease No 3.07±1.41 (.448) 19.54±4.43 (.289) 55.19±5.77 (.153) 71.29±9.85 (.250)
Family history Yes 3.13±1.45 0.35 19.77±4.16 0.46 54.46±5.48 -1.77 71.15±9.13 -0.37
of cancer No 3.07±1.39 (.725) 19.53±4.47 (.648) 55.71±5.98 (.078) 71.59±10.22 (.711)
Periodic Noa 2.84±1.42 2.43 18.61±4.56 2.52 53.66±6.03 2.17 66.13±9.85 8.61
checkup Once a yearb 3.03±1.37 (.065) 19.66±4.39 (.058) 55.75±5.84 (.091) 73.19±9.69 (＜.001)
  Once in two yearsc 3.44±1.33   20.52±3.73   55.73±5.28   72.34±9.23 a＜b, c†
  Once in three yearsd d 3.00±1.75   18.72±5.39   55.56±6.90   71.61±8.16  

† Scheffé test.

Table 4.
Correlations of Perceived Stress, Cancer related Knowledge, Cancer related Attitude, and Cancer Prevention Behaviors (N=314)
Variables Perceived stress Cancer related knowledge Cancer related attitude
Cancer related knowledge -0.09 (.118)    
Cancer related attitude -0.08 (.138) 0.30 (＜.001)  
Cancer prevention behaviors -0.40 (＜.001) 0.15 (.006) 0.31 (＜.001)
Table 5.
Factors Influencing Cancer Prevention Behavior in Adult Women (N=314)
Variables (reference) Model 1 Model 2 Model 3 Model 4
b β p b β p b β p b β p VIF
(Constant) 42.23 0.19 .002 58.57 0.15 .013 54.95 0.15 .017 35.56 0.18 .003 1.64
Age 0.21 0.14 .019 0.16 0.12 .037 0.16 0.11 .064 0.19 0.08 .156 1.56
Marital status (Unmarried) 3.54 -0.03 .543 3.07 -0.03 .588 2.75 -0.03 .569 2.03 -0.03 .538 1.06
Religion (Yes) -0.63     -0.54     -0.57     -0.59      
Education (≤High school)
  University 1.42 0.06 .288 0.51 0.02 .699 0.25 0.01 .850 0.76 0.03 .549 1.57
  ≥Graduate school 0.09 0.01 .969 -1.01 -0.03 .658 -1.48 -0.04 .523 -1.02 -0.03 .646 1.48
Occupation (Yes) 0.87 0.03 .583 0.25 0.01 .869 0.47 0.02 .759 0.22 0.01 .881 1.17
Economic status (Lower)
  Middle 1.00 0.06 .248 0.01 0.01 .997 -0.08 0.01 .941 0.10 0.01 .926 1.35
  Upper -0.60 -0.03 .582 1.94 0.06 .248 1.91 0.06 .255 1.88 0.06 .243 1.33
Perceived health status (Lower)                          
  Middle 3.98 0.27 ＜.001 3.17 0.22 ＜.001 3.22 0.22 ＜.001 3.28 0.22 ＜.001 1.38
  Upper 0.70 0.04 .521 0.45 0.02 .671 0.42 0.02 .695 0.43 0.02 .670 1.24
Current disease (Yes) -0.40 -0.01 .856 -0.45 -0.01 .832 -0.44 -0.01 .835 0.23 0.01 .911 1.08
Family history of cancer (Yes) -0.16 -0.01 .884 -0.02 0.01 .985 0.02 0.01 .985 -0.51 -0.02 .616 1.07
Periodic checkup (No)
  Once a year 5.78 0.29 ＜.001 5.06 0.26 ＜.001 1.40 0.11 .068 4.09 0.21 .002 2.12
  Once in two years 3.69 0.16 .019 2.98 0.13 .051 3.63 0.18 .001 2.25 0.10 .127 1.92
  Once in three years 2.75 0.06 .249 2.64 0.06 .254 -1.47 -0.03 .572 1.73 0.04 .437 1.28
Perceived stress       -0.48 -0.24 ＜.001 -0.48 -0.24 ＜.001 -0.45 -0.23 ＜.001 1.22
Cancer related knowledge             0.15 0.07 .196 -0.02 -0.01 .861 1.25
Cancer related attitude                   0.43 0.25 ＜.001 1.17
R2 (ΔR2) .261 .311 (.050) .314 (.003) .369 (.055)
F (p) 7.02 (＜.001) 8.36 (＜.001) 7.99 (＜.001) 9.60 (＜.001)
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